Susumu Hiranuma

Expression of gap junction protein connexin 32 and E-cadherin in human hepatocellular carcinoma

The expression of connexin 32, a major gap junction protein, and E-cadherin, an intercellular adhesion molecule that is supposed to be involved in the regulation of gap junctional intercellular communications, was examined immunohistochemically in seven specimens of human hepatocellular carcinoma and surrounding non-carcinomatous tissues. We found that the number of connexin 32-positive spots per mm2 was significantly less in hepatocellular carcinoma tissues than in the surrounding non-carcinomatous cirrhotic tissues (4360 +/- 3390/mm2 vs 10,030 +/- 3690/mm2; p < 0.01). The number in the latter was also significantly less than that in normal controls (23,560 +/- 4170/mm2). E-cadherin was expressed in all non-carcinomatous hepatocytes as well as carcinomatous cells, except for one case of Edmondsons grade III hepatocellular carcinoma. These results suggest an impairment of cell-to-cell communications in human hepatocellular carcinomas.

Choledochocele with obstructive jaundice: A case report and a review of the Japanese literature

A case of a 57-year-old farmer with a rare type of choledochal cyst (choledochocele; Alonso-Lejs type III) is described. The patient was admitted because of obstructive jaundice and acute biliary infection. Abdominal computed tomography scan showed a cystic lesion in the head of the pancreas, and endoscopic retrograde cholangiopancreatography disclosed cystic dilatation of the terminal portion of the common bile duct. It was suspected that the choledochocele could swell and compress the common bile duct, causing obstructive jaundice and acute cholangitis; therefore, it was surgically resected. We also reviewed 61 cases of choledochocele reported in Japan; the findings were similar to those reported in the English literature.

Clinical studies of gastric cancer cases at a rural hospital in southern district of Ibaraki Prefecture.

茨城県県南地方の農村地帯を診療圏とする土浦協同病院外科における胃癌症例の臨床的検討を行なった。昭和53年1月から昭和63年12月までの11年間に1,287例の胃癌の入院があり, そのうちの1,233例 (95.8%) で手術を施行した。切除数は1,059例 (切除率85.9%), 治癒切除数は863例 (治癒切除率70.0%) であった。胃全摘施行例は337例 (切除例の31.8%), 手術直接死亡率は2.35%, 切除直接死亡率は1.32%であった。昭和53年から昭和58年の間の症例の5年生存率は切除数に対して57.5%, 治癒切除数に対して69.3%であった。昭和55年5月以来, 間接撮影による施設胃集検を行ない, 昭和63年末までに, のべ54,455人の受診者から162例の胃癌を発見した (胃癌発見率0.30%)。そのうちの120例を当施設で手術し, 84例 (70.0%) が早期胃癌であった。われわれの症例を年次的にみると, 切除率, 治癒切除率, 早期胃癌の率, 5年生存率のいずれも次第に向上してきたが, 切除範囲 (全摘率, 合併切除率), リンパ節廓清程度などには年次的変化はなく, この向上は早期例の増加によるものであり, 胃集検, 人間ドックを含めた無症状期の健康診断の受診者の増加が胃癌の手術成績の向上に寄与していた。

Results of gastric mass survey in Tsuchiura Kyodo Hospital.

We began gastric mass survey at our hospital in May, 1980. During 3 years and 8 months since then, (May, 1980-December, 1983) we performed screening examinations to 16, 341 people by indirect radiography, and checked 2, 824 cases (17.3%) for thorough examination. Among these cases, 2, 083 (73.8%) received endoscopic examination actually, and 55 cases of gastric cancer were discovered. The discovery rate of gastric cancer was 0.336 per cent.35 cases of these 55 gastric cancer were operated in the surgical department of our hospital. 34 cases were resected (rate of resection was 97.1%) and 33 cases were resected curatively (rate of curative resection was 94.3%). These results were better than that of gastric cancer cases from out-patient clinic of the same period. The results of cases from out-patient clinic of our hospital were: total number of cases 321, resected cases 254 (79.1%), curative resection 189 cases (58.9%), respectively.