The Specificity of the Penetrating and the Superficial Spreading Types of Early Gastric Cancer—Classification of Early Gastric Cancer Using the Interactive Image Analysis System—

Abstract: Specific types of early gastric cancer were investigated in accordance with the cancer surface area and the degree of penetration by means of quantitative measurements of the surface area of early gastric cancer using the interactive image analysis system. The results indicated a significant correlation between the surface area and the penetration depth in ordinary early gastric cancer. However these correlations were not observed in both well and poorly differentiated adenocarcinoma cases of the so-called PEN and SUPER types, which showed a significant specificity when compared with ordinary early gastric cancer. The PEN and SUPER types of early gastric cancer also exhibited various clinicopathological characteristics, and it was suggested that the poorly differentiated PEN type might be the initial lesion of a linitis plastica type gastric cancer. Examination of the conditions of the mucosa surrounding the cancer revealed a difference between the PEN and the SUPER types, and this suggested that the environment at the site of a cancer growth influences the type of growth and the spread of early gastric cancer.     

A Small Gastric Cancer in Association with Menetrier Disease

Abstract: We studied a 57-year-old man who was diagnosed as having giant rugae at a mass-screening for gastric cancer. He was examined endoscopically for check-up purposes. In addition to giant rugal folds which occurred throughout the entire fundus and body of the stomach, a type IIc lesion was noted in the posterior lower wall of the gastric body. A biopsy revealed signet ring cell carcinoma. A total gastrectomy was performed. A resected specimen was serially sectioned and underwent histopathological examination; hypertrophy and cystic elongation of the gastric glands indicative of so-called giant hypertrophic gastritis was seen. The histological type of the type IIc lesion was undifferentiated adenocarcinoma with the signet ring cells being confined to the mucosal layer. This patient had a rare case of Menetrier's disease complicated by intramucosal carcinoma.     

A rare case of alveolar haemorrhage due to malignant hypertension.

Sir, We describe a patient with an alveolar haemorrhage that probablyarose due to malignant hypertension. A 26-year-old man noticeda cough with clear sputum 10 days before admission to the hospital.Six days before admission, he flew from Miyazaki to Osaka, andreturned 4     

129Xe spectra from the heads of rats with and without ligation of the external carotid and pterygopalatine arteries.

After rats inhaled hyperpolarized (129)Xe gas, in vivo spectra from their heads revealed a dominant peak around 195 ppm, another easily resolvable peak near 189 ppm, a broad peak around 210 ppm, and two minor peaks around 198 ppm and 192 ppm. However, the source of each peak remains controversial. To further study the origin of each peak, we compared spectra obtained from the heads of normal rats with spectra taken from the heads of rats that had undergone ligation of the external carotid (ECA) and pterygopalatine (PPA) arteries, the major feeding vessels of nonbrain tissue in the rat head. The amplitude of the peak at around 189 ppm was greatly reduced in the ECA/PPA-ligated rats, while the peak around 195 ppm persisted. We conclude that the signal that originates from the rat brain after inhalation of (129)Xe gas is overwhelmingly dominated by the single resonance at 195 ppm.     

Distribution of cerebello‐olivary degeneration in idiopathic late cortical cerebellar atrophy: Clinicopathological study of four autopsy cases

Late cortical cerebellar atrophy (LCCA) is a neurodegenerative disease which presents with slowly progressive cerebellar ataxia as a prominent symptom and is characterized neuropathologically by a limited main lesion to the cerebellar cortex and inferior olivary nucleus. To elucidate the features of lesions in the cerebellar cortex and inferior olivary nucleus, four autopsy cases suffering from idiopathic LCCA without other cortical cerebellar atrophies, such as alcoholic cerebellar degeneration, phenytoin intoxication, or hereditary cerebellar atrophy including spinocerebellar ataxia type 6, were examined. All affected patients had identical distinct features of cerebellar cortical lesions. In all four cases, the most obvious pathological finding throughout the cerebellum was loss of Purkinje cells, but the rarefaction of granular cell layers was observed only where loss of Purkinje cells was very severe, and thinning of the molecular layer was seen only where the rarefaction of granular cell layers was moderate to severe. Two patients presented with vermis dominant cerebellar cortical lesions, but the other two patients showed hemispheric dominant pathological changes. Neuronal loss of the inferior olivary nucleus was observed in the three autopsy cases. Two of the three cases had a prominent lesion in the dorsal part of the inferior olive and the cerebellar cortical lesion disclosed the vermis dominance, but the other patient, showing prominent neuronal loss in the ventral olivary nucleus, had a cerebellar hemisphere dominant lesion. The patient without neuronal loss in the inferior olivary nucleus had suffered from a shorter period of disease than the others and the rarefaction of granular cell layers and narrowing of the molecular layer of the cerebellar cortex were mild. Therefore, it is obvious that there are two types of cerebellar cortex lesions in idiopathic LCCA; one is vermis dominant and the other is cerebellar hemispheric dominant. The lesion of the inferior olivary nucleus occurs as a secondary degeneration after rarefaction of the granular cell layer and thinning of the molecular layer of the cerebellar cortex progresses. Furthermore, the distribution of the degeneration in the inferior olivary nucleus depends on the distribution of the cerebellar cortex lesions.     

Outpatient basis extracorporeal shock wave lithotripsy for ureter stones: Efficacy of the third generation lithotripter as the first line treatment

Aim:   We assessed the efficacy of a third generation extracorporeal shock wave lithotripsy (ESWL) machine for ureter stones using the Dornier Lithotriptor Compact Delta.
Methods:   A total of 471 consecutive ureter stones were treated with ESWL using the Dornier Lithotriptor Compact Delta from December 2001 on an outpatient basis. Four hundred and one cases were followed up at least once after the procedure and were included in this study. All of the cases, except one patient who was three years old, were treated without anesthesia, and the procedure was principally performed on outpatient basis.
Results:   The overall stone free rate was 94.5% and the mean number of treatment sessions was 1.23. The stone free rates were compared considering various clinical factors and significant differences were observed in the stone length, the stone location and the sex in univariate analysis. However, only the stone length maintained a statistically significant impact in multivariate analysis and the stone free rates were 91.2% and 98.0% respectively in larger stones (length 10mm) and smaller stones (length < 10mm) (p = 0.004). In mid-distal stones, the stone free rate was higher than that of proximal stones (97.5% vs 92.6%, p = 0.04) and not affected by stone length.
Conclusions:   Extracorporeal shock wave lithotripsy performed by the third generation machine achieved an excellent stone free rate with a relatively small number of treatment sessions. This procedure is strongly recommended as the first line therapy for all ureter stones including mid-distal ones.     

Metastatic renal cell carcinoma to right ventricle without vena caval involvement

Abstract:   Cardiac metastases from renal cell carcinoma without vena caval involvement are extremely rare. We report 49-year-old man who presented symptoms of heart failure and thrombocytopenia. Computed tomography and echocardiography revealed a left renal tumor and a right ventricular mass without vena caval involvement. His symptoms progressed rapidly and he died at nine days following diagnosis of the right ventricular tumor.     

Tumor-associated tissue eosinophilia of penile cancer

BACKGROUND: Tumor-associated tissue eosinophilia (TATE) occurs in many kinds of cancer. This study analyzed whether TATE improves the survival of penile cancer patients. METHODS: In 17 patients with penile cancer, survival was compared between the TATE-positive group and the TATE-negative group. Tissue eosinophils were observed by transmission electron microscopy. RESULTS: In all cases, 5-year survival was 72.9% in the TATE-positive group (n = 8) and 38.9% in the TATE-negative group (n = 9; P = 0.131). In stage III and IV, it was 60% in the TATE-positive group (n = 5) and 0% in the TATE-negative group (n = 5; P = 0.058). Transmission electron microscopy images revealed the vigorous infiltration of tissue eosinophils. CONCLUSIONS: It is suggested that TATE improves the survival of patients with advanced penile cancer. However, a greater number of subjects is needed to prove statistical significance.