Commissurotomy for mitral stenosis is generally thought to be one of the simplest, easiest, and most widely performed procedures in cardiac surgery. There are, however, some cases of mitral stenosis in which there is shrinkage of the auricular appendage or intraauricular thrombi. These cases make a surgeon's digital insertion through the auricle difficult. There are also other cases of mitral stenosis that, despite the easy digital insertion via the auricle, have severe pathological changes of the stenotic valve. Some are so involved at both commissures, that they prevent us from performing a complete or satisfactory commissurotomy. Thus, the procedure has inadequate results. The cases where digital manipulation alone gives us an adequate opening of the stenotic valve are few. In the conventional procedure of so-called “finger fracture valvuloplasty”, the opening is usually obtained only up to the size in which the index finger is easily permitted. In these cases, only the anterolateral commissure is usually fractured and the subsequent opening is about 2 cm. in its diameter.The pathological nature of the stenotic valve, particularly at both commissures, is not always consistent with the severity of the clinical manifestations or the severity of the stenosis.The future prognosis of the valvuloplasty depends upon various factors. This is, however, influenced mostly by the size of the opening following the commissurotomy.As supplementary measures to the finger fracture method, many surgeons, throughout the world, have devised a large variety of knives and valvular dilators for the purpose of opening the stenotic mitral valve. None achieved in making the ideal device.Generally speaking, valvulotomy with a sharp knife is not without the danger of incising or damaging the valvular cusps, for this is a closed technique. In comparison, the regular valvular dilators are safer, for those are not sharp and are forcibly, but evenly, applied against the stenotic valvular opening. The weakest points, which are at both commissures, therefore, are more safely torn.Most valve dilators have been metal instruments until 1953 when C. S. Beck successfully originated a new device and maneuver. He wrapped a length of wet cotton tape around the distal phalanx of his finger, and covered this “dilaror” with a second glove; re-introducing the finger into the auricle, he passed it forcibly through the mitral orifice. The valvular orifice was adequately opened to the valvular annulus at both commissures and no regurgitation was produced. In 1953 and 1954, he employed this technique and procedure in about 200 cases of mitral stenosis with satisfactory results. Recently Péretz-Alvarez reported that he successfully applied this procedure in 78 cases of mitral stenosis. He also reduced the use of sharp valvulotomes in his series. The author has also employed Beck's procedure in over 20 cases with good results.The procedure is simple and good. It is true, however, that this, too, has some technical limitations. For instance, in cases with a very small auricle or old clots in the auricle, the finger alone can be passed but not the finger which is wrapped with tape. At times, there are such occasions that several separate digital dilatatory manipulations are required. Each time the finger must be removed from the auricle and more cotton tape wrapped around the finger tip before re-insertion . It would be desirable to eliminate the difficulties of increased seperate finger manipulations and the skillful selection of the appropriate size of taped finger for each occasion by the new invention of devices.The author has devised a new method to avoid such technical difficulties as mentioned above.

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As the pathological changes of liver occurring in cases of schistosomiasis japonica are nothing but partial symptomes which happened to appear in the liver, it is difficult to gain a full understanding of the pathology of liver fibrosis (cirrhosis) due to schistosomiasis japonica as long as observation is confined to the liver alone. Therefore, the pathological changes occurring not only in the digestive system but also in the portal, arterial, venous and bile-duct system, which are thought to have a great influence on the liver in case of schistosomiasis japonica, must be examined together. Both the digestive tract and the liver are organs which are attacked by preference by ova in the present disease. In this paper the relationship between the state of intervention of ova in the digestive tract and the degree of liver fibrosis will be described.

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An Influenza epidemic in Kyushu and Yamaguchi Prefectures occurred the months of January to March of 1964. This epidemic was unusual in that it was prevalent only in Kyushu and Yamaguchi profectures, contrary to past epidemics which have generally spread, in time over all the districts of Japan. This fact seemed to indicate that the present epidemic was due to a new type of influenza virus and (or) to a specific immunological state in these districts.The present study was designed to determine the type and character of this particular virus, and to clarify the degree to which it spread in the course of the epidemic. Therefore, epidemiologic examinations were carried out on the isolated virus and on es imating the situation of antibody retention before and after the epidemic.

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The most important and difficult problems in the treatment of alcoholism are how to relieve alcoholics from addiction, and how to keep them from addiction for a long time until they are completely cured.Practically, however, in many cases, the abstinence forced on heavily-addicted alcoholics ends in failure even though it may be successful temporarily. This shows how difficult abstinence is for alcoholics. Therefore, we must try to find some other effective therapy. If it is possible to reduce the alcohol tolerance of the patient and if allowed to drink as much as ordinary people do instead of depriving him of the pleasure of drinking entirely, such a therapy probably is the most reasonable one.For this purpose, the authors worked out a new therapy for reforming the problematical drinking habit by administering cyanamide to alcoholics, and named it “Sesshu Ryoho” or the temperance therapy.

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There have been no reports regarding the effects of a different kind of serum on the infectious activity of Myc. lepraemurium. To determine the most suitable serum for maintenance of the infectivity of Myc. lepraemurium would be very important for the studies on pure culture and tissue culture of this bacillus. Probably, this bacillus might slowly multiply in tissue culture as well as in the tube containing appropriatemedia with some kind of serum.Uraba and Yoshimura (1) described that Kirchner medium (2) was the most suitable one for maintenance of the infectivity of Myc. lepraemurium. In the previous paper (3), the infectivity of the bacillus was maintained for approximately 60 days at 37°C. in Kirchner medium containing bovine serum.On the other hand, it should be necessary to obtain the data concerning the resistance of the bacillus against various kinds of enzymes, because some enzymes would be available for isolation of the bacilli from infected tissues which might contain some inhibitors for the growth and development of the bacillus. In the previous papers (3, 4), the effect of trypsin on the infectivity of the bacillus was investigated as a tool of purification of the bacillus.This communication describes the effects of various kinds of serum and enzyme on the infectivity of the bacillus for the studies of tissue culture and pure culture of Myc. lepraemurium.

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