Recently science has been making the rapid strides which are also giving an important roll for the medicine.
To diagnose and cure or prevent difficult diseases, such as neoplasma, vascular damages, metabolic or hereditary ones, we must utilize in maximum many new methodologies and electronics system from wide angles.
Accordingly our laboratories should make an effort to develope or progress in new fields, and the test or research works increase vastly every year in both quantity and quality.
For the dissolution of those difficult problems, we must consider the best plans which are promoting forward our laboratories and then bring into practice.
With this view, I would like to point out several following practical plans or conclusions throughout my relatively long experiences in laboratory works and the co-operative studies on clinical pathology in National Hospital Section:
1. All clinical laboratories in national hospitals and sanatoriums should have the ideal organization which shows harmonious differentiation and centralization, in accordance with progress of science and medicine.
2. Laboratory activities must advance to operation quarter and patient wards, and set up duty system for emergency laboratory.
3. It is necessary to build national central institute for clinical pathology with well-organized laboratory net-work system of all allied organisms, including private ones.
4. Each regional central laboratory should apply so-called collecting testing material system to expect good effectiveness in laboratory jobs, and computer attempting to do information storage, quality control, retrieval and operations research.
5. As early as possible, we hope to have a qualified doctor's system, such as clinical pathologist and anatomical one, in the education and training programs of national hospitals and sanatoriums.

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Forty four patients with mitral stenosis with minimal or without regurgitation were used as the material. They were divided into four groups according to their preoperative mean pulmonary arterial pressures. Frank vectorcardiograms were recorded before and one month after transatrial mitral commissurotomy.
The postoperative changes in VCG were as follows: In the groups with absent (less than 20 mmHg) and minimal (20 to 34 mmHg) pulmonary hypertension, the leftward components of the 0.03-second, 0.04-second and maximal QRS vectors were significantly increased. The spatial magnitudes of these vectors were increased without significant changes in the azymuth and elevation angles. In the groups with moderate (35 to 54 mmHg) and severe (55 mmHg or more) pulmonary hypertension, the leftward components of the 0.02-second, 0.03-second, 0.04-second and maximal QRS vectors were significantly increased. The spatial magnitudes of these vectors were increased. The azymuth angles showed that these vectors became to point more leftwards while the elevation angles did not show significant alterations. The maximum posterior and rightward components were significantly decreased.
The hemodynamic improvement owing to the operation was well manifested to VCG within a relatively short period postoperatively.

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Three cases of chronic cholesterol pneumonitis were experienced in the Okura National Hospital in the years from 1963 to 1967. They were Japanese male and aged 34, 39 and 47 years old. Initial complaints were fever and persistent hemosputum. The chest rentgenograms revealed that diffuse opacity of the lungs increased subacutely in the course of the disease in two cases but in one case it remained stationary. Laboratory findings showed anemia, increased serum gamma globulin and moderately reduced A/G ratio. One of them was remarkably severe. He was admitted to this hospital three weeks after the onset of preceding fever and hemosputum which continued until his death. The right middle and lower lobe lobectomy was performed two month after admission and enough amount of antibiotics were given. He expired by sudden massive hemoptysis. In this case the pulmonary vein (r V 3) was ruptured and right pleural cavity was filled with blood.
Other two cases recoverd well after the operation, one by middle lobe lobectomy and another by pneumonectomy.
The bacteriological examination of sputum or discharge from the resected specimens revealed no predominant causative bacteria and fungus.
In general pathological examinations of the affected lesions showed pneumonic consolidation of lung tissue with the diffuse discoloration of bright golden yellow on cut surface and partial necrosis in all cases. Golden yellow discolored pneumonic lesions were composed of fibrous thickening of alveolar septa involving moderate lymphocytic infiltration and aggregation of histiocytes. Alveolar lumina were filled with innumerable foamy macrophages which contained lipid substance, showing bright with oil-red staining, bluish gray with Baker's phospholipid staining and double refraction by Nicol's prism.
The necrotizing area of pneumonic lesion were found closed to the obstructive and suppurant bronchitis with the destruction of the wall and surrounding parenchyma.
These findings suggested that the disease began with the proliferative alveolitis followed by the appearance of lipid laden macrophages in the alveolar lumina. Cholesterol pneumonitis was accomplished and later replaced by dense fibrous tissue with time, but the obstructive bronchitis led to the destruction of pneumonic lesion as a secondary affection.
The pathogenesis of this disease is still open question, but it is likely that the bacteria would be excluded from the pathogenesis of the disease.

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A total of thirty cases of early gastric cancer has been treated in the Surgical Department during the seven year period from 1962 through 1968. That is 11.8 per cent of the resected gastric cancer (254 cases) and 3.8% of all gastric resections (799 cases).
Age of the patients ranged from 20 to 70. Male patient predominated over female in a ratio of 2 to 1 (21 to 9). All the female patients were in the younger age group.
The breakdown according to the types of the lesion was as follows:
Protruding or superficial protruding type 6 Concaving or superficial concaving type 21 Superficial protruding with concaving or
superficial concaving type 3 Site of lesion: C (proximal one-third) 0 M (middle one-third) 21
A (distal one-third) 9 Depth of invasion: Infiltration limited to mucous membrane 20 Infiltration invading submucosa 10 Lymph node metastasis: Positive in Group-I nodes in 3 cases.
Follow-up: All 30 patients are on follow-up study up to Aug. 1, 1969. Six patients who had operation five or more years ago are alive so that it makes five-year survival 100 per cent. Of the remaining 24, four died of causes other than cancer, one died of the operation itself on 5th post-operative day. Another patient died of unknown cause, therefore classified as dying of cancer according to the General Rules for the Gastric Cancer Study in Surgery and Pathology edited by Japanese Research Society for Gastric Cancer.
The type or site of the lesion or depth of invasion seemed not to make any difference. One of these patients survived over 5 years despite lymph node metastasis confirmed microscopically.
Because of the nature of the disease and its prevalence in older age group, the critical study of those patients who develop recurrence of the malignancy deserves as much or even more consideration as the five-year survival rate.

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The combination effect of hydroxyzine with pentazocine which is non-narcotic analgesics, was also examined. The comparison was made among the three drug groups taking the duration of analgesic effect as the index for judging the effect. These are (A) combination of pentazocine 30 mg with hydroxyzine 2 mg/kg, (B) pentazocine 15 mg with hydroxyzine 2 mg/kg and (C) pentazocine 15 mg alone. In the former studies, the mean times were compared for judging the effect, while in this case, the judgement was made as the followings. Patients responses were taken, and failure or no effect means the effect is shorter than 12 hours after operation, and effective is the patients group whose duration is longer than 12 hours after operation. The numbers of cases in these two groups were subjected to analyze Chi square test. As the result, it was found that no significant difference between the two of combination drug groups of pentazocine 30 mg and 15 mg with hydroxyzine. However the significant difference at P<0.01 was observed between the combination drug groups and pentazocine alone.

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The patients who were consulted and/or treated at the Urological Department in Atami National Hospital during 16 months from March, 1969 through June, 1970 were statistically analysed.
The total number of outpatients was 950 with 528 males and 422 females.
The total number of inpatients was 173.
The total number of operations was 170.

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A case of the leiomyogenic sarcoma from the gallbladder in a 53-years-old woman was reported.
She was admitted to our department with the complaints of the right upper quadrant abdominal pain, want of appetite and emaciation. In the right upper quadrant, goose-egg, painful tumor was palpated.
As the result of several clinical and laboratory examinations, a diagnosis of the primary cancer of gallbladder was made and operation was performed.
The gallbladder was greatly enlarged and consistent as like as cancer, and cholecystectomy was done. The metastasis to the liver, the lymphnodes and the other sites could not be found and there was no stone in the bladder or the biliary ducts.
Microscopic sections taken from the tumor, showed the leiomyogenic sarcoma.
6 months after the operation, she died from the liver metastasis of the relapsed sarcoma.

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