Experimental and clinical results with retrograde infusion of anti-cancer drugs to ophthalmic artery obtained past one year have been reported.
The technique was as follows.
One cm of skin incision was set on the nasal fold of upper lid. From the wound, frontal artery or supraorbital artery was exposed. A thin cannula was inserted in the artery. Through retrograde route, the cannula reached to ophthalmic artery. When patent-blue solution was injected in the cannula, retinal artery was filled with dye if the cannula reached rightly. When retinal artery was stained surely, anti-cancer drugs were injected.
The technique was done in retinoblastoma children and favourable effects were observed.
In order to establish dose of infusing drug, retrograde cannulation to external ophthalmic artery was done in dogs. In the experiment, 2mg mitomycin was applied, Mitomycin levels in aqueous humor, uvea, retina, and systemic blood sample were examined and compared with results of infusion by way of common carotid. In the former, mytomycin levels (mean value) were 0.067r/g in ageuous humor, 0.026r/g in vitreous body, 0.212r/g in retina & uvea, and 0.470r/g in systemic blood sample.
In the later, 0.0023r/g in aqueous humor, 0.r/g in vitreous body, 0.023r/g in retina & uvea and 0.55r/g in systemic blood sample.

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Thirty-six patients with cervical cancer received 38 urinary diversions in four years and seven months from June, 1962. Twenty-six operations were performed because of hydronephrosis, and other 12 operations were done because of urethral and bladder infiltration and ureteral fistula. Nine cases of urinary pathology were due to primary cancer including the cases under initial treatment, 24 were due to recurrent cancer and 5 were due to postoperative complications. Two cases of urethral infiltration, one of ileovesical fistula and one of ureteral fistula caused by recurrent cancer resulted unsatisfactory. A case of hydronephrosis was operated prophylactically. The other 25 cases were azotemic. Using BUN level as the index, the primary effects were divided in 4 groups, The BUN level of the postoperative cases with long standing ureteral stenosis and pyelonephritis was hardly returned to the normal range even after the diversion, but no further elevation was found. Six patients died with high BUN levels after the diversion. One case had pyelonephritis, and 4 cases had extensive cancer. Only one case failed to show response without any obvious cause and this may be due to irreversible kidney damage.

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We examined the correlation between fasting blood sugar (FBS) and incidence of hyperlipidemia and or hyperacetoacetatemia in diabetic patients in general and in association with condition of the disease. Then, effect of treatment for diabetes on hyperlipidemia and hyperacetoacetatemia was observed. No blood lipid lowering drugs were administered to the patients before and during the observation period. The results were as followings.
1) There was linear positive correlation between serum cholesterol (Ch) and betalipoprotein (bL) levels and between Ch and triglyceride (Tg) levels, but no correlation was found between FBS and Ch, or between FBS and Tg levels.
2) There was no correlation between plasma acetoacetate (Ac) and FBS, Ch, Tg or bL levels.
3) At the beginning or reestablishment of treatment of diabetes, abnormally high levels of Ch were found in 54% of the cases, of Tg in 52%, of bL in 48%, of Ac in 79% of the cases, respectively.
Incidence of hyperlipidemia and hyperacetoacetatemia was independent on FBS level, sex, or retinal lesions, but hypertriglyceridemia was found less frequently in the groups of under 40 years of age, of emaciation, and hyperacetoacetatemia being less frequently in the group of obesity.
4) After the treatment for 1 to 12 month's peiod abnormal high levels of Ch, Tg, bL and Ac were improved significantly in incidence of 62%, 41%, 38%, 52% of the abnormal cases, respectively.
Kypercholesterolemia was more frequently improved in the group in which post-therapeutic FBS was maintained under 14.0mg dl, in female group, in the group of under 40 years of age, and in the group with no significant retinal lesions. Hyperacetoacetatemia was more frequently improved in female group and in the group of emaciation. Hyperbetalipoproteinemia was more frequently improved in the group of under 40 years of age, in the group of emaciation and in the group with no significant retinal lesions.

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Case 1. Th 8 injured forty seven year-old male, died twenty years after injury.
Case 2. Th 8 injured forty year-old male, died twenty years after injury.
Case 3. Th 6 injured fifty seven year-old male, died twenty five years after injury.
Case 4. Th 12 injured fifty eight year-old male, operated and radiated with ⁶⁰Co after twenty four years, and now, three years after operation there is remarkable changes of the scar tissues.
All cases of malignant changed ulcers were located on the sacral region, and histologicaly, all the same, “squamous cell carcinoma.” In the tweny four cases of chronic ulcers not malignant changed, histological findings have similarity except a case, capillary vessels formation, fibrosis, and leucocyte, infiltrations. One case has findings, with same of chronic granulation tissues, of atypic al metaplasia of the cells.

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1) At the age from 14 to 59, the intravenous infusion of LMD decreases the lowering of blood pressure, caused by bleeding, rather than that of 5% of glucose solution does.
2) Over 60 years of age, the intravenous infusion of LMD is unable to control the lowering of blood pressure caused by bleeding.
3) With 100 to 149mmHg at the systolic pressure prior to surgery:
a) In the case of bleeding less than 4g/kg of body weight, the intravenous infusion of LMD is able to control the lowering of blood pressure caused by the bleeding.
b) If the bleeding is more than that of the above, the LMD cannot control it.
4) With over 150mmHg prior to surgery, the LMD cannot control it.

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After the World War II. during the past 23 years, in Japan, the observation on blood transfusion has passed the stages of its entire support, reconsideration and decrease in frequency of its usage. Today, it is in the period of decreasing. At the First National Hospital of Tokyo, since 1964, they have been taking the measures of decreasing the blood transfusion and the quantity of its usage has now been decreased to approximately a half in 1958. On the other hand, the number of operations without blood transfusion has reached to 73.3% of the operations under general anesthesia. In contrast to this, the usage of Plasma Volume Expander was remarkably increased.
In 1960, only 18 bottles of Plasma Volume Expander were used, however, in 1966/1967 472 bottles were used. Dextran and Low Molecular-Weight Dextran are mostly used as Plasma Volume Expander.
We sincerely hope that, in the future, the better quality of Plasma Volume Expander wills be studied and the method of whole blood transfusion will not only be taken but also the blood transfusion may be considered due to the nature of desease.

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Incidence of serum hepatitis after blood transfusion has been increasing for the past several years, and various preventive measures were reported.
In order to avoid such complication, major surgical procedures without blood transfusion were performed on 18 cases for tuberculosis or other pulmonary diseases in the period from April to August of 1967.
Our experience disclosed that major surgical procedures could be performed safely if hemorrhage was less than 19 to 12ml/kg of body weight. All of our patients tolerated the operations quite well with uneventfull post-operative course.

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In 171 cases of pulmonary tuberculosis, the acid-base balance was measured by the micro-method of Astrup, showing the data in many cases within the normal range. —But the % VC had a close realationship with acid base. —In cases with to VC lower as 50, the blood pH became always lower; in case with these two tendencies the FEV_1.0 remained of ten under 30. -In cases with % VC lower as 60, the PCO₂ showed a wide distribution of values: In cases with % VC lower as 50, extremely high values of PCO₂ were observed; three cases with %VC lower as 30 showed the PCO₂ higher than 40mmHg. -In cases with %VC lower than 60, the buffer base mostly showed high value; in 32 cases lower than 50 of %VC, the latter showed the value higher than 48mEq/l in 26-(81). -Regarding the significance band in chronic hypercapnia of Schwartz, the cases with %VC lower than 60 remained more frequently as the cases higher than 60.

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Between January 1956 and the end of December 1966, we had 41 cases of unexpected major hemorrhage in the thorax after pulmonary resection. They represented 7.9 percent of a total of 517 cases of pulmonary resection, of the 41 cases, 27 underwent a total of 30 operations of rethoracotomy within 48 hours of their initial pulmonary resection. They were called as emergency thoracotomies, The patients ranged in age from 18 to 58, and consisted of 24 men and 3 women. With respect to operation types, an overwhelming proportion of the cases had resection in the right upper lobe, and seven had pneumonectomy.
As for the blood pressure, which has much to do with the period of time before rethoracotomy and is an indicator of the patient's progress, many of the cases experienced blood pressure falls below 100mmHg, and eight of them were in shock.
The source of postoperative hemorrhage was the thoracic wall in 10 of the cases, parenchymatous lung tissue in three, bronchial artery in one, intercostal artery in one, and the edge of a resected rib in one, whereas in fourteen cases the source could not be identified. Considering the causes of postoperative hemorrhage in connection with the observed thoracic wall adhesions, we found that such hemorrhage more often than not accompanied high degrees of adhesion, suggesting that the thoracic wall is most responsi ble.
We have also studied these cases with respect to the incidence of postoperative hemorrhage in each type of operations as well as sucked blood, blood collecting in the thorax, total blood transfusion and other factors.
The cases of emergency thoracotomy showed favorable results with respect to the postoperative breathing capacity when compared with cases of hematoma removal.
There were no complications except for atelectasis noted in one of the cases, and there were no deaths.
From these results we stress that operable cases should be subjected to rethoracotomy as soon as possible. With reference to operability, also, we consider that radiography as well as blood pressure, pulse, and other observations is an important means of determining the operability of a patient. Finally, a few suggestions to be followed in rethoracotomy are offered.

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Six cases of malignant lymphoma were reported. The swelling of profound lymphnodes was the first attack on 3 cases. In another 3 cases, superficial lymphnodes were attacked at first. The former 3 cases were as follows;
1st case was initially diagnosed as intestinal adhesion because of surgery of stomach about 2 years ago.
2nd cases was diagnosed as Banti's syndrome because of remarkable splenomegaly. Laparatomy was done.
3 rd case had various clinical findings (miliary dermato-exanthemas, arythmia, uremic coma, leukemoid blood-picture etc). Autopsy proved leukemic reticulo-sarcoma.
The latter 3 cases were diagnosed easily by the needle-biopsy of superficial lymphnodes.
It was important diagnostic factor that atypical young form cells (tumor cells?) were always observed in peripheral blood specimen.
The cytochemical findings of tumor cells in peripheral blood by lymphosarcoma or reticulosarcoma were discussed.

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With the purpose to know the combinations of drugs which produce chemical changes without apparent changes by admixing and to identify the substances there produced, thin-layer chromatography has been applied to the experiments with different combinations of reduced-form glutathione and various drugs for injection for detection of the changes due to the admixture.
Thin-layer plates are prepared with Wakogel B-5 (25μ thick, 200mm×50mm), Sample drugs are admixed in identical volume, and after leaving for 10 minutes, equimolar to twice molar N-ethylmaleimide is dissolved in the mixed solution, and the whole is spotted at the middle of the starting line while the component solutions are spotted on both side before development is carried out to the extent of 10cm of distance.
The experimental results are summarized as follows.
(1) Combinations that gave no visual changes as well as no changes in thin-layer chromatograms showing symmetrical spots are: Sigmamycin, Ilotycin, Viccillin, Hostacyclin, Leucomycin, Dicinone, Coagumin, Transamin, Adona, Trostin, Vitamin B₁, Vitamin B₂, Flavitan, Vitamin B₆, Fresmin, Vitamin C, Vitamin K₁, Vitamin K₃, Pancal, Guronsan, Methionin, Inosie, Sohamin G, Glucose, Fructose, Klinit, Pyretia, Dehycol and Trinosin S.
(2) Combinations that gave no visual changes but produced anomalous spots on thin layer chromatograms are: Alinamin F and Neuvita.
Due to the action of the SH group in glutathione vitamin B₁ in these drugs should have been liberated to produce a mercaptan odor, resulting in fall of the residual rate. These combinations are recommended to avoid.
(3) Combination that gave visual changes but no changes on thin-layer chromatogram is: Terramycin.
(4) On Tetracyclin, Pyretia and Pancal, reports have been published recommending prohibition of the combination, but in the present studies no changes have been observed in appearance and on thin-layer chromatogram. With Pancal, residue rate was determined after different time of leaving to find no anomalous phenomenon in particular.

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By culturing bacteria from the inflammatory lesions of outpatients who were treated at the Oto-Rhino-Laryngological Clinic of Nagoya National Hospital during the last three years, the kinds of bacteria and the frequency of detection of each organism were examined.
A tendency of increase in the rate of gram-negative bacilli as the major infective agent was observed, and sensitivity of the cultured bacteria to various antibiotics was compared with the results of other reports.
Moreover, the correlation between the effects of chemotherapy and the results of the sensitivity testing was examined.

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Among the allergic diseases, the immediate type hypersensitivity occupies a unique position for an abnormal reactivity to the allergic mediators as well as the presence of reaginic antibody.
It is known that some bacterial products produce the altered respons to so-called allergic mediators such as histamine and serotonin in experimental anaphylaxis.
The present investigation was performed to know the mechanism of abnormal altered reactivity to the allergic mediators in the immediate type hypersensitivity of human being.
The course of pertussis vaccine injections and the β-receptor blockade were given to the asthmatic children who had showed the positive challenge test to the house dust extract.
The positive reactions to challenge tests were provoked more easily after the course of pertussis vaccine injections and β-receptor-blockade than before these procedures.
Based on these observation, the infection and endotoxin like substance are supposed to play some role in producing a hypersusceptibility of the immediate type hypersensitivity.

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The predominant subgroup of Shigella organisms in Japan was Shigella Flexneri, except a period just after the world war II. The pattern of isolated Shigella organisms, however, began to change in 1962 to 1963, and the rate of the number of Sh. Sonnei increased recently, thus the most of the organisms isolated in Japan are occupied by Sh. Sonnei now.
In April 1967 the endemic prevalence due to bacillary dysentery occured in a some primary school of Ichikawa City and 53 patients were admitted in Konodai Hospital. In this paper, the results of the bacteriological investigation on the serological identification of the isolated organisms and the drug susceptibility against them were reported, and they were compared with the data of another 25 cases by Sh. Sonnei which were isolated from the patients occured sporadically in the area of Ichikawa City and its neighborhood in 1967

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Seventeen (17) cases of acute hypnotic intoxication were treated with CDP-choline, and the following results were obtained, in comparison with those experienced previously in five hundred (500) cases.
1) No side effects were obtained in any of the cases.
2) The effects became apparent rather slowly and the patients awoke in a normal way.
3) CDP-choline was effective against acute hypnotic intoxication, but the effect was not significant in comparison with other central and cardiac stimulants.

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A new born baby of primipara who was delivered by the breech extraction method could not stretch the right leg since on the 4th day of life. On the 21st day of life it was found roentgenographycally, that the right femur showed massive cortical thickening and lateral displacement of the distal epiphysis. The stretch of the leg since 20th day of life became better and roentgenogram was almost perfect on the 43rd day of life. The baby had, moreover the haematoma in the right M. S. C. M, and on the left occipital region.

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A Case of periodic paralysis presented clinically interesting course.
1) High carbohydrate diet produced paralysis, in which second degree A-V block of Wenckebach type and hypokalemic type EKG was seen, and recovered by Thiamine monophosphate disulfide (TMPDS) 100mg I. V.
2) Despite of the previous administration of O. Butyryl thiamine disulfide (BUTDS) 150mg P. O., the paralysis with hypokalemia and A-V block of Wenckebach type was provocated by I. V. drip infusion of 50% glucose 400ml.
Regular insulin 30 units I. M. made the palsy more severe with lowering of serum potassium, although administration of insulin improved the second degree A-V block of Wenckebach which was already noted just before the injection as the first degree A-V block with prolonged PQ and flat T.
Although no recovery of the palsy was obtained by an administration of Potassium chloride 5 gm. P. O., the alteration of hypokalemic type EKG was noted with the more elevated T and the disapperance of U wave.
TMPDS 100mg I. V. followed to Potassium chloride 5gm, induced complete recovery.
3) Previous administration of Potassium salts of aspartic acide 3 to 6gm, and BUTDS 150 to 300mg P. O. prevented paralysis followed by the I. V. drip infusion of 50% glucose
400 ml or the high carbohydrate diet.

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