After the administration of antithyroid drug, thyroid substance or thyroid stimulating hormone, the weight, the uptake of Radioiodine and iodization in the rat thyroid gland were studied.
The separation of the thyroxine from other iodine containing compounds of the thyroid gland were based on the method of Taurog, Chaikoff. The results obtained from the study are as follows:
1) The thyroid gland of rat in which hormonal synthesis was blocked by methiocil showed the secondary decrease of I¹³¹ uptake and compensatory hypertrophy and increase of weight by the T. S. H.
2) The administration of Thyreoidin produced the decrease of I¹³¹ uptake and thyroid weight, and the atrophy of the thyroid gland.
It's due to the depressing of hormonal synthesis and secretion in the thyroid gland in accordance with the decrease of T. S. H.
It means the hypofunction of the thyroid gland.
3) The administration of T. S. H. produced an increase of I¹³¹ uptake by the thyroid gland and an increaseof hormone secretion, showing hyperfunction of thyroid gland.

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After the administration of serum and thyroid-extract from the patient of the thyroid disease, the weight, the uptake of Radioiodine and iodization in the rat thyroid gland were studied.
The results obtained are as follows:
1) There were no influence to the rat thyroid by the administration of patient's serum.
2) The administration of thyroid extract caused the decrease of rat body weight, I¹³¹ uptake and thyroxine fraction in the thyroid gland.
It seems that thyroid extract has the same action with the thyroid substance and is more effective.

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1) Re-cxpansion of the lung, a condition occupying the thoracic cavity with remaining lung. was related to over-expansion and displacement of the lung itself, and to reduction of thoracic cavity dne to displacement of the diaphraem and the mediastinum.
The main roles in over-expansion and displacement of the lung were played by apical segment and S₄ and S₅ of middle lobe.
2) The result in re-cxpansion was better in the younger than the older, the female than the female than the male.
3) Intensity of thickening and adhesion of the pleura were intimately related to the re-expansion, worse in intense adhesion and addition of extrapleural decortication. No relations were observed between re-expansion and separation of diaphragmatic pleura.
4) The expansion was less when the resecting area was larger, and in the cases resected apical segment as compared with the other portion.
5) Re-expansion was worse in the cases in which hemorrhage during aed after operation was severe.
6) Re-expansion was much better in the cases presented a slight stenosis of bronchus.

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Studies were performed on the aspiration of fluid in the thoracic cavity after pulmonary resection, from the points of tube and mode for suction. Following results were obtained.
1) For aspiration, two tubes (one from the axilla to upper median, another from posterior axilary line in 7th or 8th intercostal space to diaphragm posteriorly) were preferably nsed as compared with one tube.
2) In general, the upper tube is mainly to aspirate air and the lower exudate. The effect of fluid aspiration it invariably related to air leak from the lung and relating reexpansion of the lung.
3) It is better in the result that the length of the tube is about three cantimeters in the upper and nine to twelve in the lower. when a difficulty in expansion is presumed the upper tube is to be six to eight centimeters for getting better aspiration of the fluid.
4) It is better to leave about 200cc of warm saline solution in the thoracic cavity immediately after operation.
5) Horizontal recumbent position is best after opertion.

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A chronological survey was done on the operation for pulmonary tuberculosis in 1353 cases admitted to this Sanatorium, from April 1949 to March 1947.
The cases formerly indicated for thoracoplasty were mostly undergone pulmonary resections.
Annual changes were not seen in sex, but ago distribution, tended to shift from younger to older.
Preoperative condition of the patient was gradually improved, and reached to its limit recently.
The condition roentgenological was improved annually, though, almost one half of the cases had cavities which were less expected to being improved by chemotherapy.
The positive cases of tuberculous bacilli in sputa were getting decreased in number, without any expectations for improving by subsequent ohemotherapy. By the way, occurrence of resistant bacilli was increased in a sense.
Duration from onset to operation was increase.
Preoperative chemotherapy was shifted use of streptomycin, PAS and INAH instead of single use, and the dosage and duration were tended to increase.

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Pulmonary resection for tuberculosis in this Sanatorium, from 1957, was remarkably changed in its method and mode, directing to a destination of preserving pulmonary function.
Sincc the postoperative treatment for pulmonary resection was improved, complications such as hemothorax and incomplete pulmonary expansion were decreased, 7.9 per cent in incomplete expansion.
Mortality, 2.7 per cent as a whole, was also decreased due to reduction in exacerbation of pulmonary tuberculosis and other tuberculous comrplications.
The rate of bacilli negative was 87.7 per cent, 96.3 per cent when transitory positive cases which became negative for over six months afterwarde were turned to negative rate.
As a whole, over ninety-three per cont of all cases were operated on successfully, attaining the level of that in the other general surgery.

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Statistical survey in 1332 cases of pulmonary resections, eight years since 1949. was pesformed on the complications such as bronchial fistula, empyema and exacerbation.
Those retes were 8.4 per cent in bronchial firtula (two per cent in peripheral), 2.5 per cent in empyema except for the pre-existing, and 3.1 per cent in exacerbation within six months after operation, in which 86 per cent was within two months.
These complications showd a similar diagrammatic curve in the annual occurrences. noticeably high in the fore period and lowest in the later, coming up slightly in afterwards.
Postoperative complications were intimately related to the operative indicetion selected, i. e. preoperative chemotherapy.
Occurrences in postoperative complications were mainly decided by presence of positive bacilli in sputa and cavity, further presence of resistant bacilli. The rate was higher in case of presenting becilli in sputum from the cavity even after a long duration of chemotherapy and in case of developing resistant bacilli.
These complications wese controlled in most cases, by adequate treatment in the early postoperative course.

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In his electronmicroscopic observations conducted on the red muscle fibers and white muscle fiders with the use of M. soleus and M. gastrocnemius in rabbits and cats, the author obtained the following results.
1. The source of functional differentiation in the red muscle fibers and white muscle fibers exists only in sarcoplasm, and no marked differences can be seen between the red and white muscle fibers as regards their myofibrils, nuclei, and sarcolemmas.
2. Mitochondria of the red muscle fibers are either round or elliptical in shape and are dense and numerous in the muscle fibers; while mitochondria of the white muscle fibers are slender and extremely less in number.
3. Mitochondrial cristae of the red muscle fibers are projecting like a cog-wheel but few in number, while those of the white muscle fibers are arranged at right angle to the long axis of the mitochondria and forming a dense crease.
4. Judging from the relationship between the shape and number of mitochondria as well as from the state of cristae, there seems to exist an intermediary type of muscle fibers between the red and white muscle fibers.
5. The sarcoplasmic reticnlum is well developed in the white muscle fibers.
6. The structural differences of sarcoplasm in these two muscle fibers coincide well with the differences in the function and energy metabolism of the two.

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With the purpose to determine the influences of hot and highly humid environment on the B₁-metabolism the author pursued the changes in the tissue B₁-eontent and body weight in albino rats fed various foods for 30 days under a fixed hot environment and obtained the following results.
1. The concentration and quantity of the tissue B₁ in the albino raised with common foods under hot environment decreased temporarily 5 days after the start of experiment, but thereafter with the lapse of time the B₁-concentration gia ally re ed to the normal level. However, the absolute B₁-content in the liver alone remained at a low level even 30 days later.
2. When young albino rats were raised with Shimazono B₁-deficient diet or with low fat Shimazono B₁-deficient diet for 30 days under hot environment, the decrease in the tissue B₁-concentration showed no significant difference from that in the control group raised under the normal environment. Howeyer, the B₁-content in the liver of all those raised under the hot environment alone showed a lower value than in the control group.
3. The tissue B₁-concentration and quantity in the young albino rats raised with the low fat diet under the hot environment showed markedly lower values than those observed in the group raised with the B₁-deficient Shimazono diet.
4. The gain in the body weight of the albino rats raised with various foods under hot environment was markedly poorer than that in the control group raised under the normal environments. However, the loss in the body weight of the young albino rats fed B₁-deficient diet was less in the group raised under the hot environment than that in the control raised under the normal temperature.
5. The fluctuations in the B₁-content and concentration of the brain were remarkably small throughout the experiment in both environmental conditions when compared with those of other tissues.

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In order to see the utilization of B₁-intake under a hot and highly humid environment, the author raised albino rats under a hot and highly humid environment keeping the hygrometric temperature around 28-30°C and administering B₁, stimated the tissue B₁-content, changes in the body weignt, the amount of food consumed, and the B₁-content excreted in the urine. The following are the results.
1. When the daily dose of 6γ B₁ was adminstered for one week to albino rats raised with B₁-deficient Shimazono diet under a hot environment. the B₁-concentration of the heart was 1.3 times that of the control raised under the normal environment, and the B₁-concentration in the liver, kidneys, and brain was likewise somewhat higher but the B₁-content was smaller than that in the control.
2. When the daily dose of 40γ B₁ was given one week to the albino rats raised with the B₁-defieient Shimazono diet, the tissne B₁-concentration was rather higher in the heart and kidneys than in the control, but the B₁-content was lower in the liver and no differences could be observed in other tissues as compared with the control.
3. After injectiog 0.5r/g B₁ to the albino rats raised with B₁-deficient diet under the hot environment and by bathing in hot water for 10 minutes every one honr the concentration of tissne B₁ after 9 hours showed no difference from that in the control, but the B₁-content was generally lower, especially the B₁-content in the heart and liver was only about 60-70 per cent of the control.
4. The B₁-content excreted in the urine of the albino rats raised uuder a hot environment in the case of daily administration of B₁ under the dosc of 6γ showed no difference from that in the control raised under the normal temperature, but when the daily dos of B₁ was raised to 40γ or 80γ, the B₁-content excreted in the urine at last rose to 1.3 times that on the control.

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By estimating the contents of pyramin and vitamin B₁ excreted in the urine of the albino rats raised under the hot and highly humid environment of hygrometric temperature at 28-30°C, the author obtained the following results.
1. When the daily dose of 40γ B₁ was administered to the albino rats being raised under a hot environment, the mean averago of the pyramin content excreted in the urine per day by an individual rat was around 3.52-3.38γ, showing no difference from that of the control. While the B₁-quantity excreted in the ruine per day was around 6.28-5.8γ, proving to be 1.3 times that of the control. In this instance, the quantity per 1, 000 calories of non-fatty substance taken in by B₁ remaining in the body amounted to about 0.68-0.64 mg, proving greater than that in the control (0.45-0.47 mg).
2. When B₁ was administered in various under the hot environment, the pyramin content excreted in the urine increased in proportion to the increasing dose of B₁, but the degree of the increase, being only slight, differed not much from that of the control. The amount of B₁ excreted in the urine, when the B₁ dose was increased to 40γ or 80γ, was 6.4γ and 26.1γ respectively, each value proving to be 1.3 times that of the control (4.4γ and 21.3γ respectively).
3. When the common foods was given freely under the hot environment, the B₁-content and pyramin-content excreted in the urine were 4.9-5.8γ and 3.8-3.9γ respectively, both being less than the respective values in the control (6.2-7.2γ and 4.7-4.2γ). This seems to be due to the decrease in the food intake with the attendant decrease in the amount of B₁-intake.
4. The gain in the body weight and the amount of food intake in the case of the albino rats under the hot and highly humid environment were for poorer than those of the control raised under the normal environment.

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1. In observing the polarographic catalytic wave of protein by making arsenic acid at various concentrations act on fresh human milk, fresh cow's milk, regulated powdered milk, and milk on the market, no decrease in the degree of the SH activity of milk protein due to the addition of arsenic can be detected. In this instance when the concentration of arsenic acid is gradually increased to a certain point, the reductive wave of arsenic appears on the heel of the proteinic wave. The arsenic acid concentration required to have the appearance of such an arsenic wave is 6 γ/cc in the case of fresh human milk; 5 γ/cc in fresh cow's milk; 4 γ/cc in regulated powdered milk; and 3 γ/cc in milk sold on the market.
2. In drawing the polarographic curve of the reductive wave of arsenic by addition of milk at various concentrations to a hydrochloric arsenic acid solution, the arsenic wave falls in proportion to the addition of milk protein. The percentage of the fall in the amplitude of arsenic wave is greatest in fresh cow's milk followed by milk on the market regulated powdered milk and fresh human milk in the order mentioned.
3. The rate of decrease in the amplitude of the arsenic wave in fresh human milk and the gelatin-protein of an equal concentration is greater in the latter. Therefore, it is obvious that the reaction between milk protein and arsenic is in no way associated with the SH-group.
4. By applying the Langmuir's formula to these results, it has been confirmed that the reactions are induced by the action of surface activity of the milk proteins.

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1. In the estimation of freely reacting SH-group of milk proteins by the electric photometer, the Kajita method is modified so as to use ammonium sulfate, (NH₃)_2SO4, in deproteinization-defatting processes.
2. The quantity of the freely reacting SH-group of milk proteins is greatest in regulated powdered milk dissolved to the concentration of the whole milk, followed by that in fresh human milk and milk on the market.
3. Even when the arsenic acid solution is made to act on liquid milk, no decrease in the freely reacting SH-group of milk protein can be recognized. In other words, no binding occurs between the freely reacting SH-group arsenic.

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1. In drawing the polarographic curve of SH-wave by making arsenic acid at various concentrations act on cysteine and glutathione, because the SH-wave and arsenic wave overlap with one another, it has been impossible to pursue the changes in the amplitude of the SH-wave itself.
2. In drawing the polarographic curve of arsenic wave by making cysteine or glutathione at various concentrations act on arsenic acid solution, no fall in the amplitude of arsenic wave can be recognized.
3. In the investigation of the binding of the SH-group of cysteine, glutathione and BAL with arsenic by Kajita's photometric method, while cysteine and glutathione do not combine with arsenic, the binding of arsenic and a dithiol compound, BAL, has been recognized.

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In drawing the polarographic curves of catalytic wave of protein and reductive wave of arsenic after adding arsenic acid to various milk solutions, by variation in the concentration of arsenic acid or proteins, changes occurred in the shape of these waves due to the action of surface activity of milk proteins. On comparing the action of surface activity of human milk protein with that of cow's milk protein, the following results were obtained.
1. As for human milk and cow's milk, when the concentration of cow's milk protein is adjusted so as to contain the same concentration of protein in human milk, it has been found that human milk protein possesses a superior action of surface activity than that of cow's milk protein.
2. In comparing the action of surface activity of human milk protein and cow's milk protein after changing the quality of milk protein by heating, it has been found that the surface activity of human milk pretein is greatly decreased by boiling, while that of cow's milk protein is decreased only slightly.
3. In comparing the action of surface activity of various milks by adjusting the pH of hydrochloric arsenic acid solution to 4.5 which is close to the pH of gastric juice of infant and to 2.5 which is the pH of gastric juice of adult, and when these solutions are made to act on milk, the most marked action of surface activity can be observed in human milk at the pH of gastric juice of infant. while in cow's milk at pH of gastric juice of adult. Moreover, at the pH of gastric juice of infant, the action of surface activity is superior in raw milk than heated milk in the case of human milk, while in heated milk rather in raw milk in the case of cow's milk.

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The granuloma pouch (Selye), being made on rat's back by injection of crotton oil, was observed under several conditions following application of some agents, curettage and so on.
1) At first, granuloma pouch showed hemolytic inflammation as mesenchymal reaction, and then gradually healing process was appeared.
2) In the hydrocortisone protected rats, granuloma pouch had tendency towards rapid fibrosis but these changes was not remarkable qualitatively or quantitatively.
3) In the salicylic acid injected rats, above mentioned changes were less than the former group.
4) The reaction of granulation tissue to chemical stimuli was examined. The results were same as “croszed resistance” of Selye, i. e. crotton oil made granuloma pouch was little influenced by chemical stimuli.
5) Repair process of incised wound of pouch wall was similar to healing process by secound intention, and initiated at the layer of granulation tissue.
6) The surface of granulation tissue became the fibrous or cicatrical healing after curettage. In the previously hydrocortisone injected pouch, granulation tissue showed same changes but more slowly.

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The 22 cases of serum hepatities (8.2%) was observed in the 217 cases of chest surgery with the blood transfusion of the stored blood.
The incubation was 42 to 205 days and most of the cases were occured in 3 months. The dosis of blood traesfusion was 600 to 2450 cc. The chief complaints were fever in the 14 cases, general tiredness in the 10 cases, anorexia in the 21 cases, nausea in the 13 cases, full feeling of the upper abdomen in the 4 cases, constipation in the 7 cases, vomiting in the 4 cases, headache and itching etc., and jaundice was seen in all cases, hepatomegaly was seen in the 19 cases and various liver function damages were also observed.

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1. The new patients of so called secondary epidemy of infectaous hepatitis were chiefly those who had been listed as the patients of latent hepatitis or inapparent infection in the previous epidemy.
2. In fairly great number of cases in which the patients were listed as inapparent infection, patients complained trifling subjective symptoms and later they were suspected as of slight abortive form. In the cases of compiaining subjective symptoms as well as in the cases of having no complaint, the percentage of onset was approximately the same.
In case of infectious hepatitis, it is considered that the germs may have same slight responsive effect upon the patient after infected, or sometimes may have no effect for considerablly long time, but as the physical strength declines, the germs show their special quality of causing the apparent symptoms.

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107 students of Showe Junior High School (out of 510) suffered from infectious hepatitis in a short period after 24th of May, 1954. Detailed clinical and epidemiological researches were made on them and the following results were obtained.
1. In the epidemic of this school, abortive form (gastro-intestinal form and partly common cold form) was seen in most cases and the epidemic belonged to the slight form of infectious hepatitis.
2. At that time, sporadic epidemie was seen among the people of this district.
3. It was supposed that this epidemie was carried by the contaminated water of the common well and it was the common vehicle epidemie.
4. The fact that many hepatitis patients appeared especially in June, was presumably due to the precipitating factor of interim examination, athletic meetings etc. reducing the physical strength.

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The complete examination was done on the 143 cases, passed for 1 year after the release of treatment under the diagnosis of recovery or after the suspensiou of treatment at Kamiarikan-Mura, Jyobo-Gun, Okayama in where there were the prevalence of shight abortive form of epidemic hepatitis with the prolonged course and the repetition of recurrence.
1. The cases remaining of subjective symptom were 50 (34.9%) and their complaints were mainly same to those on the course of disease.
2. Hepatomegaly iu 30 cases (20.9%) and splenomegaly in 10 cases (7.0%) were observed.
3. The cases showing a postive liver function test were 5.6-30.9%, and the cases showing only a slight increasion of serum bilirubin were and 5 (3.5%).
4. Since the above results, the cases required of treatment were 22 (15.4%), the cases required of care were 42 (29.3%). On the other hand, the cases having only subjective symptom without any evidences of liver damage were 36 (25.2%) on the addition of the above cases.
5. In this epidemic district, the unrecovered cases were mainly observed on female, especially female in the third decade.
6. It was keenly felt, that the recovery of epidemic hepatitis was very difficult, since the results of our observations in the epidemic area.

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The complete examination was done on the 81 cases, passed for 1 year after the release of treatment under the diagnosis of recovery or after the suspension of treatment at Kagato-Cho, Wake-Gun, Okayama in where there were the prevalence of slight abortive form of epidemic hepatitis.
1. The cases remaining of subjective symptom were 33 (40.7%) and their complaints were mainly same to those on the course of disease.
2. Hepatomegaly in 35 cases (43.2%) and splenomegaly in 12 cases (14.8%) were observed.
3. The cases showing a positive liver function test were 8.6-18.5% and the cases showing only a slight increasion of serum bilirubin were 5 (6.2%).
4. Since the above results, the cases required of treatment were 21 (25.9%), the cases required of care 4 (3.7%). On the other hand, the cases having only subjective symptom without any evidences of liver demage were 20 (24.7%) on the addition of the above cases.
5. The concept, the recovery of epicemic hepatitis was difficult, was supported with the above results in the epidemic area.
6 In this epidemic district, the unrecovered cases were manily observed on female, especially female in the third decade.

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The recovery of cpidemic hepatitis was investigated by the massexamination on the 340 cases, released from the treatment for not less than 6 mouths under the diagnosis of clinical recoverh. at Yoshikawa-Mura, Jyobo-Gun, Okayama in where the slight abortive form of epidemic hepatitis broke out in a large number. And the results were as follows.
1. The cases remaining of subjective symptom were 101 (29.6%) and their chief complaints were almost same to those on the course of disease.
2. Hepatomegaly was observed in 36.8% of the cases. The cases with palpable splenomegaly was observed in 2.8% and the cases with the enlargement of splenic dullness was observed in 19.4% of the cases.
3. Serum colloidal reaction was mainly applied for the liver function test, and the positive cases were 4.7-11.5% and questionably positive cases were 5.0-29.1%. On the other hand, the cases showing a increased serum bilirubin were 4.7% and it was 10.9% on the consideration of the cases showing a slight increasion of serum bilirubin.
4. Since the above results, the cases required of treatment were exdosed in 8.5%, the cases required of care were exposed in 23.3%, and the cases belonging to posthepatic syndrom were exposed in 7.1%.
Judging from the above results, it is thought that the complete recovery of this disease, even the slight abortive form, is considerably difficuls.

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It is well Known that B. coli. B. dysenteriae and B. cholera etc., so called indole positive Bacillen produce indole from tryptophan.
There are many reports of B. coli but only a few reports of B. dysenteriae. Then the author performed experiments with sh. flexneri 2a belonging to B. dysenteriae in order to study the Mechanism of indole production from tryptophan on B. dysenteriae.
The results were as follows:
1) Indole production from tryptophan by this organism is the most remarkable between PH 8.0 and 8.5.
2) Tryptophdn is completely converted into indole by this organism and the rate of indole production is almost equal to the rate at which the tryptophan disappears.
3) Of the various divalent metal ions tested, Hg⁺⁺, Ni, ⁺⁺ Co⁺⁺ and Cu⁺⁺ inhibit strongly indole production by this organism and the most remarkable is the inhibitive action of Hg.⁺⁺
4) Of the various inhibitors tested, KCN inhibits indole production most markedly.
5) When glucose, galactose or mannit are present in the growth medium, indole production is inhibited markedly. In contrast, xylose, lactose, saccharose, sorbit, and glycogen were without influence upon indole production.
6) When the glucose is present in the growth medium, small amount of indole was produced and no appreaciable indole production commenced until all the glucose was completely utilized. The inhibitory effect of glucose is not entirely due to the development of the acid side in culture resulting from the utilization of the glucose by this organism.
7) Tryptophanase activity is markedly reduced when bacterial cells are harvested from a meidum containing glucose.

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It is well known that tryptophan is necessary for the growth of B. typhosus.
The anthor analyzed this requirement of tryptophan from the point of view of the nutritive requirement of B. typhosus. The results were as follows:
1) Of ten strains, seven strains require tryptophan for growth, three strains do not.
2) S-58 which requires tryptophan utilizes no amino acid singlely as N source and S-60 which does not require tryptophan utilizes singlely glutamic acid, cystine and aspartic acid. Glutamic acid is especially utilized by S-60.
3) S-58 does not grow in the absence of tryptophan and grows scarcely in the absence of cystine and grows a little in the absence of aspartic acid. On the contrary S-60 grows in the presence or absence of tryptophan and grows scarcely in the absence of cystine and grows a little in fhe absence of aspartic acid.
4) Tryptophan has the effect on growth at 10^-8 Mol. From this and the fact that above mensioned the strain which requires tryptophan could not grow in the absence of tryptophan tryptophan is fouud to be “growth factor” fot the strain.
5) Indole is found to be approximately equally effective as tryptophan.
6) Indole acetic acid and skatole is more weak effective compared with indole.

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Ever since Papanicolaou (1923, 1933) first reported the application of vaginal smears in determining the changes in pregnancy, cytological studies on the vaginal smears in the field of obstetrics gained its importance in the application for early diagnosis of pregnancy, for various disturbances and fidings during pregnancy, for the prognosis, for the determination of fetal sex, and for the determination of the delivery time. In this field of study there are numerous works, but reports of the successive follow-up studies on the same subject are scarce and for in between. In view of individual differences in the cytological picture of vaginal smears and various changes under varied conditions it is impossible to carry on accurate observations satisfactorily unless continuous observations be carried on the same subject. Therefore, the author undertook a series of continuous observations as regards changes in vaginal smears in the course of pregnancy from the endocrinological standpoint and studied the diagnostic value of the vaginal smears on the determination of the delivery time and various disturbances, and conducted screening tests for the purpose of detecting uterine cancers as well.
The subjects of the present research were 1, 275 patients visiting our obstetrics clinic during the period from July 1, 1957 to the end of December 1958. Vaginal smears were taken from everyone of them, and after staining these smears with Papanicolaou E. A. 36 stain observations were carried on. As for the endocrinological observations the author stupied the percentage of various cells, variations in the cornification index and acidophilic index, charactristics of various cells, and components other than those of the epithelium. The representation of the determined values are classified into I to V grades according to Papanicolaou's method.
The Experimental Results
1. In the continuous observations carried on the changes in the vaginal smears of 40 normally pregnant women for the period from the early stage of pregnancy to the stage just before delivery distinct differences can be recognized according to the degree of cleanliness. Namely, in 21 cases whose cleanliness has been maintained at a high degree throughout the period a considerable number of intermediate cells can be observed, and these increase gradually with the advance of pregnancy; but decrease just before delivery. The cornification index is, however, low and keeps on decreasing gradually but it tends to rise before delivery. In the seven cases whose cleanliness has been poor throughout the period the percentage of intermediate cells is low, showing not much variations. The cornification index shows a high percentage with marked fluctuations, and gradually decreasing with the advance of pregnancy, it shows a slight increasing tendency just before delivery. In 12 cases whose cleanliness varied during the period the vaginal smear picture presents a tendency to change the number of various cells above mentioned in proportion to the changes in the clenaliness.
2. Because there is a tendency to present variations in the number of cells, an increase in leucocyte count and mucus content, the dissemination of cells and a decrease in the stainability of cells during the period before delivery as a forementioned, from these changes in cytological picture it is possible to determine the time of delivery to a certain extent. On the observations in 275 cases the rate of reliability in such a determination amounted to 68 per cent, but it was difficult in those with a low degree of cleanliness.
3. In 15 cases of miscarriage the cornification index and acidophilic index were low, with increase in the leucocyte count and mucus content, but similar findings were revealed even in normal pregnancy with a low level of cleanliness, making it difficult to diagnose accurately.

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Of 451 cases treated by the non-bleeding technique at Department of Orthopedic Surgery, Okayama University Medical School for the period from June 1954 to December 1955, the author pursued the 47 cases on which the follow-up study was possible for the periods of 3 years and one month to 4 years and seven months after the treatment, and obtained the following results.
1. For the treatment of infants with congenital dislocation of hip joints we took a special care so as to keep the tissue damage as little as possible by the atraumatic technique. As a consequence with one exception that developed cerebral paralysis in all other 46 cases we were able to obtain excellent clinical results.
2. However, by the X-ray examination the majority of them revealed the roof of acetabulum to be still steep and also the head of femur to have moved slightly exteriorly upward. Moreover, at this instance various measurement of α angle, h/1 and H/1 were significant, but CE angle and Schenton line was not.
Furtnermore, although the atrophy and sclerosis of bone can not be represented numesically, it is believed that these will have a significant bearing on the treatment and prognosis of congenital dislocation of hip joints.
3. From the examinations of the tissues obtained from the edge of the acetabular roof of foetus and of the biopsy specimen from infants both with dislocation of the hip joint, it is assumed that the congenital defect of mesenchym coupled with the kinetic relationship between the roof of acetabulum and the head of femur presents pathological findings.
4. For those showing a poor growth of the acetabular roof in congenital dislocation of hip joint during the treatment by non-bleeding technique and still revealing a steep acetabular roof we replaced the cartilagenous tissues of that part by trephin, expecting to promote the growth in that part. The results were at variance, and in the final analysis, it seems that a more important problem in such cases is the method how the head of femur may be kept centripetally.

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Out of 10, 000 cases delivered at the Department of Obstetrics and Gynecology, Okayama University Medical School during the period from April 1934 to November 1957, the author conducted statistical observations on 29 cases of prolapse of the umbilical cord from various viewpoints; and obtained the following results.
1. The incidence of prolapse of the umbilical cord is 0.29 per cent being lower than that formerly encountered. The incidence of the prolapse in primpara and grand-multipara is significantly higher than that in multipara.
In the age range below 29 years old and over 30 years there is no significant difference in the incidence. Looking at from year to year, the incidence of prolapse of the umbilical cord is on the increase, and from the duration of pregnancy the incidence in premature labor is low.
2. As for the causes the abnormal presentation, premature baby, the shift of the presenting part due to Metreulysis or Colpeurysis, abnormally long umbilical cord, early rupture of membrane, contracted pelvis, enlarged pelvis, placenta preavia and so forth can be pointed out.
3. Hardly any disturbances can be recognized in the mother.
4. The mortality rate of infants with prolapse of the umbilical cord.
a. The prognosis of such infants is extremely poor, amounting to 44.44 per cent of the total mortality, while the mortality rate of the infants still living at the time of discovery of the prolapse amounts to 44.0%. This is somewhat lower than the formerly reported rate, still it is quite high.
b. There seems to be no marked relationship between the mortality rate and the frequency of labors, but it tends to show a higher rate in older women.
c. The mortality rate is highest in transverse presentation followed by cephalic presentation and breech presentation in the order mentioned. In breech presentations foot presentation can not be said to be always good in the prognosis.
d. The mortality rate is generally high in abnormally long umbilical cord.
e. It is higher in spontaneous rupture of membranes than in the artificial rupture.
f. Speaking from the height and the movableness of the presenting part, the mortality rate is highest in those engaged in pelvic inlet or slightly engaged in pelvic inlet, but it becomes lower in the order of those with the mouable head above pelvic inlet, with the head in pelvic expantion, and in plane of pelvic contraction and plane of pelvic outlet.
g. The mortality rate is higher in ones with poor dilatation of the uterine orifice than in those with the complete dilatation.
h. As for the treatment of prolapse of the umbilical cord, since the mortality rate is higher in the case requiring a longer period of time for delivery and expectant treatment such as reposition of cord is unsatisfactory, it is desirable to give abdominal caesarian section as far as it can be indicatad.
i. The longer the duration from the onset of labor to expulsion the poorer is the result. For this reason, it is necessary to discover prolapse of the umbilical cord earlier and what is more, the care must be excercised so as to prevent its occurrence.

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The rupture of the umbilical cord at labor is relatively frequent in the precipitate or operative delivery but it is quite rare in the spontaneous labor. Moreover, a single rupture of the umbilical artery is all the more rare. In the present report is presented a rare case of stillbirth due to a single rupture of the umbilical artery in the first stage of labor, the case on which we were able to perform autopsy, and confirmed it to have specific changes in the umbilical cord alone despite no abnormalities in other parts.
The mother was a 26-year-3-month-old primpara. Her family is composed of seven members, with no abnormalities in hereditasy relation nor in pregnancy, Rer S. T. S, negative, and no incompatibility of the Rh factor. About 19 hours after the onset of labor, 18 days past the expectant date suddenly the heart sound stopped at the time when the exfernal os was about 4 cm. dilated. One hour and 40 minutes after that the external os was fullydilated with spontaneous rupture of the membrane, (fluid of reddish, yellow and green color). Ten minutes after the complete dilation of the orifice she gave a stillbirth to a mature baby girl. There was no malformation or any other abnormalities such as the coiling of the umbilical cord, the length of which was 48 cm. One umbilical artery had no Walton's jelly subsrance at five points, namely, 1, 10, 17, 22, and 27 cm from the navall and the exposed artery had hematoma of umbilical cord. as large as the tip of thumb at the point 15 cm from the navol. One of the exposed arteries was complefely ruptured and form-ed a ruptured foramen.
In histological examination of the umbilical cord, the ruptured part had no Walton's jelly substances whatsoever, and although no marked changes such as of syphilis on the arterial wall itself, could be recognized the growth of elastic fibers was extgemely poor.
According to the literature there are found the fallowing causes for the rupture of the umbilical cord, namely, A, traumatic changes; B, anatomical changes; C, retrogressive changes; and D, inflammatory changes It is believed that each of these causes will work in conjunction with one another in various ways. The authors are of the opinion that B and C are mainly responsible for the present case. Moreover, Klein, Montaflora and Nebesky state that the point 1/3 from the foetus is the point where the rupture of the umbilical cord is apt to occur. Likewise, we found the rupture at 1/3 away from the foetus in the present case.

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It is generally accepted that the air pressure in the middle ear cavity is regulated by the Fustachian tube. Moreover, it is well known that the opening of the Eustachian tube is brought about by the tensor palati muscle, the lebator palati muscle and the salpingopharyngeus muscle, but there is no complete agreement as yet on the question by what mechanism each of these msucles performs the opening action.
With the purpose of elucidating this point, the author studied by the methods mentioned below the relationship between each of these msucles and the Eustachian tube, especially the relatiônship between the tensormuscle and the membranous portion, that between the levator palati muscle and the base of the Eustachian tnbe and alse the question as to whethet or not the salpingopharyngeus msucle can function independently.
1. Macroscopic observations; Using six autopsy specimens containing the tensor palatini muscle, the levator palatini muscle and the salpingpharyngeus muscle which were taken from the right side only and fixed in a 10% formalin solution, the author explored muscle fiber ends of each by magnifying them threefold with a loupe.
2. Histological oaservations; In six autopsy cases other than the above-mentioned, their tissues surrounding the Eustachian tube and tube and tubal muscles are removed and fixed in a 10% formalin solution and decalcified, embedded in paraffin, and than sliced at a right angle to the axis of the tube into serial sections 25U thick. After hematoxylin-eosin staining the author studied hsitologically the relationship between the tunal cartilage, membranous portion and tubal muscles. The following are the results.
a. Tensor muscle. It is sometimes possible to divide the tensor msucle into the anterior, middle and posterior parts, ans the muscle fibers are abundant in the middle part. Commonly the source of this muscle is found in the skull base and in the lateral cartilaginous lamina, but in some instances this muscle originates in the middle portion of the muscle at the membranous portion near the lateral cartilginous lamina. The other portions of the tensor muscle appear to be connected with the membranous portion only by connective tissue. The density of the connection differs in individual cases, and moreover, in some cases they can be readily separrted while in others they are compactly connected with one anoeher.
b. Levator muscle. This muscle generally runs parallel with the longitudinal acis of the tube under the base of the Eustachian tnbe, ane some send out several muscle fibers from the inferior part of the mucous membrane of the tube. In some instatces muecle fibers are observed originating from the inferior terminal of the medial carti agenous lamina and inferior exterior side of the tube.
Moreover, the relationship betwee tensor muscle and tubal base differs according to the construction of the tubal cartilage. Namely, in the shape generally know, the levator muscle adheres to the base of the tube for its whole length, and in the case where the inferior terminal of the tubal medial cartilagenous lamina is running around the exterior side like lateral lamina (the author designates this as type II distinguishing it from the cartilage of the generally-Know shape which is designated as type I) and in the case where by the presence of auxiliary cartilage the cartilage presents a shape similar to type II, it is obvious that cartilage exists between the levator muscle and the base of the tube.
c. Salpingopharyngeus muscle. In some cases muscle fibers are lacking in the salpingopharyngeus muscle, and even in those having muscle fibers, the number of such fibers is small, occupying only a portion of the salpingopharyngeal fold.

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On the basis of the findings on the relationship between tubal muscles and the Eustachian tube as described in the previous report, the actions of various tubal muscles on the Eustachian tube are discussed, and the observations carried out by the methods described below on the movements in vivo of the naso-haryngeal orifice at the time of phonation and of swallowing reveaied the following results.
1. Observations were carried out with the use of a nasopharyngoscope.
2. Observations were done on the patients who underwent the radical operation for the cancer of maxillar sinus. As the inferior nasal concha was already removed at the time of the operation, it was possible to insert a small nasal mirror into the posterior nasal cavity of the operated side to catch the whole view around the tubal orifice of healty side.
3. For the children over 5-6 years old with cleft palate, observations were carried out directly on the pharyngeal orifice through the mouth cavity (motion pictures were taken in this instance).
At a result it has been found that the nasopharyngeal orifice of the tube is widened because the posterior lip and the mucous membrane of the base of the Eustachian tube move slightly outward at the time of swallowing. In anatomically summarizing these observations the author arrived at the following conclusions.
At the time of swallowing the tensor muscle of the palate dilates the Eustachian tube at the points near the middle part and the anterior part of the tube. The levator palatini muscle assists the opening action of the tensor muscle by fixing or by drawing the base of the tube slightly toward the inferior-interior side. The salpingopharyngeus muscle or the salpingopharyngeal fold, being drawn inward by the cephalopharyngeal muscle and pahryngopalatine muscle and widening the nasopharygeal orified, assists the dilatating action of the tensor muscles.
When the muscles are relaxed, the Eustachian tube is closed probably by the elasticity of the lateral cartilaginous lamina and by the pressure of the tissues surrounding the tube.

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It is well known that the serum of cancer pationt possesses a specific coagulability to heat. By estimating heat-resistant non-coagulating substances of the serum in the rabbits previously injected with cancer tissue extract and benign gastric mucosa extract by Tsuda-Okujima's method the author pursued changes in these substances as well as inves tigated the relationship between the erythrocyte count, leucocyte count, and plasma protein content. The following are the results.
1. Rabbits given intravenous injection of cancer tissue extract to the ear-lobe show marked differences from those similatly injected with benign mucosa extract.
2. Observation for a long period of time is possible when extract is given intraperitoneal, and those injected with cancer tissue extract show a marked increase in heat-resistent non-coagulating substances when compared with those injected with benign mucosa extract.
3. There is a certain relationship between the change of the erythrocyte count and that of the hemoglobin content, namely, between the degree of anemia and the change of heatresistant non-coagulating substances in serum, but in the strict sense it is not a parallel relationship.
4. Between the leucocyte count and heat-resistant noncoagulating substance not any relatinoship can be recognized.
5. No completely parallel relationship can be recognized between the plasma protein content and heat-resistant noncoagulating substance.
6. Likewise no parallel relationship can be seen between tyrosine excreted in urine and heat-resistant non-coagulating substance.

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While paying a due attention to the change in heat-coagulability of the serum of cancer patient, the author estimated the fluctuations of heat-resistant non-coagulating substance in the serum with polarography, and applying it on cancer diagnosis, studied the relationship between anemia, the leucocyte count, the rate of erythrocyte sedimentation, and the liver function
In addition, with the cases with gastric cancer the author studied the relationship between the fluctuations above mentioned and various supposed to exert in fluences on the height of the polarographic wave; and obtained the following results:
1. In the patients with gastritis, gastric and duodenal ulcers the polarography gives the negative cancer reaction in 100 per cent.
2. Gastric cancer patients show the positive cancer reaction in the polarograph in 92.9 per cent.
3. In the patients with malignant tumors other than gastric tumor the cancer reaction is positive in 79.2 per cent. Negative cases are found frequently in the cases with malignant tumors such as those of mammary glands and thyroid glands not belonging to the digestive system.
4. In various diseases other than malignant tumors (excepting gastric cancer) 73 per cent of them show negative cancer reaction, but positive raction can be frequently encountered in tuberculous disease, occlusion ileus, extensive disorders in the digestive system, and diseases of the reticulo-endothelial system.
5. No direct relationship can be recognized between the heat-resistant non-coagulation reaction of serum (Tsuda-Okujima's method) and the polarographic cancer reaction.
6. Neither any direct relationship can be observed between this cancer reaction and anemia, the leucocyte count, the plasma protein content, the rate of erythrocyte sedimentation, the liver functon, and jaundice.
7. As for the cases with gastric cancer:
a. No relationship can be recognized between existence or non-existence of free hydrochloric acid in gastric juice and the height of polarographic wave.
b. The greater the size of gastric cancer the higher is the height of the polarographic wave.
c. There is no relationship between the site of gastric cancer and the height of polarographic wave.
d. In the macroscopic classification (Borrmann) of tumors, it has been found that the height of polarographic weve increases along wirh the progress of the disease from type I to type IV.
e. In those histologically suggesting undifferentiation and a higher degree of malignancy, the height of the polarographii wave is higher.
f. Summarily viewing the course of progress in the symptoms of gastric cancer, as the disease progresses from the early stage to the terminal stage, the height of polarographic wave becomes higher.

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With the brain and liver of various animals (mice, catfish, bull-frogs, common turtle, and chicken) as the materials the author investigated the transamination of taurine and α-ketoglutaric acid by means of paper chromatography; and obtained the following results.
1. No transamination of tuarine-glutamic acid can be recognized in any of these animals.
2. In the liver likewise no transamination can be detected.
3. Taurine is in no way associated with glutamic acid in the processes of the transa-mination.

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Thirty patients with heart diseases, both congenital and acquired in origin, have been treated surgically. Pre- and postoperative changes in serum calcium and potassium were studied in comparison with those in the other operations.
Results obtained were as follows;
1) Preoperative Ca and K concentrations in sera remained within normal ranges, and para- and postoperative changes were almost similar to those in other operations with some exceptions.
2) Most of the cases who resulted in death showed variations in Ca and K levels before the operations which were easily influenced even by anesthesia, and many of them showed distinguishable decrease in Ca and increase in K levels. Disturbances of cardiac function due to those abnormal metabolism of electrolytes can be considered one of the causes of death.
3) Marked variations in Ca and K levels were found in cases with combined two cardiac lesions one of which was treated surgically, cases with the signs of cardiac failure, cases subjected to only exploratory thoracotomy, inadequately indicated cases and cases advanced in age.
4) Patients operated by means of pump-oxygentor showed almost same changes with patients operated on without the pump.
5) Application of pharmaceutical hibernation did not cause any significant changes in Ca and K levels. However, combined methods of pharmaceutical hibernation with general hypothermia or selective brain cooling by irrigation both showed considerable decrease in those levels, which remained in slight changes by preoperative administration of DOCA and Cortisone.
In cardiac surgery, no special cares were needed on the changes in electrolytes metabolism when the pathological conditions caused by the heart diseases were correctly evaluated and treated under precise preoperative laboratory works.

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Selective brain cooling by irrigation combined with coronary perfusion and controlled cross circulation for the purpose of circulatory interruption during intracardiac correction under direct vision were studied on the standpoint of myocardial Ca and K metabolism in dogs. Following results were obtained.
1) Changes of the myocardial intake and output of Ca and K in the both methods were slight as in the routine thoracotomy at normal body temperature. They were found to be very useful methods is this regards.
2) However, in the use of low or moderate flow in these methods, and in combination of brain cooling with induced cardiac fibrillation or cardiac arrest, the changes in Ca and K levels were relatively marked. Therefore, it would be suggested that attentions should be pay to the pathological meanings of these Ca and K changes in the diseased heart.

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