We experienced 17 cases, 21 sides of chronic subdural hematoma during the recent 3 years. About those cases, all of them were male, 50 decade was mode in age, mean duration was over 1 month between previous head injury to the initiation of syptoms and 2 months between the head injury to the operative treatment following diagnosis. The operative technique was barr-hole and drainage of the hematoma with satisfactory result on the all cases.
The hematoma content fluid was examind for specific gravity, ash content, water content, osmotic pressure, P, electrophoresis and spectrophotometric curve to ask which value may relate to the process of the hematoma. Among those estimated value, the specific gravity was easy to measure and showed enough satisfactory parallel proportion to the progress of subdural hematoma. The result was as follow: the specific gravity of the content is around 1050, that is about the same as the specific gravity of the total blood in early stage of the hematoma such as earlier than 1 month, and the specific gravity decreases gradually and reachs to around 1025, that is about the same as the specific gravity of the serum in the late stage such as 3 months.
The physical power of expansion of the hematoma is not crystal osmotic pressure but colloid swelling pressure according to the above mentioned estimated value. And besides the physical power, exudation of serum-like component and bleeding from the capsel wall of the hematoma are possibly relate to the expansion.

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A method and clinical results of open heart operation with extracorporeal circulation using the disposable vinyl sheet oxygenator and its tubing sets are described.
Authors operated 70 patients successfully using them under hemodilution with or without small amount of heparinized blood.
This disposable vinyl sheet oxygenator was utilized in many patients for the repair of Fallot's tetralogy and the replacement of artificial valve.
The extracorporeal circulating unit using the disposable vinyl sheet oxygenator is very widely available and deserves further employment.

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Cerebral angiography (CAG) performed on 5 cases of hemiplegia accompanied with mild cloudiness of consciousnes revealed obstruction of the middle cerebral artery.
CAG on one of the 5 cases showed marked arteriosclerosis with incomplete obstruction of the anterior cerebral artery. The general condition as well as the clinical symptoms gradually became aggravated together with hemiplegia, and eventually, death followed. Autopsy revealed obstruction consistent with the CAG finding. On study of the appearance of the obstructed end of the artery in each of the 5 cases, sharp demarcation was noted in 3 cases but 2 cases presented a floccular appearance, which was suggestive of soft thrombi.
Repeated CAG in 1 to 3 months revealed another patency in the 2 cases in which the obstructed end showed a floccular appearance. Their clinical symtcnis were well improved as compared with those of the other cases.
Another one of these cases was a 24-year-old female, who developed the obstruction on the day when oral administration of luteal follicular hormone was started. It is indeterminable whether this drug has caused thrombosis.

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Screening test of diabetes mellitus has been made for all patients with pulmonary tuberculosis, who were hospitalized into 50 or more national sanatoria in the whole country. The tests which were performed four times at intervals of six months indicated that the number of the patients with tuberculosis (TB) and diabetes mellitus (DM) was slightly increasing in such an order as 3.22, 3.5, 3.93 and 4.3%.
In sex distinction, the case number was less in the female but the rate of the serious cases was more to some extent in the female. In the examination of age distribution, the maximum of the number of the patients located in the forties but that in the female deviated to a certain degree toward the elder aged group. The total number of the patients with TB and DM who had been found out by the present authors was 703. The status of these patients, contrary to that of the patients with only DM, was frequently the leptosomatic type. This fact was specific for the tuberculous patients complicated with DM. As for the chance of discovery of the disease, most of the patients were found out by medical examination and a few patients were discovered by their subjective symptoms. This fact indicates that group examination of DM is not yet popularized in our country.
It was clarified from this survey that the patients with TB and DM were followed by serious symptoms, i. e., cavity was found out in a ratio of 71.3% and tubercle bacillus was positively excreted in 52.4%. When DM was found out in the patients with TB, 60% of them had been already treated with secondary drugs.
Tubercle bacilli acquired tolerance rapidly; e. g., in the cases with an administration of SM, 50% of mild cases of DM showed tolerance 9 months after, 50% of moderate cases of DM already demonstrated tolerance 3 months after, and all of severe cases of DM revealed tolerance 6 months after.
It is summarized from these results that the delayed discovery of DM results in the change of tuberculous symtoms to progress, the easy acquirement of tolerance and insufficient effects of antituberculous drugs.
Accordingly, the therapy of tuberculosis should be made with taking account for DM itself or the presence of occult DM. For this purpose, screening test for DM should be repeated. The contol of DM thus found out influences considerably upon progress of TB.
It should be noticeable that many reports of the patients with TB and DM in the advanced nations have indicated that DM preceded TB in the majority of the cases while this survey has demonstrated the reverse consequence.
The cause of death in the patients with TB and DM was due to primarily tuberculosis in our survey, and this fact is different from the results reported by the investigators in other nations.
In observations of 75 patients with TB and DM who were treated with thoracic surgery, it has been clarified that opereative therapy could bring out satisfactory results in patients with TB alone as well as in patients with TB and DM if the operation is performed with adequate procedures at the time that tubercle bacilli have disappeared.
Because adequacy of the control influences fairly on the postoperative prognosis at this time, the close control should be required for postoperative one week.

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From April, 1967 to the middle of 1968, 11 cases of bronchial asthma and the resembled cases with lung tuberculosis and diabetes mellitus etc. were admitted to the internal department, for which the allergen extract ‘Torii’ were applied, and the most of cases show most sensitivities for house dust, but eventually some patients did not show any positive reaction to the material. Besides, we decided the order of reactions of numerous antigens at each patient by the ratios to the control solution reaction. Furthermore we added the result at pediatric department.

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A case, 70-years-old male, retrospectively with typical clinical course of primary hepatoma, however, which was overlooked clinically until late stage, was described.
He was admitted to some other hospital with C. C. of right hypochondralgia which developed about 3 months prior to admission. At that time clinical conclusian stating “No particular abnormality” was drawn from physical findings and laboratory data in which CCF was ++ though. No further study was made for the liver disease.
On his first visit to our hospital, 3 months later the above described admission, a pretty large tumor nodule locating at the dome of right lobe of the liver was found by chest x-ray. He was given combined chemotherapy with Mitomycin C, Chromomycin A₃, and 5 Fluorouracil. No response to chemotherapy was noted. On the 69th hospital day, about 7 months from initial symptom, he died. At autopsy, bleeding into peritoneal cavity from metastatic foci in the peritoneum, due to primary hepatoma with portal liver cirrhosis was confirmed.

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Idiopathic dilatation of the common bile duct has been consideredas very rare disease, since Vater first reportedin 1723.
In this country, however, it has been frequently encountered. Two hundred and forty two operations were performed on the biliary tract at the Kure National Hospital, Hiroshima, from Jan. 1, 1958 to Dec. 31, 1967, and two patients with this disease were discovered. Outpatients who visited this hospital in the same periods were 121, 770.
The purpose of this paper is to report two cases with idiopathic dilatation of the common bile duct.
Case 1: A male infant, only 4 months of age, complaining of green colored stool and a childhead-sized right abdominal tumor, was admitted for the suspicious retroperitoneal tumor.
The diagnosis had been uncertain before laparotomy. The dilated common bile duct was resected except for the distal portion of this duct for about 3cm., and end-end anastomosis was made between hepatic duct and the rest of common bile duct. Cystic duct was cut-off with gallbladder and anastomosed to the hepatic duct end-side. The gallbladder was fixed to the peritoneum, then a fine vinyl tube was inserted from the surface of the abdominal wall to the duodenum by way of gallbladder, cystic duct, hepatic duct and rest of common bile duct as a external drainage of biliary system. This operative procedure had been successfully performed but he died of biliary peritonitis due to opening of the anastomosed wound between hepatic duct and common duct.
Case 2: A girl, 4 years and 9 months of age, complained of jaundice, right abdominal mass and slight tenderness of the upper abdomen. Laboratory data showed an obstructive jaundice and moderate anemia. Cholecystogram was negative, however, she was stronly suspected as an idiopathic dilatation of the common bile duct from these typical clinical symptoms. The diagnosis was confirmed at laparotomy, and side-side choledocho-duodenostomy was performed. Her postoperative course was uneventful and discharged after 21 days.

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