A series of 1,630 patients with gastric cancer was reviewed with special reference to their ages. The overall resectability rate was 84.6%. With increasing age, there was also an increase in: the male-to-female ratio, the frequency of tumors located in the distal third of the stomach, and the degree of differentiation of the carcinoma (p less than 0.01). There was no age-related association to: tumor size, early gastric cancer of 30-40%, macroscopic classification, histological staging, or symptomatology. The 5-year survival rates did not differ significantly among the various age groups. From 1980 to 1984, clinical characteristics were evaluated in 58 patients under 40 years of age and in 39 patients 80 years of age and older. Preexisting medical illnesses and postoperative complications were more frequent in the aged group; however, there were no operative deaths in either group. In conclusion, although there are several distinct properties depending on the age of the patients, very elderly as well as young patients can be successfully treated.
In a 7 1/2-year period (from 1 January 1980 to 30 June 1987), 997 patients with gastric cancer underwent gastric resection at the Department of Surgery, Matsuyama Red Cross Hospital, Japan. We studied clinicopathologically 83 patients (182 lesions) with synchronous multiple gastric cancer and compared them with patients who had solitary cancers only in the same period. We found that elderly men had a relatively high incidence of multiple gastric cancer, and that early cancer of the elevated well differentiated type was the most common. Of the 182 lesions, as many as 42 (23.1 per cent) were missed in the preoperative examination. Eighteen of these 42 lesions were found only with the aid of a microscope in sections almost incidentally excised. Small flat lesions tended to be missed. We should always be conscious that other gastric lesions may be present when treating patients with gastric cancer.
Five hundred ninety-two patients with early gastric cancer underwent surgical resection from 1970 to 1986 in our hospital, and 13 died from a recurrence of their disease. A careful analysis of these 13 patients suggests that carcinomas which invaded to the submucosa tend to recur more often than those confined to the mucosa. Well differentiated and papillary adenocarcinomas characterized by protruded or elevated lesions tend to recur earlier than poorly differentiated or signet-ring cell carcinomas characterized by depressed or excavated lesions. However, both types recurred from hematogenous metastases, with the liver being the most common site. Therefore, the macroscopic and histological features presently used to characterize early gastric cancer do not provide sufficient information to accurately predict which patients are at most risk for recurrence.
In 20 eyes with posterior subcapsular cataract, ultrastructural changes were observed in the capsule and the subcapsular cortex. In 13 eyes, lens fibers of the subcapsular cortex were markedly swollen and liquefied, and contained granules of various sizes. In 4 eyes, various vacuoles or wide separations of the cell membrane were seen. In 3 eyes, the lens fibers became narrow and showed high electron density. The structure of human posterior subcapsular cataract affects the operation for posterior subcapsular cataract. In 1 case of posterior subcapsular cataract, a lamellar structure containing fine fibrils was observed in the deep layer of the posterior capsule and the epithelial cells which had a long nucleus and poor cytoplasm were scattered just under the posterior capsule. It is considered that these changes in the cells indicated a reduction of cellular function.
A case of rectal carcinoid tumor in a 79-year-old Japanese man is reported. The tumor, 1.5 x 0.9 cm, was localized in both mucosa and submucosa of the rectum with neither invasion nor metastasis. Microscopically, neoplastic cells were mainly arranged in rosette-like and trabecular structures within thin fibrous stroma. Histochemically, both argyrophil and argentaffin reactions were positive. At the ultrastructural level, two distinctive types of neurosecretory granules were found in the cytoplasm of tumor cells.
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