Application of ultrasonography (USG) was performed to diagnose three pediatric surgical diseases, such as incarcerated inguinal hernia, hypertrophic pyloric stenosis, and intussusception at Gunma Childrens Hospital Medical Center.
1. Use of USG in patients with incarcerated inguinal hernia.
A) The mean diameter of the maximum hernial content was 14.6mm in reducted cases and 20.1mm in operated cases. The minimum hernial content was 7.8mm in reducted and 5.8mm in operated.
The ratio (maximum/minimum) was 2.0 in reducted and 3.5 in operated.
B) Sonographic “reducible sign” was able to observe when the reduction was possible.
2. Use of USG in patients with hypertrophic pyloric stenosis (H.P.S.)
A) The sonographic standard in H.P.S. was more than 14mm in diameter of pyloric canal and more than 3mm in the muscle thickness.
The “stenotic index” (muscle thickness × 2/diameter) was valuable in the diagnosis.
less than 0.30 : normal case
0.31-0.50 : possible case more than 0.51 : definitive case
B) After operation, muscle thickness was decreased from 3.8mm to 2.5mm and stenotic index was changed from 0.53 to 0.35.
C) “Wedge sign”, demonstrated at the portion of pyloromyotomy, was observed immediately after operation and couldn't be seen about 2 weeks later.
3. Use of USG in patients with intussusception.
Sonographic pattern, demonstrated as multiple concentric ring sign, was, valuable to diagnose intussusception.
Measurement of the diameter of the intussuscipiens by ultrasonography was 25.2mm in reducted cases and 30.0mm in operated cases.
The ratio of intussusceptum/intussuscipiens was 0.55 in reducted and 0.41 in operated.

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We studied the antitumor effect of activated vitamin D₃, which is reported to have a proliferation inhibitory action in vitro against several strains of breast cancer cells in vivo using 7, 12-dimethylbenz (a) anthracene (DMBA) -induced rat mammary tumors.
After mammary tumors developed as a result of administration of 20 mg of DMBA to 6-week-old female Sprague-Dawlay (SD) rats, we conducted daily oral administration of 1α-hydroxyvitamin D₃ (1α (OH) D₃) for 4 weeks in a dose of 0.02, 0.1, 0.5 and 1μg/kg. Every week tumor size and body weight were measured, and after 4 weeks the estrogen receptors (ER) of the tumor and serum Ca concentration were determined. Moreover., we compared the rate of change in tumor size when each of the 3 drugs, 5-FU, Medroxyprogesterone acetate (MPA) and Tamoxifen (TAM) was administered alone or in combination with 1α (OH) D₃.
The results showed that 1α (OH) D₃ suppresses the growth of DMBA-induced rat mammary tumors dose-dependently. In combination with 5-FU, potentiation of the antitumor action was suggested, but in combination with MPA and TAM, no potentiation was observed.

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Esophageal rupture by trauma is very rare in Japan, only nine cases being reported from 1970 to 1989. This patient was a 42-year-old man who suffered from traumatic rupture of the esophagus in a traffic accident. He was admitted to Takasaki National Hospital nine days after the accident, with fever and dyspnea.
Esophageal rupture was diagnosed by esophageal fluoroscopy only. The right pleural space was drained by thoracotomy. On the 15th day after the first thoracotomy, tracheotomy, gastrostomy, and substernal drainage were performed.
On the 12th day after the second operation, the right pleural space was drained by thoracotomy again.
In the third month after the first operation, closure of the esophageal rupture was confirmed by esophageal fluoroscopy. After four months of conservative treatment, he was discharged.

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A case of locally advanced breast carcinoma after augmentation mammaplasty is reported, and carcinogenesis in response to foreign bodies and the differential diagnosis between foreign body granuloma and breast cancer are discussed. The patient was a 51-year-old woman into whose breasts silicone-fluid had been injected 25 years ago. A mass with an ulcer was found in her right breast, and a subcutaneous mastectomy was performed based on a diagnosis of foreign body granuloma. The tumor was intraoperatively diagnosed by the frozen section technique to be a ductal carcinoma. A radical mastectomy was immediately performed. Microscopically, the tumor was found to be solid-tubular carcinoma with positive nodes, and foreign bodies and granulomas were found to be present in or adjacent to the tumor tissue.

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An autopsy case of cardiac rupture complicating acute myocardial infarction in a 69-year-old man is described, and six additional cases including this case, all of them autopsied at our department during between 1968 and 1987, were clinicopathologically reviewed. A common pathologic finding of these cases was the transmural infarction without old infarction scars, and the majority of them revealed a thrombotic occlusion of a main coronary artery, and thinning of the infarcted cardial wall. From a clinicopathologic point of view, mechanical stress, such as the intraventricular pressure and pathologic strain elicited by myocardial overcontraction, which acts on the center of the transmural necrotic wall, seems to be necessary for the occurrence of cardiac rupture.

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