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The authors describe a neonate with unilateral pulmonary agenesis and esophageal atresia (Gross type C). Definitive repair for the atresia was completed during the early neonatal period, and the patient is alive and well more than 1 year after surgery. Most patients with pulmonary agenesis associated with esophageal atresia have not survived, mainly because of postoperative cardiorespiratory failure. Early protection and preservation of respiratory units is essential for the management of these patients.

A 42-year-old male was admitted with subarachnoidal hemorrhage. Dexamethasone 224 mg was used to reduce brain edema. His operation was successful without blood transfusion. No remarkable signs and symptoms were found except HBsAg positive and mild GPT elevation during his admission. He was discharged on the 33rd day. But 2 weeks later, he felt general fatigue and became worse day by day. He was re-admitted on the 75th day. Several therapies were given but he died of hepatic failure on the 85th day. The autopsy showed liver cirrhosis with massive necrosis. We believed that the steroid-withdrawal-phenomenon caused excessive immunological response and this process caused his hepatic failure leading to death.

A 59-year-old male was admitted to our hospital with complaints of general fatigue, abdominal distension and edema in the legs in February, 1985. Laboratory findings were as follows: GOT 152 IU/l, GPT 129 IU/l, LDH 555 IU/l, ALP 1147 IU/l, gamma-GTP 413 IU/l, T.-Bil 2.1 mg/dl and AFP 422.6 ng/ml. Multiple SOLs were recognized in both lobes of the liver by abdominal CT scan and echography. Interferon-gamma (gamma-IFN: KW-2202; Kyowa Hakko Co.) therapy was started in March from an initial dose of 1 X 10(6) units and was increased up to 4 X 10(6) units, 2 X 10(6) units being administered as a maintenance therapy for 12 weeks. The tumors became remarkably smaller in size, AFP was decreased to 38.8 ng/ml, and PR was obtained. The only side effect was temporary fever. The patient was subsequently followed without gamma-IFN at an outpatient clinic for about 100 days, but finally died due to rupture of esophageal varices and hepatic failure.

Extracorporeal shock-wave lithotripsy (ESWL) was first applied for calculi of the bile duct system in 1985. Recent improvement of the crushing apparatus has enabled us to crush the biliary calculus more accurately than before, and moreover, to conduct the procedure without anesthesia, and to treat easily. We performed ESWL in 30 cases of calculus in the cholecyst using MPL-9000 (Dornier Co., Ltd.) which is said to be a crushing device of a new generation. Here, the study is presented. The results of crushing effect demonstrate the efficacy in 26 of 30 cases (87%), and disappearance rate in 18 cases (60%) at present after an average follow-up period of 4.4 months. The disappearance cases were mainly those with a single calculus (75% disappearance rate) or pure cholesterol calculus (100%). Concerning the complications, right upper abdominal pain which was expected to accompany excretion of the crunched fragments was recognized in 10 cases (33%), it was not seen in cases in which laparotomy or endoscopic papillotomy was performed.

A 58-year-old woman who was inoperable because of S3 (pancreas and colon) and P1 at the initial operation was treated with UFT, ADM and MMC at a dosage of 242.7 g, 418 mg and 166 mg, respectively. After the chemotherapy (2 years and 6 months from initial operation), a second look operation revealed that a tumor was localized in the submucosal layer and there were no lymph node metastases. Thus, it could be resected radically. Until now, various methods of chemotherapy for unresectable gastric cancer have been reported, and many cases of CR contained fluoropyrimidine derivates. In the case under study, combination chemotherapy containing UFT was performed with good results.