[Carcinoid tumor of the thymus--a case report].
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Biomedical subjects
Publications and source records attributed to J Soga.
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Superficial spreading type of carcinoma of the esophagus was defined as lesions with intramucosal extension of carcinoma 20 mm or more from the main lesion. Eleven (6.1%) of 179 cases were thus selected for this investigation. These cases were further divided into two groups: Group A, consisting of four cases (2.2%) with the main lesion confined to the submucosa, representing a relatively early stage; and Group B, consisting of seven cases (3.9%) with the main lesion invading the muscular layer or deeper. One of the most characteristic features in the four cases belonging to Group A was an unexpectedly high incidence of lymphatic permeation and lymph node metastases leading to a poor prognosis. Another feature that may be important, particularly for surgeons performing esophagectomy, was the difficulty in deciding the proximal resection line of the esophagus because the boundaries between involved and uninvolved portions were frequently indistinguishable in this particular pathologic entity, not only in Group A but in Group B.
A histological comparison of 1,687 cases of gastric carcinoma in Niigata, a high mortality prefecture for this cancer, and 954 cases in Kagoshima, a low mortality area, was carried out in order to investigate whether or not this difference in mortality reflects any change of histological type of gastric carcinoma. In both series, in both males and females , the proportion of adenocarcinoma increased with increase of the patients' age, while that of diffuse carcinoma decreased. When data from the two prefectures were compared, there was no significant difference in age group distribution of each histological type. It appears that the same histological types of gastric carcinoma occur throughout Japan.
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There have been 7 patients with postoperative osteomalacia in our series of 500 patients who had a gastrectomy for gastric or duodenal ulcers. All seven of these patients had a Billroth-II type gastrojejunostomy or esophagojejunostomy which caused food to bypass the duodenum and the upper part of the jejunum, and six of these patients showed milk intolerance and had diarrhea on food other than cow's milk. From this finding, it may be surmised that patients are predisposed to osteopenia after gastrectomy due to disorder in the process of calcium absorption and they develop osteomalacia when treated with the Billroth-II procedure, showing milk intolerance and diarrhea on food other than cow's milk.
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Pathophysiological and nutritional conditions were compared after esophageal reconstruction in 15 patients with a gastric tube and in 12 patients with a pedicled colon segment for the treatment of esophageal cancer. There was no significant difference in the postoperative nutritional index, iron and vitamin B12 metabolisms. On the other hand, the long gastric tube from the greater curvature of the stomach used as an esophageal substitute retained some secretory functions of both exocrine and endocrine although the effect of truncal vagotomy may have to be taken into consideration.
The preoperative use of Bleomycin (BLM) alone or combined with irradiation in the treatment of esophageal cancer was evaluated in 58 patients who underwent surgical removal of the lesion for the past three and a half years. Histologic study showed such preoperative treatment is effective in inducing favorable changes in neoplastic cells in 69 per cent (40/58) of the primary lesions and in a significant number of involved lymph nodes of the second or the third groups. The study clearly suggests that preoperative Bleomycin administration combined with irradiation may be an useful adjunct preoperative procedure in esophageal cancer.
To analyze the early stages of argyrophil cell carcinoid growth, complete serial sections were cut from the glandular portion of the stomachs of 22 Mastomys and submitted to Sevier-Munger's reaction. The 154 grossly invisible foci of argyrophil cell microproliferation thus detected were classified into three stages of microproliferations (I, II, and III), and the last stage was definitely a microcarcinoid. There was a gradual transition in cell proliferation among these three stages; the first stage (microproliferation I), in which the cells were morphologically indistinguishable from those of hyperplastic proliferation by general morphologic criteria, was where the initial change of argyrophil cell carcinoid formation was detectable by a light microscope. Whereas multiple occurrences of microcarcinoids accounted for the multiplicity of well-developed tumors in the stomachs of Mastomys, a well-developed carcinoid in this species was formed by the confluence of several microcarcinoids.
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