For 50 cases of fundectomy (gastroesophagostomy) and 29 cases of total gastrectomy, complains of postoperative reflux esophagitis, X-ray examinations, fiberscopic observations, biopsies, and determinations of esophageal pH were investigated, and the following results have been obtained :
1. Esophagitis symptoms were classified as, “moderate”, “mild”, and “sever”.
2. Endoscopic criteria were classified as, “mucosal color tone change type”, “erosion-ulcer type”, and “hyperplastic swelling type”. Endoscopy grade was devided into I, II, and III, mainly under reference of infiltration extent.
3. Biopsy criteria was used to judge neutrophil infiltration, parakeratosis, basal zone's change, expansion and increase of blood vessel on lamina propria, and fibrosis.
4. Observing the similarity of the pH curve of esophageal mucous membrane to that on jujunal interposition, it was shown that gastroesophagostomy is little influenced by gastric juice and duodenal juice.
5. As prevention against regurgitation, a slim stomach tube was used, and for anastomosis, the pointed end of esophagus was made to invaginate inside the tube.
6. In gastroesophagostomy, there were few occurrences of esophagitis. The symptoms were of light grade, and in the course of time after operation, they became very well.
7. During endoscopy investigations and gastroesophagostomy, there was observed slight and limited esophagitis near the anastomatic site, but there was no tendency toward worsening in the progress of time.

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Skinfold thickness (ventral) was measured with 1461 children in total of elementary and junior high school, and Rohrer's index was also computed with them. And change by age distribution of these values were studied, and it was further inquired what significance they would have as an obesity index, with the following results :
1) The mean and the median value of skinfold thickness increased with age in both males and females, and this was especially marked in age of over 10 years. And the skinfold thickness was greater in girls than in boys, and the difference increased with age.
2) The skinfold thickness showed bimodal or trimodal distribution. Thus both in males and females, the first peak of 5-6mm tended to appear in age of 6-9 years, the second peak of 10-11mm in 12-14 years, and the third peak of 15-16mm in 13-14 years. And each distribution was positively skewed toward the higher value, and each showed extremely wide dispersion.
3) The mean and the median Rohrer's index gradually decreased in both males and females as the age advanced from 6 to 9 years. Thereafter they remaind scarcely unchanged in boys but gradually increased in girls until 14 years.
The distribution was nearly normal in 6-7 years of age, but later skewed progressively toward the higher value, thus exhibiting asymmetry. The peak always shifted to the lower value in both males and females as the age advanced from 6 to 12 years, but in 12-14 years it came to be nearly fixed or to shift rather to the higher value.
4) The skinfold thickness and body weight had high correlation, and this was the case even after the elimination of stature's influence. Also skinfold thickness and Rohrer's index had similarly high correlation, and this tendency became more prominent with age.
5) In the evaluation of obesity, it seemed necessary to take into consideration the respective features of skinfold thickness and Rohrer's index, and the author came to a conclusion that the combination of these two in obesity evaluation would remove various irrationalities, and thus offer a more adequate means.
For example, when a subject shows skinfold (ventral) of above 15mm and Rohrer's index of above 160, he can be judged as showing obesity. When, however, the skinfold is above 20mm, the judged of obesity can be formed even when Rohrer's index may be below 160. When the skinfold is below 15mm, the judgedment of obesity can be suspended even when Rohrer's index may be above 160. The details of this point must await future study for full elucidation.

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The incidence of congenital atresia of the esophagus in generally quoted as 1 in 3, 000 live births. In majority, it is associated with a tracheoesophageal fistula. Prematurity and multiple severe congenital anomalies are the two most common causes of death in these infants.
A case of Gross A type atresia of the esophagus associated with high jejunal atresia, jejunal perforation and christmas tree deformity of the distal intestine was presented.
The patient, a seven-hour-old girl, was referred to the Department of Surgery, Gunma University Hospital, on March 23, 1974 because of increasing abdominal distention and recurrent cyanotic spells since birth. The up-right scout film of the distended abdomen on admission showed generallized flank opacity without intestinal gas. A Replogle catheter with radiopaque sentinel line was introduced but lodged in the upper third of the esophagus and could not be advanced.
Upon entering the peritoneal cavity, a large amount of bilious ascites was gushed out. A markedly distended proximal segment of jejunum ended abruply 5cm. distal to the ligament of Treitz. The remaining small intestine was coiled as an “apple peel” around a narrow mesentery attached at the ileocecal junction. A rupture was found at the apex of the distended proximal blind end of the jejunum. The perforated blind end was resected and end-to-side anastomosis was carried out. A Stamm gastrostomy was performed and a jejunal trans-anastomotic feeding tube was introduced. The abdomen was closed with a tube drainage. Immediately postoperative course was complicated with apneic spells but jejunal tube feeding was started from third p.o.day. She did well thereafter and she weighed about 8Kg. at eight months of age. She is now waiting a definitive operation.

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As to X-ray examination of the naviculare and tibiale externum bones, the authors worked out a way to project them obliquely as follows; A new X-ray projection technique for taking shots anteversio oblique at an angle of 28 degrees to the footbottom. The reason for determining the angle at 28 degrees is that it corresponds to the degree at which the space between the tibiale externum and naviculare can be most clearly projected. It was the average degree out of 21 samples taken. Using this oblique projection technique, the space along these two bones does not overlap and its shadow is projected sharply.
The figures of the naviculare and the tibiale externum of 540 adults (25-74 years old) on roentogenograph by means of such oblique projection are now classified as the Oneda-Katada classification in 6 divisions (A', A, B, C, D and E types) and 2 subdivisions (+S₁, or +S₂ and L, M, or S types) (cf. Figs. 8 and 9 and Tables 2, 3 and 4), referred to the dorso-plantar X-ray projection figures.
Further, using this oblique projection method, the authors classified the both bones of 1, 159 growing children from age 6-19 years old (cf. Tables 5, 6 and 7). It was concluded that the frequency of occurrensce of each type was about one or two years earlier for the female than for the male. Due to the frequency of occurrence of each type in each age group, the growth of the naviculare and the tibiale externum is assumed by the authors to be as Fig. 11.
It must by assumed therefore, that in some cases growth ceases in each type and that the bones remain unchanged.

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The present paper discussed the perinatal emergency care system for further improvement of child and maternal health in Gunma prefecture, Japan.
The possibilities for the prevention of perinatal deaths were estimated from the data about the causes and local distribution of hebdomadal deaths which were main concern of emergency care system.
The deaths from obstetrical causes, which were mostly preventable, were less than one third of the total cases. The rest of above were caused by environmental factors and most of them were difficult to prevent. Introduction of high risk care unit for pregnant women as developed in advanced nations was needed to reduce the number of deaths from environmental factors.
The frequency of toxaemia and bleeding in the rural under-doctored region and part of town area (previously published data) also urged the need of careful perinatal control in these area.
The definite plan for these emergency care system are under investigation analyzing the data from questionnaire.

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