The preschool children with mental retardation, cerebral palsy or emotional disturbance usually tend to have speech disorders. The parents of such children often visit outpatient clinics in the hospital for consulting about their problems, with chief complaints of their children's misarticulation or delayed speech. As a pediatrician the author has diagnosed, treated and guided their parents how to manage these various physically and mentally handicapped children for nearly two decades, Therefore, he could not help develcping a strong interest in speech disorders of preschool children.
The following ten cases are selected out of the patients he has managed recently, because of their unique characteristics.
The parents of all children complained their children's delayed speech. These children were examined by the medical staff in the Saitama National Hospital. Then, these cases were further studied by the Clinical Research Group for Speech Disordered Children in the Research Institute for the Education of Exceptional Children, Tokyo Gakugei University. (The author is also a member of this group)
From case No. 1 to No. 5, there were no complicated problem for the management as their diagnoses were clear. From No. 6 to No. 10, however, any reliable diagnosis has not been made. In spite of the frequent diagnostic sessions there is still some doubt in evaluating their intellectual level or other conditions though the etiological factor has been strongly suggested.
Now the author wants to stress the following; in evaluating the speech disordered children, it is very desirable to have a team of specialists, such as neurologist, paychiatrist, oto-rhiro-laryngologist, ophthalmologist, orthopedist, psychologist, speech patholgist, Breech therapist. educator, case worker and pediatrician. In such a diagnostic team, one specialist should assume the responsibility of integrating all the information about the child. The guide-line for the patient can be best found in such procedure.

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A method and clinical results of hemodilution perfusion using disposable bubble oxygenator which is commercially available as a sterile packaged unit (Junken), is described.
According to our previous experimental results at 1st. Department of Surgery, Osaka University Medical School, we concluded the feasible degree of intentional hemodilution for clinical normothermic extracorporeal circulation. That is hematocrit value of 20% or above.
Using this principle, 28 congenital heart disease patients received intracardiac operation and they are all alive.
The authors have studied upon the changes of gas transport, acid-base balance and electrolyte in serum under these hemodilution perfusion.
The results provides numerous important informations for hemodilution perfusion and also many problems which must be dissolved in future.

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We practiced ultrasonic examination for breast tumors since April, 1964.
We studied the relation between ultrasonic echo pattern and histological findings in 94 cases (cancer 20 cases, mastopathy 37 cases, fibroadenoma 15 cases and another benign tumor 22 cases.).
The apparatus employed was the type SSD-I manufactured by Japan Radic Co. Ltd. We used a barium titanate of 10mm in diameter at a frequency of 5 MC.
Ultrasono-tomography was mainly applied.
1) Ultrasono-tomography of normal breast was almost homogeneous pattern.
2) We classified the various kinds of echo pattern obtained in the ultrasono-tomography of mastopathy as four component pattern such as spotted, hear, combined and almost homogeneous pattern. There was number of almost homogeneous pattern.
3) We classified the various kinds of echo pattern obtained in the ultrasono tomography of fibroadenoma as three component pattern such as almost homogeneous, spotted and contoured pattern. There was number of spotted pattern. 4 cases showed contoured pattern.
4) Ultrasono-tomography of gynecomastia showed benign homogeneous pattern.
5) We classified the ultrasonic echo pattern of cancer two types, one was the irregular malignant pattern which showed localized irregular and bright configulation at the inside of breast tissue. Another type was the malignant homogeneous pattern. 15 cases showed ma-lignant homogeneous pattern, 5 cases showed irregular malignant pattern. We observed no special relationship between ultrasonic echo pattern and histological findings. Irregular malignant pattern was showed in relatively small size of cancer.
6) In the cases of nipple discharge we observed no special ultrasonic echo pattern. In one case that cancer cell was negative in exfoliative cytology, ultrasonic diagnosis was malignant, histological finding was cancer.
7) Diagnosis of malignant tumor correctly performed in 90%, and that of non-malignant tumor was 95.9%. Synthetic diagnosis-rate was 94.7%.
8) We must examine synthetically by change of sensitivity and section in the ultrasonic examination.

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We studied on 108 patients who have been admitted to our hospital for traumatic paraplegia, in whom 101 patients had histories of decubitus ulcers (60: ulcers, 41: scars). Ulcers and scars were Located on the regions of sacrum, ischial tuberosity, greater trochanter, heel and others.
The graphs of body pressure were stained on supine and sitting positions on 51 cases, In order to calculate the body pressure, wet lints containing same weight of 10% FeCl₃ solution were inserted under the papers, and pressed papers by body for 10 minutes and papers were stained with 0.2% Na₄SCN solution.
In comparison with 9 cases of pressure graphs of healthy body, stained points were all the same, but stained area pressed by the bodies of paraplegics were larger and lighter than healthy bodies.

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The process of reaction in triosorb test is represented in the following equation.
SpU … sponge uptake
A … ability of the sponge to take triosorb
B … ability of TBP to take triosorb
The nomogram to correct the sponge uptake in according with the standard value of each triosorb kit is designed on this equation. (Fig. 6 )
Sponge uptake by the deficient quantity of serum may be corrected approximately with this nomogram. But the corrected values are usually less than the corresponded sponge uptakes by the regular quantity (1. Qml) of serum. This deviation is due to the dissociation of the TBP-Th combination.
Ten times diluted samples of serum are inspected concurrently with regular quantity of respectively same samples. Inquiries about the measurements on each pair of samples may inform the cause of abnormal value of sponge uptake, hypo thyroxinaemia or hyper-TBP-aemia.

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One hundred and four cases of traumatic cranio-cervical syndrome were treated in the Orthopedic Department of Tosei National Hospital in the period from January, 1967 through September, 1968.
These 104 cases were analyzed in a view point of pressure tenderness of the cervical muscles, especially of sternocleidomastoid and scalenus anticus muscle, which showed significance for severity and prognosis of the traumatic cranio-cervical syndrome.
Two cases reported here, presented typical scalenus anticus syndrome and cured dramatically by scalenotomy.
1) Pressure tenderness on the scalenus anticus muscle was more frequent on the left than the right side (22:10).
2) Most onset of pressure tenderness of the sternocleidomastoid was on the same day of trauma.
On the other hand, tenderness of the scalenus anticus started mainly on the fourth day of trauma.
These traumatoonset of tenderness time relations suggest the tenderness of the sternocleidomastoid is most likely due to its primary injury and the tenderness of the scalenus anticus isdue to secondary muscle spasm caused by nerve root irritation.
3) Most of the cases with tender sternocleidomastoid did not show early recovery. About a half of cases without tenderness of the muscle showed early recovery but on the other hand some of these, also, showed much prolonged course. Most of the cases with tender scalenus anticus showed prolonged course and the cases without tenderness showed early recovery.
As a conclusion, it is emphasized that a great attention should be paid to injury of cervical muscles when traumatic cranio-cervical syndrome is dealt with.

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We presented a follow up study of thirteen patients with cervical discopathy and arthrosis in whiplash injuries operated on by anterior cervical fusion. Operation was performed at average eleven weeks after injury. Length of follow up was between 24 and 8 months.
We had obtained good result in about 70 percent of patients.
The indication of operation was limited to radiculopathy or myelopathy caused by disc degeneration.

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We were investigated 48 cases of so-called whiplash injury after settlement of indemnity.
14 cases showed recovery and 34 cases had residual complaints before indemnity.
After the settlement of indemnity, some patients recovered and many patients had some minor complaints.
We considered in this investigation, chronic symptom of whiplash injury consists of psychosomatic factor and emotional factor, especially those concerning monetary compensation.

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In the previous reports, the authors showed that the serum concentration of free INH and the amount of free INH in urine increased in the case of administration of INH with sulfisoxazol than INH only.
The experiments in vitro and in vivo was tried in order to make those cause clear.
In vitro: When 0.02 M solution of INH and sodium pyruvate reacted at 37°C, pH 7.4 in 0.001 M phosphate buffer, the formation of pyruvic acid isonicotinoyl hydrazon was decreased if SF were mixed in its reaction system.
In vivo: The INH metabolites in urine, which was excreted till 6 hours after administration of INH only or INH with SF to healthy persons, were separated and determined. Free INH and isonicotinic acid were increased and hydrazone type INH (HZ-INH) was decreased considerably but N-isonicotinoyl-N'-acetylhydrazin (INH-Ac) was not decreased when INH
was used with SF. Long acting SF had those effects on INH considerably and the effects of SF on slow inactivator type was greater than rapid inactivator type.
From those experiments, the authors know that the cause of increase of free INH by concomitant administration of SF was not that SF prevented the acetylation of INH which had been thought till now, but that SF prevented the formation of HZ-INH, and that the transformation into hydrazone of INH was not enzymolysis but chemical reaction except the conjugation with glucuronic acid.

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Minimal inhibitory concentration of isoxazole to the growth of the strains isolated from sputa of pulmonary tuberculous patients treated with it was higher than those of other sulfonamides in the reported experiment.
An experiment was done on the strains isolated from sputa of pulmonary tuberculous patients who were excreting tuberculous bacilli in spite of the treatment with specific sulfonamides for a long time. Media used were 1% Ogawa's egg slant and Kirchner's semi-liquid agar media with albumin at the rate of 10%.
The cross resistance and the power to Myc, tuberculosis were compared between sulfonamides already used and those never used in a correlation diagram and a histogram of minimal inhibitory concentration to the growth of Myc, tuberculosis at 3 weeks culture.
14 strains isolated from the sputa of pulmonary tuberculous patients treated with sulfisoxazole, 7 strains isolated from those treated with sulfamonomethoxin, 3 strains isolated from those treated with sulfadimethoxin and, as a control, H₃₇Rv were used.
6 sulfonamides were used, that is, sulfisoxazole, sulfamethizole, sulfamezole, sulfamonomethoxin, sulfadimethoxin and sulfamethomidin.
1) Sulfamonomethoxin was most powerful to strain treated with specific sulfonamides in the used 6 sulfonamides.
2) The cross resistance may exist between different sulfonamides on Myc, tuberculosis, Also the one-way cross resistance between isoxazole and diazin may exist, too.

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By use of thin-layer chromatography, we have investigated the substances formed by chemical reaction at the time of mixing of drugs.
Seventy five kinds of injectable preparation such as hypnotics, sedatives, antipyretics, analgesics, antihistamins, cardiotonics, vitamins and levertonics were chosen as sample drugs for this study, and 298 kinds of mixed solution for the test were prepared by the combination of the said drugs.
The test was carried out partially at 24 National Hospitals. The test was on pH determination, change of appearance and investigation of formed-substance by thin-layer chromatographic method.
Injectable solution was mixed at equal volume, change of appearance was observed at 10 minutes after mixing and then thin-layer chromatography test was carried out. Wakogel B-5 was used as absorbent and various types of solvent for development were adopted according to the combinations of durgs, but the most used solvent was the mixture of n-Butylalcohol,
glacial acetic acid and water at 4 : 1 : 1 mixing ratio.
The most used method for detection was as follows: The thin-layer was irradiated by ultraviolet ray, iodin method was adopted and then coupl
ing development was done according to the cases.
The change of appearance such as discoloration, turbidity, precipitation and crystalization was detected at 25 cases in 298 cases.
At the case of the combination of Isoniazid injection and glucuronic acid injection, change was detected to some extent by thin-layer chromatography, in spite of no appearance change detected by microscopy. It was confirmed that the change was due to Isoniazid-glucuronic acid formed by mixing two kinds of solution.

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We had wished to treat fracturs without the external fixation using the cast, because of avoidance of the complications.
Recently, we could treat fractures with good results using the compression plate by Prof. T. Tamai et al. and the hanging cast method.

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A boy aged 6 years, weighing 17 kg, was admitted to the hospital with chief complaints of severe anaemia and oral pigmentation on 28th February, 1968.
On the admission patches of discrete pigmentation involving the lips, buccal mucosa and lower palpebral conjunctiva were seen. Since gastro-intestinal X-ray series revealed marked hypertrophic gastric mucosa, many polypoid filling defects in the duodenum, jejunum and
ileum, a diagnosis of PEUTZ-JEGHERS' SYNDROME was made. It seems certain that the formation of melanine spots was due to dysfunction of the adrenal gland which was caused by malabsorption of the small intestine occupied by a large number of polyps.
Therefore, examinations of pituitary-adreno-cortical function and intestinal absorption were carried out.
However, D-xylose absorption test and ₁₃₁I-Triolein absorption test failed to reveal accelerated loss of them. None of abnormality of the results concerning pituitary-adreno-cortical function can be made clearly.
He was discharged from the hospital on 17th May, 1968, because he was in extensive nature of the intestinal lesion and also unsuitable indication for surgical therapy.
He is under care of our outpatients clinic to follow the further course of this disease.

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We have protocoled much suggestive 2 cases of gastric cancer which could not be picked up in X-ray examination, but caused general metastasis into lung and bone system.
Those 2 cases were revealed pathologically to be mucogenic cancer.
Of 2 cases, the 1st one was a woman, who carried Kreuckenberg's tumor in both ovarian and most distinct findings on X-ray examination was milliary pattern of lung, which was difficult to diagnose. The stomach, on X-ray examination, showed only a little nisch-like finding at the upper part of stomach.
The 2nd case was a man, and the findings on X-ray were ulcer-formation of stomach and the swelling of both hiliary nodes of lung, moreover he carried osteopetrotic changes in all bone system.
To be instructed through these 2 cases were, the 1st, we must take attention upon general metastasis of gastric cancer, even the findings of stomach is very few, the 2nd, we must first take mind into stomach cancer in woman, when ovarial abnormality is suspicious, the 3 rd, once osteopetrotic changes were picked up we must suspicious upon reactive change due to metastatic change of gastric cancer.

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