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Small, flat-type advanced colonic adenocarcinomas are rare. We present a case of small colonic carcinoma invading the subserosal layer. A 61-year-old asymptomatic man was admitted for further examination of positive occult blood test. Barium enema and endoscopic examination revealed a small (10 mm in diameter) flat lesion with elevated margins and a central depression, in the transverse colon. Biopsy specimen taken from the tumor showed poorly differentiated adenocarcinoma. Based on radiologic and endoscopic evaluation, a provisional diagnosis was made of colonic tumor with invasion of the deep submucosal layer. Surgical resection of the transverse colon was performed. The tumor was macroscopically a type IIa + IIc lesion measuring 10 mm in diameter. Histological examination showed poorly differentiated adenocarcinoma infiltrating the subserosal layer. Awareness of this type of tumor should allow early diagnosis and treatment, resulting in improved prognosis., Acta medica Nagasakiensia. 1999, 44(1-2), p.66-69

Two cases of superficial depressed type (IIc) early cancer of the colon are reported. Case 1 was a 65-year-old male and case 2 a 69-year old male. The lesion was located in the descending colon in both cases, and was removed by strip biopsy endoscopically in the former and surgically in the latter. The size of the lesion after resection was 6 mm in case 1 and 5 mm in case 2. Histopathologically, both cases were well differentiated adenocarcinoma without adenomatous components, and carcinoma developed de novo by submucosal (sm) invasion. As to the immunohistochemical staining of the cancer tissue by tumor associated antigen, case 1 showed a strong expression of carcinoembrionic antigen (CEA) and partial expression of sialyl Lewisx, and case 2 showed expressions of both CEA and sialyl Lewisx . The nuclear DNA content by flow cytometry was aneuploid only in case 1. Thus, although the two cases were morphologically the same IIc type cancer, the process of carcinogenesis and secondary phenomena varied., Acta medica Nagasakiensia. 1997, 42(1-2), p.56-59

The distribution of endocrine cells in the human intestine was studied by immunostaining using the labeled avidinbiotin technique. The total number of endocrine cells was abundant in the proximal portion of the small intestine and the distal portion of the large intestine. Gastrin, cholecystokinin, and motilin immunoreactive cells were localized in the proximal portion of the small intestine. Peptide YY, serotonin, and glucagon/glicentin immunoreactive cells were distributed more abundantly in the lower large intestine. The serotonin and somatostatin concentrations in the colonic mucosa determined by high-performance liquid chromatography and radioimmunoassay were higher in the distal than proximal portion of the large intestine, being in correlation with the distribution of serotonin and somatostatin immunoreactive cells estimated by immunostaining. Therefore, the regional differences in the number of endocrine cells and the mucosal concentrations of the hormones probably reflect differences in the physiological functions of different regions of the gut. Not many endocrine cells with unknown peptides and animes and immature endocrine cells were present in the lower large intestine. Therefore, the frequent occurrence of carcinoids in the rectum is difficult to explain by the quantitative dominance of endocrine cells alone in the rectal mucosa, and other factors are considered to need evaluation., Acta medica Nagasakiensia. 1994, 39(4), p.30-39

Epidemiological data suggest an increase in both developed and undeveloped countries of inflammatory bowel disease. Furthermore, its etiology and pathophysiology remain unknown. Appropriated animal models are needed. We have studied a rat model of hapten-induced chronic colitis. In Wistar rats, intracolonic instillation of 20 mg or 42 mg of the hapten trinitrobenzene sulfonic acid in 30 % and 40 % ethanol proved to induce chronic colitis after 14 to 21 days of administration, in dose-dependent fashion when compared with ethanol alone that induced only acute colitis after three days of administration. This chronic colitis shares some characteristics with inflammatory bowel disease in humans, specially with Crohn's disease, such as transmural inflammation, development of strictures, ulcerations and infiltration of inflammatory cells throughout the colonic wall. These features make this model suitable for further studies of intestinal inflammation., Acta medica Nagasakiensia. 1994, 39(4), p.1-10

To evaluate the activity level of eosinophils in patients with ulcerative colitis (UC), we analyzed peripheral blood eosinophil counts, serum levels of eosinophil cationic protein (ECP) and the percentage of hypodense eosinophils among all eosinophils in peripheral blood. Patients with active UC had significantly higher serum ECP levels and eosinophil counts, compared with patients in remission and healthy controls. Serum ECP levels correlated positively with eosinophil counts. In patients who could be followed from the active stage of UC to remission, ECP decreased significantly over time and eventually reached approximately normal levels, while eosinophil counts showed no significant change. The mean percentage of hypodense eosinophils (specific gravity < 1.082 g/ml) in peripheral blood was 5% or less in patients in remission and healthy controls, but it was 31.7 % in patients with active UC. These results suggest that eosinophils are activated in patients with UC, and that they are involved in injury to the colorectal mucosa by inducing the release of cytotoxic proteins such as ECP., Acta medica Nagasakiensia. 1994, 39(4), p.40-44

Using two-color immunofluorescence, multiparameter flow cytometry has been used to examine the antigenic characteristics of the nature of changes due to aging in lymphocyte subests. The percentage and absolute numbers of T cells (CD3+T) declined in the aging humans. This decline was associated with a decreasing trend of CD8+T (cytotoxic/suppressor) cells in aging. The aged men had a slight but non-significant increased proportion of CD4+Leu8-T cells, which mediate the helper functions in B cell differentiation in association with an increasing tendency in the number of CD4+ T cells. A wide variety of changes took place in activated T cells expressing antigens such as Leu17(CD38), HLA-DR, or HLA-DQ, Although the decrease in the number of total CD8+ T cells was only slight, the proportion of CD8+ cell bearing Leu7 (CD57) antigen was strikingly increased in the elderly. For NK cells, a total number of NK cells (Leu19+CD3-) in the aged subjects was increased, but a subpopulation of cells having the high NK activity (Leu19+CD57-cells) decreased in the elderly men. The present study revealed various changes in lymphocyte subsets in aging humans., Acta Medica Nagasakiensia. 1992, 37(1-4), p.190-194

Clinicopathological significance of strip biopsy was evaluated in 23 gastric lesions in 22 patients. The 23 lesions consisted of 16 adenomas, 4 adenomas with focal carcinoma, 1 carcinoma, and 2 "no atypical cell"l. Strip biopsy provided precise information for accurate histological diagnosis and the depth of cancer invasion. Eleven % of lesions diagnosed as Group III by forceps biopsy and 66.7% of Group IV lesions had focal carcinoma in adenoma. Sixteen of 23 lesions were completely resected by strip biopsy. Seven lesions resulted in incomplete resection. One patient of the 7 cases underwent piece-meal resection because the lesion was too large to be resected by single strip biopsy. Four of the 7 lesions received additional endoscopic coagulation by laser or heater probe. All lesions except for 2 lesions which were resected by operation were followed by repeated endoscopy and all remained disappeared. The combination of strip biopsy and coagulation therapy appears to give great benefit in eradicating lesions., Acta Medica Nagasakiensia. 1992, 37(1-4), p.66-70

The efficacy of endoscopic laser irradiation for gastric tumors was evaluated on 130 patients. The patients consisted of 51 cases with advanced cancer, 30 with early cancer, 33 with adenoma and 16 with hyperplastic polyp. In 14 of 22 patients with advanced cancer complicated by stricture of the cardiac region, palliation of the stricture was successfully obtained by laser therapy. The survival rate of patients who obtained an effective improvement of the stricture was greater than that of the patients without palliation. Moreover, relief of the stricture enabled the patients to aquire a better quality of life. Significant tumor reduction by the laser did not affect the survival rate. As for early cancer, 12 of the 30 patients were cured by laser therapy. Adequate eradication of early cancer was possible in lesions of 10mm or less in diameter, which were confined to the mucosal layer with differentiated type of histology, and were without ulcer. The indication of curative laser irradiation should be restricted to highly selected patients, and careful follow-up study by restricted endoscopic examination is required. Adenomas were eradicated in 29 of 33 patients. However, cancer developed within a few years of the laser therapy in 3 of these, possibly indicating an adverse effect of the laser. Recently in Japan, endoscopic mucosal resection (EMR) has become the preferred treatment for early cancer and adenoma. Laser therapy, however, is useful when EMR is impossible because of the location or size of lesions, and when the lesions remain after EMR., Acta Medica Nagasakiensia. 1992, 37(1-4), p.9-15

181 gastric polyps obtained by endoscopic polypectomy were studied clinico-pathologically. The polyps occurred most frequently in the lower portion, and the incidence of the polyps tended to increase with age. 91% (164/181) of the polyps were occupied by hyperplastic polyps, and 3 polyps and one polyp respectively with dysplastic and carcinomatous foci were detected in 164 hyperplastic polyps. Although hyperplastic polyps rarely transform into dysplasia or carcinoma, careful follow-up is recommended., Acta medica Nagasakiensia. 1991, 36(1-4), p.238-242