For several years the bone marrow functions have been studied by using rabbits by Ito's new methods.
Materials and methods
Female rabbits, weighing 2, 500 to 3, 000g, were used.
1. The rabbits were affected by infections, phlebotomy, hemolysis, splenectomy, steroid hormon administration and so on.
2. After placing a polyvinyl catheter into the nutrient vein of the femur, the
rabbits were affected by phlebotomy, hemolysis, steroid hormon administration or I.V. adrenalin and then the release of blood cells were studied.
3. Blood samples were obtained from the nutrient vein of the femur of the rabbits treated with ⁵⁹Fe and ferrokinetics were studied.
4. Blood samples obtained from the nutrient vein of the femur of the rabbits with infection were incubated in vitro for 1 to 5 hours with ⁵⁹Fe or ³H-thymidine, and examined with microradioautographic technics.
5. After injection of indian ink into the femur bone marrow of one side or Coirradiation ³H-thymdine was administered intravenously to the rabbits, and blood samples obtained from the bilateral femur bone marrows were examined with microradioautographic technics.
The patients with infection (pulmonary abscess, pueumonia) and blood disease (leu-kemia, iron deficiency anemia, polycythemia, pernicious anemia, idiopathic thrombopenic purpura) comprised the substance of this study.
Bone marrow aspirates obtained from the patients were incubated in vitro for a short time with ⁵⁹Fe or ³H-thymidine, and the grain counts of labeled cells were examined.
The results of this experimental study differed from those of the clinical studies. These results suggest that the blood cells issuing from the bone marrow under morbid conditions alter while they circulate through the whole body.
From this study some possibilities of the alterations of the hemopoiesis and the release of blood cells under morbid conditions were discussed.

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For the purpose of esophageal anastomosis, we have produced a joining tube by way of the soluble material which was cutgut. In conformity with the basic studies of animals, we applied this method on clinical cases.
Our joining tube remained just as it is, in seventh or tenth days postoperatively at the position of anastomosis, but for tenth or fourteenth days it was transformed and moved to the lower intestine, and finally melted away.
We believe that our method is very successful, as that is never to occur the suture failure at the anastomosed segment of the esophagus, therefore oral administration is possible from the first or the second postoperatively without any anxiety.
We feel that our operative technique is most simple and trustworthy.

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Antibodies produced by inoculation of attenuated live measles vaccine were analyzed by sucrose density gradient centrifugation. When live vaccine was inoculated one month after inoculation of killed vaccine with one dose, 19S antibody was clearly demonstrated on the 18 days and on the 27 days after inoculation of live vaccine, but not on the 54 days. Antibody activity in 7S fraction was not dominant on the 18 days but increased predominantly on the 27 days. These antibody responses were quite similar to those of natural measles.

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This study was based on an analysis of 126 consecutive cases of newborns and infants under one year of age with diseases of the alimentary tracts, and they were treated surgically at the Sagamihara National. Hospital from January, 1960 to August, 1968. There were 26 post-operative deaths in this series (a mortality rate of 20.6 per cent). Of the 126patients, 27 were newborns, 99 infants under one year of age, 9 prematures, 90 boys and 36 girls. The mortality rate for newborns was 48.1 per cent, for infants under one year of age 13.1 per cent, for premature 44.4 per cent, for boys 16.7 per cent and for girls 30.6 per cent.
In the 47 patients (37.3 per cent) who underwent operations for the intussussception, there were 6 deaths, or a mortality rate of 12.8 per cent. There have been no cases in newborns, only 2 cases between the ages of 2 and 3 months and 45 cases (95.7 per cent) over 4 months of age. The seasonal incidence was found lesser in May to August, summer than the others. The vomiting and nausea were noted in 93.6 per cent of the total cases, bloody and blood mucous stool in 89.4 per cent, ill-humour and crying in 59.6 per cent and pale face in 17.0 per cent. An abdominal mass was palpated in 76.6 per cent. In the 3 cases out of 6 deaths marked abdominal distention was seen. In 24 patients (51.5 per cent) there was a swelling in the ileocecal mesenteric lymph nodes at laparotomy. According to the intestinal segments involved, there were 40 cases (85.1 per cent), of ileocecal type, 3 cases (6.4 per cent) of ileoceeal, 3 cases (6.4 per cent) of ileoileocecal and 1 case (2.1 per cent) of sigmosigmoid. There have been no deaths in 10 patients whose symptoms were of 12 hours duration or less prior to surgery, 13 cases between 13 and 24 hours duration with 1 death, 16 cases between 25 and 48 hours duration with 2 deaths, 4 cases between 49 and 72 hours duration with 3 deaths, 3 cases over 73 hours duration with no deaths and 1 case unspecified time.
In the 42 patients who underwent pyloromyotomy for congenital pyloric stenosis, there were 4 deaths, or a mortality rate of 9.5 per cent. There have been 3 cases with no deaths in newborns, 39 cases with 4 deaths in infants, 5 cases with 2 deaths in prematures, 33 cases with 3 deaths in boys and 9 cases with 1 death in girls. In all cases projectile vomiting was noted. An abdominal mass was palpated in 81.0 per cent. A coffeeground vomitus was observed in 35.7 per cent and jaundice in 4.8 per cent. One patient had vomited from birth, 4 patients had symptoms beginning from birth to the seventh days of life, 12 patients between the ages of 1 and 2 weeks, and 32 patients (76.2 per cent) between the ages of 1 and 4 weeks. The age of patients at the time of admission to our hospital for treatment of congenital pyloric stenosis was between the ages of 3 and 4 weeks in 9 patients and between the ages of 3 and 7 weeks in 27 patients (64.3 per cent). Eight patients (19.0 per cent) were operated upon between the age of 5 to 6 weeks. But the age of patients at the time of admission and operation were marked dispersedly. Eleven point nine per cent of the patients of congenital pyloric stenosis weighed under 2, 500 grams at birth, 16.7 per cent weighed between 2, 500 and 3, 000 grams, 47.4 per cent weighed between 3, 000 and 3, 500 grams and 16.7 per cent weighed over 3, 500 grams. As compared birth weight with weight at the time of operation, 35.7 per cent of the patients lost weight, 2.4 per cent unchanged, and 61.9 per cent gained weight. At the time of operation the patients of 16.7 per cent had no oral feedings, 61.9 per cent was given under 30 cubic centimeters of the amount of oral feedings each time, and 76.2 per cent under 5p cubic centimeters. By the time of their discharge from our hospital, they were usually taking 60 or more cubic centimeters every 3 hours.

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Primary cancers of the liver were examined clinically and pathologically on about 22 autopsy cases. Out of these 22 cases, 18 cases were hepatomas combining with cirrhosis of the liver in 9 cases and 4 cases were cholangiocarcinomas showing no cirrhotic changes.
Regarding to clinical symptoms of these 22 cases, 12 patients had fever and ascites was observed on 16 patients in which bloody ascites was proved in 10 cases. Jaundice also appeared on 16 patients. Abdominal pain was severe in patients who had remarkable hemorrhage and necrosis of the liver and these were no distinct relations between ab-dominal pain and weight of the liver, extension and metastasis of the tumor. Ascites was remarkable in cases which had pressure or obstruction around the porta hepatis and cirrhosis of the liver. Bloody ascites was mainly observed in cases which had liver weighed over 2, 500 grams or in cases which had very extensive tumors. Also all cases that had ascites and died within a month showed bloody ascites. Jaundice was not so remarkable in cases which pressed on porta hepatis but was remarkable in cases which had extensive tumor invasion in the liver. In the cases that showed jaundice, depositions of bile pigments were eminently seen in liver cells and the aspects which were suggestion of the secretion of bile pigments by tumor cells were observed partly. High fevE r appeared in cases which had marked infiltration of leukocytes combined with infection, hemorrhage and necrosis of the liver. Antibiotics were not effective in the most of caves which had slight fever under 38°C and had little complication of infection.

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It is said that there are many hepatomas arising from liver cirrhosis. We collect 20 cases of hepatomas and made a study of liver tissues pathologically.
The following results were obtained.
1. By Dr. Miyake classification, A type 1, B' type 5, B type 12 and 2 cases have no liver changes,
2. In the neighbouring area of the hepatoma, pathological changes; fatty degeneration, necrosis, icterus, tumorous thrombosis, hemorrhage, diffuse fibresis, are strcner than in the separated one from the hepatoma.
3. We can see two cases of hepatoma in which liver cirrhosis cell translate into tumor cells.
4. It is necessary that we make a large specimen of liver tissue for this study.

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Authors demonstrated two cases of severe hepatic injury successfully operated in Iwakuni National Hospital and offered discussion about operative method. The operative technique applied to these two cases were following.
Case 1. 19-years-old male
The hepatic wound was at diphragmatic surface of the liver. Even after hepatic suture, considerable hepatic bleeding was continued so persistently that gauze was packed between diaphragm and liver. Hemorrhage was well controlled and the patient was discharged on the 86th hospital day.
Case 2. 11-years-old male.
Following debridement of hepatic wound, dacron prothesis was placed at the wound edge and mattress suture was performed along the prothesis with chromic cut- gut. The patient was discharged on the 90th hospital day.
To determine the early accurate diagnosis of hepetic injury, authors emphasized the effectiveness of early abdominal paracanthesis and liver function test, especially of GOT, GPT and LDH.
Some technical devices of hepatic suture are stated in literatures and here by authors but if the suture is impossible because of hepatic tissue damage is serious, hepatic resection should be preferable.

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As the priming blood, blood from the hospital blood bank was utilized on 40 cases of 46 patients of congenital heart disease at the open heart surgery. Examination of liver function, such as bilirubin index, S-GOT and S-GPT, was carried out at the time of preperfusion and followed up every 2 weeks until 24 weeks of post perfusion. The blood of a person with a history of liver disease or jaundice was excluded in this study. The donor was examined on the agglutination test of syphylis and S-GOT as screening. As a result, the occurence of liver dysfunction indicated 23. 9%, although it was moderately high average, but they were all latent in clinically.
As attempt to banishing “yellow blood”, promotion of system of blood bank and volunteer in Japan has a great significance. But on a point of view of serum hepatitis or liver dysfunction, it seemed to be a limit of prophylactic plan.

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Percutaneous transhepatic cholangiographies were carried out 35 times on 30 cases, in which cholangiographies were obtained 24 times on 20 cases, at the 2nd Tokyo National Hospital from June, 1967 up to September, 1968. This report is the result of comparative study of each contrast medium, i. e.: Conray, Conraxin L, Urograf in, Urovison and Biligrafin. The former four consist of sodium salt, methylglucamine salt of their mixture of various derivatives of triiodobenzoic acid, which has 3 iodines in a molecule, and the latter one, methylglucamine salt of adipin-diamino-triiodobenzoic acid, which has 6 icdir.es in a molecule.
Basic experiments were aimed to compare easiness of mixing with bile, clearness of radiolucency in interposition of biliary stones and ability of making contrast in narrow tube by these contrast media. Clinically, the following points were studied in practical FTC examinations; the clearness of contrast in intrahepatic ducts, radiolucency in a case of biliary stone, presence of fluid level between contrast medium and bile, the side effect and so on.
The result suggested that Biligrafin was better to distinguish in a case of biliary stone and the others were more excellent to find out abnormalities of intrahepatic ducts and common duct. All of them were not satisfactory in mixibility with bile. Any troublesome side effect did not occur in each contrast medium.

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A 16-years-old female patient was admittted to the Iwakuni National Hospital for the evaluation of undergrown condition. Physical examination disclosed mental retardation, webbed neck, cardiac enlargement and dislocation of hip joint. Endocrinological examination showed diabetes mellitus and adreno-ovarial hypof unction. Chromatin number was 46 with XX sex chromatin. Hepatosplenomegaly was increased in spite of diet therapy, while clinical improvement was gradually appeared, but sudden death of unknown reason occured when she took a walk.
Based on clinical course and autopsy findings suggested that Mosaicism is a possible explanation.

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Four cases of testicular tumor were reported and the summary of them are as table below.

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1) We have experienced nine cases of leukemia in two years and a half from 1966 to 1968 at Kochi National Hospital.
Seven of these cases were acute leukemia, consisted of six myelogenous cases and one lymphogenous, and they all died.
Two out of nine cases were chronic leukemia, one of which was a child who has attended school in good health in past three years.
2) Acute leukemic cases showed a tendency to afflict young and middle-aged.
3) Young-aged patients complained of pain more than the other age cases.
4) Three out of seven acute cases showed no sign of leukemia at the first medical examination by us.
5) Concerning the thrapy, many kinds of drug and fresh blood-transfusion wree used to relief the symptoms and to prolong the course of the disease.
6) Most of cases died of bleeding and circulatory insufficiency.

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Two cases of spontaneous fracture of tarsal bone in leprosy are reported.
The cause of these fractures is supposed to be due to secondary bone atrophy following non-weight bearing.
Regarding symptom, it begins with local warmth and swelling of the ankle without inducement.
Immobilization in plaster cast gives favorable results, but cannot avoid the development of the deformity of tarsal bone. It may be that unless early diagnosis and immobilization are made, the condition may gradually develop Charcot's joint.
Finally, it seems to be necessary to pay attention to the treatment after operation of the foot and the immobilization in plaster cast for tarsal fracture in leprosy.

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