[Four case reports of sarcoma combined with carcinoma]

We report 4 cases of double cancer, combined sarcoma and carcinoma. Case 1 was a 50-year-old woman, had a malignant fibrous histiocytoma in the leg and an advanced gastric carcinoma. The soft tissue sarcoma was resected and the gastric carcinoma was treated with chemotherapy. She died from pulmonary metastasis from the sarcoma. Case 2 was a 72-year-old woman with a liposarcoma in the leg and a thyroid carcinoma. Both tumors were resected, however, she died from pulmonary metastasis from the carcinoma. Case 3 was a 65-year-old man with a liposarcoma in the buttock and lung carcinoma. Both tumors were resected and he is alive and disease-free. Case 4 was a 47-year-old man with spindle cell sarcoma of the tibia and a rectal carcinoma. Both tumors were treated surgically, but he died from pulmonary metastasis from the sarcoma. We suggest that the combination of sarcoma and carcinoma is very rare and that the prognosis in these cases is very poor.

[Surface negative waves in penicillin-induced epileptogenesis in cats]

The "surface negative (SN) wave" produced by pyramidal tract stimulation and recorded at the cortical surface has been identified as a reflection of postsynaptic potentials generated through recurrent inhibitory pathways (Humphrey, et al.). We studied changes in SN wave in an attempt to examine inhibitory mechanisms underlying epileptogenesis in immobilized cats. 1) A single shock applied to the cerebral peduncle evoked alpha and beta wave at the surface of ipsilateral anterior sigmoid gyrus (Fig.1 A). A train of 4 shocks with 4 msec shock-interval elicited SN wave which had a peak latency of 20 msec and decayed in 60-80 msec (Fig. 1 B,C,D). 2) The spindle-like after-discharges elicited by direct cortical shock were markedly suppressed with conditioning stimulation of the ipsilateral pyramidal tract (Fig. 2). Spike-and-wave complexes and other ECoG paroxysms produced by intramuscular administration of penicillin (Pc) were also depressed by repeated stimulation of the cerebral peduncle (Fig. 3). These facts revealed that the inhibitory effects of pyramidal tract stimulation caused to suppress the occurrence of epileptic discharges. 3) SN wave gradually diminished in amplitude after topical application of Pc at the anterior sigmoid gyrus (Fig. 4 A-D). It disappeared completely when tonic-clonic sustained paroxysms occurred at the focus (Fig. 4 E). These effects are due presumably to depression of recurrent postsynaptic inhibition caused by topical penicillin. 4) SN wave observed at the contralateral secondary focus was almost unchanged during interictal and ictal stage (Fig. 5).(ABSTRACT TRUNCATED AT 250 WORDS)

Platelet tocopherol levels in mucocutaneous lymph node syndrome (MCLS: Kawasaki disease)

Studies of changes in platelet tocopherol in 16 children with mucocutaneous lymph node syndrome (MCLS) were undertaken during the disease course. Plasma tocopherol was lowest at the beginning of the disease (during the first 1 to 2 weeks), while it increased with improvement in symptoms at 4 to 5 weeks. Platelet tocopherol however was lowest in the first 2 to 3 weeks, and at about the 4th week or later increased. When compared with normal levels, determined in 24 children without MCLS (5 to 14 years old), the lowest level seen throughout the disease course coincided with it. Thus, platelet tocopherol may be generally higher in MCLS. There was little correlation between plasma and platelet tocopherol levels which were simultaneously assayed, (r = 0.26, p less than 0.1, n = 44), while, the correlation between platelet tocopherol and plasma tocopherol/total lipid ratio was increased significantly to 0.55 (p less than 0.001, n = 38). Individual patients in whom platelet tocopherol and plasma tocopherol/total lipid ratios were repeatedly assayed, were divided into two groups based on the Asai scoring, as a high risk group and a low risk group. No correlation was observed between the risk grades and either platelet tocopherol or tocopherol/total lipid ratios in plasma.

[A histopathological study on a glioma with radiation necrosis and brain stem spongiform degeneration (author's transl)]

A histopathological study on an autopsy case of 38-year-old female who had suffered from huge glioma and received radiation therapy as well as operation and chemotherapy was reported. The tumor mainly involved the right frontal lobe and partially invaded to the left cerebral hemisphere. Subarachnoidal dissemination of tumor cells was noticed in cerebellum, brain stem and spinal cord. Under the microscope the tumor was mainly consisted of astrocytic tumor cells, while oligodendrocytic ones and those with anaplastic or bizarre nuclei were observed among them. Though ependymomatous appearance was partially seen, no true rosette was found. From these findings the tumor was histologically diagnosed as anaplastic glioma. Simultaneously, there was massive coagulative necrosis which was limited to the irradiated area in the tumor tissue and surely attributable to irradiation. In addition, proliferation of gemistocytic astrocytes which was independent of glioma itself was widely observed in the field of irradiation. Another remarkable finding was spongiform degeneration which was located in the subpial area of brain stem including degenerative products of myelin sheaths and axons with neither inflammatory changes not gliosis. In some papers it is suggested that such a lesion has something to do with irradiation or chemotherapy. But in our case this lesion was found in non-irradiated area and no intramedullary injection of chemical agents was performed. Further, the distribution of this lesion was for the most part restricted to the domain of the pontine cistern which had been huge owing to stagnant hemorrhagic fluid. Therefore, it is highly probable that this lesion was caused by the abnormal pia-glial barrier.

Electron microscopy of a ciliated cell in the human stomach

A ciliated cell was observed electron microscopically in a pyloric gland with intestinal metaplasia. This specimen was obtained from the gastric antrum of a 61-year-old man suffering from gastric cancer. The cell had flask-like contour and possessed numerous cilia protruding from the free surface of a deeply indented cytoplasm into the glandular lumen. Most cilia were similar in structure to normal kinocilia and had nine peripheral doublets and two central microtubules (9 + 2 configuration). Some cilia, however, showed varying configurations, such as 9 + 0,9 + 3, or 9 + 4. The occurrence of ciliated cell in human stomach may be related to the disturbance of cellular differentiation of the gastric primordial cells during metaplastic change.

Electron microscopic study of signet-ring cells in diffuse carcinoma of the human stomach

The signet-ring cells seen in gastric carcinoma of the diffuse type were studied by light and electron microscopy. A classification of these cells into Types A, B and C was developed, based on intracellular mucous granules, nuclei and organelles, and be reactions to PAS and Alcian-blue staining. The gradual transition of type A cells to Type B and the subsequent change of Type B to Type C suggest successive stages in maturation. These cells, especially those of Type B, resemble the mucous neck cells of the corpus and the glands of the pylorus.