Nine cases of acute gastric anisakiasis.

From 1983 to 1988, we treated 19 patients with acute gastritis which was highly suggestive of gastritis anisakiasis. Almost all of these patients complained of sharp, periodic, upper abdominal pains which occurred several hours after ingestion of raw fish. Among the 19 patients, 10 anisakis larvae from nine patients were successfully removed by endoscopic forceps. However, in the remaining 10 patients, who also showed the typical clinical course of anisakiasis, we could not find the anisakis larvae endoscopically. All 10 larvae were identified as stage III, anisakis type 1. The intolerable pain was relieved as soon as endoscopic removal of the larvae was accomplished in all nine patients. The purpose of this article was to report the clinical findings and emphasize the importance of early endoscopic management of acute gastric anisakiasis.

The acceleration of cosmic-ray protons in the supernova remnant RX J1713.7-3946.

Protons with energies up to approximately 10(15) eV are the main component of cosmic rays, but evidence for the specific locations where they could have been accelerated to these energies has been lacking. Electrons are known to be accelerated to cosmic-ray energies in supernova remnants, and the shock waves associated with such remnants, when they hit the surrounding interstellar medium, could also provide the energy to accelerate protons. The signature of such a process would be the decay of pions (pi(0)), which are generated when the protons collide with atoms and molecules in an interstellar cloud: pion decay results in gamma-rays with a particular spectral-energy distribution. Here we report the observation of cascade showers of optical photons resulting from gamma-rays at energies of approximately 10(12) eV hitting Earth's upper atmosphere, in the direction of the supernova remnant RX J1713.7-3946. The spectrum is a good match to that predicted by pion decay, and cannot be explained by other mechanisms.