Evaluation of linear gastric ulcer as a precancerous lesion.

During the recent 13 years from 1961 to 1973, 21 cases of ulcer-carcinoma satisfying Hauser's pathologic criteria have been found endoscopically, 5 cases (2.6%) of which were mucosal carcinoma accompanying linear ulcer over 30 min in length. In addition, one submucosal carcinoma and 2 cases of sub-early gastric carcinoma, partially invaded into the proper muscle layer, were used for this study. Using these 8 cases and 11 operated ones of benign linear ulcer, we have a comprehensive study of histologic and clinical findings of both groups. As the results, malignant linear ulcer was similar in condition to the benign, either in mother ground or in histologic and clinical findings. Moreover, coexistent carcinoma with all kinds of gastric ulcer and with linear ulcer among them was found in 1.5% and 3.8%, respectively. In a series of controlled group, early gastric carcinoma was found in 2.1% out of 284 cases of no ulcer scar from its follow-up study. Its x2 test revealed no significant difference among these values. However, we might conclude that endoscopical follow-up study of chronic gastric ulcer, especially long linear ulcer, is indispensable for understanding the evaluation of malignant change of ch ronic gastric ulcer.     

Pancreas divisum : An uncommon cause of acute pancreatitis

Pancreas divisum is the most common congenital anomaly of the pancreas and has been reported to be an infrequent cause of acute and recurrent pancreatitis. The authors herein report a 4-year-old child with acute pancreatitis associated with pancreas divisum. Coexistent ascariasis initially suggested a diagnosis of pancreatic ascariasis.     

Spontaneous rupture of laryngeal ventricle

An extremely rare case of spontaneous rupture of laryngeal ventricle is presented. Surgical anatomy of ventricle and management of the case is discussed.     

Distance from the Primary Health Center: A GIS method to study geographical access to health care

Aerial distance from the dependent Primary Health Center is a crude but objective measure of geographical accessibility to Primary Health care facilities. This report describes a method for calculation of distances between the PHC and the population it serves using the data available from the local health authorities and the Swedish Central Statistical Bureau. The Swedish annual population registration records of 1991 and the property register available with the Central Statistical Bureau of Sweden formed the main data sources. By coupling the address in the population register to the property register each individual was mapped to the centroid of a property. The location of the PHCs as well as the areas covered by each were obtained from the local health authorities and mapped. By intersecting the population coverage with the PHC coverage the population for each PHC area was identified. Subsequently the distance to the PHC was calculated for each individual (property centroid). The population maps so generated can be linked to other databases to visualize and analyze the spatial dimension of health and disease. The methodology can be adapted for use with postal code districts, census enumeration tracts, or any other small area.     

On the dye spraying method in colonofiberscopy.

Dye spraying method was applied in colonofiberscopy; 111 cases of normal colonic mucosa and 26 cases of ulcerative colitis were examined by this method. Using indigocarmine in this method, we could recognize the fine mucosal changes more easily and clearly and get better information for differential diagnosis. Furthermore, the degree of staining of the mucosa by methylene blue, one of the ultra vital staining dye, is different according to the stage of the inflammatory process of colonic mucosa itself in ulcerative colitis. Namely the stainability of the colonic mucosa is corresponding to the healing process of the disease.