[Recent progress in diagnosis and treatment of digestive diseases. IV. Colonic cancer. 9. The diagnosis of early colonic cancer].
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Biomedical subjects
Publications and source records attributed to K Nagasako.
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Esophageal lesions are rarely seen in patients with intestinal Behçet's disease. Three patients with esophageal lesions (dissection of esophageal mucosa, esophageal ulcer, esophageal varices) were observed among 15 patients with intestinal Behçet's disease or non-specific simple ulcer (1974-1984). Two-thirds of these fifteen patients had fully developed or suspected Behçet's disease, and one-third had no symptoms typical of Behçet's disease. They are classified as non-specific simple ulcer. The average age of the 15 patients was 43 years, all patients but one were male. The recurrence rate after surgical treatment was 70%, that of medical treatment was 90%.
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Localized colitis cystica profunda (CCP) is a rare condition found in the rectum. Localized CCP of 70-year-old man was found in the sigmoid colon, it was accompanied by a cancer in the ascending colon and an adenomatous polyp with focal malignancy in the sigmoid colon. Colonoscopically, the tumor appeared like a submucosal tumor.
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A large juvenile polyp in the ascending colon of a 5-year-old boy was successfully polypectomized . The boy often had rectal bleeding, and anemia was known. Transection was necessary to prevent bleeding and anemia.
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In view of the fact that Japanese dietary patterns have been undergoing rapid "Westernization," in part characterized by decrease in fiber, we assessed dietary and crude fiber content in the Japanese diet using food consumption tables for the period from 1911 to 1980, and studied the trend in the reported prevalence of diverticular disease of the colon. Fiber content declined in diphasic pattern: the first decline, which probably had started in the late 19th century, progressed until the Second World War. Although records during the war period were unavailable, the high fiber content of the Japanese diet in the period immediately after the war reflects the tendency to supplement rice with more fiber-rich cereals, and to increase the amount of rice through reduced polishing during the war time. The second decline in fiber content in the Japanese diet, which started in the 1950s and progressed throughout the period of "high economic growth," was mainly due to the decrease in cereal consumption. The changes in crude fiber content in the Japanese diet after the Second World War resemble the pattern of rapid decline noted in the United States during the 1930s to the 1950s. The prevalence of diverticular disease in both countries also shows sudden steep upward turns during the period between 1930 and 1950 in the United States and the late 1970s in Japan, suggesting the presence of threshold level(s) of fiber intake for the effective prevention of diverticular disease. The prevalence of diverticular disease is still relatively low in Japan. However, if the current dietary trend continues, it may rise to a level currently found in the "Western" countries in the coming few decades.
A case of Peutz-Jeghers syndrome in which one colonic polyp showed many foci of glandular dysplasia is reported. Peutz-Jeghers polyps are considered to be hamartomatous, and their malignant potential has been considered doubtful. This case is valuable because foci of glandular dysplasia existed within hyperplastic glands. Glands of Peutz-Jeghers polyps are proliferative in nature, and therefore it is not surprising that there are areas of glandular dysplasia and of cancerous change.
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A 43-year-old Japanese woman with asynchronous onset of ulcerative colitis and aortitis syndrome (Takayasu's arteritis) is reported. The possible relationship between the two disorders is discussed.
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Colitis cystica profunda is a benign condition that has been confused with carcinoma. This rarely recognized condition is characterized by submucosal cysts. Macroscopically, the ulcerated character of the mass suggests carcinoma. Microscopically, attenuation of the innocuous-appearing cyst linings may give the false impression of a mucus-secreting carcinoma. A case of colitis cystica profunda in which the macroscopic appearance was so suggestive of malignancy that operation was carried out is reported.
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