[Clinicopathological study of asymptomatic gallbladder carcinoma found at autopsy].
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Biomedical subjects
Publications and source records attributed to A Kuroda.
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A 44-year-old male was admitted with complaints of gross hematuria and high fever. An excretory urogram and renal angiography revealed a massive lesion in the right kidney. A computed tomographic scan showed bilateral renal tumors with low-density areas. Transperitoneal right radical nephrectomy, regional lymph node dissection and left renal biopsy were performed on September 5, 1984. The tumor was 14.5 X 7 X 6 cm in size and yellowish in cross section. The pathological diagnosis was bilateral angiomyolipomas and the same in the right hilar lymph node and the surrounding tissue. There was no evidence of malignancy.
A 63-year-old man underwent total gastrectomy and partial resection of the transverse colon for Borrman IV gastric cancer on August 27, 1985. On August 8, 1986, 11 months after the operation, he visited our department with chief complaint of swelling of both groins. The spermatic cord was swollen to about 3 cm in diameter from both groins to inside of the scrotum and was hard as a club. The diagnosis of bilateral spermatic cord metastasis of gastric cancer was established and a biopsy was carried out. Histopathologically the diagnosis of spermatic cord metastasis of gastric cancer was confirmed.
Sulfated proteoglycans of fetal, newborn and adult bovine tendon are extracted with neutral salt and then with 4 M guanidine HCl in the presence of proteinase inhibitors. Dermatan sulfate containing small proteoglycans are separated from chondroitin sulfate rich proteoglycans by CsCl-gradient centrifugation, by affinity chromatography using concanavalin A and by molecular sieve chromatography. These proteoglycans are comprised of a core protein with an average Mr of about 53,000 on polyacrylamide gel electrophoresis with SDS and of dermatan sulfate side chains with Mr 25,000-38,000 by gel chromatography. The tryptic peptides patterns observed in the small proteoglycans from newborn calf and adult bovine tendon are identical but are distinct from those of embryonic calf tendon. The patterns of the tryptic peptides of the core proteins from embryonic calf tendon are similar to those from the dermatan sulfate proteoglycans of calf skin. These results indicated that genetically independent genes of the core proteins from dermatan sulfate proteoglycans in tendon tissues were expressed by aging.
Five cases of prominent, diffuse dilatation of the main pancreatic duct caused by mucin-hypersecreting carcinoma are reported. Adenocarcinoma was noted mainly within one markedly dilated main pancreatic duct. On endoscopic retrograde pancreatograms, dilated main pancreatic ducts with amorphous or well-defined filling defects resulting from mucin (five patients) or tumor (one patient) were noted. The proximal portion of the main pancreatic duct alone was delineated in three cases because of reflux of contrast material as a result of the presence of excessive mucin and a patulous orifice of the papilla of Vater (major duodenal papilla). Diffuse dilatation of the main pancreatic duct was demonstrated or suggested on computed tomographic (CT) and ultrasound scans. Four patients who underwent operations are alive and free from carcinoma (mean, 50 months after diagnosis). Whenever prominent, diffuse dilatation of the main pancreatic duct is encountered on CT or ultrasound scans, endoscopic retrograde pancreatography is mandatory to permit confirmation or ruling out of mucin-hypersecreting carcinoma of the pancreas.
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An automated 13CO2 analyzing system for the 13C breath test was designed, built and evaluated. The system, which was designed to be controlled by a micro-computer, includes CO2 purification, 13CO2 abundance measurement, data processing and data filing. This article gives the description of the whole system with flow charts. This system has proved to work well and it has become feasible to dispose of 5 to 6 CO2 samples per hour. With such a system, the 13C breath test will be carried out much more easily and will obtain much greater popularity.
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Eight autopsy cases of pancreatic cancer (duct cell adenocarcinoma) with T1 and T2 primary tumors were studied histologically to examine the exact extent of lymphatic and local spread. Six of them had microscopic metastasis in grossly negative lymph nodes near the primary tumor. In addition, four of them had a few metastatic nodes in the para-aortic region. In cases with lymphatic metastases, the extent of cancer infiltration within lymphatic vessels, nerves, and/or connective tissues was almost the same as that of lymph node metastasis. Major vascular involvement was found in four cases. There was no case in which multicentricity or marked intraductal spread of cancer cells was observed in the pancreas. It has been suggested that most of T1 and T2 pancreatic cancers have a fairly widespread microscopic extension, although extremely small T1 cancers have a very limited extension.
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The purpose of this study is to elucidate the pathophysiology of the acute pancreatitis and set up the criteria for assessing the severity of this disease. One hundred and fifty seven cases of acute pancreatitis were treated at the First Surgical Department of Tokyo University Hospital and its affiliated hospitals. They consisted of 24 severe cases, 76 moderate cases, and 57 mild cases according to our classification. In early stage ten parameters, namely, abnormalities of white cell count, platelet count, hematocrit, lactic acid dehydrogenase, blood urea nitrogen, serum calcium, base excess, PaCO2 and fasting blood glucose and age within 24 hours after admission and X-ray CT scan within 48 hours as early prognostic signs, enabled us to predict severe, moderate, or mild pancreatitis. More than 4 weeks later than the onset of acute pancreatitis, X-ray CT scan, white blood cell count, elevation of serum FDP level, endotoxemia and fall of plasma opsonic index served as good indicators to evaluate the severity of abdominal sepsis. In experimental pancreatitis, CH50 and opsonic index were remarkably decreased at 6 and 12 hours after induction of acute pancreatitis. As the above results, determination of early prognostic signs immediately after onset and late prognostic signs 3-4 weeks after onset is very important to evaluate and manage the acute pancreatitis patients.
UNLABELLED: Twenty-eight patients with insulinoma treated at our institutions during the years 1935-1983 were available for this study. These patients included 15 males and 13 females ranging 20 to 77 years of age and averaging 48 years. DIAGNOSIS: Inappropriate elevations of plasma insulin (IRI/BS greater than 0.3) in the fasting state were demonstrated in all 18 patients. Accurate tumor localization was defined by arteriography in 61% of 18 patients. Decision of localization by transhepatic portal catheterization and insulin assay was successful in all of 4 patients in whom it was performed. Pathology: Twenty-five patients had a single tumor and 3 had multiple tumors. The tumor was located in the head in 8, in the body in 12 and in the tail in 14. Thirty of 34 tumors were benign and 4 were malignant. SURGICAL TREATMENT: Enucleation was performed in 6 patients, 19 patients underwent distal pancreatectomy and one patient had pancreatoduodenectomy, One patient with occult tumor in the head had 80% resection of the pancreas. One patient with two tiny occult tumors close to the duodenum underwent distal left to right pancreatectomy finally resulting in total pancreatectomy. RESULT: There was no operative death and no recurrence of symptoms in all patients after operation.
Automatic calculation of control charts for precision and accuracy of radioimmunoassay was reported by Faure, et al. Duplicate control samples independently measured was assumed to have a bivariate normal distribution. In this case they assumed that the correlation coefficient between each value of the pairs of control samples is zero. Our experience using this method revealed that a considerable number of assayed samples distributed outside the calculated control limits in case of "accuracy control". It was considered that this happened because in radioimmunoassay the between-assays precision is usually larger than the within-an-assay precision and there is a significant correlation between values of duplicates. We also found equal probability density did not make a true circle but a long circle. Therefore in the present paper we proposed for control charts of radioimmunoassay an equal probability long circle calculated by bivariate analysis of Mahalanobis' generalized distance. It was found that a Mahalanobis' long circle could explain the density distribution of radioimmunoassay with a reasonable percent of samples outside the calculated control limits. What happened here can be interpreted by a large between-assays variability shown by some commercial kits. This automatic calculation method could be applied not only for quality control but also for evaluation and comparison of radioimmunoassay system or commercial kits. Control survey could also be analyzed by such a method.