Hiroyasu Iishi

Autofluorescence Imaging Video-Endoscopy System for Diagnosis of Superficial Gastric Neoplasia

An autofluorescence imaging video-endoscopy system (AFI) produces real-time pseudocolor images from computed detection of autofluorescence emitted by endogenous fluorophores in the mucosa. In the AFI images of the gastric body, the fundic mucosa appears purple, whereas atrophic mucosa appear bright green. Gastric tumors appear purple or green in the AFI images according to their morphology, i.e., elevated or depressed, respectively. Therefore, the color patterns of gastric tumors are classified into four types: purple tumors in a green background, purple tumors in a purple background, green tumors in a green background, and green tumors in a purple background. Purple tumors in a green background and green tumors in a purple background are readily distinguished by their color. In contrast, purple tumors in a purple background are difficult to define by color. Green tumors in a green background appear similar in color to the surrounding mucosa, but the tumor extension can be determined by their purple rim. Diagnostic accuracy of AFI for tumor extension was better (68%) than that by white light endoscopy (36%), but was not as good as chromoendoscopy (91%). The low accuracy rate was mainly caused by interference of an ulceration or scar, while the AFI diagnosed flat tumor extension more accurately than did white light images. Because the AFI could visualize flat or isochromatic tumor extension compared with white light endoscopy, it detected more multiple neoplasia in patients who underwent endoscopic treatment.

Case of Superficial Esophageal Adenocarcinoma in Short-Segment Barrett's Esophagus

A 64-year-old man with a history of myocardial infarction presented with heartburn and abdominal fullness that he had had for a month. He visited a primary physician, and barium radiography and esophagogastroduodenoscopy revealed a tumor in the distal esophagus. He was referred to our institute for surgical treatment. Vital status and physical examination revealed no abnormality. Except a mild elevation of the fasting plasma glucose level, blood cell count, blood chemistries, and serum carcinoembryonie antigen (CEA) level were all normal.

Morphological changes of scirrhous carcinoma cell line of human stomach(KATO-III) induced by co-cultivation with human fibroblasts(WI-38).

スキルス胃癌細胞に及ぼす問質線維芽細胞の影響を明らかにするために, ヒト胃印環細胞癌由来細胞 (KATO-III細胞) とヒト胎児肺由来線維芽細胞 (WI-38細胞) を混合培養し, KATO-III細胞の変化を形態学的に検討した. 線維芽細胞と混合培養したKATO-III細胞では, 単独培養時に比べ細胞径が増加し, 糖蛋白, 酸性ムコ多糖類を含む空胞をもつ細胞が著しく増加した. このようなKATO-III細胞の形態学的変化は, 線維芽細胞のconditioned mediumでKATO-III細胞を培養した時にも認められた。また, 混合培養で生じたKATO-III細胞の形態学的変化は単独培養を行うと著減し, KATO-III細胞に認められた形態学的変化は可逆的であることが明らかとなった. 以上の結果は, 線維芽細胞の分泌する液性因子が, スキルス胃癌細胞に可逆的影響を及ぼす可能性を示唆している.