A hospital system is proposed to accomplish a reasonable information communicating network among a group of hospitals. The central core of this system is a district supervising hospital where the district medical data center is located. The hospital is closely connected to a government organization of health and welfare to obtain any important clinical and statistical informations from outside of the district in addition to send any local medical information to the organization. The supervising hospital may be equipped with a larger computer to acquire and to process local medical data from its satellite hospitals. These satellite hospitals may be ordinary general hospitals, teaching hospitals and clinical centers operated by a local association of doctars. The satellites are opened to any patients. Such hospital system is still a dream in present condition of our medical situation in Japan. It is very important to follow such idea, however, when any hospital wants to introduce a computer to improve the operation of the hospital from economical point of view.
Among a considerable number of projects at our department, following data processing techniques are suggested according to the above mentioned concept.
1) Data processings for the improvement of recognition speed.
2) Data processings to compute complicated mathematical processes involved in clinical laboratory measurements.
A colored animation technique of EKG field distribution investigations is a representative example of 1). A data process technique for a dye dilution method with a model functon is suggested for an example of 2).
Pattern recognition in medicine is emphasized as an important factor of automation of hospital. An image processing technique to eliminate unwanted factors (such as position and direction of free cells under microscope) by a new holographic space filters is explained as an example.
Some graphic display techniques are stressed to accelerate the recognition of various symptoms at an instant. These techniques are very important, especially in treatments of cardiac patients, in observation of fetal health during delivery and in many other acute medications.
Difficulties in automatic diagnosis by a computer are emphasized and an objective statistcal method is recommended for the improvement of present condition of this field.

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Sulfhemoglobinemia was produced experimentally in rabbits by oral administration of PETHOXYPHENYLUREA (DULCIN) and SULFUR 750mg respectively. Although methemoglobinemia did not occur by DULCIN alone, sulfhemoglobinemia developed in short period by combination with SULFUR. The experiment revealed that sulfhemoglobinemia is more easily produced than rnethemoglobinemia under these condition, Methemoglobin would not be precurser of sulfhemoglobin. DULCIN (in general, aromatic amino- or nitro-compounds, which are thought to be causative chemicals of sulfhemoglobin) would affect and accerelate hemoglobin to react with SULFUR, like a catalyst,
Blood gas analysis of rabbits with experimental sulfhemoglobinemia revealed reduction of O₂ content, O₂ capacity and ₂ saturation. CO₂ content was not changed. Circulating hemoglobin other than su'lfhemoglobin would be changed during development of sulfhemoglobin so as to reduce the combinig power with oxygen under physiological partial pressure.
Marked reticulocytosis was observed in the rabbits with sulfhemoglobin by injection of PHENYLHYDRAZIN HYDROCHLORIDE, Sulfhemoglobin was identified in the reticulocytes.

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A case of vertical nystagmus directed downward is reported with reference to the literature including MLF syndrome.
Case:
A 5D-years-old taximan visited to our clinic in March, 1969, with C. C, of diplopia, which developed suddenly at the night on October 15th, 1968, when he was watching TV with side down position. He had been treated by several doctors but the symptom did'nt clear up, He was admitted to the 2nd Tokyo National Hospital on March 14th, 1969.
Physical examination on admission revealed a well developed well nourished male patient who was alert and cooperative. The blood pressure was 124/82mmHg. The significant neurological findings revealed bilateral ptosis, weakness of lateral gaze on the right, oscillopsia and positive Babinski's sign, Convergence was well preserved, There was no hearing-loss. The equilibrium test revealed no abnormal findings except dissociated nystagmus, i. e.: on direct forward gaze, both eyes had no nystagmus. On attempting conjugate lateral gaze at first horizontal nystagmus was seen, then after ca 15 sec, this horizontal component gradually disappeared but vertical component (downward) became evident in both abducting eyes, whereas in the case of adduction the vertical nystagmus was seen and did'nt change. The nystagmus were recorded by electronystagmography. The optokinetic nystagmus was elicited in both horizontal and vertical directions by projecting a black-white striped pattern rotating from 0°/sec. to 120°/sec. on a halfcylinder screen that nearly fills the visual fields. Optokinetic inversion occured in the horizontal plane. When the optokinetic stimulus directed downward was used, elicited vertical nystagmus was diminished in its degree.
One year after the onset of his illness diplopia cleared up with full ocular movement and vertical nystagmus diminished much.
According to his history both medial rectus palsy was suspected at the onset of illness. We presumed this case was an incomplete type of MLF syndro me due to a vascular lesion in the brain stem.

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Authors reported an interesting case of Takayasu's disease that manifested vertebro-basilar insufficiency.
The case was a 41-year-old woman who had often tonsillitis since young. She complained of frequent episodes of syncope, dizziness, headache and transient visual deficit since the age of 39, and then her radial pulse became faint. Systolic blood pressures were 84mmHg on right arm and 96mmHg on left.
Laboratory findings were as follows; leucocytosis: 14, 600, ESR: 50mm per 60min., ASLO titer: 500 todd, and increased γ-globulin fraction: 20.1%, Both angiographically and surgically, it was confirmed that there were total occlusion of bilateral common carotid and subclavian arteries, the narrowing of left vertebral artery, and furthermore excellent collateral vessels developed in the cervical portion.
On the biopsied examination, we found a degeneration of elastic tissue and mesodermal proliferation in the middle layer of the wall of the common carotid artery.
Of the above mentioned clinical features we discussed in the relation to the special references.

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Diseases of mandibular joint are either abnormalities of joint or its attached muscle.
In the domain of oral surgery, we experience such following symptoms; abnormal movement of mandibular joint, pain, trismus and clicking etc, and we treat them as a syndrome.
Treatments consisted of use of analgesics or antiphlogistic drugs or infusing streroid hormon into joint cavity. Dr. Kraus proposed muscle training method.
We have been experienced 100 cases of mandibular althrosis at Nagoya National Hospital during past three years. On 35 cases of them, we used muscle training method, on the other 35 . ones we used Camalon (muscle relaxant), and on the rest of hem infusional Triamcinolone Acetonide infused into joint cavity.
We report the result.

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1) Confirming Cade's report (1949) on the psychiatric use of lithium, since 1966, enteric coated lithium carbonate tablet (250 milligram) was orally administered to seventy-one manic cases (male 45, female 26, mostly manic-depressive psychosis), Fifty-six of these (78.9%) were improved while no recurrence has got in thirty-five cases (49.3%).
2) In improved cases, without producing sleep, those manic excitement was calmed, those attitude became conciliatorily, and those behaviour properly settled mostly within several days after prescribing lithium carbonate 1, 0-1, 5G./day (about 30-40meq, of lithium ion per day).
3) After being ealmed, lithium carbonate 0.5-0.75G./day has been given 1-3.5 years without marked recurrence of affective illnesses including depression.
4) Referring common unwanted effects and lithium plasma levels, frequent serum lithium estimates are necessary to avoid any untoward symptom or sign which should be carefully evaluated, although most of gastrointestinal symptoms were able to be avoided by using our enteric coated tablet.
5) Lithium carbonate was used safely and effectively in the treatment of two manic cases who had liver trouble by checking their lithium level in serum and urine.

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We have been in charge of making medical examinations by way of close examination during five years since 1965 for the purpose of finding out gastric diseases among the people who had undertaken a group medical checkup. This is the report about the scores and our opinions of the examinations.
(1) Objects of examination ar the residents in TSUZUKI and SORAKU district, southern part of Kyoto-Fu, workers in two big concerns and the persons who have taken examinations from public health nurse's patrol.
(2) Though the rate of the persons required close examination to the persons who underwent group examination are different by time and place, they show, generally speaking, high percentage. The cause of this is supposed to be the fact that there were many cases showed suspicious symptoms and many of them had family histories related with cancer. The signification of a group medical checkup is how to make a good choice of the right numbers of the right persons who need closer examination from all the examinees.
To those (doctors) who makes group examination, the percentage of carrying out close examination and how to carry it out are the most important problems.
The high percentage of close examinations to group examinations, such as 89.1% in 1969 is, we suppose, due to our good consideration about the situation of the districts in our charge and proper campaign by public health centers for district residents to educate about the necessity of sanitation. On the contrally, in the case of 75.6% comparatively tow in 1967, it was unexpected thing. Delay of examination time, and farming and tea-picking season might have been the causes of such low percentage.
It deserves special mention from the fact that we have found out eight cases of gastric cancer. The ratio of detected cancer patients to all examinees is 0.5% and 2.9% to close examinees. Four cases among the eight cases were treated surgically and two of them are still alive. (another four patients might have gone under some kind of treatment, we think.) This fact tells that the group examination was very effective to the residents. Since we have learned that the early discovering of cancer would be possible by a group examination, we can expect the value of group examinations will increse much.
Summing up these things mentioned above, we have recognized that
(1) to make the term between the time of first screening and the time of second examination as short as possible.
(2) to make a good choice of the time of examination considering the situation on the district.
(3) to promote a positive interest among the doctors and public health centers in the districts.

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We have been performing open heart surgery using extracorporeal circulation since April, 1971.
The weight balanced disposable oxygenator is used, and it is easy and safety for extracorporeal circulation.
We reported on the hemodilution method or overinfusion with clinical cases.

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A case of bronchial adenoma (carcinoid type) was presented. 52-year-old female with leprosy was noticed to have an abnormal circumscribed shadow in the right lower lung field during a mass x-ray examination on December 9, 1970.
Bronchography disclosed complete obstruction in the peripheral part of the segmental bronchus in the dorsobasal segment of the right lower lobe. A right lower lobectomy was performed on February 5, 1971.
Macroscopically, the tumor was 3×2×2cm in diameter, solid, well-circumscribed and slightly yellow in color. A part of the tumor protruded into the dilated bronchus. Histologic examination revealed round or oval tumor cells, generally uniform in size, arranged in solid nests or sheets. In areas, tumor cells were arranged to form irregular gland-like structures. The surface of the tumor was partly covered by the bronchial epithelium. No argentaffin granules were demonstrable in the tumor cells by Fontana-Masson's silver stain

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