A clinical observation was done on 1, 100 patients with genito-urinary tuberculosis who were treated for 8 years from 1959 through 1966.
The results obtained were as follows:
1) Incidence of genito-urinary tuberculosis showed a tendency of decreasing. The ratio of the patients with genito-urinary tuberculosis to all out-patients was 6% in 1966, while it was 21% in 1959.
2) Urinalysis showed A. F. B. positive in 73% of these patients.
3) According to Lattimer's classification of pyelographic findings, 54% of them are belonged to Group 4.
4) Radio-renography was found to be effective in diagnosis of uretero-pelvic stricture, but renal angiography and scanning in diagnosis of localized lesion in the renal parenchyma.
5) In prostatic tuberculosis urethro-vesicography was found to be the method of choice in its diagnosis.
6) Efficacy of anti-tuberculous chemotherapy was investigated histologically.
7) Difficulty of hearing, as a side effect of anti-tuberculous agent (S. M.) occurred more frequently in the patients with impaired renal function.
8) Nephrectomy, partial nephrectomy, speleotomy, uretero-cystostomy, vesicoplastic procedure and epididymectomy were performed on these patients according to the indication.
9) Follow-up study was done on 244 cases who had been discharge from hospital over 2 years. Healing rate of these patients was found to be 89%.

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It has been reported as primary steps that the blood of corpses had been taken at the time of pathological and medicolegal post mortem examination, and the following results were obtained.
1) Presently after death, values of potassium and phosphorus were high.
2) It has been indicated that natrium and chloride decreased.
3) Calcium decreased slightly, then increased.
4) It has been indicated that glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and lactic dehydrogenase increased presently after death.
5) Addition of the solution of ACD did not show any clear change.
6) when corpses were kept in the icebox, potassium level were unchanged.

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A total of 50 cases of adenovirus infection suffering from relatively acute respiratory illness c/s various complications were studied during the period from January 1962 to July 1967. In all of our series, association of adenoviruses with their diseases were confirmed by virus isolation and serological surveys by means of a complement fixation test or neutralization test. Age and season: By the age of 5 most children (72%) have suffered some clinical disease. Whereas the syndrome of pharyngo-conjunctival fever and aseptic meningitis occured predominantly during summer months, adenovirus pneumonia and gastrointestinal disease showed a peak during winter. Complications: In this period of our study, the following complications were encountered : 5 cases of pharyngo-conjunctivitis, 1 case of kerato-conjunctivitis, 5 cases of pneumonia, 2 cases of intussusteption, 3 cases of epileptiform seizure, 4 cases of transitory limb paralysis, and aseptic meningitis respectively, 5 cases of febrile skin exanthema and 17 cases of acute gastrointestinal disturbance (including 10 cases of profuse watery colorless diarrhea). The serotype of each isolated strain from children with the above-mentioned complications are seen in their respective tables. Finally, the results of studies designed to provide data on the role of enteropathogenic viruses, including adenoviruses, are described. The patients in this study of enteropathogenic viruses, a total of 80 cases, admitted to our hospital in the past 5 years, consisted of those who were suffering from profuse watery colorless diarrhea and severe vomiting combined with respiratory symptoms.

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20 cases of so-called excited schizophrenia received “Rauwolfia serpentina” (Reserpine), then Ethopropazine (Parkin) were added with remarkable effect.

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About 200 cases of non-tuberculous pulmonary diseases were chosen for this study. These cases consist of three groups: 1. surgical non-tuberculous pulmonary diseases (pulmonary cancer, pulmonary suppuration, bronchiectasis), 2. chronic obstructive pulmonary diseases (chronic bronchitis, chronic emphysema, bronchial asthma), 3. pulmonary fibrotic diseases (pneumoconiosis, sarcoidosis, other pulmonary fibrosis).
We examined pulmonary functions on these cases, and discussed the relation between clinical picture and pulmonary functions.

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Four cases of phacomatoses in childhood, two cases of Recklinghausen's disease and two cases of Sturge-Weber's disease were reported.
The author pointed out the importance of the adequate treatment for the characteristic ocular findings of these disease even from early stage.

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Since Romberg demonstrated his first work in 1952, it has been published many articles on the cytological diagnosis of the functional uterine bleedings, however, much still remains to be investigated. Cytological diagnosis of the endometrium has been made on the finding of the various cells which were naturally free from the endometrium. It usually follows the endometrial changes caused by hormonal environment and occasionally gives the most important clue to suggest a cancer of the uterine body.
The author demonstrated a correlationship between histology and cytological findings. The results of observation on 91 cases of the endometrial bleeding excluding the menstrual and organic bleeding were as follows:
1. Prolif erative phase:
Hyperchromatic nuclei with scanty cytoplasm were observed in 27 cases.
2. Secretory phase:
Less nucleic variety in rather large size having finely divided chromatin and definite cytoplasm were found in 8 cases.
3. Atrophic phase:
Gathered small round-shaped nuclei with rather hyperchromic trends and none of the cytoplasm were seen most likely to be a sheet of nucleous in 13 cases.
4. Irregular shedding phase:
8 cases of cytologic finding were based on the mixtured type of the secretory and proliferative phase.
5. Hyperplastic phase:
So-called hyperplastic endometrial cells, rich in cytoplasm and irregular in nucleic size, could be seen in some of 25 cases. Others showed a similar figure of proliferative phase. Malignancy could not be ruled out in some dyskaryotic cells. These results apparently indicated that pathology of the functional bleeding was complicated and mainly affected by the hormonal environment. The full significance of these were differenciation of malignancy from the functional bleeding especially in menopause.

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Epidemiological investigation on sarcoidosis by correspondence from national hospitals and sanatoria to our inquiary is reported. Analysis was made from data for 4 years from 1964 through 1967 (371 cases).
1) In a frequency distribution by age, class interval of the twenties revealed peak in both sexes. There was another peak around 45.
2) Pulmonary sarcoidosis was found in the second decade most frequently and it decreases by advancing age. On the contrary, sarcoidosis of other parts of the body was found much in higher age groups.
3) In a frequency distribution by residential area, 5000 was in city area and 26% in pine wooded area.
4) Tuberculin skin test was negative in 60% of whole cases.
5) Diagnosis was based on by chest X-ray (96%), biopsy (64%) and Kveim reaction (16%).
6) About localization of this lesion, 94% was found in the chest, 19% in the eye, 9% in the skin and 4% in the other parts of the body. Among pulmonary sarcoidosis, 71% was hilar lesion, 26% was mixed lesion and 3% was pulmonary field lesion.
7) In geological distribution of freq uency, 0.79 cases out of 100, 000 population was in Hokkaido, 0.75 in Tohoku and 0.09 in Kyushu.
Higher incidence was found in the cold area where yearly average temperature was under 11°C and the lowest temperature was less than 7°C.
8) Five cases of occurence in the same family were reported.
9) Incidence in Akita-ken was 0.5 out of 100, 000 population.

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Observations of 97 cases of sarcoidosis reported in Hokkaido 1953 to 1966 have been summarized. Fifty-nine cases of 97 patients were Kveim-positive and/or organ biopsy positive (groups 1 to 3 of the international classification). The peak age prevalence was in the second to fourth decades.
In most cases, the disease was localized to the hilar lymph nodes and to the lungs. The localization of the desease in other organs such as the' eyes, skin, bones, superficial lymph nodes, et cetera was present in a lower percentage of cases.
The tuberculin reaction was negative in 30 of the 48 patients in groups 1 to 3. (In 11 cases, the reaction was not checked.) But, the relationship between the progress of the diseasee and the pattern of the tuberculin reaction was various. It was reported by Kitamura that the number of patients with sarcoidosis per 100, 000 population in each of the eight districts in Japan decreases gradually from north to south, that is, from the cold to the warm areas of the country, but in Hokkaido the similar tendency was not found. The ratio of BHL was one per 10, 000 students of junior and senior high school in Sapporo, Hokkaido.

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Until may, 1967, 139 cases are diagnosed as sarcoidosis in Miyagi-ken. 125 cases of them, 89.9% are diagnosed at the Tohoku University.
According to the international diagnostic criteria, 37 cases of 85 who have been found after January, 1963, are I-III group.
The patients are most, 32 cases (37.6%), bllonged to teenagers, the next to the secoud decade. 46 cases (54.1%) are female, and 38 cases (54.3%) are liuing in Sendai city but rare in the seaside and mountain village.
Intrathoracic organs are involved in 71 cases (83.5%) Ophthalmological changes are found in 44 cases (52%), in which 13 cases showed no pathological findings in the other organs.
Pulmonary functions are as follows: vital capacity and %FEV₁ are tested in 25 cases. %VC is more than 80% in 24 cases. %FEV₁ are more than 70% in all cases, and 17 cases of them are more than 80%.
Pulmonary diffusing capacity measured by single breath method in 18 cases and %Dco is less than 80% in 9 cases.

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Up to the present, in the treatment of sarcoidosis, steroid has been considered to be effective. However, with steroid ill effects have been observed; and when the medication is stopped, the disease again recurs, such is the condition generally experienced. In using chloroquine we have found that it can be administered without any ill effect ; in regard to the effectiveness of these two medicines, the investigations were centrally based on comparative X-ray examinations. The cases examined were 20 of hilar lymph nodes and 11 cases of lungs and hilar lymph nodes sarcoidosis.
The results were as follows:
1) Watching the progress of X-ray changes during three months of a group of patients under medical treatment and a group without medication, the rate of improvement of those in the first group was markedly higher and the rate of deterioration was lower. However among the group without medication, there was a show of improvement to some extent so that there is evidence of a tendency towards natural improvement.
2) Comparing two groups of patients, one under steroid, the other under chloropuine, examination over a three-months period shows clearly that the rate of improvement of the first group is higher, but examination over a six-months period shows little difference between the two groups.
3) In Comparing the frequency of relapses, the group under steroid has had more cases than the group under chloroquine. Furthermore, in the cases of short-term medication, relapses are more in number.
4) As for the ill effects, for the group under steroid, the tendency of occurrence was 23.1%, while for the group under chloroquine, it was only 5.6%.
From the above results, chloroquine seems to be rather effective for the disease, and especially as in the case of steroid there is tendency of ill effects and the fact that one cannot expect good results, one comes to believe that chloroquine should be further tried. It is the intention of this writer to continue to test more cases in the near future.

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Clinical and laboratory study of 50 cases including 20 true sarcoidosis, 13 suspicious sarcoidosis and 17 miscelloneous disease.
From fluoroscopic examination true sarcoidosis was divided into 4 types: i. e. bilar type, bilar pulmmal type, pulmmal type and bibulous type.
Diagnosis is easy if bilateral lymphadenopathy was found in chest X-ray, however in fibrous type it is very difficult, unless sarcoidosis come to mind.
In these series, usefulness of scalene node, liver, skin biopsy was compared.
Scalene node biopsy was useful in 13 cases out of 21 cases, 9 cases of sarcoidosis involving the liver was diagnosed by liver biopsy.
In laboratory findings alkaline phosphatase was high especially in the liver, involving eases.
Significance of liver biopsy and high alkaline phosphatase activity in diagnosis of sarcoidosis was stressed.

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Three cases of sarcoidosis were reported with electron microscopic observation on cells constituting the granuloma in the lymph nodes. In two of these three cases, simultaneous enzyme histochemical study was performed.
Interesting facts revealed by the present study were as follows.
1) Epithelioid ceps constituting the granuloma of sarcoidosis resemble reticulum cells or monocytes. They demonstrate prominent cytoplasmic processes interdigitating with juxtaposed similar cells. Occasionally, tight junction develops between these interdigitations. Invagination of such compelx membrane structure with tight junction was seen in one of the multinucleated giant cells.
2) Multinucleated giant cells have a large number of lysosomes of moderate to minute size. In other respects, they are quite similar to epithelioid cells. Cytoplasmic membrane also forms prominent processes.
3) Between epithelioid cells are fibroblasts, lymphocytes and occasional plasma cells. Fibroblasts are more frequent in the peripheral portion of and around the granuloma. Characteristic hyalinization of this disease probably is due to prominent activity of f ibroblasts rather than due to immunological processes.
4) Enzyme histochemical study revealed prominent acid phosphapatase and glucosaminidase activity in the giant cells and also in some of the epithelioid cells. This finding corresponds well to the ultrastractural feature. These lysosomal enzyme activity are quite similar to that of tuberculosis granuloma and may be related to the digestion of possible causative micro-organisms.
5) During the present investigation, however, no microorganisms or structures suggestive of such, including viruses, are encountered in the granuloma of sarcoidosis.

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Of all the urinary tract neoplasmas, the vesical tumor is a case with the highest frequency. The medical treatment for vesical tumor holds various problems Its predilection age lies in age between 50 and 70 years old. Its genetic pathology is yet in an unexploited sphere. Chronic stimulation is considered to be the serious factor for its outbreak. Exposure to the aniline coloring matter is assumed to be an inciting cause. 95% of tumors is epithelial and 90% of them is papilloma or papillary cancer resulting from the maligned papilloma.
Medical treatment contains “electro-cautery trans-urethra (TUE of TUR)”, “resection of vesical tumor” “partial cystectomy” and “total cystectomy”, but each of these therapy has problems respectively.
Now, we report on the statistical observation we conducted recently on the vesical tumor in-patients in our hospital extending 9 years between 1958 and 1966. Such in-patients inn this period totaled 60. Among them 49 patients were male and 11 patients were female, the ratio between male and female was five to one. We traced back their development after treatment on the basis of their respective term between the onset of symptom and hospitalization and their histological state of tumor.
We investigated into each treatment after hospitalization, dividing treatments into resection of vesical tumor, partial cystectomy, electro-cautery trans-urethra (TUE or TUR) and non operation, and classifying them into categories of performance and non performance of ⁶⁰CO treatment.
Death case numbered 35 out of 60 in-patient. 31 out of these 35 death cases died within. 3 years after hospitalization. In-patients passing away after survival of longer than 5 years and those alive longer than 5 years numbered 6.
Number of in-patients classified according to their respective treatment after hospotalization is as follows.
However, there were so many inpatients who could not undergo operation, although they were admitted hospitalization, because they were under-malignant conditions. Such categories of cases numbered 24. 10 out of these 24 cases received allopathy only. For this reason, there were 22 in-patients whose histological state was not made clear. Investigation into death case shows that more malignant the histological state is, the prognosis is so much worse.
The prognosis observed on the basis of their respective treatment shows that 6 in patients survived longer than 3 years after resection of vesical tumor, 3 in-patients after TUR survived longer than 3 years respectively. 12 out of 33 cases of total operation survived longer than 3 years, while only 3 out of 27 cases of non-operation survived longer than 3 years. Judging from such state of affairs, the significance of operation and treatmet with. ⁶⁰CO is recognizable.

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The efficacy of Betahistine in treatment of Mèniere's disease was evaluated in clinical study and statistical analysis.
A preliminary pilot study was first carried out on 21 patients with this disease who were given Betahistine orally for a period of two weeks (504mg in total dose), and whose signs and symptoms were compared before and after the administration. The signs and symptoms taken into consideration in the study were nine in total and listed as below.
The results were tabulated and tested according to multi-variable analysis. From this study it was concluded that Betahistine is uniformly effective in all cases studied. Equilibrium seemed most remarkably improved, followed by paroxysmal dizziness, vertigo, headache in this order, Auditory acuity was hardly improved by the medication.
On the basis of this pilot study, a double-blind study in 36 patients with this disease was designed. The same items of symptomatology were studied using the same dosage schedule but this time the results were subjected to Fischer's test. In conclusion, Beta-histine was found to be effective beyond the placebo effect in reducing the symptoms of Mèniere's disease in all the study cases. Especially headaches, dysfunction of equilibrium, tinnitus, shoulder stiffness, nystagmus were more amenable to the treatment among the sign and symptoms listed. Hearing improvement was the lesst noticeable.
There were no significant side-effects throughout the study period.

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A Statistical study was made on 360 cases of the hypertension in the younger age group, seen in 1966, collected from the fourteen National Hospital of the Investigation group. Out of 360 hypertensives essential hypertension or hypertension of unknown etiology were seen in 46.8% of all cases, and the renal hypertension were seen in 43.0% of all cases, whereas the cardiovascular, the neurogenic, and the endocrinological hypertension were seen in relatively few per cent, namely 4.4%, 2.2%. and 3.6% respectively. These statistics were nearly same as that in cases of hypertension in the younger age group from the university hospitals. Among renal hypertensions chronic glomerulonephritis occupied most portion.

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We reported a case of cretinism of 7=years old girl with a sub-lingual thyroid gland. Her family noted her growth retarded since age of 2 years old and mental retardation started at 4 years old.
She has myxedema, height of 84cm and weight of 14kg.
Serum P. B. I. 3.83γ/dl; Serum Cholesterol 334mg/dl; ¹³¹I uptake 6.3% at 24 hours. X-ray film of wrist did show no ossification center in the carpal and shown the epiphysal dysgenesis in the distal part of femur.
Scintigram only revealed the ectopic thyroid gland in the sublingual area. Recently, it has been thought that the sporadic cretinism with ectopic thyroid gland has been detected at higher incidence with Scintigram examination.

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This 6-year-old boy was admitted to Hirosaki National Hospital because of acetonemic vomiting. He developed urticaria-like rash, gangrenous angina and lymphadenopathy of the cervical lymph nodes on the 10th day of the hospitalization, when he had high fever for the first time. The high fever dropped down once by administrating various kinds of antibiotics and Dexamethasone, but he had high fever again with rash, hepato-splenomegaly and jaundice after a non-febrile period of one week, when the second high fever elevated, the diagnosis of agranulocytosis was made by C. B. C. and bone-marrow puncture. As for the treatment, Dexamethasone, ACTH, transfusion of fresh blocd, Colistine, Trichomycin, folic acid and VB₁₂ were used after discontinuing antibiotics which had been previously used. He completely recovered with about 2 weeks treatment.
The etiologic studies—provokation test, Prausnitz-Küstner reaction, etc.— in this case revealed that Aminobenzyl Penicillin might be the etiologic agent. We ascertained that antigen-antibody reaction played the role in the etiologic mechanism of the disease.

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We have reported a case, who was clinically diagnosed. as primary Haemochromatosis. At autopsy, the patient was considered to be atypical primary Haemochromatosis.

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