The significance of electrolytes in cardiovascular surgery is well known. Recently it has been shown that changes of electrolytes, especially hypopotassemia, occures during cardiopulmonary bypass and surface cooling.
Most previous studies have pointed out a drop in serum potassium level. It is said that this phenomenon is due to anesthesia, hemodilution, length of perfusion, glycemia, administration of diuretics, digitalis, or urinary loss of potassium.
Clinical studies on surgery for the patients with congenital heart diseases and experimental studies of mongrel dogs was performed. Extracoporeal perfusion was performed with bubble oxygenators. Perfusion was performed at 25% hemodilution using blood and lactate Ringer's solution in clinical and experimental studies. And moderate hypothermia was performed with surface cooling.
1) Results obtained were as follow :
a) Potassium level of R.B.C. changed little. But serum potassium level decreased during perfusion, especially in hypothermic perfusion and surface cooling.
Its level gradually returned to precooling level by warming in experimental surface cooling.
b) Potassium level of striated muscle decreased in the course of perfusion. especially it is remarkable in hypothermic perfusion, and also in experimental surface cooling.
c) Potassium level of heart muscle decreased in the course of perfusion, especially in the case of aortic clamping and artifical ventricular fibrillation, while calcium level increased.
d) Potassium level of striated muscle correlated with that of R.B.C. in clinical studies.
e) Potassium level of the liver increased in hypothermic perfusion and surface cooling.
2) Conclusion :
It has been said that hypopotassemia caused by anesthesia, hemodilution, prolonged perfusion, administration of digitalis or diuretics. and urinary loss of potassium during the perfusion,
But during the perfusion and surface cooling, metabolism of the periperal tissues, such as striated muscle were more disturbed than the principal tissues, such as liver including a lot of intra-cellular organellae.
In spite of decrease of temperature, metabolism of the liver is maintained in relatively high level, and in such condisions serum potassium is transported to the liver.
It is considered that hypothermic state is an important factor contributing to hypopotassemia in the course of perfusion.

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LDH, HBD, LAP, γ-GTP, ALP and ACP activity levels and LDH isoenzymes in gastric mucosa were studied.
The materials were obtained by endoscopic biopsy from the stomach. Thirteen patients who were determined endoscopically normal, 26 patients who had gastric ulcer and 29 patients who had cancer were investigated. The results were as follows :
1. In caner tissue, the activity levels of five enzymes except HBD were higher than those of normal gastric mucosa. Some differences in the activity levels of those enzymes were observed in histologically different types.
2. LDH-M subunit values (%) were relatively higher in well differentiated cancer tissue than in poorly differetiated one.
3. Statistical study revealed no difference between cancer lesions and the neighbouring mucosa about LDH isoenzyme.
4. Only in the upper part of the greater curvature, LDH-M subunit values showed significantly higher in cancer bearing gastric mucosa than in normal gastric mucosa.
5. The older the age of patients, the less the activity levels of LDH, HBD, LAP and γ-GTP were observed. As the age progressed, the ratio of LDH-M subunits was increased, especially in the upper part of the lesser curvature.

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Congenital esophageal atresia is one of the important diseases in newborn. In Department of Pathology of Gunma University, such anomalies have been observed in 13 cases of 4658 autopsy cases during 28 years from January 1947 to December 1975. Many of the patients were born prematurely. And pneumonia, especially aspirated pneumonia often occurred. Associated anomalies have been recognized, such as congenital heart disease, atresia ani, stenosis of ureter, hermaphrodism, polydactyly etc.

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A case of perforation of the cecum in a two-day-old boy was presented. He started to vomit green bile from the night of the birth day. As his abdomen became distended on the second day of life, he was transfered to our institutions. A scout film of the abdomen on admission to the Tomioka-Kosei Hospital showed free intraperitoneal air with gas distension of stomach and upper intestine. There were a few scattered gas shadows in the right lower quadrant of the abdomen but no further gas shadow was visible, and the dilatation of a loop of jejunum in the left upper quadrant was noted. Under the preoperative diagnosis of a diastatic perforation of the small bowel due to congenital stenosis or atresia, the emergency celiotomy was carried out. On laparotomy, a large amount of purulent ascites with meconium gushed out. A segmental dilatation of the upper jejunum was found, but the small bowel tapered gradually toward the terminal ileum and neither atresia nor stenosis was found. By means of the systematic examination of the gastrointestinal tract, a perforation of the anterior wall of the cecum with contracted small caliber colon suggestive of an entire colon aganglionsis was found. The perforated cecum was exteriorized and the abdominal cavity was irrigated and drained. The appendix was removed for histological verification of the ganglion cells and it was reported as aganglionic. Postoperative course was uneventful, however, the postoperative barium enema revealed the small caliber colon, but the delayed film demonstrated almost normal evacuation of the contrast material contradicting to the aganglionosis. Thus, the etiology of this perforation of the cecum is unknown at present.

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Gastric cancer discovered in Gastric Mass Survey and diagnosed in the 1st Department of Internal Medicine, Gunma University during the 13 years from April 1962 to March 1975 were 212 cases (219 lesions) of early gastric cancer, and 256 cases (259 lesions) of advanced cancer.
The gastric cancer are distributed as follows :
1) Frequency of the gastric cancer by age distribution has the peak in fourties to sixties in both sexes, and that of early gastric cancer is also prominent at this age group.
2) The discovery rate of cancer in age grouping increases with aging and reaches to the peak at the age of seventies in both sexes ; the rate is 0.79% for male and 0.33% for female.
3) The ratio of early gastric cancer to advanced cancer is 4 : 5 in all sujects. It should be noticed that relatively high incidence of early gastric cancer in mass survey.
4) The prevalence of discovered gastric cancer in the mass survey could characterized as follows :
(a) In the sixties of male subjects :
protruding type of early gastric cancer, Borr. III advanced cancer and differentiated carcinoma were mostly localized in lower part of stomach.
(b) In the fifties of female subjects :
depressed type of early cancer, Bona advanced cancer and differentiated carcinoma were mostly found in mid-portion of stomach.
(c) In the forties of female subjects :
depressed early cancer (especially cancer IIc) Borr. IV advanced cancer and undifferentiated carcinoma were mostly localized in midportion of stomach.

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Thyroid crisis is an exaggerated or decompensated stage of thyrotoxicosis. Although the clinical features and precipitating causes are well known, the pathogenesis of thyroid crisis remains obscure.
Six patients with thyrotoxicosis and typical features of thyroid crisis were studied. The serum levels of protein-bound-iodine (PBI) observed in crisis do not differ significantly from the value observed in 10 patients with uncomplicated thyrotoxicosis. In a case of crisis, both serum thyroxine and triiodothyronine levels were slightly elevated during the crisis compared to the value found before crisis and markedly decreased after an extensive treatment with Lugol's solution, propylthiouracil, propranolol and steroid. The precise contributions of adrenal cortex or medulla on the thyroid crisis have not been determined.
It should be pointed out that serum concentrations of thyroid hormones in crisis are not discernibly different from those in uncomplicated thyrotoxicosis. The pathogenesis of thyroid crisis may be related to the increased susceptibility of peripheral tissues to a given dose of thyroid hormones, including possible increased free hormone concentrations.

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The so-called respiratory resistance (RR) was measured on rural inhabitants with the RR meter (MZR-4000), which is based on oscillation technique and pressured sine wave were fixed to 3Hz. The measured values from 434 normal males and 704 normal females were studied with the following results ;
1) RR (more rightly to be called 3Hz respiratory impedance), showed positively skewed asymmetric distribution. The mean (X) and standard deviation (SD) for age group of 40-64 years old was 3.16±0.835 in males and 3.61±0.852 in females (in cmH₂O/l/sce). The difference between males and females was statistically significant (P<0.01).
2) RR was significantly correlated with FVC, FEV_1.0 and Wright's PFR (P<0.01). And it was also correlated significantly but lower than with FVC, FEV_1.0 and PFR, with age and height (P<0.01).
3) When RR 4.0 for males and 4.5 for females were provisionally taken as the screening levels on the basis of X+1SD, RR of those with obstructive impairments were, in comparison with those levels, shown as follows : In pulmonary emphsema, RR inexceptionally exceeded the level, while in bronchial asthma and chronic bronchitis (except during attack), it is sometimes below the level, though they can all be distinguished by it with the additional findings of % FEV 1.0 or PFR.
Also normal subjects occasionally gave RR which is above the screening levels, but more than half of them showed one or more of FVC, FEV_1.0 and PFR to be low. And among obese subjects, the incidence rate of low level RR was significantly decreased (P<0.05).
4) The time necessary for RR measurement of repeated three consecutive tests was about 3-4 minutes per person.

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