Peyer’s Patches in the Terminal Ileum in Ulcerative Colitis: Magnifying Endoscopic Findings

Peyer’s patches (PPs), a major component of the gut-associated lymphoid tissue, serve as important antigen entry sites in mucosal immunity. PPs may play a role in the extension of ulcerative colitis (UC) into the terminal ileum. We sought to clarify the magnified endoscopic findings of the PPs in the terminal ileum of UC patients. Eighteen UC patients underwent magnifying chromoendoscopy before initial treatment to evaluate the follicle-associated epithelium (FAE) on the PPs domes and the surrounding villi. In 8 UC patients, as in healthy controls, the PPs’ domes were slightly elevated, covered with the regular FAE lining, and surrounded by dense and bulky villi; however, in 10 UC patients, the PPs’ domes were irregular, and the surrounding villi were sparse and atrophic. These abnormal findings within the PPs were associated with minimal mucosal lesions but not with backwash ileitis; both electron microscopy and magnifying endoscopy confirmed that these lesions were reversible following remission with prednisolone-mesalazine therapy. Similar to Crohn’s disease patients, UC patients commonly had abnormalities in the FAE on PPs’ domes and the surrounding villi on magnifying endoscopy

Surgery for Diverticular Disease of the Colon

Surgery for complications of colonic diverticulum was evaluated on the basis of a result of clinical experience for the 15 patients. 1) Average age was 48.9 years, and right-side oriented lesions were more often seen in younger patients. The men and women ratio was 1.5 to 1.0. 2) The reasons for surgery were disticulitis in 7 (46.7%), perforation in 3 (20.0%) and abscess and fistula formation in 2 (13.3%), respectively. 3) Complications on the left side were much more severe than those on the right side and also seen more often in older patients

Malignant Potential in the Analysis of DNA Ploidy Pattern in Patients with Colorectal Cancer

Recently the measurement of cellular DNA content has been focused on knowing the extent of cancer extension and biological behaviour of the tumor cells as well as on producting occurrence of recurrence and the survival time in patients with carcinomas of various organs. And also it is well known that tumor markers such as CEA, CA19-9 and CA72-2 are of great value in predicting recurrence in the follow-up study. It is common that colorectal cancers show well differentiated carcinoma which demonstrates relatively fair prognosis. However, some revealed aggressive and rapid extension of carcinoma, indicating a poor prognosis. The purpose of this study is to certify the significance of the measurement of cellular DNA content for assessing biologic behavior of colorectal cancer in comparison with clinicopathologic factors which have been used for assessment of their prognosis. Development of flow cytometer enabled us to measure the nuclear DNA content with ease, speed and producibility. Furthermore, prevalence of flow cytometric technique makes it possible to know more accurate outcome. When assessed biologically aggressive behavior of tumor cells, potent chemotherapy and extensive surgery are mandatory for improvement of the outcome. It is necessary to search for the method of the accurate assessment of the outcome for patients with carcinomas. The purpose of this study is to clarify the validity of nuclear DNA measurement for assessment of the prognosis in patients with colorectal cancer in comparison with clinicopathologic factors

Surgery for Gastric Cancer in Younger Patients

Twenty-five patients with gastric cancer were clinically evaluated in terms of a clinicopathological pattern in younger patients. 1) Female was more predominant than male. 2) The main tumor location was the cardia and the gross appearance was Borrmann IV of undifferentiated carcinoma in the majority. 3) Less hepatic metastases were seen in younger patients, whereas, the common extension in younger patients was peritoneal dissemination and serosal invasion. 4) The surgical outcome was satisfactory as far as a curative operation be performed. On the contrary, the result of non-curative operation was extremely pessimistic. Recently great strides in the surgical outcome of gastric cancer have been achieved in combination with adjuvant therapy of immunochemotherapy. Improvement of surgical outcome is attributable to the standarized operative procedure with reasonable node dissection. It is common that carcinomas in various organs affect older patients, not usually younger ones. The purpose of this study is to clarify the clinicopathologic features of gastric cancer in younger patients on the basis of our result of clinical experience

En Bloc Resection for Lung Cancer Involving Left Atrium

En bloc resections for patients with left atrium involved by lung cancers were evaluated in the 8 patients in terms of the operative procedure, the indication and the outcome. In one patient, application of extracorporeal circulation was accomplished to perform a complete resection and also to permit patch plasty to compensate volume diminution. En bloc resection on extracorporeal circulation is recommended for patients with limited cancer extension of squamous cell carcinomas without nodal involvement. In addition, emphasis has been placed in the genesis of double cancer in follow-up study according to improvement of surgical result in reflection of susceptibility to carcinomas in other organs

The Validily of Tracheal Surgery for the Aged

Surgery for tracheal stenotic lesions in older patients over age 70 was evaluated in comparison with younger patients under age 69 on the basis of our clinical experience. The causes of tracheal lesions were mainly malignant diseases in spite of varying variety of etiology in the younger patients. The outcome of surgical treatment in the older ones was not inferior to that in the younger ones as far as postoperative complications were prevented. In conclusion, it is emphasized that the surgical treatment of choice is essential for palliation of symptoms and expectance of high quality of life

Esophageal Carcinomas with Synchronous and Metachronous Primary Malignant Carcinomas in Other Organs

Seventeen patients with 10 synchronous and 7 metachronous double cancers with carcinomas of the esophagus were surgically treated in the First Department of Surgery, Nagasaki University School of Medicine. All patients were men with an average of age 68.5. The incidence of double cancers with carcinoma of the esophagus accounted for 12.7% in a total of 134 of this series. The three triple cancers were included. Of the three, one was synchronous triple cancers in the esophagus, the stomach and the colon. The outcome was not necessarily satisfactory. Two had recurrence 3 and 5 months after surgery, but one is still alive for 33 months, free from carcinoma

Significance of Needle Aspiration Biopsy for Breast Cancer

The results of aspiration biopsy cytology were clinically evaluated on the basis of clinical experience with 608 patients with breast cancer at the First Department of Surgery, Nagasaki University School of Medicine. Aspiration biopsy is of clinical value in making a diagnosis of small-sized tumors. There was no detrimental outcome to promote tumor-cell spread locally as well as to give rise to distant metastasis into the other organ. One should be aware of a no cell finding in relation to scirrhous carcinoma and intraductal papillomatosis. Emphasis is placed on recommendation of open biopsy without repeated aspiration maneuver

Blackcurrant Extract with Phytoestrogen Activity Alleviates Hair Loss in Ovariectomized Rats

Ancocyanin-rich blackcurrant extract (BCE) has phytoestrogen activity; however, its effect on hair follicles is unknown. Additionally, hair loss is known to occur during menopause in women owing to decreased estrogen secretion. This study examined whether BCE alleviated female pattern hair loss using a rat model. RNA was extracted and analyzed using a microarray and ingenuity pathway analysis. A quantitative polymerase chain reaction revealed that 1 μg/mL BCE altered many genes downstream of beta-estradiol in human hair dermal papilla cells. Additionally, the expression of the hair follicle stem cell marker keratin 19 was greatly enhanced. In a menopause model, ovariectomized rats were fed a diet containing 3% BCE for three months. An analysis of the number of hair shafts revealed that BCE increased the number of hairs by 0.5 hairs/follicular unit. Moreover, immunostaining revealed that the expression of Ki67 also increased by 19%. Furthermore, fluorescent immunostaining showed that the expression of other stem cell markers, including keratin 15, CD34, and keratin 19, was induced in rat hair follicular cells. In conclusion, these findings suggest that BCE has phytoestrogen activity in hair follicles and contributes to the alleviation of hair loss in a menopausal model in rats