Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 25, Issue 3
Displaying 1-17 of 17 articles from this issue
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Contents
  • Diagnosis of Breast Cancer by Mammography
    HIROKUNI HIRATA
    1979 Volume 25 Issue 3 Pages 293-317
    Published: September 10, 1979
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.25.293
    JOURNAL FREE ACCESS
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    The purpose of this study is to establish an objective and reliable method of the determination of malignancy by mammography. The preoperative mammograms were analysed and the findings were scored according to the rate of each abnormality. The histopathological findings were compared to the mammographical ones. One hundred and fourty-six patients with primary breast cancer and 84 individuals with negative (or benign) biopsy were subjected for this study. 1. Mammographical findings. The rate of each malignant feature on the mammograms were as follows : increased radiodensity (80.1%), irregular radiodensity (78.1%), margin irregularity or spicula (69.9%), Leborgne's law (43.2%), fine calcification (24.7%), comet sign (17.1%), retraction of the supporting ligament (41.8%), dilatation of the vessels or hypervascularization (36.3%) and thickening of the skin (11.1%). For determination of the tumor malignancy those abnormalities appearing around the tumor margin seemed to be highly pathognomonic. Details of the soft x-ray films of large slices of a resected specimen were also studied. 2. Histopathological findings. Increased and irregular radiodensity was highly correlated with population of both tumor cells and stroma cells as well as occurrence of necrosis or degeneration of stroma cells. The former findings were proved by the fact that the higher was the rate of stroma cells in a specimen, the more increase the radiodensity on films. The spicula and the comet sign immediately representetd infiltration of scirrhous cells into adjacent fat tissues or into ductus. Retraction of the supporting ligament was produced by carcinoma infiltration with more or less proliferation of fibrous connective tissue. Thickening of skin layer observed on mammogram was due not only to the dermis thickening but evenly to that of subcutaneous tissues. 3. Scoring of the mammographical findings. For rate of each abnormality, such as increased radiodensity, irregular radiodensity, margin irregularity (or spicula), Leborgne's law, fine calcification and comet sign, which were all a sign directing to malignancy, the score ranging from points 6 to point 1 was given. Those findings which may be indirect sign of malignancy were evaluated with the score from points 3 to point 1. They were retraction of the supporting ligament, dilatation of the vessels or hypervascularization and thickening of the skin, respectively. This method of scoring was a good measure to the determination of the malignancy of a breast cancer.
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  • Retrospective Analyses of Mis-Diagnosed Breast Carcinoma, A Review of the Mammograms and Pathology
    TSUYOSHI SAKURAI, TAKASHI KAWAGUCHI, HITOSHI KATAYAMA, NORIYUKI KUWABA ...
    1979 Volume 25 Issue 3 Pages 318-326
    Published: September 10, 1979
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.25.318
    JOURNAL FREE ACCESS
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    One thousand and six hundred cases of mammographies were performed at Juntendo University Hospital from March 1974 through August 1977. In this study a retrospective analysis was performed on 45 mis-diagnosed cases of the breast cancer, of which histology were verified by the pathologist, one of authors. They were 23 false negative cases and 22 false positive cases. The rate of false negative was 19.5/ and that of false positive was 13.6%. The false negative cases ware divided into two groups : the one, consisted of 9 cases with no definite mass density on mammograms, and the other, consisted of 14 cases with mass density on mammograms. Mastopathy was a common mis-diagnoses for the cases without definite mass density. The mammography with inadequate compression of the breast was considered to be most responsible for mis-diagnosis. Fibroadenoma or other benign tumor was the most frequent mis-diagnoses when a mass density was present on film. It was particularly true with medullary tubular carcinoma. Out of five cases of medullary tubular carcinoma two cases were diagnosed as fibroadenoma and other two as benign tumor. Three cases out of five scirrhous carcinomas were mis-diagnosed as mastopathy. A cautious analysis of various features on the mammograms could avoid such a mis-diagnosis. In the false positive cases, also mastopnthy was the commonest mis-diagnosis. Marginal irregularity and unsharpness of the density were apt to be over-estimated as a sign of a malignancy. A phantom experiment which simulated the mommographic geometry demonstrated that the marginal unsharpness appeared at the periphery of the exposure, and this was regarded as one weak point of the mammographic unit. To reduce the mis-diagosis mentioned above multidirectional compression mammography should be made under the supervision of a radiologists.
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  • Study on Fibrinolytic Dynamics during Open Heart Surgery with Extracorporeal Circulation. Part 1. Activation System
    TOSHIMITSU KITAJIMA
    1979 Volume 25 Issue 3 Pages 327-347
    Published: September 10, 1979
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.25.327
    JOURNAL FREE ACCESS
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    The purpose of this study is to clarify the fibrinolysis in serum by open heart surgery with extracorporeal circulation. The fibrinolysis was evaluated by the determination of fibrinogen, plasminogen, plasminogen activator, a1-antitrypsin, a2macroglobulin, antithrombin III, platelet, fibrinogen/fibrin degradation products (FDP) in serum and arterial blood gas analysis in 76 patients with open heart surgery. Hypofibrinogenemia, increased plasminogen activator and FDP, decreased proactivator, al-antitrypsin, a2-macroglobulin, antithrombin III, and platelet count were characteristic during bypass. Plasminogen did not show remarkable change. Hyperfibrinogenemia and decrease of plasminogen activator were observed on the first day after surgery. From the results author suspected the phenomenon of microthrombi during bypass.
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