R E P O R T ON V I S I T TO J A P A N ,

OCTOBER, 1969.

D.A.H. CHAMPION,
Engineering Division,
Government Architect's Branch,
Department of Public Works, N. S. W.
 CONTENTS.

PAGE

1. Preamble 1

2. Twelfth International Congress of Radiology 3

3. Factories visited 12

4. Japan Electronics Show 15

5. Japan Electric Measuring Instruments

Automation Exhibition" 16

6. Hospitals visited 17

7- Conclusions and Recommendations 21

APPENDIX: List of books and pamphlets available

for perusal.
 P REAMBLE.

The Electronics Section of the Engineering Division,

Government Architect's Branch, Department of Public Works,N.S.W.
acts as consultant to all branches of the Department and to other
departments of the Public Service of New South Wales in respect
to all types of electronics and communications equipment.
A major part of the work relates to X-Ray and electro-
medical equipment for the Public Hospitals and Health Department
Hospitals of N.S.W. and the Supervising Engineer of the Section,
Mr. D.A.H. Champion, is also Chairman of the Staie X-Ray
Committee.
The Department considers that in this dual capacity
Mr. Champion should be thoroughly conversanx with the latest
trends and developments in X-Ray equipment and was of the
opinion that advantage should be taken of the opportunity presented
by the International Congress of Radiology to further that
objective.
The concurrence of the Public Service Board having been
obtained the Minister obtained the approval of the Premier for
Mr Champion to represent the Department at the Congress and
to remain in Japan long enough to inspect some hospitals and
factories.
Mr Champion also took the opportunity to visit the
Japan Electronics Show and the Japan Electric Measuring
Instruments Automation Exhibition.
 INDEX TO SECTION 2

2.1 Introduction
2.2 Philips
2.3 Siemens
2.4 Toshiba
2.5 Hitachi Roentgen Co. Ltd.
2.6 Shimadzu Seisakusho Ltd.
2.7 N.E.C./Varians.
2.8 Sakura Films
2.9 Canon, Japan.
2.10 3M Company
2.11 Picker Nuclear
2.12 G. E, Company
2.13 Nishimoto Sangyo Co. Ltd.
2.14 Japan Radiation and Medical Electronics Inc
2.15 N.V. Optische Industrie "De Unde Delft".
2.16 Mobile Vans
2.17 Seico X-ray Accessories
2.18 Picker International Corp.
 . 3 .

2, TWELFTH INTERNATIONAL CONGRESS

OF RADIOLOGY,

2.1

The Twelfth International Congress of Radiology was held

in Tokyo, Japan, from 6th to 11th October, 1969.
There were nearly 5,000 delegates from 68 countries,not
only breaking all attendance records for the Congress, but also
making this the biggest academic gathering ever held in Japan.
It is understood that there were about 130 delegates from
Australia and I was surprised and pleased at the number of
radiologists from this and other States who expressed their
pleasure at seeing a government representative at the Congress.
The lectures and symposia were presented at the Motel
New Otani and the trade exhibition at the International Trade
Fair Grounds, Harumi. Unfortunately these places are about
•f hour bus ride apart, so that it was not practicable to visit the
exhibition between lectures. This seriously affected the attend-
ance at the exhibition of those primarily interested in the
lectures and symposia. However, I devoted most of my time to
the exhibition and to technical discussions with the trade rep-
resentatives. I also had discussions with interstate delegates
who sought my views on various items of equipment.
One hundred and seven (107) exhibitors were rep-
resented in the trade exhibition, the major part of which was
presented in one mammoth circular hall, with smaller exhibits
and the scientific displays occupying a smaller adjacent hall.
The major exhibitors were Philips, Siemens and the
three Japanese firms, Tokyo Shibaura Electric Co. Ltd.
(Toshiba), Hitachi Roentgen Co. Ltd., and Shimadzu
Seisakusho Ltd. , but several others also had large exhibits.
The following comments are made:

2.2 Failips.
The first unit on the stand v/as a Diagnost 100
remotely controlled universal system for routine diagnosis and
tomography. The generator was a "Super 100."
This is said to be the only table in which the top can be
adjusted to and from the X-ray tube, thus facilitating its use for
single layer linear tomography.
The X-ray tube is overtable and the image intensifier
undertable and recording can be by full film, 70 mm. intensifier
fluorography, cinefluorography or videotape.
The construction of the table is somewhat lighter than
one would expect, particularly in comparison with similar
Japanese tables.
 The next unit was a Diagnost "C" operating theatre unit. This
unit, and a similar unit made by Siemens, represents a new approach
to X-ray equipment in the operating theatre and appears to be a satis-
factory equipment for both casualty and major theatres.

The ceiling suspended "C" arm carries an X-ray tube and

image intensifier in a similar manner to existing mobile image
intensifier units.

The arrangement is such that the tube is always under the

table, but a certain amount of angling is available. The arc is
from 90° chrough the vertical to 15° and the tube can be moved up
to 20 in the opposite direction.

The construction is very robust and great attention has

been paid to enclosure of cables to limit the sterilizing problem.

The Diagnostic "N" neuroradiological system is designed

for fractional gas encephalography, ventriculography, etc. The
system is fully illustrated in the booklet "Philips Tokyo Monitor"
and a film on the unit will be available in Sydney shortly.

The. Bucky tomography system type BT-S2 is an

excellent table for use in a second X-ray room where it can be
used for all normal techniques requiring a plain Bucky table,
and, by a simple and rapid mechanical connection, can be used
for multi-directional tomography. An image intensifier is
available for this unit as an extra and fits underneath the
Bucky tray. This table also is illustrated in "Philips Tokyo
Monitor."

Philips equipment for the medical application of radio-

isotopes included a scintillation scanner, a gamma camera and
a gamma analyser.

The scanner and the analyser appeared to be very

satisfactory and well constructed pieces of equipment.

In the gamma camera the crystal size is only 9i inches

and it is questionable whether this is sufficient. Also the
display is black and white only and although a colour converter
is available as an extra, this in effect only converts black and
white to black and red.

The display of closed circuit T.V. equipment was

primarily to illustrate that images from various departments
can be readily displayed in other departments by a relatively
simple switching system.
 . 5 .

Image intensifiers are being continually improved and a

new image intensifier tube is now available with improved
chemicals on the input and output phosphors. What appears at
this stage to be a major step forward is the development by
Philips of an image intensifier system using fibre optics to
replace the normal lens system. A prototype was on display,
but was not operating.

2.3 Siemens.

Siemens "Orbiskop" is a remote controlled diagnostic

• X-ray unit with provision for rotating the patient by up to
1 90° and swivelling the X-ray beam about the patient's
J long axis by up to +125 and - 4-5° at any angle of the table.
j
I The remote control desk is in the same room as the
* table and has mounted on it the monitor for the image inten-
! sifier closed circuit T.V.

] The top of the table is concave and the patient has

to be strapped to the top.

The urological examination table B.F.incorporates a

I tube arm for mounting the overtable tube and an image inten-
sifier is built in undertable.

The monitor can be ceiling suspended or mounted on

a mobile trolley and the control desk is a mobile floor
mounting unit.

The "Arcoskop" 100 O . P . operating theatre unit

consists of an X-ray tube and image intensifier mounted on a
"C" arm and ceiling suspended for operating theatre use.
Other versions, the 100 3D and the Siremobil 2, are also
available.

This unit is similar to the Philips unit already described

and demonstrates that some thought is at last being given to
special X-ray units for operating theatres. .

In conjunction with similar suspensions for patient

monitoring equipment it is now possible to remove a subs-
tantial part of the electrical equipment from the theatre floor.

The remainder of the equipment on Siemens stand was

familiar and a booklet giving a full description is available.

Associated with Siemens is Elema-Schonander of

Sweden and among other things they were demonstrating a
new cut-film changer, the "Puck."
 . 6 .

This is a simple, large film high speed serialograph designed j

for a maximum of 20 exposures and 2 exposures per second. j

Two models arc available (L. & U.) one being for 14."xl4"
film and other 12"xlO" film and an image intensifier can be used
with either model. However, one model is arranged for overtable j
tube and undertable image inx*«nsifier while the other is for undertable " j
tube and overtable image intensifier. I

The changer can be mounted on a stand or placed on a

table and the programme is controlled by a punch card system,
which can al.-o control table movement, injection, etc.

The changer operates efficiently and quietly and appears

to be an ideal unit for those requiring a film changer limited
to two exposures a second.

It is understood that this unit may be redesigned to give

higher speeds at some future date.

2.4 Toshiba.

The first exhibit on the Toshiba stand was a 13 meV

linac Model LMR-13 and a universal simulator Model LX4-. The
linac is arranged for X-ray or electron beam with an output of J
200-1000 R/min. at the centre of rotation. Both items were j
well constructed. J
I
The next exhibit was a universal gyroscopic X-ray j
unit in which the patient can be rotated and moved to almost any 1
position conceivable. This unit has a control desk similar to a
ana
ring stand/is complete with image intensifier, T.V., and video
tape recorder.

Next was a Toshiba remote control ring stand, which is

very similar to the Hitachi, but does not have the large metal
wall behind the table. It has a bank of cassettes in a box at the
rear of the table, which can be programmed at the control desk.
In other ways it is similar to other ring stands and its construction
was very robust. I
\
I:

I
 . 7 .

A very interesting exhibit was a sonolayergraph, that is a

diagnostic equipment using an ultrasonic pulse echo to examine the
part under investigation.

There are two types of scanning, one being linear

scanning in which a pliable plastic bag containing water takes up
the contours of the part being examined, while the transducer
scans by moving in one plane over the area to be examined; and
the other being contact scanning, in which the transducer is
moved by hand over the area to be examined in contact with the
skin.

The Toshiba gamma camera type D.C.A.-101 has a

12 inch x \ inch crystal and has no colour facilities. It appears
to be soundly constructed and has no other features of note.

Toshiba had a new piece of equipment called a senograph,

specially designed for mammography. It is a small compact unit
with a 20-40 k . v . molybdenum anode tube, which also incorpor-
ates a molybdenum filter. This was, I think, the only special
generator for mammogrsnhy on display.

The circulatory organ diagnostic system had a table

j similar to the "Koordinat", two Elema-Schonander A.O.T.
j film changers and three ceiling mounted tube stands, (two
carrying tubes and one the image intensifier. )

! There was a contrast medium injector made by Toshiba

and a polycorder equipment for recording purposes.

2. S Hitachi Roentgen Co • Ltd.

I have available a Hitachi X-raj' and Electro-medical

apparatus catalogue for 1970 which fully describes all their
equipment and there is little need for further comment.

I would remark however on the extensive range of

equipment offered by this Company and warn that the less
expensive utility type of equipment in their range (particularly
the small ring stands) are designed for the Japanese market
and are not only too small for Australian adults but are of
relatively light construction and unsuitable for Australian
i
I hospital use.
 . 8 .

The remainder of the equipment is very well made, robust,

well finished and of modern design.

Attention is drawn to the use by Hitachi (and other Japanese

firms) of condenser discharge units for mass survey mobile units,
for both stomach cancer and T.B. detection.

It is considered that condenser discharge equipment should

replace all present generators on P . F . equipment as the old units
become unserviceable.

2.6 Shimadzu Seisakusho Ltd.

This firm had a large display showing a representative

cross section of their equipment. Included were two Cobalt 60
units, a 35 meV Betatron, two ring stands and a condenser
discharge mobile unit.

I have available a full catalogue and the company is

further discussed in Section 3.4-.

2.7 N.E.C./Varians.

This partnership of an American and a Japanese firm had

on display a new 4- meV linear accelerator. It is generally
similar to their 6 meV unit, but as the voltage is lower it has been
possible to make the accelerator vertical and so dispense with beam
bending. This gives much less loss of energy and much less
dispersion of the beam, thus compensating for the lower voltage.
It was stated that 24- of these have already been sold.

Also on this stand was a model of the Clinac 35, one of

which is at present being installed at Hiroshima Hospital.

2.8 Sakura Films.

Sakura Films displayed a range of automatic processing

units (which are genei-ally similar to Kodak), densitometers and
processing accessories.
I have a catalogue of this equipment.

2.9 Canon, Japan.

This firm displayed a full range of mirror camera units

which are generally similar to Odelca. It is claimed that the
optics are now made in Japan and this firm therefore becomes the
only known competitor to Odelca.
 . 9 .

A film viewer for 70 mm. film capable of viewing four films

at one time was very good, as was also an automatic X-ray
processor for 70 mm. film. Unfortunately, no literature is yet
available on either of these items.

2.10 3M Company.

The 3M Company's interests in Australia in regard to

processors and chemicals are looked after by Amyl Chemicals.

The only thing of interest on their stand was a film

processor, which was similar to Kodak and other makers, but
was capable of operating on either 90 second or 3 minute
processing by the turn of a switch. However, as the solution
temperatures are different for the different timing cycles it
takes about 30 nunutes after switching over for the correct
temperatures to be reached.

2.11 Picker Nuclear.

Picker Nuclear had on display two rectilinear scanners

and a gamma camera, all of which appeared to be excellent
pieces of equipment.

It should be realised that scanners have been much

improved in speed and facility and are adjustable for particles
of different energy.

The bigger scanner can produce the scan in colour

and also displays the scan on a small monitor screen, which
is very useful for setting up and for detecting patient move-
ment.

The gamma camera is practically essential for

children and elderly people who cannot remain still, but
will give false readings for high energy particles.

The gamma camera should be regarded as supplem-

entary to and not replacing a scanner.

2.12 G.E. Company.

The G.E. stand had a catheterization table similar to
the "Koordinat", a ring stand of simpler and lighter construction
than others on display, a plain Bucky table and a mobile image
intensifier.
 . 10 .

The image intensifier is very similar to the Mueller BV20.

2.13 Nishimoto Sangyo Co.Ltd.

This company had on display an automatic washer-dryer (the

Ecomat) suitable for small dark-rooms, which do not warrant the
installation of an automatic processor. The system used is similar
to that in the washing-drying sections of an automatic processor,
using a series of rollers to advance the film and remove surface
water by compression.

2.14- Japan Radiation and Medical Electronics, Inc.

This firm market radiation equipment under the trade-

name "Aloka." On display was an echo-encephalograph and an
auto-scanner. Both these items were soundly constructed and I
have pamphlets available for perusal by anyone interested.

2.15 Optische Industrie "De Unde Delft."

The Odelca stand had on exhibition a full range of their

equipment and I now have an up-to-date range of pamphlets fox*
perusal by anyone interested. Of particular note was the
mammography camera, the 100 mm. unit coupled with an automatic
processor, the 12i inch optical image intensifier, the T.V.
subtraction apparatus and the new 100 mm. viewer.

2.16 Mobile Vans.

Five mobile vans were available for inspection, all

containing mass stomach survey equipment. All these units
were designed for Japanese people and were far too small for
Australian use, but it was interesting to note that these units
all used capacitor discharge generators of up to 1.5 microfarad
capacity and two used mirror-optics systems (one Odelca and one
Canon).

2.17 Seico X-ray Accessories.

The main exhibit on the Seico stand was the Seico

Multiscope X-ray viewing cabinet. This -compact stand is
capable of storing thirty 17" x 14" films at a time,, six on each
plane. The viewing screens move vertically, half of each
screen moving up into a top compartment and half into a lower
compartment. ~'\

A selector switch selects the screens to be brought into

view and a zero button returns all screen to the stored position.
 . 11 .

Illumination is by fluorescent tubes and the brightness is

controlled by a dimmer.

2,18 Picker International Corp.

The Picker 4-2OCP X-ray cassette changer consists of

three parts, the cassette changer proper, the vacuum loader
and the programmer. Each cassette consists of a black piastre
envelope into which the intensifying screens and the film is
loaded, the air evacuated and the package sealed.
i

t Thes.a cassettes are then loaded into the changer which

has a capacity of 20 cassettes and will change up to four
\ cassettes a second.

j The programmer uses an I.B.M. punch card to control

; programme, speed, exposure, injection, sequential table-top
movement and auxiliary devices.

I It is claimed that the cost of this equipment is compar-

] able with an A.O.T. changer and auxiliary items, but the plastic
j cassettes are expensive and are not re-usable (except perhaps
! once for a smaller size film).
1
I

• \
 . 12 .

3. FACTORIES VISITED.

3.1 Tokyo Shibaura Electric Co. Ltd, (Toshiba)

Tamagawa Works.

The Tamagawa Works of this company are devoted entirely

to the manufacture of X-ray equipment covering practically all
phases from the raw material to the finished product.

The factory employs about 1,200 and buildings are under

construction for a larger factory.

The machine shop is very big and is capable of machin-

ing large castings for cobalt therapy units, linear accelerators,
etc.

The metal workshop is also big and has the largest

presses I have seen anywhere in an X-ray factory.

This factory gives a lot of attention to detail and is the

only X-ray factory, as far as I can recall, where all metal work
is phosphor treated before spray painting.

The workmanship is generally very good, construction

is robust and electrical work of a good standard.

1
3.2 Hitachi Ltd., Kameido Works. j
Hitachi Roentgen Co.Ltd. occupy only part of this large J
works, the remainder of which is devoted to other electrical |
products.

The factory is large and manufactures a full range of

X-ray equipment, except condenser discharge units which are
made in the Osaka works.

All equipment is considered to be of sound construction,

robust and well finished.

A full description of all equipment is included in the

company's 1970 catalogue. <|
pi

3.3 Hitachi Ltd., Osaka Works.

This factory is somewhat smaller than the Kameido Works

and has no machine shop, metal shop or paint spraying facilities.
 . 13 .

Manufacture is limited to condenser discharge units, u

small cheap ring stand, some inexpensive tilt tables, electro-
encephalographs, electro-cardiographs and echo-encephalographs.

Manufacture is of the same quality as the Kameido Works,

but the tilt tables and ring stands made here are designed for
the Japanese market and are not suitable'for Australia.

The condenser discharge units have no automatic dis-

charge on the condenser when the unit is switched off, and the
dark shutter available cannot be fitted together with a collimator.

A mobile condenser discharge unit is also available

with a motor drive, energised by a 12V. 35A battery. An
automatic charger is incorporated and the mobility of this unit
is very satisfactory.

The products of this factory are also marketed under

the trade name "Sirius."

3.4- Shimadzu Seisakusho Ltd., Kyoto.

While Shimadzu is not a large firm compared to Toshiba

and Hitachi, it is large by Australian standards and is owned
by the Mitsubishi Company. It enjoys a substantial share of the
Japanese X-ray equipment market and in many ways was more
interesting than the larger, more impersonal firms,

1 inspected the aircraft instrument, betatron7scientific

instrument, X-ray tube and X-ray equipment factories, but
these represented only a small portion of the factory complex,
the remainder of which makes all types of electrical equipment
including heavy duty generation equipment.

Much of the metal work at this factory is bought in, but

production appears efficient, workmanship is good and the
quality of the finished product is very satisfactory.

I was particularly impressed by a new condenser

discharge mobile unit, code number CM100L which will be
available from this company shortly.

It is the most versatile condenser discharge unit made,

as yet, and appears to incorporate every facility one could
wish for in exposure control.
 The technique selector selects any one of three modes-
difference, percentage or full discharge.

The difference technique allows an exposure to be made by

discharging from the set kilovoltage to a preselected lower kilo-
voltage.

The percentage technique applies tail cut-off at 60% of

discharge and the full discharge technique allows either full
discharge or photo-timer control.

The charge can be stopped at any point and can be raised

or lowered before an exposure is made.

Switching off the unit automatically discharges the con-

denser and a neon indicator light on top of the condenser unit
shows when discharge is completed.

I had a long discussion with the Senior Engineer and

the Factory Manager regarding the Japan Industrial Standard
applying to X-ray generators and its relationship to type-
tests specified by the Department.

It was clear that the two standards' are closely related

and the Japan Industrial Standard would be acceptable, except
that it does not include any measurement of transformer
temperature rise under specified load conditions. This seems
to be a curious omission and I asked that this test be made by
a recognised test authority in Japan or Australia for generators
purchased by the Department.

fj
 . 15 .

4. JAPAN ELECTRONICS SHOW, 1969.

4.1
The Japan Electronics Show, 1969, was held in the Osaka
Trade Fair Grounds, in three huge buildings housing a very
comprehensive display, mainly Japanese, but with a represent-
ative section of foreign exhibitors.

The displays covered consumer electronics equipment,

radio apparatus and associated electronic devices, testing and
measuring equipment and electronic components.

The huge range of equipment and its high quality

admirably demonstrated how advanced Japanese manufacturers
are in this field.

1 have available an Official Exhibitors' Directory and

some pamphlets, but do not wish to comment on any specific
equipment.

The main value in seeing an exhibition of this type is

to appreciate what equipment is available and to bring oneself
up-to-date on new items so that one knows the availability of
equipment when a particular demand arises.
 . 16 . I
1
5. 13TH. JAPAN ELECTRIC MEASURING |
INSTRUMENT-AUTOMATION EXHIBITION.

5.1 This exhibition was held at the Tokyo International Trade

Centre (Harumi).

While it was not on the same scale as the Electronics Show

it was very extensive, having 79 exhibitors.

The same remarks as 1 have made in Section 4 in regard to

the Electronics Show apply to this exhibition. However, there were
some items of particular note:

5.2 An excellent single pen recorder, called the "Mini-writer,"

manufactured by Watanabe Instruments Corporation.

5.3 A portable multi-element recorder using pressure sensitive

paper, manufactured by Pyso Electric Co.Ltd. (Pamphlet in
Japanese).

5-4- Multi-pen recorders by various manufacturers using up

to six pens, each capable of continuous recording over the full
width of the paper in different colours.

5.5 Panel meters incorporating automatic, high and low cut-

off contacts for voltage or current.

5.6 Level meters using 2kH audio frequency for single or

multiple tanks.

5-7 A very big range of XY recorders.

5-8 A level recorder using a radio-active source.

5.9 Electro-magnetic flow melers for water supply metering

for \ inch to 30 inch diameter mains. This method offers no
restriction to water flow.

A very complete illustrated catalogue is available for

perusal by anyone interested.
 . 17 .

6. HOSPITALS VISITED.

6.1 Tokyo Medical College Cancer Centre.

The Tokyo Medical College Cancer Centre is associated

with the Tokyo Medical College and the Tokyo Medical College
Hospital.

It has six departments : lung cancer, cancer of

digestive organs, radiology, nuclear medicine, pathology and
mass examination. The hospital has about 1,000 beds.

I was shown through the Centre by the Deputy Director,

Dr. Shinjiro Okamoto, Professor of Tokyo Medical College and
Dr. Hiroyasu Murayama, Chief of the Department of Nuclear
Medicine.

; The equipment is fully described and illustrated in

a colour booklet which I can make available for inspection
: by anyone interested.
j
\
! The majority of the equipment was supplied and installed
I by Shiinadzu Seisakusho Ltd. , but one notable exception is the
scintillation camera, which was supplied by Nuclear-Chicago.

The equipment installed appears to be adequate and

comprehensive and the departments are spacious and well
planned.

In regard to treatment, perhaps the only notable thing

is that the 26 meV Betatron is used exclusively for electron
therapy.

6.2 Osaka University Hospital.

In many ways Japan is a land of extreme contrasts and

this hospital is undoubtedly the most disreputable I have been
in anywhere in the world. Not only was plaster missing from
walls and ceilings and paint flaking, but the walls were thick
with the dust of y e a r s .

The reason given was that the building is to be

demolished and a new hospital built, but there is apparently
no set date for this and there seems to be no reason for
discarding the high standards of cleanliness and hygiene so
noticeable throughout Japan. It was stated that the building
originally housed a veterinary hospital and was converted
to an 800 bed general hospital.
 . 18 .

Most of the X-ray equipment is old and installed in rooms of

inadequate size and the overall efficiency of the department must be
very low.

A Toshiba ring stand has been in use for seven years and
has given very good service, but is now at the end of its useful
life.

The only modern room was that for cardiac catheteris-

ation, which was well equipped on standard modern lines.

6.3 Cancer Hospital, Osaka.

This is a general hospital and is a complete contrast to
Osaka University Hospital. It is modern, clean, bright and well
equipped.

It has an extensive diagnostic X-ray Department in

which the most notable items are five ring stands. One of
these is an older type, but is still functioning well.

The other four are modern Shimadzu units and are

arranged in two suites of three rooms, the centre room in each
case being the control room.

All ring stands were in use and I was amazed at the

quiet and efficient manner in which patients were examined,
the minimum effort required by the radiologist and the speed
of each examination.

Anyone with doubts about the justification for the high

cost of ring stands should see this department in operation.

Processing in this department was carried out in

Kodak X-Omat units.

The X-ray Therapy Department had a Cobalt 60 unit,

an N . E . C . 6 meV linear accelerator, a simulator and a
"dermopan" superficial therapy unit.

Although labelled "N.E.C." the linear accelerator

appeared to be a "Varians. "
 . 19 .

The arrangement of the simulator and the Cobalt 60 unit

in the same room was very good. The room was also very
tastefully decorated including two large goldfish tanks.

The "dermopan" is very little used as the incidence of

skin cancer in Japan is very low.

The hospital has a mobile van for mass surveys to

detect gastric cancers, the incidence of which is very high
in Japan.

6.4 Kodaira Memorial Tokyo Hitachi Hospital.

This is a modern 200 bed hospital commemorating

the founder of the Hitachi Company, catering primarily for
Hitachi staff, but also open to the public.

The diagnostic X-ray Department has three rooms, one

having a ring stand, one a conventional screening equipment and
the third a plain table,planigraph and chest stand.

The rooms are spacious and very well kept and the.
layout is standard.

The X-ray Therapy Department has a Cobalt 60 unit and

a 300 k.V.P. X-ray therapy unit.

6.5 Queen Elizabeth Hospital, Hong Kong.

Construction of the Queen Elizabeth Hospital in Kowloon

was completed in 1963 and it is said to be one of the largest
and best equip-- d general hospitals in the British Common-
wealth .

Considering the crowded living conditions in Hong Kong

and the scarcity of reasonably flat areas for building the
hospital is extraordinarily spacious.

The Royal Hong Kong Jockey Club donated $HK6,000,000

towards the cost of the Institute of Radiology and it is stated
to be the best equipped of its kind in the Far East.

However, all the equipment is now six years old and

consequently, there are no modern pieces of equipment such as
ring stands, condenser discharge units, etc.
 . 20 .

The Physics Department (headed by an Australian) includes

electrical, mechanical and electronic workshops, planning rooms,
mould making rooms, research laboratories, isotope and radium rooms.

The Hospital fills the same role as the Radiation Branch of

the Public Health Department, N.S.W., in being responsible for
all radiation protection in the Colony and for running the film badge
service.

As servicing of equipment is virtually unavailable in Hong

Kong, the Physics Department carries out all its own servicing of
instruments and would like to do the same with X-ray equipment.

However, shortage of staff prevents this and consequently

X-ray equipment is sometimes out of service for considerable
periods.

The X-ray equipment is conventional and there is ample

to meet the needs of the Department.

It is notable that the Brown-Boveri betatron has operated

since 1963 with the same "doughnut" tube, a remarkably long life
for such, a tube. The betatron is used extensively for electron
beam therapy.

The hospital is at present planning the setting up of an

intensive care ward.

An illustrated colour booklet produced for the Public

Works Department, Hong Kong, by the Information Services
Department is available for examination by those interested.
 . 21 .

7. CONCLUSIONS AND RECOMMENDATIONS.

7.1
The value of a departmental representative attending an
international congress such as the International Congress of
Radiology cannot be assessed in monetary terms, but the knowledge
gained has already been applied since my return m my capacity as
the senior departmental engineer advising the Hospitals Commission
of N.S.W. on X-ray and electro-medical equipment.

I have no hesitation in saying that the contacts made and

information obtained at the Congress, the two electronics shows
and by visiting hospitals and factories will be far greater in
valae than the small expenditure involved in this trip and I
strongly recommend that the Department be represented at all
future International Congresses of Radiology. (These are
held every four years and the next Congress will be in Madrid).

7.2 Capacitor discharge mobile X-ray units.

I recommend that the present specification be retained

until a price is available for the new Shimadzu unit. If this
proves to be competitive the specification should be amended
to incorporate the additional features which will give the
radiographer the maximum flexibility obtainable.

7.3 Capacitor discharge generators for mass chest survey units.

Any new generators purchased and any replacement

generators for this wcrk should be capacitor discharge type.

7.4 Ring Stands.

Ring stands should be no longer regarded as an innovation
but as a standard working equipment for major hospitals.

While it is appreciated that the technique in handling

patients is very different from that at present used, my
observations in Japan and at Prince Kenry Hospital, Sydney,
indicate that the additional patients which could be handled
would compensate for the greater cost of the equipment.

7.5 Generators.
It is recommended that the present policy regarding
generators be continued, that i s , that 500 m.A. generators
be the normal standard and that three phase generators be
installed only for situations requiring very short exposure
times, (children, mental patients).
 . 22 .

7.6 Operating Theatre Units.

In designing new operating theatres intended to have X-ray

equipment installed consideration should be given to the Use of a
"C" arm, such as that developed by Philips or Siemens.

D.A.H. CHAMPION,
A . S . T . C . , M.I.E. (Aust.),
Chartered Engineer,
(Australia),
6th February, 1970.
 APPENDIX.

LIST OF BOOKS AND PAMPHLETS AVAILABLE

FOR PERUSAL.

1. 12th International Congress of Radiology.

Book of Members
Book of Abstracts
Scientific Programme
Guia« Book.

2. Japan Measuring Instruments Catalogue, 1969.

3. Japan Electronics Show, 1969, Directory.

4.. Tokyo Medical College Cancer Centre.

5. Philips Tokyo Monitor.

6. Siemens X11I.C.R., Tokyo.

7. Hitachi Ltd. - Guide to Kameido Works . - 1970

Catalogue.

8. Queen Elizabeth Hospital, Hong Kong.

9. Shimadzu Seisakusho Ltd. Catalogue.

10. Sakura Films Catalogue.

Sundry pamphlets on individual items of equipment

(X-ray, electro-medical and electronic).