A series of thirty subjects with hyperlipemia selected among the out-patients with the chief complaint of hypertension, etc, were treated with clofibrate (C. P. I. B.; Amotril-Sumitomo) given at daily dosage of 6 to 12 capsules with average duration of 5.2 weeks. Clinical response of the patients to the treatment was as follows
a) An average decrease in serum total cholesterol of 57.2mg/100ml from a mean pre treatment level of 283.8mg/100ml was observed.
b) The patients also responded with an average decrease in serum triglycerides of 45.0mg/100ml from a mean pre-treatment level of 272.5mg/100ml.
c) We observed no evidence of significant alterations in the serum level cf uric acid.
Serum levels of unesterified fatty acids in normal adults following oral administration of the compound in a single dose of 25mg/kg indicate that, despite the conventional views, the compound produces no significant lowering of free fatty acid levels in the serum. The results thus implicate the mechanism whereby clofibrate effectively lowers the serum level of triglycerides involves not only inhibition of the free fatty acid utilization from the adipose tissue, but most probably some other ways of interference with the serum triglyceride level as well.

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Sometimes we encounter the passage disturbance at anastomosis site in early stage as one of uncomfortable post-gastrectomy complication.
We performed gastrectomy in 1, 487 patients in the past 10 years from 1958 to 1967 and had 52 cases (3.6%) of the complication. The onset came out mostly at 8th to 10th day postoperatively. Edema, spasm and adhesion at the anastomosis sites are thought to be the causes of the complication, but on the other hand asynchronous peristaltic movement between the rest part of the stomach and anastomosed intest'ne would be one of the important factor. We can show the cases of so-called funnel shaped exhaust which we had reported as good evidence for the thesis.
We also made statistical analysis in relating to the basic desease, pre-operative state and method of operation.
As treatment of the complication, we had performed re-operation rather positively until few years ago but recently most of the cases have been treated conservatively with continuous tube feeding of 2 to 3 weeks with success.
I repored the outline of the tube feeding method which we originated.

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The authors have used two new preparations, SLA (2.5-Di-O-acetyl-D-glucuro-(1→4) (6→3)-dilactone) and SLNA (S dium D-glucuro-(1→4)-lactonate), in the treatment of patients with rheumatoid arthritis.
The preparations, saccharate derivatives known to be one of the specific inhibitors of β-glucuronidase in vitro, were administered to 31 patients together with other anti-rheumatic drugs.
Of the 14 patients, who received 6-9 tablets (each containing 375mg) of oral SLA per day for 3 weeks up to 14 months, 10 (about 71%) were improved.
Of the 17 patients, who received 100mg of intraarticular SLNA, 10 (about 60%) showed some improvement in clinical signs of local inflammation.
The immediate anti-inflammatory effect of these compounds was not so remarkable when they were used in the form of single medication.
The compounds, however, may be used to good advantage together with other antirheumatic preparations in the treatment of patients with rheumatoid arthritis.

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A large number of baby with rubella syndrome was observed after rubella epidemic of 1963 in United States of America and of 1965 in Okinawa. However, rubella syndrome babies were scarcely found in Japan, although the outbreak swept over the whole country from 1965 to 1967. In this situation, it is of interest to know the immunity of pregnant women to the virus at the time when epidemic occured. Recently, rubella epidemic in Sendai area occured in 1961 and 1966 to 67. Therefore, HI antibodies of sera obtained from pregnant women in 1962, next year of epidemie, and in 1965, the year before epidemic, were retrospectively examined. As a result, HI antibody with moderate titer against rubella virus was demonstrated in all of the sera tested, although most of children showed the high titer more than 1:512 next year of epidemic. Thus it is suggested that pregnant women in Sendai might be scarcely infected with the virus at the rubella epidemics, because they had acquired the immunity before the epidemics. It may be concluded that immunity of pregnant women is the most important factor to influence the occurence of rubella syndrome.

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We have been reporting on the cytologic diagnosis of ascites at this Society and the Society of the clinical pathology. At this time, we investigated pleural fluid by cytodiagnostic technics. As a rule, the mesothelial cell and phagocytes which appear most commonly in pleural fluid are negative for mucus stain, while some of the carcinomatous cells are positive. Therefore, like in the cytologic examination of ascites, PAS stain and alcianblue stain were combined with HE and papanicolaou original stain.
Most of the cases, from which the pleural fluid materials were taken during their lifetime were autopsied and their primary lesions were confirmed.
Of the 30 cases studied, 11 cases were pulmonary, 4 were gastric, 4 breast, 4 ovarial, 3 intestinal, 1 pancreatic, 1 gallbladder carcinoma and 2 inflammatory pleurisy. In the control materials, mucous stain was negative. Of 28 materials obtained from carcinomatous. pleurisy, 32.0% were postive for mucous stain.
The stain was positive in 27.2% of the cases with pulmonary carcinoma, the most corn non cause of carcinomatous pleural effusion. In the previously performed similar study on the ascites of carcinomatous peritonitis, the mucus stain was positive in 13 cases (35.1%) of the 37 cases, and the rate went up to 48% in the case of gastric carcinoma, that is the most common cause of carcinomatous peritonitis. Thus the rate of positive stain in the carcinomatous pleural effusion was lower than that in the carcinomatous ascites. Among the mucous stains used for cytodiagnosis, PAS stain was the most reliable.
With this stain, however, glycogen is also stained, and hence its differentiation from mucus is necessary. The differentiation can be made in some extent, since mucus is stained like droplet and glycogen like glanula. However, the differentiation of mucus from other polysaccharides becomes difficult if the PAS stain is too strong, and thus one should pay attentionn to the strength of the stain.
In a cytologic diagnosis of pleural fluid, one is often encountered with those cells which should be classified as grade III.
In such occasion, one may diagnose it as a carcinomatous cell if it is positive for mucus. stain.
Therefore, the mucus stain should be performed as a routine.

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Thirty six cases were examined by colored discography during the operation.
Hernia-positive pictures were got in the degenerative types and hernia-negative views were showed in the relative normal form in the discogram.
We can see the results as the next table.

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The authors made experiments on the decomposition of INEI derivatives in simulated gastric and intestinal juice at several pFI, in order to know how INH derivatives were more worth than INH is clinical therapy.
And the authors made experiments using rabbits in order to know how INH derivatives absorbed by the intestinal canal if there were INH derivatives which did not decompose in the stomach and passed through.
We obtained the following results.
In the stomach, isonicotinoyl hydrazde methan-sulfonate (Neoiscotin: IHMS) was comparatively stable and about 20% was decomposed into INH, and in the intestine it was absorbed as INH with being decomposed. The administration of IHMS kept the serum concentration of free INH higher for a long time than INH. And so IHMS is an adaptability drug.
Sodium glucuronate isonicotinoyl hydrazone (Hydronsan: INHG) and calcium pyruvinate isonicotinoyl hydrazine (Vivoniplen: IPC) were decomposed over 70% into INH within half an hour in the acidic stomach. Free INH and glucuronic acid, which were made by decomposition of INHG, were not conjugated into INHG by reversible reaction in the intestine. And so the administration of INHG or IPC was nearly as equal as the administration of INH. But in the stomach which did not show acidity, they were sent to intestine within 15% decompositon, after a few hours they were gradually being decomposed and absorbed as INH. Thus blood concentration of free INK was kept higher for 10 hours. Therefore when they do not decompose in the stomach, they are long acting antituberculous drugs.
As the absorption and excretion of INH is very first, it seem to be effective and profitable that the times of administration are increased and the dose is controled according to the INH metabolic patterns of patients.

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We studied the factors of observational errors in the result of resistance test at Tohoku National Sanatoria.
The results obtained were us follows:
1) In the variation of medium, condition of culture, especially dispersion of bacilli in the bacillary Liquid and inoculated weight, difference were observed National Sanatoria.
2) Judgement of culture i. e.
Observational errors on colonie in medium were recognized greatly.
3) Observational errors could be decreased by making provision on the each factor.

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One hundred and fifty three psychosis accompanied with tuberculosis, classified as 35% schizophrenia, 20% alcoholism and 18% senile psychosis, were sent to our sanatorium in past 2 years.
Their mortality rate is high as much as far advanced tuberculosis, i. e. 16%. We keenly feel the necessity of psychiatrical consideration in tuberculosis-sanatorium.

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I propose herein to report a case of subacute glomerulonephritis confirmly suggested a collagen disease because of its various findings. While under observation the patient had a acute renal insufficiency with the typical E. K. G. of a hyperkalemia.
Though temporarily he was improved by a peritoneal dialysis, the patients was complicated by the development of bronchopneumonia and died.

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A 52-yrs-old lady was admitted with c. c. of lower back aching & difficulty of walking. X-ray of thoracic spine showed spondylosis deformans and the myelography did not show any abnormality. A laminectomy was carried out without effect. Repeated myelography pointed out saddle-shaped shadow suggested mass lesion at the thoracic region at this time. This mass was disclosed as psammomatous meningioma after a resection. The post-operative course was favourable.

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A recurrent ameloblastoma of the mandibular body formed hen's egg size cyst, gradually enlarged and bony absorption was reached under the periosteum. marsupialization cutting a window—of cyst was performed with good result.
Seventy-two-years-old male had been suffering from recurrent cystic ameloblastoma (Miyazaki-Arai, 2nd type). An adequate window was cut by partial resection of the cystic wall. The cyst has decreased in size and 5 months later natural bony repair processes restored the original outline of the mandibular bone. The prothesis was followed and the aim of keeping the lower jaw intact was obtained.
This result showed some cases of the ameloblastoma have indication of marsupialization aiming the lower jaw intact, furthermore, the marsupialization will be able to be adopted as operative step of complete enucleation.

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In the out patient clinic, the patients whose chief complaints of abdominal pain, melena, diarrhoea and abdominal distension were evaluated to find 4 cases of ulcerative colitis, excluding bacterial dysentery and amoeboid dysentery.
Age distribution were varied from 4 to 12 years old, among which two were male.
The clinical course were insidious in some cases and others showed various intractable symptoms.
The treatment of choice has not been established yet, including steroid therapy.
Allergic theory has been believed to be one of the pathogenesis, so that allergic disposition has been investigated for our cases.

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The patients was a 44-years-old male, with chief complaints of cloudiness of consciousness which was later superimposed by frequent spells of hiccup. Pulsation of his left common carotid artery was not recognized, and obstruction of this artery was confirmed by arteriogram that was taken prior to surgery. Thrombi were removed from the left common carotid artery, and also partially from the left external and internal carotid arteries.
Since this surgical procedure, the hiccup had completely disappeared, and cloudiness of consciousness had been gradually improved as well as the general condition, although moderate grade of cerebral atrophy was disclosed by pneumoencephalogram.

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Stability of chlorothiazide and five other derivatives in alkaline solution was studied by using thin layer chromatography and automatic spectrophotometer.
For the chromatography, silicagel G was spread on a plate in 250 u thick and Baer's method was used for the detection, Contents of six compounds in NaOH solution of pH 12 was assayed at 35° and 50°, every 30 minutes.
Benzothiadiazine derivatives are generally considered to be unstable to alkali, but the results obtained in this study indicate that some of them are considerably stable in alkaline solution.

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We experienced a case of miliary tuberculosis (diagnosed as an acute pancreatitis prior to the surgery), which was found at the time of operation (lung miliary tuberculosis was found almost at the same time). About six months later, we performed liver biopsy again under the laparatomy and compared with the previous specimens.
The results were as follows:
1. By way of using SM, INH, KM and EB at the same time, improvements in both chestgrams and liver specimens were quite significant.
2. Liver function tests (ZnTT, Co R, Alkaline phosphatase, γ-globulin) showed improvement after treatment for liver miliary tuberculosis.
3. In this case, steroid hormon was used prior to the establishment of diagnosis of miliary tuberculosis. Therefore prudent considerations required for the use of steroid hormon to tuberculosis or other infectious diseases.

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Studies were made by TLC as to incompatibility between any one of 80 injectable preparations including Erythromycin which have been used and any one of the newly adopted 4 injectable preparations: Inderal, Levophed, Venoplant and Pantosin.
As far as we have examined, it is extremely difficult to conclude whether the mixture of any one of the newly adopted injections and any one of the currently used injections is permissible or not.
It is certainly ideal if any definite advice on the possible mixture of the above mentioned injections could be made for their clinical applications, but, in practice, answer is made on the basis of the appearance of the mixed solution, its acid-alkaline balance and results of TLC obtained heretofore every time a question is raised as to the mixture of any particular injections.
In the future, further studies will be made on TLC between any of the already used injections and their IR spectrophotometric study will also be made.

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