Out of 104 patients with perimembranous or infundibular-isolated ventricular septal defect (VSD), causative factors of Prol and AR, and the operative indication were studied in 17 with prolapse of the aortic cusp (Prol) and 10 with aortic valve regurgitation (AR). The left to right shunt ratio and the size of VSD were smaller in patients with Prol or AR than in those with the normal aortic cusp, suggesting that hemodynamics might take part in the cause of Prol or AR. Twenty-two patients underwent VSD closure only, four valvuloplasty and one aortic valve replacement. Residual AR was occurred in three out of ten patients. After surgery, AR was disappeared in six out of seven patients with the first grade preoperative AR, but AR remained in all two patients with the second grade preoperative AR. Careful preoperative observation and early operation before the appearance of AR are the important factors for avoiding residual regurgitation after aortic valvuloplasty.

Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.