Augmentation of host defense by a unicellular green alga, Chlorella vulgaris, to Escherichia coli infection

Protection against Escherichia coli inoculated intraperitoneally into mice was enhanced by intraperitoneal, intravenous, or subcutaneous administration of a water-soluble, high-molecular-weight fraction extracted from a dialyzed hot-water extract from a strain of Chlorella vulgaris (CVE-A). The enhancing effect was detected with doses over 2.0 mg/kg and when doses were administered 1, 4, or 7 days before the infection. The elimination of bacteria from the spleen of CVE-A-treated mice was increased, and this enhanced elimination may have been related to the acceleration of superoxide generation and chemokinesis in polymorphonuclear leucocytes by CVE-A treatment. A cyclophosphamide-induced decrease in protection against E. coli could be prevented by subcutaneous administration of CVE-A.

[Endoscopic diagnosis and management of colonic polyps]

Colonoscopic diagnosis of colonic polyps is a rather easy task, although some small polyps might be missed when they are situated around the steep angulation or behind the fold. A correct diagnosis of mucosal carcinoma is difficult not only by colonoscopy but also by biopsy because the cancer focus may be small or not exposed on the polyp surface. Therefore, colonoscopic polypectomy is the best procedure of choice for correct histologic diagnosis of mucosal and invasive carcinoma. Only by polypectomy can correct diagnosis of invasive carcinoma be made, although there are various endoscopic signs such as irregularity of the surface configuration and white spots on the surrounding mucosa suggesting invasive carcinoma. Over the course of several years experience of colonoscopy we have encountered small flat elevations under 1 cm in diameter of which 58% were benign adenomas and 42% contained minute foci of carcinoma. These small flat lesions might have been missed quite easily during routine examination in the past and they might play an important role in the pathogenesis of colonic carcinoma. Benign polyp and mucosal carcinoma can be adequately treated by polypectomy only, whereas invasive carcinoma needs further treatment as it has a risk of node metastasis. Risk factors influencing metastasis are lymphatic permeation, poorly differentiated carcinoma, massive invasion close to the cut end. Only when one of these findings is seen in the removed polyp, further surgical treatment must be considered. However, the patient's general condition, age and site of the polyp should be carefully taken into account in order to choose the appropriate treatment in each individual case as the risk of metastasis under such situations mentioned above is not so high. Management of invasive carcinoma is still a controversial issue and a long-term, clinicopathologic study will be needed to solve this question.

Effects of angiotensin II, adrenocorticotropin, and potassium on aldosterone production in adrenal zona glomerulosa cells from streptozotocin-induced diabetic rats

Hyporeninemic hypoaldosteronism has been shown to occur in streptozotocin-induced chronic diabetic rats with normokalemia. To test the nature of the aldosterone deficiency, we investigated the responses of aldosterone production to angiotensin II (AII), ACTH, and potassium in adrenal zona glomerulosa cells from diabetic rats at 6 weeks after an injection of streptozotocin compared with those in the cells from control rats. In diabetic rats, plasma glucose was high and plasma immunoreactive insulin was low. Diabetic rats also had low levels of PRA and plasma AII, low levels of plasma aldosterone, and normal levels of plasma corticosterone and plasma potassium. The zona glomerulosa width was narrower in diabetic rats than in control rats. Basal aldosterone production, when corrected to an uniform number of cells per group, was similar in the cells from control and diabetic rats. Cells from diabetic rats showed a less sensitive and lower response of aldosterone production to AII, increases in the threshold and the ED50, and a decrease in the maximal AII-stimulated aldosterone level. ACTH, however, caused a similar effect on aldosterone production in the cells from control and diabetic rats. Cells from diabetic rats exhibited a less sensitive response of aldosterone production to potassium and a tendency to be low in the maximal potassium-stimulated aldosterone level, presumably attributable to the impairment of adrenal zona glomerulosa cells to AII. We conclude that the hypoaldosteronism observed in our diabetic rats may be secondary to the deficiency of AII.

Transrectal ultrasonography for the assessment of invasion of rectal carcinoma

To make objective and accurate assessment of depth of invasion in rectal carcinoma, transrectal ultrasonography was performed on 49 patients with rectal carcinoma. Two types of scanners were available for use; i.e., 5.0 MHz linear array scanner and 3.5 MHz radial scanner. An experimental study using fresh specimen revealed that the middle low echoic layer of the rectal wall corresponded to the muscularis propria. Depth of cancer invasion was assessed as to whether or not invasion had reached the muscularis propria, or whether invasion had gone through the muscularis propria. The result of 5.0 MHz linear array scan was superior to 3.5 MHz radial scan, and was fairly satisfactory. Future studies, using a sonographic probe with higher frequency and better resolution, are expected to produce valuable benefits in deciding indications for local excision of rectal carcinomas.

Small "flat adenoma" of the large bowel with special reference to its clinicopathologic features

Thirty-three small "flat adenomas," not more than 1 cm in diameter, were collected from surgically and colonoscopically removed specimens, and their colonoscopic and histologic characteristics were described. There were 14 adenomas with mild atypia, five with moderate atypia, 14 with severe atypia (or focal carcinoma limited to the mucosa). The grade of atypia seems to increase with the size of lesions, and these lesions were assumed to play an important role in the adenoma-carcinoma sequence. The importance of recognizing the presence of these small "flat adenomas" in everyday practice is stressed.

[Surgical indication and outcome of Crohn's disease with special reference to management of anal lesions]

A total of 31 cases of Crohn's disease; 23 males and 8 females; 8 small bowel, 11 colon, 8 both small and large bowels involvement and 4 unknown, were collected and analysed. Twelve cases were treated medically and 19 were operated with 61% of operative and 37% of reoperative rate. There was no death due to Crohn's disease. IVH was successful as non-surgical treatment. Indications for surgery were stricture, fistula formation and unsuccessful medical treatment. Limited resection of the diseased segment was performed and in 4 cases diseased segment was left behind without significant postoperative symptoms. Quality of life of the surgically and medically treated patients was satisfactory except one who had many operations during 20 years and still suffers from Crohn's disease. In 15 (48.4%) periproctal abscess or fistula was associated. There were 2 types of anal lesions, the one being ordinary type of low intersphincteric abscess or fistula and the other complex or Crohn's disease related high abscess or fistula. The former was successfully treated by laying-open whereas the latter was treated rather conservatively by drainage not to damage external sphincter muscles. Outcome of medical and surgical treatment of Crohn's disease was quite satisfactory and operation should not be hesitated in patients with serious complications. Type of anal lesion is to be identified and proper surgical treatment should be performed in feasible cases.

B cell malignant lymphoma in a patient with progressive systemic sclerosis and Sjögren's syndrome. Report of a case and review of the literature

We report a patient with progressive systemic sclerosis (PSS) and Sjogren's syndrome (SS) who developed B cell malignant lymphoma 11 and 10 years after the onset of signs of PSS and SS, respectively. As her lymphoma developed, autoantibodies such as rheumatoid factor and antinuclear antibody disappeared from the serum, the lupus erythematosus test yielded negative results and her immunoglobulin levels declined. A good response to chemotherapy was obtained but she died of acute interstitial pneumonitis. Postmortem examination revealed marked diffuse interstitial fibrosis of the lungs.

Antitumor effect induced by a hot water extract of Chlorella vulgaris (CE): resistance to Meth-A tumor growth mediated by CE-induced polymorphonuclear leukocytes

When a hot water extract of Chlorella vulgaris (CE) was injected into the peritoneal cavity of BALB/c mice inoculated with syngeneic Meth-A tumor cells, the survival times were strikingly prolonged. Furthermore, peritoneal exudate cells (PEC) rich in polymorphonuclear cells (PMN) obtained from normal mice 24 h after CE injection exhibited an antitumor effect in a Winn-type assay using normal recipients. Such an activity of PEC remained almost intact after T cell or macrophage depletion. However, such PEC did not express an antitumor effect in a Winn-type assay using irradiated recipients. It was suggested that CE-induced PEC, presumably PMN, expressed an antitumor effect in cooperation with a host- or recipient-derived element(s) sensitive to irradiation. The antitumor mechanism of CE may be different from that of OK-432, one of the biological response modifiers.

Histopathologic comparison of colorectal adenomas in English and Japanese patients

Histopathologic comparison of colorectal adenomas removed at St. Mark's Hospital, London, England, and those removed at the University of Tokyo, Japan was performed. There were 1242 lesions in the St. Mark's series and 310 in the University of Tokyo series. All adenomas were removed either by colonoscopic polypectomy or hot biopsy. The indications and methods of colonoscopic removal were similar in the two series. Age distribution of the patients showed a younger peak incidence in the University of Tokyo series compared with the St. Mark's patients. The percentage of adenomas larger than 1 cm, of tubulovillous or villous type, and with moderate or severe dysplasia were greater in the St. Mark's series than in the University of Tokyo series. Percentages of adenomas with mild, moderate, or severe dysplasia in each category of size did not differ between the two series. In view of the fact that there is a high colorectal cancer risk in England and medium cancer risk in Japan, our results give further epidemiologic support to the concept of the adenoma-carcinoma sequence.

Hypertrophic effect of unavailable carbohydrate on cecum and colon in rats

The effects of unavailable carbohydrate on the cecum and colon were investigated in rats raised on diets containing 20% of glucomannan or cellulose for 8 weeks. Glucomannan ingestion caused the increase of cecum and colon weights, and the effect was greater in the cecum than in the colon. However, on ingestion of cellulose, a remarkable increase in tissue weight was observed in the colon rather than in the cecum. Measurement of DNA, RNA and protein in cecal and colonic mucosa demonstrated that the cecal enlargement caused by glucomannan was dependent on the increases in both number and size of mucosal cells, and that the cecal and colonic enlargements caused by cellulose and the colonic enlargement caused by glucomannan resulted from an increase in the number of mucosal cells; i.e., hyperplasia. (Na + K)ATPase activity of the cecal and colonic mucosa in the cellulose and glucomannan groups was significantly higher than that in the control group. Thus, (Na + K)ATPase activity was increased proportionally to the intensity of the process of tissue enlargement.

Mode of rat cecal enlargement induced by a short-term feeding on glucomannan

The increase in wet weight of rat cecum was evident at 16 hr of glucomannan ingestion and continued until 184 hr (the longest period observed in this experiment), reaching about 2.5-fold. The ratios of total protein/DNA and RNA/DNA were both always higher in cecum of rats fed glucomannan than the control group (0 hr). During the initial 40 hr, no significant change in total DNA content was observed with the increase in total protein and RNA. Furthermore, the incorporation rate of [3H]thymidine in cecal DNA was even lower in the glucomannan feeding than the control (0 hr) during the initial 40 hr. After 88 hr of the experiment, however, a significant increase in the synthetic rate of DNA was found as well as [14C]leucine incorporation into total protein. It was discussed that a hypertrophic change in rat cecum was initially induced by glucomannan ingestion and was followed by hyperplastic growth under continuous exposure of glucomannan.

Augmentation of antitumor resistance by a strain of unicellular green algae, Chlorella vulgaris

Growth of Meth-A tumor in CDF1 mice was inhibited significantly by injection of a hot water extract of a strain of Chlorella vulgaris (CE) into the tumor or into the subcutaneous tissue near the tumor. The augmentation of resistance by CE may require the participation of T cells and macrophages, since it was abolished or reduced in athymic nude mice or mice treated with carrageenan, a macrophage blocker. Mice treated with CE exhibited antigen-specific augmented resistance against rechallenge with tumor. Moreover, the antitumor effect of CE was comparable with that of Corynebacterium parvum, but its mechanism of effect might be different.

[Primary adenosquamous carcinoma of the ileum--a case report]

A 41-year-old woman with a mass of the right lower abdominal quadrant was admitted to our hospital. Ileocecal resection was performed on December 30, 1975; and she is in good health at present. The resected specimen showed a protruded tumor with a central excavation at the terminal ileum; there was a small cyst in the submucosal layer. Histologically, most of the tumor consisted of squamous cell carcinoma. A small nest of squamous metaplasia and adenocarcinoma was observed at the cyst wall. The pathological diagnosis was adenosquamous carcinoma arising from an enterogenous cyst of the ileum.

Macroscopic lesions in dysplasia and carcinoma complicating ulcerative colitis

Visible changes associated with dysplasia or carcinoma have been assessed in 62 colectomy specimens from patients with ulcerative colitis. In 34 colectomy specimens with one or more carcinomas, there were 51 visible carcinomas and 65 macroscopic dysplastic lesions; only one carcinoma was found in flat mucosa. Among 28 specimens with microscopic dysplasia but no carcinoma, eight contained no visible dysplastic lesion, and the remaining 20 contained a total of 40 polypoid or elevated dysplastic areas. In 32 operative specimens removed for long-standing chronic colitis without dysplasia or carcinoma, nine contained visible inflammatory polypoid lesions. On radiological or endoscopic examination of the colon in long-standing colitis close attention should be given to the identification and biopsy of polyps, elevated nodular areas or plaques, strictures, and isolated ulcers. It is likely that colectomy specimens with visible polypoid or elevated dysplastic lesions will contain a carcinoma more often than those removed for dysplasia in flat mucosa.

Gardner's syndrome associated with periampullary carcinoma, duodenal and gastric adenomatosis. Report of a case

A 48-year-old man with Gardner's syndrome, who had abdominoperineal resection for rectal carcinoma in 1962, was found to have an ulcerating growth of the duodenum, and pancreaticoduodenectomy was performed in 1979. Histologic examination by complete step-serial sectioning disclosed a well-differentiated adenocarcinoma with adenomatous remnants, a large adenoma with focal carcinoma, 256 adenomas of the duodenum, and 91 adenomas of the gastric antrum. The world medical literature was reviewed, and 29 cases of periampullary carcinoma and 12 cases of gastric carcinoma complicating familial polyposis coli or Gardner's syndrome were analyzed.

Pathology of colorectal adenomas: a colonoscopic survey

The size, histological type, and grade of dysplasia of a large series of colorectal adenomas removed by colonoscopic polypectomy were matched against other variables such as anatomical site, age, sex, and number of adenomas per patients. Special emphasis was placed on the criteria for grading dysplasia in adenomas and the possible significance of severe dysplasia as a selective marker for increased colorectal cancer risk. The results showed that small adenomas (mostly with mild dysplasia) were evenly distributed throughout the colorectum but that adenomas showing severe dysplasia (mostly the larger tumours, greater than 10 mm diameter) were concentrated in the left colon and rectum, particularly the sigmoid part which is also the segment with the highest risk of colorectal carcinoma in high risk populations. Severe dysplasia in adenomas appears to be a selective histopathological marker for increased colorectal cancer risk. It is closely linked with increasing age and numbers of adenomas per patient, with the large adenomas and particularly those with a villous component in their histology. Severe dysplasia and multiple adenomas could be valuable markers for selecting from the total adenoma population those most deserving of close surveillance in follow-up cancer prevention programmes. Conceptually it would appear advantageous to think in term of the dysplasia-carcinoma sequence in the colorectum rather than the polyp-cancer or adenoma-carcinoma sequence. The implications of these results in the study of the aetiology of colorectal cancer are discussed.

Effect of cimetidine on the regeneration of the gastric mucosa around a peptic ulcer

Histological changes in gastric ulcers during the healing process with cimetidine treatment were compared with those seen with conventional treatment. Healing time of the ulcers was clearly shortened, and the regeneration of the marginal mucosa of gastric ulcers was strongly stimulated by cimetidine. Heightening of the marginal mucosa resulted from active regeneration of the mucosal cells and made the endoscopic features mimic those of gastric cancer. These results suggest that it is necessary to differentiate clearly peptic ulcer from gastric cancer before beginning treatment of a gastric ulcer with cimetidine.

Mechanism of inhibitory effect of unavailable carbohydrate on intestinal calcium absorption

The effect of unavailable carbohydrates on the intestinal absorption of calcium was studied in rats raised for 7 or 8 weeks on diets containing 10 or 20% of cellulose, glucomannan, or pullulan. The following results were obtained a) Body weight gain was diminished more severely in glucomannan groups than in cellulose groups. b) Serum calcium levels were slightly lower in all groups fed unavailable carbohydrates, whereas serum inorganic phosphorus levels were similar to that of the control group. c) There was a significant reduction of bone ash from rats fed glucommanan or cellulose with 620 glycoside bonds. d) Calcium transport measured in the everted duodenal sac remarkable decreased in the glucomannan 20% group, but slightly increased in the cellulose groups. e) Calcium binding activity was lowered significantly in all groups fed unavailable carbohydrates. f) Alkaline phosphatase and sucrase activities in the duodenum were also markedly decreased by prolonged intake of unavailable carbohydrates. These results indicate that inhibitory effect of unavailable carbohydrates on intestinal calcium absorption is partially due to the loss of calcium binding protein caused by gastrointestinal transit of large amounts of undigested substances.

Acquired cystic disease of the kidney and renal cell carcinoma on long term hemodialysis four surgical cases of young adults in Japan

Four surgical cases of acquired cystic disease of the kidney in the third decade are reported, which include renal cell carcinoma in three patients and multiple adenomas and cystadenomas in all patients. The intervening parenchyma of these kidneys was disorganized as end stage kidney and numerous cysts were found in both kidneys. Some of the cysts were lined by hyperplastic epithelium consisting of clear and granular cells arranged in piled up and papillary fashion. These cysts were diagnosed as cystadenoma. Multiple solid adenomas of a 28-year-old male on hemodialysis for 6 years were of various size as if arranged in developing stage of the growth. Summing up all cases included in the literature, the mean duration of hemodialysis of the cases with renal tumor was 5.2 years, while 2.9 years without tumor. With increase of duration of hemodialysis, acquired cystic disease of the kidney is exposed to a high risk of developing malignancy.

Synergistic effect of vitamin C and aspirin on gastric lesions in the rat

The effects of varying levels of dietary vitamin C on the incidence of aspirin-induced gastric hemorrhagic lesions were studied in young, male rats. Rats fed diets containing either 20, 40, or 60 mg of L-ascorbic acid per gram of diet did not exhibit focal gastric lesions. Administering a single oral dose of aspirin (30 mg aspirin/100 g of body weight) to rats fed control diets produced gastric lesions. When the rats were given aspirin plus a diet containing either 40 or 60 mg ascorbic acid per gram of diet, there was a significant increase in number of gastric lesions. Since vitamin C and aspirin seem to act synergistically in producing hemorrhagic lesions in the stomach, it is recommended that all individuals taking megadoses of vitamin C be cautioned against taking aspirin concurrently.

Dietary assessment of coal miners in southern Illinois

A survey was conducted in southern Illinois with a population of 46 coal miners and ex-coal miners ranging in age from 42 to 86 years. All the subjects were suffering from some degree of respiratory insufficiency. Three 24-hr dietary recalls were obtained from each participant and the mean daily intakes of 11 nutrients and calories were calculated by computer. Selected hematological analyses of blood were performed. Dietary intakes of calcium, vitamin A, and vitamin C were lowest within the population sample. The mean blood values indicative of iron status were within normal range. Physical inactivity among some of the miners accompanied by inadequate calcium intakes could predispose them to calcium-related skeletal infirmities. Inadequate intakes of vitamin A by the majority of subjects were particularly significant in this population. The role of vitamin A in maintaining healthy epithelial tissues is discussed and its possible association with a coal miner's susceptibility to pulmonary complications resulting from chronic exposure to coal dust. The results emphasize the value of assessing the nutritional status of individual coal miners and the need for personal dietary counseling.