Isao Inoue

Stage Ib, IIa, and IIb cervix cancer, postsurgical staging, and prognosis

Two hundred fifty‐five cases of International Federation of Gynecology and Obstetrics (FIGO) Stage Ib, IIa, and IIb cases of cervical cancer were analyzed following radical surgery with regard to the extent of invasion into vagina, parametria, and pelvic lymph nodes. Restaging was carried out based on the finding. Discrepancies were found between FIGO stages and the actual extent of the disease, particularly in Stage IIb. Among 99 cases of Stage IIb, only 42.4% were correctly staged. The 5‐year disease‐free survival by FIGO and postsurgical stagings were, respectively: Ib, 88.4% and 87.0%; IIa, 85.2% and 95.0%; IIb, 70.7% and 62.3%. Prognostic significance in the pathologic examination of operated materials was demonstrated when there were deep stromal invasions of cancer cell or parametrial invasions or pelvic lymph node metastases. When cancer was present in both of the parametrium and pelvic lymph nodes, the prognosis of the patient worsened (5‐year survival rate, 41.4%).

Malignant fibrous mesothelioma of the tunica vaginalis: a histologic and ultrastructural study.

An unusual malignant fibrous tumor of the testicular tunic in a 35‐year‐old Japanese man is presented. It apparently arose from the visceral layer of the tunica vaginalis where focal mesothelial hyperplasia was seen. Microscopically the tumor conststed of interlacing bundles of spindle cells and numerous polygonal cells with variable amounts of collagen fibers. The electron microscopic study demonstrated the former cell type closely resembling the fibro‐blast and the latter to be more epithelial having very plump cytoplasm with fairly well developed desmosomes. The tumor was diagnosed as malignant fibrous mesothelioma upon histopathologic and ultrastructural comparison with the similar tumors in the pleura and peritoneum. Because of the scarcity of the diagnosis in the region it is suggested that fibrous paratesticular tumors are critically reviewed.

Periodic alternating nystagmus in a patient with MS

Periodic alternating nystagmus (PAN) is a rare horizontal nystagmus that periodically reverses its direction, usually about every 2 minutes.1 Acquired PAN has been reported in various neurologic disorders, such as spinocerebellar ataxia, Arnold–Chiari malformation,1-3⇓⇓ and MS.4 We report a case of MS with PAN demonstrated by electronystagmography (ENG). A 39-year-old woman is presented. At age 27, she had a left optic neuritis. At age 31, she developed a moderate right limb and truncal ataxia and ataxic dysarthria with mild left hemiparesis. MRI detected multiple lesions in the right middle cerebellar peduncle, right lateral midpons, and right ventral midbrain. She was diagnosed as having MS, improved with corticosteroid treatment, and continued to take low-dose prednisolone thereafter. At age 39, she again developed a moderate truncal and, at this time, left limb ataxia, as well as an ataxic dysarthria. About 3 months later, she had a left visual loss and exacerbation of cerebellar ataxia, and was admitted to our hospital. On admission, blindness …

A patient with delayed posthypoxic demyelination: a case report of hyperbaric oxygen treatment

A 62-year-old man who developed akinetic mutism with delayed white matter demyelination after hypoxia was treated with hyperbaric oxygen (HBO). HBO in the subacute period markedly improved the patients activity in daily life, cognitive function and organization on EEG. 1H-MRS showed a recovery of aerobic metabolism of the neurons. However, dementia and cerebral atrophy slowly progressed despite HBO treatment. Thus, HBO had a beneficial effect on the activity of depressed neurons but did not improve the prognosis.

2109 Impaired exploratory behavior observed in mice lacking histamine h1 receptors

Hypothalamic neuronal histamine suppresses food intake. Interleukin-lp(IL-14) and Tumor necrosis factor a(TNF-a) also decreases the daily food intake of the rat. The feeding suppression induced by these cytokines has been mediated by Prostanoids sach as prostaglandin E2(PGE2). In this study, we investigated functional relationship between hypothalamic neuronal histamine, prostanoids and cytokines in the relation of feeding behavior.

Cytologic Studies of Endometrial Adenocarcinoma

子宮体癌患者38例について, 治療前細胞診と病理組織診との関連性を検討した. 内膜スメアでは癌の分化度と異型細胞出現率との間に関連性はなく, 高分化型腺癌, 低分化型腺癌いずれにも高い出現率が認められたが, 頸管スメアでは低分化型腺癌ほど異型細胞出現率が高いという結果が得られた.癌の筋層浸潤度による異型細胞出現率の違いでは, 頸管スメア, 内膜スメアいずれにおいても筋層浸潤度と異型細胞出現率との問に関連性は認められなかった. しかし頸管浸潤のあるものでは, 高い異型細胞出現率が頸管スメアで得られた.体癌細胞診の特徴について, 細胞診の背景と正常内膜細胞の出現状態という点から検討を行った. 腫瘍性背景は頸管スメアよりも内膜スメアにおいて高い頻度でみられ, また頸管スメアでは腫瘍性背景を示しながら異型細胞が認められないものもあった. 閉経後体癌患者の頸管スメアでは, 比較的高頻度に正常内膜細胞が認められるものがあり, このなかには異型細胞が認められないものもあった.