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Biomedical subjects

M Itabashi

Publications and source records attributed to M Itabashi.

At least 91 records · Page 5Linked to original sources
PubMed1984

Chronological changes in the morphological features of early gastric cancer, especially recent changes in macroscopic findings.

At the National Cancer Center, 1,300 patients with early gastric cancer were operated on during a period of 21 years, from 1962 to the end of May 1983, and the chronological sequence of the pathological features was analyzed by dividing the 21 years into five periods (I approximately V). The number of elderly patients, especially those above the age of 70 years increased with time, reaching about 20% of all patients in the later period. As to the CMA classification, lesions in A region (antral region) tended to increase, reaching 32.8% in the last period. Lesions on the anterior and posterior wall increased, reaching 20.2% and 30.5%, respectively. Lesions on the greater curvature side were almost unchanged in frequency. The depressed type of carcinoma tended to increase in frequency in the later period, accounting for 75.3% of the total. The depressed type lesions, especially those consisting mainly of IIc element, were therefore subdivided into deep IIc and shallow IIc. In the later period, shallow IIc or not readily detected indistinct IIc increased markedly, reaching 83.3% in Period V. In the initial period, 40% of the lesions were larger than 5 cm. In the later period, lesions larger than 5 cm decreased to 10%, and more than 40% were 2 cm or smaller. Histologically, differentiated and undifferentiated types were found at almost the same frequency. In the later period, the differentiated type became more frequent, reaching as much as 58.2%. Ulcerative lesions (presence of ulcers or ulcer scars in the cancerous lesions) comprised more than 90% of depressed type early gastric cancer, but gradually decreased to 71.9% in the later period. From these findings, early gastric cancer may be said to be changing. Factors contributing to such changes were studied with reference to the progress and multiplication of diagnostic techniques, changes in age composition of the population and changes in environmental factors.

Adult↗
PubMed1984

The role of the biopsy in diagnosis of early gastric cancer.

In order to determine the reliability of endoscopic biopsy in diagnosis of early gastric cancer, and to clarify the problems with biopsies, preoperative endoscopic biopsies from 771 early gastric cancer cases were reviewed and analyzed clinicopathologically in comparison with surgically resected specimens. The 771 cancers were surgically resected at the National Cancer Center Hospital during the period from 1972 to 1982. Definite histological diagnosis was obtained in 87.4% of the carcinomas at the initial biopsies. Repeated biopsy raised the percentage of correct definite diagnoses to 96.1%. False-negative (including suspicion of cancer) diagnosis was most frequent in the case of depressed lesions (50 lesions). Half of the false negatives were found to be due to sampling errors by the endoscopists. The other half of these 50 lesions were diagnosed as "suspicious of malignancy" because of the histological difficulty in differentiating early gastric cancer from regenerative atypia with intestinal metaplasia, or because there was not enough information, or for the other reasons. Most of the 31 false-negative diagnoses at the initial biopsy from elevated lesions were reported as adenoma (group III) or suspicious of carcinoma (group IV), indicating that differential diagnosis between well-differentiated adenocarcinoma and adenoma is very difficult. The result of the present study suggests that repeated biopsy from correct sites and discussion of the lesions between clinicians and pathologists are very important.

Biopsy↗
PubMed1984

Endoscopic treatment of early gastric cancer: polypectomy and laser treatment.

With the tremendous development of gastroenterological endoscopy, it has become possible to treat some types of early gastric cancer by endoscopy. There are two principal methods for this purpose, endoscopic polypectomy using a high frequency electric current and laser endoscopy. We developed the technic and instruments of endoscopic polypectomy, in 1972. Since then, we have experienced 358 cases of gastric polypoid lesions treated by endoscopic polypectomy. Nineteen patients with the elevated type of early gastric cancer were treated by endoscopic polypectomy. Seven patients were operated on after polypectomy and 12 were followed without surgery. Out of the 12 patients, nine are alive after more than five years. On the other hand, we started research to apply lasers for treating early gastric cancer in 1978. Since then, 18 patients have been treated by laser endoscopy, with Nd-YAG laser, argon dye laser or a combination of both lasers. We have established criteria for these treatments for early gastric cancer.

Aged↗
PubMed1984

Surgical treatment of early gastric cancer.

In Japan, R2-gastric resection which consists of gastrectomy, omentectomy and complete removal of Group 1 and 2 regional lymph nodes has been generally accepted as the procedure of choice in the treatment of early gastric cancer during the past 20 years. As a result, surgical treatment for early gastric cancer patients has achieved a very good survival rate, 97.7% and 96.2% 5 and 10 years, respectively, after surgery. To determine a new rationale for surgical treatment for early gastric cancer, the relationship between various prognostic factors and postoperative prognosis in 1,200 patients with early gastric cancer was studied. The survival rate for patients with a single focus of cancer in the stomach was significantly higher than that for patients with multiple foci. The incidence of recurrence was very low (2.8%) as a whole and most recurrence was found in patients who have had invasion into the submucosa with regional lymph node metastasis. The characteristic mode of recurrence was hematogenous metastasis to the liver and lung. The majority of causes of death were non-malignant disease and multiple primary malignant neoplasms. As to the survival rate in relation to the extent of lymph node dissection, no significant difference in survival rate was observed among the three procedures R0-, R1- and R2-resection in single cancer regardless of cancer invasion through the gastric wall. The survival rate for intramucosal carcinoma without lymph node metastases and with Group 1 lymph node metastases in both single and multiple cancer was 100%. In addition, 125 patients with intramucosal polypoid cancer (types I and IIa according to the macroscopic classification of early gastric cancer) showed no lymph node metastasis and had 100% survival. Therefore, from the present study a new rationale for surgical treatment for early gastric cancer is recommended as follows: 1) In general, R1-resection is indicated for intramucosal carcinoma and R2-resection for submucosal carcinoma. 2) Local resection of the tumor or R0-resection with preservation of the regional lymph nodes is thought to be sufficient for an intramucosal polypoid carcinoma less than 2.0 cm in diameter.

Adult↗
PubMed1983

The intramucosal cysts of the stomach. III. In Japanese subjects with gastric or duodenal ulcers.

Gastrectomy specimens from 102 Japanese patients with peptic ulcer disease were examined for intramucosal cysts. The number of cysts for each centimeter of mucosa analyzed (cyst index) was calculated. The intramucosal cysts occurred in 90% of the patients. The mean number of cysts in the 102 specimens was 12.3 (SD +/- 23.45). The resulting cyst index was 3.4 (SD +/- 6.6). Earlier studies have demonstrated a significantly lower cyst index in Swedish patients with peptic ulcer disease. A significantly higher cyst index was found in Japanese and Swedish patients with focal elevated dysplasias and in patients with early gastric cancer. The possibility that some intramucosal cysts of the stomach may be symptomatic of lesions antedating malignant transformation in that organ has been discussed.

Adult↗
PubMed1983

[Prognostic factors and surgical method in patients with leiomyosarcoma of the stomach--with special reference to local tumor excision].

Between 1962 and 1982, 48 patients with leiomyosarcoma of the stomach who had undergone resection at the National Cancer Center Hospital were studied to define the prognostic factors clinicopathologically and the criteria of local excision of the tumors. The 5 and 10-year survival rate after resection was 84.3% and 80.5% respectively. Since the extent of surgical resection did not affect survival, gastrectomy is of no greater benefit than local excision. The important prognostic factors were location, size, mitotic index and cellularity of the tumor. Criteria of local tumor excision are defined as tumor location in the anterior wall, small size (much less than 5.0 cm in diameter), low mitotic index (5.0/25 HPF) of low cellularity (0-3/0.0004 mm2).

Adult↗
PubMed1982

A pathologic study of benign breast diseases in Tokyo and New York.

Two hundred thirty-two biopsies of benign breast conditions from the National Cancer Center Hospital in Tokyo and 263 comparable biopsies from Memorial Hospital in New York City were reviewed. The component lesions of benign breast disease were identified and evaluated according to their relative frequency for different ages. Apocrine cysts, apocrine hyperplasia, intraductal hyperplasia, sclerosing adenosis, blunt duct hyperplasia, and atypical lobular hyperplasia were at least twice as common in biopsies from American women. Solitary papillomas were twice as common among biopsies from Japanese patients and tended to show more epithelial proliferation and sclerosing papillomatosis than did Americans. No major differences were found in the frequency of cysts, duct stasis, periductal mastitis, sclerosing intraductal papillomatosis, fibroadenomatoid mastopathy or fibroadenomas. Assuming intraductal hyperplasia and atypical lobular hyperplasia may represent premalignant epithelial changes, the high frequency of these lesions in New York biopsies when compared to Tokyo biopsies correlates well with the higher rate of breast cancer in the United States as compared to Japan. The greater frequency of lobular proliferative lesions and apocrine disease in New York suggests that these lesions may be produced by factors which also predispose American women toward breast cancer.

Adenofibroma↗
PubMed1980

Sequential studies on the histopathogenesis of gastric carcinoma in rats by a weak gastric carcinogen, N-propyl-N'-nitro-N-nitrosoguanidine.

Sequential studies were made on the histopathologic changes in the glandular stomach of rats induced by a weak carcinogen. N-propyl-N'-nitro-N-nitrosoguanidine (PNNG). Fiftyfour rats were given 100 micrograms/ml of PNNG in their drinking water for 44 weeks, and then normal tap water until the end of the experiment. Rats were killed at intervals between week 1 and week 88. No marked atrophy or ulceration of the mucosa was found between week 1 and the end of the experiment. Focal intestinal metaplasia was found in week 19 and its incidence increased during the experiment. Adenocarcinoma in situ with extreme cellular atypia was found in mucosa with a normal appearance in week 67. An adenocarcinoma invading the submucosa was found in week 69, and one invading the serosa in week 88. All these pathological lesions were found on the anal side of the pyloric region. No pathologic changes were found in the fundic region. The sequential changes of the mucosa of the glandular stomach induced by this weak gastric carcinogen, PNNG, were very different from those induced by the potent gastric carcinogen, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Gastric carcinoma induced by PNNG seems to be more similar to human gastric cancer than that induced by MNNG.

Adenocarcinoma↗
PubMed1980

Clinicopathologic study of minute and small early gastric cancer. Histogenesis of gastric cancer.

According to the report by Sano, and our previous study of 900 cases of early gastric cancer, multiple gastric cancers were seen in 73 patients (8 percent). The remaining 827 had solitary cancers. In comparison with solitary cancers, multiple gastric cancers were seen more often in males, with the predominant histologic type being well-differentiated adenocarcinoma. A higher incidence (28 percent) of elevated types (I and IIa) was noticed in multiple gastric cancer cases than in solitary cancers (19 percent). The incidence of ulceration within the cancerous lesion was low (35 percent) in multiple cancers but high (69 percent) in solitary cancers. These differences between solitary and multiple cancers observed in 900 early gastric cancer cases were also noted between solitary and multiple cancers in the present series, regardless of the size of lesions.

Adenocarcinoma↗
PubMed1980

Distribution of marker enzymes and mucin in intestinal metaplasia in human stomach and relation to complete and incomplete types of intestinal metaplasia to minute gastric carcinomas.

Intestinal metaplasia of the human stomach was classified into two types, complete and incomplete. The complete type was associated with the intestinal marker enzymes sucrose alpha-D-glucohydrolase, alpha, alpha-trehalase, aminopeptidase (microsomal) (APM), and alkaline phosphatase (ALP). Tissue of this type contained goblet cells and Paneth's cells but not high-iron diamine (HID)-positive mucin staining with HID-Alcian blue. The incomplete type of intestinal metaplasia was associated with sucrose alpha-D-glucohydrolase, APM, goblet cells, and HID-positive mucin but not with alpha, alpha-trehalase, ALP, or Paneth's cells. For the examination of the distribution of the complete and incomplete types in 84, 27, and 16 resected specimens of human stomach with gastric carcinoma, gastric ulcer, and duodenal ulcer, respectively, disaccharidases were located with Tes-Tape. Specimens with intestinal metaplasia were divided into three classes: complete type only (class I), incomplete type only (class II), and a mixture of areas of the complete and incomplete types (class III). Of the 84 specimens from patients with gastric carcinoma, intestinal metaplasia was found in 76 (01%), and the percentages of specimens of classes I, II, and III were 32, 22, and 46, respectively. In these specimens, the percent incidence of class I increased and that of class II decreased with age. Of the 27 specimens from patients with gastric ulcer, 16 (59%) shopwed intestinal metaplasia and 10 of the 16 (63%) specimens were of class II. Of the 16 specimens from patients with duodenal ulcer, only 3 (19%) specimens showed intestinal metaplasia and all of them were of class II. The relationships of the complete and incomplete types of intestinal metaplasia to gastric carcinoma wre studied in 26 foci of minute carcinoma of the stomach less than 5 mm in largest diameter. Nineteen of 20 (05%) foci of the intestinal type of minute carcinoma were surrounded by intestinal metaplasia and 16 foci (80%) were surrounded by the incomplete type of intestinal metaplasia.

Adult↗
PubMed1977

Changes in peroxisomes in preneoplastic liver of rats induced by 3'-methyl-4-dimethylaminoazobenzene.

Histochemical investigations used the 3,3'-diaminobenzidine reaction to demonstrate the catalase activity and thus variations in numbers of peroxisomes, and electron microscopic examinations were made of hyperplastic liver lesions in rats fed 0.06%3'-methyl-4-dimethylaminoazobenzene. At the 10th week of carcinogen feeding, hyperplastic lesions (hyperplastic foci, areas, and nodules) appeared and advanced to further stages. Most of the foci and some of the areas and nodules showed very low catalase activity and, correspondingly, a small number of peroxisomes. When rats were administered ethyl-alpha-p-chlorophenoxyisobutyrate, most of the foci, areas, and nodules showed a moderate increase in catalase activity and in peroxisome number. Hyperplastic foci seemed to grow larger with time to form hyperplastic areas and/or nodules, mostly accompanying maturation as well as proliferation of the hepatocytes involved. Maturation is well characterized by an increase in the endogenous level of catalase and in the number of peroxisomes, as well as by an enhancement of the responsiveness to ethyl-alpha-p-chlorophenoxyisobutyrate. However, there was a small proportion of lesions in which all cells or some cells did not mature and thus were considered persistently altered. It is suggested that these altered cells serve mainly as intimate precursors of hepatomas.

Animals↗
PubMed1977

Carcinoma of the esophagus of rabbits induced with N-methyl-benzylamine and sodium nitrite.

Esophageal carcinomas were induced in three of five rabbits given 0.25% N-methylbenzylamine and 0.16% NaNO2 in their drinking water. The three rabbits with carcinoma had consumed more than 94 g of NaNO2 and had survived for more than 536 experimental days. The esophageal carcinomas were a slightly elevated type, and no polypoid lesions were seen. They were classified histologically as squamous cell carcinomas or adenosquamous carcinomas, or both. No metastases were found. The other two of the five rabbits died early in the experiment before any esophageal carcinoma had developed.

Adenocarcinoma↗
PubMed1976

Glomiform and fibrillar cytoplasmic inclusions.

Glomiform inclusions, also called tubular arrays in endoplasmic reticulum, are found in the epithelial cells of glandular tissues of a patient with systemic lupus erythematosus, a patient with Reye's syndrome, and a dog. Their three dimensional structure is interpreted as a skein of contorted tubules of endoplasmic reticulum. Fibrillar inclusions found in the pancreatic acinar cells of two patients are believed to represent altered zymogen granules.

Adult↗
PubMed1976

Concentric nuclear inclusions.

Membrane bound concentric lamellar inclusions were found in the nuclei of pancreatic acinar cells of a patient with multiple primary neoplasms and in the parotid acinar cells of a patient with systemic lupus erythematosus. It is proposed that these inclusions form from rough cisternae sequestered in the nucleus.

Adenoma, Islet Cell↗