Purpose and Method: Senile hypertension is characteristic of systolic high blood pressure and good prognosis on the basis of sclerosis of elastic arteries especially thoracic and arcus aorta. In such view points it must be strictly distinguished from essential hypertension. In order to find the relationship between the renogram and laboratory data of senile hypertension, physical examination, funduscopic examination, laboratory studies of urine, serum electrolyte and total cholesterol, chest X-ray, EKG, PSP excretion test and renograms were carried out on 40 cases of out-patients over 60 years old, who had systolic level of higher than 150mmHg B. P., and no past history concerning hypertension.
On analysing the renograms, total concentration (TC), minute concentration (MC), minute excretion (ME) were calculated by Krueger's method, and time from maximum counting ratio to half value on c-segment (T1/2), angle of b-segment (θ) were measured.
Results: The renogram appeared following outcomes in senile hypertension; TC: 64.5±12.2%, MC: 26.8±6.9%, ME: 14.1±6.1%, T1/2: 7′47″±2′54″, θ: 57.2º±9.5º. All these values were somewhat inferior to those of the normotensive group of same age, but presented prominent decrease of ME and prolongation of T1/2 compared with those of juvenile hypertensive and healthy group from 15 to 35 years old. Spread of the data was also remarkable in senile hypertension. PSP excretion rate correlated positively to MC, ME and θ (coefficients of correlation: +0.477∼+0.678), inversely to T 1/2 (coefficients of correlation -0.561∼-0.598). Systolic blood pressure revealed negative correlation to MC and ME but diastolic pressure did nothing peculiar. The higher grade of Keith Wagener, the lower MC, ME and cases having EKG abnormalities also indicated decrease of ME. Serum cholesterol cardio-thoracic ratio, nycturia, urinalysis did not correlate to MC and ME.
Conclusions: In senile hypertension renogram data showed inclination of negative correlation to systolic blood pressure but no significant difference to those of senile normotensives. Fairly good correlationships were recognized between MC, ME and PSP excretion rate.

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Hypothalamic, thyroidal, and pituitary-adrenocortical function were investigated on 9 extreme obese women and the adrenocortical function in obesity was compared with Cushing's syndrome.
1. Thyroid function (BMR, PBI, ¹³¹I uptake) was in almost normal level.
2. Urinary excretion of 17-OHCS is within normal limits. ACTH test and dexamethasone suppression test were performed on 7 obese women without any abnormal results.
Urinary excretion of 17-OHCS decreased gradually after weight reduction.
It has been suggested that the adrenocortical overactivity has been found in obesity.
3. Insulin tolerance test is insensitive in 3 of 4 obese women. It is suggested that there is partial diencephalic dysfunction in obesity.
4. In distinguishing obesity with increased adrenocortical function from Cushing's syndrome, the following procedures are the most helpful:
(a) eosznophils: (b) ACTH-test: (c) Dexamethasone suppression test: (d) urinary excretion of 17-OHCS.

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The frequency of pregnancy in cardiac patients, types of the disease, and age distribution were examined in pregnant women who were seen at the OB Department of Nagoya National Hcspital during the 5 year period from 1961 to 1965. The material was reviewed as to the number of previous deliveries (primipara or multipara), functional capacity (NYHA), use of digitalis, courses of deilvery and puerperium.
The incidence of deliveries in cardiac patients was 33 (0.51%) of a total of 6, 518 deliveries. The majority (66.7%) of the 33 cases was of mitral disease. Among congenital diseases, ventricular septal defect was a predominat lesion. The most frequent ages were 21-25 years; 16 cases belonged to this age range. The majority (23 cases) of the 33 cases was primiparas.
In three cases of mitral disease, artificial interruption was done because of cardiac failure. The interruption was done at the 3rd month in one case, which had a history of cardiac failure following the first delivery. In two other cases, interruption was performed during the second trimester.
In all cases except one, the delivery was done vaginally. In many cases, however, the deliveries were done with the aid of forceps in order to shorten the duration labor.
In three cases of mitral lesion, serious complications occurred during the puerperium, that is, cerebral embolism and pulmonary edema in a case of MI, pulmonary edema in a case of MS, and occurrence of atrial fibrillation and subsequent cerebral and arterial embolism in a case of MS. The three cases overcome the serious condition, and in the two cases of MS, mitral valvulotomy was successfully done later.
In another case of MSI, cardiac failure of mild degree occurred immediately after the delivery.
At the terminal stage of pregnancy digitalis preparations were used in all of grade 2 patients and in some of grade 1 patients. But hospitalization to the OB ward in advance to the initiation of labor is not recommended and has not been practiced.
Pregnancy should be avoided in those who have a past history of cardiac failure, in those whose functional capacity is grade 3 or 4, or in those who have atrial fibrillation.
Proper management and advises during the puerperal period are of critical importance to avoid complications, for at this period most patients are overloaded with unexperienced work nursing.

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Nineteen cases including four normal persons, seven diabetic patients and eight other patients were studied on the effect of long term administration of xylitol.
Thirty gram of xylitol were given orally daily to these cases for one month to thirteen months. Meanwhile the serum albumin, total cholesterol, the number of erythrocytes and hemoglobin content were measured periodically.
The cases with anemia and hypoproteinemia recovered after one or two months administration of xylitol. The cases which showed nomal value of serum albumin, normal number of erythrocytes and normal hemoglobin contents fluctuated within normal ranges during the long term administration of xylitol for three to thirteen months.
The effect of xylitol to the total cholesterol is hard to be discussed by this time.
Thus the long term administration of xylitol would not make unfavorable results, but would smoothen the carbohydrate metabolism by accelerating the Warburg-Pickens circle, and wield good influences to the correlated metabolism.

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1. The tissue changes in the reticulo-endothelial system in leprosy are characteristic, in particular intensity of phagocytic activity to the pathogenesis markedly feeble and insignificant, and the production of immune substances may be little or none, that would be demonstrable by Lopromin Test on the patient.
2. Essentially, the most important function in the R. E. S. is phagocytosis, which are carried out by histiocytes and phagocytes in blood and interstitial tissue. The phagocytes are derived from wandering and resting histiocytes in the connective tissue and sinus endothel cells in the viscera.
According to the study of Maximow and Sabin they are classified as follows:
1. Clasmatocyte type,
2. Vascular endothelium type.
Sinus endothel cells are most important on phagocytic activity. They belong to clasmatocyte type, and act strongly on phagocytosis and production of immune substance. The phagocytes are mostly derived from the endothels in the sinuses and sinusoids in the spleen, lymph nodes, liver and so on. The other kind of phagocytes, endothelial cells, are derived from the lining cells of blood and lymphatic vessels. And they may be proved milder than that of the former type at the time of phagocytosis.
3. Macrophages or phagocytes originally make a defense action against pathogens or foreign materials.
In leprosy, particularly, the function is awfully feeble and scanty, and the tissue of that system are liable to be broken or undergo hyaline degeneration and fatty alteration. The R. E. S. in viscera, at last may be consumed and reduced to atrophy. The defensive power in the R. E. S., consequently may be prostrated or are exhausted.
4. Some times, on the occasion of the illness may carry out phagocytic activity owing to some other kinds of cells saving for the RE. cells. We can often may meet with an unusual phagocytosis in epithels or endothels, also in tuberculosis or rickettsial diseases and so on.
In leprosy these fact could be found, especially, in the endothel cells of blood vessels and in the epithel of sweat glands and in the liver cells. It is uncertain that such matter may be due to whether infectious intrusion or phagocytosis, and or symbiotic liviug to the cells.
5. Generally speaking, lepra bacilli are said to be non virulent to the human body, notwithstanding, really act upon the allergic reaction severely and bring about damage considerably in the tissue.
6. The most important factor that decides difficulties in healing in the illness lies in the nature of lepra bacilli itself, and exhaustion in the faculty of the R. E. S., on that occasion, the reactive power of that tissue is severely decreased.
7. Finally, the most important factors of pathogenesis of leprosy, come to consider as consumption and atrophy in the R. E. S.
The author, in conclusion, will emphasize the exhaustion (encroachment) and damage in the R. E. S. have to the most important thing to decide on the healing in the illness.

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S-3800 C, containing norethindone 2mg. and mestranol 0.1mg. was administered for long periods on cyclic basis (Pincus Method) to determine the contraceptive efficacy and side effects.
1. In 45 patients through 1, 166 cycles, no unplanned pregnancy occurred. This dosage is completely effective.
2. The incidence of side effects was considerably low. Gastrointestinal symptoms, break-through bleeding and spotting were observed during the early few cycles.
3. Variation of cycle length was not significant.
4. 20 patients discontinued the therapy because of the side effects. 9 of them dropped out during the first cycle.
Details were irregular bleeding: 6, silent menstruation: 1, nausea and vomiting: 2, gastrointestinal symptoms: 8, weight gain: 2 and breast discomfort: 1.
5. Laboratory tests except liver function test failed to reveal clinically significant abnormalities. Though some deviations were observed in some cases, there was no evidence that the liver function became worse after the prolonged administration. The causual relationship between the pill and the liver dysfunction is unknown.

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There are no detailed investigations in the field of the clinicophysiological examinations. The object of this report is to describe the present status and problem of the physiological examination in 239 National Hospitals and Sanatoriums in Japan, dealing statistically with the reported informations from each hospital.
1) Outline of Physiological Examination
The number of the examinations was 2, 898 per one Hospital, 1, 433 per one Tuberculosis Sanatorium and 459 per one Mental Sanatorium, and 8.8, 4.0, and 1.0, respectively, per one bed during a year. The chief articles of the examinations are electrocardiography (62%) in Hospital, others (59%) and respiratory test (18%) in Tuberculosis Sanatorium, and intelligence-character test (43%) and electroencephalography (28%) in Mental Sanatorium.
2) Electrocardiography and Phonocardiography
About 75% of all has two or three electrocardiographs and they are within five years after a purchase in 78% of all. Electrocardiographing system is unified in a central laboratory in about 70%, but reading and custody are done in each clinical division in the majority of Hospital and Tuberculosis Sanatorium. Vectorcardiography or telemetercardiography is not yet sufficiently populized. Phono cardiography is also not yet applied adequately to clinic, and further examinations in recording are necessary.
3) Electroencephalography
The possession of an electroencephalograph is 55% in Hospital, 8% Tuberculosis Sanatorium and 83% in Mental Sanatorium. Thirty-five percent of electroencephalograph in Hospital is passed over five years after a purchase. The method or time of recording and activation is different in each Hospital. Electroencephalogram is chiefly read by a specialized doctor.
4) Respiratory Function Examination
This test is not satisfactorily applied in clinic. No examination is carried out at 55% in Hospital and 17% in Tuberculosis Sanatorium. Half of the instruments are over five years after a purchase. Further studies on a method, instrument and system of the examination are necessary.

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On the purpose of statistical studies upon the significance of low votage EKG observed only in standard and unipolar limb leads, I had sent inquiring cards to all national hospitals and sanatoriums in Japan. According to the data summed up inquiring cards, following results were recognized.
1) Total number of cases during past two years were 441 (containing 230 cases in my hospital) in this series. The incidence of low voltage EKG was about 1%, and mortality rate was 20%. Low voltage EKG in limb leads were found mostly in circulatory diseases, diseases of respiratory organs, and malignant neoplasas. The findings of clinical examinations showed anemia, disturbances of hepatic, renal and pulmonary functions.
2) Autopsy-findings of the heart in fatal cases were increased cardiac weight, hypertro phy and dilatation of both ventricles, degeneration and fibrosis of myocardium which may be seen in the primary myocardial disease.
3) Although low voltage in limb leads are determined by spatial angle between the axis of limb lead and maximum vector of QES roop, it may be thought that the deviations of spatial angle are occurred by the myocardial changes due to intra- and extra-cardiac abnormalities. Therefore, when we found the patients showed low voltage EKG in limb leads, further detail examinations are necessary.

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Usefulness of vectorcardiogram and telemeter-electrocardiogram was discussed, showing various examples. Vectorcardiogram provides twenty per cent more informations than routine twelve leads and was very valuable especially in the diagnosis of the myocardial infarction, ventricular hypertrophy and ventricular conduction defect.
Telemeter-electrocardiogram was very valuable in the reseach work of cardiac arrhythmias and of loading electrocardiography, such as Master's two !step test, although its method especially the method of leading was considered to be required to be more improved.

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The electroencephalography has been widely adopted as a medical research in recent years. Therefore, we would like to examine the present status of EEG work handled by the EEG laboratories in several National Hospitals in order to study what and how we must to do in future.
We checked the numbers of EEG studied by two hospitals in the past two years. The numbers of EEG increased year by year, especially in the Pediatrics and Neurosurgery.
The EEG is used firstly to check epilepsy, it is used secondly to check the cerebral injury resulted mainly from traffic accidents.
Abnormal EEG waves were found 3310 - 35%, borderline waves were 21%-19% and normal waves were 46%.
The EEG research is not only the functional and organic inspection of brain but also good method, as an index, to examine the whole physical condition. The polygraphic recording of EEG, EKG, EMG, GSR, etc, is good to find out the correlation of each physical change.
The study of evoked potential of brain makes a great progress and gives aid to medical diagnosis at present. In case of light stimulation upon eyes, we can get the electroretinogram from eyes and visual evoked potential from cortex. The evoked potential is so low that we have to use a compact electronic calculating machine for medical use in order to find out differences of waves by means of adding electric potential to some extent.
We have to, in the EEG laboratory, cultivate the medical study in addition to the routine work on EEG, and make endeavour to find out more progressive and beneficial achievements of EEG under the cooperation of encephalographers and technical electric operators.

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The significance of the test of pulmonary function have been presented with the following conclusion: the test is required practically for the purpose of 1) desicion of indication of lung operation, 2) diagnosis or judgement on the effects of treatments of obstructive pulmonary diseases such as chronic emphysema or bronchial asthma, 3) judgement on the abilities of rehabilitation for postoperative or chronic lung diseases, 4) decision of the severity of pneumoconiosis and physical injury, 5) diagnosis of the other respiratory disturbances.
Several problems concerning the methods to mesure the normal lung function or reserve capacity of the patients have been discussed.
Finally author emphasizes the necessity of well-organized condition including staffs and equipments for the test of pulmonary function.

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The Co-operative Research Program of Radiotherapy of Cancer started since 1963. The member of this program consists of 10 major national hospitals and National Cancer Center Hospital.
The registration of cases was begun June 1964. During the latter 6 months of 1954, 1207 cases were registered for this program. This report is the summary and the result of radiotherapy given to them.
Considering the difference in the character of the hospitals, the data gathered from National Hospitals were analysed and illustrated in comparison with the data from National Cancer Center Hospital.
The items of this study are as follow:
1. Primary cases or secondary cases? (previously treated or not)
2. If secondary; the type of previous treatment.
3. Diagnostic procedures.
4. Site of cancer.
5. Pathological diagnosis.
6. Malignancy code, -site and pathology.
7. Staging according to TNM system.
8. Time lapse from the definite diagnosis to the start of treatment.
9. Type of radiotherapy.
10. Primary effect of radiotherapy.
11. Survival after the end of treatment, followed up to 2.5 years.
Although the individual data from National Hospitals has shown large variety in the every item, the summarized result shows a quite reasonable pattern in the present status of radiotherapy.
The survival data from National Hospitals was almost similar to the data from National Cancer Center Hospital after the adequate correction of case distribution. This result means that the effectiveness of radiotherapy of cancer will be almost same when it is performed on the sound basis.

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Chronic obstruction of the main arteries arising from the aortic arch in young females is now called as aortitis syndrome (Veda, 1986).
In this syndrome, decrease or absence of one or both carotid blood flow causes the most unfavorable prognosis.
A 29-year-old female was admitted for evaluation of a basal cardiac murmur, left visual disturbance and left sided headache.
Radial pulsation in left arm was not felt. Retrograde aortogram showed dilatation of aortic arch and brachiocephalic trunk, and obstruction of left common carotid and left subcllvian arteries. There was also segmental narrowing in the abdominal aorta near the origin of renal arteries. Arterial reconstructive operation with Tetoron graft was employed between the ascending aorta and internal carotid artery, under hypothermia (28°C).
The cerebral symptoms have been significantly decreased, but systemic hypertension remained.
Pathologic examination of the left common carotid artery showed panarteritis withh giant cells.

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A 58-year-old male patient was admitted to Maizuru National Hospital on June, 15, 1967, complaining of lumbago. Physical examinations revealed hypesthesia on the S₁, S₂ regions and abolished both ankle jerks.
The findings of the cerebrospinal fluid obtained by lumbal puncture and myelography performed by suboccipital puncture, revealed the evidence of a block at the level of T₁₁ and laminectomia was performed on July, 11, 1967. The dura mater was thikened to a width of 8mm and we found pus in the subdural space. Staphylococcus aureus. was found. Clinically and histologically, this case was diagnosed as secondary pachymeningitis hypertrophicans circumscripta.

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