A Case of Esophageal Carcinoma and Collision Tumor of the Stomach

A case of double primary cancer of the esophagus and stomachwith metastasis of the esophageal cancer to the stomach is reported.The entire stomach and the lower part of the esophagus weresurgically resected and intrathoracic esophagojejunostomy wasperformed. Macroscopically, two tumors were found to be present,both in the lower esophagus and the stomach. There were twoprimary cancers, one a squamous cell carcinoma of the esophagusand the other a collision tumor of the stomach which consistedof well-differentiated adenocarcinoma and signet ring cell carcinoma.Furthermore, this collision tumor was present together witha metastatic lesion from the esophageal carcinoma.     

A Case of Duodenal Crohn's Disease Associated with Ampullar Insufficiency and Cholangitis

Abstract: A 67-year-old Japanese woman with duodenal Crohn's disease developed cholangitis. Radiographic and endoscopic examinations revealed a marked stenosis of the third portion and a dilatation of the second portion of the duodenum. The endoscopic and histopathological observations showed this disease affected the Vater's papilla. Duodenoscopic manometry indicated a reduced pressure of the phasic sphincter of Oddi, indicating ampullar insufficiency. E. coli was found in the bile culture as the infecting organism. The authors suggest that the cholangitis in this patient was caused by the reflux of duodenal contents into the biliary tract.     

Anti-neutrophil cytoplasmic antibody for proteinase 3 in a child with polyarteritis nodosa

We report a case of a 15 year old boy with polyarteritis nodosa associated with antineutrophil cytoplasmic antibody (ANCA) against proteinase 3 (PR3). After months of steroid and immunosuppressant therapy, the symptoms subsided and the polyaneurysms almost disappeared. The levels of anti-PR3 antibody and of cytokines also decreased. The results indicate that ANCA is a good indicator of this disease activity, and may play some pathogenic role in the disease.     

Relation between serum hepatitis C virus-RNA levels and efficacy of interferon-β therapy

We performed two courses of interferon-β (IFN-β) to a child with chronic hepatitis C. A complete response was not obtained by the first interferon treatment, however, the results of the second treatment differed from those of the first. Hepatitis C virus (HCV)-RNA remained negative and both aspartate aminotransferase and alanine aminotransferase levels remained normal after completion of the second course. From these results we estimated that HCV-RNA levels before IFN therapy could be significantly associated with the efficacy of this treatment. The serum level of HCV-RNA was 10⁶ copies/50 μL before the first treatment, but was 10³ copies/50 μL before the second course. We conclude that IFN therapy to children with hepatitis C should always be directed at providing a cure. Even if the clinical effects of the first course are minimal decreasing quantities of HCV-RNA still offer hope for cure by subsequent readministration.     

A SURVEY OF ACUTE TOXICITY OF CYCADS AND MORTALITY RATE FROM CANCER IN THE MIYAKO ISLANDS,OKINAWA*

In 1959, the Miyako islands, Okinawa were continually attacked by typhoons and the natives who had lost their agricultural products subsisted largely on cycads. Since cycad compounds have a carcinogenic effect in a variety of laboratory animals, it is possible that they could become carcinogenic agents after ingestion in humans. The present authors attempted a statistical survey of the mortality from cancer during the years 1961 through 1966 to follow-up the tumor incidence among these natives. Mortality from stomach cancer in the Miyako islands was lower than in interior Japan. Although there was no significant difference in death rate for hepatoma between the two, it was higher in TJeno and Irabu district. The death rate for liver cirrhosis in the Miyako islands was higher than that in interior Japan, especially it was most prominent in Tarama district. These statistical results in each district was not proportional to the rate of ingestion of cycad material during the time of famine. However, most natives in these islands have long used this plant as a food before and during World War II. High death rate for liver cirrhosis in the Miyako islands may have some correlation to such a habit of the natives. Symptoms of an acute toxicity of cycad in humans were also studied on 18 patients. ACTA PATH. JAP. 20: 327 - 337, 1970.     

Concentrations of Human Atrial Natriuretic Peptide in the Cord Blood and the Plasma of the Newborn

ABSTRACT. Concentrations of human atrial natriuretic peptide (hANP) in the cord blood and the plasma were measured in 25 newborns. The level of hANP in 0 to 1 post-natal days (212.8±118.1 pg/ml; mean±SD) was significantly higher than that in cord blood (69.7±53.2 pg/ml) ( p < 0.005). There were no significant differences in the levels of hANP at the ages of 0 to 1, 4 and 6 post-natal days. The level of hANP did not show any significant correlation with urinary excretion of Na, urinary Na/Cr or Na/K ratios. Further evaluations should be made in order to clarify the role of hANP during the early post-natal period.     

A Clinical and Experimental Study on Longitudinal Deficiencies in Lower Limbs in Relation to Pathogenesis of Cleft Foot

Abstract In order to determine whether cleft foot is caused by the same mechanism as tibial and fibular ray deficiencies, clinical cases of these anomalies and those in rat fetuses induced by myleran were analyzed. In tibial and fibular ray deficiencies, arrest of tibia or fibula was closely related to the missing of toes and tibial and fibular ray deficiencies can be accepted as an occurrence of so called longitudinal deficiency. On the other hand, cleft feet were frequently associated with central Polydactyly and syndactyly. In our experimental study, the critical period of formation of cleft foot was different from that of tibial ray deficiency, but it was similar to those of central Polydactyly and syndactyly. It seems that cleft foot is caused by the abnormal induction of toe rays as in cleft hand and does not belong to the same group as tibial and fibular ray deficiencies.