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Background: Snowboarding injuries have become more common with the remarkable increase in the sport's popularity. However, although there are many reports of orthopedic injuries caused by snowboarding, there are few reports on injuries to the chest. In this study, we attempted to identify the characteristics of snowboarding injuries of the chest in comparison with alpine skiing injuries., Methods: Between December of 1988 and April of 1997, 1,579 and 9,108 patients were treated for snowboarding and skiing injuries, respectively. All patients were initially examined by emergency physicians who used chest x-ray film. Patients with known or suspected chest injuries were further examined by using chest computed tomography and ultrasonography by thoracic and general surgeons. A total of 96 snowboarding patients and 247 skiing patients had chest injuries., Results: The chest injuries among snowboarders accounted for 6.1% of all injuries compared with only 2.7% amongst skiers. Snowboarders with chest injuries were younger, more often beginners, and more frequently occurred during the afternoon than skiers. Several distinct patterns of injury were noted among these two groups. As the cause of injury, a riding mistake during jumping was significantly higher for snowboarders (50.0%) than for skiers (0%). The incidence of rib fracture during snowboarding (55.2%) was significantly higher than during skiing (41.3%). There were no mortalities in either group., Conclusion: A riding mistake during improper jumping may be the primary cause of chest snowboarding injuries. Furthermore, snowboarders are much more likely to injure the chest, particularly by rib fractures, than skiers.

A retrospective study was conducted to identify the characteristics of snowboarding injury of the abdomen in comparison with those of alpine skiing injuries. Between December 1988 and April 1997, 1579 patients were treated for snowboarding injuries and 9108 patients were treated after skiing accidents. 19 patients (1.2%) in snowboarding and 64 (0.7%) in skiing had abdominal injuries. The abdominal injury rate in snowboarders was significantly higher than that in skiers. Snowboarders with abdominal injuries were similar to skiers with respect to epidemiology but the patterns of injury in the two groups showed several distinct differences. Riding mistakes after jumping for the snowboarders (31.6%) was significantly higher than that for the skiers (0%). The main organs involved in snowboarding and skiing injuries were kidney, liver and spleen. The incidence of solitary renal injury in snowboarding (68.4%) was significantly higher than that in skiing (29.7%).

Three cases of early stage carcinoma of the gallbladder are reported. In two cases, radiolucent shadow was demonstrated on cholecystogram. The masses were papillary adenomas with foci of adenocarcinoma. In the third case, the cholecystogram did not reveal particular findings except for shadows of numerous tiny gallstones. The malignancy was completely unexpected clinically, even after gross inspection of the organ. It was an incidental finding of microscopic examination, which disclosed abundant Rokitansky-Aschoff's sinuses associated with foci of cytologically malignant cells in the muscular layer. It was explained as malignant change of epithelium on one of the sinuses. All three patients underwent simple cholecystectomy. So far they have been free from evidence of metastasis or recurrence. The diagnosis and treatment of early carcinoma of the gallbladder are discussed.

In retrospect, we analyzed 12 cases of gastric smooth muscle tumor, nine cases of leiomyomas and three of leiomyosarcomas. In only half the number of these patients was an adequate preoperative diagnosis made. Ulceration of the tumor apparently led to the misjudgment in some cases. Features more relevant to leiomyosarcoma than to leiomyoma were findings of a larger size, exogastric growth, ulceration and tumor in patients over 50 years of age. It is stressed that enucleation is the treatment of choice for leiomyoma and an extensive gastrectomy for cases of leiomyosarcoma.

The structures of thyroxine metabolites after total deiodination bear on the mode of thyroxine (T(4)) action in vivo. The present study was undertaken to determine the integrity of the ether linkage during thyroxine metabolism in man. Normal volunteers were given simultaneous intravenous injections of two thyroxines labeled with either (14)C or (3)H on the opposite sides of the ether linkage, D,L-[alpha,beta-(3)H]T(4) and D,L-[phenolic ring-(14)C]T(4). The ratio of alanine side chain to phenolic ring which was measured as (3)H:(14)C ratio was found to remain constant in the serum, urine, and feces during the subsequent 3 wk. The disappearance rates of the (3)H and (14)C radioactivity from blood were similar. The values of half-life were in the ranges of 4.2-6.7 days. 51-63% of the (3)H and 50-57% of the (14)C doses were recovered from urine and 13-20% of the (3)H and 15-20% of the (14)C doses were recovered from feces. Chromatography of the urinary metabolites confirmed that the phenolic ring and the nonphenolic ring including at least part of the side chain remained linked together.