[Body surface distribution of the signal-averaged ECG in patients with previous myocardial infarction].

Signal-averaged electrocardiograms (SAEs) were recorded from 28 unipolar leads placed on the upper body in patients with previous myocardial infarction (MI). We measured the filtered QRS duration (fQRSd) for each lead to obtain a new parameter, called a "departure ratio (DR)". The DR was the standardized difference between the fQRSd of a patient and the mean fQRSd obtained in the healthy controls in each of the 28 leads. A DR map was then constructed using the DR. Patients with sustained ventricular tachycardia (VT) demonstrated a small negative area surrounded by dense, positive iso-DR lines and/or a large maximum. These features were located on the left anterior chest through the left back in patients with anterior MI and on the right lateral to the right anterior chest in patients with inferior MI. Both of these characteristic patterns in the area corresponding to the infarct site were present in few patients without VT. These characteristic patterns were highly correlated with the occurrence of sustained VT, suggesting that the characteristics of the DR map represent the body surface manifestation of delayed excitation conduction which can be a sustained VT substrate. Our results indicate that the DR map based on the fQRSd on SAE provides useful information that could not be obtained from vector magnitude analysis.

[Therapeutic treatment of Borrmann type 4 (scirrhous) gastric cancer-chemotherapy and histopathological studies].

Up to now, there has been no investigation documenting clearly the effectiveness of chemotherapy for Borrmann type 4 gastric cancer from a histopathological viewpoint. In this paper, we present a few representative cases of Borrmann type 4 gastric cancer in which microscopic examination revealed the therapeutic effectiveness (degradation of cancer cells) of neoadjuvant chemotherapy. Further, comparative studies will be needed to clarify the relationship between the assessed effectiveness of therapy by roentgenological and histopathological examination.

Clinical basis of chemotherapy for gastric cancer with uracil and 1-(2'-tetrahydrofuryl)-5-fluorouracil.

Studies were performed on the clinical basis of chemotherapy for human cancer with uracil and 1-(2'-tetrahydrofuryl)-5-fluorouracil (FT). In 62 operated patients with stomach, breast, and uterine cancers, the concentration of 5FU and FT were compared in serum, tumor and normal tissues 1, 2, 4, 6, 8, and 12 hours following the administration of 300 mg of UFT (300 mg of FT plus 672 mg uracil, a uracil/FT molar ratio of 4), or FT alone. It was found that the level of 5-FU in tumor tissue remained above 0.05 mcg/g over 12 hours. This value for 5-FU corresponds to a minimum inhibitory concentration in the Vitro experiment with L1210 cells. BLood levels of 5-FU increased up to 0.1 mcg/ml 1 hour after UFT administration and then decreased below 0.05 mcg/ml. The drug concentration in normal tissues was lower than that of the tumor tissues. On the basis of the above findings and phase I study, a protocol of UFT-therapy was made and applied for the treatment of gastric cancer. Our patients were given an oral dose of 300 mg of UFT twice a day per 50 kg body weight (12 mg/kg BW). Therapeutic effects were detectable in 7 of 20 cases. In addition, a combination of mitomycin C (6 mg i.v. weekly) with UFT seemed to improve the response rate (5/7). Diarrhea (15%) and skin pigmentation (10%) were major side effects of UFT.

Application of magnification radiography to the biliary system.

Magnification radiography was applied for the diagnosis of the biliary tract diseases including cancer. Our X-ray unit was consisting of HITACHI DR-155-23 U-6M-55P and 0.1 mm focal-spot tube, FFD 80 cm giving a magnification of x2 with the conditions of 60 kVp, 20 mA, 0.8 sec. Intensifying screens such as Kyokko LH II (for a standard sized subject) or DuPont Q II (for an obese subject) were used in combination with Fuji RX films. We confirmed a high diagnostic value in revealing early lesions of this sytem. The skin dose test indicated that this technique was routinely applicable with safety for clinical use.

A case of carcinoma of the common bile duct, diagnosed at the non-icteric stage of the disease.

It is rather seldom to detect a cancer of the common bile duct at the non-icteric stage of the disease. This report presents a non-icteric case of carcinoma of the choledochus. A 70-year-old woman complained of r-hypochondralgia with occasional fever. Laboratory examination revealed an increased serum alkaline phosphatase activity without any elevation of serum bilirubin content. The oral cholecystography failed to visualize the gallbladder. By endoscopic retrograde cholangiopancreatography (ERCP), a bilateral filling defect was demonstrated at the common bile duct. Pancreatoduodenectomy was performed and the resected specimen showed a 1 X 2 cm tumor (adenocarcinoma) at the choledochus. She is now in good health over 13 months after operation.