To assist in the evaluation of inflammatory changes of the affected bowel, we classified the transabdominal ultrasonographic findings into types A-C. We compared the in vivo and in vitro sonographic images to the histopathologic findings of resected specimens. A total of 22 bowel specimens (five normal, 12 with Crohn's disease, five with ulcerative colitis) were examined sonographically with a 3.75-MHz curved and a 7.5-MHz linear array scanner; histologic examination of the same area of tissue was performed afterwards. These three examinations corresponded well to each other. Our classification scheme is useful in quantifying the severity of inflammatory changes in the affected bowel.

Bezoars are conglomerates of undigested material in the stomach. Previous reports have shown that a decrease in secretion of pepsin and gastric acid and a delay in gastric emptying might contribute to their formation. To clarify the pathogenesis of the formation of gastric bezoars, we studied gastric emptying in five patients who presented with a bezoar. In addition, gastric acid secretion was studied in three of the cases. Gastric emptying was not delayed in any case, and there was no trend toward a decrease in gastric acid secretion. The five patients were successfully treated by the endoscopic fragmentation and enzymatic dissolution of the bezoars. We conclude that, in Japanese, factors other than a delay in gastric emptying are the main contributors to bezoar formation.

A gastric submucosal tumor in a 56-year-old man was presumed to be heterotopic pancreas on the basis of endoscopy and endoscopic ultrasonography. To obtain a histologic diagnosis we injected ethanol at the tumor site to create an artificial ulcer. This facilitated the removal of endoscopic biopsy specimens from the submucosal layer so that histologic examination could confirm the presence of heterotopic pancreatic tissue.

Background. To better understand the malignant grade of gastric smooth muscle tumors, the DNA content of these tumors was studied. Methods. In 43 patients with gastric smooth muscle tumors, the cellular DNA content was determined by flow cytometry and compared with the histologic classification and the prognosis. Results. Flow cytometry indicated that all 21 leiomyomas and 9 of the 10 low‐grade leiomyosarcomas were diploid; 10 of the 12 high‐grade leiomyosarcomas were aneuploid. All patients with leiomyomas and 8 of the 11 patients with diploid leiomyosarcomas had neither local recurrence nor metastasis. By contrast, 8 of the 10 patients with aneuploid leiomyosarcomas died of their disease (mean survival, 41 months; range, 18‐78 months). Conclusions. These results indicate that the DNA ploidy pattern shown by flow cytometry is related closely to the histologic classification and prognosis of gastric smooth muscle tumors.

A silver-staining technique to identify nucleolar organizer region-associated proteins (Ag-NOR) was applied to 55 gastric myogenic tumors. The mean numbers of Ag-NOR in the nucleus were: leiomyoma (30 cases), 2.0 + 0.6 (mean + SD); low-grade leiomyosarcoma (11 cases), 3.0 + 0.7; and high-grade leiomyosarcoma (14 cases), 3.9 + 0.7. The Ag-NOR counts were compared with DNA ploidy as determined by flow cytometry in 46 tumors. The Ag-NOR counts were significantly different in the aneuploid leiomyosarcomas (4.1 + 0.6: mean + SD) and diploid leiomyosarcomas (2.9 + 0.6: mean + SD). Thus, this parameter may serve as an objective histological discriminant for malignancy.