A case of histoplasmosis Report 1. Cinical, mycological and pathological observations

In our country it has been believed that there is no histoplasmosis here in Japan. However, from the above clinical signs, radiological characteristics, laboratory tests, pathological and mycological examinations, and experimental findings, we believe this is the first case of histoplasmosis in Japan.</p

Diagnosis of Gastric Cancer in Early Stage — The Clinical Ob­servation of Operated Cases

1. An attempt has been made to find the diagnostic criteria for early gastric cancer. It is most important to detect the evidences or suspected features of the malignant growth in incipient stage in order to attain the radical cure by surgical operation. 2. Twelve patients with early gastric cancer (groups A and B) were selected out of 476 patients who had undergone gastrectomy during the past three years in the Okayama Saiseikai General Hospital. The other 6 patients in the &#34;precancerous group&#34; (group C) were also studied, who had abnormal epithelial proliferation in the resected stomach membrane during the same period. 3. The processes of discovery of early cancer have been described. Fairly precise diagnosis can be made in the mucosal carcinoma, but it is not in the ulcer-carcinoma. It was generally difficult to estimate the degree of the malignancy and the extension of the growth preoperatively. 4. The details of the diagnostic aids are as follows. i. Negative occult blood of stool does not always mean the definite diagnostic aid. ii. The malignant gastric change may occur even in non-anacidity. Further investigations should be followed up on gastric ulcer patients if malignant alteration is under the consideration. iii. Minor roentgenological findings, such as the absence or irregularity of mucosal folds, rigid and/or overlapped contour, localized absence or decrease of the peristaltic waves and absence or bow-shaped deformity of the angulus, are of important significance. Such changes should be minutely sought for by X-ray film examination. iv. On gastroscopy and gastrocamera photography, such changes as erosion or irregular granular thickening of the membrane with abnormal reddening and edematous appearance, irregularity of ulcer edge, uneven swelling on ulcer margin with reddening and unsharpness of the edge of adherent coat on ulcer floor, must be noted in the early gastric cancer. v. It is not safe to leave a patient having stomach ulceration under a mere conservative management because it is often quite difficult to dissolve the question of malignancy of the lesion with all sorts of examinations. vi. So far as clinical examinations have indicated malignancy, histological examination must be carried out immediately at the time of operation, even when malignant lesion is absent in inspection and palpation on the exposure of the stomach. vii. On the gross observation of the resected stomach, a particular attention must be paid to erosion, depression or atrophy, irregular granular thickening and abnormal reddening on the restricted areas of the mucosal surface.</p

Studies on Histoplasmosis Part II Mycologfcal Studies on the Histoplasma capsulatum Identified in our Department

Aseptic cultivation of various tissues from the patient's corpse with the diagnosis of histoplasmosis since the findings of chest X-ray and the results of clinical tests while in life was attempted and histoplasma capsulatum never identified in Japan was isolated, mycologically identified and it's pathogenicity was confirmed. Furthermore, the author put forward a life cycle of histoplasma capsulatum since the observation of various conditions in relation to the two phases and the electron microscopic observation on the use of the fungus isolated from the reported case

Studies on Histoplasmosis Part I Studies on the Clinical and Pathogical Findings of Histoplasmosis

One case showing a special chest X ray finding with remarkable calcification, differing from miliary tuberculosis or hematogenous diffuse form of moniliasis, was accidentally observed on the study of various diseases with chief complaint of cough and the cases was reported, as the first cases of histoplasmosis in Japan, in marking various observation

Studies on Histoplasmosis Part III Epidemiologic Studies on Histoplamosis

Histoplasmin test and calcification herd of lung field were studied on the people in Okayama prefecture. And the results were as follows. 1. The positive rate was 3.9% in 2, 970 people on the observation of histoplasmin skin test in each district and it showed such a high rate of 8.4% in Mitsuishi district. 2. The positive rate was high in the miners and workers in the brickyard on the observation of professional distinction, and it showed close relation to the profession handling the ground and to the handled ground. 3. No correlation was recognized between histoplasmin and the size of induration or redness of skin reaction. and also between the induration's size of histoplasmin test and the reddend size of tuberculin skin test. 4. On the observation of lung calcification herd in each group of histoplasmin and tuberculin skin test, it showed the most high rate in the group with the positive histoplasminand negative tuberculin skin test, and the distribution of calcification herd in the lung field showed difference between the cases with the positive histoplasmin skin test and the cases with the positive tuberculin skin test and the calcification herd in the former showed a spread tendency to the lung fields. 5. The adoption of the standard being used hitherto, i. e. the size of skin induration between 5 mm and 7 mm was appropraite for the decision of positive histoplasmin skin test. According to this standard, the positive rate of histoplasmin skin test was 0.37% in Okayama prefecture

Studies on Histoplasmosis Part III Epidemiologic Studies on Histoplamosis

Histoplasmin test and calcification herd of lung field were studied on the people in Okayama prefecture. And the results were as follows. 1. The positive rate was 3.9% in 2, 970 people on the observation of histoplasmin skin test in each district and it showed such a high rate of 8.4% in Mitsuishi district. 2. The positive rate was high in the miners and workers in the brickyard on the observation of professional distinction, and it showed close relation to the profession handling the ground and to the handled ground. 3. No correlation was recognized between histoplasmin and the size of induration or redness of skin reaction. and also between the induration's size of histoplasmin test and the reddend size of tuberculin skin test. 4. On the observation of lung calcification herd in each group of histoplasmin and tuberculin skin test, it showed the most high rate in the group with the positive histoplasminand negative tuberculin skin test, and the distribution of calcification herd in the lung field showed difference between the cases with the positive histoplasmin skin test and the cases with the positive tuberculin skin test and the calcification herd in the former showed a spread tendency to the lung fields. 5. The adoption of the standard being used hitherto, i. e. the size of skin induration between 5 mm and 7 mm was appropraite for the decision of positive histoplasmin skin test. According to this standard, the positive rate of histoplasmin skin test was 0.37% in Okayama prefecture