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An unusual case of focal nodular hyperplasia (FNH) of the liver is presented. A 31-year-old male was admitted to our hospital for the evaluation of an hepatic mass 10 cm in diameter located in segment 4. Routine examinations including liver function tests were all normal. Hepatitis B surface antigen, hepatitis C virus antibody, alpha-fetoprotein were all negative. Imagining studies could not detect specific findings of FNH such as a central scar structure or a spoke-wheel appearance due to dilated tumor vessels coursing centrally followed by radiating peripheral coursing vessels. Extensive left lobectomy of the liver was performed. Histological examination of the specimen cut into 1-cm-thick slices revealed no central stellate scars. Preoperative diagnosis of FNH with imaging studies was difficult because of the absence of central scars.

A 67-year-old female was admitted with diarrhea. Preoperatively, we diagnosed intussusception due to malignant lymphoma in the ileocecal region by image and colonoscopic examinations. We resected the right hemicolon for the tumor, which was located mainly in the cecum, causing intussusception. The stenotic terminal ileum free of the tumor was invaginated within the cecum with infiltrating tumor, thus showing the appearance of an anthill. The growth of the tumor corresponded with Wood's constrictive type, in which intussusception rarely occurs.

A 52 year-old woman with systemic amyloidosis complicated with multiple myeloma died suddenly of intraperitoneal hemorrhage due to spontaneous rupture of the spleen and liver. Autopsy revealed multiple myeloma involving the bone marrow and diffuse amyloidosis involving the liver, spleen, kidneys, heart, bone marrow, lymph nodes, lungs, gastrointestinal tract, thyroid, skin and adrenal glands. The splenic red pulp and the hepatic parenchyma were replaced by masses of amyloid. Amyloid deposits were also numerous in the walls of blood vessels and linearly in the intracapsular regions of both the liver and spleen. This is the eighth case of spontaneous rupture of the spleen and the second case of spontaneous rupture of the liver in association with systemic amyloidosis.

Four stages of gastric ulcer healing have been established by correlating endoscopic findings with those obtained from stereoscopic microscopy and histologic observations: I. initial healing stage; II. proliferative healing stage; III. palisade scar stage; IV. cobblestone scar stage. The palisade scar and cobble stone scar stages roughly correspond to Sakita's red and white scar stages, respectively. It is suggested that healing is not complete until the cobblestone stage with attendant micropit formation is achieved.

A randomized controlled clinical study was conducted to determine (a) whether basic aluminum sucrose sulfate (sucralfate) is effective in preventing or reducing gastric ulcer recurrence, and (b) the clinical parameters contributing to ulcer recurrence after endoscopically proved healing has been effected. A total of 167 patients were assigned on a random basis to either of two treatment groups, control (aluminum hydroxide and magnesium oxide) or sucralfate, and given these medications for 6 months. At the end of this period all medication was withdrawn from both groups and the patients were followed for an additional 12 months. Each patient was examined endoscopically at bimonthly intervals throughout the 18-month observation period. Treatment (sucralfate), ulcer history, size of previous ulcer(s), prestudy healing time, and prestudy healing stage attained (red or white scarring) were associated with a significant reduction in recurrence rate. Ulcer recurrence was markedly reduced in sucralfate patients as compared to control when the pretreatment ulcers had healed slowly (P less than 0.001).