The authors studied pathologically on fibrotic changes in the lung tissues from pulmonary tuberculosis patients in regard to clinical characteristics, especially to radiological and physiological findings.
The following results have been obtained:
1) In 122 cases of resected lung specimens, the proliferations of fibrous tissues apart from tuberculous lesions were observed in 79 cases, while those in surroundings and/or within tuberculous lesions were found in 33 cases and no fibrosis were detected in 10 cases.
2) The perivascular type of fibrosis was observed in 29 cases out of 79 cases who had fibrosis in the lungs independent of tuberculous lesions, while cases with the interstitial type were less and those with peribronchial type were least not only in frequency but also in severity.
3) In the lungs of sixteen autopsy cases of pulmonary tuberculosis the fibrosis were also detected in the parts separated from tuberculous lesions, and in six cases the proliferations of fibrous tissues were so advanced and extensive that the fibrosis could be considered as diseases independent of tuberculosis.
4) The cholesterol pneumonia was observed in one case and was considered as a cause of death. The foam cells containing cholesterol particles were found in tissues of 3 necropsied and 8 resected lung specimens, too.
5) The localized shrinkage of lungs and the dislocation of trachea or hilum in chest radiograms were more frequently observed in the cases with perivascular fibrosis than those with other types of fibrosis.
6) The cases who had complained of dyspnea and who had higher respiratory resistance were more frequent in those with radiogram showing localized shrinkage and dislocation of trachea or hilum.
The authors emphasized that the frequent occurences of fibrosis in the lung apart from tuberculous lesions and their predominance of perivascular type should be of considerable clinical importance.

抄録全体を表示

During the last 20 years (1949-1968) we have experienced 47 cases of early gastric cancer which have undergone operative procedure. The frequency of early gastric cancer was 5.2% of the 836 resected gastric cancers during this period. In regards to sex, males are slightly over females: 20 to 17. All cases, except for one case who was found to have the lesion by periodic detailed examination, came to the hospital with some complaints. About 2/3 of their complaints were epigastric aching while being hungry, and other complaints were boating feeling of the stomach after meals, nausea, vomiting and loss of body weight.
The age incidence of early gastric cancer was highest in the fifties and sixties, so that it was almost the same percentage as the advanced cancer. The gastric juice anaylsis revealed hypo- or achlorhydria in group of protruded type, but hyperhydria in the excavated type.
According to the endoscopic classification of early gastric cancer, there were 9 cases of protruded type (I Type), 6 of superficial elevated type (II a Type), 9 of mixed type (II a+II c). And there were 9 cases of superficial depressed type (II c Type), one excavated type (Type III) 12 of mixed type (II c+III). One case was classified as superficial flat type (II b). In these cases there were 25 cases of mucosal cancer (53.6).
As to the location of the lesion, the antrum was the commonest site and most of them were located on the lesser curvature, but 6 cases of protruded type out of the 9 cases was located on the greater curvature. Pathologically allmost all cases showed adenocarcinoma. The lymphnode metastasis was found in 2 cases of the mucosal cancer and 7 cases of the submucosal cancer.
The 3-year survival rate to all cases is 94%, 5-year survival rate 75%. Among these cases the intramucosal cancer gave 100% of 5-year survival rate with favourable result. In spite of detecting early cancer, however, there were 6 cases of death and 5 cases died of recurrence (one case died of other illness). Moreover, by detailed examination of there 5 fetal cases in the depth of its invasion, all cases showed deep penetration of cancer cell into the submucosal layer, and in 3 cases the metastasis of lymphnode was already found at the first operation. Most (4/6) of these fetal cases were of protruded type. In regards to the histological pattern of the mode of tumor into the submucosal layer, carcinoma cells infiltrated diffusely or partly with penetrating growth into the submucosal layer through the muscularis mucosa, which showed destruction such as fragmentation or frayed appearance. It has been assumed that the prognosis was influenced according to these penetrating growth.
It is concluded that there would be the possibility of recurrence of cancer even in the early stage and the need of the careful observation was stressed in these case after operation.

抄録全体を表示

1) Atomic bomb radiation sickness, here I say, is the chain reaction of human body, which was exposed to a large quantity of gammaray in a moment at Hiroshima in 1945. The quantity over the allowance limits of human body means death, and on the contrary, the quantity under the limits produces the biological rational reaction, which leads, after all, to spontaneous recovering.
2) Concerning here described cases, those who were alive over 7 days from the fever attack improved in symptoms. And this improvement did not mean temporal event, but would be the first one step of natural recovering.
3) Those, who died under the almost same exposure conditions, departured from the lives within 5 days after fever attack. And the majority of unfortunate cases died within 30 days after the exposure, and vice versa, the cases who could live over 30 days seemed to be guaranteed of their lives. By the way, under such exposure conditions the death rate was 73%.
4) Crisis phenomenon recognized in the clinical process of atomic bomb radiation sickness seemed to offer an important problem.

抄録全体を表示

We are making a report about the outline of the sequela of head injuries received by battle just before and during the World War II on the basis of summarized data for the 25th commemoration of the sanitorium foundation.
From this report we tried to go into details of how head injuries had been treated in the early days of the war and where and what sort of the operation had been performed, and how many cases were treated. We selected 68 patients who were admitted to pro-visional Tokyo 3rd Army Hospital.
The cases of cephatic trauma were classified into three groups by the periods of war, first one year from 1937 to 1938, second two years from 1939 to 1941, third three years from 1942 to 1945. Moreover we reviewed the medical information of the unit-treatment in conjunction with the army medical school at Tokyo 3rd Army Hospital, and obtained the following results.
1 For the first aid the unit-surgeons had dressed sufferer's injuries with antiseptic bandages before emergencies occurred and they had taken immediate action to save a life.
2 As the war was intense, it was difficult to remove the wounded from the battle field. At that time the treatment by the hospital was a very simple one.
Neurosurgery made the great advances during the intense part of the war forcing surgeons to do so much head surgery.
3 The above operations did not result in bad prognosis.
4 Though very little surgery was performed during the first one year, yet it increased greatly during the next few years and head surgery progressed rapidly.
Especially the army medical school attempted difficult cases and made a great ad-vance.

抄録全体を表示

Complaints related to the respiratory tract and the ventilatory functions of the lung were studied on the students of four middle schools in polluted and non-polluted areas in Sapporo and Muroran in five occasions (two in summer and three in winter) during January, 1966 and January, 1968. Complaints analyzed were cough, sputum, shortness of breathing and wheezing. The ventilatory functions include vital capacity (VC), forced expiratory volume in one seconde (FEV1.0), maximal midexpiratory flow (MMF) and peak flow by the Wright's peak flow meter. The past and family histories were also analyzed. A criteria of Fletcher was used for chronic bronchitis. These data were examined against such factors as body height (classified by every five cm), sex and seasons.
Results: 1) VC, FEV1.0 and MMF were tended to be lower in the polluted than in the non-polluted areas. 2) An occurrence of the obstructive patterns (lower %, FEVI.0 than 79% and MMF than 2.4/sec) was significantly higher in the polluted areas, eventhough seasonal difference in the pulmonary functions was not seen, 3) Symptoms of the respiratory tracts were complained more frequently in the polluted areas. The occurrence of the symptoms in winter was not significantly different in the polluted areas from that in the non-polluted areas in Sapporo, however, it was significantly frequent in Muroran both in winter and summer. 4) 1.5 to 2.4% subjects fitted to the criteria of Fletcher for the chronic bronchitis. 5) A past history of the bronchial asthma was documented from 1.6% in the non-polluted area in Muroran to 4.5% in the polluted area in Sapporo. These two extremes were significantly different.

抄録全体を表示

Clinical statistics for vesical tumor cases, who were treated for 3 years from 1966 through 1968, was discussed.
1) The number of primary vesical tumor cases was 45 in this 3 year period, and it was 1.77% of all out-patients.
There is no difference between male and female, and in occupation.
Age of the most cases was in the sixth decade.
2) The majority of vesical tumor cases had hematuria, pollakiuria and micturition pain, among which hematuria was observed in more than half of the cases.
Eighty percent of these were treated within 1 year after the onset, but 10% of these cases were not treated more than 2 years after the onset.
3) By cystoscopic examination most tumors were detected in the trigone of the bladder.
Seventeen percent of tumors are single and pediculated.
4) Seventy percent of cases were treated surgically and 20% of these were treated with irradiation and chemotherapy.
5) Transitional cell carcinoma, papilloma, cancroid and adenocarcinoma were observed histologically, and especially transitional cell carcinoma was observed in about 50%.

抄録全体を表示

Two cases of metastatic carcinoma of the umbilicus are presented here.
They were hospitalized because of a firm fixed tender nodule of the umbilicus. Abdominal explorations revealed that the primary lesion was the rectum in the first case and the biliary tract in the another.

抄録全体を表示

Incidence of penile fracture is very low. We experienced two cases of penile fracture with very similar clinical episodes. Both patients were 25 years old bachelors without any history of urethritis or periurethritis, who sustained their injuries during manipulation of their erected penis.
Rupture of tunica albuguinea took place at middle of the right side on each instances. Surgical removal of the hematoma and repair of the ruptured portions were performed successfully. Post-operative courses were uneventful without any sequelae.

抄録全体を表示

The pulmonary disease caused by unclassified mycobacteria has been reported in industrial zone where many people worked, but it was not found in rural area, whereas the authors originally found three cases of the disease in NAGANO-ken.
All three patients were male and over forty years old. Two of them have had a chance to inhale a great deal of dust under their circumstances for a long time.
Nonphotochromogen in the culture examination were positive in two of them and scotochromogen in the third case. In all cases roentgenographic findings revealed cavities in their lungs. The susceptibility of unclassified mycobacteria to the antituberculous drugs was much lower than that of human tuberculous bacilli. In the most interesting case human tuberculous bacilli were positive in the culture examination of this sputum. The bacilli were negative in the examination, however, according to the administration of antituberculous drugs for five months. He had the unclassified mycobacteria in his sputum seven months after antituberculous therapy.
We would like to say that in this case the unclassified mycobacteria grew on in the lungs instead of human tuberculous bacilli. That would be, so-called “alternating phenomenon of bacilli”.

抄録全体を表示