Prasugrel effectively reduces the platelet reactivity units in patients with genetically metabolic dysfunction of cytochrome P450 2C19 who are treated with long-term dual antiplatelet therapy after undergoing drug-eluting stent implantation.

Dual antiplatelet therapy (DAPT) with aspirin and P2Y inhibitor is administered following percutaneous coronary intervention (PCI) with coronary stent implantation. Several studies have reported the effects of switching between P2Y inhibitors on platelet reactivity (P2Y reaction units: PRU), from acute to late phase after PCI. However, the effect of switching at very late phase is unknown.

History of distal gastrectomy prevents metabolic syndrome and chronic kidney disease.

Aims: Chronic kidney disease (CKD) due to metabolic syndrome has recently become a social problem in Japan. In this report, the associations between the history of distal gastrectomy (DG) and the incidence of metabolic syndrome or CKD were evaluated.

Methods: Arteriosclerosis-related factors were compared among patients with a history of DG who were <70 years old (n=41) and controls selected at random (n=410) after matching for age and sex.

Traumatic Abdominal Wall Hernia: A Case Report of High-Energy Type without Surgical Repair.

Repair of traumatic abdominal wall hernia (TAWH) has been reported to be necessary. Reported here is one case of TAWH without repair. A 27-year-old man was accidentally sandwiched between a rock and a truck and admitted to our emergency department.

A case of lymphocytic mastopathy requiring differential diagnosis from primary breast lymphoma.

Lymphocytic mastopathy is a benign breast disease characterized by dense fibrosis, lobular atrophy, and aggregates of lymphocytes in a periductal and perivascular distribution. The condition affects young to middle-aged women and frequently shows an association with diabetes mellitus or autoimmune disorders. Here, we report a case of the disease clinically and radiologically mimicking primary breast neoplasms.

Multiple repeat metastasectomies for recurrences of colorectal cancer.

Background/aim: The disease-free interval after resection of the primary tumour was found to be an independent significant prognostic factor for single repeat metastasectomy for colorectal cancer. In the present study, the intervals from resection to relapse for multiple repeat metastasectomies were evaluated.

Methods: Sixteen patients who underwent multiple repeat metastasectomies after the first curative resection were studied to determine whether their intervals from resection to relapse were associated with the prognosis.

[Subclassification of stage IV gastric cancer].

We studied the prognosis of 185 stage IV gastric cancer cases. The univariate analysis and multivariate analysis suggested that liver metastases (H) and peritoneal disseminations (P) were prognostic factors, the number of factors may be it, and lymph nodes metastases (N) and invasion to the other organs (T) were not it. Based on these findings, we proposed a subclassification of stage IV: IVa [T1-3N3-or T4N2] and IVb [the others].

[A case of adult neuroblastoma arising in the retroperitoneum following a poorly aggressive course].

A 69-year-old man complaining of enlarged cervical mass, appetite loss and lower abdominal pain was found to have abdominal tumors in heaps forming a large mass around the retroperitoneum. The biopsy specimen in the cervical mass showed undifferentiated carcinoma with neuroendocrine feature. This malignancy followed a poorly aggressive course and caused death in only 24 hospital days.

[Augmented regional pancreatoduodenectomy ensures an excellent pain control for the case with pancreatic cancer invading the superior mesenteric artery and vein].

A 49-year-old woman with a complaint of severe abdominal pain and lumbargo was diagnosed with pancreatic cancer invading the superior mesenteric artery and vein. Since the lesion was unresectable by general Whipple's procedure, she was treated with gemcitabine and opiate. However, these treatments resulted in failure due to the side effects such as bone marrow suppression, severe nausea, and constipation.

Clinical study of gastric cancer patients with complaint of hematemesis.

Eighteen gastric cancer patients with complaint of hematemesis, who underwent early endoscopic treatment for hemorrhage and received standby oncologic treatment after recovery, were retrospectively compared with 661 gastric cancer patients without complaint of hematemesis. Patients with hematemesis had a statistically high rate of type 2 gastric cancers. Stage I in patients with hematemesis was significantly less frequent than in patients without.

Acute respiratory distress syndrome is a serious complication of microwave coagulation therapy for liver tumors.

Background: Acute respiratory distress syndrome (ARDS), also known as noncardiogenic pulmonary edema, is a severe complication in cirrhotic patients undergoing microwave coagulation therapy (MCT) for liver tumor. In this study, cirrhotic patients with ARDS after MCT were compared with others without ARDS.

Methods: Four patients with ARDS after open MCT and 17 other patients without ARDS were compared in terms of preoperative status, intraoperative findings, and postoperative management.

[Lymphatic basin dissection and function-preserving limited gastrectomy for early-stage gastric carcinoma].

Sentinel node biopsy accurately predicts the nodal status of early-stage gastric carcinomas. Nevertheless, surgeons are concerned about missing a micrometastasis in applying the sentinel node-negative finding to surgery. Of 36 patients who underwent D2 dissection based on positive sentinel node biopsy, 15 patients had histologic metastasis in the sentinel nodes, 20 patients in both the sentinel and nonsentinel nodes in the lymphatic basin system, and 1 in the nodes not only in the basins but also in the nonbasin system.

Overexpression of a petunia zinc-finger gene alters cytokinin metabolism and plant forms.

Shoot branching and plant height are among the key factors that define the overall architecture of plants. We found that overexpression of a cDNA for a zinc-finger protein of petunia, designated Lateral shoot-Inducing Factor (LIF), in transgenic petunia plants resulted in a dramatic increase in lateral shoots and reduced plant height. LIF overexpression also caused a decrease in the number of cells in the stem, leaf, and flower, accompanied by enlargement of cells.

Early electroencephalographic findings in patients with anoxic encephalopathy after cardiopulmonary arrest and successful resusitation.

This study investigated whether or not early electroencephalographic (EEG) findings and brain computed tomographic (CT) features reflect the prognosis of comatose patients for 48 h after cardiopulmonary resuscitation (CPR). EEGs and brain CT scans were collected from 21 patients within 72 h after CPR. The EEG findings were classified according to the five Hockaday grades.

Correlation of lymph node metastases and expression of matrix metalloproteinase-7 in patients with gastric cancer.

Background/aims: Matrix metalloproteinase-7 (MMP-7) is thought to play an important role in the progression of cancer invasion. However, the expression of MMP-7 in primary and nodal lesions of gastric cancer is unknown.

Methodology: Expression of MMP-7 protein in primary and nodal lesions of human gastric cancer was evaluated by immunohistochemistry.

Breast cancer with endocrine differentiation: report of two cases showing different histologic patterns.

We report two cases of breast cancer with endocrine differentiation. Case 1 was a 56-year-old woman with a 2-cm tumor in the upper outer quadrant of the right breast and right axillary lymphadenopathy. Excisional biopsy suggested carcinoma and we performed breast-conserving surgery with lymph node dissection.

[Sentinel node navigation surgery in early-stage gastric carcinoma: a limited gastric resection with lymphatic basin dissection in sentinel node-negative patients].

The high accuracy of sentinel node biopsy in clinical T1 gastric cancer leads to the idea of excluding conventional D2 from node-negative patients. The question now arises of what to do when sentinel nodes are missed during surgery and micrometastases are over looked in frozen tissue sections. To avoid and correct a mistaken diagnosis, surgeons should remove the lymphatic basin even in the case of negative sentinel nodes, because the basin is exclusively associated with the involved nodes.

Immunohistochemical study of protein induced by vitamin K absence or antagonist II in hepatocellular carcinoma.

Background And Objectives: Protein induced by vitamin K absence or antagonist II (PIVKA-II) has been used as a tumor marker of hepatocellular carcinoma (HCC). In this study, we examined the expressions of PIVKA-II in HCC tissues.

Methods: Expression of PIVKA-II in HCC was evaluated with the avidin-biotin-peroxidase complex method.

Micrometastases in sentinel nodes of gastric cancer.

The sentinel node (SN) is the first lymph node in the lymphatic basin to be affected by metastasis from the primary tumour and is used to predict the status of the remaining nodes in the basin. We succeeded in detecting SNs of clinically early gastric cancers by intraoperative injection of a blue dye around the tumour. In the study presented here, multiple-marker reverse transcription-polymerase chain reaction (RT-PCR) was used to detect micrometastases in SNs and results were compared with those obtained with conventional histology.

Identification of DNA markers of tobacco linked to bacterial wilt resistance.

Bacterial wilt caused by Ralstonia solanacearum is one of the most destructive soil-borne diseases in the world. Breeding resistant commercial varieties of tobacco is difficult because most donor candidates' resistance is controlled by polygenes. In this paper, we demonstrate the identification of useful DNA markers for bacterial wilt-resistant tobacco breeding.

Lymphoplasmacytic sclerosing pancreatocholangitis successfully treated by pancreatoduodenectomy.

A 68-year-old man complaining of jaundice was admitted to our hospital in October 1996. Radiological imaging studies, including dynamic computed tomography, endoscopic retrograde cholangiography, and angiography, were highly suggestive of pancreatic head cancer, and laparotomy was performed on October 25, 1996. On gross examination, the pancreas appeared firm, as in chronic pancreatitis, with a mass lesion in the pancreatic head measuring 35 x 35 x 25 mm.

Myxoid malignant fibrous histiocytoma of the breast: report of a case.

Malignant fibrous histiocytoma (MFH) is the most common type of soft tissue sarcoma, but it rarely develops as a primary tumor in the breast. Furthermore, no case of the myxoid variant of MFH in the breast has ever been documented. We report the case of a 52-year-old woman with a breast tumor that was immunohistochemically confirmed to be myxoid MFH.

Histological subtypes of ductal carcinoma in situ of the breast.

Background: It has become common to divide ductal carcinoma in situ (DCIS) of the breast into two main groups, comedo or noncomedo by tumor morphology. But noncomedo DCIS can be further stratified into several morphological patterns that exhibit several different growth patterns and most DCIS lesions have more than one pattern. In this study, DCIS elements were classified by morphological pattern and the association between predominant or recessive elements of DCIS lesions and clinicopathological findings was evaluated.

Long-term survival of a patient with primary papillary serous carcinoma of the peritoneum treated by subtotal peritonectomy plus intraoperative chemohyperthermia.

We report the long-term survival of a patient with primary papillary serous carcinoma of the peritoneum, treated by subtotal peritonectomy combined with continuous hyperthermic peritoneal perfusion. After subtotal peritonectomy and continuous hyperthermic peritoneal perfusion, early postoperative intraperitoneal chemotherapy with cisplatin and three cycles of cisplatin-based intravenous chemotherapy were administered. The patient currently remains alive 23 months after surgery.