[Utility of CA19-9 and CEA as tumor marker in colorectal cancer--comparison between serum level and distribution].
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Biomedical subjects
Publications and source records attributed to H Takami.
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A case of total thumb reconstruction after traumatic amputation is described. The reconstruction was carried out as a staged procedure with preliminary application of a pedicle flap, and a normal index finger transposition, followed by opposition transfer using the abductor digiti quinti muscle. Twenty-seven months after the index finger pollicization, the reconstructed thumb had satisfactory function.
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DU-PAN-2 is an antigen detected by a monoclonal antibody to pancreatic adenocarcinoma. In order to determine the clinical usefulness of DU-PAN-2 for diagnosis and monitoring in cancer patients, the DU-PAN-2 level (EIA, less than or equal to 300 U/ml) was measured in 238 patients with cancer of the digestive tract including 47 with pancreatic cancer, and in 57 with benign abdominal disease. The positive rate and maximum level for pancreatic cancer were 48.9% and 85,960 U/ml, respectively. However, DU-PAN-2 levels were also relatively high in hepatobiliary cancers. For stage II pancreatic cancer, the positive rate and maximum level of DU-PAN-2 were only 22.2% and 661 U/ml, respectively. On the other hand, these values were 0% and 196 U/ml (pancreatic cyst) in 15 benign pancreatic diseases. In postoperative monitoring of up to 35 months in 17 resected patients with pancreatic cancer, the DU-PAN-2 level decreased on resection of the tumor and increased on recurrence. This study suggested that DU-PAN-2 seems promising as a means for differentiating pancreatic cancer from benign pancreatic disease and for detecting the recurrence of pancreatic cancer. However, differentiation between pancreatic and hepatobiliary cancers appears difficult.
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A new, highly sensitive method for quantitative separation and determination of capsaicin and dihydrocapsaicin by high-performance liquid chromatography with electrochemical detection is elaborated. The method employs a Cosmosil 5Ph column eluted with 100 mM potassium dihydrogenphosphate containing 45% acetonitrile (pH 5.0) at a flow-rate of 1.0 ml/min, and an electrochemical detector (at a potential of +750 mV versus the Ag/AgCl electrode). The detection limits for both capsaicin and dihydrocapsaicin were 12 pg (39 fmol) at a signal-to-noise ratio of 3:1. By applying this method, the biological half-life of capsaicin in the rat was investigated.
A case of subtotal reconstruction of the thumb is described. The reconstruction was carried out as a staged procedure with an intact index finger transposition, followed by opposition transfer using the abductor digiti quinti muscle after three weeks. Twenty-eight months postoperatively, power grip and precision grip were restored despite destruction of the thenar muscles.
Affinity electrophoresis of human alpha-fetoprotein (AFP) with the erythroagglutinating phytohemagglutinin of Phaseolus vulgaris (E-PHA) gave up to five resolved bands (y, h, i, l and a; given in the order of decreasing affinity for E-PHA); band a having no affinity and bands y and h representing asialo-AFP's. The proportion of band y increased in extrahepatic tumors producing AFP, including yolk sac tumor, and of band h, in addition, in hepatocellular carcinoma. The proportion of either band y or h (or y + h) increased, over the means plus 2 standard deviations of the respective bands of cord serum AFP, in 20 out of 25 cases (80%) of hepatocellular carcinoma, including cell lines, and in all the patients with extrahepatic malignancy. Band i was detected in more than half the cases with malignancy, although the extent of its increases was much less. Band a appeared only in limited cases. None of the hepatitis and cirrhotic patients showed increased proportions of band y or h (or y + h), indicating the usefulness of the determination of asialo-AFP for the discrimination between benign and malignant liver diseases.
To determine the clinical usefulness for diagnosis and monitoring of pancreatic tumor markers, serum levels of CA 19-9 (RIA; less than or equal to 37U/ml), POA (EIA; less than 11 U/ml), CEA (EIA; less than or equal to 4.4 ng/ml) and TPA (RIA; less than or equal to 110 U/ml) were measured in 57 patients with pancreatic cancer and 25 patients with benign diseases of the pancreas. Frequencies of elevation for pancreatic cancers were 73.9% for CA 19-9, 69.2% for POA, 48.9% for CEA and 73.2% for TPA. Furthermore, the frequencies of elevation at relatively early stages of pancreatic cancer were not high. It was therefore thought that these markers were unsuitable for early diagnosis of pancreatic cancers. Although serum levels of CA 19-9 and POA in cases of pancreatic cancer were distributed up to on extremely high level, those for benign diseases of the pancreas were located up to twice the values of the cut-off levels. Therefore, these two markers seem promising for differentiating preoperatively between pancreatic cancer and benign diseases of the pancreas. CA 19-9 and POA were also useful for monitoring the recurrence of pancreatic cancer. In particular, patients with high preoperative levels seem good candidates for postoperative monitoring.
Serum levels of POA (EIA; less than 11.0 U/ml) and CA 19-9 (RIA; less than or equal to 37 U/ml) were measured in 54 patients with pancreatic cancer and 19 patients with benign diseases of the pancreas. Although serum CA 19-9 and POA were elevated in 72.7% and 69.4% of patients with pancreatic cancer, respectively, patients in relatively early stage showed low percent of elevation. Therefore, these markers are unsuitable for early diagnosis of pancreatic cancers. However, these markers seem promising in differentiating preoperatively between pancreatic cancer and benign disease of the pancreas. These markers are also useful for monitoring the recurrence of pancreatic cancers. Of particular, patients with preoperatively high level seem good candidates for postoperative monitoring.
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Development of 1,2-dimethylhydrazine (DMH) induced colonic neoplasia were studied using male Wistar rats given 120 mg DMH per kg s.c. weekly for 5 weeks. During the course of colon carcinogenesis, changes in cellular proteins of colonic mucosa were analysed by two-dimensional gel electrophoresis. Rats were sacrificed just before and at 10, 15 and 20 weeks after the initial DMH treatment together with controls. Incidence and number of colorectal tumors gradually increased. At the 20th week, colon carcinoma was found in every rat. Most tumors (92%) were found in the major flexure and the distal colon and rectum, while only 1% and 7% were found in the cecum and proximal colon, respectively. Histologically, most (92%) were classified as well differentiated or moderately differentiated adenocarcinoma. Eighty-five percent of the tumors were semipedunculated or sessile without depression, and the remainder were sessile with depression. All of the latter were carcinomas with invasion to the submucosa or further. Two-dimensional gel electrophoresis revealed 180 spots in cellular proteins before and after the initial treatment. Three new spots appeared and four spots greatly increased during the course of carcinogenesis, while one spot disappeared. The above results suggest that the appearing and increasing spots may be associated with cancer and that the disappearing spot may be associated with the normal colon.
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A successful reconstruction of a large tibial defect with a free vascularized fibular graft is presented. The fibular graft demonstrated a significant hypertrophy 2 years postoperatively.