Despite of the progress made in surgical treatment of brain tumors as a whole, certain malignant tumors, such as glioblastoma multiforme and medulloblastoma, still defy the most refined surgical skill, claiming 80% mortality within a few years of operation and almost 100% in five years.
Resection of as much tumor tissue as possible followed by irradiation is the commonly practiced method of treatment for these tumors. Some newer developments in the treatment have been reported but these are at present either limited to a few institutions epuipped with special instruments or only in their experimental stages. Boron-neutron capture therapy, immunotherapy and BAR therapy fall in this category.
In an attempt to improve the efficacy of post-operative irradiation therapy within the framework of available facilities, an increase in dosage with the use of the linear accelerator and implantation of radon seeds at the site of the tumor resection have been studied in our series. Conventional irradiation plans call for a daily dose of 100 to 150 R, that is 600 to 900 R per week and a total of 6, 000 R in eight to nine weeks. With the use of the linear accelerator, larger daily dosage, up to 300 R, can be delivered without increased hazard or discomfort to the patient, owing to its greater precision and higher output. Enhanced therapeutic efficacy has been impressive in all 23 patients with malignant brain tumors, as compared with that of the conventional therapy with ⁶⁰Co. while total dose of up to 10, 000 R seems to be well tolerated without serious hematopoietic or hepatic disorders in these patients, further study to define an acceptable maximum dosage and optimal spacing of the irradiation schedule, rather than daily treatment, is clearly needed. Implantation of radon seeds at the site of resection of the tumor was carried out in 9 patients in whom conventional irradiation therapy using ⁶⁰Co was suspected to be hopelessly inadequate. The results were disappointing because the number of the seeds required to assure destruction of the remaining tumor was often exorbitant in contrast to the space available for implantation. Unless combined with post-operative external irradiation, the implantation offers little practical therapeutic efficacy. Incidental advantage of the planted seeds was found in that they serve as a convenient guide marker in following up the growth of the tumor on plain skull films.

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We have 5 cases of cavitary cancer with surgical operation, with 4 cases were primary lesions at chest X-ray and one case was found by bronchogram.
They were all squamous cell carcinoma, and received lobektomy.
The incidence in number, size, thickness of cavitary lesions, histological type, symptom, laboratory data and mechanism of cavitation were described and disscussed their relationships.

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The emergency medical care for children has been considered important and recently the premature medical care has been added on the emergency medical care. But the situation of the emergency medical care for children is not sufficient now. I would like to report the research of 40 national hospitals on this problem.
1. The number of pediatrician in each national hospital is so few that the emergency medical care system for children is not sufficient. Pediatricians can not be kept on duty in every night or holidays.
2. The admitting capacity for premature infants is so small and the number of doctor and nurse is so few, that the premature infants from other hospitals are not permitted to enter the national hospital. It is also necessary to make emergency system for bilirubin measurement and blood exchange.
On these situation, we can consider the following articles.
1. It is necessary to establish clearly the role of the national hospitals and to make the planning for emergency medical care.
2. By making the cooperation between several hospitals, we may establish the emergency medical care system.
3. It is desirable to establish the emergency medical care center and to increase the number of premature medical center.
4. It is desirable to increase the number of doctor and nurse for children.
3. It is important to increase the role of pediatric education both on the undergraduate and the postgraduate education.
6. It is desirable to improve the health insurance to promote the children's welfare.

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The total cases reported from the all study units in 1970 (as the IInd year of this project) was 110 and they were consisted of 76 cases of group A (definite cases), 27 cases of group B (suspicious cases) and 7 cases of group C (ruled out cases) according to the classified standard of our project team.
The report from the epidemiological section
Females are more frequently affected than the males in the ratio of about 2.7 to 1. Many cases had been suffering from intense abdominal aching in group A, while less frequently noted in group B and C. There was only one case presented abdominal symptom at the same time within the same family.
About the roll of Quinoform administration, 58% of group A, 46% of group B and 43% of group C received Quinoform definitely, while 9% of group A, 19% of group B and 43% of group C never had Quinoform.
The report from the clinical section
Fourty seven % of them were treated by adreno-cortico steroids, massive doses of nicotinic acid with A. T. P. and vitamins, by which there was improvement in 73% of the sensory impairment, 75% of the motor weakness and 30% of the impaired visual acuity.
On the amelioration of neurological symptom, it was apparently better in the cases under the fourth decade than the above, and in the cases started treatment at the early period than the late stadium.
Fifty cases had been taking Quinoform even after the onset of illness, and they were 44 improved, 2 unchanged, 4 died and 7 relapsed. Among them 16 cases received Quinoform for a long period after the onset with 14 improvement and 2 deaths, 2 cases had once a while with one improvement and one unchanged, 32 cases had had for a short term with 29 improvement, one unchanged, 2 relapse and 2 deaths. The causes of death were one myocardial infarction, one carcinoma of the uterus, one Banti's syndrome and one unknown.
Nineteen cases never had Quinoform after the onset of illness, and all of them improved but 2 relapsed.
Fourteen cases were unreliable about taking Quinoform after the onset, among them 13 improved and one progressed.
According to the psychological test by C. M. I., there were many psychoneurotic cases in group A.
The report from the bacteriological and serological sections
There were some differences between the distributions of the fecal flora on SMON patients and normal individuals. The sequential observations of fecal flora should be carried out in future, considering the dietary; sexual, aging and others' effects on the fecal flora.
The agglutinating antibody titers in SMON patients against Salmonella meleagridis were evaluated higher than those of non-SMON patients, in a certain stage of the disease. This fact would be directly unrelated to the ethiology of SMON, but considered as host response in SMON patients,
The report from the virological section
Serological investigations on viruses were concentrated to the detection of complement fixing antibodies, hemagglutination inhibiting antibodies against Polio 1, 2, 3 type, ECHO, Coxsackie A, B, Adeno, Mumps, Herpes and JBE viruses. The neutralizing antibodies (NT) and the neutralizing antibodies requiring complement (C'NT) against ECHO 21 type were examined. Generally speaking, the serologically significant results were not obtained and there were no cases which showed significant increase of NT and C'NT antibody titers. The isolation of viruses from feces, spinal fluid, throat swab was negative in any cases.

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Eighty two cases of the severe double handicapped juvenile patients were examined by use of percutaneous carotid angiography in this institute. Although this procedure was considered to be difficult for such handicapped patients, authors would emphasize that the procedure is not only a very useful techique for diagnosis but also quite safe when performed carefully.
The method of anesthesia and practical technique in our clinic were described and the complication was discussed, and three interesting cases were presented in detail.

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The author reported a case of solitary polyposis of the colon of a ten-year-old girl. As she had been complaining for a year of severe diarrhea and a pain in the left lower quadrant of the abdomen on bowel movement, she admitted to the Kasumigaura National Hospital on May 7, 1968. Clinical manifestations showed anemia and a tumor in the lower abdominal quadrant. Barium enema revealed incomplete obstruction of the sigmoid colon with polyposis. Exploratory laparotomy performed on May 31, 1968, revealed numerous polyps of the colon and formation of double intussusception in the sigmoid colon. The sigmoid colon with polyps was then resected in order to eliminate the cause of intussusception and an end-to-end anastomosis was performed. Pathologic examinations showed that one of these polyps was adenocarcinoma. She had several episodes of intussusception caused by polyps of the remaining colon even after surgery, and she underwent subtotal colectomy and ileorectal anastomosis at last on May 21, 1970. She was discharged from the hospital on July 20, 1970 without any remaining evidence of malignancy. Diagnosis of this disease is considered to be difficult in the childhood unless it induces the symptoms of ileus.

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The outpatients who visited to the urological department of Atami National Hospital in 1970 were 818 with 423 males and 395 females.
The inpatients were 140 with 103 males and 37 females.
The operations were 156.

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