Conditions within the abdomen known generically as acute abdomen may be divided roughly into 3 groups, i. e. acute peritonitis, ileus and gastrointestinal bleeding, according to symptom, In children these groups of diseases are believed to have a characteristic pattern of distribution at varying age levels, i. e. neonatal stage, infancy and school age. Since, moreover, children affected with these illnesses become emaciaed more quickly than adult patients and usually are brought to an outpatient clinic with impaired water and electrolyte balance, ample caution should be exercised in diagnosing and treating such patients.
Acute abdomen usually constitutes a surgical emergency, demanding immediate operation. Since, however, early correction of water and electrolyte imbalance may be of therapeutic and prognostic importance, immediacy of surgery is not necessarily a factor of paramount importance.
In the present communication a study is made mostly of children with the presenting symptoms of abdominal pain and vomiting, chosen from those seen at the Department of Surgery of Narashino National Hospital during the year of 1972.

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The hardness of indication of radiation therapy for advanced cancer is due to radio-resistency and terminal stage of cancer patients.
As it is known that evaluation of radiation therapy effect, depend 60% upon the pathological classification of the tumor, 30% on the docter's skillfulness and training, and only 10% on the choice of treatment. Moreover, cachectic condition was considered to interrupt the treatment. Thus corticosteroid hormone was (Methazon) administered.
Seventy-four cases of cancer patients was treated. These cases were divided into 3 types by effect response to the methazon treatment. 27 cases showed quick improvement from subjective complains as pains and fatigue, by 50 mg. dosage administered. 32 cases improved from leucopenia or anemia by intermediate dosage (150 mg.);and the rest of 15 cases showed no influence for the primary disease.
Results indicate that radiation therapy with corticosteroid hormone have effectiveness at least 80% for these cancer disease.

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The present report outlines this disease and gives the results of treatments in this department with special stress placed on the treatment of the infectious focus. Thirty one cases of this disease were observed here more than 6 months. Out of 22 cases which showed infectious foci at any rate, 18 received the treatment of the focus. And there out of these 18 cases, one had a decayed tooth removed, and 2 had chronic tonsillitis and received antibiotic therapy, were recovered, other 4 cases improved and the remaining 11 unchanged. Two out of 4 with untreated infectious foci improved, while the other 2 unchanged. Two cases, whom the presence or absence of the focus was not evidenced, and 7 without the focus all remained unchanged. This nearly agreed with the result we reported previously.
For this disease, the systemic administration of corticosteroids is efficacious. However, the presence of infectious focus has significant bearing on the disease, and when the steroid therapy is discontinued, it recurs without fail. Therefore, the oral steroid therapy is not preferred on this account. This disease is hardly curable, but we must endeavour to find the infectious focus and to take active treatment against it.

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Recently, pulmonary diseases which seem to be closely connected with environmental factors are increasing in remarkably overpopulated cities.
With progress of the pulmonary function tests, pathophysiology of the chronic pulmonary diseases finaly leading to cor pulmonale has something in common with that of the airway ob-struction. These diseases are similar to one another on clinical finding and then physiological treatment of them is also similar to one another. So they are called “chronic obstructive lung disease, COLD”or “chronic obstructive pulmonary disease, COPD”.
Although these diseases can apparently be reduced to a simple disease or change of bronchus, their background factors are complicated in pathogenesis. In clinic, therefore, we must be based on making the patho-physiology clear upon them.
Now today, we have five specialists here, so we will discuss the problem on treatment of the chronic obstructive lung diseases.

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The concept of cure for such kind of chronic diseases was discussed because of no complete reconstruction of lung tissue and recovery of physiological functions to normal value could be expected.
As no expectation of complete cure was observed, the treatments of such chronic diseases was considered in two points, prevention of unexpected relapse, and symptomatic treatments for acute aggravation.
As a refer to such concept, the following three groups of the factors were considered to treat COLD;
The first, personal backgrounds, age, sex, occupation, and the kind, length, stage of the disease.
The second, environmental factors, smoking habit and air pollution.
The third, condition of medical facilities, whether the chest specialist could treat the patients and or well personnel and equipped intensive respiratory care unit could be available.

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A definition of “Chronic stadium”was defined throughout natural course of chronic obstructive lung disease. We have noted patients who experienced worsening of ventilatory failure, interspersed with stable plateau periods under admission, characterized by persistent pulmonary insufficiency. We call such condition as “chronic stadium”.
The COLD follwing such condition was characterized by irreversible deterioration of lung. And management of “chronic stadium”was discussed, which include therapeutic program such as bronchial hygiene, pharmacotherapy, breathing exercise and rehabilitation program. As could be expected, however, because of the permanently damaged lung tissue, improvement of the lung function pittern could not be considered.

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We studied 117 cases of anoxemia whose general condition had been involved in fataly serious state on thier course for the period of April 1969 through December 1972. Out of these cases defined as acute aggravation of chronic respiratory insufficiency, 47 cases or 40% were those of chronic bronchitis, bronchial asthma and pulmonary emphysema. Information that only 3 deaths of pulmonary emphysema were accounted out of the chronic obstructive lung disease, whereas 30 deaths of the lung tuberculosis out of restrictive lung disease suggests us that acute irreversible aggravation is likely to occur in chronic ventilatory insufficiency such as severe restrictive lung disease or pulmonary emphysema. In those cases, aging, infection or body fluid unbalance contribute to the aggravation.
Mortality in the aggravation, 40% is in 60s mmHg of PaO₂, 26% in 50s mmHg, 48% in 40s mmHg and 50% in 30s mmHg. This result indicates us that we cannot define the prognosis as no good, as far as the PaO₂ is kept higher than 30 mmHg, although the PaO₂ lower than 30 or 35 mmHg is taken to be fatal zone. Commonly, the mortality in anoxemia is high in case complicated with hypercapnia and acidosis.
Treatment of the acute aggravation of the chronic obstructive lung disease should be considered from the fact that the basal vitality must not be lost entirely on acute aggravation of the chronic obstructive lung disease as far as the pulmonary function has revealed reversible on routine tests. Hypo-xemia and hypercapnia being due to the alveolar hypoventilation in the midst of symtom of the aggravation. Thus, administration of oxygen and maintenance of alveolar ventilation are important on it. Analysis of causes of death in anoxemia shows that 25% of hypoxemia lower than 49 mmHg in PaO₂ die of CO₂ narcosis, which exceeds cardiac insufficiency 16% and pnumonia 12%.
Inadequate oxygen administration also contributes partly to cause of the death, because the respiratory regulation depends only upon the oxygen chemoreceptors, since the CO₂ receptor are avoided in role in chronic hypercapnia. Therefore, we usually prevent from CO₂ narcosis by means of adjusting the inspired oxygen flow every 0.5 per minute on monitoring PaCO₂.
To alveolar hypoventilation, tracheotomy or assistant ventilation with respirator can be recom-mended, but the former tends to imped sputum excretion because of coughing effect avoided and the latter tends to help the aggravation because of inadequate humidification to the inhalated gas. Dehydration accompanied with electrolyte loosing can be factor dominating its prognosis. Out of the aggravation, 63% has urine less than 1, 000 ml per day and 73% has sputum less than 20 ml per day, and out of these cases 60% did not survive. Such a dehydration is mostly due to the water loosing brought by sweating, malnutrition or insensible perspiration under the abnormal breathing, and it must be treated carefully accompanied with ventilation control.
From our clinical experience, administration of bicarbonate ion is the first choice to the patients involved in severe respiratory acidosis.

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In eighteen symptomatic asthmatics, measurements were made of VC, FEV_1.0, R1, Cst (1) and arterial blood gases including A-aDo₂ before and after inhalation of isoproterenol aerosols. In twelve subjects, dynamic compliance was measured at different respiratory frequencies, and the results compared with those obtained from normal control group. Although there was marked improvement of R1 and FEV_1.0, eleven subjects had a fall of PaO₂, and fifteen showed an increase in A-aDo₂ after administration of the aerosols. Seven subjects showed improvement of PaO₂ with decreased R1. Improved A-aDo₂ was observed only in two cases. In all subjects compliance was frequency dependent and remained so after the use of bronchodilator aerosols. Three subjects, whose FEV_1.0 and R1 returned to normal values by bronchodilator, showed decreased PaO₂ and increased A-aDo₂. Their frequency dependence of Cdyn (1) was not improved even after the bronchodilator. In these subjects, it seems likely that the aerosol was delivered preferentialy to low-resistance areas of the lung which were already better ventilated to the other areas. It might also be considered that the bronchodilator action of isoproterenol does not extent as deeply as the smallest bronchioles. The results would be the further increments of uneveness of VA/Q distribution, even though measured airway resistance falls. In one subject, who showed marked improvement of PaO₂ and A-aDo₂ with better FEV_1.0 and R1, the frequency dependence of Cdyn (1) was also markedly improved.
In all four subjects in remission, whose routine lung function tests gave normal values, Cdyn (1) was frequency dependent. These data are thought to demonstrate the obstruction of peripheral airways in asthmatics during remission.
In three patients, after one week administration of predonisolone (30-60mg/day, orally), the pulmonary function tests were repeated. The results were marked improvement in both frequency dependence of compliance and arterial blood gases. These data are thought that the steroids have dilating effects on the obstructive lesion of peripheral airways.

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It is practically very hard to collect all data on the reactions caused by mixing of injections in various combination. Then, from the view-point that the changes by mixing may be conjectured to some extent from the physical and chemical characters of each injection to be combined, the interrelation between the measured data on the characters of certain injections and the changes caused by mixing them was studied.
In the first year, next two subjects were carried out. First, all prescriptions of injection ordered for a week were inquired of all national hospitals. 1 Secondly, several characters of individual injection such as pH, capillary action, turbidity, viscosity, color tone and reaction to acid and alkali were actually measured.
The following facts were learned upon the inquiry:
1) The infusion solution used in the mixed injection was almost one kind, mainly glucose or xylitol solution, which was occupied 88 %.
2) The injection mixed to infusion solution was overwhelmingly ascorbic acid.
3) The injections (including infusion solution) used in the mixed injection was mostly 4 kinds and was 4.72 kinds on the average. This average number was nearly consistent with 5 kinds on the average reported in the meeting of Japan Pharmaceutical Association.
4) 21 kinds of injections were mixed in the most Case.
The main results obtained by the actual measurement of several characters of individual injection were as follows:
1) Most of pH was kept arround neutral.
2) There were 48 injections reacted peculiarly to acid or alkali.
3) There were 67 injections to be confirmed containing stabilizer or antiseptic.

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The retinal lesions in Systemic Lupus Erythematosus were observed in a case of 21-years-old
lady and the following results were obtained.
1) Funduscopic findings we observed by fluorescein fundus photography were typical edema of the optic discs and the filling time markedly leaked fluorescein only from optic disk. 2) The fundamental pathological lesions such like cotton wool lesion and striking changes of blood vessel were not found.
3) After about 8 month, edema of the optic discs were absorbed and there were no shift to atrophy.

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We had renal tumors in two women, who were at 9 and 10 months of pregnancy. Results of surgery of these tumors were a hydronephrosis and a benign non-epithelial tumor. This benign tumor was an angiomyolipoma.

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Among groups of drug-induced hepatic injury, the description of side-effect related to propyl-thiouracil (Propasil) is rare in the literatures throughout the world.
An old woman, 65 years of age, who had had administration of Propasil for hyperthyroidism for about half a year, had complained of anorexia, itching and jaundice, and physically she was found to have enlargement of the liver with corresponding laboratory findings of cholestatic disorder. A month after discontinuance of the drug, a challenge test prompted by Propasil was attempted with suspicion of drug-induced liver damage manifested by hypersensitive reaction, and that result-ed to the expected facts well. Histological examination of the biopsied liver tissue after this trial, revealed recent cholestatic and glissonitic alterations superimposed on progressing periportal fibrosis, which was clinically latent. She left the hospital with apparent rescue.

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A patient of sarcoidosis was described who was initially found because of bilateral pulmonary changes on chest x-rays and submandibular lymphadenopathy and was treated for four years showing an interesting clinical course.
The patient was a ten-years-old girl at the time of initial examination. Steroid hormone and chloroquin phosphate were administered, but had to be discontinued due to side effects. During treatment the patient developed dermatologic and ophthalmologic manifestations. All these manifestations of the various organ systems, however, rapidly improved when the patient had first menstruation. For the following five years of observation she did not show any sign of recurrence of sarcoidosis.
It is an interesting question whether menstruation had something to do with remission of sarcoidosis.

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This is a report of follow-up study for 24 months on the 62 cases of severe cavitary pulmonary tuberculosis treated wtih Rifampicin every other day for 6 months.
During these 24 months, 14 cases (23%) died. 15 cases (24%) showed conversion of sputum to negative, and 5 of them were discharged. At the end of this study 39 cases (63%) were still in hospital.
Most of the cases with negative conversion turned to negative within the first 3 months, and only a few cases showed positive conversion after 6 months negativity.
Continuous treatment of Rifampicin on the cases that showed positive conversion with temporary negativity or continuous positive sputum for 6 months or more, failed to get negative conversion.

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