The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer. Further studies and prudent interpretation of results are needed.

Pasteurella multocida, which colonizes upper respiratory and digestive tracts, is a leading cause of respiratory diseases in many host species. Here, we describe a case of P. multocida pneumonia with hemoptysis. A 72-year-old female diagnosed with bronchiectasis with a 36-year history presented with a worsened infiltrative and granular shadow in the lower right lobe and lingular segment. Bronchial lavage fluid culturing suggested Pasteurella pneumonia. P. multocida was confirmed by 16S rRNA sequencing. The patient was readmitted to our hospital because of hemoptysis, and she was treated successfully with antibiotic therapy. The possibility of P. multocida infection must be considered in patients who own pets.

Abstract. Partial or complete spontaneous cancer regression is a rare phenomenon, particularly in patients with lung cancer. This is the case report of a patient with lung cancer who exhibited spontaneous regression of the primary as well as metastatic lesions, without receiving any treatment. Spontaneous regression commenced within a week of obtaining pathological specimens by transbronchial and percutaneous biopsies from the primary lesion and metastatic lymph nodes of the left side of the neck. The reason for this phenomenon is unknown; however, we hypothesized that there may be an immunological association between the stimulus of the biopsies and the spontaneous regression. This patient should be closely followed up to monitor the clinical course of this unusual case.

BackgroundAlthough Korea and Japan have a national gastric cancer screening program, their screening intervals are different. The optimal screening interval of endoscopic screening in Japan was investigated based on the stage distributions of screen-detected gastric cancers.MethodsPatients with gastric cancer detected by endoscopic and radiographic screenings were selected from the Niigata City Medical Association database. The stage distributions of the detected gastric cancers were compared among patients with different screening histories in both groups. Gastric cancer specific survival rates were analyzed using the Kaplan-Meier method with the log-rank test.ResultsThere were 1585 and 462 subjects in the endoscopic and radiographic screening groups, respectively. In the endoscopic screening group, the stage IV proportion was lower in patients with screening history 1 and 2 years before diagnosis than in patients without screening history. Stage IV development was significantly related to the absence of screening history (p < 0.001); however, there were no differences between patients who had endoscopic screening history 2 and 3 years before diagnosis. The survival rates were not significantly different between patients with endoscopic screening 1 and 2 years previously (p = 0.7763). The survival rates were significantly higher in patients with endoscopic screening history 1 and 2 years before diagnosis than in patients without screening history (p < 0.001), and in patients with endoscopic screaming 3 years before diagnosis (P < 0.0069).ConclusionThe endoscopic screening interval for gastric cancer can be expanded to at least 2 years based on the stage distributions of detected cancers and the patient survival rates.

Gastrointestinal: Rectal polyp associated with schistosomiasisA Japanese man, aged 64 years, was investigated by colonoscopy because of a positive fecal occult blood test. Colonoscopy revealed a sessile polyp, about 2 cm in diameter, in the rectum. The appearance of the polyp after spraying the region with indigo carmine is shown in Fig. 1. As the polyp was thought to be an adenoma, the polyp was removed by endoscopic mucosal resection. Histological evaluation revealed a hyperplastic polyp and calcified Schistosoma eggs in the submucosa (Fig. 2).Schistosomes are tropical parasites that are thought to infect at least 200 million people worldwide. The major human parasites are Schistosoma hematobium , S. mansoni and S. japonicum . S. hematobium is endemic in several countries in Africa while S. mansoni is endemic in Africa and Central and South America. S. japonicum is largely restricted to East Asia but is now rare in Japan. The location of adult worms in the human host is partly determined by parasite species. For example, the preferred site for S. hematobium is vesical veins while the preferred sites for S. mansoni and S. japonica are the superior and inferior mesenteric veins. Adult worms of S. japonicum survive for approximately 5 years and produce up to 3000 eggs per day. At least half of these eggs pass through the intestinal wall and are discharged in feces. The remainder lodge in the intestinal wall or go back to the liver via the portal vein. These eggs elicit a chronic inflammatory response that includes granulomas and large numbers of eosinophils. Common clinical manifestations include hepatomegaly and various manifestations of portal hypertension. It is unclear whether intestinal schistosomiasis predisposes to colorectal polyps but S. japonica eggs were found in the base of the polyp in the above case.