Diagnosis of Gastric Cancer in Early Stage — The Clinical Ob­servation of Operated Cases

1. An attempt has been made to find the diagnostic criteria for early gastric cancer. It is most important to detect the evidences or suspected features of the malignant growth in incipient stage in order to attain the radical cure by surgical operation. 2. Twelve patients with early gastric cancer (groups A and B) were selected out of 476 patients who had undergone gastrectomy during the past three years in the Okayama Saiseikai General Hospital. The other 6 patients in the &#34;precancerous group&#34; (group C) were also studied, who had abnormal epithelial proliferation in the resected stomach membrane during the same period. 3. The processes of discovery of early cancer have been described. Fairly precise diagnosis can be made in the mucosal carcinoma, but it is not in the ulcer-carcinoma. It was generally difficult to estimate the degree of the malignancy and the extension of the growth preoperatively. 4. The details of the diagnostic aids are as follows. i. Negative occult blood of stool does not always mean the definite diagnostic aid. ii. The malignant gastric change may occur even in non-anacidity. Further investigations should be followed up on gastric ulcer patients if malignant alteration is under the consideration. iii. Minor roentgenological findings, such as the absence or irregularity of mucosal folds, rigid and/or overlapped contour, localized absence or decrease of the peristaltic waves and absence or bow-shaped deformity of the angulus, are of important significance. Such changes should be minutely sought for by X-ray film examination. iv. On gastroscopy and gastrocamera photography, such changes as erosion or irregular granular thickening of the membrane with abnormal reddening and edematous appearance, irregularity of ulcer edge, uneven swelling on ulcer margin with reddening and unsharpness of the edge of adherent coat on ulcer floor, must be noted in the early gastric cancer. v. It is not safe to leave a patient having stomach ulceration under a mere conservative management because it is often quite difficult to dissolve the question of malignancy of the lesion with all sorts of examinations. vi. So far as clinical examinations have indicated malignancy, histological examination must be carried out immediately at the time of operation, even when malignant lesion is absent in inspection and palpation on the exposure of the stomach. vii. On the gross observation of the resected stomach, a particular attention must be paid to erosion, depression or atrophy, irregular granular thickening and abnormal reddening on the restricted areas of the mucosal surface.</p

Efficient Packet Demultiplexing for Multiple Endpoints and Large Messages

This paper describes a new packet filter mechanism that efficiently dispatches incoming network packets to one of multiple endpoints, for example address spaces. Earlier packet filter systems iteratively applied each installed filter against every incoming packet, resulting in high processing overhead whenever multiple filters existed. Our new packet filter provides an associative match function that enables similar but not identical filters to be combined together into a single filter. The filter mechanism, which we call the Mach Packet Filter (MPF), has been implemented for the Mach 3.0 operating system and is being used to support endpoint-based protocol processing, whereby each address space implements its own suite of network protocols. With large numbers of registered endpoints, MPF outperforms the earlier BSD Packet Filter (BPF) by over a factor of four. MPF also allows a filter program to dispatch fragmented packets, which was quite difficult with previous filter mechanisms