[The Origin of the Disorder Named "Ryoku-naisho (Glaucoma)"].

It is said that the description of an ocular disorder related to the color of the sea in the Hippocratic Corpus is the oldest medical reference to glaucoma. In the early Edo period in Japan, the Books of Secrets of the Majima school, describe a disorder called aosokohi. This nomenclature is believed to be based upon the Five Elements' Theory (Wu-Xing Thought)in ancient China, which assigned five colors for intraocular disorders ("naisho/sokohi" in Japanese), blue ("ao" in Japanese), red, yellow, white and black. In Japanese literature, in late Edo period, "ryokunaisho (glaucoma)" appeared after the publication of Dutch-Japanese translation by Dutch scholars. The Japanese name is thought to derive trom "Glaukos" which means green in ancient Greek. Since the Meiji period, "ryoku-naisho (glaucoma)" has been used inmost textbooks including those by foreign teachers and the works of Jujiro Komoto, the first Professor at the Department of Ophthalmology of (Tokyo)Imperial University.

Application of a 70-Gene Expression Profile to Japanese Breast Cancer Patients.

BACKGROUND: As data on using MammaPrint®, a 70-gene expression profile for molecular subtyping of breast cancer, are limited in Japanese patients, we aimed to determine the gene profiles of Japanese patients using MammaPrint and to investigate its possible clinical application for selecting adjuvant treatments. PATIENTS AND METHODS: 50 women treated surgically at our institution were examined. The MammaPrint results were compared with the St Gallen 2007 and intrinsic subtype risk categorizations. RESULTS: Of 38 cases judged to be at intermediate risk based on the St Gallen 2007 Consensus, 11 (29%) were in the high-risk group based on MammaPrint. 1 of the 30 luminal A-like tumors (3%) was judged as high risk based on MammaPrint results, whereas 7 of the 20 tumors (35%) categorized as luminal B-like or triple negative were in the low-risk group. There have been no recurrences to date in the MammaPrint group, and this is possibly attributable to most of the high-risk patients receiving chemotherapy that had been recommended on the basis of their MammaPrint results. CONCLUSIONS: Our results indicate that MammaPrint is applicable to Japanese patients and that it is of potential value in current clinical practice for devising individualized treatments.

Apocrine gland carcinoma of the mammary skin concomitant with pagetoid phenomenon.

We reported a 52-year-old woman with an apocrine gland carcinoma of the mammary skin concomitant with pagetoid phenomenon. She had a 23-year history of a small nodular lesion on the lower left part of her right breast with a 1-year history of the pigmented plaque spreading peripherally around the nodule. Our diagnosis revealed that the nodule was an apocrine gland carcinoma and the intraepidermal neoplastic cells with pagetoid spread in the pigmented plaque were derived from the apocrine gland carcinoma. No Paget's cells were detected in the right nipple, and no tumor cells were observed in the sentinel lymph node and underlying mammary gland tissue. We also investigated the immunohistochemical changes in this case. They showed that both intraepidermal neoplastic cells with pagetoid spread and tumor cells of the apocrine gland carcinoma were positive with cytokeratin-7 and human epidermal growth factor receptor-2 (HER-2)/neu overexpression. The results of the present study conclude that the intraepithelial spread of tumor cells in the mammary skin distant from the nipple occurred as a pagetoid phenomenon, and that HER-2 may have a key role in pagetoid phenomenon of an underlying apocrine gland carcinoma, as well as in mammary Paget's disease.

Diffuse pulmonary hemorrhage as a fatal complication of Schönlein-Henoch purpura.

We report a case of a 69-year-old man with Schönlein-Henoch purpura who developed diffuse pulmonary hemorrhage. He complained of dyspnea and hemoptysis while he was treated with steroids for gastroenteropathy associated with Schönlein-Henoch purpura. The drop in his hemoglobin levels and diffuse ground-glass opacity at all levels of the lung fields on chest computed tomography were a significant clue to diagnosis. Despite pulse therapy, no clinical improvement of the lung was achieved, and he died on the 36th day after the admission. Although the combination of the corticosteroid and immunosuppressive agents is normally recommended, diffuse pulmonary hemorrhage could become a fatal complication in elderly Schönlein-Henoch patients.

Subungual glomus tumour: evaluation of ultrasound imaging in preoperative assessment.

For an evaluation of the preoperative assessment of subungual glomus tumours, a non-invasive examination of the lesion is desirable. Previous studies, however, have not clearly demonstrated these findings. We examined two cases of subungual glomus tumours and applied the approximately 5-14 MHz broadband B-mode and C-mode ultrasound imaging methods combined with Color Doppler imaging (CDI) and B-flow imaging (BFI) to clarify the significance of the preoperative assessment. We confirmed the tumour's localization, size and depth, using B-mode and C-mode imaging; and tumour vascularity using CDI and BFI. BFI is a newly developed ultrasound technique that enhances the B-mode imaging quality of the blood flow, including high-frame-rate and high-spatial-resolution imagings. BFI revealed the exact fine blood vessels within the subungual small tumour with no blooming compared to CDI. Our results indicate that these ultrasound scanning imagings are non-invasive and nonionizing evaluation methods, and that an accurate preoperative diagnosis using these methods will result in more effective surgical excision and relief.