Exploratory eye movement (EEM) dysfunction during visual recognition has been reported to be specific to schizophrenia. To elucidate the relationship between EEM dysfunction and individual schizophrenic symptoms, we conducted the EEM test, consisting of retention and comparison tasks, together with a detailed symptomatic evaluation using the Positive and Negative Syndrome Scale (PANSS) in 76 schizophrenics. Total eye scanning length (TESL) during the retention task and responsive search score (RSS) during the comparison task were used as the EEM parameter. The subjects were dichotomized at the median of the TESL (good vs. poor TESL groups) and that of the RSS (good vs. poor RSS groups). The PANSS individual symptom scales were examined between the good and poor groups. We found that negative symptoms of PANSS were more severe in the poor TESL group and the poor RSS group compared with the good groups, but that positive symptoms did not differ between good and poor EEM groups. Given that EEM is controlled in the frontal lobe, these results suggest a functional relationship between negative symptoms and frontal lobe dysfunction in schizophrenia.
Background: This classic article is a translation with commentary of a seminal treatise on the status of surgery for peripheral nerve sheath tumors in the “early Meiji period” of Japan. It was during the Meiji period in the 19th century that modern medicine, even surgery for the nerve tumors, was introduced to our country. This allowed differences between Japanese and Western medicine to be investigated. Methods: “Geka setsuyaku” (Surgery Theory) was published as a textbook by Tadanori Ishiguro in 1873. This surgical text was written with reference to the works of Heschl, Gross, Stromeyer and Roser. “Shinkei ryu” (nerve mass) was described as being derived from a nerve sheath, with illustration of the resected nerve mass. We have researched the background factors contributing to understanding of such nerve masses during historical times. Results: The neuromatous tumor described in Gross′s surgery text corresponded to the nerve mass illustrations presented in Surgery Theory here in Japan. Tumor resection included a portion of the nervous system, based on medical practices available during the time period that this classic text was in use. Conclusion: This textbook has been key to the development of modern medicine. Our country was greatly influenced, particularly by Western medical theory and practice, during the “early Meiji period”.
We experienced a case of early breast cancer that was discovered during a population-based breast cancer screening. A 50-year-old woman visited our hospital, after she was made aware of an abnormality during breast cancer screening. We were not able to detect any tumors on her breast. Mammography showed grouped microcalcifications in the M area of her left breast. Ultrasonography did not show any lesion. We attempted vacuumassisted breast biopsy (VAB) to diagnose the lesion. However, VAB was not effective because her breast was too thin. We subsequently performed surgical biopsy. Since it was difficult to determine the biopsy site, because intra-operative ultrasonography could not reveal the lesion, we guessed on the location of the lesion. The histopathological diagnosis was invasive ductal carcinoma. Breast conserving surgery and axillary lymph node dissection were performed. This case suggests that surgical biopsy is necessary to diagnose a lesion in which VAB is not successful.
We experienced a case of invasive micropapillary carcinoma of the breast that was treated using neo-adjuvant chemotherapy. The chemotherapy resulted in a partial response. A 60-year-old woman presented with the complaint of a left breast lump. Ultrasonography detected a heterogeneous mass, 35 mm in diameter, in the C area of her left breast. Swelling of the axillary lymph nodes was noted. A core needle biopsy was performed. The pathological diagnosis was an invasive micropapillary carcinoma (IMPC), negative for estrogen receptor and progesterone receptor, positive for HER2 protein. We administered neo-adjuvant chemotherapy, which resulted in a partial response (response rate was 60.0%). Muscle-preserving mastectomy and axillary lymph node dissection were performed. The histological diagnosis after the chemotherapy was Grade 2a. Five years since the surgery, the patient continues to be well with no metastases.
We report a case of breast cancer after breast augmentation. The patient was a 95-year-old woman who had undergone breast augmentation surgery 50 years ago. A palpable left breast tumor (7 cm in diameter) was observed with red skin. Ultrasonography and MRI revealed a 7 cm diameter mass. The time-intensity curve from contrastenhanced MRI suggested malignancy. A core needle biopsy of the tumor led to the diagnosis of invasive ductal carcinoma. She underwent mastectomy under local anesthesia. The patient was elderly and her respiratory function showed restrictive ventilatory impairment. Breast cancer after augmentation mammaplasty is difficult to discover. In such cases, advanced cancer is often discovered. Our case supports that patients who have undergone augmentation mammaplasty should perform breast cancer screening regularly.
Peritoneal metastasis is a relatively rare manifestation of metastasis from hepatocellular carcinoma. The prognosis of peritoneal metastasis is generally poor, because multiple metastases can occur. It has been reported that hepatocellular carcinoma can be treated with balloon-occluded transarterial chemoembolization. However, there have been no reports of the treatment of peritoneal metastasis from hepatocellular carcinoma with transarterial chemoembolization. A 65-year-old man had a history of partial hepatic resection of segment 8 for hepatocellular carcinoma. At that time, a percutaneous tumor biopsy was performed. Follow up computed tomography showed hepatocellular carcinoma in segment 4, and peritoneal metastasis. Therefore, the patient was admitted for treatment of the hepatocellular carcinoma and its peritoneal metastasis. The feeding arteries to the peritoneal metastasis were identified and treated with balloon-occluded transarterial chemoembolization. Two months after transarterial chemoembolization, contrast-enhanced computed tomography showed greater than 50% tumor necrosis.