Biomedical subjects
Publications and source records attributed to O Masamune.
Brain tumors have not been previously described as a cancer found in cancer family syndrome (Lynch Syndrome II). Astrocytoma found in the 24-year-old son of a proband of cancer family syndrome with an unusual aggregation of transitional cell cancer is reported. The possibility of brain tumors as a rare spectrum of neoplasms in cancer family syndrome is discussed.
A 14-year-old girl diagnosed as Crohn's disease had lymphoid hyperplasia throughout the large bowel. Biopsy specimens from the lymphoid hyperplasia demonstrated non-caseous granulomas within the lymph follicles. An immuno-histochemical study of biopsy specimens showed that HLA-DR antigens were expressed on epithelium close to the lymph follicle, which was observed in all specimens containing the lymph follicle. This case provides evidence for the importance of the lymph follicle in the etiopathogenesis of Crohn's disease by demonstration of non-caseous granulomas within the lymph follicle and expression of HLA-DR antigens on epithelium close to the lymph follicle.
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We have re-evaluated over-diagnosed cases which were first diagnosed, pre-operatively, as gastric cancer yet later confirmed as benign lesion (excavated lesion, in particular) in the post-operative histological examination of resected stomachs. We have experienced a total number of 1,358 cases which, being detected through mass survey, were diagnosed as cancer and, consequently, operated upon. On the other hand, 61 benign cases were misdiagnosed as cancer, 28 cases being protruded lesions and 33 cases excavated lesions. Among the misdiagnosed cases of excavated lesions, 27 cases were gastric ulcers or their scars, the remaining 6 cases being gastritis or gastric erosion. In 22 out of 33 cases of misdiagnosis, the wrong diagnosis was made by relying solely upon X-ray and endoscopy. Even after the addition of cytology, there were still 9 cases of misdiagnosis. Since, however, biopsy was introduced, there have been only 2 cases of wrong diagnosis. We may safely say that through these findings the absolute necessity of biopsy for the attainment of an accurate diagnosis of early gastric cancer has been sufficiently attested.
In this study is intended a measurement of the pressure of the lower esophageal sphincter (LES) in resting state and after various stimuli such as beef soup and AOC-tetrapeptide in cases of healthy subjects and various diseases by means of an infused open-tip method. The following results were obtained: In the cases of esophagitis, the resting LES pressure is lower than in the cases of healthy subjects and after stimulation by beef soup or tetrapeptide the LES pressure is less elevated. Based on these observations, we concluded that there are some factors other than gastrin which make the LES pressure in the cases of esophagitis lower than in controls.
To evaluate the diagnostic significance of the Sudan III staining for the fecal fat, the quantitative relationship between the number of fecal fat droplets examined microscopically and the amount of the fecal fat determined chemically was examined. In 43 out of 60 cases, the results of the chemical determination and the microscopic examination were in agreement and the accuracy was 72 percent. On the other hand, the false positive cases totaled 9 out of the 24 cases (37 percent) and 8 out of 9 false positive cases were diagnosed as showing a slight increase. In contrast, the false negative cases were only 2 out of 36 cases (6 percent). In addition, the comparative study of the various procedures of the Sudan III staining indicated the importance of the processing with acid and heating even in cases of steatorrhea caused by pancreatic insufficiency.
In order to clarify the correlation between decrease in micellar formation and degree of steatorrhea, upper intestinal content was analyzed after administering a test meal of Borgström et al. Fecal fat was also measured. It was demonstrated that micellar phase was composed chiefly of fatty acid and monoglyceride, with low concentrations of diglyceride and triglyceride. The fat composition of micellar phase was nearly constant in normal subjects and in cases of malabsorption syndrome. The correlation between the ratio of micellar fat to the whole ingested fat in the intestinal content and daily excretion of fecal fat was very marked.
In order to clarify the abnormal micelle formation in various malabsorption syndromes, the analysis of upper intestinal contents after administering a test meal of Borgström et al. was performed. It was demonstrated that the percentage of micellar fat to total fat and lipase concentrations decreased markedly from the normal controls despite of normal concentrations of bile salts and pH in cases of pancreatitis and pancreatectomy. In contrast, it was shown that the percentage of micellar fat was markedly low and the concentrations of conjugated bile salts were reduced in cases of ileal diseases. Unconjugated bile salts were detected although the concentrations of total bile salts were normal in blind-loop syndrome. The correlation between the percentage of micellar fat and lipase concentrations or bile salts concentrations in normal controls and various malabsorption syndromes was also reported.
Most of the cases of Crohn's disease reported in Japan were originally treated surgically as acute appendicitis and, after appendectomy, they were diagnosed as acute terminal ileitis or acute Crohn's disease, which should belong to a category different from typical Crohn's disease, according to the international nomenclature by the Council for International Organization of Medical Sciences in 1973. Reviewing our university hospital records from 1954 to 1974, the incidence of typical Crohn's disease and idiopathic proctocolitis has been increasing, while the patients with intestinal tuberculosis have been decreasing. Clinical and histopathological features of operated three groups of our patients with Crohn's disease of the small intestine, non-specific ulcers of the small intestine and prestomal ileitis were comparatively studied. Furthermore, 9 cases of operated Crohn's disease of the colon and 23 cases of operated idiopathic proctocolitis were similarly evaluated. The importance of diagnosing Crohn's disease as a whole from both clinical and histopathological stand points of view was emphasized, and main differential diagnostic criteria between Crohn's disease and idiopathic proctocolitis were discussed.