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Na(+)-K+ ATPase on the cell membrane is activated to compensate for hyperkalaemia; however, when this compensation is incomplete, hyperkalaemia occurs.

This is the fmt report of a newborn infant with Down's syndrome associated with combined congenital pyloric and esophageal atresias without a tracheoesophageal fistula (Gross A type).A mother was noted to have marked abdominal distension and hydramios was suspected at 28 weeks gestation. Ultrasonographic findings of her abdomen demonstrated that the fetus was suspected of having congenital duodenal and esophageal atresia, from the large doubleecho-free spaces occupying the greater part of the abdomen. Chromosome analysis of the amniotic fluid showed a karyotype of 21 trisomy. The newborn baby had clinical characteristics of Down's syndrome and severe abdominal distension after birth.At 19 days after birth, autopsy revealed pyloric and esophageal atresias without tracheoesophageal btula.We conclude that ultrasonographic examination is useful for the prenatal diagnosis of a patient with gastrointestinal obstruction combined with esophageal atresias, without tracheoesophageal fBtula. Case ReportA 2,678 g female was born at 35 weeks and three days gestation. The mother was 37 years old, gravida 3, para 2, abortion 0, and had no remarkable medical history except for hysteromyoma. Her first and second children were in good health. The pregnancy had progressed satisfactorily.At 28 weeks gestation, ultrasonogra-