Norio Kawamura

Pepsinogens I and II in Gastric Cancer: An Immunohistochemical Study Using Monoclonal Antibodies

Monoclonal antibodies were used to examine the immunohistochemical expression of pepsinogens I and II in 31 early and 76 advanced gastric cancers. Of the 107 carcinomas studied, 19 contained pepsinogen II and only 3, found exclusively in pepsinogen II‐positive cases, contained pepsinogen I. Gastric cancer produces pepsinogen II more frequently than pepsinogen I, and production of the latter is significantly associated with the former. Historically, there were 54 intestinal‐type and 53 diffuse‐type cancers. The former produced pepsinogen II more frequently than the latter. In the diffuse type, the four pepsinogen II‐positive cases were found exclusively in females. Although the pepsinogen expression was independent of the macroscopic features in advanced gastric cancer, it was found that the protruded‐type early gastric cancer produced pepsinogen II more frequently than the depressed type. Incidences of pepsinogen positivity were not different between early and advanced gastric cancers or between cancers with or without lymph node metastasis, suggesting that production of pepsinogen is independent of tumor growth.

Late Radiation Injury of the Large Intestine : Colonoscopic Findings in 103 Cases

Abstract: Late radiation injury of the colon and rectum after radiotherapy for a pelvic malignancy is a not uncommon complication. Although the colonoscopic appearance of radiation injury is well known, few reports have focused on the progression of radiation proctocolitis. The colonoscopic examinations of 103 patients with late radiation injuries were reviewed. The radiotherapy had originally been administered for carcinoma of the uterine cervix (79 patients), prostate (13), uterine corpus (3), ovaries (3), urinary bladder (2), vagina (2), and pelvic metastasis of breast cancer (1). In 31 patients, changes in colonoscopic appearance were followed‐up. Anal bleeding was the major initial symptom, with more than half experiencing bleeding within 2 years of radiotherapy. Lesions were limited to the rectum and sigmoid colon. The incidence of late radiation injury, according to cancer site, was calculated to be 3.8% for the cervix uteri, 5.1% for the prostate, 0.60% for the corpus uteri, 0.80% for the ovary and 0.35% for the bladder. Seventeen patients underwent colostomy. Between eight and 37 years after radiotherapy, six patients developed a second colorectal cancer. As to radiation injury, two response types, bleeding and stricture, occurred. Virtually no resolution of the strictures was observed in this series. The grade of radiation injury did not correlate with radiotherapy dosage.

A Case of Extensive Gastrointestinal Involvement of Malignant Lymphoma Associated with Early Gastric Carcinoma

Abstract: Described is a 59 year old Japanese man With malignant lymphoma involving the stomach, duodenum, terminal ileum, colon and rectum, who developed early gastric carcinoma. Repeated gastroduodenoscopy revealed various appearances of the gastrointestinal involvement in malignant lymphoma, such as giant folds, polypoid lesions, and ulcerations, in addition to a depressed lesion of early gastric carcinoma. Colonoscopy also showed multiple polypoid lesions throughout the large bowel. Though the gastrointestinal involvement in malignant lymphoma is not rare, diffuse multiple polypoid lesions in the entire large bowel as seen in our case have rarely been endoscopically described.

Ascending Colon Stenosis:A Rare Presentation of Perforated Appendicitis

Abstract: Described is a 49‐year‐old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum.