PubMed Health⌕ Search

Biomedical subjects

Daijo Hashimoto

Publications and source records attributed to Daijo Hashimoto.

At least 19 recordsLinked to original sources

Primitive neuroectodermal tumor arising in the colon: report of a case.

Peripheral primitive neuroectodermal tumors (pPNETs) are usually found in the soft tissue of the extremities, paravertebral region, and chest wall. We report a rare case of a pPNET arising in the colon. A 59-year-old man underwent left hemicolectomy for an infiltrative ulcerating tumor, 11 cm long, in the descending colon. Histological examination of the resected specimen revealed small, round cell proliferation with rosette-like structures, and confirmed regional lymph node involvement and peritoneal dissemination near the primary tumor. Immunohistochemically, the tumor cells were positive for synaptophysin and MIC2 (CD 99). ESW-FLI1 chimeric mRNA was detected in the tumor by reverse transcriptase-polymerase chain reaction. The patient underwent resection of recurrence in the retroperitoneum 3 months later, but metastasis rapidly developed and he died of the disease 7 months after his first operation.

Base Sequence↗

Pyloromyotomy through a sliding umbilical window.

PURPOSE: The semi-circumumbilical incision for treatment of infantile hypertrophic pyloric stenosis, described by Tan and Bianchi (Tan KC, Bianchi A. Circumumbilical incision for pyloromyotomy. Br J Surg 1986;73:399), does not allow a comfortable access to the pylorus in up to 30% of cases, resulting, not infrequently, in unexpected seromuscular lacerations. To get easier access to the pylorus we have performed the Ramstedt pyloromyotomy through a sliding umbilical window after full-circumumbilical incision in 13 initial consecutive cases. PATIENTS AND METHODS: Skin was incised along the entire circumference of the umbilicus, and then was undermined, creating a circular subcutaneous space, 8 cm in diameter. The umbilical window, about 1.5 cm in diameter, was slid diagonally toward the right upper quadrant, by shifting a pair of muscle retractors, 3 to 4 cm from the umbilicus, with the umbilicus left in its original position under the slid skin. Through the sliding window at the right upper quadrant, the abdomen was entered, and the hypertrophied pylorus was identified within the center of the window. Then the pyloromyotomy was performed intracorporeally with ease. RESULTS: In all 13 infants, an adequate pyloromyotomy was safely performed. The wound healed primarily in all cases, without leaving conspicuous scar, subcutaneous abscess formation, or incisional hernia. The postoperative course was quite uneventful in each. CONCLUSION: This new approach allows far easier access to and exposure of the pylorus, and facilitates a safe intracorporeal pyloromyotomy, and achieves an excellent cosmetic outcome.

Female↗

Ornithine decarboxylase, mitogen-activated protein kinase and matrix metalloproteinase-2 expressions in human colon tumors.

AIM: To investigate the expressions of ornithine decarboxylase (ODC), MMP-2, and Erk, and their relationship in human colon tumors. METHODS: ODC activity, MMP-2 expression, and mitogen-activated protein (MAP) kinase activity (Erk phosphorylation) were determined in 58 surgically removed human colon tumors and their adjacent normal tissues, using [1-14C]-ornithine as a substrate, ELISA assay, and Western blotting, respectively. RESULTS: ODC activity, MMP-2 expression, and Erk phosphorylation were significantly elevated in colon tumors, compared to those in adjacent normal tissues. A significant correlation was observed between ODC activities and MMP-2 levels. CONCLUSION: This is the first report showing a significant correlation between ODC activities and MMP-2 levels in human colon tumors. As MMP-2 is involved in cancer invasion and metastasis, and colon cancer overexpresses ODC, suppression of ODC expression may be a rational approach to treat colon cancer which overexpresses ODC.

Antineoplastic Agents↗

Umbilical approach using the sliding-window method to avoid a large abdominal incision: report of two pediatric cases.

The sliding-window method of minimally invasive abdominal surgery was introduced in adults. Here, we describe its use in children. Two girls below age 12 underwent minilaparotomy by this method through umbilical incisions. Conditions requiring the operations were a large omental cyst in one patient and splenomegaly and cholelithiasis in the other. Postoperative courses were uneventful, and cosmetic results were acceptable. An umbilical approach using the sliding-window method is a practical way to avoid large abdominal incisions in pediatric patients undergoing major abdominal surgery.

Child↗

Incarcerated recurrent rectal prolapse with ileal strangulation: report of a case.

We report a rare case of incarcerated rectal prolapse with ileal strangulation occurring after a Gant-Miwa procedure with anal encircling (Thiersch's procedure) for recurrent rectal prolapse. The patient was a 78-year-old woman who presented to our outpatient clinic the day after sudden rectal protrusion had occurred. She had undergone a Gant-Miwa procedure for rectal prolapse 4 years previously, and another Gant-Miwa procedure with anal encircling for recurrent rectal prolapse 18 months earlier. The patient attempted to reduce the prolapse manually, but was unsuccessful. On admission, a 10 x 4-cm semispherical mass was observed extra-anally, with a necrotic surface. We performed an emergency laparotomy, which rerealed a prolapse of the anterior wall of the rectum with part of the ileum protruding into the sac formation. Thus, we resected the incarcerated ileum followed by primary anastomosis and proctectomy (Hartmann's procedure) with good results. This case demonstrates that ileal strangulation can occur as a complication of rectal prolapse recurrence after perineal repair.

Aged↗

Chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion: a case report.

Abstract We report on an extremely rare chest wall mesenchymal hamartoma associated with a massive fetal pleural effusion. Prenatal ultrasound examination demonstrated a heterogeneous mass in the right thorax associated with a massive pleural effusion and right lung compression at 29 weeks of gestation. The patient underwent pleuroamniotic shunting at 30 weeks and was delivered at 33 weeks by cesarean delivery secondary to fetal distress. After management of the respiratory distress and evaluation of the mass, surgery was performed at day of life 8. Histological examination confirmed the diagnosis of a chest wall mesenchymal hamartoma.

Adult↗

[Expression of mRNA levels of thymidylate synthase, dihydropyrimidine dehydrogenase, and orotate phosphoribosyltransferase of colorectal cancer--relationships among mRNA levels in association with response to 5-FU based treatment].

We semiquantificated the mRNA levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and orotate phosphoribosyltransferase(OPRT) from the frozen tissue of colorectal cancer, in order to examine the relationships among these enzymes and the efficacy for 5-fluorouracil (FU)-based treatment in terms of the combinations of the expression levels of these enzymes. There were weak and positive relationships among TS mRNA expression and OPRT mRNA expression or DPD mRNA expression, while there was no significant relationship between DPD mRNA expression and OPRT mRNA expression (n = 112). In 39 patients who received 5-FU-based chemotherapy with evaluable lesions, patients with low TS expression (n = 23) showed a higher response rate (52%) as compared to those with high TS expression (13%, p = 0.02). Patients with low TS, low DPD, or high DPD expression tended to show a higher response rate (50%) than those with the other combinations (26%, p = 0.09). In addition, all of the responders with only one favorable factor (n = 4) were associated with low TS or low DPD expression. In conclusion, low TS expression followed by low DPD expression is important to predict the efficacy of 5-FU-based treatment for colorectal cancer. However, it may be of little significance to semiquantify the expression of OPRT.

Adult↗

Anorectal agenesis with a rectourethral fistula diagnosed in an adult: report of a case.

We report an unusual case of anorectal agenesis with a rectourethral fistula diagnosed in a 48-year-old man. The patient presented after noticing hematuria, although he had been aware of urinary leakage from his colostomy with occasional fecal urine for about 4 years. He had had a double-barrel colostomy created soon after birth for an imperforate anus, with revision at the age of 4 years to correct a prolapse of the stoma, but his malformation had never been repaired. We performed a physical examination, which did not reveal a perineal fistula, but urethrocystography demonstrated high anorectal agenesis with a rectourethral fistula. Thus, we resected the rectourethral fistula and created an end-colostomy. The patient had an uneventful postoperative course, and was discharged in good health on postoperative day 19. To our knowledge, this is the oldest patient to be diagnosed with anorectal agenesis and undergo resection of a rectourethral fistula.

Anus, Imperforate↗

[Tumoral dihydropyrimidine dehydrogenase expression and efficacy of 5-fluorouracil plus leucovorin plus UFT therapy in patients with colorectal cancer].

The purpose of this study was to examine the relation between tumoral expression of dihydropyrimidine dehydrogenase (DPD), the rate limiting enzyme of the degradation pathway 5-fluorouracil (5-FU), and the efficacy of 5-FU based chemotherapy for colorectal cancer. Twenty-eight colorectal cancer patients who had underwent noncurative resection (n = 16) or had developed recurrence (n = 12) were enrolled. All patients were given 5-FU plus leucovorin intravenously and UFT (1 M Tegafur, 4 M Uracil) perorally. The expression levels of the DPD in the primary lesions were determined by the enzyme-linked immunosorbent assay. Group A (n = 10) consisted of one patient with complete response, 4 with partial response, and 5 with no change (time to disease progression (TTP) > = 90 days). Group B (n = 18) consisted of 14 patients with progressive disease and 4 with NC (time to progression, < 90 days). The tumoral DPD levels did not differ between the groups (p = 0.58). There were no effective cases (n = 6) whose tumoral DPD levels were equal to or more than 83.2 U/mg protein (high DPD expression). There were marked overlaps in the DPD levels between the two groups whose DPD levels were less than 83.0 U/mg protein (moderate or low expression). These results suggest that high expression of tumoral DPD would be predictive to failure of fluoropyrimidine-based treatment. However, it is unlikely to set the optimal cutoff value for predicting the efficacy of this type of chemotherapy.

Adult↗

[Histological examination of the effect of hepatic arterial infusion of degradable starch microspheres mixed with adriamycin and mitomycin C for liver metastases of colorectal cancer--second report].

We histologically examined the effect of hepatic arterial infusion of degradable starch microspheres mixed with adriamycin and mitomycin C (DSM therapy) for liver metastases of colorectal cancer. The subjects were 15 liver metastatic lesions from 9 patients with colorectal cancer who underwent potentially curative hepatectomy after DSM therapy. Ages were ranged from 36 to 71 years old (mean, 57). The ratio of male to female was 4 to 5. Six patients had synchronous lesion(s). A single injection dosage of the DSM therapy was comprised of 300-600 mg degradable starch microspheres, 30 mg ADM, and 10 mg MMC. Three lesions from the two patients who were given a single DSM therapy did not show any radiographical changes. In addition, histological examination of these lesions demonstrated a grade 1 effect. The radiographical effect of the 12 lesions from the 7 patients, who were given the DSM therapy at least three times, showed SD in 4 lesions, PR in 6 lesions, and PD in two lesions. Histological examination of these lesions demonstrated Grade 2 in 4 lesions and Grade 3 in 5 lesions. In conclusion, it was histologically confirmed that a repeated DSM therapy could cause satisfactory effects beyond expectations by radiographic imaging in patients with liver metastases of colorectal cancer.

Adult↗

[Efficacy of hepatic arterial infusion of adriamycin and mitomycin C mixed with degradable starch microspheres for liver metastasis of colorectal cancer--correlation with the mRNA expression of DNA topoisomerase-IIalpha and glutathione-S transferase-pi in primary lesions].

DNA topoisomerase-IIalpha (topo-IIalpha) is a target enzyme of adriamycin (ADM). Glutathione-S-transferase-pi is known to be correlated with the resistance of various anticancer drugs including mitomycin C (MMC) and ADM. Expression levels of topo-IIalpha and GST-pi mRNA of primary colorectal lesions were semi-quantitatively determined by the RT-PCR method in 22 patients with colorectal cancer, who underwent hepatic arterial infusion of ADM and MMC mixed with degradable starch microspheres for synchronous (n=17) or metachronous (n=5) liver metastasis. Expression of topo-IIalpha mRNA/beta-actin mRNA was 0.872+/-0.564 (mean+/-SD) in responders (PR, n=10) and 0.369+/-0.133 in non-responders (SD+PD, n=12) (p=0.047). The relative expression of GST-pi was 0.638+/-0.593 in responders and 1.014+/-0.682 in non-responders (p=0.22). These results suggest that determining the mRNA expression of topo-IIalpha is useful for predicting the efficacy for this regimen, whereas determining the mRNA expression of GST-pi is not.

Adult↗

Inflammatory breast cancer: vasculogenic mimicry and its hemodynamics of an inflammatory breast cancer xenograft model.

We recently established a new human inflammatory breast cancer (IBC) xenograft (WIBC-9) originating from a patient with IBC. The original tumor and WIBC-9 revealed invasive ductal carcinoma with a hypervascular structure of solid nests and marked lymphatic permeation in the overlying dermis. In the central part of the solid nests, vasculogenic mimicry, which showed an absence of endothelial cells, was observed. Comparison of WIBC-9 with an established non-IBC xenograft (MC-5), using time-course dynamic micro-magnetic resonance angiography analysis (with a newly developed intravascular macromolecular contrast agent for magnetic resonance imaging) demonstrated that the WIBC-9 tumor had blood flow and a vascular mimicry-angiogenesis junction.

Animals↗

Fulminant amoebic colitis with perforation successfully treated by staged surgery: a case report.

Radical surgery for fulminant amoebic colitis leads to extremely high mortality; however, resective surgery is mandatory if a patient develops massive fecal peritonitis. We herein report an extremely rare case of fulminant amoebic colitis with multiple perforations, which was successfully treated by staged surgical procedures. A 48-year-old man who had been treated with predonisolone under a diagnosis of ulcerative colitis was admitted. Biopsy specimens from the colonic mucosa revealed Entamoeba histolytica. On the day of diagnosis, he developed severe abdominal pain and underwent emergency laparoptomy, showing total colonic gangrene with multiple perforations associated with massive fecal peritonitis. Subtotal colectomy, mucous fistula of the rectosigmoid, and ileostomy were performed. He recovered well although disseminated intravascular coagulopathy developed postoperatively. As the middle and upper part of rectum was found to be severely stenotic 4 months after surgery, we performed proctectomy, ileal pouch anal canal anastomosis, and diverting ileostomy, which was reversed 6 months later. The patient has been well with satisfactory anal function 37 months after the initial surgery. This case suggests that (1). early and accurate diagnosis of amoebiasis is important to avoid surgical intervention, and (2). staged surgery including total colectomy should be considered as one of the treatment choices even in patients with total necrotizing amoebic colitis.

Colectomy↗

Serum levels of tissue inhibitor of metalloproteinases-1 (TIMP-1) in colorectal cancer patients.

PURPOSE: Expression of tissue inhibitor of metalloproteinases (TIMP)-1 in colorectal cancer tissue is known to be related to disease progression; however, the clinical significance of measuring the blood level of TIMP-1, which we evaluate herein, has not yet been clarified. METHODS: The serum level of TIMP-1 was measured by a one-step enzyme immunoassay in 123 patients who underwent resection of primary colorectal cancer. RESULTS: An elevated level of serum TIMP-1 was associated with advanced Dukes' stage ( P = 0.03), greater diameter of the primary tumor ( P = 0.03), more lymph node metastasis ( P = 0.04), and liver metastasis ( P < 0.001). There was a weakly positive correlation between the serum carcinoembryonic antigen (CEA) level and the serum TIMP-1 level. In patients who underwent potentially curative resection, the disease-free survival was not different between those with a high TIMP-1 level (>=203.5 ng/ml, n = 32) and those with a low TIMP-1 level (<203.5 ng/ml, n = 66, P = 0.62). In patients with Dukes' stage D cancer who underwent noncurative resection, the survival times were not different between those with a high TIMP-1 level ( n = 13) and those with a low TIMP-1 level ( n = 10, P = 0.20). CONCLUSIONS: Elevated levels of serum TIMP-1 reflect the extent of colorectal cancer, without a close correlation with the serum CEA level. These findings suggest that measuring the serum TIMP-1 level would not help to predict the prognosis of patients with colorectal cancer.

Aged↗

Muscle strength and walking ability after laparoscopic hernioplasty versus conventional repair.

PURPOSE: We examined muscle strength and walking ability after hernia repair to compare the effects of laparoscopic hernioplasty and conventional repair. METHODS: Twenty-seven patients with primary inguinal hernias were randomly divided into two groups according to the surgical procedure: 15 patients were treated with laparoscopic hernioplasty and 12 with conventional repair. Two types of muscle testing around the inguinal region, one by manual examination and one using a musculator, were done preoperatively and 1 week postoperatively. Walking exercise tests were performed at the same time as muscle testing. RESULTS: Manual examination showed that the postoperative muscle strength of the iliopsoas muscle was decreased in six patients from the conventional repair group, but not in any of those from the laparoscopic hernioplasty group. The musculator showed decreased strength of the iliopsoas muscle after conventional repair, but not after laparoscopic hernioplasty. The walking exercise test showed that conventional hernia repair influenced walking. CONCLUSION: A decline in muscle strength of the iliopsoas muscle and walking ability was evident after conventional repair, but not after laparoscopic hernioplasty. Thus, laparoscopic hernioplasty is superior to conventional repair from the perspective of muscle testing and walking ability.

Adult↗

Carcinosarcoma of the rectosigmoid colon: report of a case.

We report an unusual case of carcinosarcoma of the colon. An 80-year-old woman was admitted to our hospital with lower abdominal pain. Computed tomography showed a large pelvic mass, 18cm in maximal diameter, and barium enema and colonoscopy both showed a type-2 tumor in the sigmoid colon. We performed Hartmann's procedure with resection of the ileocolic segment. Immunohistochemical stains of the resected specimen revealed that most of the tumor consisted of spindle cell sarcoma with neural and muscle differentiation, while only the superficial area of an ulcerated lesion contained adenocarcinoma positive for carcinoembryonic antigen. The patient died of a fast-growing recurrent pelvic tumor 6 months postoperatively. Our experience of this case and our review of eight other cases in the English literature indicate that wide resection provides the best chance of cure, but careful postoperative follow-up is essential.

Aged↗

Determining the levels of matrix metalloproteinase-9 in portal and peripheral blood is useful for predicting liver metastasis of colorectal cancer.

BACKGROUND: Matrix metalloproteinase-9 (MMP-9) is one of the MMPs that play an important role in cancer invasion and metastasis. Increased levels of MMP-9 in tumor tissue have been found to correlate with advanced stages of colorectal cancer. However, the clinical significance of determining the levels of MMP-9 in blood samples from patients with colorectal cancer has not yet been clarified. The purpose of this study was to clarify the relationship between the clinicopathological variables of colorectal cancer and MMP-9 levels of drainage (portal) or peripheral venous blood and to examine whether this assay would be useful for predicting liver metastasis. METHODS: Blood samples were obtained from peripheral and drainage veins of 102 patients with colorectal cancer during surgery and the plasma levels of MMP-9 were determined by a one-step sandwich enzyme immunoassay. RESULTS: The levels of portal MMP-9 were significantly higher than those of peripheral blood (P < 0.01, n = 102). The levels of MMP-9 in peripheral venous blood did not correlate with any of the 12 clinicopathological variables examined, while the levels of MMP-9 in portal blood correlated with macroscopic type of the primary tumor (P = 0.02), Dukes' stage (P = 0.03), liver metastasis (P < 0.01) and lymph node metastasis (P = 0.02). By setting the cutoff ratio of portal to peripheral MMP-9 levels at 1.6 in patients with curative resection (n = 73), elevated ratios predicted subsequent emergence of liver metastases with 77.8% sensitivity, 81.3% specificity and 80.8% accuracy. CONCLUSION: The results suggest that synchronous determination of the levels of MMP-9 in portal and peripheral blood would be useful for selecting colorectal cancer patients at high risk of hepatic recurrence.

Adenocarcinoma↗