A 68-year-old man was admitted to our hospital because of epigastric pain. An upper gastrointestinal contrast study and endoscopy revealed a II c type tumor in the posterior wall of the pyloric antrum. and computed tomography showed lymph node enlargement along the left gastric artery. Operation was performed after a presumptive diagnosis of gastric cancer with lymph node involvement. During the laparotomy, more extensive lymphadenopathy was found than was detected preoperatively, and tumor metastasis was suspected because of its firmness. Distal partial gastrectomy with D, and more extensive lymph node dissection were performed. Subsequently, the histology of permanent sections revealed not tumor metastasis but a sarcoid-like reaction in the lymph nodes. The patient recovered uneventfully: however, he was killed in an accident 38 months after the surgery. A postmortem examination was not performed, but there had been no clinical signs of either recurrence of gastric cancer or sarcoidosis.
The case is reported of a 57-year-old woman with familial amyloidotic polyneuropathy and concomitant orthostatic hypotension for which L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS) was clinically effective. Testing of autonomic function under telemetric intra-arterial pressure monitoring before and during L-threo-DOPS treatment clearly demonstrated the pathophysiology of the sympathetic nervous system and its modification by L-threo-DOPS.
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