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Biomedical subjects

J Kondo

Publications and source records attributed to J Kondo.

266 records · Page 15Linked to original sources
PubMedDate not supplied

A case of primary adenosquamous/squamous cell carcinoma of gallbladder directly invaded duodenum.

A rare case of primary gallbladder carcinoma is reported. A 67 year-old woman was admitted to our hospital for treatment of suspected duodenal carcinoma. A series of radiographic examinations demonstrated a giant tumor involving the duodenum, gallbladder, pancreatic head, and transverse colon. These extensions made it difficult to identify the primary origin of the carcinoma. Pancreatoduodenectomy, cholecystectomy, and resection of the transverse colon were performed. Macroscopically, ulcerative lesions were seen in both the gallbladder and the duodenum. Microscopic examination revealed adenosquamous cell carcinoma of the gallbladder, invasive of the adjacent organs, including circumferential invasion of the second portion of the duodenum. The patient tolerated the operation well and was discharged 28 days post-operatively, but died of liver metastasis 4 months after surgery. Local invasion of the surrounding tissues is characteristic of adenosquamous/squamous cell carcinoma of the gallbladder. Although surgery for cure is deemed possible, the rapid growth rate of this type of tumor may cast doubt on the value of extensive radical surgery.

Aged↗
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Sialyl Tn antigen expression is associated with the prognosis of patients with advanced colorectal cancer.

BACKGROUND/AIMS: One of the main problems in multimodal cancer treatment is the lack of prognostic parameters for the individual patient. This study was conducted to clarify the prognostic factors in patients with advanced colorectal cancer. METHODOLOGY: We examined DNA ploidy, Ki-67-derived growth fraction and the expression of CA 19-9, Sialyl Tn (STN) and carcinoembryonic antigens (CEA), along with standard clinicopathological variables including age, sex, tumor location, tumor size, cell differentiation, depth of invasion, and lymph node metastasis in 78 patients with advanced colorectal carcinoma, who underwent curative surgical resection. In addition, we determined the prognostic significance of these parameters. RESULTS: Forty-six patients (59.0%) showed aneuploidy and 32 (41.0%) showed diploidy. The Ki-67 labeling index ranged from 13.9-40.3% with a mean of 24.9%. The index was not correlated with standard clinicopathological variables. There was no significant correlation between seropositive rates for CEA, CA 19-9, or STN and standard clinicopathological variables except for age. In tumor tissue, the positive rates for these antigens were 62.8% for CA 19-9, 67.1% for STN, and 96.2% for CEA. There was no significant correlation between positive rates and clinicopathological variables. The expression of STN in serum had the strongest association with survival, followed by lymph node metastasis and expression of STN in tissue. CONCLUSIONS: We conclude that not only lymph node metastasis but also STN expression are important prognostic factors in patients with advanced colorectal carcinoma who undergo curative surgical resection.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Clinicopathological analysis of poorly differentiated adenocarcinoma of the stomach.

BACKGROUND/AIMS: Our aim was to investigate clinicopathological characteristics of a medullary cancer infiltration with scanty stroma type (por1) and a diffuse cancer infiltration with scirrhous stroma type (por2) of poorly differentiated gastric adenocarcinoma, especially differences in lavage cytodiagnosis, lymph node metastasis pattern and nuclear DNA ploidy between them. METHODOLOGY: Age and gender of 168 patients (46: por1, 122: por2) and clinicopathological characteristics such as tumor site, lymph node metastasis, vascular invasion and serosal involvement were compared. Lymph node metastasis patterns were classified into 1) marginal, 2) nodular, 3) diffuse, and 4) massive types. The whole abdominal cavity was intra-operatively washed with 200 ml of saline, Papanicolaou-stained and used for lavage cytodiagnosis. Nuclear DNA ploidy pattern of carcinoma was determined using flow cytometry. RESULTS: Lymph node metastasis rate was significantly higher in por2, especially in those with positive serosal invasion. Positive rate of lavage cytodiagnosis was significantly higher in por2 (38.9%), than that in por1 (9.1%). There were more hematogeneous recurrences in por1 more peritoneal disseminated recurrences in por2. Survival rate was better in por1. CONCLUSIONS: There were differences in lymph node metastasis, lavage cytodiagnosis and recurrence pattern between por1 and por2 even in poorly differentiated adenocarcinoma. These characteristics should be understood when selecting post-operative chemotherapy and also during follow-up.

Adenocarcinoma↗
PubMedDate not supplied

Hemostasis of colonic diverticular bleeding with hemoclips under endoscopic control: report of a case.

This paper reports a case in which endoscopic hemostasis of a bleeding colonic diverticula was successful with endoscopic hemoclip. The patient, a 53 year-old man with painless hematochezia, was urgently admitted to our institute. After colonic cleaning preparation, colonoscopic examination was performed. At the bottom of the diverticulum of the ascending colon, a vessel with oozing blood was endoscopically noted. Hemoclips were placed on and around the visible vessel and immediate hemostasis was completed. Endoscopic clipping method for management of bleeding diverticular vessel is an effective, simple, and safe procedure.

Colonoscopes↗
PubMedDate not supplied

Small cell carcinoma of the esophagus: a case report.

Primary small cell carcinoma of the esophagus, which is similar in appearance and behavior to its counterpart of the lung, is a rare tumor. We describe a 77 year-old woman whose esophagram revealed a well-defined mass in the lower third of the thoracic esophagus. A biopsy specimen showed an infiltration of small malignant cells. The individual cells were oval- or spindle-shaped with hyperchromatic nuclei and scant cytoplasm. Synaptophysin staining was positive. The mass was diagnosed as a small cell carcinoma of the esophagus. She underwent an esophagectomy with esophagogastric anastomosis. We discuss the treatment of small cell carcinoma of the esophagus.

Aged↗
PubMedDate not supplied

Helicobacter pylori of the remnant stomach and its eradication.

BACKGROUND/AIMS: Many authors have reported that Helicobacter pylori (H. pylori) is one of the major causes of gastritis and peptic ulcer. This study was conducted to evaluate the incidence of H. pylori infection and the curative effects of amoxicillin and omeprazole on H. pylori in the remnant stomach. METHODOLOGY: Biopsy specimens were obtained from 70 patients who underwent gastrectomy for gastric cancer. H. pylori was subsequently diagnosed by CLO test and culture of H. pylori. Gastritis was assessed by the scoring of four characteristic pathological parameters. Patients with positive H. pylori were eligible for the eradication study. Amoxicillin, 750 mg per day for 2 weeks, and omeprazole, 20 mg per day for 8 weeks, were administered to them. Endoscopic reexamination was performed 12 weeks after the initiation of treatment. RESULTS: The overall positive rate of H. pylori was 37.1%; 39.6% in Billroth I reconstruction, 0% in Billroth II reconstruction, and 55.6% in pylorus preserving gastrectomy, respectively. The positive H. pylori rate of Billroth II reconstruction was significantly low. However, there was no association of positive rate of H. pylori with time. There was no significant difference of gastritis scores between H. pylori infected patients and non-infected patients. The eradication rate was 70.0%. CONCLUSIONS: H. pylori was present in 37.1% of patients who underwent gastrectomy. Gastritis was not significantly severe in H. pylori infected patients. The treatment with amoxicillin and omeprazole was effective for these patients.

Aged↗
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Serum CA 19-9, SLX, STN and CEA levels of the peripheral and the draining venous blood in gastric cancer.

BACKGROUND/AIMS: This study was conducted to elucidate the relationship between the seropositive rates of Carcinoembryonic antigen (CEA), Sialyl Le(a) (CA 19-9), Sialyl Le(x) (SLX) and Sialyl Tn (STN) and the clinicopathological variables. The correlation of serum levels of these antigens between the peripheral venous blood and the venous blood draining from the tumor was also evaluated. METHODOLOGY: The subjects were 113 patients with gastric cancer, who underwent gastrectomy at the First Department of Surgery, Yokohama City University, between 1991 and 1996. Serum levels of CA 19-9, SLX, STN and CEA in the peripheral blood and the draining venous blood were measured. RESULTS: The positive rates for CA 19-9, SLX, STN and CEA were closely correlated with tumor stage, lymph node metastasis, and depth of invasion. Although the seropositive rates for CA 19-9, SLX, STN, and CEA in the draining venous blood were lower than those in the peripheral blood, a close correlation for serum levels of 4 antigens between the peripheral venous blood and the draining venous blood was observed in advanced cancer. CONCLUSIONS: These results suggest that these antigens may be drained by the lymphatic route as well as the hematogenous route. Further studies must be performed to elucidate the mechanism of these antigens entering into the peripheral blood by devising a technique for collecting the lymph.

Adult↗
PubMedDate not supplied

Insulin resistance and tissue glycogen content in the tumor-bearing state.

BACKGROUND/AIMS: Insulin resistance in cancer patients may play an important role in post-operative outcomes. METHODOLOGY: In an effort to understand the mechanism responsible, we measured glucose uptake by euglycemic hyperinsulinemic glucose clamp, glycogen content in skeletal muscle, liver, and adipose tissue by an enzymatic method, and facilitative glucose transporter mRNA by reverse transcription polymerase chain reaction (RT-PCR), in 10 patients with gastrointestinal cancers. Glucose uptake was also examined in 5 volunteers. RESULTS: The M value was significantly smaller in cancer patients (6.11 +/- 2.49 mg/kg/min) than in controls (8.55 +/- 0.91 mg/kg/min). A significant decrease in glucose storage was also observed in cancer patients compared with that of controls, 3.18 +/- 2.46 and 4.95 +/- 0.55 mg/kg/min, respectively. The glycogen content of skeletal muscle from cancer patients averaged 12.1 +/- 2.7 micrograms/mg tissue and was correlated with the M value (r = 0.75, p < 0.05). Muscle glycogen had an even stronger correlation to glucose storage (r = 0.964, p < 0.05). The glycogen content of liver averaged 105.4 +/- 79.0 micrograms/mg tissue but was not related to the M value. Glycogen in adipose tissue was not measurable by this method. Muscle and liver samples were positive for periodic and Schiff (PAS) stain, while the stain in adipose tissue was very weak. Glucose transporter 4 mRNA was the dominant facilitative glucose transporter in skeletal muscle. CONCLUSIONS: These results suggest that patients with gastrointestinal (GI) cancer and insulin resistance have decreased glycogen storage in skeletal muscle. These may be the patients who are in need of pre-operative nutritional support.

Adipose Tissue↗
PubMedDate not supplied

A case of segmental primary sclerosing cholangitis.

A 74-year-old man was admitted to the Yokohama City University School of Medicine for investigation of high values of ALP and Y-GTP. Radiographic examinations, including abdominal computed tomography and percutaneous transhepatic cholangiography, strongly suggested bile duct cancer in the hepatic hilus. After left lobectomy, pathological examination disclosed segmental primary sclerosing cholangitis. Clinical examination cannot always distinguish primary sclerosing cholangitis from cancer. We report a case of segmental primary sclerosing cholangitis and discuss the diagnosis and the treatment of this disease.

Aged↗
PubMedDate not supplied

Helicobacter pylori of remnant stomach and optimal dose of amoxicillin for eradicating Helicobacter pylori.

BACKGROUND/AIMS: The optimal dose of antibiotics for Helicobacter pylori eradication is not known. The aim of this study was to evaluate optimal dose of antibiotics (amoxicillin) for eradication of H. pylori in the remnant stomach. METHODOLOGY: Biopsy specimens were obtained from 77 patients who underwent gastrectomy for gastric cancer. H. pylori was subsequently diagnosed by rapid urease test and culture. Gastritis was assessed by scoring. Patients with positive H. pylori were eligible for the eradication study. Amoxicillin 750 mg per day for 2 weeks and omeprazole 20 mg per day for 8 weeks were administered to them. Endoscopic reexamination and 13C-urea breath test were performed 12 weeks after the initiation of treatment. RESULTS: The positive rate of H. pylori was 38.9% in the remnant stomach. Eradication rate was 50.0%. Mean dose of amoxicillin in effective cases was 14.1 +/- 1.5 mg/kg/day. This was significantly higher than that in non-effective cases (12.5 +/- 1.5 mg/kg/day). Remnant gastritis was significantly improved after complete eradication. CONCLUSIONS: H. pylori was present in 38.9% of patients who underwent gastrectomy for gastric cancer. The optimal dose of amoxicillin was 15.6 mg/kg/day for 14 days with omeprazole-amoxicillin therapy.

Amoxicillin↗
PubMedDate not supplied

Clinicopathologic differences between early gastric remnant cancer and early primary gastric cancer in the upper third of the stomach.

BACKGROUND/AIMS: This study was designed to clarify the clinicopathologic characteristics and survival in early gastric remnant cancer and compare with early primary cancer in the upper third of the stomach. METHODOLOGY: Twenty-five patients with early gastric remnant cancer, who underwent resection at Kanagawa Cancer Center and First Department of Surgery, Yokohama City University between 1974 and 1996 were evaluated in this study. Various clinicopathologic characteristics, such as age, sex, symptoms, size of tumor, depth of invasion, lymph node metastasis, cell differentiation, and survival were investigated and early gastric remnant cancer was compared with early primary cancer in the upper third of the stomach. RESULTS: According to the macroscopic type, protruded type such as I or II type accounted for a great majority in early gastric remnant cancer, while II c depressed type was common in early primary cancer in the upper third of the stomach, comprising 64.2% of all cases. Pathological examination disclosed that well-differentiated carcinoma and mucosal carcinoma were more frequently observed in early gastric remnant cancer than in early primary cancer in the upper-third of the stomach. The 5-year survival rate was 83.5% for early primary cancer in the upper-third of the stomach. In contrast, no patients experienced recurrence after operation for early gastric remnant cancer. CONCLUSIONS: From the view point of clinicopathological evaluation, gastric remnant cancer is a special from of gastric cancer. A follow-up program is important in order to detect early gastric remnant cancer. A low incidence of lymph node metastasis suggests that endoscopic mucosal resection of the tumor or limited operation could be performed under strict indication.

Aged↗
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Plasma interleukin-6 is not a mediator of changes in lipoprotein lipase activity in cancer patients.

BACKGROUND/AIMS: Cancer cachexia is characterized by a variety of metabolic disorders. Alterations in fat metabolism have been reported to be associated with suppression of tissue lipoprotein lipase (LPL) activity in tumor-bearing animals. Interleukin-6 (IL- 6) has been documented to reduce tissue LPL activity and may play a role in inducing cancer cachexia. This study was conducted to clarify the changes in LPL activity and the role of IL-6 in patients with either gastrointestinal cancer or breast cancer. METHODOLOGY: Twelve patients with colorectal cancer, 7 patients with gastric cancer, 7 patients with breast cancer and 5 normal volunteers were studied. Serum concentrations of triglycerides (TG), non-esterified fatty acids (NEFA) and IL-6 were measured. LPL activity was measured in plasma post-heparin administration. The relationships of LPL activity to tumor progression, body weight loss and serum IL-6 levels were examined. The effect of tumor resection on LPL activity was also studied. RESULTS: LPL activity was suppressed with tumor progression in patients with either gastrointestinal cancer or breast cancer. Suppression of LPL activity and the degree of weight loss were negatively correlated in patients with either gastric or colorectal cancer (r = -0.5826, p = 0.011) but not in patients with breast cancer. The decrease in LPL activity was not always reversed after resection of the tumor. Circulating IL-6 did not correlate with either plasma LPL activity or tumor progression. CONCLUSIONS: Reduced LPL activity in patients with advanced gastrointestinal or breast cancer may reflect changes in nutritional status. Serum IL-6 is less likely to be a mediator of these alterations.

Adult↗
PubMedDate not supplied

Carcinosarcoma of the esophagus: three cases with immunohistological examination.

Carcinosarcoma of the esophagus is a rare malignant tumor with both carcinomatous and sarcomatous components. We present 3 cases of carcinosarcoma of the esophagus and discuss the histogenesis of the tumors. We performed immunohistochemical studies using various antibodies: anti-cytokeratin, anti-vimentin, anti-smooth muscle actin, anti-p53, and MIB 1 reacting with Ki-67 nuclear antigen.

Biomarkers, Tumor↗