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We have established a novel method which make electron scattering off short-lived radioactive nuclei come into being. This novel method was named SCRIT (Self-Confining RI ion Target). It was based on the well known "ion trapping" phenomenon in electron storage rings. Stable nucleus, 133 Cs , was used as target nucleus in the R&D experiment. The luminosity of interaction between stored electrons and Cs ions was about 1.02(0.06) × 1026 cm -2 s -1 at beam current around 80 mA. The angular distribution of elastically scattered electrons from trapped Cs ions was measured. And an online luminosity monitor was used to monitor the change of luminosity during the experiment.

A syringe-type radiopharmaceutical being supplied by a manufacturer has a syringe shield and a plunger shield, whereas an in-hospital labeling radiopharmaceutical is administered by a disposable plastic syringe without the plunger shield. In cooperation with Nihon Medi-Physics Co. Ltd., we have produced a new experimental plunger shield for the disposable plastic syringe. In order to evaluate this shielding effect, we compared the leaked radiation doses of our plunger shield with those of the syringe-type radiopharmaceutical (Medi shield type). Our plunger shield has a lead plate of 21 mm in diameter and 3 mm thick. This shield is equipped with the plunger-end of a disposal plastic syringe. We sealed 99mTc solution into a plastic syringe (Terumo Co.) of 5 ml with our plunger shield and Medi shield type of 2 ml. We measured leaked radiation doses around syringes using fluorescent glass dosimeters (Dose Ace). The number of measure points was 18. The measured doses were converted to 70 microm dose equivalent at 740 MBq of radioactivity. The results of our plunger shield and the Medi shield type were as follows: 4-13 microSv/h and 3-14 microSv/h at shielding areas, 3-545 microSv/h and 6-97 microSv/h at non-shielding areas, 42-116 microSv/h and 88-165 microSv/h in the vicinity of the syringe shield, and 1071 microSv/h and 1243 microSv/h at the front of the needle. For dose rates of shielding areas around the syringe, the shielding effects were approximately the same as those of the Medi shield type. In conclusion, our plunger shield may be useful for reducing finger exposure during the injection of an in-hospital labeled radiopharmaceutical.

Tailoring of nanostructures with energetic ion beams has become an active area of research leading to the fundamental understanding of ion-solid interactions at nanoscale regime and with possible applications in the near future. Rutherford backscattering spectrometry (RBS), high resolution transmission electron microscopy (HRTEM) and asymmetric X-ray Bragg-rocking curve experimental methods have been used to characterize ion-induced effects in nanostructures. The possibility of surface and sub-surface/interface alloying at nano-scale regime, ion-beam induced embedding, crater formation, sputtering yield variations for systems with isolated nanoislands, semi-continuous and continuous films of noble metals (Au, Ag) deposited on single crystalline silicon will be reviewed. MeV-ion induced changes in specified Au-nanoislands on silicon substrate are tracked as a function of ion fluence using ex situ TEM. Strain induced in the bulk silicon substrate surface due to 1.5 MeV Au 2+ and C 2+ ion beam irradiation is determined by using HRTEM and asymmetric Bragg X-ray rocking curve methods. Preliminary results on 1.5 MeV Au 2+ ion-induced effects in nanoislands of Co deposited on silicon substrate will be discussed.

We have studied the crystal orientation of Ag thin films on a [Formula: see text] surface using grazing incidence X-ray diffraction with synchrotron radiation. After preparation of a [Formula: see text] surface, 50 ML Ag was deposited on the [Formula: see text] at the substrate temperature of 50–300 K. We found the [Formula: see text] structure at the interface. As for the Ag film, the Ag}111{ plane was mainly grown on the surface. The domain size of the Ag films strongly depends on the substrate temperature of the deposition. The domain size is found to be regulated by an original domain size of the [Formula: see text] surface before Ag deposition, which relates to the surface-structural phase transition. By scattering intensity measurements in the reciprocal lattice space, we found streaky scattering along the [Formula: see text] direction parallel to the surface. This scattering is thought to originate from the CTR (crystal truncation rod) scattering from a sidewall plane of the Ag {111} nanometer-scale crystals.

胃上部癌に対して噴切後,食道胃管吻合を施行した15例を対象とした.年齢は47～81歳,男性12例,女性3例であった.手術適応はEC-junction近傍の早期癌やhigh risk症例でU領域を占拠する進行癌とした.リンパ節は(1), (2), (3), (7)番のみ郭清し,胃管の長さは約20～25cmとした.術後のQOLとして経口摂取量の変化,体重の推移,臨床症状の有無,内視鏡所見,排出能を検討した.退院時,経口摂取量は術前の50～85%,体重は術前の80%まで低下したが術後1年目には15例中8例が術前のレベルに回復した.食後のつかえ感は1例にみられたが,胸やけやDumping症状は認めなかった.内視鏡検査では逆流性食道炎を12例中3例に認めたが保存的に軽快した.残胃炎や胃石は認めなかった.噴切症例の排出能は墜落型のパターンを呈した.胃上部癌に対する噴切後の大彎側胃管を用いた再建法は手術手技も簡便であり,術後のQOLも良好に保たれていた.

We studied the affection of thin (i.e., 0.2–0.8 nm) Ni films on hydrogen-terminated Si(1 1 1) substrate surface by using strain-sensitive X-ray diffraction. It was reported that Ni deposition onto hydrogen-terminated Si surface apparently does not cause film growth, but rather diffuses into the Si crystal, creating an “Ni diffusion layer” up to Ni deposition 0.8 nm thick. Measured rocking curves of the Si 1 1 3 reflection and integrated intensities of the rocking curves for the substrate provide information about the evolution of the strain field introduced near the substrate surface during Ni diffusion into the substrate. Comparing the measured and calculated rocking curves indicates that compression of the {1 1 1} spacing of the Si occurs gradually up to an Ni thickness of 0.6 nm, and that above this thickness, strain relaxation occurs. We found that the slope of the integrated intensity of the rocking curve versus X-ray wavelength correlates to the strain field near the surface, in the same way that the shape of the rocking curves correlate to the strain field near the surface. Dynamical diffraction calculations indicate that measurement of the slope of the integrated intensity of the rocking curve versus X-ray wavelength is useful for strain analysis, because the dependence is not only sensitive to strain fields, but is also insensitive to the effect of absorption by the overlayer, which otherwise would cause deformation of the shape of the rocking curve.

症例は48歳,女性. 1996年9月,左乳房腫瘤を自覚し近医受診し,乳癌を疑われ当科紹介される.触診上,左乳房CAE領域に径3cmの腫瘤を触知したが,リンパ節は触知しなかった.穿刺吸引細胞診にてClassV, adenocarcinomaと診断され, T2aN0M0 Stage IIの乳癌と診断し, Bt+Axを施行した.切除標本は4×3cm大の充実性腫瘍であり,組織学的には浸潤性乳管癌胞巣と紡錘状異型細胞の混在よりなり,軟骨化生と骨化生を伴う組織を認めた.リンパ節転移は認めず, ER, PGRともに陰性であった.骨・軟骨化生を伴う乳癌は浸潤癌の特殊型に属し,その発生頻度は稀であり,本邦での報告は60症例程度である.これらをあわせ,臨床的特徴や予後について検討する.

神経鞘腫は末梢神経のSchwann細胞から発生する腫瘍で,主に頭頸部や四肢にみられ後腹膜腔からの発生は比較的稀である.臨床上は,後腹膜臓器由来の腫瘍との鑑別が重要であるが,必ずしも容易ではない.当科では1992年から2000年5月まで6例の後腹膜神経鞘腫を経験した.平均年齢は55.3歳,平均腫瘍最大径は11.7cmであった. 1例を除き有症状であった.4例で術前に後腹膜腫瘍と診断しえたが,質的診断はいずれも不十分であった.全例で腫瘍切除を行った.仙骨前面に強固に癒着していた1例では剥離困難のため腫瘍遺残を認めた.病理診断は全例AntoniA型とB型が混在する良性神経鞘腫であった.免疫組織染色ではS-100蛋白が陽性であった.再発徴候はいずれの症例も認めていない.良性後腹膜神経鞘腫は予後良好であるが,再発例や悪性化例が少数報告されており慎重な経過観察が必要である.

Extremely asymmetric X-ray diffraction is a noble method to evaluate strain fields near crystal surfaces or interfaces. This method is sensitive to crystal structure near surface region because a glancing angle of X-ray is set near a critical angle of total reflection. A minute strain fields (≥ 0.1%) at surface brings a variation of intensity and width of rocking curves. Therefore we can evaluate strain near surfaces by analyzing curve-shape or integrated intensity of the curves. We show two examples of experimental strain evaluation. One is Si reconstructed surfaces. We quantitatively evaluated intrinsic strain fields near Si reconstructed surfaces, i.e., Si(111)-(7×7), Si(111)-(√3×√3)-Al, and Si(111)-(√3×√3)-Ag surfaces. From the fitting of the experimental rocking curves with calculated curves, we found that all reconstructed surfaces bring a contraction of the (111) spacing due to surface lattice relaxation, and such strain extends to some ten nm under the surfaces. Another example is silicide surface. We evaluated a strain evolution near hydrogen-terminated Si(111) surface due to nickel deposition. We found that a compressive strain gradually introduces into the substrate accompany with a growth of “Ni diffusion layer” near the hydrogen-terminated surface.

症例は33歳,女性.心窩部痛および右下腹部痛にて近医受診し,保存的治療を行うも症状の改善を認めないため,当科紹介となった.発熱と炎症反応の亢進,右下腹部痛および圧痛を認めたが,腹膜刺激症状は認めなかった.保存的治療にて症状は改善したが,再び症状の増悪をきたしたため手術を施行した.術中所見では,骨盤腔内の小腸が非連続性に広範囲にわたって壊死に陥っており,小腸切除を行った.病理学的所見として結節性多発動脈炎による小腸壊死と診断した. 結節性多発動脈炎は多彩な全身症状をきたすが,急性腹症を呈し開腹手術にまで至ることは稀である.急性腹症で発症し小腸壊死をきたした1例を経験したので報告する.

症例は62歳,男性.平成6年4月8日胃癌に対し胃全摘術を施行.病理学的所見は, papillary adenocarcinona, ssγ, noであった.術後再発傾向なく外来にて経過観察中,平成11年9月に左乳房腫瘤に気付き,増大傾向を認めるため,平成11年12月に受診した.左乳房E領域に2.7×2.4cmの比較的硬い腫瘤を触知し,左腋窩に径10mmのリンパ節を2個触知した.超音波検査では,左乳頭直下に2.5×1.0cmの低エコーで内部均一,境界明瞭な腫瘍を認めた.穿刺吸引細胞診ではclass lVであり,乳癌を疑い,平成12年1月7日腫瘍摘出術を行い,術中迅速細胞診にて,浸潤性乳管癌と診断されたため,定型的左乳房切断術を施行した.組織型は充実腺管癌, n2であった.術後CEFとTAM療法を施行した.術後1年10カ月した現在,再発徴候なく健在である. 男子乳癌と胃癌の重複癌の報告例は稀であり,若干の文献的考察を加えて報告する.

症例は50歳,男性. 1999年12月当科にて胃癌に対して幽門側胃切除術を受ける.切除標本の病理所見は, tub1, mp, n1, ly2, v1でStage II, CurAであった.軽快退院後, 5'-DFUR600mg/dayの経口投与を行っていたが, 2000年5月より通院しなくなった. 2001年6月頃より黄疸と体重減少がみられたため,7月当科を再診し精査目的に入院となる.腹部CT検査にて肝に多発性肝転移を認めたため, paclitaxelweekly投与(90 or 120mg, day 1, 8, 15 div, 1週休薬)を3クール施行した.血液検査上,黄疸は消失し,腫瘍マーカーは著明に低下した. Paclitaxel療法による重篤な副作用は認めず, CT上,肝転移巣は著明に縮小した(PR).多発性肝転移を伴った再発胃癌症例に対して, paclitaxel weekly投与が有望である可能性が示唆された.

We studied a buried interface reconstructed structure of the Ag/Si(111)√3 x √3-Ag samples using grazing incidence X-ray diffraction with synchrotron radiation. We found that the √3 interface superstructure can be explained by an inequivalent-triangle (IET) model, which has been observed on the Si(111)√3 x √3-Ag surface at low substrate temperatures by STM. The calculated structure factors of the IET model were found to be very close to our observed ones. The reliability factor (R-factor) using the IET model was about 25%. The R-factor was improved to be much less value, 12% by considering defects of Ag atoms forming the √3 structure. The Patterson map expected from the IET model having the defects was very similar to that calculated from the observed structure factors.

The strain fields near three different reconstructed Si surfaces, Si(1 1 1)7×7, Si(1 1 1) 3 × 3 -Ag, and Si(1 1 1) 3 × 3 -Al, were measured by using a strain-sensitive X-ray diffraction technique. The rocking curves of Si 1 1 3 reflection for these surfaces differed in peak intensity and peak width. The strain fields near these surfaces were quantitatively evaluated by fitting the measured curves with curves calculated by assuming a distorted atomic layer under the reconstructed surfaces. The results show that all three reconstructed surfaces induce compressive strain in the substrates and that this strain penetrates to a depth of 10–30 nm beneath the surface. Among these three reconstructed surfaces, the 3 × 3 -Ag surface induces the largest strain to the substrate.

早期胃癌に対して幽門保存胃切除(PPG)を施行した5例と懊状切除11例を比較検討した.手術適応は,術前EUSにて深達度がMである事に加え, PPGではM領域で30mm以下の分化癌,模状切除では30mm以下で境界明瞭な隆起・平坦型病変もしくは15mm以下で潰瘍疲痕を伴わない陥凹型病変とした.術後のQOLとして,経口摂取量の変化,体重の推移,臨床症状の有無,内視鏡所見,術後運動能を検討した.経口摂取量や体重の推移はPPGでは術前のレベルまで回復したのは1例のみであったが,模状切除では11例中10例が術後6カ月目にはほぼ術前のレベルまで回復した.食後のつかえ感や胃石形成をPPGでは高率に認めたが模状切除では認めなかった.アセトアミノフェン法を用いた術後の運動能では, PPGでは健常人と差を認めなかったが,模状切除の排出能は健常人に比べると軽度遅延していた.早期胃癌の縮小手術として,懊状切除のQOLは, PPGよりも良好に保たれていた.

症例は45歳,女性. 1993年8月,右乳癌に対して非定型乳房切除術を施行した.術後定期的に外来通院するも1998年3月より上腹部膨満感や嘔吐が出現するようになり,胃透視にて幽門狭窄を認め,内視鏡で粘膜面正常なるも壁伸展不良を認めた.胃癌の診断にて6月胃亜全摘術を施行した.術中,横行結腸漿膜の2カ所に腹膜播腫と思われる小結節を認めたため,これを摘出した.切除標本の病理所見はmetastatic poorly differentiated adenocarcinoma, se (m: intact), n1, PM(+), DM(-), P1であり,乳癌からの転移と考えられた.術後経過良好であり,化学療法としてCEF1クール施行した後,退院した.以後,外来にて経口の内分泌化学療法を施行し,術後3年の現在,無再発生存中である.乳癌の胃転移は少なく若干の文献的考察を加えて報告する.

For the system of polycrystalline Si/SiO 2 (thermal)/Si(001), the strain field introduced into the Si substrate was studied with the asymmetric X-ray diffraction method. Polycrystalline Si layers with a thickness of 10.0 nm were grown on 4.5-nm thick thermally grown oxide layers. To study the strain fields, the rocking curves for Si {113} planes of the bulk films were measured. The intensity of the rocking curves increased for polycrystalline Si-grown films, whereas the intensity must be decreased by the absorption of X-rays in the polycrystalline Si layer. This indicates that the strain is introduced into the substrate. The Darwin dynamical calculation for a distorted crystal indicates that the intensity enhancement of a rocking curve can occur as a compressive strain. From a comparison of the measured and calculated curves, we conclude that the compression of the {001} spacing near the substrate surface occurs during the growth of the polycrystalline Si layer.

We experienced a rare case of spindle cell carcinoma of the breast. A 46-year-old woman was admitted to the department because of a left breast lump. She underwent a modified radical mastectomy with a preoperative diagnosis of normal type breast carcinoma. The tumor was pathologically diagnosed as spindle cell carcinoma. The spindle cell component was immunoreactive for vimentin and EMA (epithelium membrane antigen). No metastases were found in the axillary lymph nodes. The pathological stage was t2n0m0. The patient has been free from recurrence, as of 14 months after the operation. Spindle cell carcinoma of the breast is an uncommon tumor. Histologically, its dominent component consists of sheets of spindle-shaped cells and includes contiguous carcinoma components. Despite its sarcomatous features apparently, spindle cells are derived from epithelial cells of the mammary glands. A total of 62 cases collected from the Japanese literature including this case were reviewed clinicopathologically. Spindle cell carcinomas were thought to be bigger in size than normal type breast carcinomas. Otherwise, lymphogenous metastases occurred infrequently. Many cases have cystic lesions. Therapy and prognosis of the disease are still controversial, but many patients experienced hematogenous metastases in their early stages. Strict observation and careful treatment would be mandatory for the disease.

We measured strain fields near semiconductor surface by X-ray diffraction. The diffraction geometry was using the extremely asymmetric Bragg-case bulk reflection of a small incident angle to the surface and a large angle exiting from the surface. The incident angle of the X-rays was set near critical angle of total reflection by tuning X-ray energy of synchrotron radiation. The X-ray intensity of the silicon substrate 311 reflection was measured to study a Si(111) surface in the ultrahigh vacuum chamber. A clean Si (111)-(7 × 7) surface was found to give a sharper X-ray diffraction peak than that of the native oxide/Si(111) system. By comparison of experimental results and theoretical calculations, it was concluded that the thin silicon oxide film itself gives strong strain fields to the silicon substrates of lattice expansion toward the [311] direction. The strain fields at the Al- and Ag- induced [Formula: see text] surface reconstruction on the Si(111) substrate were also measured. By comparison of experimental results and theoretical calculations, Al-induced reconstruction was suggested to give a strain field to the silicon substrate of lattice expansion toward the [311] direction, whereas Ag-induced reconstruction was suggested to give a strain field to the silicon substrate of lattice compression toward the [311] direction.

The change of the strain field near the SiO2/Si(111) interface during removal of an oxide layer was investigated by X-ray diffraction under ultra high vacuum conditions. It was observed that the width of the rocking curve for the 311 plane became narrow during thinning of the oxide layer. From a theoretical consideration, it was found that the width of rocking curve depends upon the thickness of oxide layer, even if there is no strain field at the interface. This behavior of the width is mainly due to an absorption effect of X-rays in the oxide layer. By using a resultant equation, the intrinsic curve, containing only the strain effect, was obtained by deconvoluting the absorption effect from the experimental curve. From the result, it was concluded that the strain field near the interface relaxes for thinning of the oxide layer. The strain field near the Si(111) 7×7 surface is concluded to be smaller than that of the SiO2/Si(111) interface.

Microangiopathic hemolytic anemia (MAHA) is a term which describes the association of hemolytic anemia with red cell fragmentation caused by microangiopathy mechanically. This paper reports a 45-year-old woman with bone metastases from breast cancer. She developed MAHA and disseminated intravascular coagulation (DIC). Although the prognosis of MAHA associated with malignant tumor has been very poor, she achieved remission of the syndrome after chemoendocrine therapy.

患者は86歳, 女性の進行膵頭部癌症例.高カロリー輸液 (総合ビタミン剤非配合) 施行中に, 温熱化学療法を契機に経口摂取不良となり, 高カロリー輸液21日目に急激な意識低下 (II-20), 末梢循環不全, 呼吸促拍を認め, 腹痛を訴えた.血液ガス分析でpH7.193, Base Excess-16.6mEq/lと著明な代謝性アシドーシスを認め, 7%炭酸水素ナトリウムを計480ml投与したが改善しなかった.発症より16時間後ビタミンB1欠乏を疑い, 塩酸チアミン150mgを静注したところ, 1時間後にpH7.507, BaseExcess 3.8mEq/lとなり, 4時間後に意識レベルは1-2に改善した.発症時の血清乳酸値は119mg/dlと異常高値を示し, 血中ビタミンB1値は13ng/mlと異常低値であったがそれぞれ塩酸チアミン静注後正常化した.本症例を含めた高カロリー輸液施行中のビタミンB1欠乏による乳酸アシドーシスの報告例48例について文献的に考察した.

We report five cases of metastatic brain tumor preceded by neurological symptoms. All patients received removal of the brain tumors prior to resection of the primary lesions. The primary site of cancer was the lung in 3 patients, and esophagus and breast in one each. The number of brain tumor was one in four patients and 3 in one. The duration from the removal of the brain tumors to the resection of the primary lesions ranged from 0.5 to 6 months. Two patients with lung cancer, who did not undergo postoperative whole brain radiation therapy, died of recurrence of brain tumors 14 months and 15 months after the resection of the primary lesions, respectively. On the other hand, no recurrence of the brain tumor was found in 3 patients with postoperative whole brain radiation. One patient with breast cancer died 14 months, and two patients with esophageal and lung cancer are alive 30 months and 37 months after the resection of the primary lesions, respectively. Curative resection for both brain metastasis and primary lesions was performed in 2 patients surviving for more than two years. Resection of brain metastasis and primary lesions, and postoperative whole brain radiation therapy according to the progressive extent of the lesions would improve the prognosis.

Liver cysts have been treated by an operation under laparotomy or ultrasonography-guided alcohol sclerotherapy so far. With a recent wide-spread use of laparoscopic procedure, laparoscopic fenestration (LF) has been increasingly performed for liver cysts. In this paper four cases of liver cysts treated with LF were studied to elucidate LF's characteristics by comparing with other procedures. Two patients had a simple cyst and two had multiple cysts. The size of cysts ranged from 8 to 18cm. Two of the four patients underwent simultaneous laparoscopic cholecystectomy for coexisted cholecystolithiasis. LF was performed safely without postoperative complication. No recurrences were found during a follow-up period of 10-42 months. The duration of hospital stay of patients treated by LF was 7±2 days, which was shorter than that of patients treated by ultrasonography-guided alcohol sclerotherapy (22±10 days) and by fenestration with laparotomy (16±3 days). Drunkenness and abdominal pain occured to all patients treated by alcohol sclerotherapy. These results would indicate that LF appears to be a safe and useful method for liver cysts.

Six patients who underwent segmental autotransplantation of the caudal pancreas (SAT) following total pancreatectomy for pancreatic cancer were investigated. The graft was transplanted to the left groin, and pancreatic juice was diverted outside through a polyethylene tube indwelled into the main pancreatic duct. In these SAT patients, the responses of insulin (IRIS) in terms of plasma levels and pancreatic secretion to subcutaneous injections of somatostatin octreotide (Sandostatin: SMS201-995) were simultaneously observed. Four doses (0.039, 0.156, 0.625 and 2.5 micrograms/kg) of SMS201-995 were given on separate days. As a control, saline was injected subcutaneously. Standard liquid test meal was given 1 h after the subcutaneous injection. The basal plasma IRI were significantly decreased with doses greater than 0.156 microgram/kg. The postprandial responses of IRI was also significantly suppressed with the same doses. On the other hand, the basal pancreatic exocrine secretion was significantly suppressed with doses greater than 0.625 microgram/kg. The postprandial pancreatic exocrine secretion was also significantly suppressed with doses greater than 0.625 microgram/kg. Those suppressions were dose-dependent. The postprandial CCK secretion was also significantly suppressed in dose-dependent manner with SMS201-995. The CCK suppression was significantly correlated with the suppression of pancreatic exocrine secretion. This clinical study under the setting of SAT demonstrated not only the direct inhibitory effect of somatostatin on both the islet and acinar cells but also, probably, the indirect inhibitory effect on the acinal cells via suppression of CCK release in humans.

Kinetic energy and charge state dependencies of soft X-ray yields from Mo and Ta polycrystalline targets have been investigated for kev O q+ ( q = 2–7) ions. For X-rays for target atoms, MoM 1 N 2, 3 , MoM 2 N 4 , TaN 2 O 4 , TaN 3 O 4 and TaN 3 O 1 , these dependencies of the X-ray yields were nearly the same as those of O K α . The possible explanation is that the charge transfers from the 3s, 3p levels for Mo and the 4p levels for Ta to the 1s level of oxygen ions take place.

We report a case of rapidly growing pulmonary carcinosarcoma admixed with osteosarcomatous component. A 66-year-old male was admitted to our hospital because of hemosputum. A chest X-ray film and CT showed a tumor mesured 9×8cm in the middle field of the left lung. Squamous cell carcinoma was suspected by cytological examination of sputum. Left upper lobectomy and partial resection of the left lower lobe were performed. Histologically, the tumor was composed of carcinomatous (squamous cell carcinoma and adenocarcinoma) and sarcomatous (fibrosarcoma and osteosarcoma) elements, and there was an apparent transition of the squamous cell carcinoma into the fibrosarcoma, so the patient was diagnosed as so-called carcinosarcoma of the lung. Postoperative chemotherapy was performed, but the patient died seven months after the operation. In a review of 25 Japanse cases of pulmonary carcinosarcoma described in the literature since 1974, only 4 cases including our case had both the transposition between two elements and sarcomatous component with obvious differentiation. We thought that these cases occupied an intermediate position, between the so-called carcinosarcoma and true carcinosarcoma. Because some cases could not be classified according to the conventional pathological classification, we think that pulmonary carcinosarcoma might be classified by some other different method.

We report a 46-year-old female with Budd-Chiari syndrome associated with intractable ascites. Ultrasonography (US), hepatic venography and cavography showed an obstruction of the confluence of hepatic veins (HV) and severe stenosis of the hepatic portion of the inferior vena cava (IVC). An operation was performed by the suprahepatic approach under partial cardiopulmonary bypass. The severe stenosis of IVC was reopened by finger fracture, and the scar was resected. The obstructed HV was reopened by using forceps. Ringed Gore-Tex patch graft was secured over the incision of IVC. The blood flows by pulsed Doppler US before the operation were 0.73l/min in hepatic veins, 1.59l/min in IVC and 0.70l/min in potal vein. Postoperatively, these values were increased to 1.75l/min, 2.38l/min and 1.26l/min, respectively. Doppler waveform in the hepatic veins and the IVC changed from continuous flow to triphasic one. In this case, pulsed Doppler US was quite useful in evaluating the hepatic hemodynamics before and after the operation, as well as in assessing the therapeutic effects.

Spontaneous esophageal rupture is a life-threatening entity. Here, a 64-year-old male who presented with sudden onset of severe back pain was diagnosed as having an esophageal rupture to the right pleural cavity. Emergency operation was carried out 16 hours after the onset. The rupture was as large as 7 cm and the surrounding tissue was fragile and necrotic. We performed an esophagectomy as a primary salvage procedure. An esophageal reconstruction was carried out successfully 6 months after the initial operation. Staged operative strategy including esophagectomy is still an important option to treat this kind of high risk patient.

胃癌の手術を契機に超音波検査で発見された腹腔動脈起始部圧迫症候群 (celiac axis compressionsyndrome: 以下, CACSと略記) の1例を報告する.症例は50歳の男性.既往歴として幼少時より月に1～2度腹部仙痛を自覚.主訴は嚥下困難で, 噴門部癌の診断のもとに当科に紹介入院-術前の超音波検査にて, 腹腔動脈起始部の狭窄と総肝動脈の遠肝性血流を認めCACSと診断した.左開胸開腹下に胃全摘術, 摘脾術を施行した.術中に内側弓状靱帯による腹腔動脈起始部の圧迫を確認し, 靱帯を切離した.電磁流量計により測定した総肝動脈血流量は靱帯切離前後で40ml/分から115ml/分に増加した.術後に腹痛の発生を認めず, また術後の超音波ドプラ検査にて総肝動脈の求肝性血流を確認した.超音波検査はCACSの診断および治療効果判定に有用と思われた.

A 46-year-old woman had suffered from occasional attacks of upper abdominal pain and mild jaundice for 6 years, and had been diagnosed as hepatolithiasis with computed tomography and abdominal echography at elsewhere. On admission to the hospital endoscopic retrograde cholangiography (ERC) and percutaneous transhepatic cholangiography (PTC) revealed the double gallbladder associated with gallstones in the accessory gallbladder and with choledochal stones. It was diagnosed as double gallbladder with biliary stones (H-shaped type, Gross' classification type B). Both gallbladders were removed and a T-tube was placed in the common bile duct. The postoperative course was uneventful. The double gallbladder is a rare anomaly. Fifty-two Japanese cases of double gallbladder including this case have been seen. Correct preoperative diagnosis has been achieved in 28 (58%) of the 52 cases. The correct diagnosis rate has been increasingly improved with the progression of imaging techniques, such as 11% before 1980 to 48% after 1981. The association of gallstone was reported in 28 (61%) out of 46 cases. Except 9 cases in which no description was found about whether the stones existed in both gallbladders or not, 11 out of 19 cases had gallstones in the both gallbladder, and of the remaining 8 cases 5 had gallstone only in the accessory gallbladder like this case. Gallbladder carcinoma was found in 3 cases. These results indicate that both gallbladders should be removed.

Insulin secretion was investigated by oral glucose loading before and early (mean: 8.9 weeks) after distal pancreatectomy (DP) in 9 patients with a tumor of the caudal pancreas. In 6 patients the same investigation was repeated later (mean 17.8 months). Two parameters expressing the initial and total secretion of insulin in response to elevation of the plasma level of glucose ([ΔIRI/ΔBS]30m and [ΣΔIRI/ΣΔBS]o-180min) were calculated for each individual patient for serial comparison. These parameters were significantly smaller before the operation compared with 10 normal controls. Early after DP, the parameters decreased significantly, and a further significant decrease was noted late after DP. It is concluded that distal pancreatectomy causes a progressive decrease in insulin secretion in patients with pre-existing disorders of the pancreas.

A case of minor omental cyst discovered by an abnormal shadow of the mediastinum in a chest X-ray film is repoted. A 52-year-old man was pointed out an abnormal shadow of the mediastinum in a chest X-ray film on mass screeing, and was admitted to the hospital for minute examination. CT and angiography indicated a hernia of a minor omental cyst to the mediastinum. Operation was done by thoracotomy and laparotomy. In laparotomy, a 10×6 cm cyst in minor omentum was shown to slide into the mediastinum through the esophageal fissure. After removing the cyst, Nissen's fundplication was performed to prevent postoperative hernia of esophageal fissure. In histological findings, the cyst was lymphangioma but no malignant sign was shown. There was no problem in the postoperative course.

A novel technique for forming internal targets, named SCRIT (Self-Confining RI Ion Target), has been developed, which can make electron scattering off short-lived radioactive nuclei possible in an electron storage ring. SCRIT confines the ions of interest by utilizing the “ion trapping” phenomenon in the electron storage ring. Approximately 107 stable 133Cs ions were trapped in a three-dimensional configuration along the electron beam axis at an electron beam current of 75mA. The angular distribution of the electrons scattered from the trapped 133Cs ions was successfully measured, and a collision luminosity of 1026/(cm2 s) was achieved.

A total of 236 cases operated on for colon cancer in a recent 5 year period was compared for the location of tumor, s-Tchol and s-TG by grouping on whether gallstone was associated or not, and whether cholecystectomy had been done or not. Fecal bile acid deviation before and after cholecystectomy was also comparatively studied in 33 gallstone cases. Twenty-eight cases (11.9%) out of the 236 were accompanied by gallstones. When the cecum and ascending colon were regarded as right side and the discending colon, sigmoid colon and rectum as left side, the proportion occupied right side colon was 33.3% in the associated gallstone group, which was higher than 18.3% in non-associated group with a significant difference (p

We carried out a demonstrative electron scattering experiment using a novel ion-trap target exclusively developed for short-lived highly unstable nuclei. Using stable $^{133}\mathrm{Cs}$ ion as a target, this experiment completely mimicked electron scattering off short-lived nuclei. Achieving a luminosity higher than ${10}^{26}\text{ }\text{ }{\mathrm{cm}}^{\ensuremath{-}2}\text{ }{\mathrm{s}}^{\ensuremath{-}1}$ with around only ${10}^{6}$ trapped ions on the electron beam, the angular distribution of elastic scattering was successfully measured. This experiment clearly demonstrates that electron scattering off rarely produced short-lived nuclei is practical with this target technique.