At present, the treatment of malignant tumor is chiefly dependent on the surgical treatment. Early detection and early operation are considered indispensable. The rate of complete cure, however, is extremely low as yet. On the other hand, a number of antitumor drugs have appeared in the last decade. This author is of the opinion that there is a limit in the surgical treatment of malignant tumor and, therefore, it should be applied in combination with chemotherapy. Out of the 23 patients hospitalized since the year 1956, 135 cases were selected to undergo the treatment of 23 different combinations of antitumor drugs such as Sarkomycin, Carzinophilin, Nitromin, TESPA, Glucosamine, Mitomycin etc. It was not successful, however, to detect any combination of special significance. Side effects of those drugs also showed no particular difference by the difference in their combination. Somewhat better effect, however, was observed by the combination of Sarkomycin, Nitromin and Carzinophilin. Leucopenia is the most harmful therapeutic disturbance among the side effects of antitumor drugs. If it is possible to inhibit the development of this leucopenia, there will be a marked enhancement in the therapeutic effect of the present antitumor drugs. In this connection, animal experiments were undertaken in order to know the effect of Cobalt greenpole, Splenic homogenate, L-4 cystein, Glucosamin and Leucon. Cobalt greenpole and Splenic honogenate were relatively effective, but Leucon gave the most satisfactory result. As for L-4 cystein, though it appeared to show remarkable effect, its clinical application should be suspended as reported by Iwata, until further studies are completed. Shock treatment with a large dose of Nitromin was also attempted, but in many cases, there was a sudden appearance of systemic emaciation accompanied by remarkable leucopenia and in some cases their deaths were quickened. Though chemotherapy of malignant tumor has a number of difficult problems to solve, some elongation of the life span was recognizable among the patients received chemotherapy in comparison with that of the 96 cases without chemotherapy enocuraging and promising the further development of the chemothepapy of malignant tumor.
Frequency of the appearance of cystic mastitis and its histological types were investigated on the 3 groups of mammary glands collected from autopsy, breast cancer and biopsy cases. Frequency of the appearance of mastitis in the mammary gland of autopsy cases was discrepant among different investigators. This discrepancy is considered to be due to the difference in providing standards of mastitis or the difference in the method of survey. In this connection, this author provided 7 different criteria and investigated the frequency of the appearance of mastitis. As the result of this investigation, mild mastitis was observed in more than 90% and depending on the criterion employed. The figure showed a great variety of changes. Same was true with the mastitis accompanying breast cancer, and in this case the frequency of the appearance of mastitis was much higher. As for the mastitis detected by biopsy, it was characterized by adenosis, namely, the frequency of the appearance of adenosis was higher among the cases of breast cancer and biopsy than those of autopsy. Especially, the frequency of appearance from biopsy cases was twice as much as that of autopsy cases. This fact may indicate that adenosis is the most important factor of developing mastadenoma among the outpatients of this author's clinic. As for the frequency of the appearance of breast cancer, it was the highest in the age group of 41-50 years and mastitis in the age group of 31-40. In autopsy cases, moreover, it should be emphasized that the duct papillomatosis was most frequent among the age group of 41-50. This finding is highly significant in combination with the especially high rate of the appearance of apocrine metaplastic epithelium. Clinically, the breast cancer accompanying mastitis in the age group of 41-50 should be carefully watched.
Mice fed a low protein diet or a low sulfur compound diet showed a marked decrease inn redioresistance. Survivors reduced 50% compared to the control animals 30 days after irradiation in both malnutriated animals. 500r whole-body irradiation made in the liver of mal-nutriated animals the severe lesion off necrosis, which otherwise was never the case. The time of death was different in mal-nutriated from those assumed to be bone marrow death. And this offers very interesting fact in relation to the liver necrosis.
While investigating the blood vessels of embryonic adrenal gland, this author happened to make a corrosion anatomical preparation of the central veins of adrenal medulla and dicsovered a new fact. In most cases, the horizontal central vein which begins from the lateral angle of medulla is the largest and all the other veins gather into this venus. Intramedullar central veins join into the horizontal central vein passing through the first, second and the third veins.
Mucoid type variant generated from the Mutabile type variant of Salmonella enteritidis by mutation. Its characteristics were found to be as follows : 1. When the Mutabile-type variant (Mut) was cultured on Endo's or galactose-Endo's plate over night and lett standing in a room temperature for 2-3 days, daughter-like growth of mucoid Mut colony was recognized. 2. M-N (Kauffmann) variation was recognized on the mucoid Mut. 3. Mucoid Mut has a lesser degree of changes in the bacterial body than ordinary Mut and its galactose sensitivity was 6.3γ/0.01 ml being relatively resistant in contrast to that of 1.67 for the starting Mut and reversed Mut. 4. The variation from mucoid Mut to non-mucoid Mut (Murase) was recognized. 5. The variation from mucoid Mut to mucoid RT (Fukutome et al) was recognized. 6. The variation from mucoid RT to non-mucoid RT and to non-mucoid Mut was recognized. 7. The variation from mucoid RT to mucoid Mut was recognized. 8. The mucoid character of mucoid Mut was dependent on the presence of galactose or galactose factor in the culture medium, but mucoid RT formed mucoid colonies even on plain agar plates. It can be said, on genetic point of view, that the mucoid character acquired in Mut generation (whether or not it is due to the spontaneous mutation is dependent on the fact that whether or nott the same mutation does take place in the original strain or RT) was transmitted to the following., RT generation and further to the Mut generation.
Several supplementary studies were undertaken on the dwarf (D) type variation of Salmonella typhi. Firstly, D type colony mutants were isolated from Salmonella typhi Ty2 (S type) and the one obtained from V type colony of Ty2 strain was named as dv and that from the W type colony as dw. Findings of the studies made on those variants were as follows : 1. D type colonies of the 24 hour growth were 0.2-1 mm in diameter, while S type colonies had a diameter of ca. 2 mm. In contrast to the latter, the bacilli of the former type colony were rather irregular in size. 2. The variation of S (V) -3dv→S (V) —dv was recognized. 3. The variation of S (W) →dw→S (W) →dw was recognized. 4. The rate of D-S variation showed no difference on varying culture media such as blood agar, various kinds of sugar agar, Endo's agar, and sodiun sulphite agar. 5. All the 4 kinds of colonies possessed similar f ermentability against various kinds of sugars. Acid agglutination and O, H and Vi factor serum agglutination showed the presence of relationship of V type to W type but not to D type or S type. 6. As for their virulence in mice, there will not be a great mistake in regarding that those 4 mutants possess the relationship same as that stated above.
To investigate the influences of reduced and oxidized caeruloplasmin on the liver metabolism of rats, copper and iron metabolism, catalase activity and tissue respiration were estimated. Caeruloplasmin were administered to rats repeatedly into their tail veins. Following results were obtained. 1) The increase of copper level and marked increase of iron level per gram of liver weight were observed in rats administered caeruloplasmin. 2) Catalase activity and tissue respiration of the liver of rats were increased by administration of copper protein. 3) These influences of caeruloplasmin on the liver of rats were greater in its reduced form than in its oxidized form. The increase of catalase activity, tissue respiration and iron level of rats was observed more markedly when caeruloplasmin was administered for long period.
Chemical elements of Gelée Royale (R J) are reported to be somewhat different depending on the analizer but it is said to contain Vitamin B1, B2, B5, B6, B8, B12, Pantothenic acid, Biotin, Amino acids, Mono-Saccharide, Polysaccharide, Enzyme, Acetylcholine, Cholinesterase, Biopterine, Kynurenine, Antibacterial and Antitumor substances etc. In the present study, fertilized eggs received the injection of R J and an investigation was made on the influence of this injection on the development of chick embryos as well as on the nitrogen metabolism in the allantoic fluid of the developing eggs. Generally speaking, embryos of the eggs received R J injection showed better growth with larger increase in the body weight than the control eggs in the latter stage of incubation. In all cases, no deformity was recognized. X-ray findings of the bone showed no abnormality. In the latter stage of incubation, the nitrogen content of allantoic fluid was slightly higher in the eggs received R J than that of the control demonstrating the change in the dose of nitrogen excretion.
Usually, renal blood flow is temporarily stanched when applying partial nephrectomy. A number of different methods have been devised for this purpose of which the use of forceps is most popular. This mechanical stanching of the renal blood flow, however, inevitably gives damage on the renal parenchyma more or less. With an intention of knowing the difference in the intensity of this disturbance and in the mode of its healing following the difference in the power of oppression by the forceps and also in the period of stanching, experiments were undertaken employing rabbits. First of all, pressures given on the point of Kocher's non-toothed forceps and intestinal forceps were determined. The pressure of the former was found to be about 3-4 times as strong as that of the latter. With those two different kinds of forceps, renal blood flow was stanched for 5 different periods of 30, 60, 90, 120 and 150 minutes and nephrectomy was applied on varying days from 3 to 20 days after applying forceps for histological observation. Intensity of the renal disturbance was severer when Kocher's forceps were used provided the period of stanching was short. There was no difference in the intensity of renal disturbance, however, when the period of stanching was long. In order to know the maximum limit of stanching period, renal blood flow was stanched for different periods from 30 to 150 minutes. In the animal received stanching less than 60 minutes, the parenchymal damage was found to be virtually healed by 6 days after application of forceps. Some changes still remained, however, even after 10 days in the animal received stanching for 90 to 120 minutes. Temporary stanching of the renal blood flow at the time of parenchemal operation, therefore, should be made by application of the minimum pressure for the shortest period of time required for the operation.
Descriptions were made on the pathological and histological findings with some consideration on the literature of an autopsy case of a female 40 years old suffering from pseudo-diaphragmatic hernia probably due to the costal fracture experienced 8 years in advance.
The effect of penicillin on the Cholera vibrio was studied and the following results were obtained. 1. Cholera vibrio is originally resistant to penecillin and the minimum inhibitory dose ranges from 1 to 32 u/ml. The resistance was increased by successive inoculation in the penicillin-containing media. 2. The biological activities of strains on increased resistance were slightly decreased or not changed, as compared with original strains. 3. The catalase activities were increased in the early stage of penicillin action, and became normal after 10th passage in penicillin-containing media. 4. The resistance of Cholera vibrio was decreased to the original level when preserved in the broth. 5. No special difference was seemed to be present in the mode of resistance increase between penicillin-sensitive staphylococcus and resistant vibrio.
The effect of sodium chloride on the chromogenesis and coagulase activity of pathogenic staphylococci isolated from surgical infections were studied, and following results were obtained. 1. 7.5% NaCl proteose lactose agar can be used for the test of chromogenesis of staphylococci, with slightly poorer result than milk agar, though better than ordinary nutrient agar. 2. Coagulase test with 7.5% NaCl proteose lactose agar culture, immediately after suspending the culuvre in broth of NaCl at low concentration, shows no enhancement of coagulation of plasma. For the enhancement of coagulase activity, incubation at 37°C after suspending in broth of NaCl at low concentration is necessary.
The antibiotic sensitivity was determined by paper disc method for 102 strains of staphylococcus aureus isolated from the pus of surgical suppurative infections, and following results were obtained. 1. The percentages of sensitive strains among 102 strains against five antibiotics are as follows 7.8% against penicillin 73.5% against streptomycin 97.1% against aureomycin 91.2% against chloromycetin 90.2% against terramycin 2. Most of antibiotics show additive action by the combined use of them, and this action is marked for staphylococci isolated from un-treated patients rather than those of treated patients with penicillin, streptomycin, and their combination. 3. The combine action of penicillin and streptomycin is mostly additive to the strains isolated from un-treated patients, and mostly antagonistic to the strains treated with penicillin, streptomycin, and their combination.
Many workers studied about the synergism and antagonism that will occur among many antibiotics, but the results differ each other according to the strains of bacteria, drug concentration and the other conditions of experiment. The authors investigated the combined action of penicillin and aureomycin on staphylococci, and the following results were obtained. 1. Staphylococci became highly resistant to penicillin by continued passages in penicillin-containing media, but these bacteria obtained the slight increase in resistance to aureomycin by continued passages in aureomycin-containing media. 2. The increase in penicillin resistance of staphylococci was inhibited almost completely by continued passages in penicillin media containing either 1/3 or 1/6 dose of minimum inhibitory dose of aureomycin, and the aureomycin resistance of staphylococci was also highly inhibited by continued passages in aureomycin media containing either 1/3 or 1/6 dose of minimum inhibitory dose of penicillin. 3. The effects of combined action of penicillin an aureomycin on staphylococci were synergistic in most cases and slightly antagonistic or indifferent in few cases, when the doses of one drug added to another were varied in quantity from 1/3 to 1/6 dose of minimum inhibitory doses. 4. The toxicity of antibiotic-treated staphylococci to mice was weaker than those of original strains.
Since reports on the prevention and the closing method of the ramnant cavity of lower or middle lower lobectomy of pulmonary tuberculosis are few, there are a number of problems yet to be solved in this connection. Reported in the present paper are the findings of the effect of phrenic anesthesia and upper thoracoplasty applied in combination with lower or middle lower lobectomy. The results obtained were as follows: 1. Phrenic anesthesia should not be applied in combination with lower lobectomy as it reduces pulmonary functions. Remnant cavity closes by itself without the application of anesthesia. 2. As for the upper thoracoplasty, a modification was devised in order to retain the motility of the 6th rib which is impaired by Björk's osteoplasty. 3. Lobectomy applied in combination with upper thoracoplasty leaves less post operational changes on the diaphragm and the pleura. In spite of the disadvantage of thoracoplasty, it maintains excellent diaphragmatic movement and accordingly pulmonary functions. 4. Lobectomy combined with upper thoracoplasty produces marked diminution of the Segment 1 and Segment 2 and therefore is effective on the lesions left in those segments. It produces, however, an excessive swelling of the Segment 3. This combined application of upperthoracoplasty, moreover, appears to be effective also on the lesions of the counter side. 5. This author's Serial tomography is recommended for the determination of the lung volume with its shape before and after operation.
Descriptions were made on the 4 cases of non-tuberculous spontaneous pneumothorax (cured by a single time evacuation 1 case, drainage 1 case, and cystectomy 2 cases) all of which were found to be caused by the emphysematous cyst. Descriptions were also made on the 3 cases of giant cyst (no treatment for 8 years 1 case, total extirpation 1 case and cystectomy 1 case) found among the patients diagnosed as spontaneous pneumothorax. Treatment given was first the evacuation attempted by the use of the appartus for artificial pneumothorax, when this was not sufficient, drainage was applied and if this was still insufficient, cystectomy was given. Spray of talc in inside of the thorax before the treatment could prevent recurrence. Talc spray was also applied at the time of surgical operation, but no symptoms of irritation due to this spray of talc was recognized.