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We initiated a long-term and highly frequent monitoring project toward 442 methanol masers at 6.7 GHz (Dec >−30 deg) using the Hitachi 32-m radio telescope in December 2012. The observations have been carried out daily, monitoring a spectrum of each source with intervals of 9–10 days. In September 2015, the number of the target sources and intervals were redesigned into 143 and 4–5 days, respectively. This monitoring provides us complete information on how many sources show periodic flux variations in high-mass star-forming regions, which have been detected in 20 sources with periods of 29.5–668 days so far (e.g., Goedhart et al. 2004). We have already obtained new detections of periodic flux variations in 31 methanol sources with periods of 22–409 days. These periodic flux variations must be a unique tool to investigate high-mass protostars themselves and their circumstellar structure on a very tiny spatial scale of 0.1–1 au.

Astrometric Very Long Baseline Interferometry (VLBI) observations of maser sources in the Milky Way are used to map the spiral structure of our Galaxy and to determine fundamental parameters such as the rotation velocity ($\Theta_0$) and curve and the distance to the Galactic center (R$_0$). Here, we present an update on our first results, implementing a recent change in the knowledge about the Solar motion. It seems unavoidable that the IAU recommended values for R$_0$ and $\Theta_0$ need a substantial revision. In particular the combination of 8.5 kpc and 220 \kms\, can be ruled out with high confidence. Combining the maser data with the distance to the Galactic center from stellar orbits and the proper motion of Sgr\,A* gives best values of R$_0$ = 8.3 $\pm$ 0.23 kpc and $\Theta_0$ = 239 or 246 $\pm$ 7 \kms, for Solar motions of V$_ \odot$ = 12.23 and 5.25 \kms, respectively. Finally, we give an outlook to future observations in the Bar and Spiral Structure Legacy (BeSSeL) Survey., Comment: 6 pages, 3 figures. 'Highlight talk' held at the Meeting of the Astronomische Gesellschaft (2010). To be published in Reviews in Modern Astronomy, Volume 23

We have conducted VLBA phase-referencing monitoring of H2O masers around the red supergiant, S Persei, for six years. We have fitted maser motions to a simple expanding-shell model with a common annual parallax and stellar proper motion, and obtained the annual parallax as 0.413+/-0.017 mas, and the stellar proper motion as (-0.49+/-0.23 mas/yr, -1.19+/-0.20 mas/yr) in right ascension and declination, respectively. The obtained annual parallax corresponds to the trigonometric distance of 2.42+0.11-0.09 kpc. Assuming the Galactocentric distance of the Sun of 8.5 kpc, the circular rotational velocity of the LSR at the distance of the Sun of 220 km/s, and a flat Galactic rotation curve, S Persei is suggested to have a non-circular motion deviating from the Galactic circular rotation for 15 km/s, which is mainly dominated by the anti rotation direction component of 12.9+/-2.9 km/s. This red supergiant is thought to belong to the OB association, Per OB1, so that this non-circular motion is representative of a motion of the OB association in the Milky Way. This non-circular motion is somewhat larger than that explained by the standard density-wave theory for a spiral galaxy, and is attributed to either a cluster shuffling of the OB association, or to non-linear interactions between non-stationary spiral arms and multi-phase interstellar media. The latter comes from a new view of a spiral arm formation in the Milky Way suggested by recent large N-body/smoothed particle hydrodynamics numerical simulations., Comment: 28 pages, 11 figures, 5 tables, ApJ (accepted)

We have conducted the first parallax and proper motion measurements of 6.7 GHz methanol maser emission using the Australian Long Baseline Array (LBA). The parallax of G339.884$-$1.259 measured from five epochs of observations is 0.48$\pm $0.08 mas, corresponding to a distance of $2.1^{+0.4}_{-0.3}$ kpc, placing it in the Scutum spiral arm. This is consistent (within the combined uncertainty) with the kinematic distance estimate for this source at 2.5$\pm $0.5 kpc using the latest Solar and Galactic rotation parameters. We find from the Lyman continuum photon flux that the embedded core of the young star is of spectral type B1, demonstrating that luminous 6.7 GHz methanol masers can be associated with high-mass stars towards the lower end of the mass range.

We report phase-referencing VLBA observations of H2O masers near the star-forming region W3(OH) to measure their parallax and absolute proper motions. The measured annual parallax is 0.489 +/- 0.017 milli-arcseconds (2.04 +/- 0.07 kpc), where the error is dominated by a systematic atmospheric contribution. This distance is consistent with photometric distances from previous observations and with the distance determined from CH3OH maser astrometry presented in a related paper. We also find that the source driving the H2O outflow, the ``TW-object'', moves with a 3-dimensional velocity of > 7 km/s relative to the ultracompact HII region W3(OH)., 14 pages, 6 figures, accepted to ApJ

Using the Very Large Array (VLA) and the Very Long Baseline Array (VLBA), we have observed water maser emission in the proto-planetary nebula candidate IRAS 19134+2131, in which the water maser spectrum has two groups of emission features separated in radial velocity by ∼100 km s^−1. The blue-shifted and red-shifted clusters of maser features are clearly separated spatially by ∼150 mas, indicative of a fast collimated flow. However, not all of the maser features are aligned along the axis of the flow, as is seen in the similar high-velocity water maser source, W43A. Comparing the VLA and VLBA maps of the water maser source, we find 4 maser features that were active for 2 years. Using only VLBA data, we identified proper motions for 8 maser features. The full 3D outflow velocity is estimated to be ∼130 km s^−1, indicating that the dynamical age of the flow is only ∼50 yr. On the basis of the relative positions with respect to the nearby extragalactic reference source, J1925+2106, we also obtain a secular motion of IRAS 19134+2131 of μl = −4.6 ± 0.7 mas yr^−1 along the Galactic plane toward the Galactic centre. This indicates a “far distance” (≥16 kpc) for IRAS 19134+2131 if the Galactic rotation curve remains flat at 220 km s^−1. Hachisuka, Kazuya, Kazuya.Hachisuka@uv.es

We report parallaxes and proper motions of three water maser sources in high-mass star-forming regions in the Outer Spiral Arm of the Milky Way. The observations were conducted with the Very Long Baseline Array as part of Bar and Spiral Structure Legacy Survey and double the number of such measurements in the literature. The Outer Arm has a pitch angle of 14.9 +/- 2.7 deg and a Galactocentric distance of 14.1 +/- 0.6 kpc toward the Galactic anticenter. The average motion of these sources toward the Galactic center is 10.7 +/- 2.1 km/s and we see no sign of a significant fall in the rotation curve out to 15 kpc from the Galactic center. The three-dimensional locations of these star-forming regions are consistent with a Galactic warp of several hundred parsecs from the plane., Comment: 19 pages, 7 figures, Accepted for publication in ApJ

Fiber type differentiation as revealed by myosin ATPase activities and the immunological analysis of myosin light chains (MLC) by the Western blotting method were done on the postnatal rat soleus and extensor digitorum longus (EDL) muscles. In the soleus, type 1 (slow-twitch) muscle fibers gradually increase in percentage after postnatal day 10, and, in the EDL, the differentiation of type 2A and 2B (fast-twitch) muscle fibers is also pronounced between postnatal days 10 and 15. The present immunological analysis of MLC indicates that the antigenicity of LclS becomes more intense with a rapid decrease in anti-genicity of Lc2F from postnatal day 7 in the soleus, while the antigenicity of LclF becomes noticeable during the same period in the EDL. These results suggest that the differentiation of slow-twitch fibers is mainly due to that of Lc1S in the soleus and the differentiation of fast-twitch fibers is mainly due to that of Lc1F in the EDL

We performed astrometric observations with the VLBA of WB89-437, an H2O maser source in the Outer spiral arm of the Galaxy. We measure an annual parallax of 0.167 +/- 0.006 mas, corresponding to a heliocentric distance of 6.0 +/- 0.2 kpc or a Galactocentric distance of 13.4 +/- 0.2 kpc. This value for the heliocentric distance is considerably smaller than the kinematic distance of 8.6 kpc. This confirms the presence of a faint Outer arm toward l = 135 degrees. We also measured the full space motion of the object and find a large peculiar motion of ~20 km/s toward the Galactic center. This peculiar motion explains the large error in the kinematic distance estimate. We also find that WB89-437 has the same rotation speed as the LSR, providing more evidence for a flat rotation curve and thus the presence of dark matter in the outer Galaxy., Comment: The Astrophysical Journal, accepted, 16 pages, 4 Figures

We present the results of a high sensitivity survey for 6.7 GHz methanol masers towards 22 GHz water maser using the 100 m Efflesberg telescope. A total of 89 sources were observed and 10 new methanol masers were detected. The new detections are relatively faint with peak flux densities between 0.5 and 4.0 Jy. A nil detection rate from low-mass star forming regions enhances the conclusion that the masers are only associated with massive star formation. Even the faintest methanol maser in our survey, with a luminosity of 1.1 $10^{-9} L_\odot$ is associated with massive stars as inferred from its infrared luminosity., Accepted for publication in A&A

Determination of outer rotation curve using Galactic masers The rotation curve of the Galaxy is poorly determined outside the solar circle (e.g. Honma & Sofue 1997). The situation makes difficult to derive the dynamical mass of the Galaxy, which is essential for inferring the amount of Galactic dark gravitating matter. We selected Galactic masers in this study since they distributed over the whole Galaxy. Moreover, they can observed with VLBI at extremely high angular resolution, allowing a measurement of the annual parallax, and thus the source’s distance, and its proper motion due to Galactic rotation with phase referencing VLBI astrometric observation. We have already performed phase-referencing VLBA observations between Galactic water masers and adjacent extragalactic continuum sources. We succeeded to detect the annual parallax of masers in W3(OH) which are located at 2 kpc away from the Sun. This result showed the feasibility for this line astrometric observation to kpc scale in the Galaxy. Although we detected the astrometric parameters of Galactic water maser sources, this limited sample of sources is insufficient to determine the outer Galactic rotation curve. To observe other water masers with the VLBA, we searched for possible candidates to attain of our scientific goal. We observed with the VLA a survey of 36 Galactic water maser sources in the Perseus arm and will survey over 50 candidate water maser sources beyond the Perseus arm with single-dish radio-telescope.

We present VLBI maps of the 6.7 GHz methanol maser emission in 32 sources obtained using the Japanese VLBI Network (JVN) and the East-Asian VLBI Network (EAVN). All of the observed sources provide new VLBI maps, and the spatial morphologies have been classified into five categories similar to the results obtained from European VLBI Network observations (Bartkiewicz et al. 2009). The 32 methanol sources are being monitored to measure the relative proper motions of the methanol maser spots.

Immunoreactivity for desmin, plectin and alpha-actinin was investigated in rat atrophic soleus muscle fibers induced by hindlimb suspension between 1 and 4 weeks (hindlimb suspension group, HSG), and compared with that of the control group (CG). Some of the HSG for 4 weeks were allowed unrestricted cage activity for 2 weeks as the recovery group (RG). In the cross-sectioned muscle fibers of the CG, desmin and plectin showed honey-comb immunoreactive patterns extending throughout the sarcoplasm. Superimposed images by double immunofluorescence labeling showed overlapping of both immunoreactivities. In the longitudinally sectioned profiles, superimposed images of alpha-actinin and desmin were overlapped at the level of Z-discs. The focal disorganization of the above honeycomb immunoreactive patterns, followed by the reduction of the cross-sectional area (CSA) of atrophic soleus muscle fibers and the appearance of Z-streaming, uniquely arose in the HSG from the first week and extended throughout the sarcoplasm in proportion to the suspension period. Such honey-comb patterns of both desmin and plectin were already restored in the RG at 2 weeks, followed by the disappearance of Z-streaming, prior to the recovery of the CSA. These findings indicate that the disorganization of topological and structural relationships of desmin and plectin with Z-discs surrounding individual myofibrils is primarily evoked, which leads to Z-streaming of atrophic soleus muscle fibers, and that the restoration of the muscle activity results in an early arrangement recovery of desmin and plectin around myofibrils.

Postpolio syndrome (PPS) is generally defined as a clinical syndrome of new weakness, fatigue, and pain in individuals who have previously recovered from acute paralytic poliomyelitis. These new problems may lead to loss of employment as well as new deficits in instrumental activities in daily living (cleaning, washing, shopping, transportation, etc.), walking, climbing stairs, and personal assistance. We presented three cases of PPS with working disabilities in Japan, and stated the issues confronted with. Particularly at the workplace, PPS individuals need special supports from both rehabilitation medicine and occupational health services, including improved nutrition, achieving ideal body weight, regular and sensible exercise, frequent checkups, and modifying working conditions.

The purpose of this study was to examine the moisture permeability properties of materials used for total surface bearing (TSB) socket with a silicone liner, a combination of Silicone Suction Socket or Icelandic Roll-On Silicone Socket (ICEROSS) and an acrylic plastic sheet (Degaplast), patella-tendon bearing (PTB) socket, a combination of Pe-Lite and Degaplast, and wooden socket made of poplar. Moisture permeability of the socket materials was measured as the diminution of water in a container after 12 hours in a climatic chamber. Eight containers with their open, top side were uncovered (no material) or sealed with one of the socket materials; the experiment was repeated four times. One-way analysis of variance followed by Bonferroni's test was applied to examine the differences in moisture permeability. Moisture permeability levels were as follows: no material, 85.9 +/- 1.3 g; poplar, 4.3 +/- 0.4 g; Silicone Suction Socket, 1.1 +/- 0.2 g; ICEROSS, 1.0 +/- 0.2 g; Pe-Lite, 0.8 +/- 0.1 g; 3S + Degaplast, 0.8 +/- 0.1 g; ICEROSS + Degaplast, 0.8 +/- 0.2 g; and Pe-Lite + Degaplast, 0.8 +/- 0.1 g. There were significant differences between the uncovered container and the others, and between poplar and the others (P0.05). We concluded that the TSB socket with a silicone liner is not superior to the PTB socket with regard to moisture permeability, and that it is necessary to develop a new prosthetic socket that allows heat release and drainage of sweat.

The purpose of this study was to elucidate the effects of human immunodeficiency virus (HIV) on haemophiliacs with physical functional disabilities induced by haemophilia in Kyushu, Japan. The subjects were 38 adult haemophiliacs who were selected from 129 patients registered with the North Kyushu Haemophilia Centre. They were divided into 21 asymptomatic HIV-positive and 17 HIV-negative adult haemophiliacs. Coagulation factor levels, modified DePalma classification, Arthritis Impact Measurement Scale 2 (AIMS 2), and a satisfaction in daily life (SDL) questionnaire were used to investigate the clinical severity of their haemophilia and arthropathy, physical functional disabilities, and satisfaction. Although there were no significant differences in the objective assessments of health status between the HIV-positive and -negative haemophiliacs, the HIV-positive haemophiliacs were significantly more dissatisfied with their social activities and mood, according to AIMS 2, and with social intercourse, job, self-development, and social security and pension according to SDL assessment. These dissatisfactions were due to the effects of HIV, in addition to the physical functional disabilities that were caused by haemophilia. Dissatisfaction with social security and pension may be a specific feature in HIV-positive haemophiliacs in Japan resulting from the origin of HIV infection.

This study was undertaken to determine whether the direction of trunk rotation would have any effect on trunk muscle performance of post-stroke hemiplegic patients. The design consisted of a nonrandomized control trial in a setting of secondary care (rehabilitation unit at hospital facility). The subjects included 65 hemiplegic patients (50 males) and age-matched 80 healthy controls (38 females). Isokinetic trunk rotatory muscle performance at angular velocities of 60, 120, and 150 degrees per second was measured by using an isokinetic dynamometer (Cybex Torso Rotation Unit). There were no significant differences in the peak torque and best work between the right and left directions of the trunk rotation in the hemiplegic patients or in healthy controls, regardless of the gender of the subjects (paired t test, P0.05). The muscle performance of the hemiplegic patients was significantly lower than that of the controls for both genders (t test, P0.05). In the hemiplegic patients, the direction of trunk rotation does not affect the trunk rotatory muscle performance, although the performance itself was slightly decreased.

To evaluate the relationship between diabetic neuropathy and retinopathy, we examined autonomic nervous function, postural hypotension, nerve conduction velocity and coefficient of variation of R-R intervals. Forty-five non-insulin dependent diabetic cases were classified as no diabetic retinopathy (group A), simple diabetic retinopathy (group B) and proliferative diabetic retinopathy (group C). These groups did not differ in age or gender. The rate of postural hypotension (depression of systolic blood pressure over 30 mmHg) was 0% in group A, 7% in group Bs and 53% in group C. Nerve conduction velocity in both motor and sensory nerve was delayed over 20% in 0% of group A, 8% of group B, and 33% of group C. In CVR-R, 11% of group A and 7% of group B were decreased, and 44% (during rest) and 33% (during deep breathing) of group C was decreased. Between groups A and B there was no statistical difference. But group C had statistically significant difference from other groups, particularly in postural hypotension. Peripheral neuropathy might be closely related to diabetic retinopathy.

In order to study preliminary the safety of 5'-DFUR treatment as postoperative adjuvant therapy, intermittent and continuous treatment regimens were administered to patients undergoing curative resection of carcinomas of the stomach and the colorectum. Two treatment schedules were employed: 5'-DFUR was either given continuously in a daily oral dose of 600 mg/patient (continuous group) or for 2 weeks in a daily oral dose of 1,200 mg/patient followed by 2 weeks of no treatment (intermittent group). Twenty-one stomach cancer patients and 34 colorectal cancer patients were registered in the study. The rates of adverse drug reactions in the patients who completed treatment were 20.0% (2/10) in the continuous group and 50.0% (4/8) in the intermittent group of gastric cancer patients, and 16.6% (2/12) in the continuous group and 17.6% (3/17) in the intermittent group of colorectal cancer patients. The main adverse drug reactions were gastrointestinal symptoms. The incidence of diarrhea, a problematic side effect of 5'-DFUR, was 4.5% (1/22) in the continuous group and 12.0% (3/25) in the intermittent group. There were no statistically significant differences between the continuous group and the intermittent group in regard to the incidence of adverse drug reactions and survival rate. In addition, as there were no serious adverse drug reactions, both treatment regimens were demonstrated to be highly safe when administered as postoperative adjuvant therapy.

A 54-year-old man had a 7 x 8 cm hard mass in the epigastrium. Sonography showed an isoechoic tumor in the body of the pancreas. CT showed two contrast-enhanced masses in the pancreas and two low-attenuating masses, one in the left adrenal gland and the other in the upper pole of the left kidney. ERCP showed almost complete obstruction of the main pancreatic duct in the head of the pancreas (Fig. 1A). Constriction of the main pancreatic duct in the head and body of the pancreas was not evident. A computer image analysis system was used to improve the ERCP image. With the Interactive Build Analysis System (IBAS; Carl Zeiss, Oberkochen, Germany), input of the original ERCP image was generated with an image resolution of 512 x 512 pixels (8 bits, 256 gray levels) [1]. Image analysis was done by combining the functions of contrast normalization, edge enhancement (delineation and emphasis) (Figs. 1 B and 1C), and enhance contour and image arithmetics (added and combined) (Fig. 1D). The image analysis system allowed visualization of secondary branches of the main pancreatic duct in the body and tail of the pancreas (Figs. 1 B and 1 C). Afilling defect was seen in the main pancreatic duct suggesting a columnar mass (Fig. 1 D). These findings were interpreted as a renal cell carcinoma of the left kidney and its hematogenous dissemination in the pancreas and adrenal gland. At surgery, a renal cell carcinoma in the left kidney and metastasis in the pancreas and left adrenal gland were found. Tumor was seen invading the main pancreatic duct in the body of the pancreas. The main pancreatic duct in the head of the pancreas was filled with a columnar tumor mass, but was not constricted. The tumor mass in the main pancreatic duct of the pancreatic head was successfully resected, along with the main tumor in the distal part of the pancreas. Nephrectomy, left adrenalectomy, splenectomy, and distal pancreatectomy were performed. The pathologic diagnosis was clear cell carcinoma in the left kidney with hematogenous dissemination to the pancreas and left adrenal gland. The resected pancreas revealed two nodular tumors in the parenchyma that extended into the main pancreatic duct.

Surgical specimens of carcinoma in the papilla of Vater were studied histologically. Adenomatous residue which suggested that the carcinoma was derived from a pre-existing adenoma was found in 18 cases (81.8%) out of 22. The histological transition of adenoma into carcinoma was also frequently seen.

Over the past 10 years, we have experienced 11 cases of early gastric cancer limited to the mucosa and submucosa, with a widespread lymph node metastasis over the perigastric node. These cases represented 3.8% of all the early gastric cancer cases treated at our hospital during this period. The average age of these patients was 49.1 years, and consisted of 7 males and 4 females. Of these 11 cases, 10 cases (90.9%) were, macroscopically, the depressed type. Histologically, 7 cases (63.6%) were poorly differentiated carcinoma. Curative resections were possible in 8 cases (72.7%). The cumulative 5-year survival rate was poorer than for other types of early gastric cancer, and amounted to 66.7% in cases that were curative, and 0% for non-curative cases.

Twenty-two cases of primary gastric lymphoma have been clinicopathologically reviewed and factors influences the prognosis were examined. An increased tumor size of more than 10 cm, an increased tumoral penetration, a lymph node involvement, and stage IV classification decreased the survival rates. All patients given stage I classification have remained alive without having received chemotherapy. The survivors of stages IIIIV amounted to only three patients who were treated by surgery and systemic chemotherapy. A radical operation is the choice of treatment for a gastric lymphoma but aggressive chemotherapy should be supplemented for advanced cases.

A case of perforated early gastric cancer and a collective review of the relevant Japanese literature is reported. A 83-year-old woman with free air discovered by an abdominal X-ray, was referred to our hospital. On operating, a perforated ulcer was found within and lesions, indicative of a IIc + III type early gastric cancer. Macroscopically, there was an elevated lesion at the antrum of the stomach as well. Histologically, these lesions were connected and moderately differentiated adenocarcinoma. Another lesion was also found at the anterior wall and diagnosed as IIb type gastric cancer.

The results of treatment of 40 cases of primary malignant tumor of the small intestine are reported. The malignant tumors included 14 leiomyosarcoma, 12 malignant lymphoma and 14 adenocarcinoma. Our standard treatment for these tumors was segmental resection of the small intestine with its mesentery including the regional lymph nodes and we used additional adjuvant chemotherapy for some cases of malignant lymphoma and adenocarcinoma. Curative resection was performed in 57.1% of leiomyosarcoma, 50.0% of malignant lymphoma and 61.5% of adenocarcinoma. Cumulative 5-year survival rates were leiomyosarcoma 21.4%, malignant lymphoma 53.0% and adenocarcinoma 43.3% respectively. Serosal infiltration, lymph node metastasis and operative curability proved to be the prognostic factors. In particular, the 5-year survival rate of patients on whom curative resection could be performed was significantly better for each tumor type than that of patients for whom this was not possible, the figures being leiomyosarcoma 40.0%, malignant lymphoma 83.3% and adenocarcinoma 83.3%.

A 37-year-old male was admitted to our hospital because of an abdominal tumor, about the size of a fist, located anterior to the pancreas head. This tumor oppressed the antrum of the stomach to the left, and an operation was performed, the tumor being diagnosed as a leiomyosarcoma of the stomach, determined from image findings. After histopathological examination, however the tumor proved to be an adenocarcinoma. An early gastric cancer was found at the anterior wall of the antrum during the operation, and the tumor was thought to be a metastatic lymph node. Lymph node metastasis also was observed at the root of the mesentery.

Adenocarcinoma, malignant lymphoma and leiomyosarcoma are the main malignant tumors found most frequently in the small intestine and adenocarcinoma should be differentiated from these lesions as well as benign tumors. Ten cases with primary adenocarcinoma of the duodenum and 14 of the small intestine (the jejunum and ileum) were diagnosed and treated surgically in our clinic during recent 22 years. Analysing the clinical signs, symptoms and roentgenological features of these patients, the diagnosis, treatment and prognosis for these lesions were discussed and reviewed. To enhance the 5-year survival rate for these patients, the early diagnosis in the curative stage should be established.

A case of leiomyosarcoma of is reported. A 78-year-old man was admitted with a history of constipation and deformation of the stools. Barium contrast study and sigmoidoscopy showed a submucosal tumor of the rectum. On computed tomography and angiography, the tumor was suspected of being leiomyosarcoma. Abdominoperineal resection was performed. Microscopic examination revealed a leiomyosarcoma of the rectum and widespread lymph node metastases were found. Leiomyosarcoma of the rectum is an uncommon tumor. In our country, 89 cases have been reported. Six had lymph node metastases initially and another six subsequently. We have referred to the literature on leiomyosarcoma of the rectum.

We report two cases of carcinoid tumor of the stomach together with a collective review of the Japanese literature. Case 1 was preoperatively diagnosed as carcinoid, and the lesion, measuring 10 X 7 mm, and located in the body of the stomach, had no metastases. Case 2 was preoperatively diagnosed as gastric cancer and was recognized as a submucosal tumor measuring 5.8 X 4.7 cm in the antrum of the stomach. There were metastases to the brain and the skin, and the patient died on the 50th day after the operation. From a collective review of previous cases, it was ascertained that small carcinoid tumors sometimes had metastases. For this reason, we feel gastrectomy should be performed together with local lymph node resection.

Seventeen cases of a recurrent gastric cancer that were treated by a resection of the remnant stomach have been studied retrospectively. For first management 12 cases were given a Billroth 2 procedure, 4 cases a Billroth 1 procedure and 1 case a fundectomy. For the recurrent cancer, 13 cases were given a total resection of the gastric remnant and 4 cases a partial resection. The overall mortality rate was 12% and the survival rate was 58% at 1 year, and 8% at 5 years. We thus have concluded that a resection of the remnant stomach should be carried cut in cases of a recurrent gastric cancer whenever possible.

Adult intussusceptions due to metastatic intestinal-tumor are very rare. A 71-year-old man with an intussusception due to intestinal metastasis of renal carcinoma is reported. To our knowledge, this is the third such patient in the Japanese literature. The patient was suffered from an intestinal obstruction six months after his renal carcinoma was detected. Laparotomy was performed, revealing that he had developed a jejunojejunal intussusception due to metastasis of renal carcinoma. The early diagnosis of metastatic intestinal tumor is difficult. It is important to bear in mind that patients with malignant tumor may already have metastasis.