Effects of acute occlusion of intrathoracic portion of inferior vena cava on circulatory system were studied on dogs. Changes in arterial and venous pressure, cardiac output and electrocardiogram were followed during experiment and pathological studies were made on various organs after death of animals. Discussions were given on causes of death and methods for its prevention. Following results were obtained.
1) Arterial pressure goes down to shock level immediately after occlusion with decrease of cardiac output to 28.5 per cent of preexperimental value 5 minutes after occlusion. Cardiac standstill ensues around 30 minutes after caval occlusion. Arterial pressure returns to original level immediately after release of occlusion, however, experimental animals under normothermic condition die within 5 or 6 hours in shock.
2) Massive transfusion, an amount of 700-800cc, given after caval occlusion can not save animal's life though temporary slight elevation of blood pressure, relatively slight decrease in cardiac output and a slight prolongation of survival period are attained.
3) Animals under hypothemia can tolerate markedly prolonged caval occlusion and survive longer than normothermic animals after release of occlusion, however, they finally die in shock.
4) Some of animals survive experiment where vena cava is occluded under hypothermia with concomitant occlusion of descending thoracic aorta, resulting little changes in blood pressure.
5) Cause of death either during or after caval occlusion is considered to be irreversible shock due to decrease of circulating blood volume resulting from stagnation in portal beds. Mild hypothermia (rectal temperature 30°C) with concomitant occlusion of descending thoracic aorta is revealed effective to prevent animals from death.

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Stagnation in portal beds was considered to be a causative factor for death after acute occlusion of intrathoracic portion of inferior vena cava in Part I. To clarify this point, changes in pressure of hepatic vein and portal vein, and oxygen content in both were studied under various conditions as used in the previous experiment. Following results were obtained.
1) Occlusive pressure of hepatic venule and portal pressure rise rapidly and remarkably, reaching one and a half times of normal value, and marked stagnation in liver and portal beds develops. These changes return to normal immediately after release of caval occlusion.
2) Oxygen content of portal blood markedly decrease to such a degree of 52 per cent of normal value and anoxia of liver ensues. These changes are slightly alleviated under hypothermia, however, concomitant occlusion of descending thoracic aorta produces no effect on them.
3) Potassium level in hepatic vein markedly increase after caval occlusion, which is further exaggerated by occlusion of descending thoracic aorta. Hypothermia, however, prevent its increase considerably.
4) Blood containing a large amount of potassium stagnated in portal beds flows into systemic circulation after release of caval occlusion, however, hyperkalemia does not develop to produce an effect on cardiac rhythm.

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In 250 patients with pulmonary tuberculosis who were preoperative or undergoing no operation, and in 5 normal persons, the function of ventilation was examined since March 1953, and the following results were obtained.
1) The function of ventilation in normal persons at rest was almost the same as the report of other investigators, the proportion of vital capacity of the right to left lung being 51.2/48.8.
2) In pulmonary tuberculosis, slight cases presented similar function to that of normal persons, while the functional disturbance was marked as the lesion in pulmonary parenchyma was extensive. The functional disturbance. however, was not so prominent that many serious cases still presented standard values.
3) In pleural callosity and bronchial stenosis the function of ventilation was markedly disturbed. In the former a restrictive disturbance of ventilation was observed, while in the latter an obstructive disturbance as well as a tendency toward emphysema was recognized, both of which were marked, according as the fibrosis of the pulmonary parenchma became extensive. In general, severe cases of pulmonary tuberculosis displayed a mixed type of the obstructive and restrictive disturbances of ventilation due to the coexistence of the extrapulmonal factor and bronchial lesion described above.
4) Functional tests such as hypoxia and physical exercise are highly significant for the purpose of demonstrating potential disturbances which are not recognized at rest. In these tests it was found that slight or moderate cases with pulmonary tuberculosis still possessed sufficient reserve capacity of ventilation, while severe cases who did not reveal marked hypofunction at rest becauseof the compensatory activity, often displayed decompensation following these loading cited above, presenting a decreased oxygen saturation in the arterial blood, which was especially marked in cases with pulmonary fibrosis. The oximetric value in the test of respiratory arrest is not found sufficient for the index of the evaluation of the function.

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The function of ventilation, total and respective to the right and left lungs, was investigated before and after Various surgical operations in pulmonary tuberculosis, and the following results were obtained.
1) After the operation of thoracoplasty restrictive disturbance of ventilation was proved, which was marked as the number of resected ribs increased, especially to more than five. In tho respective determination, the disturbance was prominent in the operated side, but the contralateral lung exhibited likewise a slight hypofunction.
2) In the course of pulmonary resection, the pulmonary function of the operative side under the spontaneous respiration with intratracheal anesthesia was abolished almost completely coincident with pulmonary collapse. The function, however, recovered gradually according to the re-expansion of the remaining lung induced by the continuous suction of the thoracic cavity following the operation. The variation in th oximetric readings was scarecely found in the course of the operation, with the exception of a marked fall during the intratrcheal suction, especially contralateral intrabronchial suction.
3) In the cases who demonstrated a good re-expansion of the remaining lung after pulmonary resection, better function was kept than in the cases of bad re-expansion. The influence of pleural thickning as well as phrenic motor disturbance was very great, as much as the extent in the case of additional thoracoplasty.
4) The functional disturbance in the cases demonstrating good expansion after pulmonary resection depended on the extent of resection. In the cases undergoing the resection of less than 4 segments, the post-operative function was well maintained, while in some cases of more than 5 segments a pronounced tendency toward pulmonary emphysema was observed, and in the other cases of re-expansion, excessive extension of the lung was recognized. The permissible safety limit was presumed to be less than 4 segments from the stand point of the post-operative re-expansion.
5) As for the necessity of adjunctive thoracoplasty in total pneumonectomy, those cases who did not undergo adjunctive thoracoplasty, especially those who received pneumonectomy on the right side, demonstrated, in general, excessive extension of the remaining lung, therefore adjunctive thoracoplasty is recommendable in the cases of right-side pneumonectomy. As a general rule, however, adjunctive thoracoplasty should not be performed in young persons as well as in women undergoing left-side pneumonectomy.
6) The ventilating function after the decortication for the treatment of tuberculous thoracic empyema and atelectasis depended upon the degree of re-expansion; the improvement in the function was found unexpectedly small.
7) The recovery of vital capecity after various surgical treatment was usually rapid until three months after the treatment, gradual thereafter, and very slow after six months.
8) In seven cases presenting a contralateral vital capacity of 655-1014cc (the proportion to the standard total value: 15.7-24.2%), segmental resectomy or lobectomy was carried out successfully under the controlled respiration with intratracheal anesthesia. But in general, the safety limit was thought to be about 30 per cent in the proportion of the contralateral lung to the standard total value.

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Changes in platelets, bleeding time and clotting time following massive transfusions of preserved blood were studied, experimentally and clinically. Hemorrhagic tendencies were observed in three of clinical cases and also in experimental cases. Striking descrease in number of platelets were observed in every case shown hemorrhagic tendency, and was considered as its main factor. And hemorrhagic tendency was appeared before the occurrence of prolongation in bleeding time, though, changes in clotting time was not so significant.
Decrease in number of platelets was not specific to the massive transfusions of preserved blood, and was also observed in the cases transfused saline solution, red cell suspension, hemolized blood, massive fresh blood or plasma. It was surmised that the hemorrhagic tendency was preduced by intervention of vascular factor in addition to the decrease in number of platelets.

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Distribution of platelets in the various organs after massive transfusions of preserved blood was investigated by the injection of P³² labeled platelets. Higher activities were found in the liver and the spleen in case of injecting P³² labeled platelets alone, but found in the lung and the bone marrow in case of massive blood transfnsions following injection of P³² labeled platelets.
Therefore, it was guessed that remakable decrease of platelets count in the peripheral blood was caused by changing in distribution of platelets in organs, in addition to dilution with infused blood.

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Experimental studies on the qualitative changes in platelets following massive transfusions of preserved blood were performed.
It was observed that the platelet adhesiveness was decreased and the platelet agglutination was tended to increase, surmising a kind of relation between those phenomena and the distribution change of platelets.
Increase in resistance of platelets, decrease in thromboplastinogenase and remarkable suppression in clot retraction were observed only after massive transfusions of preserved blood.

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For the purpose of studying a mechanism of quantitative increase of serum spermine, the author has examined the spermine reaction of patients bearing tumor and studied, in animal experiments, the relation between cancer toxin and serum spermine, in cases of viscera damaged. Results obtained are as follows.
1) Serum spermine reaction was positive in 86 per cent (including false positive) of 69 cases of cancer patients, and in 35 per cent of cases bearing non-cancerous tumor.
2) Serum spermine had no relation to serum protein in cancer patients, and showed no differences in cancers different histologically.
3) A factor increasing serum spermine was present in cancer extract, urine of cancer patients, and toxohormone which containes so-called cancer toxin.
4) The pancreas, liver, adrenal gland and reticuloendothelial system were thought to be related to the metabolism of serum spermine.
From the facts described above, it is presumed that the serum spermine would be increased following disorders of the pancreas, liver, adrenal gland and reticuloendothelial system caused by cancer toxin.

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The origin of spermine, which tends to increase in sera of cancer patients, was studied in relation to the internal pancreatic secretion and alkalinephosphatase and obtained following results.
1) Action of extrinsic insulin: Elevation of serum spermine level was observed at prespastic stage in rabbits injected Insulin 2 units per kilo-gram.
2) Action of intrinsic insulin: On applying the experiment of B-cell destruction of Langerhans' islets followed by excessive production of insulin at early stage, serum spermine increased remarkably with compared to the experiment 1).
Serumspermine level was also higher for consideable time in sugar-loading test resulting increase of insulin demand.
3) Serum spermine was not specifically related to the blood sugar and alkalinephosphatase of cancer patients.

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Insulin Response Tests were performed on cancer patients, rabbits administered toxohormone, Brown-Pearce rabbits, and rabbits increased serum spermine experimentally. Results obtained are as follows.
1) In rabbits injected toxohormone, decrease of circulatory eosinophiles was suppressed noticeably by injection of Insulin, and serum spermine level was slightly high at the time showing marked fluctuation of eosinophiles.
2) Although, decrease of circulatory eosinophiles in B-P rabbit was suppressed a little by injection of Insulin, serum spermine was not increased.
3) Insulin Response Test was in normal limit in rabbits increased serm spermine experimentally.
4) In cancer patients decrease of circulatory eosinophiles was moderately, suppressed by injection of Insulin, but no relation was noted between insulin and serum spermine reaction.
It is thought that the cancer toxin lowers the hypophysis-adrenal function which would participate in spermine metabolism.

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A thorough understanding of the present concept of corrective surgery for mitral insufficiency substantiates the author's belief that it is an urgent technical challenge to secure the patients with advanced mitral insufficiency by balancing the increasing hazard of operative risk against the decreased and improved poor risk state as exists preoperatively. For this purpose, the author studied the effect of ligature of inferior vena cava upon experimental mitral insufficiency in dogs by means of hemodynamical, electrocardiographical and radiologic methods. Fifty dogs have been used in this experimental study. The following technical and patho-physiological innovations have been clarified:
1. The experimentally created mitral insufficiency utilizing the technique to cut the papillary tendons of posterior cusps relative widely revealed very similar hemodynamical patho-physiological patterns to human patients.
2. Marked improvement in decreasing the mortality has been found as follows: the mortality of dogs created experimental mitral insufficiency was 50% and, in contrast to this, the mortality of dogs treated by ligature of inferior vena cava at the lower level of branching portion of renal veins was only 29.6%. On the other hand, this ligature technique has been very effective to prevent the dog from immediate postoperative death or occurrence of acute and chronic pulmonary edema.
3. The hemodynamical pattern immediately after the ligature of vena cava upon experimental mitral insufficiency showed a marked improvement to restore more physiologic hemodynamics. Left atrial, pulmonary capillary and pulmonary arterial pressures increased by the creation of mitral insufficiency decreased markedly immediately after the ligature. This improved pattern is likely to be a precise reflection of decreased overloading of right ventricular system due to the decreased venous return into the heart.
4. The long durated postoperative observation on the same research also demonstrated the similar hemodynamical improvement as mentioned in item 3. Morever, the decreased pulmonary resistance seen in the postoperative observation indicated a marked hemodynamical improvement. These improved patterns durated at least one month latter after ligature.
5. In the electrocardiographic study, it has been thought to be most feasible to devide into two major diverse types of the experimental mitral insufficiency as follows: the first is high pressure group in which the left atrial pressure increased over 10 mmHg in mean pressure. The second diverse group is low pressure group with increased left atrial pressure lower than former. The temporary electrocardiographic improvement has been found in high pressure group showing the temporal shortening of the prolonged QT-ratio by ligature of inferior vena cava. Dogs with right ventricular strain used to fail to recover in long term observation. On the other hand, the low pressure group revealed the more definite electrocardiographic improvement durated about one month latter after ligature. The improved pattern has been, for examples, that increased P_II and P_III waves showed tendency to lower and prolonged QT-ratio showed tendency to shorten.
6. In the radiologic study, the author applied the left ventriculography to demonstrate mitral regurgitation, the left atriography and the simple radiography of the heart in anteriorpoesterior position. Results indicated that ligature of inferior vena cava has the reducing effect of the size of atrial chamber and heart in general. However, this has no influence on the degree of mitral regurgitation. Thus, it has been very clear that the ligature of vena cava improves the cardiac function definitely.

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The changes in the general condtions and blood have been observed in the rats receiving oxygen iehalation for 12 hours a day. In the first stage when the animals are laced in an oxygen chamber, they become less active and sooner or later they fall into a sleeping state with a reduced respiation frequency without taking food. After about 20 days' training even in the oxygen atmosphere they show a little movement with some activity and a little increase in appetite. After about 30 days in the oxygen chamber they begin to act almost as if they were outside the chamber with a slight loss in body weight.
Hemoglobin content of blood decreases day by day during the first 20 days, reaching a new equilibrium, 20-30 per cent of the original value, which is kept up for the following 40 days without any change.
Red cell number continues to fall reaching the minimum value after about 20 to 30 days, 90 per cent of the original number, and increase gradually reaching the original level about 2 months after the initiation. The reticulocyte number increases day by day reaching the maximum of 52.3 per cent after 10 days and keeps this level till the end of the experiment, i. e for two months. Leukocyte number is kept in a normal range throughout the experimental days.
From the above experimental data the author concludes that the decrease in hemoglobin content seems to be due to the toxic action of oxygen itself but far from the adaptation syndrome, as only 2 per cent or less decrease in hemoglobin can be expected from the theoretical calculation in the oxygenation rat of hemoglobin.

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By observing the organs from the animals killed after the various durations of oxygen inhalation, the author reveals the following histologic changes: The inhalation of O₂, 12 houts daily, results in the heavy depostion of hemosiderin in the liver and spleen with the capillary stagnation. The severe damages in the wall of artery and arterioles are the general changes. These damages found in the vascular system will be responsible for the other histologic changes, perivascular edema and cell infiltration, thickening of the alveolar wall with the cell proliferation, localized degenerative changes of heart muscle, alternative degeneration and regeneration in the liver parenchym and the slight atrophy of glomerulus in the kidney. Active erythropoietic picture can be seen in bone marrow but decreaded number in normoblasts.
The view of the author is that these changes will be the toxic action of O₂ desolved in blood plasm, which may have an active oxidizing effect. The reduction oferythrocyte number seems to be caused by the inhibition of maturation oferythroblasts, and the increased demolition of red cells in the eirculating blood.

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After inplanting a small sponge block subcutaneously the production of the fibroblasts and capillaries growing into the sponge block have been observed in the rats given oxygen inhalationfor 12 hours a day, and on comparing it to that of the sponge bearing animals living on air, some delay in the growth of the granulation tissues has been found in the O₂-inspiring animals.

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Since Imai advocated the C. P. L. classification in 1949, other investigators confirmed it to be adequate in their follow-up studies, thus re-affirming the significance of the role played by the interstitium in carcinoma of the uterine cervix.
In the present series of research the author studied the inflammatory processes of the original focus in the interstitium and in the parametrium and the sinus catarrh in the regional lymph nodes, in 50 cases of carcinoma of the uterine cervix obtained by the Okabayshi Operation (with pelvic lymphadenectomry extentended abdominal hysterectomy) and in 50 cases selected as the control group given X-ray irradiation six times (surface dose of 1, 800 r) before the same operation, all treated in the clinic of the Departmant of Obstetrics and Gynecology, Okayana University Medical School during the period from August 1956 to May 1958; and obtained the following results:
By dividing these cases according to the C. P. L. classification (Imai), Nagase's classification, clinical stages, the growth patterns of the original focus, and the grades of the inflammatory processes of the original focus, it has been found that those whose inflammatory reaction of the original focus is strong, the inflammation of the parametrium is weaker, showing a inverse mutual relationship between the two; and in addition, that those whose inflammatory reaction of the original focus is stronger, their prognosis is better. Morever, it has been demonstrated that the histological finding of inflammatory lesion does not necessarily coincide with the detection of bacilli. Therefore, the author is of the opinion, the same as claimed by Imai et al., that the anti-cancer factor in vivo seems to exist for the inflammtion.
Still further, no finding worthy of any special mention can be recognized in lymph nodes.
Furthermoer, an approximately similar relationship as observed in the experimental group has been found inthe control as well.

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Using the growing cells of Sal. typhi Sh. flexneri, Sh. sonnei, E. coli, A. aerogenes, Staph. aureus, Staph. albus and Staph. citreus, all of those were obtained from the departmental stock, the author investigated the effects of ribose, arabinose or xylose on growth as C-source and the decomposition of these pentoses during their growth. Following results were obtained.
1) Any pentoses added on the media containing the minimal essential dose of N-source and vitamins could not support the growth of Sh. sonnei and E. coli. Ribose could be served as C-source for the growth of Sal. typhi, Sh. flexneri, Staph. aureus, and Staph. citreus, while arabinose and xylose could not be so. Any pentose tested served well as C-source on the growth of E. coli when aspartic acid was added at the same time as N-source besides ammonium salt. In the case of A. aerogenes the pentoses showed the same effect even though additional aspartic acid was not present.
2) When peptone was added to media as N-source, any bacteria tested could consume these pentoses in the media.
Also it was noticed that Sal. typhi Sh. sonnei, E. coli and A. aerogenes adapted to the pentoses because of their increased consumption of the sugars with the passage of culture generations.
However, the adaptation was not found in the case of Staph. aureus, Staph. albus and Staph citreus.
Using the resting cells of Sal. typhi, Sh. flexneri, Sh. sonnei, E. coli, A. aerogenes, Staph. aureus, Staph. albus and Staph. citreus, the auther studied oxydation of ribose, arabinose and xylose, and obtained the following results.
1) From the comparative study of pentoses oxidation abilities of the bacteria, grown on nutrient agar media, it was found E. coli and A. aerogenes had relatively great ability to ribose, however, the others showed low abilities to these pentoses.
2) In the case of Staph. aureus, Staph. albus and Staph. citreus, the oxidative abilities to the pentoses greatly depended upon the age of culture, while in the other bacteria, the ability was not so much dependable.
3) Sal. typhi, Sh. flexneri and Sh. sonnei showed slight uptake of oxygen with addition of one of the pentoses, but the uptake of oxygen markedly increased when the pentose was added with glucose at the same time.
4) When culture passed through generations on the media containing any one of the pentoses, any bacteria except Staphylococcus adapted to the corresponding sugar.
5) It seemed that the pentoses were oxidized to pyruvate by any bacteria except Staphylococcns, and pyruvate formed was in turn decomposed thoroughly, but partly it turned to and accumlated as lactate or acetate.

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By performing a series of rabbit bone-marrow tissue culture, the author compared with various plasmas, the fixed position of thin rectangular coverglass which was introduced into the test tube, and various salt solutions; and obtained the following results.
1. When rabbit plasma is used as the plasma clot for this method of tissue culture, the tissue growth rate is greater than that in the case of chicken plasma, but it is apt to cause liquefaction and fusion of the plasma clot and also makes it difficult to observe the cell structure. In contrast to this, with the use of chicken plasma, although the tissue growth rate is lower than in the case of the former, the regressive degeneration of cells is less than the former and the cell structure is maintained distinctly. Therefore, the latter plasma is more suitable for such a tissue culture.
2. As for the position of fixing the thin rectangular coverglass, it is best to fix it in such a way so that the explant placed on the coverglass is at the maximum distance from the inner wall of the testtube, when it is fixed at the minimum distance from the inner wall of the testtube, it gives the worst results; while when the coverglass is not fixed, it gives intermediate results.
3. As for the solutions to be used in the medium, Gey's solution is excellent from the standpoints of the rate of tissue growth, the wandering velocity of pseudoeosinophils and the rate of appearance of regressively degenerated granules for the effectiveness in tissue culture, followed by Hanks's solution, Tyrode's solution, Ringer's solution and physiological saline solution, in the order mentioned. However, no marked differences can be observed among the first three solution.

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In the rabbit bone-marrow tissue culture by the roller-tube method, the author determined the optimal concentration in the medium of both the chick-embryo extracts and the first diluted solution from the sediment of the chick-embryo from which extracts was taken, and compared the effects of these two solutions on tissue culture.
1. As for the chick-embryo extracts, the relative tissue growth rate increases in a direct proportion to the concentration of the extracts in the medium, and at the concentration of 15 per cent, the wandering velocity of pseudoeosinophils is better, and the duration of wandering capacity is longest as well as the regressive degeneration of cells is least; and therefore, the chick-embryo extracts at the concentration of 15 per cent is the optimal concentration for the medium of this bone-marrow tissue culture.
2. The first diluted solution from the sediment of the chick-embryo from which extracts taken likewise affects the tissue culture almost in the same way as the chick-embryo extracts; namely, the relative tissue growth rate increases in a direct proportion to the concentration, and at the concentration of 20 per cent the wandering velocity of pseudoeosinophils is better and also the regressive degeneration is least. Therefore, the optimal concentration in the medium of the first diluted solution from the sediment is at 20 per cent.
3. As for the comparative effects of the 15% chick-embryo extracts against the 20% diluted solution from the sediment, the former surpasses the latter in every respects, namely, in the relative tissue growth rate, the wandering velocity of pseudoeosinophils and the lowness in the appearance of regressively degenerated granules. Consequently it is thought that the 15% chick-embryo extracts is the most suitable culture medium for the rabbit bone-marrow tissue culture by the roller-tube method.

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After determining the optimal concentration of serum, the transudate and exudate of ascites in the abdominal cavity as the culture media in the rabbit bone-marrow tissue culture by the roller-tube method, the auther compared the effects of these three media on tissue culture:
1. As for serum the concentration at 20 per cent shows the best relative tissue growth rate and the highest wandering velocity of pseudoeosinophils and the least regressive degeneration, and therefore, this at 20 per cent concentration seems to be most suitable as the culture medium. Moreover, when the effect of the medium containing this 20% serum is compared with that of the control (the culture medium without serum), the former excels the latter in the effectiveness in every respects such as the relative tissue growth rate, the wandering velocity of pseudoeosinophils and the appearance of regressively degenerated granules.
2. As for the medium containing the transudate and exudate of the abdominal cavity, the rlative tissue growth rate in both cases is in an inverse proportion to the concentration, but the appearance of regressively degenerated granules is least at the concentration of 30 per cent, and cells are preserved in a good condition, proving that 30 per cent of the transudate or exudate of the abdominal cavity contained in the culture medium is most effective. Furthermore, in the comparison of the medium containing 30 per cent of either one of the two no great difference can be recognized, but the medium containing exudate is somewhat superior. When the effects of the medium containing transudate or exudate are compared with that of the control (the medium without either the transudate or exudate), the former clearly excels the latter in every respects such as in the relative tissue growth rate, the wandering velocity of pseudoeosinophils and the appearance of regressively degenerated granules.
3. On comparing the case of the medium containing serum with that containing the transudate or exudate of the abdominal cavity, the great difference can not be observed in the wandering velocity of pseudoeosinophils in all three cases, but in the case of the medium containing serum the relative tissue growth rate is greatest and also the appearance of reg-ressively degenerated granules is least of all. Therefore, the former is fairly superior to either the medium containing the transudate or the medium containing exudate.
4. From these findings it seems that the medium containing the 20% serum, 15% chickembryo extracts and 65% Gey's solution seems to be most suitable for the tissue culture by the roller-tube method. However, it is believed that the medium containing the 30% ascites, the 15% chick-embryo extracts and 55% Gey's solution can also be used to take the place of the above mentioned medium.

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Electromyographical studies on the calf muscles following stimulation to the posterior tibial nerve at popliteal fossa were carried out on the patients with parkinsonian tremor or with ankle clonus.
Grouping discharges of both parkinsonian tremor and clonus of the calf muscles were suspended for a certain period followed by the same grouping discharge as before the shock when a shock was given to the nerve to provoke the monosynaptic H-reflex response on the calf muscles. The recovery curves of the H-reflex responses following each grouping discharge in both tremor and clonus tested were compared. These curves indicate that the excitabilty of the motorneurones is within normal limit in the parkinsonian tremor while it is exagger ated in clonus, when correlated with the results described by Magladery and his coworkers.

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Grouping diacharges of both parkinsonian tremor and clonus of the calf muscles were suspended a certain period with a same patient (160 to 180msec.) in tremor and 100 to 110msec. in clonus followed by the same grouping discharges as before the shock when a shock was given to the nerve to provoke the monosynaptic H-reflex response on the calf muscles. It should be noted that this is not anommission of the grouping discharge but a suspension of a certain period.
This difference of the period observed in tremor and clonus does not seem to depended on difference of mechanism driving the tremor and the clonus as the period of suspension showed pararell relation to frequency of the motor unit discharge when measured during voluntary contraction with various in tensities in normal subject.
The following clinical data of the chemopallidectomy may support this opinion that localized lesion of the pallidum is not always effective to the tremor although it is effective to the rigidity unless otherwise the pyramidal tract is involved somewhat.

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Incomplete procaine anesthesia which is descrived by K. Fuku were applied to the posterior tibial nerve in order to paralyse the gamma efferent fibers. There was no differece observed on the rhythm and the waves form of parkinsonian tremor and motor power on voluntary contractions although rigidity of the calf muscles was decreased or abolished after the injection.
This suggests that the tremor and the rigidity seen in parkinsonian syndrome is based on different mechanism.
These result may indicate muscle rigidity of parkinsonian syndrome does not depend on hyperactive alpha motor neurone excitability but on hyperactivity of the gamma system.

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Matthews and Ruthworth described selective gamma efferent fiber paralysis by Procaine applied to the peripheral nerve of cat. In our present study, the posterior tibial nerve was injected with 2% procaine at popliteal fossa in the patients who clinically showed either rigidity or spasticity in the calf muscles or ankle clonus. These clinical signs were decreased or abolished after the injection although voluntary contraction of the muscles and the monosynaptic H-reflex response following electrical shocks to the nerve were preserved. Even at this stage of anesthesia, action potentials of the sciatic nerve set up on stimulating the posterior tibial nerve was detected as well as before the injection through a pair of bipolar needle electrodes inserted in the sciatic nerve at the buttocks.
These results indicated that procaine solution of the dosis used in the experiments blocks fibers of small diameter including gamma efferent fibers mainly though it is not effective to the alpha motor and group I afferent fibers, and clinical symptoms of hyperactive stretch reflex i.e. rigidity, spascity and clonus may depend on excessive bias on the muscle spindles in the calf muscles through gamma efferent fibers.

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The author researched the degenerating nerve fibres anatomically on the brain and the spinal cord of dogs by Marchi's method, after removing the parts of each motor area for fore-limb, bind-limb and the mixed area for both limbs.
The results were as follows:
1) The efferent fibres from each part of motor cortex and from the premoter cortex are intricated underneath the cortex.
2) The area for fore-limb contains 17% of Betz's cells for hind-limb; the area for hind-limb contains 9% of Betz's cells fore-limb, and the mixed area for bothlimbs contains 44% of Betz's cells for fore-limb and 56% of Betz's cells for hind-limb; that is to say, the Betz's cells for hind-limb extended much more into the area for fore-limb than those for fore-limb into the area for hind-limb.
3) One of the Neurons from the area 6aα of premotor cortex pass through the homolateral Nucleus caudatus terminated into the homolateral Nucleus lentiformis.
4) The motor cortex of dogs contains many extrapyramidal tracts. The area for fore-limb contains them much more than the area for hind-limb, and in the midst of two areas the mixed area for both limbs is situated.

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The Author researched the Conduction Pathways of Epileptic Convulsion on dogs by Marchi method.
The results were as follows:
1. The descending fibers from the areas 4a, b of the cerebral cortex reach the homolateral lentiform nucleus and other neurons reach the lateral and ventral nuclei of the homolateral thalamus. The neurons moreover reach in the head and tail of the homolateral caudate nucleus.
2. The caudate nucleus and the lenticular nucleus are connected closely with the numerous fiber bundles crossing the internal capsule.
3. The fibers from the lenticular nuculeus descend through the lenticular fasciculus and Ansa lenticularis and reach the homolateral substantia nigra. The other neurons connect with Corpus Luysi, nucleus ruber, Cajal's interstitial nucleus, Darkschewitsch's nucleus, Westphal-Edinger's nucleus, oculomotor nucleus, and superior colliculus.
4. The descending fibers from the substantia nigra reaching the homolateral pyramis, fascicullus praedorsalis, fibrae arcuatae lateralis, nucleus funiculi lateralis are recognized. These fibers pass the Decussatio pyramidum, run down in the Funiculus lateral and reach the nucleus anterior spinalis.
5. The ascending fibers from the cerebellar cortex (lobus lunatus anterior, lobus lunatus inferior, lobus semilunaris superior, lobus semilunaris inferior) reach the dentate nucleus and pass through the brachium conjunctivum to reach the contralateral ventral nucleus of the thalamus and then connect with the descending pathways from the cerebral cortex.
6. The communication between both cerebellar hemispheres and thalami are revealed.

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On the 36 cases with trichomonas vaginitis treated at our hospital (Okayama Saiseikai Hospital) by administering trichothamin (2-Acetylamino-5-nitrothiazoel) in a daily dosage of 300mg, 400mg, or 600mg, the authors followed up the results of the treatment by the droplet method and Papanicolaou's smears, and obtained the following results:
Those temporarily cured only on the oral administration of trichothamin amounted to 84.2 per cent; those treated mainly with oral administration but combined it with suppository the cure rate was 88.8 per cent; and the rate of recurrent cases of those who had been followed up more than three weeks after the cessation of treatment was 50 per cent, namely, 9 cases out of 18 that had been followed up.
The average total doses used was 7155mg in the cases cured, and 423mg in the cases who had recurrence. As for the side effect 30.5 per cent showed the side effects mainly consisting of the gastro-intestinal disturbances. However, the side effect was most noticeable in those given a daily dosage of 600mg, but those given the daily dosage of 300mg or 400mg showed only a slight side effect, and those receiving the drug in tablet form showed no side effect at all. Those treated continuously for a quite length of time hardly revealed any ill effect either.
As for the treatment of the vaginitis by combination of oral and suppository administration, one tablet containing 50mg of trichothothiazole inserted into the vagina at the first call to the hospital has much more germicidal effect than the oral adminstration alone, and in addition, there is no side effect in evidence.
In comparing the cured cases and recurrent cases and studying the amount and the method of administration of the drug in the treatment of recurrent cases, we consider that the daily dosage of 300mg or 400mg given continuously until the total amount reaches about 7, 000mg will yield the result and that the spouse should also be treated concurrently in order to obtain a better result.

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Over the period of 23 years from 1934 to 1957 out of the total of 10, 000 deliveries at the Obstetrics Clinic of Okayama University Medical School those who had the abdominal cesarean section amounted to 91 cases, showing the rate of frequency of 0.91 per cent (1.08≥p≥0.76%).
There is a significant difference in the frequency of the abdominal cesarean section between the years (1934-1945) before the end of the World War II and the years (1946-1957) after the end of the War, with an increase in the latter period.
As for the relationship between number of delivery, age, and the frequency of the abdominal cesarean section, the frequency rate is highest in the primipara over 30 years old, followed by the multipara over 30 years, and it is lowest in the multipara under 29 years.
As regards the indication, the abnormality of the pelvis is low, showing only 17.5 per cent; and this fact seems to be due to the adjustment of indications as well as to our policy in which we try to have delivery through the vaginal way as best as we can.
Taking the relationship between pains, and rupture of the bag of water and operation, the section performed prior to the pains amounts to only 26.6 per cent, whereas that performed before rupture of the bag is rather frequent, namely, 80.2 per cent.
Those who showed the body temperature of over 38°C postoperatively amounted to 29 cases. The proportion of the postoperative rise in the body temperature by the methods of operation was highest in the corporeal section followed in a descending order of the cervical section and Porro's operation. However, no difference can be found in the rise in the body temperature between the section before rupture of the bag and that performed afterwards.
The maternal mortality rate was 4.39 per cent (9.65≥p≥2.16%). As for the neonatal mortality rate the true death rate was 26.59 per cent (44.33≥p≥1995%), and the corrected death rate, was 10.39 per cent (17.76≥p≥6.12%). The neonatal mortality rate in mothers having the abnormality of the birth canal only was markedly lower than those with toxemias or those with hemorrhagic complications.

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Patient is 40 years old with history of two deliveries and the last delivery was at the age of 28 years, but she had no irregularity with mestruation. Her chief complaint was a hypogastric tumor. On examination at our clinic we found: the size of corpus uteri, about normal; felt an immovable, soft but solid tumor as large as a head of adult in the hypogastric region; and it was diagnosed as a intraligamentary solid tumor of ovary.
Upon laparotomy we found no abnormalities in both adnexa and corpus uteri itself, but with the progress of operation we uncovered a giant myoma of the uterine cervix, measuring 19cm×25cm×20cm, and weighting 3.2kg, which grew out of the right wall fo the uterine cervix with the pedicle as big as the size of a pencil. Myomectomy and subtotal hysterectomy was performed.
It is generally accepted that the cervical myoma of uterus is relatively rare, occupying only about 5 per cent of all uterine myomas. Furthermore, with a better understanding for surgery on the part of general public, the incidence of giant myoma of the uterine cervix has become still rarer.
As for the symptoms when such a tumor reaches beyond a certain size, increased frequency of urination and corstipation are said to occur. Fortunately no such symptoms could be observed in the present case, and just as in this case, such a myoma is quite difficult to differentiate from the solid tumor of ovary and it is only after operation that it can be diagnosed correctly as a myoma of the uterine cervix. As for the relationship between the pregnancy and the delivery, it is generally the same as in the case of other uterine myoma. For the cure of such a case surgery is the sole therapeutic measure.

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Through confidential letters exchanged with 57 cases who received adbominal tubal sterilization and with 56 cases who received vaginal one, to the total of 113 cases treated at the Hospital of Takuma Town, Kagawa province during period of six years from January 1952 to December 1957, the author studied the prognosis of the tubal sterilization. The replies received were carefully compared and scrutinized as regard to each item of questionaires sent out concerning such problems as: the age of patient at the time of operation; number of pregnancy before the operation; number of children living at the time of operation; frequency of the induced abortion number of gravid months up to the operation; age of the first marriage; the pregnancy after the operation; any changes in menstruation afterwards; sexual sensitibity and desire after the operation; change in the sexual compatibility; any changes in characterisitics as observed by husband; the impression of the patient after the operation; and any disease of genital organ after the operation.
It is still difficult to decide which one of these two methods of tubal sterilization may prove to be better and any definitive conclusion or judgement on these patients must await results of further follow-up studies.

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With the use of epirocaine for the pudendal block anesthesia at the time of delivery in 50 cases, we obtained as high as 96 per cent anesthetic effect.
This drug is not only rapid in action but it also gives the desired effective space of time.
Though this drug is a product of Japan, it is an excellent local anesthetic being in no way inferior to lidocaine (xylocaine) that has been proved to be safe on both mother and child.

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With the purpose to maintain the cell function in a good condition for the peripheral-leucocyte culture the author compared various methods of tissue culture, and then investigated the tissue growth of peripheral leucocytes of normal persons in culture. The results are as follows:
1. For the preservation of blood to be cultured the use of the container whose inner surface coated with silicon is the best way to maintain the cell function as compared with the conventional method.
2. The expansion of growth area surrounding the original peripheral leucocyte mass in normal persons ceases after 6 hours' culture, and with the lapse of time the central zone of the growth area becomes less dense due to the emigration of wandering cells towards the peripheral zone, creating a space and thus this presents a corona-like appearance specific to this type of growth.
3. As for cells wandering out, the majority of them are neutrophils at the early stage of culture, and gradually numbers of eosinophils and lymphocytes increase; and after 12 hours' culture monocytes make their appearance.
4. As regards the distribution of cells in the growth area after 24 hours' culture, the peripheral zone is occupied mainly by neutrophils, and eosinophils are scattered there, too; and the intermediate zone is chiefly occupied by lymphocytes and a few monocytes, but the central part is occupied by many monocytes.

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In order to observe the cell function of peripheral leucocytes of normal persons by means of tissue culture, the author studied the wandering velocity, carbon-particle phagocytosis and neutral-red vital staining of cells from various angles; and arrived at the following conclusions:
1. Neutrophils begin to wander about actively already after 3 hours' culture, and after 6 hours' their behavior becomes still more vigorous, showing the maximum wandering velocity at this stage; but thereafter it gradually decreases, and after 24 hours' the wandering becomes very sluggish.
2. In pursuing the carbon-particle phagocytosis of various aeucocytes, neutrophils and monocytes reveal a marked phagocytosis; especially the phagocytosis of monocytes is highest, followed by that of neutrophils; but no phagocytosis can be recognized in eosinophils, basophilocytes, and lymphocytes.
3. The average phagocytic capacity of neutrophils after 6 hours' culture reaches its maximum, but thereafter it declines very slowly.
4. As for the degree of stain to neutral-red vital staining in various leucocytes, at first a few granules in neutrophils and monocytes are stained lightly, but with the laspe of time numbers of these granules gradually increase and these stained granules. swelling up by confluence, present a peculiar arrangement in a form of rosette. In eosinophils and lymphocytes all granules are stained light red, and in basophilocytes these are stained deep red. All these granules are stained almost simultaneously, but the confluence of stained granules are not so marked.
5. The neutral-red vital staining of neutrophils is quite high already at the early stage of culture, and reaching the maximum after 3 hours' culture, thereafter it gradually begins to fade and 9 hours' after it is about the same degree of stain as that immediately after the addition of neutral red. It is almost completely faded after 24 hours' culture.

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By performing the peripheral-leucocyte culture of patients with various leukemias, leukemoid reaction, and hypoplastic anemia, the author observed the tissue growth and the function of neutrophils in the culture; and obtained the following results:
1. In the case of chronic myelogenous leukemia, the tissue growth is composed of double layers of growth zones, namely, one, the inner young-cell zone with a clear-cut boundary and high cell density, and the other, the outer mature-cell zone with less cell density; but the young-cell zone gradually grows smaller with the lapse of time as these young-cells mature. The function of neutrophils is slightly inferior to that in the case of normal persons.
2. In the cases of the acute myelogenous and the lymphocytic leukemias as well as monocytic leukemia, the tissue growth area is sharply demarcated, forming no outer maturecell zone. As for the cell density, it is highest in the case of lymphocytics, and in the case of monocytic it is relatively low; and with the lapse of culture time immature blasts are seem maturing, each type of cells presenting their peculiar movement pattern and thus it is possible to distinguish different types of cells. The function of neutrophils in acute form is extremely lower than that of chronic form.
3. In the slice specimens prepared during the peripheral-leucocyte culture of leukemia many mitotic pictures were recognized.
4. In the case of leukemoid reaction the pattern of tissue growth and the function of neutrophils are identical with those in the case of normal persons, making it easy to differentiate this disease from leukemia.
5. In the case of hypoplastic anemia, the tissue growth area presents a coroma-like pattern of growth the same as in the case of normal persons, but the growth area is smaller and the cell density is less, and moreover, the function of neutrophils is markedly diminished.
From these results it has been proven that clinically the peripheral-leucocyte culture is sufficiently worthy of use for the differential diagnosis of various blood diseases.

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The respiration of human brain mitochondria was measured by the Warburg's manometer and the members of the TCA cycle were used as the substrate.
The O₂-uptake of the non-epileptic brain mitochondria is about on and half times of the epileptic brain mitochondria.
On the oxidation of the substrate:
Malate, fumarate, pyruvate, oxalacetate and α-ketoglutarate accelerate the O₂-uptake in both cases, and the O₂-uptake of non-epileptic cases are always 2 or 3 times of the epileptic cases.
Citrate accelerate the O₂-uptake in the non-epileptic case, but not in the epileptic case.
Succinate accelerate the O₂-nptake in both cases and its about several times of the other substrate.
Especially the increase of the O₂-uptake of the epileptic brain mitochondria by succinate is higher than of the non-epileptic brain mitochondria.

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The normal rabbit brain mitochondria or homogenate dose not oxidize the citrate in the experimental system generally used, but the brain mitochondria can oxidize the citrate on addition of DPN.

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The phosphorous metabolism of the inoculated mouse liver with the pathogenic agent, that was isolated from infectious hepatitis patient in Okayama prefecture was studied by use of P³².
And the following result were obtained from the fact observed on each fractions of phosphorous that were separated by the Schneider's method.
1) The P³² incorporation into acid-soluble fraction of phosphorous was increased at the early stadium of infection with the pathogene of hepatitis.
This fact should mean the increased permeability of blood vessels of animal.
2) At the active stadium of infection it was noticed the increased phosphorous incorporation into the nucleic acid fraction, and, therefore, was supposed it was occured the severe change on the substance related to nucleic acid in the tissue.
Conversely, at the late stadium phosphorous metabolism in nucleic acid fraction was suppressed.
3) From the early stadium of infection the phosphorous metabolism in the lipid fraction and protein fraction remained to be suppressed.
4) The phosphorous metabolism was affected in the higher dilutions of inoculum by the dilution test. And the most severe affection was observed at the dilution of 10^-6.

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In the past few years, the pathogene of infectious hepatitis occured in Okayama prefecture was isolated, and the study of characteristics of its pathogene were carried out in our department. Previously the author observed the significant changes on nucleic acid fraction by the investigation of phosphorus metabolism of the pathogene-inoculated mouse liver and reported its results in part I. The author studied further the phosphorous metabolism of DNA fraction and RNA-protein fraction after the fractionation of phophorous compound by the Schmidt-Thanhauser's method and obtained the following results,
1) The P³² incorpoation into DNA fraction was increased at the 6th and 7th day of the inoculation, the maximum incorporation was found at the 12th and 13th day.
However, the incorporations at the 22nd and 23rd day showed no difference against control group.
Hence, the intense change of phosphorus metabolism was presumed to occur at the early stadium after the inoculation.
2) The P³² incorporation into RNA-protein fraction was not increased at the early stadium, but the incorporation showed the maximum at the 12th and 13h day; the maximum incorporation indicated the occurence of increased specific or non-specific metabolism in the cell.
At the late stadium, the difference in the incorporation between tested and control group was not observed.
3) In the dilution test of the pathogene, it was found the serious affection on phosphorus metabolism of mouse in the dilution of 10^-4 or 10^-6.
4) These results showed the similar tendencies in the phosphorus metabolism as part I in which the study was carried out by means of Schneider's method.
The occurence of increased phosphorus metabolism of DNA fraction at the early stage after inoculation presumablly indicated that the pathogene investigated contained DNA as main nucleic acid just alike animal viruses.

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