Tateo Hanaoka

A case of dermatofibrosarcoma protuberans in the skin over the breast of a young woman

A 19-year-old woman with dermatofibrosarcoma protuberans (DFSP) of the breast is described. She presented with a tumor of the left breast with redness and swelling. She had noticed a small tumor five years previously, but it had begun to grow rapidly three months previously. Mammography, ultrasonography and aspiration biopsy cytology demonstrated an apparently benign tumor of the breast preoperatively. Wide excision was performed to confirm the diagnosis. Histologically, the tumor was composed of a uniform population of fibroblasts in a distinct storiform pattern. DFSP was diagnosed in the skin over the breast. This lesion ordinarily originates from the dermis in the trunk and proximal extremities. It is important to diagnose a soft tissue lesion accurately when it occurs in the breast.

QUANTIFICATION OF THE NA+/K+-PUMP IN SOLUBILIZED TISSUE BY THE OUABAIN BINDING METHOD COUPLED WITH HIGH-PERFORMANCE GEL CHROMATOGRAPHY

Membrane-bound Na+/K(+)-ATPase purified from dog kidney outer medulla was solubilized with octaethylene glycol n-dodecyl ether (C12E8) and incubated with [3H]ouabain in the presence of NaCl. ATP and MgCl2 for 10 min at 0 degrees C. The resulting enzyme was separated, by high-performance gel chromatography executed at 0.2 degrees C. Mainly into its (alpha beta)2-diprotomer and alpha beta-protomer, which both bound stoichiometrically to [3H]ouabain. The amounts of ouabain that bound to the tissue itself and its microsomes could be estimated in the same way, as [3H]ouabain was found to bind only to the diprotomer and protomer they possessed. The amounts of ouabain that bound to them in the solubilized state were at least 5-times higher than those that did so when they were non-solubilized, suggesting that the surfactant rendered the enzyme accessible to ouabain. When the solubilized tissue (138 mg ml-1 wet tissue) was reacted with ouabain in the presence of 0.1 M NaCl and 4.8 mM MgCl2 for 10 min at 0 degrees C, maximal ouabain binding was attained in the presence of 18.3 microM [3H]ouabain, 1.2 mM ATP and 3 to 5 mg ml-1 C12E8, which was common to the outer medulla and human colon cancer cells. The present method enabled the pump number in protein and tissue samples in the range 7.2 x 10(-9) (purified pump) to 1.5 x 10(-12) (cancer tissue) mol/mg protein to be estimated within 2 h.

New Measures for Early Detection of Carcinoma of the Esophagus

Imbriglia and Lopusniak [2] discovered early esophageal cancer through aspiration cytology in 1949, and in the same year Andersen et al. [1] diagnosed esophageal cancer by means of brush cytology. In China [5], good results have been obtained with balloon cytology. In 1976, Nabeya [3, 4] developed capsulated brush cytology.

The Effectiveness of Ultrasonography in Diagnosis of Cervical Lymph Node Metastasis in Preoperative Esophageal Cancer

In determining treatment procedures, it is most important to diagnose cervical lymph node metastasis of esophageal cancer preoperatively. Heretofore, the conventional criteria for ultrasonography (US) in metastatic lymph nodes, as designated in the Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus [1] were: (1) Well defined margins, (2) irregular inner echo images, and (3) longitudinal diameter over 5 mm. Lymph nodes satisfying all three criteria were diagnosed as metastatic. Investigations were made along these lines and it was found that sensitivity was 58.3%; specificity, 97.0%; accuracy, 80.7%; false positive, 17.5%; and false negative, 1.8%. In other words, with the current diagnostic criteria, anticipated delineation ratios could not be obtained. Therefore, keeping in mind the results of occupancy ratios of cancerous lesions within metastatic lymph nodes, new criteria that would be minimally influenced by the examination apparatus or by the examinee’s subjective point of view was established: (1) Ratio of longitudinal diameter to short axis over 0.5, and (2) lymph node longitudinal diameter over 0.5 cm. Lymph nodes satisfying these two criteria were considered to be metastatic. Investigations were made along these lines and it was found that sensitivity was 71.4%; specificity, 100%; accuracy, 87.7%; false positive, 10.5%; and false negative 0%. A satisfying delineation ratio was obtained.

Studies on Preoperative Treatment for Esophageal Cancer and Prognosis of Markedly Effective Cases

Preoperative treatment for esophageal cancer is performed with the objective of improving the prognosis of esophageal cancer. Heretofore, there have been reports [1] indicating effectiveness in preoperative treatment results but a consensus of opinion has not been reached. However, it is possible to demonstrate the histological effects of preoperative treatment for esophageal cancer. The effects range from ineffective to disappearance of the cancer cells. In cases where preoperative treatment was markedly effective, satisfactory responses in postoperative treatment could be anticipated and, in accordance with treatment methods, improvement in prognosis can also be anticipated.

STUDIES ON THE X-RAY FINDINGS OF EXTRA-ESOPHAGEAL COMPRESSION WITH SERIAL ESOPHAGOGRAMS

食道X線連続撮影による心血管食道圧迫例は, 大動脈弓6例, 異型右鎖骨下動脈4例, 下行大動脈3例, 心肥大2例, 右側大動脈弓1例の16例であった.大動脈弓による異常例の判定は, 大動脈弓食道圧迫幅によった.60歳以上の高齢者で嚥下困難を訴えるもので, 拡張期血圧が100mmHg以上であるものは, 大動脈弓, 下行大動脈による食道圧迫を考慮すべきである.