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This is a rare case of a patient with a double-layered lateral meniscus, undergoing surgical treatment. A 17-year-old woman who was a member of a volleyball club had a two-year history of right knee pain with episodes of locking, although she had no history of trauma. She was referred to our hospital because her condition did not improve after conservative treatment. On presentation to the hospital, she had full range of motion in the right knee. McMurray’s test revealed no clicks; however, it produced pain in the lateral part. Plain radiography revealed no abnormal findings, whereas magnetic resonance imaging showed high signal in the posterior segment of the lateral meniscus and an increase in its volume. Arthroscopic findings showed an accessory meniscus with a flat surface overlying a normal-sized lateral meniscus. It was firmly connected to the posterior root and middle segment of the lower normal meniscus. The accessory meniscus was markedly mobile as revealed by probing. The patient was diagnosed with double-layered lateral meniscus and underwent resection of the accessory meniscus. Postoperatively, she initiated strengthening of muscles and range of motion training without weight-bearing restrictions. Two months postoperatively, she had completely recovered and participated in volleyball practices. In the last follow-up at 18 months, she had no restrictions in daily or sports activities.

A 53-year-old woman had been receiving an antithyroid agent for Basedow disease since 2 years and 5 months before was pointed out multiple calcified picture in the bilateral thyroid lobes on ultrasonography and CT. An elastic soft and diffused goiter was palpated in the anterior region of the neck but no tumor was felt. Thyroid hormone levels were in normal range. Aspiration biopsy cytology of the calcified portion locating a little to the stenosed site in the left lobe indicated papillary adenocarcinoma. Operation was performed. The thyroid glands diffusively swelled and a total of 4 nodules, 6-10mm in size, locating at the upper polars and close to stenosed sites in the bilateral lobes was palpated. Total thyroidectomy with bilateral cervical lymph node dissection were carried out. Histologically all 4 nodules were papillary adenocarcinoma. The patient was diagnosed as multiple microcarcinoma of the thyroid associating with Basedow disease. No lymph node metastasis was found. We often find difficulties in palpating the tumor in diagnosis of thyroid carcinoma associated with Basedow disease. The importance of early detection by imaging methods, especially aggresive aspiration biopsy cytology for calcified pictures, should be emphasized.

最近の高令化に伴い, 大腸癌の増加が謂われており, われわれは農村地域における大腸癌の実態を知るため調査を行なった。昭和48年より15年間の大腸癌症例は, 338例で性差はなく, 60才代がもっとも多く, 次いで70才代と60才以上の患者が62%を占めた。部位に関しては, 直腸が140例41%ともっとも多く次いでS状結腸であった。切除率は94.3%, 治癒切除は68.3%に可能で, 治療切除例の累積5年生存率は77%, 10年生存65.9%であった。大腸早期癌は24例と小数で, ほとんどが進行癌であり, 糞便潜血スクリーニング検査による大腸癌集検もようやく普及の段階になり, 今後は検診数を増して早期発見, 治療に努めねばならない。このほかpm癌, 腸閉塞をきたした癌などについても検討を加えた。

昭和47年9月以降15年間余の胃癌症例808例を検討した。性比は1.7と男性が多かった。胃切除率88%, 治癒切除率59.2%, 手術死亡率は1.8%, 累積5年生存率はStage I 96.4%, II 68.6%, III48.7%, IV4.5%であり, 胃集検, 人間ドック等の普及により早期胃癌症例の発見率はこの間2倍の増加を見たが, 65才以上の高令者ではいぜん進行癌が多く, この年代での検診強化が必要と思われる。胃切除は75才以上の高令でも安全に施行できるが, 年令, Stage, Quality of lifeを考えた術式の選択が必要と思われる。