On the cases of uterine cervical cancer detected during pregnancy various subjects such as an incidence of abnormal cytology detected during pregnancy, an incidence of cancer cases per pregnancy and total cervical cancer, time of detection, outcome of detected cases, problems in diagnosis and treatment, and so on are discussed based on published and our data.
Number of uterine cervical cancer during pregnancy has increased significantly as well as proportion in total uterine cervical cancer. These cases were often observed in non-parous women which was contrary to statistic data, multi-parous was a risk factor for uterine cervical cancer.
Diagnosis on pregnant cases was performed as well as non-pregnant status even though cytologic evaluation was some times underdiagnostic and colposcopy seemed slightly difficult compared with non-pregnant case.
Common treatments were applied to the advanced cases and cornization was done mainly in early cancers, carcinoma in situ and microinvasive carcinoma. There were two opinions concerning time of treatment, during pregnancy and after delivery.

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During the 13 year period of 1982 to 1994 we had 103 patients with pulmonary Mycobacterium avium complex (MAC) infections. All met the citeria of atypical mycobacteriosis (Japanaese Mycobacteriosis Research Group of the National Chest Hospitals). Of 103 patients 70 had no underlying pulmonary diseases and classified as primary type.
Radiographic features of chest X-rays or computed tomography (CT) of primary infection were evaluated.
Results obtained were as follows:
1. Primary infection of MAC was classified into two types. One was localized type. This type was further classified into three patterns; tuberculosis-like pattern, pneumonia pattern in the lingula and/or middle lobe and pneumonia pattern in other lobes. Another one was diffuse type.
2. Tuberculosis-like pattern was most common in males. On the other hand, the pneumomia pattern and the diffuse type were most common in females.
3. Four characteristic features were seen as follows (Type 1-4) in the chest CT examination of diffuse pattern. Type 1: Nodules near the pleura. Type 2: Nodules with subpleural thickening.
Type 3: Bronchial wall thickening and ectatic change of the draining bronchi. Type 4: Cystic bronchiectatic change associated with atelectasis of the segment or the lobe. Bronchiectatic changes became severe and widespreaded in all lung fields as the disease progressed slowly. These findings were more prevalent in the lingula and/or middle lobe than the other lobes.

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Flow velocity of cerebrospinal fluid (CSF) was analyzed at the aqueduct and the prepontine cistern with a 1.5 tesla superconductive type magnetic resonance imager (Sierra, GE Yokogawa Medical Co.). Cine mode phase contrast MR pulse sequence using periphral gating was used to measure CSF flow direction and velocity. The CSF flow studies were done under the slice thickness of 10mm or 2mm. The flow patterns observed at 2mm thin slice showed distinct to-and-fro-pattern of aqueductal CSF flow and seemed to reflect the peripheral pulse rhythm. Until quite recently such invasive examination as the computed tomographic cisternography has been required to comprehend the CSF dynamics. The presented scan technique of cine mode magnetic resonance image is capable of comprehending the CSF dynamics without any invasive procedure.

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The Society of Gastroenterological Endoscopy in Japan has been leading the world in the field of endoscopic diagnosis and now we are in the top group of the endoscopic treatment. The progress in this field is remarkable, and new research fruit is used in the clinical setting.
In our national hospitals also, the new methods recently developed have been immediately applied. But this owes to the effort of gastroenterologists, who apply the progress to bedside rapidly and who, in spite of being under rather poor circumstances, have been keeping the high medical level as a result of prompt application of the new ideas to the daily works.
Endoscope can be utilized in various ways according to the kind of organ, purpose of it's usage or techniques, and developed many type of apparatus consequently. The concept of gastroendoscopy is far beyond important in the meaning of diagnostic procedure, and now we come to think endoscopic procedure is a part of the surgery.
The indivisual titles of this symposium shows these concepts. We often used to require emergent surgery in esophageal varices or gastrointestinal bleeding. Surgery has been definite procedure in the treatment of almost all malignancies.
The choledochal drainage for the obstructive jaundice, polypectomy were the advance field of surgery. No one had imagined that a gallbladder could be extracted without laparotomy. Laser treatment to the advanced cancer propose the new source for improvement of quality of life for patients. Endoscopic ultrasonography is not only for the diagnostic procedure but also decision of indication whether endoscopic therapy for malignant tumor is useful.

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Without any information of posoning, an unconscious case of organophosphorus poisoning is sometimes difficult to be dif f erenciated from that of cerebrovascular disease and was rarely reported without information of poisoning. We report a case of uninformed organophosphorus poisoning, with our diagnosing process and treatments.
58 year-old female was admitted by ambulance because of unconsciousness, tetraparesis and respiratory disturbance. She was initially suspected of cerebrovascular disease. She showed, however, severe metabolic acidosis in spite of neither episode of diabetes mellitus nor renal disease. This made us suspect of poisoning. Gastric tube was inserted and milky aromatic fluid was drainaged. We asked the family to find any evidence of poisoning and they finally found a empty can of Sumithion (fenitrothion) in the corner of the bath room. As extremely low level of plasma cholinesterase was revealed, we diagnosed as Sumithion posoning. In spite of the delay of treatment for organophosphorus poisoning, the patient was administered under appropriate respiratory and circulatory management and was discharged without any neurological deficits.

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A 68-year-old female was admitted to the hospital because of severe anemia. She had a history of cerebral hemorrhage and had taken phenytoin and phenobarbital in combination for 12 years. Severe macrocytic anemia was noted with elevated LDH and reduced serum folate, Blood smear showed neutrophil hypersegmentation. Bone marrow smear showed erythroid hyperplasia with remarkable megaloblastic changes. These observations led to the diagnosis of megaloblastic anemia due to folate deficiency. The anemia improved after folic acid supplements without withdrawal of the anticonvulsants. The decrease of dietary folate intake had effected the development of hematological abnormality associated with folate deficiency, such as neutrophil hypersegmentation and macrocytosis, since her activity of daily living (ADL) function dropped in 1993. In patients receiving anticonvulsant medication, low serum folate levels are relatively common. However, overt anemia is unusual. Dietary f olate inadequency is the most important facter contributing to anemia.We emphasize that in patients who have the decrease of dietary folate intake during therapy with anticonvulsants, neutrophil hypersegmentation and macrocytosis should be detected before severe anemia occurs.

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