Endoscopic findings and clinical manifestation of gastric anisakiasis

OBJECTIVES

To identify the endoscopic findings and clinical manifestations of anisakiasis, we studied 87 cases of gastric anisakiasis.

METHODS

Patient information was analyzed by means of patient records. The interval between the day of intake of Anisakis and endoscopic examination was determined in 86 cases. Then the endoscopic findings of each interval were elucidated.

RESULTS

Moderate to severe gastric mucosal edema tends to occur within 1 or 2 days after Anisakis infection, accompanied by leukocytosis. As to the sites of penetration of Anisakis, 55% of cases were found in the greater curvature with severe mucosal edema. Among 87 cases, four patients experienced anisakiasis twice during the interval examined, and six patients had past histories of anisakiasis before the investigated interval.

CONCLUSIONS

Gastric anisakiasis may be caused by an allergic reaction to the Anisakis antigen. There is a classic relationship between clinical and endoscopic findings and the interval after Anisakis administration. Anisakis usually is found in the greater curvature.

[Humoral immunity and lymphocyte subsets in patients with dilated cardiomyopathy]

We examined immunological abnormalities in patients with dilated cardiomyopathy (DCM) and reviewed their medical histories, NYHA classifications, electrocardiogram findings and chest X-Ray findings with regard to severity of DCM. Elevated CD4/CD8 ratio as well as decreased number of CD8 cells in lymphocyte subsets was recognized. These abnormalities were particularly noted in patients with past history of myocarditis. NYHA IV class increases in CTR and left ventricular dimension, and a reduced ejection fraction. These findings suggest that lasting of myocardial damage causes immunological abnormalities and the examination of DCM patients' immunological status is useful in anticipating disease process and determining medical treatment.

Trends in right and left-sided colon cancer

The increasing ratio of proximal to distal colorectal carcinomas was confirmed in this population-based study of 668 new cases diagnosed among Rochester, Minnesota residents between 1940 and 1979. The change was due to a rise in the incidence of proximal lesions (from 15.1 per 100,000 person-years in 1940-59 to 17.3 per 100,000 in 1960-79) and a simultaneous fall in the incidence of distal lesions (from 35.5 to 28.2 per 100,000 person-years). Changes in definitions or referral patterns played no role in these observations, although improved diagnostic capabilities may have had an impact on the incidence of proximal lesions. These discrepant changes in incidence strongly suggest that proximal and distal colonic cancers are different diseases or have a different pathogenesis. The changing incidence rates were not associated with consistent differences in clinical characteristics at the time of initial diagnosis.