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Biomedical subjects

H Isomoto

Publications and source records attributed to H Isomoto.

At least 73 records · Page 4Linked to original sources
PubMed1995

Total pelvic exenteration for locally advanced colorectal carcinoma--postoperative complications.

This study was designed to clarify the postoperative major complications of total pelvic exenteration for locally advanced colorectal cancer. Twenty-six patients (primary disease: 17, recurrent disease: 9) were retrospectively studied. Major complications developed in 30.8% (8 of 26); in 23.5% (4 of 17) for a primary disease and in 44.4% (4 of 9) for a recurrent disease. Only 2 patients (7.7%) died within 30 days after the operation; one patient died of hepatic failure and another of pelvic sepsis. Postoperative ileus developed at a high rate of 11.5% (3 of 26). Ileo-ileal anastomotic leakage developed at a rate of 7.7% (2 of 26) and it commonly occurred following irradiation. The remaining one patient had gastrointestinal bleeding. These 6 patients surviving the operation were successfully managed conservatively. Conclusion was as follows: Total pelvic exenteration should be performed carefully and aggressively regardless of the development of postoperative complications.

Adult↗
PubMed1994

Primary linitis plastica carcinoma of the colon and rectum.

BACKGROUND: Linitis plastica carcinoma (LPC) usually shows a scirrhous growth pattern with a severe stromal desmoplastic reaction. Another growth pattern showing lymphangiosis carcinomatosa rather than scirrhous growth pattern, however, was noted. This study was designed to clarify the clinical and pathologic characteristics of colorectal LPC. METHODS: Linitis plastica carcinoma was reviewed clinicopathologically and classified into two types according to the histologic growth pattern: The first was a scirrhous type (nine patients) and the second, a lymphangiosis type (three patients). RESULTS: Grossly, the mucosal surface of the scirrhous type had a granular, cobblestone, gyriform-like appearance. The cancer cells were composed mainly of poorly differentiated or signet-ring cells and were accompanied by a severe stromal desmoplastic reaction; lymphatic permeation was not so marked. Most patients with this type of cancer died of peritonitis carcinomatosa. The mucosal surface of the lymphangiosis carcinomatosa had a smooth and glossy appearance. The cancer cells were composed mainly of moderately differentiated cells, frequently with a glandular formation. Stromal desmoplastic reaction was not so marked. The growth pattern was characterized by lymphangiosis carcinomatosa and marked venous invasion. All patients who had this type died of distant metastases. CONCLUSION: Perhaps with earlier diagnosis and aggressive treatment, the peritoneal dissemination of scirrhous LPC and distant metastasis of lymphangiosis LPC may be minimized.

Adenocarcinoma, Scirrhous↗
PubMed1994

Clinicopathologic characteristics of large bowel cancer developing after radiotherapy for uterine cervical cancer.

PURPOSE: This study was designed to clarify the characteristics of large bowel cancer developing after radiotherapy for uterine cervical cancer. METHODS: A retrospective chart review was performed. RESULTS: The latent period was a mean of 20.5 years. The most common site was in the rectum (16/32). Mucin-producing carcinoma was observed in 53.1 percent, with an especially high rate of 75 percent in the rectum. Histologic radiation damage was also demonstrated at a high rate of 64.3 percent. CONCLUSIONS: It was difficult to judge from clinicopathologic findings whether large bowel cancer developed with relation to radiation effect. We emphasize, however, that the characteristics are different from ordinary large bowel cancer. Particular consideration should be given to the high incidence of mucin-producing carcinoma.

Adenocarcinoma, Mucinous↗
PubMed1994

A case of radiation-induced rectal cancer developing after a long-term follow-up.

A case of radiation-induced rectal cancer is presented. In November, 1971, a 58-year-old woman had a stage II squamous cell carcinoma in the uterine cervix. She underwent a hysterectomy and postoperative radiotherapy. External pelvic irradiation of 10 MV x-ray was carried out in 15 fractions of 2 Gy daily, with a total dose of 30 Gy, and intracavitary radium insertion with a total dose of 960 mg hours (20 mg x 48 hours). She had been followed-up in our department since 1972, when rectal bleeding occurred. Proctoscopy and periodical biopsies were performed when the patient visited our hospital. There was no evidence of malignant tumor cells nor of recurrent cervical cancer from 1973 to 1989. In August, 1990, a biopsy specimen taken from a rectal ulcer revealed a malignant mucinous adenocarcinoma. The time interval between the radiotherapy and the development of the rectal cancer was 19 years. Microscopically, the main lesion was situated in the granulation tissue covered with the regenerating mucosal epithelium, and histologically was found to be a mucinous adenocarcinoma. Other radiation damage was additionally found including colitis, endarteritis and intestinal wall fibrosis. The evidence strongly suggested the present case to be one of radiation-induced rectal cancer.

Adenocarcinoma, Mucinous↗
PubMed1994

Development-related changes in matrix metalloproteinase expression in human aortic smooth muscle cells.

BACKGROUND: It is known that extracellular matrix-degrading enzymes play an important role in tissue remodeling and that large amounts of structural proteins including types I, III, IV, and V collagens and elastin are produced by smooth muscle cells (SMC) in the arterial wall. We have recently shown that matrix metalloproteinases (MMPs) produced by human aortic medial smooth muscle cells are closely related to the proliferation of the cells, leading to the formation of atherosclerotic plaques, characteristic of intimal remodeling. For a better understanding of the mechanism of atherogenesis, therefore, it is important to clarify the relationship between the production of matrix-degrading enzymes and artery development. EXPERIMENTAL DESIGN: In vivo or in vitro synthesis of MMPs by SMC was analyzed by immunohistochemistry and immunoblotting. Elastase activity in the culture medium was also estimated. RESULTS: Production of proMMP 1, 2, and 3 was detected in cultured SMC isolated from the aortas of both neonates and fetuses; in medial SMC cultured from young individuals, production of proMMP-1 and -3 was extremely decreased, but was apparent in intimal SMC. Immunohistochemical observation indicated that in the media of fetal or neonatal aorta, SMC synthesized large amounts of the three proMMPs; in aortas from older individuals, proMMP-2, but not proMMP-1 and -3, was detected in the media, and relatively large amounts of proMMP-1, -2, and -3 were produced by SMC in the slightly thickened intima. Assay of elastase activity in the culture medium gave results similar to those for MMPs. CONCLUSIONS: We conclude that the production of proMMP-1 and -3 is associated with phenotypic modulation of SMC to a "synthetic" state, and that the ability of SMC to produce MMPs plays an important role in the development and/or aging of the human aorta through remodeling of the extracellular matrix; furthermore elastase is also involved in these processes in the arterial wall.

Adolescent↗
PubMed1993

Prognostic evaluation of perineural invasion in rectal cancer.

To evaluate whether perineural invasion (PNI) is an important prognostic factor in patients with rectal cancer, we reviewed the records of 373 patients who underwent curative surgery. Thirty-seven patients (9.9%) were identified as having tumors with PNI. The incidence of PNI was significantly increased in lesions categorized as stage III by the International Union Against Cancer (UICC) system (20%). There was a significant difference in local recurrence between patients with stage III lesions with PNI and those with stage III lesions without PNI (p < 0.005). Also, patients with PNI of stage III lesions had a significantly lower 8-year survival rate (26.7%, p < 0.001). We conclude that PNI is an important factor influencing the prognosis of patients with stage III disease. PNI should be classified as a subgroup of the clinical stage.

Aged↗
PubMed1993

Clinicopathological characteristics of colorectal submucosal carcinoma with lymph node metastasis.

The clinicopathological characteristics of colorectal submucosal carcinoma with lymph node metastasis are described. Lymph node positive metastasis was found in 10 (11%) of 87 cases. The depth of submucosal invasion was classified as sm1, sm2 or sm3. Lymph node positive metastases were found in 18% of the cases at sm2 or more, in 31% of those without adenomatous components, in 39% of those with positive lymphatic permeation, in 41% of those with positive budding, and in 56% of all the moderately differentiated adenocarcinomas. These characteristics are risk factors and are important for the prediction of lymph node metastasis from colorectal submucosal carcinoma. Bowel resection with lymphadenectomy is indicated in the presence of any one or more risk factors.

Adult↗
PubMed1993

Therapeutic rectoscopy for rectal tumors.

A surgical resection in the middle or upper region of the rectum is often technically difficult because of the anatomical inaccessibility of the site. A new rectoscopic operative technique reported by Buess et al. (1985, 1987, 1988) and Kipfmüller et al. (1988) permits microsurgery in the rectum and is less aggressive than other procedures. This technique was used in 7 patients with rectal tumors using an articulated monocular-optical system. The postoperative course in all patients was free from any complications and the patients were discharged at the latest on the eighth day after the operation. A stereoscopic optical system, a new surgical rectoscope, other special surgical instruments, as well as a modification to an insufflation device are necessary for improving the endoscopic operation.

Aged↗
PubMed1993

Clinicopathological studies of multiple cancers in the large bowel and other organs.

During the past 17 years, 1,463 cases of cancer of large intestine, there were 117 cases (8.0%) with overlapping cancer in other organs. The male/female ratio was 1.0:1.1 and the mean age was 65.8 years old. The region of existence in other organs was in the order of frequency: stomach 28.3%, uterus 26.3%, and liver 8.1%. The location and histology showed almost similar results to that of single cancer. In comparison with single cancer, overlapping cancer cases showed a high complication rate of adenoma. So it was suggested that a region of cancer development was present but latent. The preceding cases of cancer of the uterus almost all underwent radiotherapy. About 36% of their histology of colon cancer were mucinous carcinoma suggesting at least the development of cancer by radiation.

Age Factors↗
PubMed1992

Clinicopathologic study of perineural invasion in rectal cancer.

Perineural invasion (PNI) in rectal cancer was studied, prospectively. One-hundred patients (20%) were identified as having tumors with PNI. The incidence of PNI was significantly increased in tumors with moderate or marked venous invasion (30%, 64%), with moderate or marked lymphatic permeation (37%, 72%), with liver metastasis (50%) and with peritoneal dissemination (64%). In cases of curative surgery, the incidence of PNI was significantly increased in MAC stage C2m+g or C3 (28%, 35%). There was no significant difference in the recurrence or survival rates between the patients with PNI and without PNI in MAC stage B2m+g. However, there was a significant increase in local recurrence in the patients with both PNI and lymph node metastasis (p less than 0.05). Also, the patients with PNI in MAC stage C2m+g had a significantly lower 8-year survival rate (29.1%, p less than 0.001). Multivariate analysis using Cox regression models demonstrated that PNI was an independent prognostic factor for survival.

Aged↗
PubMed1991

A prospective clinicopathologic study of venous invasion in colorectal cancer.

We performed a long-term prospective study on venous invasion of colorectal cancer. The degree of venous invasion was divided into four stages (V0 through V3). Venous invasion was classified into three types by location (Vx, Vy, and Vz). Hepatic metastasis occurred in 27%, 33%, and 20% of patients with V2, V3, and Vz tumors, respectively. Local recurrence occurred in 33% and 15% of the V3 and Vz groups, respectively. However, there were no significant differences among the groups in terms of the rate of pulmonary metastasis. The 6-year survival rate for Dukes' stage B tumors was 94%, 88%, and 74% in the V0, V1, and V2 groups, respectively. There was a significant difference in the survival rate between patients with V0 tumors and V2 and V3 tumors. However, no significant difference was noted in the location. In Dukes' stage C tumors, on the other hand, the survival rate was 77%, 56%, and 44% in the V1, V2, and V3 groups, respectively. Also, it was 85%, 73%, and 45% in Vx, Vy, and Vz cases, respectively. Significant differences were noted between V1 and V3 (or V2), and between Vz and Vx (or Vy). It appears that the degree and location of venous invasion influence not only hepatic metastasis, local recurrence, and survival rates but also have prognostic value.

Aged↗
PubMed1991

Occurrence of desmoid tumors following surgery for familial adenomatosis coli--report of two cases.

Twenty-five patients with adenomatosis coli were subjected to operations, and two in which desmoid tumors appeared after the operation on familial adenomatosis coli are described here. These patients were 26 and 37 year-old males. After the total colorectomy, each tumor was associated with soreness and was palpated in the lower abdominal wall, and operations were performed. The histological findings from the resected specimens, 12 cm and 34 cm in size, indicated desmoid tumors. Poliposis of the large intestine with desmoid tumors, as a complication, has been reported in 23 previous cases in Japan.

Adenomatous Polyposis Coli↗