Abnormal water distribution and fatty liver have been pointed out as the most important findings of “ekiri”. Quantitative investigations, however, have been never carried out either on the water content of various organs or the lipid content of liver despite the clinical evidence of dehydration, the striking brain edema and enormous fatty liver encountered in autopsy of “ekiri”. The water content of various organs and the content of neutral lipid, the major constituent of fatty liver were measured by the author. Furthermore, the liver methionine, so called lipotropic substance, under a series of conditions divided into infectious and non-infectious diseases was quantitatively analized in order to: study the mechanism of fatty liver.
The results were as follows:
1) The water content was reduced in “ekiri” in muscle and skin, especially in thelatter, forming a striking contrast to it's marked increase in brain.
The children of 2 to 6 years of age demonstrated the greatest rise of water content of brain, whereas those of one year showed no such tendency.
When fluid is given intravenously to the “ekiri” patients, the dehydrated parts of body became normal, but edema was still more exaggerated in the already edematous parts of body, which could be, however, avoided to a certain degree by the simultaneous use of adrenocortical hormone.
2) The great majority of “ekiri” cases demonstrated a marked increase of liver lipid, and other infectious diseases showed a tendency to a slight increase. Lipid content was not elevated in none of the non-infectious diseases investigated except one case of acute phosphorus poisoning with the most intense fatty liver.3) The free as well as the total methionine were reduced in the liver of “ekiri” cases, but not at all in the liver of acute phosphorus poisoning, suggesting different mechanisms of fatty liver in these two conditions.

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1. Candida was detected in 20.4% from healthy persons (C. alb. 15.9%) which agreed well with the reports hitherto given. The incidence was high in the infancy with decline in the growing age and increased again in the adult reaching its highest value in the old age. Females were more frequently involved than men. With the new born of a few days it was 9.4%, with the sucklings 22.4% and with the artificially fed higher. Seasonally it was highest in summer. C. alb. and C. trop. were found consistently through out the year.
2. Acute infectious diseases demonstrated 52.0%(C. alb. 38.1%), 2.5 times as high as that of healthy persons. “Ekiri”, diphtheria, typhoid fever and Japanese encephalitis were conditions in which C-group, especially C. alb. were most often detected.
There was no relation between the existence of candida group and streptococcus hemolyticus, whereas a close relationship was noted with bacillus diphtheriae in pharynx.
3. Internal diseases:
The average rate was 32.2%(C. alb. 26.8), the metabolic diseases showing the highest, 56.5%, the parasitic the lowest, 20.7%. and the mental 22.7%.
4. Tuberculosis pulmonalis: 38.5%(C. alb. 27.0%) and the other tuberculosis 37.5%(C. alb. 30.0%) with a higher rate in serious cases.
5. Antibiotic therapy brought about a higher incidence of candida in acute infectious diseases, 58.7%(C. alb. 43.3%), whereas candida was found only in 39.5%(C. alb. 28.4%) of the patients without antibiotic medication. Out of the negative group 21.2% turned positive and 4.4% temporarily positive during the administration and after the completion of therapy 13.2% more converted to positive. The rate of detection was in the following rate: AM, ACM, CM, TM, SM and PC. In tuberculosis, 40.2%(C. alb. 29.1%) of SM-treated patients demonstrated candida, whereas those without SM administration showed only 28.6%(C. alb. 14.3%).

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Bacteriological and serological studies were carried out an 27 cases of acute glomerulonephritis and 12 cases of scarlet fever from November 1956 to November 1957 in our department of pediatrics.
The results were as follows;
1) The antistreptolysin titer was slightly or markedly elevated in 25 casee of acute glomerulonephritis except for one case with a normal value showing nephrotic symptoms. All cases of scarlet fever demonstrated the highest titer after two weeks from the onset.
2) All the 12 strains of streptococcus hemolyticus isolated from glomerulonephritis were classified into group A after Lancefield, one belonging to type 12. Also 8 strains isolated from scarlet fever were classified into group A.
3) The strains isolated showed the highest sensitivity to penicillin, which decreased in the order of erythromycin, tetracyclin and chloramphenicol. Resistance was found highest against streptomycin.
4) Tonsillectomy was performed on 7 cases of glomerulonephritis with chronic tonsillitis, whereafter antistreptolysin titer usuatlly came down.

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At present the bacteriological diagnosis of diphtheria is based on the gross appearance of the colonies on various kinds of tellurite-blood-agar media and the morphology on Loeffler serum medium. However, Corynebacterium diphtheriae on tellurite-blood-agar medium requires over 48 hours incubation for an accurate differentiation and not always shows a typical morphology. Also Loeffler medium, inspite of the important advantage of rapid growth and typical microscopic appearance of the organism, is not so simple to prepare.
In order to correct this disadvantage of both media, and to satisfy the clinical requirement of rapid diagnosis by visual image, morphological characteristics of the organism were studied, using beef heart infusion blood medium, added 0.5 % cow milk treated with several enzymes. The addition of cow milk treated with pancreatic ferment was found to develop the typical forms of the organism. And when compared the viable cell count of 10-6 mg/m1 suspension (each 6 strains of gravis, mitis and intermedius) on Loeffler medium and beef heart infusion blood medium, supplemented by pancreatic digestion of cow milk, the latter is remarkably superior.
Furthermore, a new beef heart infusion blood medium was prepared incorporating pancreatic digestion of cow milk, sodium fluoride and sodium arizarinate as used by Bregman for screening the suspicious colonies from their coloration. This new medium was found to be as satisfactory as Loeffler medium in regard to the morphology, appearance frequency of metachromatic bodies even in the primary isolation from patient, diameter of colony and also the detecting rate of a small number of organisms, decreasing at local lesion by antibiotic treatment.
It is pointed out that this new medium is superior to the Loeffler medium, in that the former is uniform in its quality, reproducible in its results, easy to prepare and longer preservability.

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Twenty three strains of E. coli 0-124 were detected from the stool of 8 adults and 15 children among 2, 160 diarrheal cases treated in our hospital from August 1955 to June 1958.
The major signs and symptoms of the 8 adults comprised fever as high as 38°C-39°Cwith 1 or 3 days duration, stomachache, headache, debility and diarrhea of several times daily with blood and mucus, the latter controlled on an average in 3 or 4 days. Tenesmus and intestinal cramps were observed in some cases.
A marked increase of agglutinin titer in the convalescent serum could not be recognized. The organisms were susceptible against sulfa drugs and highly susceptible against streptomycin, chloramphenicol and oxytetracyclin, no resistant strain being observed.
Comparing the symptoms of children with those of adults, it was noted that the general reactions were slighter, in the latter with commonly lacking nausea and vomiting, although fever, it's duration, findings of stool, frequency and duration of diarrhea were almost the same.

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The immuno-serologic relationship of the Mita strain of epidemic hepatitis to the patient's serum was investigated in this paper. Complement fixation test was carried out with the sera of 24 patients of infectious hepatitis and neutralization test with those of 16 patients. Five healthy persons and 5 serum hepatitis patients were investigated on both tests, together with 6 cases from Okayama medical college. The patients were divided into 2 groups, the one within 20 days and the other over 20 days after the onset of the disease. C.F.T was 100 % positive in the former and 60 % in the latter, the highest value being 32. Regarding N.T., the former demonstrated neutralizing index 320.5 and the latter 207.6 on an average. Cases from Okayama showed negative C.F.T and the average value of N.I was 21.7. The sera of healthy persons were negative in both tests. Serum hepatitis patients demonstrated negative C.F.T., and only one case proved equivocal on N.T. Consequently, the Mita strain has a specific relation to the epidemic hepatitis suggesting that the former might be derived from the latter.

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