[From Dokushoan Nagatomi to Genshun Koishi].

In the middle part of the Edo period (around the later half of the 18th Century), several new-ideated physicians did appear. Among them, Dokushoan Nagatomi and Genshun Koishi were eager to learn western style autopsy. The former got the knowledge from imported Dutch books with the aid of interpreters at Nagasaki and the latter, upon influence of the former, eventually performed on autopsy by himself, aiming at understanding relationships between organ changes and the nature of the diseases of the patients.

[Introduction to the knowledge of physiology in "Ihan Teiko," compared with that of "Jyutei-Kaitaishinsho"].

By translating imported Dutch books on anatomy and physiology, Udagawa Genshin (1769-1824) wrote the book titled "Ihan Teiko" (Concise Model of Medicine) in 1805. Owing to the vast volume of this book, his pupil Fujii Hohtei summarized it to 3 volumes. With these procedures, the book became widely known and read among physicians who had an interest in Dutch style medicine, especially the function of the organs, and tissue.

Cooperative clinical trial of photodynamic therapy with photofrin II and excimer dye laser for early gastric cancer.

Background And Objective: Photodynamic therapy (PDT) is a recently developed endoscopic method for treating malignant tumors. For obtaining more photodynamic action with less thermal effect, we employed as the excitation light source for PDT an excimer dye laser, which is a pulsed laser with extremely high peak power, instead of an argon dye laser, which is a continuous wave laser and has been used conventionally.

Study Design/materials And Methods: The effect of PDT using Photofrin II and the excimer dye laser was evaluated in 27 patients with early gastric cancer.

[Treatise on Kankeru (cancer) written in the book "Komo Ijutsu Monsho" by Goda Daisuke].

"Komo Ijutsu Monsho" (Book on Dutch Style Medicine) was written by Goda Daisuke (1738-1795), who was a physician in Sanuki (Kagawa Prefecture) and younger brother of the author of "Komo Igen" (Introductory Note on Dutch Internal Medicine) Goda Kyugo, by listening to the Japanese interpreters Yoshio Kogyu and Rofu of Nagasaki, around the 1760's. In this book, he noted the nature of Kankeru (cancer), especially of the breast, and also referred to the fact that the disease is curable when it was removed in its early stage. Later on, this information led to the success of surgical resection of breast cancer by Hanaoka Seishu in 1805 by the use of general anesthesia, which he invented.

["Kōmō Igen" written by Gōda Kyūgo].

In 1762, three years after the publication of "Zōshi" (the first anatomical book written by a Japanese) by Yamawaki Tōyō, Gōda Kyūgo, one of the disciples of Tōyō, went to Nagasaki. During his two and a half month stay there he learned Dutch style medicine, especially internal medicine, from the translator Yoshio Kōgyū and his younger brother, by the aid of imported Dutch medical books. Kyūgo recorded their lectures in five volume notes and entitled it "Kōmō Igen" (Medicine of the Netherlands).

[Therapeutic treatment of Borrmann type 4 (scirrhous) gastric cancer-chemotherapy and histopathological studies].

Up to now, there has been no investigation documenting clearly the effectiveness of chemotherapy for Borrmann type 4 gastric cancer from a histopathological viewpoint. In this paper, we present a few representative cases of Borrmann type 4 gastric cancer in which microscopic examination revealed the therapeutic effectiveness (degradation of cancer cells) of neoadjuvant chemotherapy. Further, comparative studies will be needed to clarify the relationship between the assessed effectiveness of therapy by roentgenological and histopathological examination.

Retrospective histological studies on biopsied gastric lesions of patients in whom cancer was diagnosed at follow-up examination.

Serial biopsy specimens of gastric lesions of patients in whom cancer was diagnosed at follow-up examination were reexamined retrospectively; the source materials were 17,429 gastric biopsies carried out on 14,779 patients from 1971 to 1985 at Aichi Cancer Center Hospital. Among these cases, cancers were found at follow-up in 34 cases at locations distinct from the initially biopsied lesions, and in 41 cases, cancerous changes were detected at follow-up at the locations of the original lesions. These 41 cases amounted to 0.

[Histological studies concerning the development of gastric stump carcinoma by endoscopic mucosal biopsies].

225 patients who received partial gastrectomies more than five years ago were examined by endoscopy with mucosal biopsies. In the biopsies taken from mucosa close to the anastomosis, hyperplasia of the foveolar epithelium and glandular cysts, findings identical with "gastritis cystica polyposa", were most often seen following Billroth II resection. Cases in which more than 20 years had elapsed since Billroth II resection revealed the highest rate (65.

Gastric cancer preceded by severe dysplasia.

For elucidation of histogenesis of gastric cancer derived from relatively flat mucosa, 77 cases of surgically resected stomachs with lesions of severe dysplasia in cancerous mucosae or with cancerous changes in severely dysplastic mucosae were detected out of 380 recently examined cases of early gastric cancer. Several examples of early gastric cancer of the superficial type, showing histological changes indicating that they had developed on the preexisted dysplastic mucosal lesions, have been presented, together with the background data. The frequency for detecting such changes was higher in the slightly elevated lesions than in the depressed or eroded ones.

[Initial changes in the development of gastric cancer].

Among 123 cases of surgically resected stomachs bearing minute cancerous foci, which comprised 9.5% of all the early gastric cancers obtained, six cancerous foci with either intestinal type of diffuse-type histology showing the earliest changes of development were selected and the macroscopic and histological features of the foci were presented. Foci of the former type were found in the deepest layer of the gastric foveolae in severely metaplastic mucosa in a budding-like growth pattern and tended to enlarge the area toward the surface of the mucosa, which resulted in tiny focal depressions of the affected mucosa.

Two cases of gastric cancer-bearing double choledochus with ectopic drainage into the stomach.

Two cases of double choledochus with ectopic drainage into the stomach associated with gastric carcinoma were reported. The stomachs were resected because of the presence of cancer, and the orifices of the ectopic bile duct were found in the oral side of the lesions. In these two cases, hyperplasia of gastric foveolas and atrophy of fundic gland, with its cystic dilatation, were observed around the orifices.

UDP-GalNAc:GalNAc-mucin alpha-N-acetylgalactosamine transferase activity in human intestinal cancerous tissues.

GalNAc transferase activities of 6 human intestinal cancerous tissues were examined using bovine submaxillary gland mucin and its desialylated derivative, asialomucin, as acceptors. A Triton X-100 extract of these tissues was used an an enzyme source. All the tissues examined had GalNAc transferase that catalyzes the transfer of GalNAc from UDP-GalNAc to serine or threonine residues of the polypeptide chain.

Gastric dysplasia. Significance and pathologic criteria.

In view of uncertainty regarding the criteria and significance of gastric dysplasia as a precancerous lesion, members of the Pathology Panel of the International Study Group on Gastric Cancer (ISGGC) reviewed microslides of 93 gastric lesions showing varying degrees of mucosal abnormality, and reached the following consensus: (1) immature and proliferating gastric epithelium can be divided into two categories: hyperplastic and dysplastic; (2) the term dysplasia, especially of high-grade type, should be restricted to precancerous lesions, and hyperplasia is applied to regenerative changes; (3) regenerative hyperplasia may be simple or atypical, but dysplasia includes both moderate and severe abnormalities, since they often coexist and can not be sharply separated; and (4) occasionally the possibility of malignancy can not be excluded in a severely dysplastic epithelium; in such a case rebiopsy and diligent follow-up are necessary to establish the diagnosis. Criteria for diagnosing dysplasia and hyperplasia are presented and discussed. The opinions are offered as guidelines for establishing the diagnosis of gastric dysplasia and for prospective studies.

The influence of gastro-jejunal anastomosis on gastric carcinogenesis in rats.

The effect of reflux of the duodenal contents on the development of gastric stump carcinoma induced in male rats was studied. Two gastro-jejunal anastomoses were made in the resected stomach of 28 rats and about half of the rats were also given a single dose of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Well-differentiated adenocarcinomas developed in the resected stomachs with and without MNNG administration at incidences of 40% in the former and 23% in the latter.

Structures of the major oligosaccharides from a human rectal adenocarcinoma glycoprotein.

Four oligosaccharides in the reduced form were isolated from RMG (a mucin-type glycoprotein from a human rectal adenocarcinoma). They were 1) Sia alpha s2 leads to 6GalNAc-ol; 2) Sia alpha 2 leads to 6(Gal beta 1 leads to 3)GalNAc-ol; 3) Sia alpha 2 leads to 6(GlcNAc beta 1 leads to 3)GalNAc-ol; and 4) Sia alpha 2 leads to 6(GalNAc alpha 1 leads to 3)GalNAc-ol. The amounts of oligosaccharides 1, 2, 3, and 4 corresponded to 27, 5, 11, and 8% of the total N-acetylgalactosaminitol produced on alkaline borohydride treatment of RMG.

Isolation and characterization of a glycoprotein from a human rectal adenocarcinoma.

A mucin-type glycoprotein was isolated from a human rectal adenocarcinoma, mainly be gel filtration and hydroxyapatite treatment. The glycoprotein, designated as rectal mucin-type glycoprotein (RMG), was great in amount, accounting for about 1% of the wet tissue weight. From a non-cancerous area of the patient's intestine, a similar glycoprotein reacting with anti-RMG antibodies was obtained, but the tissue content was less than 10% of the RMG content.

Dysplasia of the gastric mucosa and its relation to the precancerous state.

In an Expert Committee of the WHO, dysplastic changes of the stomach were defined as those having the following three histological features: (i) cellular atypia, (ii) abnormal differentiation and (iii) disorganized mucosal architecture. The changes were classified into three grades--mild, moderate and severe. This paper describes and illustrates each grade of dysplasia and discusses in detail the histological differences between severe dysplasia and intramucosal carcinoma.

Precancerous conditions and epithelial dysplasia in the stomach.

A distinction can be made between a precancerous condition and a precancerous lesion. The former is a clinical state associated with a significantly increased risk of cancer, whereas a precancerous lesion is a histopathological abnormality in which cancer is more likely to occur than in its apparently normal counterpart. Up to the present time atrophic gastritis, gastric ulcer, pernicious anaemia, gastric stumps, gastric polyps, and Ménétrier's disease have all been considered as precancerous conditions and lesions of the stomach.

Primary tumors of the esophagus other than squamous cell carcinoma--histologic classification and statistics in the surgical and autopsied materials in Japan.

Clinicopathological features of 405 patients with esophageal tumors other than squamous cell carcinoma, which were resected surgically at 68 institutions in Japan, were analyzed and compared with those of 4,995 cases of esophageal malignant neoplasms autopsied during 19 years (1958-1976) in Japan. Of 405 surgical cases, 149 were benign tumors, most of which (89%) were leiomyomas. The incidence of malignant tumors other than squamous cell carcinoma was 2.

Recent changes in the morphology of gastric cancer in Japan.

The macroscopical and histological features of 4,428 cases of gastric cancer resected stomachs was noted.d surgically between 1953 and 1974 were studied. Of these cases, 81.

Kinetics of preneoplastic epithelia of the the intestinal mucosa induced in Buffalo rats by oral administration of N,N'-2,7-fluorenylenebisacetamide.

A diet containing 0.025% of N,N'-2,7-fluorenylenebisacetamide (2,7-FAA) was administered orally to 18 Buffalo rats for 3 months and to 21 rats for 5 months which corresponded to non-neoplastic stage and preneoplastic stage of carcinogenesis of the intestinal mucosa, respectively. The mitotic index, labeling index, and generation time of the epithelia of the intestinal mucosa of these stages were examined by autoradiography.

Cytoplasmic leucine naphthylamidase activity expressed in signet-ring cell carcinoma of the stomach.

Histochemical studies were performed on signet-ring cells in surgically resected gastric carcinomas from 64 patients. On the basis of periodic acid-Schiff reactivity of the intracellular mucin, the signet-ring cells were classified as type A (immature), type B (intermediate), or type C (mature). Different staining reactions to Alcian blue at pH 2.

Electron microscopy of a ciliated cell in the human stomach.

A ciliated cell was observed electron microscopically in a pyloric gland with intestinal metaplasia. This specimen was obtained from the gastric antrum of a 61-year-old man suffering from gastric cancer. The cell had flask-like contour and possessed numerous cilia protruding from the free surface of a deeply indented cytoplasm into the glandular lumen.

Electron microscopic study of signet-ring cells in diffuse carcinoma of the human stomach.

The signet-ring cells seen in gastric carcinoma of the diffuse type were studied by light and electron microscopy. A classification of these cells into Types A, B and C was developed, based on intracellular mucous granules, nuclei and organelles, and be reactions to PAS and Alcian-blue staining. The gradual transition of type A cells to Type B and the subsequent change of Type B to Type C suggest successive stages in maturation.

Histochemical patterns in early lesions and infiltrating adenocarcinomas induced in mouse duodenum by n-ethyl-n'-nitro-n-nitrosoguanidine.

Intravillous, microcrater, and macroscopic invasive lesions induced in the mouse duodenum by N-ethyl-N'-nitro-N-nitrosoguanidine were examined histochemically. The cells of these neoplastic lesions and the proliferative zones of the normal crypts showed similar staining reactions in leucine aminopeptidase, alkaline and acid phosphatases, adenosine 5'-triphosphatase, and glucose-6-phosphate dehydrogenase. However, a slight decrease in succinic dehydrogenase activity and a slight increase in lactic dehydrogenase activity were observed in the intravillous and microcrater lesions compared to the activity in the proliferative zones of the crypts.