Eosinophilic gastroenteritis with ileus and ascites.

We report a case of eosinophilic gastroenteritis, which has features of the predominant subserosal type presented as an ileus and ascites. A 48-year-old Japanese woman was admitted to our hospital because of epigastralgia, lower abdominal pain and vomiting. She had a past history of allergic disorders. The computed tomographic scan revealed ascites, and marked wall thickening and dilatation of the intestine. This patient showed eosinophilic ascites without marked peripheral eosinophilia. Histologic examination demonstrated eosinophilic infiltrates did not predominate in the gastrointestinal tract. Conservative treatment of intravenous infusion of antibiotics and Ringer's solution was effective in this case.

Noncardiac chest pain due to acute gastric anisakiasis.

This paper described the first confirmed case of acute anginalike chest pain caused by gastric anisakiasis. A 55-year-old male, with a history of a sudden onset of chest pain and also a history of eating raw mackerel and tuna 9 hr prior to the onset of chest pain, was found upon endoscopy to have an imbedded parasite in the mucosal lining of his stomach. The chest pain disappeared after the endoscopic removal of larva. Endoscopy is highly recommended at the earliest possible time for patients who are suspected to have acute gastric anisakiasis.

[An undifferentiated carcinoma of the stomach--a report of 2 cases].

Two cases of an undifferentiated carcinoma of the stomach have been investigated by conventional histologic, immunohistochemical, and ultrastructural methods. The patients were a 73-year-old man and 65-year-old man. A postoperative histological examination of the resected stomach of each patient disclosed large areas of an undifferentiated carcinoma which were relatively well demarcated from areas of the adenocarcinoma. In the undifferentiated carcinomatous areas, the reticulin fiber stain was epithelial in pattern, and mucin staining proved negative. Similarly both Grimelius and Fontana-Masson staining also negative. In like manner immunostains using cytokeratin , vimentin , IgG, IgA, s-100 protein, and NSE were all negative, and an electron microscopic study showed no neurosecretory granules or mucin secretory granules. Based on these findings, the diagnosis of either a malignant lymphoma or small cell anaplastic carcinoma could be excluded, and thus an undifferentiated carcinoma was the determination.

Primary leiomyosarcoma of bone. A case report and review of the literature.

A 62-year-old female with primary leiomyosarcoma of the left femur is reported with a review of 21 cases reported in the literature. The resected specimen showed that the tumor extended from the femoral head to the diaphysis for 13 cm in length. The tumor showed mainly intramedullary proliferation, but extraosseous growth was also noted at the great trochanter. Microscopic examination revealed well differentiated leiomyosarcoma characterized by interlacing bundles of fusiform cells with eosinophilic cytoplasm and rod-shaped hyperchromatic nuclei. PAP stain of actin on the tumor cells was positive. On electron microscopy, microfilament of 6-8 nm in diameter, dense bodies, pinocytotic vesicles, marginal attachment plate, and basal lamina were noted. The patient died with pulmonary metastasis, 1 year and 7 months after the operation. An autopsy showed metastases in the right pelvic cavity and bilateral lungs, and confirmed the primary site to be the left femur.

A study on the microvasculature of the cerebellar cortex. The fundamental architecture and its senile change in the cerebellar hemisphere.

The arterial structure of the cerebellar cortex was studied by vascular stain and in diaphanized specimens after intra-arterial barium injections. A scanning electron microscope study on the corrosion cast of the arteries was also performed. Arteries distributed in the cerebellar hemisphere are classified into cortical, subcortical, and medullary arteries. The patterns of arterial distribution are similar to those in the cerebral cortex. The cortical arteries are subclassified into superficial, middle, and deep cortical branches. The superficial branches are very fine, forming capillary networks in the molecular layer. The middle cortical branches terminate in the Purkinje cell layer, by dividing into several branches extending parallel to the plane of this layer. These branches connect with capillaries in both the molecular and the granular layers. The deep cortical branches give off some collaterals along the Purkinje cell layer and terminate in the granular layer, by breaking up into capillary networks. The Purkinje cell layer is marked by arterial branches ramified from the middle and deep cortical branches and no particular dense capillary networks are formed in the Purkinje cell layer. The brains of older patients show intertwining of the middle and deep cortical branches, some forming "rope-like" appearance. These patterns are similar to those seen in the cerebral cortex, but they were found, in older people, in the cerebrum.

A study on the microvasculature of the cerebral cortex. Fundamental architecture and its senile change in the frontal cortex.

The arterial architecture of the cerebral cortex and its changes along with aging were studied by microangiography, vascular staining, and scanning electron microscopy. The arteries distributed in the cerebral cortex and medulla were classified into cortical, subcortical, and medullary arteries. The cortical arteries were further classified into superficial, middle, and deep cortical branches according to the site of their termination. There were many fountain-like rami in the middle and deep cortical branches. These fountain-like rami were composed of several to many fine arteries, ramified from a small artery by repeated bifurcation within a short segment of its course. This structural pattern is probably responsible for the ease with which pronounced ischemic state may develop in their territories nourished by these branches, and they may play a significant role in the development of pseudolaminar necrosis of the cerebral cortex. Intertwining of small branches forming rope-like structures was observed with increasing frequency with age, suggesting that this phenomenon correlates with aging or is associated with brain atrophy. The intertwining was always clockwise when looking from the proximal side of the arteries towards their distal end. While the precise mechanism of the development of the intertwining remains unclear, torsion of the trunk of the blood vessels is thought to be the cause of the intertwining of the peripheral branches.