Tadashige Murakami

Symposium (II): Submucosal tumors of the stomach

Benign nonepithelial tumor which grows covered by gastric mucosa have generally been called the gastric submucosal tumor, but aberrant pancreas and eosinophilie granuloma have been included in this category because the correct diagnosis could not be made preoperatively. The submueosal tumor are infrequent but recently reported seri;cs of this lesions have been increased in Japan . 58~3 cases were reported until 1966 but the number reached to 2,360 until 1973. While the submucosal mass was found in 0.04% in the mass survey in Akita Prefecture during the past three years, le iomyoma of the stomach were reported in 0.12% in autopsy series in Japan . Therefore, the gastric submucosal tumor was not so rare. In our cases, the following ones such as pyloric muscle hyper t rophy in adult type, duplication of the stomach, pseudotumor forming gastric varix, and metastatic lesion of cancer of the stomach were diagnosed as gastric submucosal mass preoperatively. Accordingly, the gastric submucosal mass should include aberrant pancreas, eosinophilic granuloma, pyloric muscle hypertrophy, duplication of the stomach, reactive lymphoret ieular hyperplasia in localized type and carcinoid added to nonepithelial tumor, because these histological findings were not established preoperatively and preoperative diagnosis necessarily depends on radiological and gastroscopic impressions.

Clinical aespects on Australia antigen

Serological studies of Australia (Au) Antigen were performed on 222 patients who were hospitalized at Department of Surgery, Juntendo University. Au Antigen were examined at the time of admission and once per week after they received blood transfusion. Out of 222 patients, 146 had blood transfusion (65.70/o), of which 9 (6.1~ were Au Antigen positive, but none was positive prior to blood transfusion. The nine cases of Au Antigen positive were supposed to be effected by blood transfusion. Nineteen eases showed elevated s -GOT and s-GPT over 100 u., of whom six were between 100 to 200 u. and showed no jaundice. These were temporarily seen at the period of 1 or 2 weeks after blood transfusion. The other 13 cases showed over 200 u. of s -GOT and s -GPT with jaundice, and diagnosed as post-transfilsion hapatitis. Post-transfusion hepatitis were observdd in 8.9%. Among them 2 cases showed Au Antigen positive. The blood volume transfnsed were more than 1,000 nil in most cases. It should be noted that dry plasma was transfused in I 1 cases except 2 cases. Among 9 cases with Au Antigen positive, 2 cases developed post-transfusion hepatitis, attd other cases showed the elevation of s -GOT and s GPT.

On the histogenesis of ulcus- carcinoma in its early stage: A new hypothesis on its formation

ConclusionThe pathohistological interpretation plays the decisive roll in the evaluation of the early gastric cancer. So the histology must be interpreted always actually estimating well the clinical observations and must not be wedded to the conventional or too pathological concepts. I have tried here to make a hypothesis on the mechanism of the ulceration and healing of the malignant ulcer which can be called malignant cycle in the analogy of benign cycle of the benign gastric ulcer. Furthermore I tried to combinates both benign and malignant cycles and discussed the possibility of the formation of the ulcus-carcinoma in Hauser’s type and scarcancer both in the statum and sanctuary type. The primary formation of the ulcus-carcinoma in Hauser’s type was opposite to the new concepts and was supposed that it will be introduced secondary to the scar cancer in principle.