Epidemiology should be the guide line of cancer control mainly through the study of size of the problem and of etiology. The existing strategies for cancer control were reviewed classifying cancer prevention in primary (causative), secondary (early detection) and thirdly (prolong ation of survival).
Current programmes of stomach and cervical cancer screening were judged as effective by downward trend in mortality rate and also by comparison of mortality rate between screened group and non screened group. During past 15 years male stomach cancer mortality rate for age 45-49 has decreased by 29%. This is in correspondence with our results of field observation in Kanagawa Prefecture on the mortality rate in screened and unscreened population: a 20% decline in the former group.
Apparently there is a need to broaden the existing cancer control measures to include prevention and early detection of cancer of the other site; such as cancer of the breast which does not show any tendency of decline and cancer of the lung, bladder, pancreas, and leukemia which show rapid increase in recent years. Total cancer mortality rate is expected to come down when conventional control activities of cancer of the stomach and cervix and newly introduced control measures against above mentioned cancers are combined. Much progress has taken place in the study of etiology of cancer in man.
A combined effect of air pollution and cigarette smoking on lung cancer was clearly demonstrated. A combined effect of alcohol drinking and cigarette smoking on cancer of the esophagus was also found by both retrospective and prospective studies. A census population based cohort study covering 265, 118. Adults aged 40 or older has been in progress since 1965. A significant excess risk due to cigarette smoking was observed for cancers of lung, larynx, mouth, prostate, esophagus, stomach, pancreas and liver. An additive effect of daily meat intake and cigarette smoking was also observed for cancer of the pancreas and lung. A significant effect of diet on the frequency of stomach cancer was also demonstrated by comparison of highly endemic areas and low endemic areas (Okinawa) and also by retrospective and prospective studies. Higher intake of mlik, meat and green yellow vegetables, of calcium and vitamin A appeared to be beneficial in reducing the risk of stomach cancer.
Hormons also appear to give strong influence on the risk of certain cancers such as of breast.
By series of epidemiological studies, a lower risk was found for late starter of first menses, for multi-parous women and especially for oophorectomized women. As shown by animal model, a combined effect of viral factors and hormonal factors is likely operating to raise the risk of breast cancer in man.
Seroepidemiology has revealed several important relationship, such as EBV antibody titer and Burkitts lymphoma and nasopharyngeal cancer, Australia antigen and α-fetoprotein positive primary hepatoma.
Relationship with autoimmune conditions was also found by seroepidemiology (high antinuclear antibody in nasopharyngeal cancer patients).
For leukemia, a significant clustering in time and space was demonstrated. Effect of pre and post natal radiation, relationship with malformation and consanguinity was also confirmed.
In summary, an epidemic model for cancer in man should be completed in an earliest time. Virtical spread of essential factors in high risk family plus certain horizontal factors in childhood and adulthood are postulated.
Future cancer control must be based on such epidemic models.

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Epidermal ridges on hands and feet develop during the first trimester of gestation and remain unchanged thereafter for life.
Dermatoglyphic aberrations associated with chromosomal defects are sometimes recognized according to the dermatoglyphics of cerebral palsy and severe mental retardations.
The purpose of this study is to investigate certain features of dermatoglyphics in Japanese afflicted with cerebral palsy and severe mental retardations.
The materials used in the present survey were composed of 330 Japanese with cerebral palsy (295) and severe mental retardations (71). The “Foot-printer” of the Hollister Company were applied to records of finger, palm and sole patterns. The analysis of dermal patterns were cogfarmed to the Cummins and Midlo's method and the Walker's method.
As a result of analysis, abnormal frequencies were observed on dermatoglyphics of these individuals as compared normal controls. Abnormal findings were recognized on finger prints, atd angles, axial triradius, interdigital patterns, simian lines and hallucal patterns. Especially, these characteristics were found on cerebral palsy with severe mental retardation and severe mental retarded groups more than cerebral palsy.

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In order to find out very early signs of cardiac failure, the finger tip plethysmogram was recorded in 70 patients with progressive muscular dystrophy of Duchenne type.
Patients in early stages of the disease who were able to go up and down steps (Disability stages 1 and 2) disclosed no changes in various hemopynamic indices.
The index of heart strength, which indicates the myocardial force in cardiac contraction, showed a statistically significant decrease in those who were only able to crawl on their hands and knees (stage 5) and in those in more advanced stages (stages 13, 7 and 8).
The index of the effect of cardiac beat action, which indicates the cardiac output, showed a statistically significant decrease in those who were only able to creep along on their buttocks (stage 6) and in those in more advanced stages (stages 7 and 8).
The rate of appearance of the normal catacrotic wave was decreased in inverse proportion to the advance of the disability. And, the cardiac plateau wave, which indicates reduction in the myocardial force as well as in the cardiac output, was observed more frequently in patients in advanced stages.
In addition to the changes due to myocardial degeneration, the hemodynamic condition of the patients is possibly affected by the dysfunction of the autonomic nervous system, the increase in CO₂ content in blood, and so on.
It is suggested that patients with Duchenne muscular dystrophy gradually become in a condition of latent cardiac failure, with the advance of the disease.

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It has been previously described that the immunoglobulin G (Ig G) was elevated about 20 to 30% higher in aged than that of youth. In Kure National Hospital, we examined Ig G of 292 blood samples from 139 subjects, who were given diagnoses of SMON but had not any evidences to have diagnosis of hepatitis or tuberculosis.
It has been resulted from our data that increase of Ig G was obviously observed in SMON, even though the diagnosis of SMON was given in relatively aged group in both male and female.
Authors also have some evidences that immunoglobulin M (Ig M) was elevated in the relatively acute stage of about 30% of SMON, particularly during the first 3 months after onset, as A. Kosara et al, already reported. Furthermore, in the present study, there are slight increase of serum GOT and GPT activities in many who were diagnosed as SMON.
Recently, it has been discussed whether SMON would be caused by viral infection or quinoform intoxication, but the exact cause of this disease is still unknown at present time.
In the near future, we will study whether Ig G may be elevated by some factor which increase serum GOT and GPT.

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We studied malignant tumor among 110 autopsy cases at Komyoen Leprosarium from Jan., 1962 through July, 1971. Malignant tumors were found in 33 cases (25.6%), among which adenocarcinoma of the stomach (7 cases, 21.3%) was found most frequently. There were no cases of breast and uterus carcinoma; this might be related to some hormonal disturbance in female leprosy patient. Malignant lymphoma was found in 3 cases (9.1%) and the incidence of this tumor was thought to be related to immunological depression in the aged leprosy patients. Incidence of malignant tumor in leprosy patients is on the increase. We emphasized the early detection of the disease and its treatment.

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Sixty eight episodes in 59 patients with spontaneous pneumothorax have been reviewed clinically during about five years in KINKI-CHUO-BYOIN.
1. The sex distribution is predominant in male about 5 times than females. Most patients with this disease are seen in the age of twenties followed by sixties and show a type of two peaks.
The patients with this disease are divided into 2 groups according to whether they have chronic pulmonary diseases or not. The patients who have chronic pulmonary diseases make 2 peaks in the age of thirties and sixties. Another group which may be called idiopathic group showed 1 peak in the twenties.
2. The recurrent pneumothorax occurred in 23 patients (36%), of which 10 patients were below the age of 40 years old and this showed 70% of all patients with recurrent pneumothorax. Both side affected in 9 patients (15%).
3. The etiology of 30 cases of spontaneous pneumothorax was identified by the rupture of bullae or bleb, because part of them were seen on a series of chest X-ray.
Another was found during the operation.
4. The seasonal incidence had a tendency to increase in late fall and winter.
5. As a way of approach to detect causative factors of this disease, we evaluate urinary 17 OHCS, electrophoresis of serum protein and immunoglobulin. We got the result of Ig-M depression in 12 cases with exception of 2 cases who were suffered from pulmonary tuberculosis. This suggest that the patients with this disease show decrease in immunological abillity in natural humoral results immunity.
Further examination and evaluation for this trial should be needed for detection of the etiology of spontaneous pneumothorax.

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Sixty-years-old male entered in the hospital, complaining of nausea, sence of esophageal stenosis, upper abdominal pain and abdominal mass. The patient had past history of hypertension lasted for more than 10 years, and syphilis since the age of 18.
The chest X-ray revealed marked enlarged aorta and shifted trachea to the right side, Aortogram recorded by Sony Videotape showed a huge aneurysm of the thoraco-abdominal aorta. The aneurysm extended from the aortic arch down to the bifurcation of the abdominal aorta.
G. I. series demonstrated marked esophageal stenosis with enlarged oral side of the esophagus. The stenosis was due to the aneurysm of the descending thoracic aorta. The duodenal circle was markedly enlarged because of the abdominal aneurysm.
From the review of literatures, the patients with a thoracoabdominal aneurysm rarely complain of signs of disorders of digestive system as described above.

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Four cases of inverted papilloma growing in nasal and paranasal cavities are presented. Age distribution of these 4 cases (3 males & 1 female) ranged from 28 to 56 years.
All have been treated surgically and radiologically, and these had no recurrence during a period of 11/2, 4 to 6 years on follow-up study.
Literature of nasal and paranasal papilloma are reviewed. These were 55 cases reported in 18 years.

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