Gen-ichi Nakano

Adenoma of the rectum with multiple foci of signet-ring cell carcinoma

A case with multiple foci of signet-ring cell carcinoma in an adenoma of the rectum is presented. Four foci of the signet-ring cell carcinoma and four foci of the common type of adenocarcinoma were found independently in a large polypoid tumor. An originating point of one of the signet-ring cell cancer foci was shown by an extensive serial sectioning study.

A pilot study on the usefulness of a new test for mass screening of colorectal cancer in Japan

SummaryA new screening test (Shamsuddin and Elsayed, 1988) based on the enzymatic detection of the disaccharide Β-D-Gal(1→ 3)-D-GalNAc in the rectal mucus of patients with colorectal (CR) cancer and precancerous conditions such as inflammatory bowel disease (IBD) and polyp (precancerous lesions) was evaluated in 85 Japanese patients. Following a 15-minute reaction, a sensitivity of 80.0% (8/10) for CR cancer and 72.2% (8/11) for precancerous lesions was obtained. The overall specificity for combined CR cancers and precancerous lesions was 62.2% (28/45). Correlation with abnormal mucin production in the tissues of CR cancer and precancerous lesions was studied by high-iron diamine-Alcian blue and/or periodic acid-Schiff-Alcian blue (pH= 1.0). The agreement of the results with this test was 77.8% (7/9) for CR cancers and 75.0% (6/8) for precancerous conditions. Because of the simplicity of this test, low cost, stability of the sample and reagents and accuracy for CR cancer and precancerous lesions, the test may have potential use for mass screening of cancer and high risk individuals, particularly CR cancer in Japan.

Adenocarcinoma arising at the perineal wound after pull-through procedure for imperforate anus

An extremely rate case is presented here, of an adenocarcinoma at the site of a long-standing perineal wound, the presence of which was a result of a pull-through procedure for imperforate anus. Wide local excision of a huge mass, including the perineal skin and the distal rectosigmoid segment, was carried out en-bloc on a 35 year old male. This tumor may have been caused by the repeated trauma and frequent ulceration around the perineal wound as a result of poor hygiene due to a fecal incontinence.

Appraisal of surgical treatment for distal ulcerative colitis

Most patients with ulcerative colitis respond well to medical treatment, however surgical treatment may be required in cases with severe clinical symptoms. We treated eight patients with distal ulcerative colitis (DUC), limited to the rectum and distal sigmoid colon, who were treated at St. Marks Hospital by excision of the rectum and sigmoid colon with permanent colostomy. Four who did not respond to medical treatment and had severe and intermittent symptoms of long-standing, three with no control of the distressing diarrhea with a shorter history, and those with a severe dysplasia evidenced by rectal biopsy were surgically treated. Two of eight had a recurrence at the proximal colon within 6 and 10 years respectively but responded well to conservative management. From these observations it concluded that the procedure for patients with DUC may be one of adequate operations. Histological features of the resected specimens did not relate to the postoperative outcome of these patients.