[Ultrasensitive dark-field light microscopy (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Ishihara.
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Multiple gastric carcinoma was investigated on 101 of 1901 resected stomachs. The frequency of multiple carcinoma was 4.7% and 6.9% of the advanced and early carcinomas, respectively. Male to female ratio was 2.9 to 1 with average age of 62.0 and that was 1.9 to 1 with average age of 57.7 in the total gastric carcinomas. The well-differentiated carcinomas with intimate relation to the intestinal metaplasia increased by aging and occupied about 70% of all lesions. The intestinal metaplasia usually showed higher grade in the cases with multiple carcinomas than those with single lesion. It should be considered that intestinal metaplasia plays the important role in the histogenesis of gastric carcinoma, especially in that of the well-differentiated one.
The incidence of 454 resected adenomas was histologically 87.8% of tubular, 7.7% of tubulovillous and 4.5% of villous adenomas, respectively. Eigtosigmoid region. Male to female ratio was 1 to 1.8, 1.5 to 1 and 1.8 to 1 for the villious, tubulovillous and tubular adenomas, respectively. Adenocarcinomas of large intestine consisted of 684 cases, 709 lesions and male to female ratio was 1 to 1.01. It should be considered that the adenomas in female may grow largely compared with those in male, with subsequent malignant transformation. Although the adenomas were found at the rate of 26.4% in the rectosigmoid region, 74.2% of the adenocarcinomas were found in this region, because the adenomas in this region grow largely compared with the other regions. Mucinous carcinomas were found in 33%, 23% and 9%, respectively, in the adenocarcinomas with remaining adenoma showing villous, tuvulovillous and tubular types.
A Bjork-Shiley mitral valve prosthesis had to be replaced 4 years after implantation because of disc entrapment by an over-grown fibrous tissue on its sewing cuff. This abnormal fibrous tissue was found out to be an organizing platelet-fibrin deposit, of which luminal surface was only incompletely endothelialized. It is indicated that the heart valve prosthesis generally remains non-endothelialized for a prolonged period of time after implantation in man. Anticoagulation therapy should thus be given throughout the postoperative period for patients with the heart valve prosthesis.
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Thirty-two cases of juvenile polyp were investigated for the clinical and pathological findings. This type polyps occured frequently in the first decade with male predominance. Melena and bloody stool were found in all cases, prolapse of the polyps in 28%, and spontaneous amputation in 9.4%. The duration of symptoms were usually within 6 months. The polyps were found frequently in the rectum and sigmoid colon, about 75%. One case of juvenile polyposis in a 12 years-old male was found. The size of the polyps was usually within 2 cm in diameter and the majority of the polyps were pedunculated. Polypectomy was performed for all cases and additional partial resection for 2 cases with multiple polyps and polyposis. Recurrence and malignant transformation were not found. It should be considered that these are at least two types of histogenesis for the so-called juvenile polyp like as hamartomatous and inflammatory.
The submucosal heterotopic gastric glands were found in 160 cases (10.7%) of 1500 resected stomachs; 15% in gastric ulcer, 9.9% in gastric carcinoma, 4% in duodenal ulcer and 11% in chronic gastritis. The heterotopic glands were usually found in the distal half of the stomach, diffusely or localized. Macroscopic submucosal tumor was found in 9 (5%) of 160 cases. Although the heterotopic glands were found with an intimate relation to the repeated mucosal damage and subsequent intestinal metaplasia, they had no specific relation to gastric carcinogenesis.
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