This survey of traumatic spinal cord injuries was carried out by a statistical method in the National Murayama Hospital during 1970 to 1993. The number of the patients during these 25 years was 2030.
Of the 2030 cases, cervical cord injuries accounted for 861 (42.4%) and below cervical cord in-juries amounted to 1169 (57.6%). There were 1788 males (88.1%) and 242 femals (11.9%). The age at the time of injury was from 3 to 78 years. The age distribution showed a diphasic feature, with a main peak at 20's year in age and a additioanl peak in the age at 50's year. This diphasic fea-ture has been remarkable recently.
Comparison by the degree of neurological deficits at the time of injury revealed that complete injury accounted for 54.8% of cervical cord injuries and for 67.6% of below cervical cord injuries.
The most frequent cause of the injury was traffic accidents (34.3%) followed by falls on level ground. There was increased number of the patients with the injury by falls on level ground includ-ing the falls of a few stair steps in aged people of over 60 years.
From the results of this survey, the prevention of the injury should be focused mainly traffic accidents and falls accidents involving aged people.

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During recent 1 year and 10 month, there were 12 active tuberculosis patients with lung cancer.
We have done clinical investigation on these patients and got following conclusions.
1) The incidense of lung cancer among active tuberculosis was 1.7%. This incidence was 10 times higher than corresponding figure in the genaral population. It suggested that active tuberculosis was a risk factor for lung cancer.
On the other hand the incidense of lung tuberculosis among lung cancer was 5.7 %.
2) Charactaristic feature of the patients was elder person more than 60 years old age, heavy smoker male. Histology of major cases was squamous cell carcinoma. Location of major cases was in central bronchus.
3) It was diffucult to differantiate lung cancer and active tuberculosis with radiology only. It was necessary to make the diagnosis with sputum examination for bacteology and cytology.
4) If lung cancer was resectable, operation should be done after 1-2 month chemotherapy for tu-berculosis, even if tuberculosis bacillus was not disappeared. These cancer was located in central bronchus, so we thought intra-bronchial radiation was usefull method.

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We examined the usefulness of T2* weighted gradient field echo images for diagnosis for meta-static bone tumors in comparison with T2 weighted turbo spin echo (fast spin echo) images.
In T2* weighted gradient field echo sequence to obtain maximum contrast-to-noise ratio (CNR), we experimentally manipulated flip angle (FA) (5°-90°), repetition time (TR) (400, 700msec), and echo time (TE) (10-50msec). The best CNR was 16.4 in fast low angle shot (FLASH) (TE: 24msec, TR: 700msec, FA: 40°). Magnetic resonance imaging was carried out in 28 patients with metastatic bone tumors.
In addition to conventional T1 weighted spin echo images, T2 weighted turbo spin echo (fast spin echo images) and T2* weighted gradient field echo images were obtained. T2* weighted gradi-ent field echo images were superior to T2 weighted turbo spin echo (fast spin echo) images in de-lineating the tumors, adjacent fat tissues, and bone marrow.

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Because cytokines, including interferon, have been introduced to a wide range of clinical prac-tice, in addition to the popularization of bone marrow transplant, treatment of hematopoietic di-seases, such as tumors of hematopoietic organs, mainly leukemia, and aplastic anemia, has been dramatically improved in recent years, as compared with previous treatment. In fact, we can now see complete cure cases although such cases were once beyond imagination, and also remission cases for a considerably long period of time.
As everyone knows, Japan will enter the era of ultra-aged society in the 21st century. The aged population has grown rapidly in Japan, raising the most serious social issue. Actual treatment of intractable hematological diseases requires not only large experiences and sufficient knowledge of update information, but also introduction of precise medical devices suitable for more advanced treatment.
There are many more requirements for the treatment of aged patients. Active medication sho-uld be, of course, achieved with care, such as dose adjustment and nursing under close observati-on, and if immunity and ability to recover are impaired, in addition to aging, we should make the early conquest of infection and bleeding, and sometimes other complication, such as fracture, liver injury, and renal disease. Because of this, so-called medical team support, not only from doctors and nurses, but also from other health professional, is essentially required. I believe that intracta-ble hematological diseases in the elderly can be cured, only when we exert such decent and steady efforts.
A study group of national hospital members for hematological diseases was organized 10-odd years ago by members actively participating in the treatment of hematological diseases, mainly of leading national hospitals and sanatoriums, including doctors, nurses, laboratory technicians, and pharmacists. This study group thoroughly discusses various problems difficult to solve at the time of annual meeting of the general society for national hospitals and sanatoriums. The fruits of these discussions largely reflect the actual improvement of therapeutic results in the treatment of hematological diseases at national medical institutions, highly promising further advances.

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Dose intensity chemotherapy with auto-peripheral blood stem cell support (PBSCT) is useful therapy for patients with multiple myeloma who show high serum levels of β₂ microglobin. We treated a 51-year-old-male with IgA-κtype multiple myeloma with high-dose melphalan (200mg/body) and total body irradiation (total 12 Gray) supported by autologous peripheral blood stem cells. He achieved complete remission one month after PBSCT and complete remission lasted with-out any further therapy for six month. However he relapsed and died of myeloma cell infiltration one year after relapsing. Controlled trials should clarify more definitively the role of PBSCT for specific groups of patients with multiple myeloma.

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To investigate the mother-to-infant transmission of the hepatitis B virus (HBV), cord sera from HBV-carrier mothers were examined. Among 4, 604 pregnant women examined over 10 years (1980-1989), 68 cases (1.4 %) were found to be HBs antigen-positive. Of these positive cases, 22 cases (32.3 %) proved HBe antigen-positive. HBs antigen was present in one (4%) out of 21 cord sera examined, and HBe antigen in 15 (75 %) out of 20. HBe antibody and HBc antibody were fou-nd in cord sera, transferred via the placenta. The total IgM in cord sera proved to be more than 20mg/dl in 7 out of 42 infants born to HBs antigen-positive mothers. Two infants including one with an IgM of more than 60 mg/dl, born to HBe antigen-positive mothers who received neither HBIG (anti-HBs human immunoglobulin) nor HB vaccine postnatally, were discovered to be HBV carriers at 3 months of age.
?Since 1985, infants born to HBe antigen-positive mothers have received HBIG (at birth and at 2 months) and HBV vaccine (at 2, 3 and 5 months), under the national program aimed at prevent-ing mother-infant HBV transmission. Following this, only one infant (6.2 %) out of 16 born to HBe antigen-positive mothers became positive for HBV. In short, HBV carriers numbered 3 infants in total according to our follow-up study lasting a minimum of 2 years after birth.

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Tuberculosis in pulmonary and intestinal region was decreasing in the number of them. Seventy percents of tuberculous cases had active lesions. We have experienced a case of juvenile female ac-companied with perforation in intestinal tuberculosis.
The patient was twenty-six years old juvenile female. At the noon February 16 1995, she com-plained abdominal pain, diarrhea, and vommitting. From the daylight at February 17, colic pain of abdomen appeared, and she visited our hospital on emergency. She had been treated of intestinal tuberculosis from September 20 to December 5 1994. Two years before, her father had been treated of pulmonary tuberculosis. According to X-ray photographs of the abdomen on admission, free air at right upper quadrant lesion and niveau shadow at ileum were pointed out. So we diagnosed that the intestinal obstruction at ileocaecal junction and the perforation of the intestine.
Emergency operation was performed. We found that the obstruction point at sixty centimeters oral side of ileocaecal joint, and the pin-hole like perforation point at the dilatation of ileum. Ar operation of about fifty centimeters resection of ileum with end to end anastomosis was per-formed. She had been discharged from our hospital with good condition at the 32th post operative day.
During the therapeutics with anti-tuberculous drugs, we recognized that perforative peritonitis in acute abdomen of juvenile female, so careful medication was demanded.

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A 57-year old man was admitted to our hospital with the chief complaints of dyspnea and gen-eral malaise. On admission, his blood pressure was shock level which was not controled by catech-olamine infusion. Findings of electrocardiogram and ultrasound echocardiography strongly sugges-ted pulmonary hypertension. We diagnosed acute pulmonary thromboembolism by means of right heart catheterization and pulmonary angiography. After injection of tissue plasminogen activator (t-PA), the pulmonary artery pressure decreased gradually.
On chronic state, venography and CT scan of lower extremities we proceeded demonstrated large thrombolus in the deep vein of right lower extremity. We inplaced the inferior vena cava fil-ter (Greenf ield's filter) to prevent reccurent pulmonary thromboembolism.

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