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This report describes a case of fetal mediastinal teratoma complicated by hydrops fetalis managed successfully by aspiration of the tumor cyst fluid. Fetal mediastinal teratomas are rare tumors that cause hydrops fetalis or fetal demise in the prenatal period and respiratory distress in the neonatal period. The patient presented with a large cystic mass in the thoracic cavity complicated by hydrops fetalis. The hydrops resolved after fetal aspiration of the tumor cyst fluid. The infant was born without respiratory distress, and tumor resection was performed at the age of 30 days. The postoperative course was uneventful, and the patient was in good health 6 months postoperatively.

Purpose The purpose of the paper was to study the potential risk and management of adult biliary atresia (BA) patients. Materials and Methods Clinical courses and biochemical data were retrospectively analyzed in 52 BA patients who were operated in our department and are now older than 15 years, with special emphasis on 47 patients who survived beyond the age of 20 years. Results Of these 47 patients, 45 (95.7%) are employed, receiving higher education, and/or married. Thirty-three patients showed favorable liver function at the age of 20 years with their native liver. Thereafter, 6 (18.2%) developed liver dysfunction after working hard or pregnancy. In these 6 patients, cholinesterase levels were significantly lower at the age of 20 years than those in the 27 stable patients (239.5 ± 42.6 vs 285.8 ± 47.5, P = .0216), whereas no significant difference was found in alanine aminotransferase, aspartate aminotransferase, or total protein levels at the age of 20 years or in any biochemical parameters at the age of 15 years. Of the 14 transplanted patients, 5 who underwent transplantation after the age of 20 years had relatively uneventful courses until the age of 20 years; however, their biochemical data already showed significant deterioration at puberty. Conclusion Social activities and pregnancy should be managed individually according to the risk assessment for potential hepatic failure even in stable adult BA patients. A falling cholinesterase level after the age of 20 years may predict the risk for the late hepatic dysfunction.

In 1993 and 1994, two large earthquakes occurred along the southern Kurile-Hokkaido arc: the 1993 Kushiro-oki earthquake (15 January; Mw=7.6) and the 1994 Shikotan earthquake (4 October; Mw=8.2). These were intra-slab earthquakes that ruptured through a substantial part of the subducting oceanic lithosphere. We study source spectral characteristics of these large intra-slab earthquakes based on strong-motion records. For the Kushiro-oki earthquake, the S-wave spectra on three rock-site stations are directly compared with the theoretical spectra based on the omega-squared source model and the source parameters estimated from long-period seismic waves. The observed spectra are roughly consistent with the theoretical ones at low frequencies (

We study the complex activity of the 1994 Hokkaido Toho-oki earthquake sequence based on strong motion records and teleseismic data. First we examine S-wave acceleration spectra of the aftershocks by comparison with that of the main shock; the main shock ( M w =8.2), an intra-slab earthquake, has been characterized by strong radiation of high-frequency seismic waves. From different shapes of the spectral ratios of the aftershocks to the main shock, the aftershocks can be classified into three types. Next we redetermine the source parameters (focal depth, seismic moment and source duration) for larger events by waveform modeling of teleseismic P-waves. The hypocentral locations and stress drops estimated from these parameters show that the three aftershock types fall into different categories of subduction zone earthquakes; intra-slab, relatively deep plate-boundary, and shallow plate-boundary earthquakes. Finally, we estimate source spectra for three different earthquake categories after correcting S-wave acceleration spectra for the attenuation effect. The source spectrum at high frequencies is modeled by using a high-cut filter whose parameters are a cut-off frequency, f max and a decay rate. The source spectrum of intra-slab earthquakes has high f max and small decay rate; due to this feature and the high stress drop, intra-slab earthquakes radiate strong high-frequency seismic waves. Through this study, we demonstrate that the 1994 Hokkaido Toho-oki earthquake sequence has the complex activity of intra-slab and plate-boundary earthquakes.

The authors report a case of a 9-year-old girl with a mediastinal germinoma that required emergent surgical extirpation because of tracheal compression and asphyxia. The tumor was successfully debulked under general anesthesia with the capability of extracorporeal circulation immediately available. Postoperatively, the tumor responded to adjuvant chemotherapy and irradiation and the patient survived without evidence of recurrence.