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In seven years we have operated eleven patients with the benign stricture of the distal part of esophagus secondary to the gastroesophageal reflux. We have made Thal's fundoplastic operation in the combination with the fundoplication operation. We are contented with the late results of the operation in eight observed patients. In five cases results of the operation are very good and patients consume food without difficulties. In three cases we have observed stenosis after the operation, successfully treated by dilatation. All these patients were rentogenologically examined and thus patent anastomosis without gastroesophageal reflux was prooved. High mortality (two patients) and morbidity ater the operation are conditional with the age of patients, their bad physical condition due to the malnutrition and the extensive operation. Thus clear indication and the utilization of the conservative treatment of strictures is demanded.

From 1963 to 1980, intrathoracic bypass anastomosis was performed in 42 patients with nonresectable esophageal carcinoma. In this study 25 patients are reported on; of these, seven presented with midthoracic and one with lower thoracic esophageal tumor, 13 with carcinoma of the cardia and four with recurrences on the esophagogastric anastomosis. Seven underwent left, and eight right intrathoracic esophagogastrostomy, whereas ten underwent left intrathoracic esophagojejunostomy. Exclusion of the esophagus was not performed in any of these cases. Dehiscence occurred in three (12%) anastomoses. Nine patients (36%) died in the early postoperative period. The majority of surviving patients (12/18) were able to consume solid food. The mean survival period was 6.3 months (min. 1 mo, max. 14 mos). Most patients died of cachexia. A bypass anastomosis is the best palliative procedure in nonresectable esophageal carcinoma. A relatively high mortality, however, necessitates a strict selection of patients.

Active plasma kallikrein (Mr = 90,000) can be separated by reduction of the disulfide bridges into a heavy-chain (Mr = 45,000) and a light-chain (Mr = 36,000). A partially active fragment, corresponding to the light-chain, was isolated during the purification of active human plasma kallikrein. Bovine trypsin can form a fragment corresponding to the heavy-chain when incubated with plasma kallikrein; plasmin also causes the formation of the heavy-chain but at a slower rate. High molecular weight kininogen decreases the rate of cleavage of kallikrein by both enzymes. Light-chain does not accumulate during incubation with these proteases and the heavy-chain, after prolonged incubation is also digested. Incubation of labelled active kallikrein with plasma causes formation of fragments corresponding to the heavy- and the light-chain.

This article presents a case of pseudocyst of the pancreas, clinically manifested as a benign tumor of the mediastinum. The cyst had spread from the retroperitoneum into the posterior lower mediastinum behind the oesophagus. The diagnosis was proved by the histological examination of the Wall and by analysis of amylase of the cyst contents, for the intraoperatively discovered cyst of the pancreas, the wide drainage into the pleural cavity has been an effective procedure. According to the data of the literature the mediastinal location of the pseudocyst of the pancreas is very rare.