ABSTRACT
A 72-year-old male who was admitted to our hospital with severe anemia was diagnosed as refractory anemia with ring sideroblasts (RARS), according to the French-American-British (FAB) classification of myelodysplastic syndromes (MDS). The patient showed persistent eosinophilia with no definite signs of either allergy or a parasitic infection. Chromosomal analysis of bone marrow cells revealed inv(16)(p13q22), a known characteristic of M4Eo acute myeloid leukemia (AML) in the FAB classification. This patient didn't exhibit leukemic transformation during his 20-month clinical course, nor was any found at autopsy. Therefore, this is the first case of RARS to speculate that the chromosomal characteristic inv(16)(p13q22) might be specific for eosinophilia rather than AML.
Subject(s)
Anemia, Refractory/blood , Chromosome Inversion , Chromosomes, Human, Pair 16 , Eosinophilia/blood , Eosinophilia/genetics , Erythrocytes/chemistry , Erythrocytes/pathology , Iron/analysis , Aged , Bone Marrow/pathology , Bone Marrow/ultrastructure , Cell Transformation, Neoplastic/pathology , Cytoplasmic Granules/chemistry , Cytoplasmic Granules/ultrastructure , Eosinophilia/classification , Erythrocytes/ultrastructure , Humans , Karyotyping , Leukocytes/pathology , MaleABSTRACT
After devising remote-controlled angle to gastrofiberscope in 1964, the authors invented a swan-type double-bending gastrofiberscope in 1967. The double-bending gastrofiberscope does not require any change in a patient's position, for the motion of the tip is sufficient to observe every part of the stomach on supine position. In order to relax the patient both physically and mentally, relaxation of the patient is obtained by taking off this excessive attention on the endoscopic examination. Clear visual field can be obtained at the moment when the fiberscope passes the cardia, by stopping the scope just above the cardia and inflating sufficient air, and then, inserting the scope with the lens directed to the anterior wall of the greater curvature. Several marks are put on the body of the scope, as a functional scale, which makes its handling easier.
Subject(s)
Fiber Optic Technology/instrumentation , Gastroscopes , Relaxation Therapy , Cardia , Gastroscopy/methods , Humans , Relaxation Therapy/methodsSubject(s)
Duodenal Neoplasms/diagnostic imaging , Leiomyoma/diagnostic imaging , Adult , Gastroscopy , Humans , Male , RadiographyABSTRACT
By using the swan-type double-bending gastrofiberscope, it has become very easy to observe such regions as the cardia, posterior wall of the upper corpus or the pyloric region. The authors can obtain a clear image of the cardia, especially the form of the fold of the region or the esophagogastric junction. The authors recognized that the form changes according to the amount of the inflated air, and the insufficient function of the cardia can be easily diagnosed. The degree and form of the elevation of the posterior wall of the upper corpus of the stomach was observed and classified into three types, flat type, slightly elevated type and highly elevated type. Pathological deformation of this region was studied from the shape of this elevation. By the close observation of the pyloric region, it was clarified that the appearance of the folds may be radiated, transverse at the lesser curvature or entirely lost, being closely related to the presence of the erosions in this region. The healing process of the gastric ulcer was examined endoscopically from the viewpoint of the radiating vessel zone and contraction by the scar. When the capillary vessels are the more prominent finding of a healing ulcer, it tends to form a surface possessing a scar after it is healed and when the contraction is more prominent, it tends to form a linear scar after healing. By the recrudescence of the gastric ulcer, the irregular capillary vessels or deviation of the convergence of the folds are observed, and by the recurrence of the ulcer, coexistence or completion of a scar is observed.
