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  • 1
    Electronic Resource
    Electronic Resource
    Submucosal Dermoid Cyst of the Rectum: Report of a Case (2000)
    Springer
    Surgery today 30 (2000), S. 195-198 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: dermoid cyst, rectum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050043
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  • 2
    Electronic Resource
    Electronic Resource
    Gastritis cystica polyposa associated with a gastric stump carcinoma, with special reference to cell kinetics and p53 gene aberrations (2000)
    Springer
    Gastric cancer 3 (2000), S. 165-170 
    Details
    ISSN: 1436-3305
    Keywords: Key words Gastritis cystica polyposa ; Ki-67 LI ; p53 Gene mutation ; p53 Gene deletion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: We report a case of gastritis cystica polyposa (GCP) that developed in association with a small stump carcinoma. The patient had had distal gastrectomy for peptic ulcer 33 years prior to the present illness. Total gastrectomy was carried out for the stump carcinoma of the remnant stomach, followed by Roux-en-Y anastomosis. Histological examination revealed that the cancer was associated with a GCP lesion in its neighborhood. The resected stomach was subjected to a cell kinetics study and p53 gene analysis, as GCPs are thought to have a high potential for carcinogenesis. The GCP mucosae, as well cancer tissues and remnant mucosae obtained from the same specimens, were investigated and compared. We found that cell kinetics, as measured by a Ki-67 labeling index count, was more accelerated in the GCP than in the remnant mucosa, and that p53 gene aberrations, including both mutations and deletions, took place in the GCP lesion. As the p53 gene is considered to be recessive, in principle, its tumor suppressive activity is lost only when gene aberration, either mutation or deletion, occurs concurrently or successively in both alleles. It was of interest to us that a benign lesion such as GCP had, in this instance, already developed both gene aberrations, strongly suggesting a precancerous nature for this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011713
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  • 3
    Electronic Resource
    Electronic Resource
    Assessment of In Vivo Glucose Kinetics Using Stable Isotope Tracers to Determine Their Alteration in Humans During Critical Illness (2000)
    Springer
    Surgery today 30 (2000), S. 1-10 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: glucose kinetics, critically ill patients, stable isotope, tracer methodology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Glucose plays a central role in energy metabolism, and alterations in its utilization have been reported under a variety of physiological and pathological conditions. The extent and direction of its changes provide useful information to promote the understanding of pathophysiology. The regulation of in vivo glucose kinetics is important because it is closely linked to energy production and the control of amino acid and protein metabolism. Although alterations in glucose kinetics have been demonstrated in critically ill patients, the mechanisms responsible are not well understood. The measurement of glucose kinetics in humans using stable isotopic glucose tracers provides a better understanding of the responses to nutritional support in these patients. While tracer methods have been used to quantitatively measure in vivo kinetics in patients with a variety of critical illnesses as well as in normal volunteers during fasting and exercise in European countries and the United States, they have not received the same attention in Japan. Stable isotopic glucose tracers can be safely given to humans since they are themselves naturally occurring substances, accounting for a small percentage of the total, depending on the isotopic species. The intravenous administration of a glucose tracer allows quantitative assessment of in vivo glucose kinetics under a variety of conditions. This method has wide potential for obtaining kinetic data on all aspects of in vivo glucose metabolism, with major advantages for conducting metabolic studies in humans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010036
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  • 4
    Electronic Resource
    Electronic Resource
    Metastasis to the Forearm Skeletal Muscle from an Adenocarcinoma of the Colon: Report of a Case (2000)
    Springer
    Surgery today 30 (2000), S. 1118-1123 
    Details
    ISSN: 1436-2813
    Keywords: Key words Colorectal cancer ; Distant metastasis ; Skeletal muscle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract While the liver and lung are primary targets for distant metastasis from colorectal carcinoma, metastasis in other distant sites is rarely found. We report herein an unusual case of metastasis to the skeletal muscle of the right forearm from an adenocarcinoma of the transverse colon. A 60-year-old man was originally admitted to our hospital for surgical treatment of an intestinal obstruction caused by a transverse colon carcinoma. Transverse colon resection along with lymph node dissection was performed and no evidence of distant metastatic foci was found. Angiography-enhanced computed tomography scanning done 14 months after the first operation revealed multiple hepatic metastases which were resected. A metastasis was subsequently detected in the right extensor carpi ulnaris muscle 2 years after the primary resection, and a major part of the right extensor carpi ulnaris and the extensor digiti minimi muscle were resected, warranting a sufficient margin of 5 cm of normal tissue from the tumor. Reattachment of the residual muscles into the ulna was performed. Metastases to bone and/or soft tissues from colorectal carcinomas are extremely rare and to our knowledge, only eight other cases have been reported in the world literature. This low incidence may be related to the anatomical characteristics and/or the biochemical environment of the skeletal muscle, but it is also possible that the true incidence is underestimated. Recent improvements in interventional radiological procedures may facilitate a diagnosis of skeletal muscle metastasis being made more frequently.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950070013
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  • 5
    Electronic Resource
    Electronic Resource
    Effects of nafamostat mesilate, somatostatin, and glucagon on caerulein-induced acute pancreatitis in rats (1996)
    Springer
    Journal of hepato-biliary-pancreatic surgery 3 (1996), S. 297-303 
    Details
    ISSN: 1436-0691
    Keywords: caerulein-induced pancreatitis ; experimental pancreatitis ; somatostatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The inhibitory effects of somatostatin (SMS) and glucagon (Gn) on acute pancreatitis were evaluated in an experimental acute pancreatitis model in male Wistar rats. The effects of these agents were compared with those of nafamostat mesilate (NM). The acute pancreatitis was induced by four serial subcutaneous injections of caerulein. The rats were divided into four groups. The first group (n=28) received SMS daily, the second group (n=28) received Gn daily, and the third group (n=28) received NM daily after the first injection of caerulein. The fourth group (n=42) received caerulein alone and served as the control group. Animals were sacrificed 4, 6, 8, 12, and 24 h, and 3 and 7 days after the first administration of caerulein and the degree of severity of the acute pancreatitis was evaluated by serial morphological and histological examinations of pancreatic tissues, as well as in terms of the serum concentrations of amylase and lipase. The characteristic findings of acute pancreatitis in the animals of all groups treated with SMS, Gn, or NM were markedly attenuated at all time points after the treatments compared with findings in the controls (caerulein alone) in terms of wet weight of pancreas, serum concentrations of amylase and lipase, formation of intracellular vacuoles in acinar cells, interstitial edema, and infiltration of an inflammatory cell component. The inhibitory effects of SMS, Gn, and NM on acute pancreatitis were similar at the doses used. These results suggest that SMS and Gn are as useful as NM, they may be of value for the treatment of acute pancreatitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02391031
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  • 6
    Electronic Resource
    Electronic Resource
    p53 Gene mutations and overexpression of p53 product in cancerous and noncancerous biliary epithelium in patients with pancreaticobiliary maljunction (1999)
    Springer
    Journal of hepato-biliary-pancreatic surgery 6 (1999), S. 286-293 
    Details
    ISSN: 1436-0691
    Keywords: Key words:p53 gene mutation ; pancreaticobiliary maljunction ; gallbladder carcinoma ; biliary carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: To investigate the molecular mechanisms of the high incidence of carcinogenesis in the biliary epithelium of patients with pancreaticobiliary maljunction, we examined p53 gene mutations, loss of heterozygosity of p53, and overexpression of p53 gene product in the cancerous and noncancerous biliary epithelium of 27 patients with pancreaticobiliary maljunction. Mutations of the p53 gene were examined by polymerase chain reaction-single strand conformation polymorphism and a direct sequencing method. Loss of heterozygosity of the p53 gene was determined using a double-targeted fluorescence in situ hybridization method. Expression of p53 gene product was examined using immunohistochemical staining. Mutations of the p53 gene were found in 4 of 5 biliary carcinomas (80%) and in 10 of 26 noncancerous biliary lesions (38.5%). Point mutations of the p53 gene were detected at codons 207, 212, and 217 on exons 5 through 8. The incidence of p53 gene mutations on exons 5, 6, 7, and 8 was 12.9%, 36.4%, 0.0%, and 13.8%, respectively. Loss of heterozygosity of p53 was shown in 72% of the cells obtained from the cancerous lesion, and in an average of 14% obtained from the noncancerous lesions. Overexpression of p53 protein was found in 57.1% of carcinoma, and in 31.3% of the noncancerous lesions. These results suggest that p53 gene mutations are involved in the carcinogenesis of biliary epithelium in patients with pancreaticobiliary maljunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340050120
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  • 7
    Electronic Resource
    Electronic Resource
    The Development of an Elevated Lesion Associated with Colitis Cystica Profunda in the Transverse Colonic Mucosa During the Course of Ulcerative Colitis: Report of a Case (2000)
    Springer
    Surgery today 30 (2000), S. 69-73 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: ulcerative colitis, colorectal carcinoma, mucocele
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We report the case of a 53-year-old man with a long history of ulcerative colitis in whom an elevated lesion in the epithelium of the affected transverse colon was initially diagnosed as a benign inflammatory polyp by endoscopic biopsies. After 4 years of follow-up, because the tumor had enlarged and villous components were endoscopically observed on the surface, a colonic resection was performed. The tumor was found to consist of hyperplastic colonic epithelium associated with multiple mucinous cysts lined with dysplastic colonic epithelial cells. Moreover, the mucinous cysts were primarily located beneath the submucosal layer and appeared to intrude into the muscularis propria of the colonic wall. This lesion had a unique pathological feature, presumably indicating neither benign inflammatory epithelium nor a neoplastic lesion of the colonic epithelium. Mucinous cysts lined with colonic epithelial components in the muscularis propria suggest a loss of normal integrity of the colonic wall. Areas of the epithelial cell lining of the mucinous cysts showed apparent structural and nuclear atypia and positive expression for p53, suggesting that this portion of the specimen was dysplastic epithelium. These pathological findings may indicate one longitudinal aspect of tumor development which could provide evidence of premalignant change or initial pathological features during the long-standing course of ulcerative colitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00010051
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  • 8
    Electronic Resource
    Electronic Resource
    Intrahepatic sarcomatous cholangiocarcinoma (1995)
    Springer
    Journal of gastroenterology 30 (1995), S. 677-682 
    Details
    ISSN: 1435-5922
    Keywords: sarcomatous change ; intrahepatic cholangiocarcinoma ; immunohistochemistry ; CEA-positive
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 77-year-old man, diagnosed with a liver tumor, was referred to our hospital. Abdominal ultrasonography demonstrated a low echoic mass in the liver S2 region, and abdominal CT confirmed the presence of a round low-density mass 7 cm in diameter. Enhanced angio-computed tomography (CT) showed a ring-like form with a pale periphery. In the delayed phase of angio-CT, the inside of the mass was enhanced, showing septal stricture. Abdominal magnetic resonance imaging (MRI) revealed a heterogenous low intensity area in T1-weighted images, with a clear high intensity border becoming apparent in T2-weighted images. Stretching of the hepatic artery was evident on the arterial phase of angiography, while an avascular area was apparent in the lateral segment of the liver in the portal phase. Lateral segmentectomy was performed. The size of the tumor was 6×6×5 cm. On macroscopic cross section, it was white and clearly demarcated from the surrounding tissue. Microscopic observation of H&E-stained specimens did not show any glandular formation. The tumor consisted of an irregular fascicular arrangement of spindle-shaped and round cells with poor intercellular adhesion. While there was no region containing differentiated epithelial components, silver impregnation staining revealed structures resembling regenerating bile ducts. The tumor cells were positive for wide-keratin, and for vimentin staining. Tumor cells were carcinoembryonic antigen (CEA)-positive and alpha-feto protein (AFP)-negative. From the above findings, the tumor was judged to have originated from epithelium rather than from mesenchymal elements. The final diagnosis was intrahepatic cholangiocarcinoma with secondary sarcomatous transformation, rather than hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02367798
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  • 9
    Electronic Resource
    Electronic Resource
    End-to-side choledochoduodenostomy: A widely applicable procedure for biliary reconstruction (1997)
    Springer
    Journal of hepato-biliary-pancreatic surgery 4 (1997), S. 71-77 
    Details
    ISSN: 1436-0691
    Keywords: choledochoduodenostomy ; pancreaticobiliary maljunction ; biliary carcinoma ; biliary reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract End-to-side choledochoduodenostomy was originally used for reconstruction between the duodenum and the biliary tree in iatrogenic bile duct stricture. However, we believe the procedure could be applied for various biliary disorders. We have recently shown the high carcinogenicity of biliary epithelium in patients with pancreaticobiliary maljunction, and consequently we recommend excision of the bile duct, along with appropriate reconstruction of the biliary system to divert the flow of pancreatic juice from bile fluid, to prevent carcinoma in biliary epithelium even in patients without dilatation of the bile duct. The conditions causing primary or recurrent bile duct stones must be removed. We employed this procedure for biliary reconstruction in 42 patients with pancreatico-biliary maljunction and in 30 patients with various benign biliary diseases, such as bile duct stones and benign biliary stenosis. We also used the procedure for palliation in 6 patients with malignant tumors around the head of the pancreas. Among these 78 patients over 20 years, we experienced 5 cases of reflux cholangitis with anastomotic stenosis, for which conservative dilatation was required. This procedure of end-to-side choledochoduodenostomy could be widely applicable for biliary reconstruction in terms of its being simplicity, minimal invasiveness and the establishment of a single physiological route for bile flow into the duodenum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01211345
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  • 10
    Electronic Resource
    Electronic Resource
    Hyperplastic polyp of the gallbladder in a child (2000)
    Springer
    Journal of hepato-biliary-pancreatic surgery 7 (2000), S. 448-451 
    Details
    ISSN: 1436-0691
    Keywords: Key words Hyperplastic polyp ; Gallbladder ; Childhood ; Laparoscopic cholecystectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of hyperplastic polyp of the gallbladder in a 6-year-old girl, successfully treated by laparoscopic cholecyctectomy after a 2-year follow-up from the original diagnosis. On her first admission, serum amylase level was very high, so that congenital pancreaticobiliary maljunction (PBM) was suspected. Although it became clear afterwards that the high serum amylase level was derived from a mumps infection, the diagnosis of PBM was not excluded until intraoperative cholangiography was conducted. The tumor in the gallbladder had doubled in size in 2 years. It was not possible to obtain biopsy specimens for histological diagnosis, so the risk of the tumor being malignant could not be completely excluded until surgical resection had been carried out. In spite of the rapid tumor growth, no neoplastic features were seen in the tumor by histopathological examination of the resected specimen; thus, a diagnosis of a hyperplastic polyp of the gallbladder was made.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340070043
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