Mm In Maximum Diameter Research Articles

Clinical guidelines for the early detection of plantar malignant melanoma

Of 144 pigmented lesions excised from the soles of Japanese patients, 140 were melanocytic. Apart from congenital melanocytic nevi, only a few benign acquired melanocytic nevi on the sole were more than 7 mm in maximum diameter and none exceeded 9 mm. In contrast, all plantar malignant melanomas, including malignant melanoma in situ, were 9 mm or more in maximum diameter. In addition, the majority of plantar melanocytic lesions excised from patients who were older than 50 years of age were malignant melanoma. On the basis of these data, we propose clinical guidelines for the early detection of plantar malignant melanoma.

Relationship of severe dysplasia to Stage B adenocarcinoma of the prostate

Severe dysplasia was studied in totally embedded radical prostatectomy specimens from 40 Stage B, intermediate-grade prostate cancers. All 40 cases had severe dysplasia which varied in amount (extensive in 35% of cases; intermediate in 55%; minimal in 10%). Severe dysplasia was predominantly concentrated in peripheral and posterior regions of the gland. Those cases with extensive severe dysplasia had more multifocal small cancers (14.6/case) compared with cases with intermediate (7.5/case) or minimal severe dysplasia (5.5/case). Most dominant tumor nodules had some intermingled severe dysplasia, and in 30% of the dominant tumor nodules, intermingled severe dysplasia occupied between 10% and 25% of the tumor nodule. Severe dysplasia was located next to the dominant tumor nodule in all cases. Nineteen percent of dominant tumor nodules had extensive adjacent severe dysplasia ranging from 5 to 14 mm in maximum diameter, showing that the potential exists for needle biopsy of prostate cancers to obtain only severe dysplasia. These data show a close relationship between severe dysplasia and Stage B cancers. In contrast, centrally located low-grade multifocal cancers, as seen in Stage A (incidental) carcinoma, had a significantly weaker association with severe dysplasia as compared with central, intermediate-grade, multifocal tumors or peripheral multifocal tumors of any grade.

Endoscopic ultrasonographic detection of carcinomatous invasion and of lymph nodes in the thoracic esophagus.

The use of endoscopic ultrasonography (EUS) for diagnosing the depth of carcinomatous invasion into the esophageal wall and in detecting mediastinal lymph nodes in patients with esophageal carcinoma was assessed. EUS was performed before surgery in 33 patients who underwent subtotal esophagectomy with lymph node dissection in our department of surgery between January 1987 and February 1989. The findings of EUS prospectively correlated with intraoperative macroscopic findings and histopathologic findings of the resected specimens. An accurate diagnosis of the depth of invasion into the esophageal wall was made in 30 of the 33 patients (90.1%). Visualization rates of mediastinal lymph nodes were 92.9%, 53.1%, and 1.0% when the nodes were greater than 10 mm in maximum diameter, 5 to 9 mm, and less than 5 mm, respectively. Although EUS had no diagnostic value for patients in whom the ultrasonic probe could not be inserted beyond the tumor, it is an excellent method for evaluating the depth of invasion and detecting lymph nodes greater than 10 mm in diameter. Detection is not feasible when the lymph node is less than 5 mm in diameter. EUS provides the surgeon with one more tool for the preoperative determination of curability.

A Clinicopathological Study of IIa +IIc Type Early Colorectal Cancer with Massive Submucosal Invasion

Abstract: The authors investigated clinical data and pathological findings of eight cases of IIa+IIc type early colorectal cancer which showed minimal invasion in the mucosal laver, but massive invasion in the submucosal layer (deep invasion type). The average age of these 8 patients was 57.8 years (6 out of 8 cases were between 55 and 61‐years‐old). 6 patients were males; 2 were females. Five patients were asymptomatic with a positive reaction for fecal occult blood; the other 2 had anal bleeding. All but 1 patient were diagnosed as having the IIa+IIc type of cancerous lesion, by barium enema examination and colonoscopy. Five patients had lesions in the sigmoid colon, 2 had lesions in the rectum, and 1 had a lesion in the ascending colon. The maximum lesion diameters ranged from 5 to 25 mm, averaging 15.9 mm. Six lesions were less than 20 mm in maximum diameter; 3 of these were less than 10 mm. Pathologically, 5 cases were moderately differentiated adenocarcinoma, 2 were well differentiated adenocarcinoma, and one was poorly differentiated adenocarcinoma. None of the lesions had a coexisting adenomatous component. The incidence of lymph node metastasis was considerably higher than expected (2 out of 8 cases) for early invasive colorectal cancer.Our results suggest that the deep invasion type of early colorectal cancers (which probably arise de novo) are, though small as a rule, considered to have great potential to be malignant.

Deep cerebral infarcts in the People's Republic of China.

We reviewed computed tomograms and clinical characteristics for 1,124 consecutive stroke patients from Shanghai, People's Republic of China. While there were many similarities between lacunar syndromes in these patients and patients from Europe and the United States, several differences were noted. Deep cerebral infarcts identified by computed tomography were more common in patients from Shanghai and accounted for 27% of all ischemic infarcts. Small deep infarcts occurred more commonly in women from Shanghai (44%) than in women from the West. Deep cerebral infarcts in patients from Shanghai were larger than those usually seen in patients from the West. The mean infarct volume in patients from Shanghai was 2.4 ml, and 49% were giant lacunes (greater than 15 mm in maximal diameter).

Ａｐａｔｉｔｅ ｃｅｒａｍｉｃｓを用いた歯内骨内インプラントに関する実験的研究

The purpose of this study was to investigate the possibility of applying hydroxyapatite ceramics as endodontic-endosseous implants. The upper medial incisors of 3 monkeys (Macaca fuscatae) were used. To prepare the implant cavity, the teeth were extracted and drilled from the apex by steel burns under water-cooling. Then, dense hydroxyapatite implants, 10mm in length, 2mm in maximum diameter and 1/20 tapered, were inserted into the cavity to have the implant project 3-4mm above the apex. When the teeth with the implants were replanted, the bone around the apex was removed. The teeth were splinted to the neighbouring teeth for 1 month. Five months after the operation, the specimens were taken out and fixed by 10% formalin alcohol. They were embedded in polyester resin and undecalcified sections were prepared. The sections were stained with toluidine blue and observed under light microscope. 1) At 5 months, no ankylosis between the tooth and the surrounding alveolar bone was observed. 2) There was newly formed hard tissue which extended from the cementum, on the surface of the implant. 3) Fiber bundles were observed around the implants which connected the newly formed hard tissue to the surrounding bone tissue. The results suggest that the application of hydroxyapatite ceramics as an endodontic-endosseous implant is effective.

Renal Adenoma

We report the results of clinicopathological and histochemical studies on 64 renal adenomas found in 22 patients. We selected typical renal adenomas for these studies, discarding borderline lesions. The ages of the patients ranged from 42 to 84 years, with an average of 61 years. Male to female sex ratio was 6.3:1. The background conditions included renal cell carcinoma, long‐term dialysis, chronic glomerulonephritis, pyelonephritis, hydronephrosis and polycystic kidney. The sizes of the tumors ranged from 0.1 to 2.3 mm in maximum diameter, with an average of 0.9 mm. All the tumors were located in the cortex, especially in the superficial one‐third. The cytoplasm of the tujntfr celis vtas predominantly eosinophilic, and the tumor structure Was predominantly papillary. Histochemical study of IS adenomas from 13 patients demonstrated that all of the adenomas were positive for EMA, and for at least one marker of the distal tubulus, i.e., DBA, PNA, SBA and PKK1, and that 9 adenomas/ were positive for at /east one marker of the proximal tubulus, i.e., LM1 and/LTA. Renal adenomas had predominant histochemical features of the distal tubulus, suggesting differentiation to a distal tubulus‐like histology. Acta Pathol Jpn 39: 731 736, 1989.

Surgical approach to early gastric cancer with lymph node metastasis

The clinicopathology of our series of patients (n = 486) with early gastric cancer was reviewed with special reference to metastasis to the regional lymph nodes. The incidence of lymph node metastasis was 15.8% (19/120) in patients with the protruded type of carcinoma and 11.7% (42/360) in patients with the depressed type of carcinoma. It was especially high in carcinomas of the IIa + IIc type of the former group. The incidence of lymph node involvement was higher in the group with larger tumors (greater than 30 mm) than in the group with smaller tumors (less than or equal to 30 mm). Metastatic lesions were detected in as many as 25.0% (16/64) of the cases with large tumors (greater than or equal to 50 mm); however, of the 46 cases with small tumors (less than 10 mm), 1 case had metastases to the nodes of group 1. There were 4 cases of m-cancer with metastasis to group 1 lymph nodes. Skip metastasis to group 2 lymph nodes was discovered in 4 cases. From these results, we feel that the standard operation for early gastric cancer is R2-gastrectomy including the complete removal of group 1 and 2 lymph nodes. R1-gastrectomy or local resection is thought to be sufficient for m-cancer with a lesion smaller than 10 mm in maximum diameter.

CT Appearance of Right Gonadal Vein

The CT appearance of the right gonadal vein was studied. It is usually first seen 1 cm below the bifurcation of the inferior vena cava (IVC) and empties into the IVC laterally or anterolaterally 4 cm below the union of the right renal vein and IVC. Occasionally, it empties into an accessory right renal vein rather than the IVC. The right gonadal vein was visualized partially or completely in 80% of patients, and generally measured less than or equal to 4 mm in maximum diameter. It was enlarged in a patient with portal hypertension and in a post-partum woman. Knowledge of its typical CT appearance should prevent confusion with abdominopelvic lymph nodes.

Solid cell nests of the thyroid.

The ultimobranchial thyroid solid cell nests (SCN), irregular structures of about 1 mm in maximal diameter, are usually found in the middle third of the thyroid lateral lobes. SCN are basically composed of non-keratinizing epidermoid cells which lack intercellular bridges and are immunohistochemically positive for a panel of high and low molecular weight keratin proteins, as well as for carcinoembryonic antigen. In addition, SCN display isolated or grouped peripheral calcitonin-immunoreactive 'clear' (C) cells in up to 54 per cent of cases. The SCN central lumen, when present, is usually surrounded by mucinous cells; in addition, it may contain desquamated cells, cell debris, acid mucosubstances, characteristic PAS-positive granular material after diastase treatment, and colloid-like material. The so-called mixed follicles, structures lined by epidermoid cells of SCN and follicular epithelium, are often found as an additional component of the ultimobranchial remnants. The relationship of SCN to thyroid parenchymal cells and the probable implications of the thyroid 'ultimobranchial system' to tumour histogenesis are analysed. Pitfalls that may emerge with regard to SCN in practical pathological approaches are emphasized.

Acute appendicitis: sonographic criteria based on 250 cases.

Two hundred and fifty consecutive patients with suspected appendicitis were examined with graded compression sonography. The initial diagnostic criterion for appendicitis was visualization of a noncompressible appendix; this was later modified to include the dimensions of the visualized appendix. The appendix was visualized in 91 of 250 patients (36%). Five adult patients with sonographically visible appendixes that were 6 mm or less in maximal diameter had either benign clinical follow-up (three patients) or a histologically normal appendix removed at surgery (two patients). However, two patients with appendixes measuring 6 mm in diameter and multiple appendicoliths had surgically confirmed acute appendicitis. Of 84 patients with visible appendixes measuring greater than 6 mm in maximal diameter, 78 had surgically confirmed acute appendicitis. In the remaining six, symptoms resolved spontaneously, and no surgery was required. In the absence of compelling clinical findings or an appendicolith, adult patients with maximal appendiceal diameters of 6 mm or less should undergo a period of close observation rather than immediate surgery. A diagnosis of appendicitis can be made in adult patients with persistent right lower quadrant pain and a visualized appendix greater than 6 mm in diameter.

MR imaging of pineal cysts.

Identification of pineal cysts with imaging modalities other than magnetic resonance (MR) has been infrequent, despite a reported autopsy incidence of as high a 40%. We recently identified 15 patients in whom pineal cysts were seen on MR. These cysts ranged from 5 to 15 mm in maximum diameter. The cyst walls were thin, usually measuring less than 2 mm. The signal characteristics of the fluid within the cysts paralleled that of CSF, although it differed somewhat in signal intensity from CSF collections in which there was pulsatile motion. All lesions were midline in location. There was no significant mass effect, although mild flattening of the superior colliculi could be seen. Two cases were operated on; at operation, typical pineal cysts were found, with one containing hemosiderin-laden proteinaceous material, which accounted for its markedly higher signal intensity. It is important that this entity be recognized so that these lesions are not confused with pineal tumors.

セラミックチップを用いた冠動脈レーザー血管形成術用レーザープローブの開発

In the laser angioplasty, our in vitro study exhibited that the advantages of contact irradiation are 1)to have small burned area around ablated area, and 2)to obtain smooth surface at ablated area. And the combination of YAG laser and contact ceramic tip was turned out to be suitable for contact irradiation laser angioplasty. For coronary artery application, it was required to develop a small head of laser probe that includes contact ceramic tip and more flexible fiber. The purpose of this study is to develop laser probe using contact ceramic tip for coronary laser angioplasty. In order to develop new probe, following points were improved. 1)Probe is disposable. 2)Contact.ceramic tip is not exchangable. 3)Most flexible quartz fiber with 400um diameter is used. 4)Frosting is processed at irradiating end of contact ceramic tip for easy carbonization at the point. The new probe had a head with 1.7mm in maximum diameter and 11mm long. This probe was evaluated in female rabbit's atherosclerosing aorta made by high cholesterol diet. Atheroma was well ablated with less power (YAG laser with 25-30W ) in frosting than non-processing. This probe could go through inside of PTCA catheter. So, coronary application will be expected.

Neurogenic Tumors in Coho Salmon (<italic>Oncorhynchus kisutch</italic>) Reared in Well Water in Japan<xref ref-type="fn" rid="FN1">2</xref>

Neurogenic tumors were found protruding from various parts of the body of 23 coho salmon. The tumor-bearing fish were first- or second-generation fish derived from eggs imported at the eyed stage to Japan from the United States. Twenty-two of the tumors were in young adults and varied from 14 to 80 mm in maximum diameter. Histologically, the tumors were composed of spindle-shaped cells with abundant fibrous stroma. One tumor showed typical nuclear palisading. All tumors in young adults invaded locally muscle and adipose tissues. These tumors were similar in histologic appearance to malignant schwannomas in humans. One tumor found in a fingerling coho salmon was identified as an ependymoblastoma. The Vectstain avidin-biotin-peroxidase complex immunoperoxidase staining procedure for S-100 protein revealed that the S-100 protein existed in an ependymoblastoma and in areas of typical nuclear palisading in a malignant schwannoma in coho salmon. The occurrence of soft tissue tumors in coho salmon was first recorded in Japan. The morphology and etiology of the present cases were compared with those of the tumors in salmon reported from the United States. Judging from the conditions in which the fish were reared, the development of these tumors was not related to halogenated compounds formed during water chlorination, as suggested previously. The environmental factor(s) responsible for their development has not yet been identified, and genetic influences may have been a contributory factor.

Significance of intracranial aneurysms associated with moyamoya disease. (Part II). Cause and site of hemorrhage--review of the literature

The intracranial aneurysms associated with Moyamoya disease were analyzed on the basis of the origin and location of the hemorrhage. The study was performed using 41 cases collected from the literature including a case of the authors' own. Of the 41, 27 were cases of bilateral Moyamoya disease with intracranial hemorrhage, 9 of unilateral Moyamoya disease, and 5 of unidentified Moyamoya disease, in which it remained unknown whether the Moyamoya vessel was unilateral or bilateral. This report used the diagnostic criteria adopted by the research team of the Japanese Ministry of Health and Welfare for the Moyamoya disease. The definition of the aneurysm was limited to one with a size greater than 1 mm in maximum diameter, confirmed by angiography, operation, or autopsy. Among the 13 cases of Moyamoya disease with major artery aneurysms, the origin of the hemorrhage was the aneurysm in 3 cases, Moyamoya vessels in 3, and unknown in 7. Primary subarachnoid hemorrhage (SAH) occurred in all the cases in which aneurysm was the origin of the hemorrhage. Of the 14 Moyamoya disease cases with peripheral artery aneurysms, the origin of the hemorrhage was aneurysm in 6 cases, Moyamoya vessels in 1, and unknown in 7. Intracerebral or intraventricular hemorrhage occurred in all the 6 cases in which the origin of hemorrhage was peripheral artery aneurysm. These findings suggested that the original hemorrhage was caused as a result of a rupture of the intracranial aneurysm with the Moyamoya disease and they were divided into three groups according to the hemorrhage site: 1) major artery aneurysms which caused the primary SAH just like the usual saccular aneurysms, 2) basal ganglia aneurysms which caused intracerebral or intraventricular hemorrhage, and 3) other anastomotic vessel aneurysms which might cause the primary SAH, though not previously reported. It was also assumed that in the Moyamoya disease without the aneurysm or with the unruptured aneurysm, the intracranial hemorrhage occurred as a result of a rupture of the peripheral portion of the perforating artery which constituted the Moyamoya vessels, and the hemorrhage was located in the intracerebral or intraventricular regions.

The Morphology and Reproductive Biology of the Sigillarian Cone Mazocarpon

Two new species of the sigillarian cone Mazocarpon were discovered in Late Pennsylvanian sediments of the Appalachian Basin. Mazocarpon villosum sp. nov. represents a megasporangiate cone 22 mm in maximum diameter and 15-20 cm long with helically arranged slipper-shaped sporophylls. Distally, sporophylls extend upward into a long lamina and downward into a broad abaxial heel, both of which are highly convoluted and bear numerous uni- and multiseriate hairs. Sporangia from the central and lower levels of the cone are empty; those near the apex contain numerous immature or abortive megaspores. The most apical specimen illustrates an ontogenetic stage previously unknown for this genus. A second species, Mazocarpon bensonii sp. nov., is a megasporangiate cone ca. 10 mm in diameter Sporophylls intergrade morphologically with sterile leaves of the peduncle and are characterized by long lateral laminae, a lobed, glabrous abaxial heel, and an upturned lamina. Megaspores identified as Laevigatosporites are found within the sporangia of the cone, dispersed sporangial fragments, and isolated in the coal ball matrix, and they frequently contain cellular megagametophytes.

CORDAIANTHUS DUQUESNENSIS SP. NOV., ANATOMICALLY PRESERVED OVULATE CONES FROM THE UPPER PENNSYLVANIAN OF OHIO

Four anatomically preserved cordaitean cones have been discovered in Upper Pennsylvanian sediments of Ohio, and these provide evidence for the description of Cordaianthus duquesnensis sp. nov. Specimens consist of isolated shoots. Each exhibits sterile scales, ovule‐bearing scales and scales from which ovules have apparently abscised. Cones are up to 5.5 mm long and 2.2 mm in maximum diameter, with fertile scales restricted to the distal region. Ovules occur singly at the tip of fertile scales and all are either immature or abortive. A comparison of scales and ovules at the apex with those in progressively more proximal regions forms the basis for interpreting several features of cone and ovule ontogeny.

Cordaianthus duquesnensis sp. nov., Anatomically Preserved Ovulate Cones from the Upper Pennsylvanian of Ohio

Four anatomically preserved cordaitean cones have been discovered in Upper Pennsylvanian sediments of Ohio, and these provide evidence for the description of Cordaianthus duquesnensis sp. nov. Specimens consist of isolated shoots. Each exhibits sterile scales, ovule-bearing scales and scales from which ovules have apparently abscised. Cones are up to 5.5 mm long and 2.2 mm in maximum diameter, with fertile scales restricted to the distal region. Ovules occur singly at the tip of fertile scales and all are either immature or abortive. A comparison of scales and ovules at the apex with those in progressively more proximal regions forms the basis for interpreting several features of cone and ovule ontogeny.

Doneggia complura gen. et sp. nov., a filicalean fern from the Upper Pennsylvanian of Ohio

The recent discovery of numerous permineralized frond segments in Upper Pennsylvanian sediments provides an opportunity to describe a new genus of the Sermayaceae and further enhance our knowledge of Paleozoic filicaleans. Specimens of Doneggia complura gen. et sp. nov. consist of up to three orders of biseriately branched frond segments with abaxial curvature of the vascular strand in proximal pinnae and large sori of superficially borne sporangia on laminar pinnules. Sori occur on pinnule lobes below vascular bundles and consist of about 25–35 sporangia. Individual sporangia are oblong, 0.6 mm long and 0.45 mm in maximum diameter, and are attached by a short stalk. As in Sermaya, the horizontal–oblique annulus consists of two rows of interfingering cells and is interrupted at one side by a narrow band of longitudinally oriented, thin-walled cells that presumably acts as a zone of dehiscence. Also, as in Sermaya, the vascular bundles have adaxially disposed protoxylem strands and crowded bordered pits on walls of the metaxylem tracheids. Spores are radial, trilete, triangular in polar view, and measure 45–63 μm in diameter. Material of this type helps demonstrate that some taxa that are currently assigned to the Coenopteridales actually represent vegetative organs of Paleozoic filicaleans.

Two Cases with Minutes Early Gastric Cancer Detected by Lavage Cytology

Two cases of gastric carcinoma which were as small as not more than 2mm and 1mm in maximum diameter and which were confined to the gastric mucosa, respectively, were found by protease lavage cytologic diagnosis. These cases have been presented, with special reference to the courses of their diagnoses. Clinico-pathologic problems in the diagnosis of minor gastric carcinomas difficult to grossly distinguish have been discussed.