[Our surgical technique for acromioclavicular dislocation].
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Adolescent↗
Biomedical subjects
S Teshima
Publications and source records attributed to S Teshima.
Thyrotropin releasing hormone increases 5-hydroxytryptamine1 receptors in the limbic brain of the rat.
The effect of TRH on 5-HT1 receptors in the rat brain was investigated. A crude membrane preparation was incubated at 37 degrees C for 15 min with or without TRH prior to [3H]5-HT binding assay. TRH at 100 nM increased the number of 5-HT1 receptors significantly (approximately 20%) in the limbic forebrain and the hippocampus without altering their affinity. As this concentration of TRH is close to its dissociation constant (2 nM and 51 nM in the limbic forebrain, 11 nM in the hippocampus), this effect is probably of physiological relevance. This finding seems to support a pharmacological finding of others that the anti-convulsion effect of TRH may be related to increased serotonergic transmission.
Amygdala↗
Acquired expression of hst-1 in an autonomous subline (Chiba subline 2) derived from androgen-responsive mouse mammary tumor (Shionogi carcinoma 115).
Since growth of Shionogi Carcinoma 115 (SC 115) and its autonomous subline (CS 2) were regulated by fibroblast growth factor-like peptide, expression of int-2 and hst-1 was examined in these cell lines. Hybridization of genomic DNA with long terminal repeat of mouse mammary tumor virus (MMTV) revealed the same pattern of restriction fragments, showing the same integration of MMTV. Although weak expression of int-2 was noticed in the two cells, clear expression of hst-1 was seen only in CS 2 cultured with/without testosterone. It is suggested that autonomous growth of androgen-unresponsive CS 2 is connected with expression of hst-1.
Animals↗
Pulmonary lymphangiomyomatosis diagnosed by effusion cytology. A case report.
BACKGROUND: Pulmonary lymphangiomyomatosis (P-LAM) is a rare disease, characterized by an abnormal proliferation of smooth muscle throughout the lung and occurring in females of reproductive age. The typical clinical picture in P-LAM is progressive dyspnea, often punctuated by episodes of chylothorax or pneumothorax, with eventual death from respiratory failure. The definitive diagnosis is usually performed on open lung biopsies. CASE: The cytologic findings in a chylous pleural effusion from a patient with P-LAM are presented. The effusion contained an abundance of globular cell clusters composed of two distinct cell types, inner core spindle cells and surface flat cells. Immunocytochemical examination revealed that the core cells were derived from immature smooth muscle cells and the surface cells from endothelium. Histologic examination of the excised specimen showed the typical findings of P-LAM, and the dilated peripheral lymphatics contained cell clusters similar to those in the pleural effusion. The cell clusters in the lymphatics in the P-LAM lung tissue appeared to have ruptured into the thoracic cavity. CONCLUSION: Cell clusters seem to be pathognomonic of P-LAM, and cytologic examination can obviate the need to perform open lung biopsy to confirm the diagnosis.
Adult↗
Lymph node metastasis in early gastric cancer: how can surgeons perform limited surgery?
BACKGROUND: In Japan, the standard treatment policy for all potentially curable patients with gastric cancer is radical resection, including extensive lymph node dissection. The extent of lymph node dissection remains a controversial issue in the management of early gastric cancer. A recent trend in the surgical treatment of early gastric carcinoma has been to limit surgery such that a complete cure is achieved and the patient's quality of life is improved. However, approximately 10% of early gastric cancers are reported to be node positive and little is known about the protocol of surgical treatment most appropriate for the treatment of early gastric cancer. In this study, we examined the clinicopathological features that could distinguish node-positive cancer from node-negative cancer. PATIENTS AND METHODS: The clinicopathological features of 26 patients with node-positive early gastric cancer were reviewed from the database of gastric cancer at the Department of Surgery, Sendai National Hospital. They were compared with those of 239 patients with node-negative cancer. RESULTS: Tumor size, macroscopic appearance, depth of cancer invasion, histological growth pattern and lymphatic invasion were associated with lymph node metastasis. Node-positive patients with early gastric cancer had a poorer survival rate than node-negative patients (P<0.05). CONCLUSION: Limited surgery, such as local resection without lymphadenectomy, can be performed for elevated or flat type cancer, or tumor <2 cm in diameter. Lymphadenectomy is recommended to achieve higher possible cure rates for other early gastric cancers.
Female↗
Gastric cancer with invasion limited to the muscularis propria.
The clinicopathological features of 84 muscularis propria (mp) gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach, were reviewed retrospectively, and compared with 267 early gastric cancers (m/sm cancer) and 333 gastric cancers invading beyond the subserosal layer (ss-si cancer). There were statistical differences in tumor size, histological growth pattern, cancer-stromal relationship, lymph node metastasis, lymphatic invasion, vascular permeation and operative procedure between mp gastric cancer and early gastric cancer or ss-si gastric cancer. The mp tumors were significantly larger than the early cancer tumors but significantly smaller than the ss-si tumors (P < 0.0001), and mp cancer had more frequent lymph node metastasis (50%) than did early gastric cancer (10%) but less frequent lymph node metastasis than did ss-si cancer (84%; P < 0.0001). Histologically, infiltrative and scirrhous types were more common in the mp cancer group than in the early cancer group. The frequency of vascular permeation in the mp cancer group was almost the same as that in the early cancer group. Univariate analysis revealed that the significant prognostic factors were nodal involvement (P = 0.0213) and lymphatic invasion (P = 0.0364). Multivariate analysis of the mp-invaded cancer cases, however, revealed that lymph node metastasis was not a significant prognostic factor, although it was more important than was lymphatic invasion. Multivariate analysis also revealed that the prognosis of our mp gastric cancer patients was affected most by vascular permeation, followed by tumor size.
Analysis of Variance↗
c-erbB-2, p53 protein expression and steroid hormone receptors in breast carcinomas: an immunohistochemical study.
p53, c-erbB-2 protein, steroid hormone receptors, and their correlation with clinicopathologic features were investigated in 70 primary breast carcinomas. All markers were measured immunohistochemically on paraffin sections. Altered p53 expression was found in 27.1% of cases and was associated with negative estrogen receptor status. p53 immunostaining was correlated weakly with histologically lymphatic vessel invasion of carcinoma. c-erbB-2 protein overexpression was seen in 48.6% of cases. A trend was observed in the correlation between c-erbB-2 immunostaining and regional lymph node metastases. Estrogen receptor status was not associated with any histologic or clinical parameters, whereas progesterone receptor status was associated with lymph node metastasis and histologically lymphatic vessel invasion of cancer. PgR status, p53 and c-erbB-2 immunostaining may prove to be an additional criterion in histologic diagnosis of breast cancer.
Adult↗
Significant prognostic factors in patients with node-negative gastric cancer.
BACKGROUND: We evaluated the influence of several clinicopathological variables on 5 year survival of patients with node-negative gastric cancer. PATIENTS AND METHODS: Clinical characteristics were retrieved from the records of all patients who underwent gastric resection between 1985 and 1995 at the Department of General Surgery, Sendai National Hospital, and follow-up data were obtained from our tumor registry. Pathological characteristics were determined from a detailed review of all available histopathological slides. The results of a retrospective analysis of clinicopathological data of 339 patients having no lymph node metastasis were compared with those of 358 patients with lymph node metastasis. Univariate and multivariate analyses of patients with node-negative gastric cancer were performed to evaluate the prognostic significance of clinicopathological features (age, gender, gross type, histological type, depth of invasion and location). RESULTS: The 5 year survival rate for patients with node-negative gastric cancer was 92.5%. Node-negative gastric cancers were characterized by a smaller tumor, expansive and medullary histological type, and less frequency of lymphatic invasion and vascular permeation. In multivariate analysis, the statistical significant prognostic factors were tumor size (P = 0.0185), vascular permeation (P = 0.0011) and cancer-stromal relationship (P = 0.0291). CONCLUSION: Tumor size, vascular microinvasion and cancer-stromal relationship are the most reliable predictors of 5 year survival for patients with node-negative gastric cancer.
Adenocarcinoma↗
Significant prognostic factors in patients with early gastric cancer.
BACKGROUND: Early gastric cancer is defined as a gastric carcinoma confined to the mucosa or submucosa regardless of lymph node status, and it has an excellent prognosis with a 5-year survival rate of more than 90%. From 1985 to 1995, we encountered 266 cases of early gastric cancer in our hospital. METHODS: A retrospective analysis of the 266 cases of early gastric cancer was performed to evaluate the prognostic significance of clinicopathological features (age, gender, tumor size, tumor location, depth of invasion, lymph node metastasis, histological type, lymphatic invasion, vascular invasion, histological growth pattern, cancer-stromal relationship and type of operation). RESULTS: The overall survival rate of all the patients with early gastric cancer was 95.7%. In univariate analysis, the statistical significant prognostic factors were regional lymph node metastasis (P = 0.0004), lymphatic invasion (P = 0.0053) and cancer-stromal relationship (P = 0.0016). Absence of lymph node metastasis and lymphatic invasion, and a medullary-type histopathology were associated with improved survival. In multivariate analysis, the statistically significant prognostic factors were lymph node metastasis and cancer-stromal relationship. CONCLUSIONS: Presence of lymph node involvement and a scirrhous type of gastric cancer are associated with poor prognosis. Lymph node dissection with gastric resection is necessary for patients with early gastric cancer who have a high risk of lymph node metastasis. Postoperative chemotherapy is recommended for a scirrhous type of early gastric cancer.
Adenocarcinoma↗
Probability of lymph node metastasis in small gastric cancer tumor: is it an indication for limited surgery?
The purpose of this study was to determine the factors that are predictive of lymph node metastasis in a small gastric cancer tumor <2 cm in diameter. The clinicopathological features of 17 patients with node-positive small gastric cancer were reviewed from the database of gastric cancer at the Department of Surgery, Sendai National Hospital, Sendai, Japan, and they were compared with those of 131 patients with node-negative cancer. The independent risk factors influencing the lymph node metastasis were determined by multiple logistic regression analysis. Depth of invasion, macroscopic appearance, cancer-stromal relationship, and lymphatic microinvasion were found to be associated with lymph node metastasis. The variables found to be significant risk factors for lymph node metastasis were depth of invasion (P = 0.0250) and lymphatic microinvasion (P = 0.0028). It is possible for even a small gastric cancer tumor to have lymph node metastasis. A surgeon treating a small gastric cancer tumor must consider that although the cure rate is high, >10% of these tumors have lymph node metastases. Because of the possibility of lymph node metastasis, even with accurate knowledge of the depth of cancer invasion, selective performance of local resection or limited surgery with incomplete lymph node dissection is not justified. Accurate preoperative diagnosis and the appropriate decision for surgical indication are important. Large-scale randomized, controlled trials should be performed to show the advantage of limited surgery for gastric cancer.
Adenocarcinoma↗