These findings indicated that a proximal shift in the subsite distribution of colorectal cancer has occurred in Japan. This rightward shift of colorectal cancer is due to the decreasing proportion of rectal cancer. Furthermore, the increasing proportion of older patients, especially females, may be another major determinant of the changing colon cancer subsite distribution.
Two brothers, aged 21 and 18 years, respectively, presented with Hurler‐like clinical features and normal intelligence. Both had severe dwarfism, characteristic facies, corneal opacities, hearing defect, cardiac enlargement, umbilical and inguinal hernias, and multiple skeletal changes. Both were found to excrete an excessive amount of mucopolysaccharide, shown to be dermatan sulfate and heparan sulfate in the proportion of 9:1. Metachromatic granules could not be found in the peripheral blood leukocytes of either patient. Cultured skin fibroblasts from the younger brother exhibited α‐L‐iduronidase deficiency. In view of these findings, they were diagnosed as Hurler/Scheie genetic compound heterozygotes. A lamellar corneal graft in the older brother remained clear for 4 years after operation.
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