A long-surviving case of gastric cancer with metachronous liver and lung metastases.
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Humans↗
Biomedical subjects
S Baba
Publications and source records attributed to S Baba.
Strictureplasty for Crohn's disease in Japan.
Strictureplasty has recently been advocated in the treatment of obstructive strictures of the small bowel in patients with Crohn's disease. In this group study, results for 69 patients with Crohn's disease who underwent strictureplasty were analyzed by sending questionnaires to 13 institutions belonging to the Research Committee of Inflammatory Bowel Disease of the Japanese Ministry of Health and Welfare. No mortality and anastomotic leakage were observed. Strictureplasties of both the Heineke-Mikulicz and Finney varieties were considered to be safe procedures, even though the sutures had to be applied at the slightly inflammed site. The median follow up was 37 months (range, 0-133 months), and 12 patients needed reoperation. The cumulative 3-year operation-free rate was 92.5% and the 5-year rate was 70.3%. The site of the lesion, the strictureplasty procedure, and previous history of small bowel resection did not significantly influence the operation-free intervals. The cumulative 5-year operation-free rate of the group treated with home elemental enteral nutrition (83.3%) was better than that of the non-treated group (65.3%). Strictureplasty was found to be a safe and effective surgical procedure for high-risk patients with Crohn's disease in whom an appropriate length of bowel should be saved.
Adult↗
The role of endothelin in the pathophysiology of renal impairment during acute liver rejection.
We assessed the role of endothelin in the development of renal dysfunction during acute rejection by examining the effect of a selective endothelin A (ETA) receptor antagonist BQ-123 in rats with acute liver rejection. Serum endothelin levels and endogenous creatinine clearance (Ccr) were monitored on days 1, 3, 5, 7, and 9 postoperatively. As indicators of renal hemodynamics, the estimated hemoglobin concentration of renal tissue (IHb) and the oxygen saturation of hemoglobin in renal blood (ISO2) were determined by reflectance spectrophotometry. In addition, the clearance of inulin and P-aminohippurate were determined, and the renal tissue blood flow was estimated by laser-Doppler flowmetry (LDF). As a model of allograft rejection, Lewis rats were transplanted orthotopically with DA rat livers. The serum endothelin level of allografted rejectors was significantly (P < 0.05) higher than that of isografted controls (Lewis rats with Lewis livers) on postoperative day 5, and it increased to a maximum of 5.38 +/- 0.95 pg/ml on day 9 (versus 1.23 +/- 0.18 pg/ml preoperatively). The values of Ccr, IHb, and ISO2 were all significantly (P < 0.05) lower in allografted rejectors than in isografted controls on day 5, and subsequently declined to a minimum on day 9 (P < 0.01). Treatment of allografted rejectors with BQ-123 markedly improved the renal parameters to levels similar to those in the isografted controls. These results strongly suggest that endogenous endothelin may play an important role in the development of renal impairment during acute liver rejection by reducing renal blood flow through binding with ETA receptor.
Acute Disease↗
Assessment of urinary beta-core fragment of human chorionic gonadotropin as a new tumor marker of lung cancer.
BACKGROUND: Some patients with lung cancer have been found to have elevated levels of serum immunoreactive human chorionic gonadotropin (hCG)/hCG beta (IR-beta), but it is uncertain whether it would be valuable as a tumor marker. Recently, IR-beta has been demonstrated to consist of at least three different molecules, intact hCG, free hCG beta, and hCG beta-core fragment (beta-CF), in body fluids. In this study, the authors qualitatively analyzed IR-beta in the serum and urine of patients with lung cancer and assessed its clinical usefulness as a tumor marker. METHODS: Highly sensitive and specific enzyme immunoassays were established to measure intact hCG, free hCG beta, and beta-CF in the serum and urine of patients with lung cancer. RESULTS: Of 99 patients with lung cancer, almost half of the patients achieved positive values of IR-beta in the urine, although only 12 had elevated values of IR-beta in the serum. The greater part of the elevated urinary IR-beta was identified to be beta-CF by gel chromatography on Sephadex G-100 (Pharmacia LKB Biotechnology, Tokyo, Japan), leading the authors to assess its usefulness as a tumor marker for lung cancer. Based on the cutoff value (0.2 ng/mg of creatinine) from healthy subjects, the overall positive rate of urinary beta-CF for lung cancer was 48.5% (48 of 99 patients). The incidence of the marker increased with stage of disease, from 35.7% (15 of 42) in Stage I and 35.7% (5 of 14) in Stage II to 62.5% (20 of 32) in Stage III and 72.7% (8 of 11) in Stage IV. These positive rates exceeded or equaled those of the serum tumor markers, carcinoembryonic antigen, and squamous cell carcinoma (SCC)-related antigen, measured simultaneously in the same patients. The author were encouraged that there was no significant difference in the positive rates of urinary beta-CF between two major types of lung cancer: adenocarcinoma (49.2%) and SCC (45.2%). Immunohistochemical study revealed positive staining of IR-beta in the cancer tissues from 5 of 12 patients with elevated levels of IR-beta, in which most of the positive cases had the elevated levels of serum free hCG beta (> 0.5 ng/ml) and/or urinary beta-CF (> 1.0 ng/mg of creatinine). CONCLUSIONS: Ectopic production of IR-beta by lung cancer is not rare, and urinary beta-CF might be a potential tumor marker of lung cancer.
Adenocarcinoma↗
Characterization of a 60-kilodalton substrate of the insulin receptor kinase.
A 60-kDa tyrosine-phosphorylated protein has been observed after insulin treatment of cells in immunoprecipitations of the GTPase-activating protein of Ras (called GAP) as well as the phosphatidylinositol 3-kinase. In the present studies, these two 60-kDa proteins have been shown to differ by limited proteolytic digestions as well as by immunoprecipitation with a monoclonal antibody. This monoclonal antibody was also utilized to show that the 60-kDa GAP-associated protein was rapidly phosphorylated in intact cells after insulin stimulation and to associate with GAP only after insulin treatment of the cells. In addition, the 60-kDa protein was found to be phosphorylated in vitro by the insulin receptor. Finally, the 60-kDa protein immunoprecipitated by this antibody was found not to react with a polyclonal antibody directed against a 62-kDa tyrosine-phosphorylated GAP-associated protein previously observed in src-transformed cells. These studies indicate that insulin stimulates the tyrosine phosphorylation of at least two distinct 60-kDa proteins, one that becomes associated with GAP and appears to be a direct substrate of the insulin receptor kinase and another that associates with the phosphatidylinositol 3-kinase.
Animals↗
Hepatopancreatoduodenectomy for advanced gallbladder carcinoma.
OBJECTIVE: To assess the effectiveness of hepatopancreatoduodenectomy (HPD) in patients with advanced gallbladder carcinoma directly invading the liver and pancreas, generally considered to be nonresectable. PATIENTS AND METHODS: Sixty patients with gallbladder carcinoma admitted to our hospital from 1978 to 1992, of whom 55 had Nevin stage V carcinoma and 21 had resectable tumors. Of these patients, seven underwent HPD. The remaining 34 patients had nonresectable tumors. The outcomes of patients undergoing HPD and those with nonresectable tumors were compared and the effect on their quality of life was also analyzed. RESULTS: Postoperative complications occurred in five of the seven patients after HPD, but there were no operative deaths. The 1- and 2-year survival rates were 57% and 28.6%, respectively, with a median survival time of 12 months. In contrast, the 1- and 2-year survival rates of the 34 patients with nonresectable tumors were both 5.8%, and the median survival time was 2 months. The median and mean durations of home stay after HPD were 6 and 10.5 months, respectively. CONCLUSION: Hepatopancreatoduodenectomy has the potential to improve both survival and the quality of life for carefully selected patients with advanced gallbladder carcinoma.
Adult↗
Assessment of the metabolic chiral inversion of suprofen in rat by gas chromatography-mass spectrometry combined with a stable isotope technique.
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Animals↗
Transformation from SAA2-fibrils to AA-fibrils in amyloid fibrillogenesis: in vivo observations in murine spleen using anti-SAA and anti-AA antibodies.
Early amyloid fibrillogenesis from serum amyloid A protein (SAA) has been observed in the murine spleen after an injection of casein-Freund's complete adjuvant in the presence of amyloid enhancing factor, using anti-SAA C-terminal (anti-SAA) and anti-amyloid A (AA) antibodies. In Western immunoblotting of sera, both SAA1 and SAA2 reached a maximum after 24 h and began to decrease after 48 h. In spleen extracts, SAA2, but not SAA1 or AA, was found from 48 h, when amyloid was first deposited in the marginal zone. Electron microscopic immunohistochemistry of this stage showed reaction products from SAA in the marginal zone as fine granules along the cell membrane of mononuclear cells and focal intercellular aggregates, which contained fine fibrils originating from the cell membrane. Amyloid nodules, surrounded by mononuclear cells, developed from this stage. In the nodules, fibrils were positive for anti-SAA only in the vicinity of the cell membrane, while anti-AA stained fibrils throughout. Our hypothesis for fibrillogenesis is thus as follows: Serum SAA2 is specifically deposited on mononuclear cells in the marginal zone and polymerized extracellularly into fibrils, retaining its antigenicity (SAA2 amyloid fibrils); these fibrils are then processed to AA amyloid fibrils in situ by cleavage of the C-terminal portion of SAA2.
Amyloidosis↗
Postoperative changes in plasma tissue-type plasminogen activator and type 1 plasminogen activator inhibitor.
To clarify the changes which occur postoperatively in intravascular fibrinolysis, plasma levels of tissue-type plasminogen activator (t-PA) antigen, the total plasminogen activator inhibitor type-1 (PAI-1) antigen, and the t-PA-PAI-1 complexes were assayed in this study. Blood samples were taken the morning before surgery, then at 0, 12, 24, 36, 60, 108, and 156 h postoperatively in ten patients who underwent radical surgery for thoracic esophageal cancer. The plasma levels of the t-PA and total PAI-1 antigens, and the t-PA-PAI-1 complexes were then measured by enzyme immunoassay. The plasma t-PA and total PAI-1 levels increased significantly in the immediate postoperative period, the percent increase of the latter being much greater than that of the former. Moreover, the calculated free t-PA antigen level was decreased throughout the postoperative period, suggesting postoperative hypofibrinolysis. The platelet count and neutrophil elastase level were significantly correlated with the free t-PA antigen level at r = 0.630, P < 0.001, and r = -0.447, P < 0.01, respectively. The results of this study indicated that post-operative hypofibrinolysis caused by the increased synthesis of PAI-1 may enhance postoperative hypercoagulability, and this may lead to the development of organ damage. Thus, the concentration of the PAI-1 antigen may be a potentially important index for the prediction of postoperative illness.
Aged↗
Metastases from gastric adenocarcinoma presenting as multiple colonic polyps: report of a case.
A 53-year-old woman presented with symptoms of weight loss, diarrhea, and melena. A barium enema with endoscopy revealed multiple colonic polyps which were shown histologically to be metastatic deposits of poorly differentiated adenocarcinoma. The primary tumor, a poorly differentiated gastric adenocarcinoma, had been resected 11 years earlier. This appears to be only the second published report of polypoid colonic metastases from gastric adenocarcinoma.
Adenocarcinoma↗
Variables related to risk of recurrence in rectal cancer without lymph node metastasis.
BACKGROUND: There has been recent interest in the use of local excision for rectal cancer under consideration of patient's quality of life. However, local excision of the primary tumor does not remove the areas of lymphatic spread. Therefore, the decision to use this procedure must be considered carefully. METHODS: The authors retrospectively analyzed 142 patients who underwent radical resection of rectal cancer without lymph node metastasis in order to define the risk factors for recurrence. The macroscopic and microscopic pathological characteristics, immunohistochemical staining for p53, and DNA ploidy pattern of the primary tumor were examined as potential predictors of recurrence. RESULTS: The rates for 5-year disease-free survival, local control, freedom from distant metastasis, and overall survival in these 142 patients were 87%, 93%, 93%, and 91%, respectively. Factors related to recurrence and prognosis included the depth of tumor invasion, vascular/lymphatic involvement, tumor differentiation, and tumor size. However, p53 staining and DNA ploidy pattern were not useful indicators. CONCLUSIONS: Our findings suggest that adjunctive radiotherapy and chemotherapy should be considered for patients who have rectal cancer without lymph node metastasis in the following situations: tumor invasion of the serosa, vascular/lymphatic involvement, moderately differentiated adenocarcinoma, and lesions > 2 cm in diameter. Local excision should not be used in these situations, even if there are no lymph node metastases.
Adenocarcinoma↗
Motor function in 90-year olds measured by optoelectronic kinesiology and activities of daily living.
Computer-assisted optoelectronic movement analysis using a Posturo-Locomotor-Manual (PLM) test, and assessment with an ADL (Activities of Daily Living) scale were performed in 36 (18 women and 18 men) 90-year-old subjects as part of a larger study. In the PLM test, the subjects were asked to pick up an object placed on the floor, and carry it to a shelf at the height of their chin and at a distance of 150 cm from the starting position. In the ADL assessment, the subjects were classified as ADL-dependent or independent in each of 4 instrumental (cleaning, shopping, transport and cooking) and 5 personal activities (bathing, dressing, going to the toilet, transfer and feeding). ADL independence was defined as being able to perform ADL activities without assistance from another person. In this study, ADL-dependent subjects performed the PLM test considerably more slowly than the ADL-independent group. A correlation was found in females between poorer ADL performance and slower and less co-ordinated PLM test results. Particularly, the Postural and Locomotor phases representing lower limb mobility correlated to the ADL steps. In males, no such correlation was found, indicating that factors other than mobility were important for ADL performance in this group, e.g., cooking skills. The relationships between the PLM test and the ADL assessment estimating practical motor function could be an indication that the PLM test is not only a strict laboratory method, but also measures components of everyday motor activities. Combined use of optoelectronic measurements and ADL scales will improve measurements of motor performance in elderly persons.
Activities of Daily Living↗
History and current activities of the International Diabetes Federation-Western Pacific Region (IDF-WPR).
International Diabetes Federation (IDF) is one of the biggest non-governmental organizations with its 44-year history since 1950. In 1993, 114 diabetes associations in 96 countries participated in the IDF. In 1982, it was decided to divide the globe into seven regions and to promote the diagnosis, treatment, care and education of diabetes based on the environment, natural features, culture and race of the each region. On January 24, 1984, the IDF-WPR establishment meeting was held in Melbourne, Australia, with eight original member countries (Australia, New Zealand, Korea, The Philippines, Malaysia, Singapore, Fiji and Japan). In 1993, 13 diabetes associations in 12 countries joined the IDF-WPR. New member associations are from China (Beijing and Taipei), Hong Kong, Papua New Guinea and Indonesia. The IDF-WPR has been holding congresses and council meetings every 3 or 4 years since 1984 as well as formulating strategic action plans in the scientific, clinical, health care and education fields of diabetes.
Asia, Southeastern↗
Negative and positive effects of intracerebroventricular scopolamine on memory in mice undergoing passive avoidance and escape tests.
The effects of intracerebroventricular administration of scopolamine on memory and learning in the conscious, freely moving mouse were evaluated using step-down passive avoidance and water maze tests. A new technique was used that allows convenient injection into the cerebral ventricles without disturbing the animal's behavior. No significant changes in locomotor activity were observed after low doses of scopolamine (0.1 and 1.0 microgram). However, 10 micrograms produced an increase in locomotor activity, while 100 micrograms caused an initial decrease followed by an increase in activity. In the passive avoidance test, scopolamine significantly impaired memory acquisition at doses higher than 1.0 microgram, consolidation at a dose of 100 micrograms, and retrieval at doses of 10 and 100 micrograms. In contrast, a dose of 0.1 microgram significantly improved consolidation and retrieval. In the water maze with a bridge, scopolamine either impaired memory acquisition, consolidation, and retrieval, or had no significant effect in the dose range tested. These results suggest that there are differences in the process of memory formation in the passive avoidance and escape tests.
Animals↗
Flow cytometric bromodeoxyuridine/deoxyribonucleic acid bivariate analysis for predicting tumor invasiveness of upper tract urothelial cancer.
We previously reported that flow cytometric bromodeoxyuridine/deoxyribonucleic acid (DNA) bivariate analysis can provide important information on the malignant potential of bladder cancer. Therefore, in the current study we further evaluated upper tract urothelial tumors to clarify whether DNA/bromodeoxyuridine bivariate analysis can provide additional prognostic information on patients with upper tract urothelial tumor. A total of 43 upper tract urothelial tumors that were resected by nephroureterectomy was analyzed. Flow cytometric DNA ploidy and bromodeoxyuridine labeling were determined by an in vitro bromodeoxyuridine labeling method. DNA diploid tumors were associated with an 85.9% 3-year survival rate compared to 36.5% for DNA aneuploid tumors. On the other hand, 11 high bromodeoxyuridine labeled tumors demonstrated a 16.4% 3-year survival rate compared to 82.4% for those with low bromodeoxyuridine labeled tumors. Multivariate survival analysis using the Cox proportional regression model was performed to identify the most informative factors for prognosis, with the single most important factor being histological tumor stage. Nearly as important and the next factor to be chosen was tumor grade, followed by bromodeoxyuridine labeling index status. DNA ploidy status did not influence clinical outcome. Thereafter, when actuarial 3-year survival rates according to the bromodeoxyuridine labeling index status in grade 3 tumors were estimated, 68.4% and 16.7% 3-year survival rates were observed in cases of low and high bromodeoxyuridine labeling index tumors, respectively. These results indicate that flow cytometric bromodeoxyuridine/DNA bivariate analysis may be useful in dividing patients with grade 3 upper tract urothelial carcinoma into 2 different prognosis groups.
Bromodeoxyuridine↗
Laparoscopic surgical correction of circumcaval ureter.
Laparoscopic transposition and reanastomosis of a circumcaval ureter were performed in a 52-year-old man with right flank pain. A preoperative perfusion pressure study revealed abnormally high intrapelvic pressure. Under laparoscopy, the renal pelvis was divided above the ureteropelvic junction and the ureter was relocated from behind the vena cava. A 5 cm segment of redundant ureter containing the postcaval segment was resected and the ureteral end and renal pelvis were reapproximated with interrupted sutures by intracorporeal knot typing. The postoperative convalescence was uneventful, not necessitating the administration of analgesics. The patient resumed full activities 3 weeks later. The intravenous urogram and renogram obtained 2 months after the operation revealed remarkable improvement in the ureteral obstruction.
Abnormalities, Multiple↗
Endopyelotomy in horseshoe kidneys.
Three patients aged 23 to 43 years underwent endopyelotomy to treat stenoses of the ureteropelvic junction (UPJ) in horseshoe kidneys. One patient had failed open primary pyeloplasty and division of the isthmus previously. The other two patients had primary UPJ obstruction and small caliceal calculi associated with horseshoe kidneys. A hook-shaped cold knife was used to incise the ventromedial wall of the stenosis because of malrotation of UPJ in the horseshoe kidney. In two patients, a 14F endopyelotomy stent was left indwelling for 6 weeks. All three patients improved symptomatically, and two patients have shown persistent improvement of renal function radiographically for 52 and 34 months. These results suggest that endopyelotomy can be safely applied to UPJ obstruction in horseshoe kidneys with high efficacy.
Adult↗
Three subtypes of poroid neoplasia in a single lesion: eccrine poroma, hidroacanthoma simplex, and dermal duct tumor. Histologic, histochemical, and ultrastructural findings.
A single poroid neoplasm composed of three histologically distinct lesions (hidroacanthomas simplex, eccrine poroma, and dermal duct tumor) is reported. Comparative histologic, histochemical, and electron-microscopic studies revealed that each tumor subtype contained varying proportions of poroid cells, clear cells, and cuticular cells. The major component of all three neoplasms was poroid cells, which, under the electron microscope, were characterized by a few, small, poorly developed desmosomes, and were histochemically characterized by a positive succinic dehydrogenase reaction. The dermal duct tumor was cultured, and showed similar histochemical findings to the in vivo poroid cells. These results suggest that poroid cells play the most important role in the histogenesis of these three neoplasms.
Acrospiroma↗