Shouhachi Suzuki

Estrogen and progesterone receptors in gallbladder cancer

Cancerous tissues from 21 patients with primary gallbladder cancer were examined immuno-histochemically for the presence of receptors for estrogen (ER) and progesterone (PGR). ER and PGR, localized in the nucleus, were evident in 52.4 per cent and 0 per cent of the patients, respectively. Furthermore, ER and PGR were positive only in the cytoplasm of cancer cells in 28.6 per cent and 66.7 per cent, respectively. There was a higher tendency of moderately- and poorly-differentiated adenocarcinoma to have an ER-positive rate than well-differentiated adenocarcinoma. With respect to the relationship between ER and sex, ER-positive nuclei were observed in 8 of 14 women (57.1 per cent) and 3 of 7 men (42.9 per cent), but the difference between the two was not significant due to the small number of subjects. These result suggested that gallbladder cancers with ER in the nuclei may respond to antihormone therapy.

A case of melena caused by a hepatic aneurysm ruptured into the intrahepatic bile duct in a patient with allergic granulomatous angiitis

A 46 year old woman was admitted to our institute in June, 1987 with an attack of asthma, as well as remittent fever and leukocytosis accompanied by hypereosinophilia. She was found to have melena from an unknown source upon gastrointestinal examination. Four low-density areas were found in the liver on computed tomography and one of the intrahepatic foci formed a large extrahepatic abscess communicating with the intrahepatic duct on tubography. Resection of the four hepatic segments, including the large abscess, and cholecystectomy were performed. Healed necrotizing arteritis was histopathologically observed in the resected liver specimen, with the four low-density areas on CT scan having all been necrotic foci. One of them formed an intrahepatic biliary fistula and rupture of a hepatic aneurysm into a biliary duct was found to be the cause of melena. Although eosinophil infiltration and extravascular granuloma were not observed, a diagnosis of allergic granulomatous angiitis was made from the characteristic clinical course, systemic vasculitis and peripheral blood eosinophilia. To the best of our knowledge, this is the first report of intrahepatic duct perforation most probably being caused by hepatic aneurysm rupture in a patient with allergic granulomatous angiitis.

Experimental study of intra-abdominal photodynamic therapy

We have studied experimentally the feasibility of the intra-abdominal application of photodynamic therapy (PDT) by using haematoporphyrin derivative (HPD) and an argon-pumped dye laser. The laser was used to irradiated the para-aortic area of normal and tumour-bearing rats. The results revealed that the walls of large vessels, apart from the endothelium, were left intact in normal rats after the treatment. Endothelial cells in the irradiation region disappeared and regenerated within 5 days of PDT. In the rats with tumours, extensive necrosis of the tumour was observed after PDT, and these treated rats survived significantly longer than the untreated ones (P<0.05). This study suggests that PDT for intra-abdominal tumours is a safe and effective adjuvant to other forms of cancer therapy, and that it does not cause serious damage to major blood vessels or other adjacent normal tissues.