Drugs employed are Cephaloridine, Nalidixic acid, Thiophenicol, Lincomycin, Tetracycline-lmethylenelysine, Demethylchlortetracycline, and two quinoline derivatives. These chemotherapeutic agents which were introduced recently into clinical field as anti-dysenteric medicine, were administrated principally orally with some exceptional use of intramuscular injections of Cephaloridine. Patients subjected to this series were those who had been admitted to this institute under the diagnosis of bacillary dysentery.
Changes in the pattern of the aerobic fecal flora, drug concentration in the feces in the course of administration of the drugs, and the related clinical aspects were investigated.
Although quite a few cases have shown bacterial replacement phenomena in their fecal resident flora following the drug administrations, clinical disorders which are considered to be due to such phenomenon have not been encountered yet.
Generally speaking, in the cases in which the drug concentration in the feces reached high level, the changes in the resident flora and the removing effect against Shigella bacilli were proved great. In spite of its high concentration level in the feces, however, the drugs belonging to such groups as Tetracycline and Chloramphenicol showed poor capacity for removing the Shigella, presumably because of increasing number of resistant bacilli to these drugs and the existence of cross resistance between them.
Marked removal of Escherichia coli from the culture media experienced 10 years ago following the Tetracycline and Chloramphenicol administration could no longer be observed in this series.

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Investigations were made in respect of the biological properties, the drug resistance, and the phagetype on 1171 strains of Staphylococcus which were isolated from various materials collected, from Feb. 1964 to Jun. 1965, at the Central Clinical Laboratory of the Affiliated Hospital of the Jikei University School of Medicine.
The stressing point was laid, in this paper, on properties related with coagulase activity and drug resistance.
Results are summed up as follows:
1) Materials and coagulase activity: Of total 1171 strains, 653 (55.7%) were coagulase positive, 518 (44.3%), negative. Of 440 pus-derived strains, 384 (87.3%) were coagulase positive, 56 (12.7)% were negative but considered to be pathogenic. On the contraly, of 486 urine-derived strains, 388 (79.8%) were coagulase negative and considered to be including many non-pathogenic strains, the contaminants from anteriol nare of urethra.
2) Biological properties related with coagulase activity: Mannitol fermentation activity, gelatin liquifaction activity, fibrinolysin producing activity, hemolytic activity on rabbit erythrocytes were seen in 97.1%, 94.3%, 86.0%, 83.6% of coagulase positive strains respectively. These properties were also seen in roughly 50% of coagulase negative strains except that fibrinolysin producing activity was seen in 15% of them. So, in general., comparatively paralleled relation is seen between coagulase and fibrinolysin producing activity.
3) Drug resistance: Penicillin-G (PC-G), Tetracycline (TC), Streptomycin (SM), Erythromycin (EM), Chloramphenicol (CP), Kanamycin (KM), Dimethoxyphenyl-penicillin (DMP-PC) were employed in this series. Marked increase of (EM)-resistant strains was noticed compared to others' data in 1957-1960. The incidence of resistant strains to (PC-G), (TC), (SM), or (EM) was 10-30% higher in coagulase positive strains than in negatve ones. Contrarily, to (CP), it was 14% higher in negative ones. To (KM) and (DMP-PC), however, it was only 2-3% regardless coagulase activity. As to the drug multiplicity in drug resistance, the pattern prevailing over single-drug-resistance in coagulase positive strains was (PC-G)-resistance. In duple-, or more drug-resistance, the combination of (PC-G)-(TC), (PC-G)-(TC)-(SM), (PC-G)-(TC)-(SM)-(EM), (PC-G)-(TC)-(SM)-(EM)-(CP) were predominant. Especially in quadruple-, or more drug-resistance, the latter two patterns rapidly increased. Furthermore, this tendency was more conspicuous in phage-typable strains than untypables. The multiple-drug-resistant strains, belonging to above patterns mostly belonged to the phage type Group 1 and subordinately to Group “miscellaneous”. On the other hand, the drug resistance pattern in coagulase negative strains covered comparatively wide range of drugs. It was noteworthy that the greater part of single-drugresistance was (PC-G)- resistance as seen in coagulase positive strains, while the combinations as (PC-G)-(TC), (PC-G)-(TC)-(CM), (PC-G)-(TC)-(CP)-(EM), (PC-G)-(TC)-(CM)-(EM)-(SM) were encountered very often, (CP) being replacing (SM) of triple-, and qaudruple-drug pattern in coagulase positive ones. From the results concerning the drug resistance and phage type, it can be conceivable that the phage typable strains with the drug resistance of (PC-G)-(TC)-(SM)-(EM) pattern obtained from natural world, include a large number of strains which were given the drug resistance by the transduction activity of phage.

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Since 1946, 116 patients suffering from Lung abscess were treated with intratracheal drug instillation method in this department of medicine. Of them, 104 cases have being been followed up for one to 21 years. The drugs used were chemotheraptique agents or antibiotics and, were instillated into intratracheal space by intercartilagenous puncture once every day or every other day for several months. The results obtained were considered as satisfactory; cured were 78 (76.0%), improved 16 (15.4%), unchanged 8 (7.7%), dead 1 (0.9%).
In 68 cases out of them, bacteriological examinations (mainly by aerobic culture) of intratracheal sputa withdrawn by intercartilagenous puncture were carried out by the author in parallel with the treatment.
The merits of this method as well as the clinical significance of intratracheal bacteriology were discussed in this paper
1) Advantages of the intercartilagenous puncture are that the sputa extracted can completely get rid of contamination from the upper respiratory tract, and its procedures are simple, easy, safe and not troublesome in repeating.
2) The patterns of intratracheal bacterial flora were nearly constant and stable according to each individual case in the course of treatment.
3) According to the kind of harbouring bacteria, the patients were divided into such four groups as: 1.-bacteria-free cases (25 cases) 2.-gram positive bacteria alone (17), of them, streptococcus (11) staphylococcus (6) 3.-ggram-negative bacteria alone (Bacillus coli group)(8) 4.-mixed group (18), combination of two or more kinds of bacteria such as Streptococcus, Staphylococcus, Bacillus coli group, Proteus, Pyocyaneus, Diphtheroid and Candida. In this, the combination of Streptococcus and B. coli group was predominant.
Considering these bacteriological patterns, the drugs to be applied were selected: chiefly, Penicillin to negative culture cases and cocci infection cases; Terramycin or Kanamycin to Bacilli infection; Peni cillin, Terramycin or Kanamycin, singly or alternately, to mixed infection cases.
4) Gram-negative Bacillus cases have shown the lowest cure rate (62.5%), compared to bacteriafree cases (92.0%), coccus infection (82.4%) and mixed infection (72.2%). As to the reason for this, such three factors were suggestive as: 1. Relatively later commencement of this therapy (later than a half year after onset of the illness in 50%). 2. Greater incidence in this cases of possessing the cavities and bronchectasis. 3 The inherent intractability of this bicillus. (More effective measures should be exploited in future to this group.)
5) As a whole, the bacteriologic-diagnostical and therapeutical value of this method is conspicuous, and the author considered it to be an indispensable clinical procedure in this disease.

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Clinical observations were made on Japanese Encephalitis in aged person with the following results
Outbreaks of Japanese Encephalitis in Kyoto province have been seen in every summer, and the epidemic in 1966 was the largest among them.
2) The recent trend in age distribution has been that more than 60 per cent of the patients were over 41 years of age.
3) The clinical pictures of old age were severe in general and death rate increased as the age advanced.
4) The fatality rate in male of old age groups was higher than in female.
5) The initial pressure of cerebrospinal fluid and the degree of pleocytosis of it were lower in older. age groups than in younger age groups.
6) Many healthy people of the older generation possessed HI antibodies.
7) In recovered cases, the HI antibody titer, after reaching a maximum level, declined more rapidly in older age groups than in younger age groups.
8) The HI antibody titers in the early stage of older age groups were much lower in dead cases than in recovered cases.
9) The CF antibody titers of recovered cases declined with advancing age.
10) Follow-up study revealed that many recovered cases of older age suffered from several sequelae.
11) The urinary 17-OHCS levels of older cases treated with ACTH or ACTH combined with gucocorticoid were markedly higher in recovered cases than in death cases in whom no noticeable response to ACTH was seen.

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For the purpose of bringing out the fine structure and reproductive process of Rickettsia sennetsu (Misao and Kobayashi, 1956), identified as a causative agent of infectious mononucleosis in western Japan, the agent was propagated in tissue culture L cells and the infected preparations were processed for examination by electron microscopy with ultrathin sectioning.
At first, the rickettsia particles have been absorbed at the surface of the host cell and succeedingly taken into the vacuoles of the host cell by the mechanism of phagocytosis of the cell. However, soon after, the rickettsia particles appear in the peripheral region of the host-cell cytoplasm, and with the progress of the infection, immigrate into the central region of the host-cell cytoplasm, where the rickettsia particles multiply by binary fission.
When the agents are released from the host cell in the last stage of the infection, they are enveloped by the host-cell membrane. Therefore, extracellular rickettsia particles are surrounded by double membranes, one is their specific membrane, another is from the host cell.
Rickettsia particles are almost spherical or ellipsoidal and 400 to 700 mμ in diameter, but rarely rodshaped, measuring up to 1200 mμ in longitudinal diameter. The internal structure is homogenously composed of small granules and fine filaments, but sometimes unhomogenously as a result of electronic dense concentration distributed in the viroplasm. The membrane of the rickettsia particles in the hostcell cytoplasm is a tri-layered structure (two dense layers separated by a pale layer) and about 270 Å in breadth.
The host cells degenerate with the progress of the infection, specially the mitochondria are hardly recognizable and its cristae decrease and disappear. At a glance, degenerated mitochondria closely resemble the rickettsia particle, however they are distinguished one from the other by their internal structure and membrane.

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