A Case of Advanced Gastric Cancer With Long-Term Survival as the Results of Combined Radiation Therapy and Chemotherapy

A case report on a long-term surviving patient with advancedgastric cancer with supraclavicular lymph node metastasis treatedby radiation and chemotherapy is presented. The Borrman type 2 of advanced gastric cancer was found on thegreater curvature of the antrum at the first radiological examination. Radiation was administered to the supraclavicular lymph nodeat 60 Gy and to the stomach at 64 Gy. The patient received mitomycinC (24 mg) and Tegafur (230 g). After completion of the combinedtherapy the endoscopy revealed an irregular mucosal change witherosion and hemorrhage. Radiological examination revealed atrophicand hyperplastic areas throughout the stomach. These findingslasted more than six years. The patient died of unknown causein February 1983. She had survived nine years and seven monthsafter her initial diagnosis. Radiotherapy may play a role asa means of radical treatment in certain cases of advanced gastriccancer.     

A Case of Terminal Ileum Lipoma Treated by Endoscopic Polypectomy

Abstract: This study reports on the case of a 71-year-old man who complained of repeated episodes of right lower abdominal pain. A barium enema and colonoscopy revealed a 20 times 20 times 15 mm smooth-surfaced polypoid tumor (Yamada type III) located in the terminal ileum. An endoscopy showed that the lesion had a slightly yellowish surface and the cushion sign was observed, so the tumor was considered to be an intestinal lipoma. During colonoscopy, prolapse of the tumor occurred through the orifice of Bauhin's valve and the patient simultaneously complained of right lower abdominal pain. The tumor was removed endoscopically. After a colonoscopic polypectomy, the patient's right lower abdominal pain disappeared. A pathological examination of the specimen revealed a lipoma of the terminal ileum. In general, the correct preoperative diagnosis of intestinal lipoma is difficult. Furthermore, 80% of lipomas situated at the terminal ileum are complicated by acute intussusception. We suggest that a colonoscopic polypectomy is a useful procedure for confirming the diagnosis of intestinal lipoma and for the prophylaxis of intussusception when the tumor is located in the terminal ileum.     

Structural characterization of the molten globule and native states of ovalbumin: A H NMR study

Molecular characteristics of ovalbumin (OVA) in the acidic (pD 3.08, the E-form) and neutral [pD 7.29, the N-form (native form)]. regions were studied by measuring effective radii, H NMR spectra, spin-echo H NMR spectra and cross-relaxation times (T_IS) from irradiated to observed protein protons which are particularly sensitive for detection of the mobile segments and/or structural looseness in proteins. H NMR spectra did not show significant differences between the N- and E-forms except for the spectral lines in the CH₃, °CH₂ and aromatic regions. Effective radii and T_IS values for main- and side-chains showed 1.08 and 1.5- to 2.0-fold increases on going from the N- to E-forms, respectively. The elongation of T_IS values might indicate the appearance of the fluctuating tertiary structure in the E-form. Molecular characteristics of the E-form, inferred from reported far ultraviolet-circular dichroism (UV-CD) spectra in the peptide region, near UV-CD spectra in the aromatic region [Koseki et al. (1988) J. Biochem. 103 , 425-130]., effective radii and especially elongation of T_IS values might indicate that the E-form could be in the molten globule state. The onset of denaturation of OVA using I is measurements was also studied.     

Bilateral testicular tumors: A report of nine cases with long-term follow-up

BACKGROUND: The incidence and clinical features of bilateral germ cell testicular tumor (GCTT) in the Japanese population are not fully characterized. We examined the incidence, clinical features, management and outcome, sexual status, hormonal environment, implication of androgen replacement, and human leukocyte antigen (HLA) typing of bilateral GCTT. METHODS: We treated nine consecutive patients with bilateral GCTT from 1980 through to 1999, and reviewed their hospital and clinic charts. Testosterone, luteinizing hormone, follicle stimulating hormone, dehydroepiandrosterone, and dehydroepiandrosterone-sulfate were measured in bilateral orchiectomized patients. Human leukocyte antigen typing was assessed with peripheral lymphocyte. RESULTS: The incidence of bilateral GCTT against the total number of patients with GCTT was 9/274 (3.3%). The median age of the first tumor was 29 (range 21-75) years. Three cases were synchronous and the remaining six cases were metachronous. In the case of metachronous tumor, the median interval between first and contralateral tumor was 8 (range 2-25) years. Standard treatment was defined as surveillance policy in stage I, chemotherapy for higher stages of non-seminoma, and radiotherapy for stage II seminoma. Human leukocyte antigen typing was examined for seven cases. Five cases were positive for HLA-A24. The incidence of HLA-A24 in bilateral GCTT was identical to that of the Japanese population. The relapsing incidence of stage I disease with surveillance policy was almost identical to unilateral GCTT. A 74-year-old patient with stage II seminoma died of the disease at 1.3 years. The other eight patients remained well without any evidence of recurrence at a median follow-up period of 78 (range 12-204) months. Four patients with bilateral orchiectomy did not require androgen replacement without easy fatigability. Sexual status was conserved using androgen replacement. CONCLUSIONS: Long-term follow-up, as long as 25 years, is recommended for contralateral relapse. Some patients with bilateral orchiectomy do not require androgen replacement. The significance of HLA-A24 for bilateral testicular tumor is equivocal in the Japanese population.     

Healing of Ulcers in Early Gastric Cancers: Supplementary Report

It has already been confirmed by several investigators thatulcers in early gastric cancers show significant healing withantacids and anticholinergics. This paper presents 10 casesin which ulcers in malignant lesions healed to form scars, demonstratinggastroscopic and histological findings. The purpose of the presentpaper is to emphasize that a trial medical therapy for gastriculcers is not always reliable for differentiation of the benignfrom the malignant lesions.     

Alternation of QRS Morphology and Effect of Radiofrequency Ablation in Idiopathic Ventricular Tachycardia

We performed electrophysiological studies in 13 patients with idiopathic VT and attempted radiofrequency (RF) catheter ablation in 4 of them.Results: VT was induced by programmed stimulation in all patients and the mean cycle length was 363 ± 58 msec. In 8 of 13 patients (62%), alternation of either the cycle length and/or morphology of VT was observed. Transient entrainment was achieved in all patients by rapid pacing from the right ventricular outflow tract so reentry was considered the underlying mechanism of VT. The site of earliest activation (EAS) during VT was located at the apicoposterior portion of the left ventricular septum and used as the target site for RF catheter ablation. Spikelike presystolic activity was detected 20–40 msec prior to the large deflection of the local electrogram in four patients. VT was terminated by a few seconds of RF current in all four patients, but subsequently new VTs with a slightly different morphology were induced in three of them and re-mapping showed a shift of the EAS. After additional RF ablation at the new EAS, VT was no longer induced. No complication was noted and VT did not recur during a follow-up period for a mean of 9.3 ± 5.2 months.Conclusion: RF catheter ablation seems useful and safe for idiopathic VT. The alternation of QRS morphology and the findings at the time of catheter ablation suggest that an alternative pathway or multiple exits may be present in some patients with idiopathic VT, because the change in VT morphology was associated with a shift of the EAS.