Although the number of patients with pleural malignant mesothelioma, having some relation to asbestos industries, has been increasing worldwide, the philosophies for the treatment are still con-troversially. The survival of the patients are not very much affected by current treatment. It is clear, however, that the histological type and stage of the disease, influence to the prognosis of patients. Adequate staging of the disease for surgical treatment is required, because pleuro-pneumonectomy is the most effective modality available now. Several classifications of the stage for malignant pleural mesothelioma have been proposed until now. Results of treatment must be correctly evaluated using an international classification of the stage. Recent reports suggest apparent improvement of results after treatment by multimodality combination of surgical intervention, chemotherapy and radiation therapy.

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We evaluated the diagnostic ability of low-field-strength (0.2-T) MR imaging by examining 25 meniscal tears which underwent arthroscopy of the knee. Findings from MR imaging and arthroscopy agreed in 24 meniscal tears, and gradient-echo sequence (T1-weighted image) was more useful than spin-echo sequence (proton density-weighted and T2-weighted images). We concluded that low-field-strength (0.2-T) MR imaging may provide useful imformation in the evaluation of meniscal tears of the knee with using proper scan parameters.

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In order to elucidate whether or not high levels of C-peptide excretion in urine over a 24-hour period (24 h-UCP) may be a risk factor of coronary heart disease, we examined the relationship between 24 h-UCP as an indicator of insulin secretion from beta cells and lipoprotein disorders analyzed by polyacrylamide gel (PAG)-disk electrophoresis. Serum lipid and apolipoprotein concentrations, PAG-disk electrophoretic pattern of lipoproteins, and 24 h-UCP were measured in 78 NIDDM patients with normal kidney function. Patients with liver diseases other than fatty liver were excluded. Densitometric figures of PAG-disk electrophoresis were classified into one of 4 patterns based on the shape of the LDL portion, denoted as type S, A, N and D.
Types N and D occured more frequently and showed significantly higher levels of 24 h-UCP excretion than did types S and A. Types N and D were characterized by high serum levels of total cholesterol and triglycerides and low serum levels of HDL-c.
These data suggest that patients with NIDDM and high levels of 24 h-UCP may be at risk for coronary atherosclerosis.

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A unified form was established by the Cooperative Study Group of the National Hospitals, and investigation on the medical environment of the pediatric clinics for cancer patients was conducted.
In our hospital, over half of the patients were from remote regions beyond 100 km away. Among over half of the patients, some problems in the family occurred. The parents' needs requested to the hospital included certain equipments for the parents who take care of their children, visitors' lounge, playroom, study classes in the hospital. Major reasons for unfavourable conditions in our Pediatric Ward were lacking space in the patients' room, hardly any place to keep personal belongings, human relationships among the parents, etc.
The ultimate purpose of the Pediatric Clinic must be to allow the children with cancer to return to society again, as healthy and worthy citizens. Some kinds of financial supports are necessary to provide such a medical environment in the hospital which treats chronic diseases of children as cancers.
It is urgent that evaluation of financial support possibly by the Social Health Fund should be considered to the hospitals which provide such facilities for treating the children with chronic diseases.

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Closed, locked intramedullary nailing is now widely accepted for tibial diaphyseal fractures. But there are some concerns about the use of this technique for fractures of the distal metaphysis. The authors have used intramedullary nailings for distal tibial fractures. And the results were examined.
Patients and methods There were eleven cases with a mean age of 57 years.
For fracture classification, AO-type 43-A fractures were 7 cases, 43-C fractures were 4 casess. All fractures were managed by locked intramedullary nailing (unreamed tibial nailings in 10 cases, Russell-Tailor's nail in one case). The overall results were judged with JOA-score and Burwell's evaluation system. Follow-up information ranging from one to four years was obtained.
Results Clinically, all cases were good results. Radiological review revealed satisfactory results in all but one case. One case (AO-type 43-A) had varus deformity of 10 degree respectively because of incomplete fixation of the fracture.
Discussion Treatment of distal tibial fractures with involvement of the ankle have not been discussed clearly. In surgical treatment of these fractures, reduction of fibula is important, continuously rigid fixation of tibia and fibula is necessary. Open reduction and plate fixation is associated with high incidences of soft tissue damages. Closed intramedullary nailing seems safe and effective treatment. But, this treatment isn't appropriate for distal, displaced intra-articular plafond fractures which require careful reconstruction of the articular surface.
Conclusion The authors reviewed results of intramedullary nailings for the treatment of distal tibial fractures. Clinically, all cases were good results. Radiological review revealed satisfactory results in all but one case. Closed intramedullary nailing seems safe and effective treatment.

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A 45-year-old male suddenly felt epigatralgia and was diagnosed Stanford type A acute aortic dissection by chest CT, so we underwent emergent operation. The entry was seen just distal of his aortic valve and we underwent graft replacement for only ascending aorta with 28 mm Hemashield. We used GRF glue and felt for both aortic stump reconstruction. With use of both, we could reinforce the weak dissected wall and reduce intraoperative bleeding from anastmosed leson. And complete atrioventricular block which was reported as the complication of GRF glue was not recognized.

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We evaluated the level of plasma von Willebrand factor (vWF), a marker of vascular endothelial damage, and platelet aggregation and platelet releasing factors in patients with diabetes mellitus (DM). The level of plasma vWF was increased in patients with DM. In addition, there was a positive correlation between plasma HbAlc and vWF (p=0. 0018). No apparent changes in platelet functions was detected in patients with DM. These results suggest that the grade of DM control is closely related with vascular endothelial damage in patients with DM.

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The patients is an 11-year-old boy who has been suffering from bronchial asthma since 1 year-9 months of age. He had frequent hospitalization and was intubated twice prior to the referral to our hospital. His asthmatic condition was so severe that he needed institutional therapy for 6 years. After discharge, he had frequent attacks precipitated by upper respiratory infection and psychological stress. We initiated psychological therapy besides the conventional management for asthma which included patient/patient education, environmental control, physical training and exercises, and drugs. We want to emphasize that comprehensive management should be given to every patient with asthma.

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An 8-year-old boy was admitted to our hospital because of pain and muscle weakness of the right lower extremity, back pain, dysuria. A magnetic resonance imaging examination demonstrated a mass in his pelvic cavity. A diagnosis of acute myeloid leukemia (the French-American-British M 2 subtype) with granulocytic sarcoma was made by a peripheral blood and bone marrow examination. A cytogenetic study of bone marrow cells revealed an abnormal clone with a karyotype 45, X, -Y, t (8;21). Induction chemotherapy was initiated and he was successfully induced to complete remission, however, he had a relapse in the bone marrow and in the pelvic cavity 11 months later. Because there were no HLA-matched siblings, he was referred to another hospital for unrelated donor bonc marrow transplantation.

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A new law, the “Organ Transplant Bill”was proclaimed July 16, 1997. It authorizes organ transplants from brain dead donors and, however, it requires the donor's prior written consent not only to donate the organs but also to undergo a brain death diagnosis to making organ donation and, moreover, it allows the donor's family to reject these processes.
The family of donor can decide organ donation in the case of heart arrested donor but cannot in the case of brain dead donor.
It is clear that no organ transplant from brain dead donor can be expected without the nation-wide actual results to posses the card prior written to inform his or her consent.
In this paper, the “Intension Expressing Card”is introduced for the readers.

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