Infections due to Mycobacterium szulgai (Marks, Jenkins & Tsukamura, 1972) are very rarely seen in man. The number of cases reported until now is only 22.
Seventeen of these 22 cases are pulmonary infection due to this organism. Of these, five cases were reported in Japan.
This organism has some characteristic features and is easy to be identified, and there-fore, if one knows these characteristics, more cases will be found. In this review article, the characteristics of this organism for the identification are shown, and the cases appear-ed in the world literatures are reviewed.

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There are seven papers describing infections due to Mycobacterium gordonae in man, and 10 cases caused by this organism are reported in these papers. There are also two other papers reporting that this organism caused bovine thelitis. In all these papers, however, the evidence for identifying the causative organism as M. gordonae or the evi-dence for diagnosing the cases as having real infection due to this organism are not suffi-cient. Investigators should also consider the fact that one case of infection due to M. thermoresistibile has been reported, as M. gordonae infection. Therefore, investigators who want to describe M. gordonae infection should make a sufficent differentiation of their organism from not only M. scrofulaceum but also M. sxulgai, M, xenopi and M. thermoresis-tibile. An identification table is shown in this review for this purpose.

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Goldenhar syndrome, known as oculoauriculo vertebral dysplasia, is characterized by malformations of eyes, ears and vertebral bones and sometimes associated with unilateral facial hypoplasia. However, we have no criteria at present to distinguish this syndrome from other similar diseases or syndrome including mandibulofaial dysostosis, hemifacial microsomia etc. We think it better to call this so-called Goldenhar syndrome.
As there have been almost no reports about pathological findings of this syndrome, we can't be sure about the pathological features, but the common histopathological findings of our two cases are renal cortical cysts, enlargement of Graaf ian follicle, increased and enlarged islets of pancreas, and involution of thymus. These findings are the features of serious congenital malformations including central nervous system. The etiology of so-called Goldenhar syndrome is not known, but we postulate certain causes that would make these malformations of eyes, ears, vertebral bones, heart, both extremities, facial bones etc., and this would occur at the early stage of four weeks gestation.
Associated malformations such as anterior chest wall heterotopic exostosis, situs inver-sus totalis observed in our first case, and esophagotracheal fistula observed in the second case, have not been reported. But the dermoid cyst of the Pith ventricle has been pre-viously noted in the literature. Thus, the presence of dermoid cyst in our second case of three-days-old and 1360g of birth weight is very interesting.

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In this study we examined the correlations between CT findings and prognosis in 24 cases with acute epidural hematoma. We found that the prognosis was closely correlated with the extent of cerebral contusion on the CT images. However, it was usually difficult to confirm cerebral contusion by preoperative CT conclusively.
On the other hand, obliteration or narrowing of cisterns on CT after surgery offered the important information, i. e. poor prognosis in patients.
We also discussed the limitation of surgical treatment based on these results.

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In 55 patients, pulmonary function tests with exercise ventilation blood gas changes and terminal clinical features of 23 fetal cases in Duchenne muscular dystrophy were inves-tigated, and the results were summarized as follows:
(1) The impairment of pulmonary function seen in Duchenne muscular dystrophy was caused chiefly by the chronic progressive restrictive pulmonary dysfunction, which was closely correlated with the progression of the clinical symptoms such as the worsening of grade and the decrease in ADL. And the progression of scoliosis accelerated the develop-ment of their pulmonary dysfunction.
(2) The disturbances of ventilation revealed extremely low ventilation volume. Hence, the maintenance of VE and rather high blood gas level were compensated by the increase in respiration rate.
(3) From the results of blood gas analyses, the decrease in ventilation volume (increase PaCO₂), which was showen as the feature of low PaO₂. This finding was compatible with alveolar hypoventilation.
(4) In the group whose %VC was between 40-60%, the increase in their ventilation volume by exercise depended mainly on their breathing frequency. And the patients' breathing style became fast and shallow after exercise. In this case the decreased PaO₂ and the elevated PaCO₂ were found.
(5) As to the treatment of the respiratory failure in progressive muscular dystrophy, the oxygen administration causes ventilatory inhibition. Accordingly, the therapeutic goal should be the correction of hypoventilation. Some patients may need artificial respirator, but the withdrawal of this instrument is very difficult. Practically, artificial respirator was not used so often in most fetal cases due to respiratory failure.
(6) Clinically, the causes of death in 80% of patients with Duchenne muscular dys-trophy was respiratory failure, and the rest was cardiac failure. In most of the latter case, the blood gas analyses showed almost normal value, which suggested that the cause of death in those patients might result from the degenerative changes of cardiac muscle.

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Twenty severe asthmatic children during institutional treatment and rehabilitation at Pediatric Department of Kawatana-Byoin National Sanatorium were tested for their exercise-induced bronchospasms (EIB) in four seasons over one year period, and the following results were obtained.
(1) In exercise tests using Master's two-step method, the maximum percentage fall after the exercise tests was most marked in PFR, followed by FEV_1.0 and FVC. As the children were repeatedly trained in spring, summer, autumn and winter, their EIB became weaker, which was assumably attributed to the effect of the training.
(2) Similarly in free-running exercise tests, the maximum percentage fall after the exercise was largest in PFR, followed by FEV_1.0 and FVC, while their EIB became weaker from spring to summer and autumn. In winter, however, the maximum per-centage fall was most marked in FEV_1.0, followed by PFR and FVC, and their EIB occur-red most frequently in spring, and then in winter. This frequency of EIB in winter was assumed to be attributed to the effect of temperature since free-running was conducted outdoors.
(3) The %FEV_1.0 demonstrated similar changes, indicating that their EIB evidently decreased as training was repeated.
(4) The peripheral blood pictures (RBC, Hb, Ht) did not show any significant change and remained free from the training effect.
(5) As the training was repeated, the level of serum vitamin E increased and a pos-sibility of affecting the EIB by this rise could be considered. However, serum vitamin E, in winter was lower than in autum, which may suggest that the demand for vitamin E increased in a cold environment.

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An infant with hemorrhagic cerebral infarction following a mild head injury was pre-sented.
A 11-month-old boy was discoverd by his mother to have a right hemiparesis, 2 hours after the episode of mild head trauma. A CT scan 2 days after the attack revealed a low density area in the left putamen. Ten days later, a repeated CT scan showed a high density in the same lesion. Cerebral angiography did not show the definite occlusive lesion.
We have a total of 16 children with cerebrovascular disorders seen at our department of neurosurgery. In this series there were 6 cases of cerebral arterial occulusive diseases. Cerebral arterial occlusive diseases were rarely seen in infants. We can not find other reports of a hemorrhagic cerebral infarction during infancy.

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A 79-year-old female patient developed amnesia and night delirium at the onset of de-mentia, and the symptoms ran a course of wave-like aggravation. At the age of 86, this patient died and was autopsied. Her cerebral histopathological findings consisted of ad-vanced amyloid angiopathy in arterioles and small arteries of the cerebral leptomeninges and cerebral cortex and lymphocytic infiltration in the leptomeninges and their perivascular re-gions. The cerebral cortex was found to have mild senile changes, such as senile plaques and Alzheimer neurofibrillary changes, but had many small scars and necrotic foci. Path-ological studies led to a diagnosis of multiple small infarcts in the cerebral cortex super-vening on advanced amyloid angiopathy. It is of interest to note that dementia can be of cerebrovascular origin in very old patients, as seen in this case.

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The present study dealt with, mental deficiency in patients with Duchenne progressive muscular dystrophy (DMD). Patients with spinal progressive muscular atrophy (SPMA) demonstrating a similar situation were employed as a control group. Two kinds of memory tests (short memory and memory span) and intelligence test (WAIS or WISC) were
The results of the tests in the DMD group was significantly peretormed, lower than the results of the tests in the SPMA group in all tests except VIQ. The patients in the SPMA group involved in this study demonstrated very similar clinical course and signs to the DMD group. Moreover, those patients in the two groups have been treated in the same environ-ment of the national sanatorium for a long time.
Therefore, we considered that mental deficiency in the DMD patients cannot be attrib-uted to such secondary factors as their social environment or their functional disabilities.

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The therapeutic efficacy of perivascular sympathectomy of the cervical internal carotid artery and superior cervical ganglionectomy for cerebral vasospasm due to ruptured cer-ebral aneurysm was reported by Suzuki.
As a treatment for cerebral vasospasm following surgery for cerebral aneurysm, supe-rior cervical ganglionectomy of the craniotomy side have been performed in two patients after the onset of postoperative cerebral vasospasm and in nine patients immediately after intracranial operation for prophylactic purposes. One of the two patients whose neuro-logical signs had been deteriorated by postoperative cerebral vasospasm showed a marked recovery, but the other died without improvement. Postoperative neurological deficit appeared, or was deteriorated in three of the nine patients who underwent prophylactic superior cervical ganglionectomy, and the condition was attributable to causes other than cerebral vasospasm in these three patients.
The authors have had an impression that superior cervical ganglionectomy was effective not only for the treatment, but also for the prevention of cerebral vasospasm following surgery for cerebral aneurysm.
The surgical timing after the onset of signs of cerebral ischemia is important in the therapeutic application of this technique.

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A 67-year-old man with hypopituitarism for 20 years was admitted because of general fatigue and anorexia. Urinary 17-OHCS and 17-KS excretion were low and failed to response to ACTH and Metyapone stimulation. Plasma cortisol levels was low and did not increase after ACTH stimulation. Both basal PRL levels and PRL response to TRH were low. GH levels after the infusion of arginine showed no response. LH and FSH response to LH-RH were low. Plasma triiodothyronine, thyroxine and ¹³¹I uptake were also low. Basal TSH levels was normal and TSH response to TRH was delayed. Thyroid scan and ¹³⁴I uptake showed an increase after three days of TSH stimulation (10 units/ day).
From these results it was concluded that this patient had hypothalamic hypothyroidism with decrease of pituitary reserve of ACTH, PRL, GH, LH and FSH.

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A 79-year-old male and a 66-year-old male with poroma folliculare were reported. Our two cases had the lesion located in the left temporal region and in the inner part of the left breast, respectively.
Macroscopically, the tumor of the first case revealed red bean-sized columnaly pro-truded mass and was diagnosed as cutaneous horn. The tumor of the second case was soybean-sized soft pedunculated mass and was diagnosed as seborrheic keratosis.
Histologically, the both tumors showed an epithelial proliferation growing both above and below the normal level, and associated with variable degree of hyperkeratosis and parakeratosis. The epithelial proliferation was composed of squamoid cells and basaloid cells often forming broad finger-like downward processes. In the functional area between the two types of cells, squamoid cells were often arranged concentrically in small nest (squamous eddies). In addition, the tumor of the first case had often edema and small cytic areas in the squamoid zone, and the tumor of the second case had a large number of pseudo-horn cysts. In both tumors, dendritic melanocytes of various degree were found among the basaloid cells, but any cell atypia or abnormal mitotic activiy was not observed. Occasionally, hair follicles adjacent to tumor masses were seen.
From these histological findintgs, the two cases were diagnosed as poroma folliculare. A differential diagnosis between poroma folliculare and similar related conditions, such as irritated seborrheic keratosis or Block's tumor, was discussed.

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Severe symptoms were occasionally seen in postoperative period in older patients. Es-pecially after upper abdominal surgery, disturbances of abdominal type of respiration, ex-pectoration are seen and FRC decreases, and imbalance of V/Q ratio occurs.
Epidural injection of 2 mg of morphine in 10 ml of saline was used for postoperative relief of pain in 15 elderly patients who underwent upper abdominal surgery. (3: Cholelit-hiasis. 12: Stomach cancer.) And pain relief, arterial blood gases, and complications were analyzed. Five patients complained no pain. In seven patients, analgesic effect per-sisted for 4-22 hours. (mean=10.3 hours.) In three patients, other analgesics were admin-istered for anxiety. There were no respiratory disturbance, no nausea, no dysuria, no delay of flatus, and no pulmonary complications.
After injection of epidural morphine, respiratory and circuratory system were stable.
Although this study is small, it seems that this method is useful for postoperative relief of pain in upper abdominal surgery in the elderly.

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Paients with recurrent urinary tract infection are difficult to be cured completely. It is said that a large number of those patients have congenital abnormalities of urinary tract. The most frequent abnormality of the patients accompanied with recurrent urinary tract infection is vesico-ureteric reflux. Twenty one patients with acute pyelonephritis were admitted to the department of pediatrics of this hospital during these four years. Among them, seven cases had abnormal figure on intravenous pyelography (IVP). Three of them had vesico-ureteric ref lux on retrograde cystourethrography. Those three patients had more frequently recurred acute pyelonephritis and their calix demonstrated some abnormal deformities on IVP. Two of those three patients with vesico-ureteric ref lux were treated with antibiotics together with Kanpo medicine. One patient with atonic ureter and three patients without particular abnormalities on urinary tract were also treated with antibiotics as ordinary method, together with Kanpo medicine. Kanpo medicine is Japanese traditional medicine which is composed by plural herbs. The selection of Kanpo medicine was made according to the each patient's constitutional state and symptomes. The extract of Kanpo medicine made by Tsumura Co. was used 0.1g/kg orally. The frequency of urinary tract infection reduced in one of the two patients with vesico-ureteric ref lux who were treated together with Kanpo medicine and at the same time the patient's appetite improved. Her color in cheek became better and her weight increased. Another patient did not get well despite Kanpo treatment. The rest of the patients who received together with Kanpo medicine all showed excellent weight gain during the treatment in-cluding one patient who had prolonged abnormal findings of urinalysis such as more than one hundred of red cells per one field and frequent cylinders. Kanpo medicines espe-cially Hachimigan which is a recipe traditionally used for the patients with disturbed renal function were thought to be effective to improve the patient's general condition and the findings of urinalysis in the cases of urinary tract infection.

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The hospital school class refers to a school class designed for children who are in hospital for the treatment.
It is important for children undergoing hospital treatment to be able to take regular school lessons in that the children not only can supplement their scholastic ability but also can promote health, stabilize emotional state and find something worthy to live for in their hospital life.
The public hospital school class in Japan was first founded in Hyogo Natoinal Sana-torium in 1947 for the children with tuberculosis.
As a part of the treatment for tuberculosis, the hospital school class has since been started in some of the sanatoriums.
Ahead of other general hospitals, Kokura National Hospital started this system in its childrens' ward in 1959.
As the school education for the sick children improved by the pediatricians and those concerned with education in Kitakyushu City, the number of hospital school classes have since been increased in the childrens' wards of many government-public hospitals.
At present, the hospital school class for the sick children is functioning in 10 general hospitals of this city and regular lesson are being given to children.
This is a very unique system throughout other towns and cities in the country.

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The marked increase in the workload of clinical laboratories during recent years, has led to introduce automation and computerization. The main purpose of computerization is to reduce laboratory clerical work and also to improve the quality of laboratory data. In this report, the automated data processing system of the Depatment of Biochemistry, Clinical Laboratory. National Cacer Center Hospital, which has been used for the last three years, is described.
Hardware: The system consisted of a central processing unit of 32 KW core (H-10 II A, Hitachi) with M-disk (320 KW) and C-disk (4.8 MW), a line printer, 2 data type writers, and 4 cathode ray tube (CRT) displays.
Operatton: Patient identification: Each patient, on his first contact with the hospital, is given a unique seven-digit serial number by which he remains identified throughout his life. Requisition: The requisition entry and work-sheets preparation are the main activity of the first step of the operation. In order to avoid errors in this step, “unmatch-list” is prepared. As for the multichannel analyzers, channel selection according to physicians' order is controlled by CPU. The CPU receives digital signals directly from six automatic analyzers. Data of manual measurements are keyed in the system through CRT. Comments on specimens such as hemolysis are coded and entered in the same way. Check system: After the analyses, each value is compared with the previous data of the patient by CPU, if available, and data variation exceeding 15% of the previous data are marked in the sheet and the technologists check those with other data obtained from the same specimen. The data, judged to be reliable or correct, are printed out in the card.
Furthemore, this system can provide quality control of laboratory data, and statistical reports on the workload of clinical laboratory.
After the introduction of this system, increasing laboratory workload can be better handled with the same staff members with some improvement in quality of laboratory data.

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