[Comparative study between carcinoembryonic antigen (CEA) in breast cancer tissue and morphological regional immunoreaction: preliminary report].
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Breast Neoplasms↗
Biomedical subjects
J Shikata
Publications and source records attributed to J Shikata.
Combined laminoplasty and posterolateral fusion for spinal canal surgery in children and adolescents.
Spinal deformities, especially kyphosis and instability, after laminectomy for tumors and other diseases, are major clinical problems. Since 1981, combined laminoplasty and posterolateral fusion for the prevention of postlaminectomy spinal deformities was performed on eight male and two female patients aged two to 26 years (average, 13.9 years). The follow-up period was from six months to seven years and three months (average, three years and five months). Two patients died six and ten months postoperatively because of brain metastases (astrocytoma) and lung metastases (neuroblastoma), respectively. Good alignment with no instability of the cervical or thoracic spine was obtained for all patients, including the two who died. Laminoplasty combined with posterolateral fusion was found to be very effective in preventing the development of spinal deformities after spinal canal surgery for spinal cord tumors or other diseases in children and adolescents.
Adolescent↗
[A case report of Bochdalek's hernia with volvulus of the stomach in an adult].
We report a rare case of Bochdalekhs hernia, congenital posterolateral diaphragmatic hernia with mesenterioaxia volvulus of the stomach, in an adult. A 23-year-old man suddenly felt severe pain in his left chest after drinking beer. Roentgenologic examination of the chest showed air above the left diaphragm, and the mediastinum was displaced to the right. Upper gastrointestinal series revealed mesenterioaxial volvulus of the stomach in which the pylorus was displaced to the left. Thoracotomy through the left seventh intercostal space was performed. The stomach, colon, spleen and greater omentum were displaced into the left thoracic cavity. After reduction of the herniated viscera, a defect measuring 10 X 4 cm, in the posterolateral part of the diaphragm, was closed with double interrupted Tevdek sutures. Three months later, he was asymptomatic and his chest roentgenogram was normal.
Adult↗
[Contrast-enhanced computed tomography in acute pancreatitis].
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Abscess↗
[Measurement of plasma calcitonin gene-related peptide (CGRP) level in patients with thyroid disease].
To elucidate the pathophysiology of CGRP in patients with medullary thyroid carcinoma (MTC), we measured the plasma CGRP level in patients with thyroid disease employing RIA. The plasma CGRP level (normal level 12.7 pg/ml) was elevated in all five preoperative patients with MTC, ranging from 128 pg/ml to 2010 pg/ml, and in ten of 17 postoperative patients who indicated possible recurrence. On the other hand, CGRP levels showed low frequencies of elevation in 96 patients with other thyroid tumors (anaplastic carcinoma, malignant lymphoma, follicular adenoma and adenomatous goiter), subacute thyroiditis, chronic thyroiditis and Graves' disease. Provocation test (calcium gluconate plus pentagastrin) in 12 MTC patients showed that, although the CGRP level fluctuated in parallel with the calcitonin level, the elevation rate (maximum level after administration/basal level) of CGRP was lower than that of calcitonin. Particularly, the rate of elevation of CGRP in three virulent and advanced patients with poorly differentiated MTC was below 2.0, while that in nine patients with well-differentiated MTC ranged from 2.8 to 23.3. These results suggest that CGRP may be a humoral marker of MTC and is possibly related to the degree of malignancy.
Calcitonin Gene-Related Peptide↗
[Evaluation of reservoir inserted for the prevention of liver metastasis of colorectal cancer].
The subjects were 22 patients who had undergone intra-arterial chemotherapy using reservoirs for prevention of postoperative liver metastasis during the period from January 1986 to September 1989, 3 with non-resected liver metastasis, 1 with resected liver metastasis with intra-arterial chemotherapy, and patients with systemic chemotherapy. None of the 7 patients with macroscopic stage II disease, who had undergone intra-arterial therapy for the prevention of liver metastasis survived (maximum duration, 25 months), had liver metastasis. Two of 8 patients with stage III disease died, and liver metastasis was observed. Two of 7 patients with stage IV disease died, one of whom them had liver metastasis. Four of 12 patients with stage II disease treated by systemic chemotherapy died, and 2 of them had liver metastasis. Four of 18 patients with stage III disease treated by systemic chemotherapy died, and one of them had liver metastasis. One of 11 patients with stage IV disease systemic chemotherapy died, and liver metastasis was noted in another. None of the patients who had undergone intra-arterial chemotherapy for the prevention of liver metastasis had liver metastasis within a period of one year. At present there is no difference in survival period between the group given intra-arterial chemotherapy for the prevention of liver metastasis and the group given systemic chemotherapy.
Colorectal Neoplasms↗
Calcification of spinal cord tumors: report of two cases.
Two cases of calcification of spinal cord tumors were detected by computed tomography and magnetic resonance imaging. The first; a 27-year-old male, with a very rare astrocytoma accompanied by calcification of the thoracic spinal cord, and the second; a 62-year-old female, with a rare calcified neurilemmoma in the upper cervical extradural space. The purpose of this paper is to draw attention to the fact that some spinal cord tumors occasionally contain areas of calcification, and review the literature on this subject.
Adult↗
Immunohistochemical analysis of mesocolic lymph node cells in human colorectal cancer.
Localization of lymphocyte subsets and macrophages in the mesocolic lymph node of the colorectal cancer and their distribution among the paracolic, intermediate, and main nodes were studied quantitatively by means of immunohistochemical staining with monoclonal antibodies. In all of the three lymph node groups, in the paracortex, helper/inducer T cells were more numerous than suppressor/cytotoxic T cells. The number of whole T cells in the paracortex diminished with increasing proximity to the primary tumor. In the three lymph node groups, no significant difference was found regarding the ratio of the cell number among suppressor/cytotoxic T cells, natural killer cells, and macrophages. Lymphocytes in the paracortex of lymph node had a positive correlation to lymphocytes in the peritumoral stroma and intratumoral fields. These data neither suggest the presence of a powerful immunological reaction in the mesocolic lymph node nor support the concept of conservation of uninvolved regional lymph nodes in the surgery of the colorectal cancer.
Adenocarcinoma↗
Atlanto-axial subluxation in Down's syndrome.
Atlanto-axial subluxation, which was causing symptoms in eight patients with Down's syndrome, was treated by operation. In every case various congenital bony anomalies were found. Marked myelopathy was present in four cases of ossiculum terminale, and mild myelopathy in one with anteroposterior spondyloschisis. Successful posterior arthrodesis was performed from C1 to C2 in six cases, and from the occiput to C2 in the other two patients with anteroposterior spondyloschisis. Excellent bony union and an overall improvement in symptoms was achieved. The follow-up period was from one year to five years and six months. Early surgical stabilization is the treatment of choice in those cases of symptomatic atlanto-axial subluxation in Down's syndrome where there are congenital osseous anomalies and generalised ligamentous laxity, and where the spinal cord is at risk.
Adolescent↗
Instrumentation surgery for primary tumors of the spine.
We performed instrumentation surgery on ten patients with the following rare primary spinal tumors; three solitary plasmacytomas, an aneurysmal bone cyst, a chordoma, a giant-cell tumor, a hemangioma, a solitary bone cyst, a benign osteoblastoma, and a chondrosarcoma. These tumors were found in the cervical spine (one case), thoracic spine (five cases), lumbar spine (two cases), and sacrum (two cases). The patients consisted of five men and five women, and their average age was 43.1 years. Harrington instrumentation was used in six cases, Zielke instrumentation in two, a combination of both in one case, and a Kirshner wire in one. In two cases, iliolumbar fusion was performed with Harrington instrumentation, after total resection of the sacrum. Average duration of the follow-up period was 5 years. This report describes these rare cases and emphasizes the effectiveness of instrumentation surgery in the reconstruction of the spine after extensive surgery.
Adult↗
Producing experimental cholangiectasis in dogs by the stripping method.
Despite the general belief that cholangiectasis is caused by biliary stenosis, clinical cases of cholangiectasis exist which do not seem to have biliary stenosis. The purpose of this research was to produce cholangiectasis models without stenosis, and it was found that stripping the surrounding supportive tissues from the extrahepatic bile duct resulted in cholangiectasis without biliary stenosis. The maximum diameter and intraluminal pressure of the bile duct were specifically examined in 24 mongrel dogs before and 4 weeks after stripping. The mean diameter of the bile duct was 2.44 mm before stripping but 6.47 mm 4 weeks after stripping, the latter being significantly larger than the former (p less than 0.001). There were no significant differences in biliary passage according to cholangiomanometry performed before and after stripping, which indicated an absence of biliary stenosis. Histological examination of the bile duct wall and duodenal papilla after stripping showed only mild inflammatory changes. These models could thus be used for the analysis of cholangiectasis without biliary stenosis. Moreover, these models clinically suggest that there are cases of cholangiectasis without biliary stenosis and that sphincteroplasty or choledochojejunostomy should not be applied blindly. In other words, these techniques should only be applied when biliary stenosis has been observed after careful examination.
Animals↗
Experimental detachment of the canine bile duct to evaluate mechanisms of the dilated bile duct.
The factors inducing biliary dilatation were studied morphologically and functionally by cholangiography and cholangiomanometry in experimental models of chronic biliary dilatation. These models were produced by four methods: Constriction of the lower bile duct (Group 1), formalin infusion into the duodenal papilla (Group 2), detachment of the extrahepatic bile duct (Group 3), and sphincterotomy (Group 4). Biliary dilatation was observed in the first three groups but not in the fourth group. An increase in the intraductal pressure due to blockage of the biliary outflow tract was considered to be the cause of biliary dilatation in Group 1 and 2. In Group 3, the function of the lower bile duct, including the papilla was intact, and reduced resistance of the bile duct wall and due to the loss of the support from the surrounding connective tissue was considered to have induced biliary dilatation. These results suggest that experimental chronic biliary dilatation can be produced by two approaches: 1) Blockage of bile flow in the papilla or the bile duct, and 2) detachment of the bile duct without disturbing bile flow.
Animals↗
Postprandial plasma gastrin and secretin concentrations after a pancreatoduodenectomy. A comparison between a pylorus-preserving pancreatoduodenectomy and the Whipple procedure.
Based on the observation that patients given a pylorus-preserving pancreatoduodenectomy maintain higher gut hormonal levels than do patients who have received the classic Whipple surgical procedure, which seems most likely due to a postoperative difference in the remaining digestive tract, the postprandial plasma gastrin and secretin concentrations in patients who have received either surgery have been evaluated to examine this difference more fully. The subjects were 20 patients treated by a pylorus-preserving operation and 27 patients treated by the Whipple procedure whose concentrations were compared with those of 8 healthy control patients. The postprandial plasma gastrin concentrations were found to be similar in patients given the pylorus-preserving operation and the controls and were significantly lower in patients who underwent the Whipple procedure (p less than 0.05). Similarly, the postprandial plasma secretin concentrations did not differ in these two groups, whereas patients who underwent the Whipple procedure showed significantly lower concentrations at 60, 90, and 120 minutes (p less than 0.05). The above findings, as well as supportive data in the literature, indicate that the duodenal bulb and the gastric antrum, which are resected in the Whipple procedure and are kept in the pylorus-preserving operation, seem to play important roles in the gut hormonal release and that the pylorus-preserving operation is the superior surgical technique in terms of gastrin and secretin release.
Duodenum↗
Surgical treatment for symptomatic spinal adhesive arachnoiditis.
This report concerns the outcome of 36 operations for spinal adhesive arachnoiditis (SAA) performed at Kyoto University Hospital since 1956; the follow-up period ranged from 1 to 25 years (average, 4 years 8 months). The original procedure involved intradural neurolysis after extradural decompression, but more recently microlysis was performed. The percentage of cases in which good results were obtained by nonmicroscopic lysis and microlysis was only 54.8%, however, when microlysis was followed by spondylodesis, the ratio increased to 80%, clearly showing the benefits of this new procedure. The authors therefore emphasize the value of spondylodesis following microlysis for symptomatic SAA.
Adult↗
Congenital absence of a lumbar pedicle.
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Back Pain↗
Pericholecystic abscess: classification of US findings to determine the proper therapy.
Sixteen patients with a pericholecystic abscess were classified into three groups according to the sonographic findings: Nine patients had an abscess in the gallbladder bed, three in an intramural location in the gallbladder, and four in an intraperitoneal cavity. In the gallbladder bed group, six patients with a localized abscess responded well to conservative therapy, followed by an elective operation. Two patients with a complicated abscess were initially treated with ultrasonically (US) guided percutaneous transhepatic gallbladder drainage and then with percutaneous transhepatic aspiration of the liver abscess, followed by an elective operation. A patient with a communicating abscess underwent an elective operation because the abscess completely disappeared after percutaneous transhepatic abscess drainage under US guidance. One of the three patients with an intramural abscess needed an immediate operation, and the other two were treated conservatively, followed by an elective operation. All four patients with an intraperitoneal abscess needed an emergency operation. Because each type of abscess received differing and successful treatments, the authors' method of classification of US findings seemed to provide a useful way to select the specific therapeutic procedure to achieve optimal results.
Abscess↗
Ultrasound measurement of vertebral rotation in idiopathic scoliosis.
Ultrasound can be used to outline the spinous processes and the laminae, and thus to measure axial rotation. Using our own technique, we measured vertebral rotation in 47 patients with idiopathic scoliosis. There was a strong linear relationship between the Cobb angle and the rotation of the apical vertebra in untreated patients, but this relationship was lost in patients who had had brace treatment. Vertebral rotation can easily be measured by ultrasound. This is a harmless and fairly rapid investigation which can be used at routine follow-up examination of patients with idiopathic scoliosis.
Adolescent↗
[Effects of intra-arterial infusion chemotherapy in local recurrence of anal cancer].
At present, there is no effective local therapy for skin metastasis after radical operation for anorectal cancer. Most local recurrent lesions of this type are not indications for surgery. However, successful control of the local lesion can enhance the quality of life because the general condition is good. We performed intra-arterial infusion chemotherapy for skin metastasis after Miles operation for anorectal cancer and observed marked effects. A 62-year-old female with anal cancer underwent Miles operation in November, 1987. About July, 1988, an indurated mass appeared in the perineal region but was left untreated. However, urinary disturbance due to the mass developed, and she was admitted in September. A catheter for Intra-arterial infusion chemotherapy was inserted via the lateral deep femoral artery, and 5-FU, BLM, and MMC were administered. Local bleeding was stopped, and the mass began to be reduced about 16 days after the administration. After about 1 month, no secretion from the mass was observed, and the urinary disturbance improved due to a reduction in the mass.
Antineoplastic Combined Chemotherapy Protocols↗