The liver scintigraphy is nowadays widely accepted as one of the versatile techniques for figure out of the morbid morphology of the liver.
However, it is important to note that the liver is one of the most well recognized visceral organs which reveals various anatomical dislocation and distorsion of the contour being effected by compression from adjacent visceral organs and tissues.
Based on these facts, the diagnosis on the basis of the liver scintigraphy only sometimes leads to the misdiagnosis.
For correcting this pitfall, the author has performed simultaneous application of 0 Plain X ray study, 0 Gastrointestinal study, R Angiographic study and pneumo-peritoneography. The pneumo-peritoneography has performed in 43 cases.
It is concluded the simultaneous application of the above-mentioned techniques as well as the scintigraphic study give much precised diagnostic results.
Moreover, the application of the pneumo-peritoneography to the scintigraphic study gives much better results. The clinical importance of these supplementary methods in applying the scintigraphic study of the liver was described in this communication in full detail.

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1) Third degree 30% thermal burns were created experimentally on the back of rabbits according to Stenberg's method. The adrenal corteces were examined 6, 12, 24 hours and 3, 7, and 14 days following the burn insult.
2) Light microscopically there was a marked lipid depletion in the early stages. Hydropic and granular degenerations followed, but cell necroses were not observed. Those changes showed a tendency to return to normal starting around the 7 th day.
3) Electron-microscopical findings were:
i) Inside the cytoplasm there were a marked increase in the number and size of the mitochondria, gigantic dilatation and vacuolization of the smooth endoplasmic reticulum, and deformed, atrophic lipid granules encroached upon by vacuolized smooth endoplasmic reticulum. Degenerative changes of the organelle were occasionally seen. These findings tended to return to normal around the 14 th day.
ii) Inside the capillaries in the early stages there appeared numerous cytoplasmic fragments, which seemed to represent a holocrine type secretion of the steroid hormones. They reached the maximum after 24 hours. The initially observed microcircular derangements recovered spontaneously on the 3 rd day, but reappeared on the 7 th day, suggesting the necessity of adequate fluid therapy.
4) The adrenocortical changes resulting from the burn stress were mainly manifested as an increase in the cytophysiologic function, and those resulting from the burn shock as a decrease in the cytophysiologic function. In third degree 30% burns both changes were observed, the former being much more prominent.
5) Clinically it is justified that there is no necessity for steroid hormone treatment in burns around 30% third degree. But the danger of adrenocortical insufficiency increases in cases of wider surface area burns, cases with great difficulty in recovering from the burn shock, cases with antecedent chronic diseases, or in cases complicated with septicemia. In such cases appropriate maintenance treatment with steroid hormones should be considered.

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1) The membrane potential of the newt red cell was measured with the intracellular microelectrode. The mean membrane potential was. 15.2±0.7mV (n=133, mean ± standard deviation of mean).
2) The membrane potential was almost linearly related (gradient: 1.2 mV/i0mM/L) to the concentration of Cl^- of the external medium, but not to the logarithm of the changes in [Cl-]_in/ [C1^-]_out as was expected from Nernst equation. The concentration of the external cations (Na⁺, K⁺, Ca⁺⁺) had no effect on the membrane potential.
3) Oxygenation of the medium increased the membrane potential (-18.9 ± 0.7mV) whereas deoxygenation decreased it (-11.5 ± 0.3 mV).
4) The membrane potential depended on pH of the external medium. It decreased on the acid side (-11.7± 0.4mV at pH 5.7) and increased on the alkaline side (-19.9±1.2mV at pH 8.1).
5) As the temperature of the external Ringer solution was reduced from 18°C to 1°C, the membrane potential increased linearly at the ratio of 4.1 mV/10°C.
6) The origin of the red cell membrane potential and the role of this potential in the respiratory function were discussed.

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The intestine of bullfrog tadpoles in Stage 4, 17, 20, 23 and 25 (according to Taylor and Kollros) were examined in their full length with special reference to the cells with acid phosphatase activity. The cells with acid phosphatase activity, excluding the absorptive epithelial cells, were classified into two types ; large and small ones. The large one was a macrophage, found mainly in the epithelium ; the small one was a mesenchymal cell which might have some phagocytic function, and was found mainly in the muscular layer. Both types of cells appeared in the connective tissue layer. The number of the large (macrophage) and small (mesenchymal) cells were counted in the epithelial layer, connective tissue layer and muscular layer respectively.
The number of the macrophages increased in the epithelial layer along the entire length of the intestine in Stage 17, especially in the anterior half of the intestine, and reached a maximum in Stage 20. In the anterior half of the intestine in Stage 20, the renewal of the epithelium had just occurred, whereas it had already been completed in the caudal region to the opening of the hepato-pancreatic duct, where the number of the macrophages was reduced. The region, where the number of the macrophages was reduced, was shifted from the anterior to the posterior successively through Stage 20 and 21. The renewal of the epithelium came to be nearly completed in Stage 23 and the macrophages were scarcely observed there.
In the connective tissue layer, the macrophages appeared in Stage 20, while there were more mesenchymal cells than in Stage 17. Both macrophages and mesenchymal cells had increased in number evenly along the length of the intestine in Stage 21, but decreased in Stage 23 and 25.
In the muscular layer, only mesenchymal cells were found between the inner circular and outer longitudinal muscular layers. The increase and decrease of the number of the cells in this layer was shown to have the same tendencies as the intraepithelial macrophages.
In conclusion, the changes in the number of these cells with acid phosphatase activity were correlated to the process of the histological changes of the intestine during metamorphosis.

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From 1969 to 1978, we experienced 574 cases of gastroduodenal ulcers. Of these, there were 23 gastric and 62 duodenal perforations. The perforation rate was 14.8%. Out of these 85 cases, 79 cases (92.9%) were male, including 60 cases (75.9%) of duodenal perforation. Mortality was 4.7% (4 cases). The duodenal perforation mainly occurred in the younger and the gastric perforation in the older generation.
Gastrectomy is almost an established therapy for perforated gastroduodenal ulcers. Nevertheless, the author developed a new technique, called omental implantation. In contradistinction to the classical techniques such as simple closure, omental patch and etc., the new technique consists of pulling the greater omentum, which has a component entirely different from that of the gastric wall, into the perforated cavity. The omental fatty tissue has soft elasticity, different from the granulation tissue often recognized during the recovery process of the ulcer. Moreover the omentum assists the regeneration of the gastric mucosa and the newly proliferated vessels from the omentum stimulate the cleansing of the ulcer. On the other hand, surgically speaking, the new technique enhances safety by pulling and fixing the omentum into the gastric wall about 5 cm away from the perforated site. The omental implantation has been performed on 30 cases with satisfactory results.
In the earlier days, about one month after the omental implantation, gastrectomy was performed, fearing a possible recurrence. However, the results of the endoscopic observations and animal experiments have demonstrated that the omental implantation alone can cure the ulcer, making the gastrectomy unnecessary. Consequently, the omental implantation has been recommended as the most effective radical operation for gastroduodenal perforations.

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This study, which includes 884 people over 60 years old (291 men, 593 women; mean age, 78.4), was designed to clarify what kind of relationship can be established between migraine headaches and the aging degenerative factors such as arteriosclerosis and autonomic nerve function. The following results were obtained:
1) Among those who took part, the frequency of headache attacks was figured as 14.3%, but it was not determined by age. The results revealed that women had more headaches than men.
2) In studying the characteristics of headaches, the most frequent sites were found to be the occipital and nuchal regions. The most common time for the onset of a headache was during the afternoon and toward evening. The headache consisted mostly of a feeling of heaviness, slight at the worst, and was accompanied more frequently by a stiff shoulder.
3) In comparison to the control subjects, the blood pressure of the aged patients was considered to be hypertension, and, in particular, 160 mmHg systolic or over was more frequent.
4) In their EEG in comparison to the records of the healthy subjects, some abnormalities were revealed, but no remarkable difference was noted between these two groups.
5) The roentgenographic examinations of their cervical spines revealed more frequent abnormalities compared to those of the healthy group, but no significant difference was noted between the two groups. However, more abnormal indications were definitely noted in the cervical spines of the headache patients.
6) The aged headache patients revealed a significantly higher level of cerebrospinal fluid pressure compared to the healthy in the same age range, but it was within the normal limits.
7) The autonomic nerve function showed a more significantly frequent tendency of sympathetic hyperreactor. This suggests the cause of a headache among the aged must be related to the sympathetic nerve system in the same way as the younger patients with headaches.
8) The muscle contraction headaches were more frequently observed than headaches due to cervical spondylosis. Consequently, the aged suffered fewer migraine headaches compared with the younger group of patients.
9) Among the aged, migraine was less frequently recognized. This may be because of (1) the decrease in vascular wall responsiveness due to the development of the arteriosclerosis in the brain and (2) the fact that the autonomic nerve function becomes a sympathetic hyporeactor, which is the major difference from that of youth.

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Wernicke's encephalopathy-like neurological symptoms were induced in rats by thiaminedeficient diet or administration of pyrithiamine. Male S.D. rats of 4 week-old were divided into the following three groups: (1) thiamine-deficient diet+pyrithiamine treatment (PT), (2) thiaminedeficient diet alone (TD) and (3) control diet. On the 18th day of the feeding the mean thiamine concentration in the blood was 0.56 μg/dl in the thiamine-deficient group while it was 26.76. μg/ dl in the control. Weight gain decreased remarkably on the 27 th day of the feeding in the thiamine-deficient group (P<0.001). From this time on, the intraperitoneal injection of pyrithiamine has been carried out. The injected dose was 50. μg/100g body weight/day in PT. Neurological symptoms, such as ataxic gait and convulsion, appeared within 7 days. In TD, the change in posture (arched back) appeared within 5 weeks, followed by neurological symptoms as in PT.
The slices of the cerebral cortex, 0.3mm thick, were prepared from the rats immediately after the appearance of the neurological symptoms. Then an aliquot of the slices were placed in Warburg vessels containing the incubating medium with 0.2μCi [U-¹⁴C] glucose. Oxygen uptake and ¹⁴CO₂, liberation were determined by 90 minute incubation at 37... After the incubation, the contents of the vessels were homogenized altogether and the concentrations of lipids, glycogen, glucose, amino acids, lactate and pyruvate were determined chemically as well as radiologically after the modification of Gaitonde and others.
By comparing PT with the control, the following results were obtained; significant increase in the incorporation of ¹⁴C into lactate (P<0.001); significant increase in the concentration of it (P<0.05) ; significant increase in the concentration of amino acids (P<0.01) ; increase in the concentration of lipids; decrease in the incorporation of ¹⁴C into lipids and amino acids (statistically not significant); no significant changes in oxygen uptake, glucose and pyruvate.
On the other hand, the measured values in TD were intermediate between those of PT and the control. These results may suggest that the thiamine deficiency, induced by pyrithiamine, exerts inhibitory effects not only on glucose metabolism, but also on lipids and amino acids metabolism in the cerebral cortex.
Microscopically, TD and PT showed small hemorrhage and spongy degeneration in the middle pons and the pontine tegmentum, in addition to extracellular edema in the cerebral cortex. In PT, small hemorrhage and pallor of the cerebellar white mater were also found. In PT, vacuolation of glial foot process and irregular myelin sheath were electron-microscopically noted.

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The radiograms of 391 cases of metastatic lung tumors were studied in order to find out the characteristics of the metastatic tumors with special reference to intrapulmonary dissemination of the primary pulmonary adenocarcinoma. In all of these cases, the sites of the original tumors and the histological features of the metastasized tumors were already known. The results obtained were as follows.
1) Characteristics of metastatic lung tumors were radiographically studied according to the sites of the original tumors. In 82 cases of the metastatic tumors, the time needed for doubling the size of the radiographic shadow was measured and studied.
2) It was the bilaterally disseminated shadows that characterized the intrapulmonary dissemination of the pulmonary adenocarcinoma. In some cases, the dissemination was detected at early stages. It was revealed that the increased lung markings were the first signs of the dissemination. As time elapsed, fine nodular shadows appeared. These shadows subsequently became larger and finally fused into ill-defined large conglomerated shadows.
3) It was radiographically possible to distinguish the dissemination of the pulmonary adenocarcinoma from that of the pulmonary squamous cell carcinoma.
4) The dissemination of the well-differentiated adenocarcinoma exhibited more typical diffuse-shadows as compared with that of the moderately-or poorly-differentiated adenocarcinoma. The growth of the tumor was slower in the former than in the latter.
5) In 6 out of 67 cases, it was suspected that the dissemination took place transbronchially rather than hematugenously. But this was not proved by the smear method applied to the lobe of extraprimary-lesion.

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Up to the present time pericardial effusion has been diagnosed by assessing the findings on chest X-ray, ECG, heart sound, arterial pressure, venous pressure and paradoxical pulse altogether. However, the diagnosis has been not always accurate enough.
Consequently, the author has attempted to set diagnostic criteria by combining the recently developed methods, such as cardiac pool scanning and echocardiogram with the traditionally employed examinations, such as cardiothoracic ratio and paradoxical pulse, which have been thought to provide the important information of this disease.
A discriminatory formula for cardiothoracic ratio was derived by means of principal component analysis. By this formula pericardial effusion was correctly diagnosed in 72.4% of the cases. For this purpose, the measurements of the cardiothoracic ratio on admission and one week after the admission were necessary. The paradoxical pulse more than 10 mmHg was seen in 84.6% of the cases with pericardial effusion. The pressure difference of 8.10 mmHg according to respiration was found to be used also as a positive sign of paradoxical pulse, provided that the findings obtained from other methods were taken into consideration. The free space existing between the cardiac and hepatic areas was observed in 94.1% of the cases with pericardial effusion, indicating that this is more informative than other indicators for cardiac pool scanning.
Although echocardiogram was positive in all cases with pericardial effusion, positive result was obtained also in 15% of the cases without pericardial effusion. In other words, the probability for false positivity was not small. The accumulated volume of pericardial fluid estimated from echocardiographic parameters well corresponded to the volume actually measured at surgery or autopsy.
From these results, the following conclusions may be drawn. Positive findings in more than three out of four examinations mentioned above indicate the definite accumulation of pericardial effusion. When there were two positive findings, it was not possible to decide whether or not there was pericardial effusion, except when there were positive findings in paradoxical pulse and echocardiogram or in cardiac pool scanning and echocardiogram. In the latter two cases, it was possible to diagnose as having pericardial effusion. When all the four examinations were negative, the absence of the effusion was indicated.

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In order to clarify lipid metabolism in the early stage of cerebral stroke, serum lipid in order to clarify lipid metabolism in the early stage of cerebral stroke, serum lipid peroxide, vitamin E and total cholesterol were measured in 64 patients (28 hemorrhages and 36 infarctions) within one week after the onset and in 42 age-matched healthy controls. Then, their daily transition and mutual relationship were studied. Also, vitamin E and cholesterol in serum lipoprotein fractions were measured in 10 patients and 7 controls, and their relationship with lipid peroxide was studied.
Fluorometric determinations by Yagi for serum lipid peroxide and by Abe, et al. for serum vitamin E were used. Ultracentrifugation method for serum lipoprotein fractions was applied. The results obtained in this investigation are as follows:
1) The level of lipid peroxide was significantly higher in the early stage of cerebral stroke among the cases with fair prognoses compared to the controls. It waass significantly higher in infarction than in hemorrhage. It showed quite a high level for the first two weeks, and it decreased thereafter. The level of lipid peroxide among the deceased cases with poor prognoses was significantly higher compared to the controls. There was no significant difference between hemorrhage and infarction. The high level at the onset of cerebral stroke continued.
2) The level of vitamin E in the early stage of cerebral stroke was significantly lower compared to the controls. There was no significant difference between hemorrhage and infarction. It showed pretty low level among the cases with fair prognoses for the first two weeks, and it increased thereafter. While, among the deceased cases with poor prognoses, the low level at the onset of cerebral stroke continued.
3) The level of total cholesterol in the early stage of cerebral stroke showed no significant difference either in hemorrhage or in infarction compared to the controls. No significant changes were recognized depending on the prognoses.
4) There was a negative correlation between lipid peroxide and vitamin E, while no correlation between lipid peroxide and total cholesterol was revealed. A positive correlation was higher between vitamin E and total cholesterol.
5) The concentration of vitamin E in high-density lipoprotein (HDL-V. E) and of cholesterol in HDL (HDL-Ch) in the early stage of cerebral stroke were significantly lower compared to the controls.
6) The correlation between lipid peroxide and HDL-Ch was negative. A negative correlation was higher between lipid peroxide and HDL-V. E.
The above results may suggest an important role of lipid peroxide, vitamin E and HDL-V. E in the early stage of cerebral stroke.

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Effect of TUR-P and prostatectomy on sexual potency was studied by retrospective questionnaire to 56 patients who had surgery for benign prostatic hyperplasia in 1978. 66% of patients had preoperative full potency and 43% of them remained full potent after TUR-P and 37.5% after prostatectomy.
Study of preoperative and postoperative retrograde urethrogram revealed that widening of bladder neck is not necessarily the cause of retrograde ejaculation.
Since sexual life is very important even in elderly peoples to keep their mind active, we should not neglect effect of surgery on sexual potency when we discuss about indication of prostate surgery for benign prostatic hyperplasia.

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