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We report a case of disease-free survival with uracil-tegafur(UFT)therapy after resection of primary and hepatic lesions from rectal cancer. A 64-year-old female had synchronous hepatic and multiple pulmonary metastases from rectal cancer. Image studies including colonoscopy, CT, MRI and PET-CT showed 2 metastases of lung(rt. middle lobe and lt. upper lobe) and a metastasis of liver(S6)in addition to rectal cancer(Rb, pSM, pN1, ly2, v1). Abdominoperineal resection+D3 of rectal cancer was performed, followed by chemotherapy with UFT for 28 days, and then partial resection of liver. Resected specimens of the liver demonstrated a histological Grade 2 with many CD3-positive lymphocytes. After surgeries, chemotherapy with UFT was continued, resulting in a CR for pulmonary metastases. The patient has been well without any sign of recurrence 5 years after first surgery. This case indicated that UFT was effective for hepatic and pulmonary metastases from rectal cancer, partially due to T cells(CD3+)infiltrating the metastases.

A 24-year-old man presented with abdominal distension, diarrhea, and nausea. Blood tests showed eosinophilia (WBC 14400/microl, Eos 36%) and slight hypoproteinemia (TP 6.4 mg/dl, Alb 3.7 mg/dl). Ultrasonography and computed tomography revealed massive ascites (WBC 11500/microl, Eos 95%, protein 4.7 g/dl) and wall thickening of the small intestine. Endoscopic and histological examinations showed mucosal redness and edema with eosinophilic infiltration throughout the digestive tracts. Fecal alpha1- antitrypsin clearance was increased (44.6 ml/day). A diagnosis of eosinophilic gastroenteritis with ascites and protein-losing gastroenteropathy was made, and was classified as mixed type of both predominant subserosal and mucosal disease. Prednisolone therapy improved all the symptoms and findings. Measurements of serum levels of several cytokines and chemokines showed that interleukin-5 and soluble interleukin-2 receptor, but not eotaxin, were possible indicators of the disease activity. It should be kept in mind that eosinophilic gastroenteritis is one of the causes of ascites.

A 48-year-old woman with iron deficiency anemia (Hb 8.1 g/dl) and Helicobacter pylori (H. pylori)-associated enlarged fold gastritis underwent successful H. pylori eradication. Hemoglobin, serum iron concentrations, and other indices of iron deficiency anemia reached almost normal levels 10 to 16 months after the first eradication treatment. Iron absorption tests and measurements of basal acid output were performed before and after eradication therapy. Iron absorption almost doubled within 3.5 months, whereas basal acid output was nothing but it increased after 15 months. Therefore, it was suggested that the increase in iron absorption was possibly involved in improvement of iron deficiency anemia after H. pylori eradication therapy. Furthermore, it was also suggested that mechanisms other than increase in acid secretion might be involved in increase in iron absorption.

A 73-year-old woman without a history of allergic diseases visited our hospital complaining of sore throat and nocturnal cough. Blood tests showed marked eosinophilia (18000/mm(3);WBC 21900/mm(3), Eos 82.0%) with normal serum levels of C-reactive protein, non-specific and various allergen-specific IgE. Stool tests for protozoa or helminthic ova were negative. Chest X-ray films showed no pulmonary abnormalities. Endoscopic and histological examinations revealed reflux esophagitis (grade C according to the Los Angeles Classification System) with hiatal hernia with inflammatory infiltrates including eosinophils within the esophageal mucosa. A computed tomography showed the thickening of the esophageal wall. An administration of lansoprazole improved reflux esophagitis and also eosinophilia, and an alteration to famotidine caused heartburn with an increase in eosinophils. A re-alteration to omeprazole relieved the symptom and decreased eosinophils. It was shown that gastroesophageal reflux disease was one of the possible causes of eosinophilia.

A 63-year-old man visited our hospital complaining of brown urine. A physical examination showed jaundice of the skin and conjunctiva bulbar. Blood tests showed elevated serum levels of bilirubin and hepatobiliary enzymes. A type 2-like mass lesion was found near the papilla of Vater during the endoscopic retrograde cholangiopancreatography and was histologically proven to be a well-differentiated adenocarcinoma. A diagnosis of obstructive jaundice due to primary duodenal cancer arising near the papilla of Vater was made. After the jaundice was decreased by endoscopic biliary stenting, a pancreatoduodenectomy was performed. A histopathological examination of the resected specimen concerning the location and manner of invasion of cancer cells revealed that the cancer arose from the duodenal mucosa near the papilla of Vater.

After the proposal of scavenger pathway hypothesis, a family of genes have been discovered. Here we show the precise properties of the first cloned scavenger receptor class A type I and II. Then the profiles of other members of scavenger receptors including lectin receptors are shown briefly.

A 85-year-old woman consulted our clinic due to asymptomatic macrohematuria on January 6, 1987. In the cystoscopic examination, solitary and pedunculated bladder tumor was revealed. This tumor was located on the retrotrigonal region near the right ureteral orifice. On January 20, transurethral resection of bladder tumor was planned but the base of the tumor was stony hard, so complete resection was not performed. On February 10, transurethral resection of bladder was performed repeatedly. At that time, the cystoscopic finding showed that the tumor size had increased and transurethral bladder ultrasonography showed invasion into the deep muscular layer. On February 17, total cystectomy and ileal conduit was done. Histological examination revealed poorly differentiated TCC with osteoid, bone and cartilage. This patient was discharged in good condition on March 27. Heterotopic bone formation in the bladder tumor is rare. Ten cases were collected from the literature. We report a case of heterotopic bone formation and discuss the mechanism of the etiology.

Fifty-one cases of malignant lymphomas in patients under 20 years of age have been reviewed in Osaka, Japan. The breakdown of these cases revealed 6 cases (11.8%) of Hodgkin's disease (HD) and 45 cases (88.2%) of a non-Hodgkin's lymphoma (NHL). Both the HD and NHL cases were determined by using the Rye classification, as well as the Rappaport, Kiel, and LSG classifications, respectively. The results have shown that (1) the incidence of HD in childhood is the same as that seen in the adult in Japan; (2) that a NHL of the nodular type is rare in Japan as it is in Western countries; (3) that any significant differences were not present in the distribution of each histologic subtype in the cases of a NHL among Japan and Western countries, and that the lymphoblastic type was the most common. From this study it is concluded that geographical differences were not a factor in comparing cases of childhood malignant lymphomas in Japan and Western countries.