Naoki Tokimitsu

Simultaneous occurrence of medullary and follicular carcinoma in the same thyroid lobe

A rare case of the simultaneous development of medullary and follicular carcinoma of the thyroid gland in a 51-year-old Japanese woman is examined. A preoperative diagnosis was made by needle aspiration cytology. Neoplastic cells of the medullary carcinoma were positive for calcitonin and carcinoembryonic antigen, whereas the tumor cells of the follicular carcinoma were negative for these substances. This case presents evidence that, in rare cases, two malignant epithelial neoplasms of different origins can occur in the same lobe of the thyroid.

Soy isoflavone intake and stomach cancer risk in Japan: From the Takayama study: Isoflavone and Stomach Cancer Risk in Japan

Although several experimental studies suggested that soy isoflavone intake inhibits the growth of stomach cancer, previous epidemiological studies have observed inconsistent results. We evaluated the associations of soy or isoflavone intake with stomach cancer incidence after considering several lifestyle factors, including salt intake, in a population‐based prospective cohort study in Japan. Subjects were 14,219 men and 16,573 women aged 35 years or older in September 1992. Soy and isoflavone intakes, assessed with a validated food‐frequency questionnaire, were controlled for the total energy intake. Cancer incidence was mainly confirmed through regional population‐based cancer registries. Until March 2008, 441 men and 237 women developed stomach cancer. After adjustments for multiple confounders, a significantly decreased relative risk of stomach cancer was observed in the highest vs. lowest quartile of soy intake; the estimated hazard ratios were 0.71 (95% CI: 0.53, 0.96) for men (p for trend = 0.039) and 0.58 (95% CI: 0.36, 0.94) for women (p for trend = 0.003). Similar inverse associations between isoflavone intake and stomach cancer risk were also observed in women. Higher intake of non‐fermented soy foods was significantly associated with a lower risk of stomach cancer (p for trend: 0.022 in men and 0.005 in women), whereas there was no significant association between the intake of fermented soy foods and a risk of stomach cancer. These results suggest that a high intake of soy isoflavone, mainly nonfermented soy foods, have a protective effect against stomach cancer.

Association of alcohol consumption with the risk of stomach cancer in a Japanese population: a prospective cohort study

Biological studies have provided confirmation of alcohol-related carcinogenesis in the stomach, but the association between alcohol consumption and the risk of stomach cancer remains controversial. We aimed to investigate whether quantitative alcohol intake is associated with the risk of stomach cancer in a large prospective cohort study among a Japanese population. Study participants included 30 714 participants (14 171 men and 16 543 women) aged 35 years or older, who were enrolled in the Takayama study launched on 1 September 1992. Alcohol consumption was assessed quantitatively using a validated food frequency questionnaire. According to alcohol intake (g/day), male participants were classified into quartile groups: Q1, Q2, Q3, or Q4. Female participants were classified into three groups: nondrinkers, and drinkers below or above the median alcohol level. We estimated the hazard ratios and 95% confidence intervals (CIs) for stomach cancer adjusted for age, smoking, BMI, education, total energy intake, salt intake, physical activity, and medical history of diabetes mellitus for each alcohol intake group using the Cox proportional hazards regression model. By the end of March 2008, a total of 678 participants had been diagnosed with stomach cancer. For men, the multivariate-adjusted HRs of stomach cancer for Q2, Q3, and Q4 relative to Q1 were 1.39 (95% CI: 1.07–1.81), 1.35 (95% CI: 1.02–1.79), and 1.38 (95% CI: 1.02–1.87), respectively. In women, no associations were observed. These data suggest that alcohol consumption could be associated with an increased risk of stomach cancer among Japanese men.

An autopsy case of stunted growth with fatty liver cirrhosis, hepatoma, hypogonadism, osteoporosis and lipid pneumonia.

An autopsy case of a short statured (140.5 cm), normally proportioned 31‐yearold woman who had had hypogonadism, abdominal obesity, hyperglycemia, glycosuria, and osteoporosis was presented. There were also fatty liver cirrhosis with hepatoma and lipid pneumonia. The possible relationship between the signs and symptoms during life and pathological changes has been discussed. ACTA PATH. JAP. 18: 171–184, 1968.

[An autopsy case of polymyositis associated with complete A-V block].

致死的な不整脈を呈した多発性筋炎の1剖検例にて,その原因を病理学的に検討した.症例は66才,男性.昭和56年7月より筋力低下が出現し,筋肉逸脱酵素の上昇を認め筋生検にて多発性筋炎と診断された.発症時から完全右脚ブロック,左脚前枝ブロックを認めていたが,昭和58年8月突然完全房室ブロックによる意識消失発作をきたした.体内式ペースメーカー植込術を実施し,小康を得るも翌年4月結核性髄膜炎を併発し死亡した.剖検では固有心筋の変化は軽度であったが,刺激伝導系には脂肪浸潤, fibrosisが著明で,多発性筋炎の刺激伝導系における一次的な障害であると思われた.多発性筋炎による完全房室ブロックはまれで,興味ある症例である.

Three cases of macroamylasemia.

3例のマクロアミラーゼ血症での血中アミラーゼの存在様式,アミラーゼ結合性免疫グロブリンの特異性などを検討した. 3例はいずれも男性(症例1: 55才,症例2: 69才,症例3: 58才)で,それぞれ,糖尿病,高血圧症及び高尿酸血症,或は肝硬変の治療中に,偶然高アミラーゼ血症が発見され,検索の結果, γ-globulin結合(いずれも主にIgAおよびG(κ+λtype))アミラーゼが見出された.これら症例でのアミラーゼアイソザイムの分析,家兎抗ヒトheavy chainおよびlight chain特異抗血清によるimmune precipitationの成績や, SephadexG-200でのcolumn chromatography等の検索結果,およびマクロアミラーゼ血症の臨床的意義について報告した.

[A case of primary hepatocellular carcinoma associated with hyperthyroxine-binding-globulinemia].

概 要: 高thyroxine binding globulin(TBG)血 症 を伴 つた原発 性 肝細 胞癌(肝 癌)の1例 で,血 清 中TBG,α-fetoprotein(AFP)値 が,肝 癌 の進 行 と共 に平行 して上昇,両 者 が解 離 し た死 亡 直前の値 を除 くと正 の相 関(r=0.846,p<0 .05)が 認 め られた.血 清thyroxine(T4), triiodothyronine(T3)値 はTBGと 平行 して増加 したが, free T4 (F-T4), free T3(F-T3) 値 は正常範 囲y-か 正 常 下限 で あつ た.ま た,本 例 のTBGのT3 T4に 対 す る結合 定数 は,低 値 で あ つた.以 上 か ら,本 例 の肝 癌組 織 よ りAFPと 同様,T3,T4結 合 能 の低下 した異 常 なTBGも 産 生 され た可能性 が示 唆 され た.ま た,末 期 には,血 中immunoreactive insulin(IRI)低 値 を 伴 つ た低血 糖 発 作が 頻発 し,insulin-1ike activity(ILA)産 生肝 癌 の可能性 も残 され た. 〔日内会誌 75:1644~1649,1986〕