Toru Miyaji

Pancreatic carcinoma in infancy. An electron microscopic study.

A case of a malignant epithelial tumor of tail of the pancreas in a 3‐year‐old Japanese girl is presented. This is the fourth case reported with ultrastructural study. This type of pancreatic carcinoma of the infant has no endocrine granules or endocrine function. The ultrastructural study suggests that the tumor is derived from a primitive epithelial cell with differentiation toward acinar cell.

α-FETOPROTEIN AND HEPATITIS B ANTIGEN IN HEPATOCARCINOGENESIS

Blood from 394 unselected autopsy cases was examined for HB Ag, HB Ab and AFP. Liver morphology of 71 cases of cirrhosis with hepatoma and 32 cases of cirrhosis without hepatoma was studied in detail and correlated to HB Ag, HB Ab, and AFP. Significantly lowered humoral immunity to HB Ag exposure was established for the cirrhosis with hepatoma cases. The exposure rate for both cirrhosis cases with hepatoma and cirrhosis cases without hepatoma was the same (48%), but about 80% of each exposed group were either HB Ag or HB Ab positive. The cirrhosis with hepatoma group tended to be HB Ag positive and the cirrhosis without hepatoma group tended to be HB Ab positive. The lowered immune response seems to be specific to the hepatoma association, because the group with neoplasms other than the hepatoma reacted exactly the same as the group of the cirrhosis without hepatoma. Twenty-five per cent of the cirrhosis with hepatoma were associated with inactive cirrhosis and 75% were associated with active cirrhosis. Seventy-two per cent of the inactive cirrhosis cases with hepatoma were exposed to HB Ag, but only 42% of the active cirrhosis cases with hepatoma were exposed to HB Ag. On the morphological basis, the inactive cirrhosis was interpreted as an impaired cellular immunity and the active cirrhosis as a delayed hypersensitivity reaction. The possibility was discussed that both are important factors in the development of hepatoma preceded by cirrhosis. AFP tends to be positive in the inactive cirrhosis with hepatoma as well as HB Ag, but the relationship between AFP and HB Ag for hepatocarcinogenesis needs further investigation.

ELECTRON MICROSCOPIC STUDIES OF PLACENTAL AND UTERINE TUMORS INDUCED IN RATS

The ultrastructure of eight 7,12‐dlmethylbenz (a) anthracene (DMBA) or 4‐nltroquinollne‐N‐oxide (4‐NQO) Induced malignant tumors of placental and uterine origin in the rat were studied. Three of eight tumors had the ultra‐structural characteristics of choriocarcinoma. The other five tumors had different fine structures. Two were classified as squamous cell carcinoma, one was as a leiomyosarcoma and the other two were undifferentiated sarcoma.

NITROFURAN COMPOUNDS AS A FOOD ADDITIVE

Publisher Summary Nitrofuran compounds have been widely used as antibacterial drugs. Their use as a food additive, however, has been restricted to only a few countries, including Japan. This chapter discusses how a nitrofuran compound was used as food additive and why it was subsequently banned. It presents an extensive, acute, subacute, and chronic toxicity study of furylfuramide in rats and mice. In a study described in the chapter, the hypertrophy of liver cells of a reactive nature was the main change in the rats fed furylfuramide, and its reversibility was also confirmed. In addition, 0.3% furylfuramide feeding was also carried out, but it was not possible to keep the rat alive for more than one year. Complete autopsy and extensive histological examination of the rats that died in these experiments revealed no irreversible changes in any organ. However, there have been some biological fluctuations in the weight of the liver and testis. From these experiments in rats and mice, it was estimated that the 0.0125% diet is the concentration to cause no lesion in these animals.

Prevalence of cerebral hemorrhage and thrombosis in Japan: Study of the major causes of death

Abstract The view has long been held that cerebrovascular disease and especially cerebral hemorrhage is the major killer in Japan, causing about 25% of all deaths, and that these diseases are more frequent in the North. This impression is based on information from death certificates. Data are presented to show a large diagnostic error in certification of cerebrovascular diseases, and especially of cerebral hemorrhage. Comparison of these data with those from autopsies done throughout Japan reveal major discrepancies: malignant neoplasms are the major killer, vascular lesions of the CNS constitute 4.5% of deaths, cerebral thrombosis exceeds cerebral hemorrhage, and predilection for the North is not found. These necropsy data, however, have many deficits, notably factors of selection, age and sex distribution, quality of reports, and small number in relation to total deaths. Autopsies performed by the Atomic Bomb Casualty Commission have greater validity. They are free from biases of selection for hospitalization and clinical interest. The group studied has age and sex characteristics of the mortality group in Japan. The quality of data is relatively high, and material is available for review. The ABCC findings also reveal that malignant neoplasms are the major cause of death, being 30.4%. Vascular lesions of the CNS were the fifth most frequent cause of death, and may be lower. Cerebral thrombosis slightly exceeded hemorrhage in the ABCC series. Clinical data further substantiate the concept that the rate of fatal cerebrovascular disease in Japan is similar to that in the United States. It is suggested that the high rate of cerebrovascular disease, and especially of cerebral hemorrhage, in Japan is an artefact of diagnosis and method of recording.

LEPRECHAUNISM (DONOHUE'S SYNDROME) – TWO AUTOPSY CASES

Two autopsy cases of female newborns with numerous morphologic and metabolic abnormalities were reported. These were considered Identical with a disorder which has been called leprechaunism or Donohues syndrome, and were believed to be the first and second autopsy cases reported in this country. Although it has been presumed that these might be abnormalities of endocrine system or of metabolism, the authors could not find any factors which caused the disorder in spite of minute analysis of steroid hormones In urine, investigation of laboratory data as well as autopsy findings.

CORRELATION OF LIVER FUNCTION AND STRUCTURE OF CIRRHOSIS WITH AND WITHOUT HEPATOMA BASED ON AUTOPSY STUDIES

Fifty‐one cases of cirrhosis with hepatoma, 7 cases of hepatoma without cirrhosis and 70 cases of cirrhosis without hepatoma were studied in correlation of histologic findings and liver function tests.

Symposium: ON THE PATHOLOGY OF CORTICOSTEROID INDUCED MODIFICATIONS, WITH SPECIAL REFERENCE TO HORMONAL IMBALANCES**

An extensive use of corticosteroids in various fields of medicine has drawn attention to the adrenocortical insufficiency induced by this treatment. Although new synthetic corticosteroids with low sodium retaining activity have become available for clinical use, it was demonstrated in our laboratory that adrenalsuppressing activity of each corticosteroid does not parallel either to its sodiumretaining or liver glycogen-depositing activity, but seems to parallel to its granuloma-inhibiting activity, Therefore, at least at present, adrenocortical insufficiency is thought to be an inevitable side-effect in anti-inflammatory cortcosteroid treatment. Clinical and experimental studies were performed in order to clarify the pathologic physiology of adrenocortical insufficiency induced by corticosteroid treatment and to find a way of preventing this adrenocortical insufficiency. At first, an experiment was performed to observe the effect of a synthetic corticosteroid, betamethasone, on daily urinary excretion of 17-OHCS, 17-KGS and 17-KS and on plasma-free cortisol level. Daily administrations of this steroid caused a rapid decrease in urinary steroids, especially in urinary 17-OHCS. However, in the period for one to two weeks after beginning of the treatment, urinary steroids, especially 17-OHCS increased temporarily and then decreased again. A similar fluctuating pattern was observed in urinary 17-KGS and plasmafree cortisol level. After cessation of the treatment for about one month, urinary steroids increased immediately. The plasma ACTH level increased in some patients, one to five days after the treatment had been discontinued. Column chromatographic fraction of urinary 17-KS revealed a more marked decrease in 1 I-oxy-17-KS than in 1 I-deoxy-17-KS. Column chromatographic fractionation of urinary 17-KGS demonstrated a more marked decrease in Frat* Professor of In&& Medicine ** Held at the IXth Autumnal General Meeting of the Society, Nov. 7, 1963.