OBJECTIVE: (1) To estimate the prevalence of cancer as an cause of abdominal pain, (2) to identify useful information of history and physical examination, (3) to assess performance of potential screening tests, and (4) to formulate an efficient algorithm for distinguishing patients with cancer.
DESIGN: Prospective observational study.
SETTING: General medical outpatient clinic in a university teaching hospital.
PARTICIPANTS: 470 outpatients (men, 216; women, 254; mean age±standard deviation, 44.6±16.5; age range, 16 to 89) complaining of abdominal pain at their first visits.
MEASUREMENTS AND MAIN RESULTS: A cancer causing abdominal pain was found in 18 patients (3.8%) . These 18 patients with cancer and the remaining 452 patients without cancer were compared regarding clinical findings. Findings significantly more common in patients with cancer were: age of 40 years or over; unexplained weight loss; insidious onset; and duration of pain longer than one preceding month without relief. Among recorded physical findings, countenance reflecting severe pain, fever, and abdominal tenderness were significantly associated with cancer. Elevation of LDH, WBC, CRP, ESR, and CEA were moderately useful discriminators for patients with and without cancer. The logistic regression analysis with complete clinical data set covering history, physical examination and laboratory tests showed that the only findings significantly associated with cancer were unexplained weight loss (odds ratio: 18.9, 95% CI 1.5-20.1), duration of pain over one month (odds ratio: 24.8, 95% CI 1.6-27.9), countenance of severe pain (odds ratio: 159.1, 95% CI 4.5-162.1), and WBC>10, 000 (odds ratio: 22.3, 95% CI 1.1-31.0) .
CONCLUSIONS: Our data support the value of the combined use of history, physical and selected laboratory findings in detecting cancer among patients with abdominal pain. Application of such selected criteria holds the promise of more efficient care with judicious and effective use of endoscopy or sonography without lowering the quality of care.

We have reported that many chrysanthemum- and lettuce-growers have dermatitis caused by juice of the leaves of these plants and that this dermatitis is caused by an allergic mechanism. In arecent questionnaire on the cause of this dermatitis, half the farmers answerd that it was due to agricultural chemicals. Therefore, we tested the farmers by skin patch tests with several widely used chemicals. In the tests, daconil gave the strongest reaction, results being positive in 60% of the farmers. Daconil was very irritative and phototoxic, the percentage of positive reactions in the patch test with 800 times diluted daconil solution of the concentration commonly used being about 30% after 48 hours and about 60% at 48 hours after peeling off the patch.
The parcentage of positive reactions in the skin patch test with several fractions of chrysanthemums on chrysanthemum-growers were significantly higher than non-farm-workers. Similary, tests with allergen extracted from lettuce showed a significantly higher percentage incidence in lettuce -growers than in other subjects. The patch test with 4000 times diluted daconil solution showed ahigher incidence in farmers than in other subjects. Therefore, 4000 times diluted daconil solution seems to cause allergic contact dermatitis in farmers, and as farmers reported, dermatitis seems to be caused by allergy to farm products, and the irritability, phototoxicity and allergenicity of TPN (Daconil).

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.
Asian Continental Ancestry Group ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Epidemiologic Studies ; Female ; Floors and Floorcoverings ; Gingiva ; Hospitals, General ; Hospitals, University ; Humans ; Male ; Melanoma ; Mouth Mucosa ; Mouth Neoplasms ; Neoplasm Metastasis ; Surgery, Oral ; Tongue

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.
Asian Continental Ancestry Group ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Epidemiologic Studies ; Female ; Floors and Floorcoverings ; Gingiva ; Hospitals, General ; Hospitals, University ; Humans ; Male ; Melanoma ; Mouth Mucosa ; Mouth Neoplasms ; Neoplasm Metastasis ; Surgery, Oral ; Tongue