Endoscopic Diagnosis of Early Malignant Lymphoma of the Stomach

Abstract: The findings and results obtained by endoscopies and direct vision biopsies carried out in 13 patients with early primary gastric lymphoma, were compared with those of 8 patients with RLH, 28 with depressed type of early gastric carcinoma, and 10 patients with benign gastric ulcers, to deal with problems inherent to endoscopic diagnosis of early primary gastric lymphoma The first endoscopy attained a correct diagnosis in only 1 patient (7.7%) but in 7 patients (53.8%) with the final endoscopy. Endoscopic features of early gastric lymphoma characteristically yielded a cobblestone appearance and reticulated erosion when they were compared with that of RLH, early carcinoma and benign ulcer. Furthermore, early gastric lymphoma presented ill demarcated margins associated with discoloration of the mucosa more frequently comparing with that of early gastric carcinoma. Also, hemorrhage, lustrous nodules, regulalr and white-coated ulcer were the findings more frequently seen in early gastric lymphoma but redness was less frequent in early gastric carcinoma. Dye endoscopies provided a more detailed appearance of the lesion and margins than conventional endoscopies. In addition, dye endoscopies made visible the lesions that were not visible by conventional endoscopies, in areas repelling dye solution. In this paper, the importance to pay an attention to the endoscopic findings described above and an application of dye endoscopy was emphasized for detection of an early gastric lymphoma.     

Acquired Fatty Replacement of the Body and Tail of the Pancreas Diagnosed by Endoscopic Ultrasonography —A Case Report—

Abstract: A 62-year old female was admitted for a detailed study of a pancreatic abnormality detected by abdominal ultrasonography. A CT and MRI revealed a fat deposition in the body and tail of the pancreas. An ERCP demonstrated the distal main pancreatic duct as 2 fine branches in the head, and accessory pancreatic ducts were visualized. An endoscopic ultrasonography revealed a swelling of the body. In the tail, a membrane-like hyperechoic structure was noted, and probably represented the pancreatic capsule. A angiography demonstrated branches of the dorsal and transverse pancreatic artery, and the diagnosis of acquired fatty replacement of the body and tail of the pancreas was confirmed. Endoscopic ultrasonography appears to be a useful method to confirm fatty replacement of the body and tail of the pancreas.     

Clinical outcome of conservative therapy for stage T1, grade 3 transitional cell carcinoma of the bladder

BACKGROUND: The objective of this study was to retrospectively investigate the effectiveness of transurethral resection of bladder tumor (TURBT) and intravesical instillation therapy for stage T1, grade 3 (T1G3) transitional cell carcinoma (TCC) of the urinary bladder. METHODS: Between January 1995 and December 1997, 97 patients with T1G3 TCC of the urinary bladder were treated by TURBT and adjuvant intravesical instillation with bacillus Calmette-Guérin (BCG) or other anticancer agents. The recurrence-free survival rates were evaluated according to several clinicopathological factors. The cases that progressed to muscle invasive disease were also analysed. RESULTS: In this series, the median follow-up period was 25 months (range, 5- 41) after the initial TURBT. Intravesical recurrence was noted in 44 patients (45%), and the 1, 2, and 3 year recurrence-free survival rates were 72%, 58%, and 42%, respectively. Multivariate analyses revealed that the risk of intravesical recurrence was significantly higher for patients who did not receive BCG therapy, irrespective of age, gender, tumor size, multiplicity, pathological stage, concomitant carcinoma in situ, and lymphovascular involvement. Moreover, after a median of 10 months, disease progression occurred in seven patients (7%), of which only one patient was treated by BCG therapy after initial TURBT. CONCLUSION: These findings suggest that intravesical instillation with BCG combined with TURBT is an effective conservative treatment for T1G3 TCC of the bladder. Patients with negative prognostic factors should be treated by BCG rather than other anticancer agents after TURBT.     

The relationship between psychosomatic factors and orthostatic dysregulation in young men

We carried out a questionnaire survey regarding symptoms of orthostatic dysregulation and administered the Japanese Edition of the Cornell Medical Index-Health Questionnaire (JCMI) and the Yatabe-Guilford Personality Test (Y-G test) to 151 male medical students (mean age, 24.6 yr). Orthostatic dysregulation was identified in 19 (12.5%) of the subjects based on the questionnaire results. The percentage classed as types III (possible neurotic) and IV (probable neurotic) according to the health questionnaire was 47.3% in the 19 with orthostatic dysregulation and 8.9% in the controls (n = 78). The percentage classed as types B and E, suggestive of emotional or psychological disturbance according to the personality test, was 42.1% in those with orthostatic dysregulation and 8.9% in the controls. These differences were significant (P < 0.01). These results suggest that psychosomatic factors influence the occurrence of orthostatic dysregulation in young men.     

β-PLEATED SHEETS IN OLIGOPEPTIDE CRYSTALS

Many oligopeptide crystals show the β-pleated sheet structures. Both parallel and antiparallel chain pleated sheets are found, and also both ideal (flat) and heavily twisted sheets are found. The structural parameters, such as the T (NCα-C') angles, the torsion angles (φ and ø), the fiber axis periods, the hydrogen bond lengths, and the interchain spacings, are studied. Some of them deviate signifi cantly from those proposed by Pauling & Corey (Proc. Natl. Acad. Sci. US (1953), 39, 253–256). In the heavily twisted sheets, the twists are larger than those in the globular proteins, and each two neighboring chains are almost per pendicular with each other, preserving the β-sheet type hydrogen bond system. The torsion angles in the twisted sheets are rather close to those of the poly (L-proline) II helix. It also is discussed that the (NCαC) angles sometimes deviate by almost 5° from the standard value depending on the structures of the main and side chains.     

Comparison of Lens Biochemistry and Structure between BSO-treated and Glucocorticoid-treated Developing Chick Embryos

In this paper various changes in glutathione level, which were influenced by balance of its synthesis, degradation, transport and utilization, were analysed in chick embryos administered with glucocorticoid (GC) or buthionine sulfoximine (BSO; an inhibitor of glutathione synthesis). When BSO (30 μmol egg⁻¹) was administered twice to chick embryos on day 14 and 15, the GSH in both the lens and the liver decreased to 15–20% and 30–40% of the age-matched control level, respectively, between 24 and 48 hr after the second treatment, then began to recover. Although this decline in the GSH level in these tissues was greater and more prolonged in embryos treated with BSO than with GC, the former embryos maintained lens transparency even up to 144 hr by a visual examination. However, histological changes in the lens occurred after 96 hr and more significantly 144 hr after second administration of BSO. The changes mainly consisted of pale epithelial cells on the anterior peripheral surface of the lens, irregular height of the epithelial cells at the equator, clefts between the epithelium and the cortex and swelling of almost all the cortical fibers. These observations may suggest that BSO treatment could produce the beginning of a cataract. Embryos with GC-cataract revealed the following changes at 48 hr: loss of transparency, elevation of LPO (TBA-reacting substance) in the lens, the blood and the liver. These were not observed in BSO-treated embryos during the experimental period. The GC-cataract may well depend on the generation of LPO. BSO cataract, having a distinct mechanism compared to that caused by GC, develops more slowly in GSH-depleted lenses. The BSO-treated chick embryos will be a useful model to screen the risk factors which accelerate cataract formation.