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A case was a 57-year-old man. Despite a diagnosis of cStage IV gastric cancer (cN2, cH0, cM0, cT3 (SE), cP1), we preferentially performed a non-curative surgery to avoid stenosis or bleeding by tumor invasion. Since no evidence of peritoneal metastasis was found at surgery, distal gastrectomy with D2 lymph node dissection was performed, and lymph nodes anterior to the pancreatic head were sampled. The pathological diagnosis was pT3 (SE), pN2, sH0, pM1 (LYM), pStage IV. After the surgery, S-1 was administered. One year and 9 months later, a solitary metastasis was found in S6 of the liver, and the patient underwent radiofrequency ablation (RFA) followed by adjuvant S-1. Currently, 5 years and 10 months after the surgery, the patient is under follow-up, and remains alive with recurrence-free. We speculate that in the presence of N or M (LYM) factors for stage IV gastric cancer, surgery with lymphadenectomy, which does not prevent the completion of adjuvant chemotherapy, followed by multimodal treatments such as continued chemotherapy and RFA, led to the long-term survival.

Foreign-body aspiration (FBA) obstructing the airways may lead to choking and cardiopulmonary arrest without immediate emergency care. We retrospectively reviewed medical records of 17 otorhinolaryngology subjects-8 men and 9 women aged 0 to 84 years-88% of whom were < 3 years old, requiring tracheobronchial FBA between January 1995 and October 2006 and of 62 emergency subjects-43 men and 19 women aged 0 to 91 years--10% of whom were < 3 yeares old 68% of whom > or = 50 years old, admitted between January 2000 and October 2006. Emergency Department personnel saw a mean of 8.9 patients per year versus the mean of 1.4 patients per year seen by Otorhinolaryngology Department personnel. Foreign bodies extracted most frequently from the 17 otorhinolaryngology patients were 9 seen for peanut injestion followed by 1 each seen for bean, screw, and false teeth injestion among other objects. Sixteen of the 17 were discharged without complications. Foreign bodies extracted from the 62 emergency patients most frequently involved food, especially rice cakes. Over half seen had already gone into cardiopulmonary arrest upon arrival and required cardiopulmonary resuscitation. Of the 62, 32 patients died, 13 were sent to another hospital after in-patient care, 9 were sent home without admission, and 7 were discharged without complications.

Acute epiglottitis causes sudden upper airway obstruction that may become lethal, and must be diagnosed and treated quickly and precisely. We review clinical features of 71-cases of acute epiglottitis in 6 years, focusing in cases requiring emergency airway management. Retrospective analysis was done for 1) age and gender, 2) month of onset, 3) symptoms, 4) smoking history, 5) diabetes history, 6) cause and background, 7) first medical institution visit, 8) duration from symptom onset to hospital visit, 9) oropharyngeal findings, 10) laryngendoscopic findings, 11) pharyngeal culture, and 12) deterioration after hospitalization. We found that 2 cases deteriorated in laryngendoscopic findings after hospitalization despite treatment. Even if the first medical findings are mild, it is necessary to respond to patients with the possibility to deterioration in mind. Five cases required emergency airway management-3 with tracheostomy and 2 cases with endotracheal intubation. If symptoms of laryngeal edema, oxygen desaturation, and dyspnea are present, emergency airway management should be prepared soon after hospitalization.

The multi-objective frequency processing installed in the FCR5000R (Fuji Film Medical) is superior to the conventional processing used in the FCR9000 (Fuji Film Medical) in evaluating frequency processing. A suitable combination of parameters for multi-frequency-processing in computed radiography (CR) mammography was evaluated. The paired-comparison method using phantom images was performed for the visual evaluation. Results showed that the evaluation score of mass and fiber lesions depended on the multi-frequency balance type (MRB) parameter, and the low-frequency-cycle emphasizing parameter had the highest score. In contrast, the score of microcalcifications depended on the degree of multi-frequency enhancement (MRE). The most suitable parameters for the multi-frequency processing of every size and type of breast lesion were not obtained. However, MRB=A, MRT=p, and MRE=1.0 can be recommend for CR mammography.

Four-hundred and seventy-seven subjects evaluated a set of traits and behaviors in terms of how masculine and feminine they were and in terms of how well they represented their real and ideal self-images. Within-individual correlation coefficients between these evaluations were proposed as measures of psychological gender schemata, because they would represent the degree of matching between the subjects' gender-image and ideal/real self-images of gender-related attributes. The present study aims at examining the construct validity of these measures, by testing them to psychological variables that are known to reflect gender identity. The individual difference variables used as criteria were (a) satisfaction with one's own sex, (b) general happiness, (c) self-esteem (d) gender-conflict, and (e) school and occupational achievement need. Correlations between the gender-schema indices and the criteria variables supported the construct validity of those measures. Advantages of the present measurement over the conventional simple trait approach, such as BSRI, or PAQ are discussed.