We report three cases of pigmentary demarcation lines associated with pregnancy. In addition, we reviewed 19 cases including our 3 cases, which were reported in Japan. Most cases occurred during the latter period of pregnancy (after the seventh month), and the pigmentation faded spontaneously or disappeared a few months after delivery in all cases except one. Pigmentary demarcation lines are classified into five groups (types A-E). Of the 19 cases we reviewed, 2 cases showed lines of both types A and B, whereas all the other cases showed type B lines. Although there have only been 29 cases of pigmentary demarcation lines associated with pregnancy reported to date, before ours, we experienced 3 cases within 3 months, therefore it is possible that many such cases are overlooked. Pigmentary demarcation lines are mainly a cosmetic problem. Two of our three cases presented to obstetricians initially. We suggest that dermatologists should be aware that pigmentary demarcation lines may be associated with pregnancy.

The cytoplasmic sialomucin in Paget cells of extramammary Paget's disease was examined by means of a battery of histochemical techniques. The staining methods used involved an electrolyte--Alcian Blue (pH 5.8), periodic acid--Schiff and azure A at selected pH levels. Methylation, saponification, borohydride reduction, acid hydrolysis, and digestion with diastase, neuraminidase (Vibrio cholerae) or chondroitinase ABC, were also employed. The cytoplasmic mucin was found to exhibit positive reaction for the above staining which were variously altered by the chemical modification procedures and diminished in intensity or abolished by digestion with neuraminidase. These results suggest that the cytoplasmic mucin is sialomucin without side-chain substituent in extramammary Paget's disease located in axillary or genital area, and with a substituent at C7 in the disease located in perianal area.

The relation of the infected to nephritis, rheumatic and heart diseases has been recognized but that to dermatoses has not been fully established nor applied clinically by dermatologists or otolaryngologists in the treatment of such patients. In order to assess the attitude of dermatologists as regards the dermatoses due to focal tonsillar infection, a questionnaire was sent to the departments of dermatology of 72 universities in Japan: 44 (61.1%) have replied. There were 40 dermatoses listed as possibly associated with a focal infection. About 60% of the universities endeavoured to detect the focus although the focus was not always removed when identified.

Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.

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