In resent years, there has been an increasing incidence of allergy to latex. There has also been some fatal cases reported among health care workers and patients with spina bifida in Europe and United States, in spite of the development and effort to establish the diagnostic method of latex allergy and prophylactic treatment.
Since the possibility of clinical cases with latex allergy in Japan can't be ignored, the discussion of the diagnosis and treatment of the allergy becomes a necessity, and therefore clarified in this article.

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Between August 1994 and March 1996, consecutive 50 patients aged 70 years and over, 29 male and 21 female, underwent cardiovascular operations using cardiopulmonary bypass at our hospital. The mean age was 74.3 years, range 70 to 82 years old. The types of operation were 21 coronary artery bypass graft (CABG) surgery, 16 valve surgery, 2 combined CABG and valve surgery, and 11 replacement of thoracic aneurysm. An emergency operation, that was started within 24 hours after admission, was performed in 9 patients. An urgent operation, that was started behind first 24 hours after admission but early as possible, was in 11, and an elective operation was in 30. The overall hospital mortality was 5 (10%). Hospital mortality was 9% in the patients aged 70 to 74 years, and 12% in those aged 75 years and over.
Hospital mortality was 22% in the patients undergoing emergency operation, 18% in those undergoing urgent operation, and 3% in elective cases.
Operative mortality was higher in elderly patients undergoing emergency operation, The results suggest good operative result is expected in select elderly patients undergoing scheduled operation.

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Thallium SPELT was performed in patients with significant coronary artery stenosis 1) after maximal exercise (67 cases) and 2) during coronary vasodilation induced by ATP (adenosine triphosphate) infusion (74 cases).
In patients suspected of angina pectoris, the sensitivity, specificity and predictive accuracy for detection of coronary artery disease(CAD) were 88%, 78% and 82% for exercise SPECT, and 100%, 72% and 84% for ATP SPECT studies, respectively. In patients with old myocardial infarction, these were 73%, 100% and 88% for exercise SPECT and 71%, 100% and 81% for ATP SPECT. These were 75%, 49% and 60% for treadmill exercise test in the patient group including both angina and myocardial infarction.
For detection of diseased vessels, the diagnostic accuracy for left anterior descending artery and right coronary artery lesions was almost equal for ATP and exercise SPECT study, but ATP SPECT study was more sensitive than exercise SPECT study in detection of left circumflex artery lesions.
ATP as well as exercise SPECT studies occasionally gave false positive results in patients with single-vessel disease. ATP as well as exercise SPECT studies underestimated the severity of multivessel disease.
In general, the results of ATP SPELT imaging were highly concordant with the results of exercise SPELT imaging. ATP stress thallium SPECT imaging provided a safe and highly accurate diagnostic tool for detection of CAD.

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Because of an increase of elderly females in Japan, the prevention and treatment of these diseases has become more important.
Reconsiderations of definitions, diagnosis, and treatments of these disease were performed by a squad consisting of 22 gynecological doctors belongings to 11 Japanese national hospitals.
The abstracts of their reports of 12 times of meetings from 1993 to 1995 are summarized in this report.
Our survey of complaints of disorders of perimenopausal women, taught us that the generally believed and accepted symptoms such as hot-flashes, perspiring and so on, were less important than the augmentation of common complaints such as general malaise, headache, stiff shoulder, lumbago etc..
The treatment of these patients has been usually dependent on only hormonal replacement therapy. But treatment for symptoms of autonomic nerve disturbances must also be addressed.
The administration of bromocriptine rectal suppository, not commercially available oral tablet, has effective for treating such disorders.
To prevent osteoporosis, a screening examination of bone density of pen-, and post menopausal women has become vitally important. But to do so many problems must still be solved that are concerned with more accurate measurement methods and the selection of the most representative bone for measurement purposes from all the bone of the individual female body.
Of several measurement instruments now available, the cost of the DEXA instrument must be reduced. And its manipulative uses must be simplified. As far as the cheaper and simpler MD and ultra-sonographic methods are concerned, their improvement in accuracy greater consistency in determining results are absolutely indispensable.
Several new trials to improve the measurement methods of bone density were presented in this report. Each test was subject to exhaustive computer analysis. Nonetheless, a fail-proof measurement system for predicting and preventing osteoporosis has not yet been discovered.

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Two cases of IIa+IIc like advanced colorectal cancer (rectum, ascending colon) less than 2 cm in diameter are described.
It is usually uncommon that we clinically encounter advanced colorectal cancer around 2 cm in diameter, although every large Borrmann type colorectal cancers must pass that small sized stage.
It has been thought that de novo cancer theory is just able to explain this riddle.
That is to say, the early lesion of de novo colorectal cancer indicates superficially flat or depressed change and its growth to vertical direction is surprisingly rapid causing difficult detection.
Recent many clinical results have represented that the postoperative prognosis for mp colorectal cancer is very good next to early (m, sm) colorectal cancer's. But, unfortunately mp proportion among whole colorectal cancer cases is extremely low.
On the other hand, most of small advanced colorectal cancers less than 2 cm in diameter are mp cases.
Therefore, we wish to emphasize that efforts must be made to detect no only early colorectal cancer but also small advanced colorectal cancer less than 2 cm in diameter.
These efforts will lead to more satisfactory results in treating patients with colorectal cancer.

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A 72-year-old woman presented with subacute paraparesis. She complained no sensory deficits. Sagittal magnetic resonance images, myelograms, and CT myelograms revealed a disc protrusion at T6-7 level. The herniated disc was removed by costotransversectomy. Her paraparesis gradually improved after surgery.
Thoracic disc herniation is not common. It has been recognized that most thoracic disc protrusions occurred predominantly at lower thoracic levels and presented sensory disorders as well as motor weakness. But some authors reported recently that the thoracic disc herniations occurred at mid thoracic levels more frequently than at lower levels. Another authors emphasized that thoracic disc protrusions without sensory symptoms had high risk of misdiagnosis. Our cases also suggests the posibility of misdiagnosis, We should pay careful attention for these mid thoracic disc lesions, evev if they are not acommpanied with sensory disorders.

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The patient was a 54-year-old man who was pointed out to have a superficial carcinoma of type 0'IIa (M) at gastric supra-angle and was resected endoscopically. The histological findings was as followed; papillary adenocarcinoma, invasion into the mucosal layer, ly0, v0, cut end (-). After two years and 3 months, the regional lymphnodemetastases at lesser curvature of stomach were arisen. The subtotal gastrectomy was performed with D1-lymphnode dissection. After 3 years and 3 months, the liver and lung metastases was arisen. Chemotherapy was performed (CDDP+5Fu) The efficacy of chemotherapy was not good. The patient who was endoscopically resected for gastric mucosal cancer died after 4 years and 4 months by lymphnode, liver and lung metastases.

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We evaluated the hematological recovery and the prognosis of eight patients with hematological malignancies after autologous blood stem cell transplantation (ABSCT), including non-Hodgkin's lymphoma, Hodgkin's disease, acute myelogenous leukemia and acute lymphoblastic leukemia. We performed peripheral blood stem cell transplantation (PBSCT) in five patients and autologous bone marrow transplantation (ABMT) in three patients (in two of them, using PBSCT at the same time; ABMT/PBSCT). Peripheral blood stem cells were havested using a cell separator (AS104) in 7 patients, 6 of whom were administered with G-CSF, after the conditioning with high-dose Ara-C and VP-16. The time to reach 1×10⁹/l WBC, 0.5×10⁹/l absolute neutrophilic count and 50×10⁹/l platelete were 11 days (PBSCT) vs. 15 days (ABMT), 12 days vs. 16 days, 12 days vs. over 30 days, respectively. The number of platelet transfusion needed was 7 times (ABMT) vs. 3 times (PBSCT). ABSCT of all of the three patients with relapse was performed in the second remission or later. Two of the three who received ABMT are dead and one who received PBSCT is still alive. It is suggested that PBSCT is superior to ABMT in terms of rapid hematological recovery (especially, platelet recovery).

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