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Y Atomi

Publications and source records attributed to Y Atomi.

At least 37 records · Page 2Linked to original sources
PubMed2001

Colonoscopic treatment of colon cancers.

Recent advances in endoscopic technology have enabled conservative treatment for patients with carcinoma in situ. The treatment of submucosally invasive carcinomas, or malignant polyps, is still controversial, however. The use of widely advocated histologic criteria, such as poorly differentiated histology (Grade III cancer), level 4 invasion or involved margin status, or lymphatic venous invasion as risk factors for adverse outcome, should be examined by multivariate analysis. Unfavorable histology at the invasive margin, PCNA, MUC-1 expression, and chromosomal abnormalities may be new candidates for prognostic indicators in patients with submucosally invasive carcinoma.

Carcinoma in Situ↗
PubMed2000

Pancreatic duct cell carcinomas express high levels of high mobility group I(Y) proteins.

The high mobility group I (HMGI) family of proteins in mammals belongs to a group of nonhistone nuclear proteins known as architectural transcriptional factors. They function in vivo as both structural components of chromatin and auxiliary gene transcription factors. In an earlier study (N. Abe et al, Cancer Res., 59: 1169-1174, 1999), we demonstrated that the expression level of the HMGI(Y) gene/proteins was significantly increased in colorectal adenocarcinoma and colorectal adenoma with severe cellular atypia. In the current study, we analyzed HMGI(Y) expression in several human pancreatic lesions to investigate (a) whether HMGI(Y) overexpression is also observed in pancreatic carcinoma, and (b) the role of HMGI(Y) in the diagnosis of pancreatic neoplasms. To this end, HMGI(Y) expression was determined at the protein level by immunohistochemistry using a HMGI(Y)-specific antibody in 6 surgically resected specimens of nonneoplastic tissue (4 specimens of normal pancreatic tissue and 2 specimens of chronic pancreatitis tissue), 8 pancreatic cystic neoplasms (5 intraductal papillary mucinous adenomas, 1 serous cystadenoma, and 2 solid pseudopapillary tumors), and 15 duct cell carcinomas of the pancreas. Immunohistochemical analysis revealed intense nuclear staining in the pancreatic carcinoma cells, whereas only very faint nuclear staining was seen in the nonneoplastic cells. There was a strong correlation between HMGI(Y) protein overexpression and a diagnosis of carcinoma (P = 0.000018). Thus, an increased expression level of the HMGI(Y) proteins was clearly associated with the malignant phenotype in pancreatic tissue. In addition, a low level of protein expression was also apparent in two of the cystic neoplasms that exhibited cellular atypia, but not in those that did not exhibit cellular atypia. Based on these findings, we propose that the HMGI(Y) proteins could be closely associated with tumorigenesis in the pancreas and that HMGI(Y) could serve as a potential diagnostic molecular marker for distinguishing pancreatic malignancies unambiguously from normal tissue or benign lesions.

Carcinoma↗
PubMed2000

Pylorus-preserving total pancreatectomy for pancreatic cancer.

Standard total pancreatectomy (TP) combined with gastric resection often results in uncontrollable diabetes and malnutrition. Pylorus-preserving total pancreatectomy (PPTP) and standard TP for pancreatic cancer were compared in terms of operative outcomes, nutritional recovery, and long-term survival. Twenty-four patients with pancreatic ductal adenocarcinoma (n = 14) or intraductal papillary mucinous carcinoma (N = 10) underwent PPTP (n = 10) or standard TP (n = 14). There were no significant differences in age, gender, or tumor type or stage between the PPTP and standard TP groups. Early (within 30 days of surgery) morbidity and mortality rates were 20% and 0% for PPTP and 29% and 7% for standard TP, respectively. Delayed gastric emptying occurred in 2 patients in each group. The incidence of late complications, including uncontrollable diabetes, diarrhea, and malnutrition, tended to be lower after PPTP (30%) than after standard TP (69%). Serum albumin and body weight at 6 months after surgery were significantly higher in the PPTP than in the standard TP group. Regardless of the tumor type, long-term survival did not differ significantly between patients receiving PPTP and those with standard TP. PPTP for pancreatic cancer improves nutritional recovery, without compromising long-term survival, compared with standard TP.

Adenocarcinoma↗
PubMed2000

Laparoscopic pancreatic cystgastrostomy.

Internal drainage of acute pancreatic pseudocysts is indicated 6 weeks after the first documentation of pseudocyst. It is also indicated for symptomatic chronic pseudocysts 6 cm or more in diameter. When pseudocysts are located in close contact with the posterior wall of the stomach, they are best drained by pseudocyst-gastrostomy. This procedure can also be completed making use of intragastric surgical techniques. Under standard laparoscopic observation, three intragastric ports are placed through the abdominal and anterior gastric walls, establishing working channels for a telescope and hand instruments. After the presence of pseudocysts is confirmed, the posterior wall of the stomach and the cyst wall can be incised by electrocautery. After a sufficient drainage orifice is made and the cyst contents are thoroughly debrided, the intragastric ports are removed and defects in the gastric wall are closed with sutures placed via the standard laparoscopic approach. This approach is much less invasive than the conventional approach, which entails a large gastrotomy in the anterior wall of the stomach. This procedure should be the method of choice when interventional radiology or endoscopic intervention fails to effectively drain retrogastric pseudocysts.

Drainage↗
PubMed2000

Endoscopic biliary stenting for treatment of persistent biliary fistula after blunt hepatic injury.

BACKGROUND: Surgical treatment for persistent biliary fistula after blunt hepatic injury is often technically difficult. Endoscopic treatment for such fistulas has been described only infrequently. METHODS: We reviewed 6 patients who underwent endoscopic biliary stent placement with (n = 1) or without (n = 5) sphincterotomy for persistent (12 to 138 days; mean 48 days) biliary fistula after blunt hepatic injury. RESULTS: ERCP showed bile leakage from a second-order or more peripheral branch of the intrahepatic bile ducts in 5 patients but failed to reveal the fistula in 1. Stent placement was successful without complications in all patients. Bile leakage resolved within 1 to 3 days in 5 patients. After 36 to 86 days, the stent was removed and ERCP confirmed disappearance of the fistula. These patients have remained asymptomatic for a mean of 2.6 years since stent removal. In the patient in whom ERCP had not shown a fistula, bile leakage continued despite successful stent placement. CONCLUSIONS: Endoscopic biliary stent placement is a rapid, safe and effective treatment for persistent post-traumatic biliary fistula demonstrated by ERCP.

Adult↗
PubMed2000

Endoscopic sphincterotomy for bile duct stones in patients 90 years of age and older.

BACKGROUND: Little information is available on the outcomes of endoscopic sphincterotomy for choledocholithiasis in patients of advanced age (>/=90 years). METHODS: Endoscopic sphincterotomy was performed for choledocholithiasis in 22 patients aged 90 years or more (group A) and 381 aged 70 to 89 years (group B). Clinical features and early outcomes of endoscopic sphincterotomy were compared between the two groups. In group A, long-term results for a mean follow-up period of 33 months were assessed. RESULTS: Group A patients had a higher incidence of symptoms, acute cholangitis and concomitant diseases, as well as larger and more numerous gallstones than did group B patients. Endoscopic sphincterotomy was technically successful in 100% of group A patients and 98% of group B patients. The rate of early complications was low in both groups: 5% in group A and 7% in group B. No deaths related to endoscopic retrograde cholangiopancreatography occurred in group A patients. Complete stone clearance was achieved in 86% of group A patients and 95% of group B patients. Group A required an emergency procedure, general anesthesia, multiple sessions, mechanical lithotripsy, and permanent biliary stent placement more frequently than group B. Late complications occurred in 5% of group A patients. CONCLUSION: Endoscopic sphincterotomy is safe and effective for the treatment of choledocholithiasis in patients 90 years of age or older. Biliary stent placement is a reasonable alternative treatment when stones prove to be difficult to extract.

Age Factors↗
PubMed2000

Induction of autoimmune colitis by Yersinia enterocolitica 60-kilodalton heat-shock protein.

BACKGROUND: Many investigations of the relationship between ulcerative colitis (UC) and heat-shock protein (Hsp) 60 have been reported. We have already established an animal model exhibiting UC-like lesions caused by administration of Escherichia coli expressing Yersinia enterocolitica Hsp60. In this study, we therefore attempted to induce mouse colitis by purified Y. enterocolitica Hsp60. METHODS: Purified Y. enterocolitica Hsp60 was injected intraperitoneally into B10A/SgSn mice at a dose of 3 microg/0.2 ml once a week for 2 months, and morphological changes in the intestine were examined by light and electron microscopical analysis. Autoimmune responses were also examined. RESULTS: The mice treated with Y. enterocolitica Hsp60 exhibited immune reaction between large intestine and autologous serum. Light and electron microscopically, degradation of glandular ducts, erosions, ulceration, crypt abscess-like formation, infiltration of inflammatory cells and absence of perivascular reticular fibers in lamina propria mucosae and subepithelial reticular layer were observed. CONCLUSIONS: These findings indicate that administration of Y. enterocolitica Hsp60 induces UC-like lesions with autoimmune responses.

Animals↗
PubMed2000

Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series.

BACKGROUND: Differential diagnosis is often difficult for small (</=20 mm) polypoid lesions of the gall bladder. AIM: To assess the diagnostic accuracy of endoscopic ultrasonography (EUS) for polypoid lesions in a surgical and follow up series. METHODS: A total of 194 patients with small polypoid lesions underwent both ultrasonography and EUS. A tiny echogenic spot or an aggregation of echogenic spots and multiple microcysts or a comet tail artefact indicated cholesterol polyp and adenomyomatosis respectively. Other lesions were diagnosed as neoplastic (adenoma or adenocarcinoma). In the 58 patients who underwent surgery, the histological diagnoses were cholesterol polyp (n = 36), adenomyomatosis (n = 7), adenoma (n = 4), and adenocarcinoma (n = 11). Of the remaining 136 patients with an EUS diagnosis of non-neoplastic lesions, 125 were followed up with ultrasonography alone or with EUS for 1-8.7 years (mean 2.6 years). RESULTS: In the surgical series, EUS (97%) differentiated polypoid lesions more precisely than ultrasonography (76%). During follow up, the lesions remained unchanged in size in 109 (87%) of the 125 patients with non-neoplastic lesions diagnosed by EUS. No neoplastic lesions developed in these patients. Ultrasonography had shown lesions to be neoplastic in 13% of the follow up series. CONCLUSIONS: EUS is highly accurate for differentially diagnosing polypoid gall bladder lesions. It is recommended when ultrasonography cannot rule out neoplastic lesions. Non-neoplastic lesions diagnosed by EUS may be followed and observed with ultrasonography.

Adenocarcinoma↗
PubMed2000

Fiber-type-specific alphaB-crystallin distribution and its shifts with T(3) and PTU treatments in rat hindlimb muscles.

Changes in alphaB-crystallin content in adult rat soleus and extensor digitorum longus (EDL) were examined after 8 wk of 3,5, 3'-triiodothyronine (T(3)) and propylthiouracil (PTU) treatments. Cellular distributions of alphaB-crystallin expression related to fiber type, and distribution shifts with these treatments were also examined in detail from the gray level of reactivity to specific anti-alphaB-crystallin antibody. alphaB-crystallin content in both soleus and EDL muscles was significantly decreased after T(3), and that in EDL was significantly increased over twofold after PTU treatment. In both control soleus and EDL muscles, the gray level of type I fibers was higher than that of type II fibers. alphaB-crystallin expression among type II subtypes was muscle specific; the order was type I > IIa > IIx > IIb in control EDL muscle and type IIx > or = IIa in soleus muscle. The relation was basically unchanged in both muscles after T(3) treatment and was, in particular, well maintained in EDL muscle. Under hypothyroidism conditions with PTU, the mean alphaB-crystallin levels of type IIa and IIx fibers were significantly lower than levels under control conditions. Thus the relation between fiber type and the expression manner of stress protein alphaB-crystallin is muscle specific and also is well regulated under thyroid hormone, especially in fast EDL muscle.

Analysis of Variance↗
PubMed1999

Determination of high mobility group I(Y) expression level in colorectal neoplasias: a potential diagnostic marker.

High mobility group I(Y) [HMGI(Y)] proteins are architectural factors abundantly expressed during embryogenesis, and their overexpression is known to be closely associated with neoplastic transformation of cells. This study was performed to investigate whether determination of HMGI(Y) expression level could assist in (a) differential diagnosis between colorectal carcinoma, adenoma, and normal tissue and (b) determination of the prognosis of patients with colorectal cancer. To this end, HMGI(Y) expression was determined at both the protein and mRNA levels in 30 colorectal carcinomas, 26 adenomas, and 23 normal mucosa samples, and further correlations between the protein expression levels and various clinicopathological parameters, such as depth of tumor invasion, lymphatic and/or venous involvement, regional lymph node metastasis, and Dukes' stage, were determined in 30 carcinoma cases. The expression of HMGI(Y) proteins was significantly increased in carcinoma and adenoma with severe atypia compared with that in adenoma with less atypia and normal colorectal mucosa. This increase in HMGI(Y) protein expression was found to be because of an increase in its mRNA expression by RNA in situ hybridization analysis. Clinicopathological analysis revealed that the level of HMGI(Y) protein expression was significantly correlated with parameters known to be indicative of a poor prognosis in colorectal cancer patients. These findings indicate that the determination of the HMGI(Y) protein expression level could be a potential marker for the diagnosis of colorectal neoplasias and can be of great value in predicting the prognosis of patients with colorectal cancer.

Adult↗
PubMed1999

Management of unsuspected common bile duct stones found during laparoscopic cholecystectomy by means of transcystic catheter placement and papillary dilation.

BACKGROUND: The optimal treatment strategy for treatment of bile duct stones first diagnosed during laparoscopic cholecystectomy has not been established. We prospectively treated unsuspected bile duct stones by means of intraoperative placement of a transcystic catheter followed by postoperative pharmacologic papillary dilation or endoscopic papillary balloon dilation. METHODS: In 17 patients with bile duct stones first found at laparoscopic cholecystectomy, a catheter was introduced via the cystic duct into the bile duct. If postoperative cholangiography via a transcystic catheter showed stones 5 mm or less in diameter, glyceryl trinitrate was infused via the catheter into the bile duct. Patients in whom medical dilation was unsuccessful or who had larger stones underwent endoscopic papillary balloon dilation. RESULTS: Stone diameter measured 3 to 11 mm (mean 6.4 mm). Postoperative cholangiography revealed spontaneous passage in four patients. After pharmacologic papillary dilation, two of five patients with stones 5 mm or less in diameter had stone clearance. The remaining 11 patients underwent successful endoscopic papillary balloon dilation with stone clearance. In two patients, a guidewire introduced via a transcystic catheter through the papilla facilitated selective biliary cannulation. One early minor complication occurred. All patients remained without symptoms for a mean follow-up of 13 months. CONCLUSION: For unsuspected bile duct stones (usually small ones), this strategy is a simple and effective alternative to laparoscopic bile duct exploration and postoperative sphincterotomy and may minimize early and late complications. Transcystic catheterization ensures access to the bile duct, thereby avoiding endoscopic treatment failures.

Adult↗
PubMed1999

Does endoscopic papillary balloon dilation affect gallbladder motility?

BACKGROUND: Endoscopic papillary balloon dilation for treatment of bile duct stones is likely to preserve papillary function. However, endoscopic papillary balloon dilation may affect gallbladder motility. We investigated the effects of endoscopic papillary balloon dilation on gallbladder motility. METHODS: Ten patients with an intact gallbladder (six with and four without gallbladder stones) who underwent endoscopic papillary balloon dilation for choledocholithiasis were studied. Gallbladder motility was examined before and 7 days and 1 month after endoscopic papillary balloon dilation. Gallbladder volume, while fasting and after dried egg yolk ingestion, was determined by ultrasonography. RESULTS: Before endoscopic papillary balloon dilation, particularly in patients with gallbladder stones, the gallbladder showed significantly larger fasting volume and lower yolk-stimulated maximum contraction compared with control subjects. Seven days after endoscopic papillary balloon dilation, fasting volume was decreased and maximum contraction was increased, regardless of the presence of gallbladder stones, with significant differences from the values before endoscopic papillary balloon dilation. One month after endoscopic papillary balloon dilation, these changes were reduced and gallbladder function did not differ significantly from baseline. CONCLUSIONS: After endoscopic papillary balloon dilation, gallbladder motility improves transiently at 7 days but returns to baseline at 1 month. In terms of gallbladder motility, endoscopic papillary balloon dilation does not seem to increase the subsequent risk of acute cholecystitis.

Aged↗
PubMed1999

Mouse colitis induced by Escherichia coli producing Yersinia enterocolitica 60-kilodalton heat-shock protein: light and electron microscope study.

In patients with inflammatory bowel disease (IBD), including ulcerative colitis (UC), heat-shock protein (Hsp) 60 has been detected in serum and the intestinal tract. Our mouse colitis model was established using Escherichia coli transformed with Yersinia enterocolitica Hsp60 gene as an immunizing antigen, and examined light and electron microscopically as compared with lesions of UC. The large intestine of mice injected with Hsp60 antigen showed swollen goblet cells, glandular dilation, erosion, ulceration, and infiltration of inflammatory cells. The change like crypt abscesses was also found, and various phases of inflammation were observed simultaneously in individual mice. In addition, the reticulum fibers were absent ultrastructurally in the subepithelial reticular layer. Hyperplasia of the thymus was found in antigen-treated mice. These lesions were similar to those of UC. These results suggest that UC-like enteritis in mice was induced by using Hsp60, considered as one of the pathogens for UC.

Animals↗