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Biomedical subjects

K Shirouzu

Publications and source records attributed to K Shirouzu.

At least 181 records · Page 10Linked to original sources
PubMed1990

[Clinicopathologic study on venous invasion of colo-rectal cancer: a prospective study].

Metachronous liver metastasis developed less than in 5% of v0 and v1 groups, while it developed in 22% of v2 and v3 groups. In addition, it developed in 15% of EF(I) group, in 19% of EF group, in 10% of Intramural greater than Extramural group and in 16% of the Intramural less than or equal to Extramural group. Six-year survival rate of v0, v1, v2 and v3 groups in the cases of curative resection for advanced colo-rectal cancer were 97%, 85%, 57% and 51%, respectively. Also those of E, EF, EI(F), Intramural, Intramural greater than Extramural and Intramural less than or equal to Extramural groups were 83%, 65%, 55%, 86%, 80% and 55%, respectively. Non-hematogenous recurrence developed in 19.4% of v3 group, in 13.6% of EF(I) group and in 15% of Intramural less than or equal to Extramural group. Conclusions were as follows: (1) There was a close relationship between venous invasion and development of liver metastasis (or of non-hematogenous recurrence) and survival of patients. (2) It was proved that the diagnostic criteria of venous invasion established by the authors were good indices to predict survival of colo-rectal cancer patients.

Adult↗
PubMed1989

An index for estimating the probability of lymph node metastasis in rectal cancers. Lymph node metastasis and the histopathology of actively invasive regions of cancer.

We examined resected specimens from 40 cases of advanced rectal cancer to determine the extent of microtubular cancer nests and undifferentiated cancer cells (budding). We investigated the relationship between this budding and lymphatic invasion (ly), venous invasion (v), and lymph node metastasis (n), respectively. Moreover, we examined the relationship between ly, budding, and n in the preoperative biopsy specimens of 112 patients, including those of the 40 cases mentioned above. The degree of budding, which was abundant in the actively invasive region, showed a strong correlation with the degree of ly and the existence of n in the resected specimens. Also, budding was recognized in a relatively large portion of the biopsy specimens (52 of 112 [46.4%]) and lymph node metastasis was found in 41 of 52 specimens (78.8%). In 57 specimens, neither ly nor budding was found, and 16 of these specimens (28.1%) had positive lymph nodes. These results implied that the degree of budding in the actively invasive region can be a great help in predicting the presence of n. The presence or absence of budding in preoperative biopsy specimens also can be an important factor (along with the degree of differentiation and ly) in estimating the probability of n.

Adult↗
PubMed1989

Effect of OK-432 on large-bowel carcinogenesis in rats.

To examine the carcinogenetic and growth inhibitory effects of OK-432, large-bowel carcinoma was induced experimentally in rats by intrarectal injection of N-methyl-N-nitrosourea (MNU), and OK-432 was administered intradermally. Rats were sacrificed after six months and the large intestine was cut into serial sections. Histopathologic examination and analysis of the infiltrating mononuclear cells, using monoclonal antibodies, were performed. The average rate of carcinogenesis per rat was 15.7 +/- 8.5 in the MNU alone group (n = 10) and 8.3 +/- 3.5 in the MNU and OK-432 group (n = 6). The invasion was deeper than the muscularis propria in 16 out of 157 lesions (10.2 percent) in the MNU alone group and in one out of 50 lesions in the MNU + OK-432 group (2.0 percent) (P less than 0.05). When time of appearance of atypical glands or carcinomas were compared in the MNU alone and MNU + OK-432 group, carcinogenesis was found to be delayed in the MNU + OK-432 group. In the investigation of infiltrating mononuclear cells using monoclonal antibodies, there were increases in helper T cells in both the MNU alone and MNU + OK-432 groups, but there was little difference between the two groups. The results of this study suggest that the suppression of experimental carcinogenesis in the large bowel by the concomitant administration of OK-432 with MNU, may be due to the enhanced activation or prolonged activated state of immunocompetent cells, which appear via antigen recognition, by OK-432.

Adenocarcinoma↗
PubMed1989

[Intra-arterial infusion chemotherapy of liver metastases in colorectal cancer].

We report the complications and the results of intra-arterial infusion chemotherapy (IAIC) for liver metastases in colorectal cancer. Fifteen synchronous liver metastases and 11 metachronous liver metastases were treated from September 1986 to February 1989. Eight cases had H1 (metastases in one lobe only), 11 cases H2 (a few scattered metastases in both lobes) and 7 cases had H3 (numerous metastases in both lobes). Eight cases underwent hepatic resection and 20 cases were treated by IAIC with implantable reservoir. Incidence of complication was decreased from 75% to 17% by the improved technique of hepatic arterial catheter intubation. Median survival was 12 months, 20 months and 8 months, respectively. When used with MMC, the IAIC showed unsatisfactory results. We should therefore investigate possible use of alternative drugs, their optimum dosages, and the regimens for improved chemotherapy.

Adult↗
PubMed1988

Evaluation of endorectal ultrasound for the assessment of wall invasion of rectal cancer. Report of a case.

To accurately assess the depth of cancer invasion, endorectal ultrasound was performed using a radial scanner (Aloka, 7.5 MHz) in 145 patients with rectal cancer. High-resolution ultrasound clearly depicted five- or seven-layer echographic structures in the normal rectal wall, and demonstrated cancer as a hypoechoic lesion. These layer structures provided an important feature in determining the depth of cancer invasion. Rectal cancers of 122 patients were examined thoroughly by endorectal ultrasound. In 95 of these patients (77.9 percent), ultrasonic assessment of the depth of cancer invasion as classified in four groups was correct, corresponding accurately to the microscopic findings. Ultrasonography overestimated the depth of cancer invasion in 21 patients, however, and underestimated it in six patients. This study indicated that a cause of the overestimation was inflammatory cell infiltration around cancer, and that one possible cause of underestimation was microscopically minimal invasion of cancer. Although there are certain limitations of endorectal ultrasound, this ultrasound technique will provide valuable information to determine the preoperative staging of rectal cancer.

Female↗
PubMed1987

Long term survival case of small (oat) cell carcinoma of the rectum.

A long term survival case of small (oat) cell carcinoma of the rectum in a 39-year-old female is presented. She complained of anal pain and occasional anal bleeding. The tumor was located at the anterior wall in the lower rectum. Biopsy specimens revealed a carcinoid tumor. She underwent trans-anal local resection for the first time in December, 1980. Macroscopic findings of the resected specimen showed a small nodule, 0.4 by 0.4 by 0.5 cm, with yellowish cut-surface. Microscopically, the tumor deeply invaded the submucosal layer. The appearances were indistinguishable from pulmonary small (oat) cell carcinoma. Since lymphatic permeations were moderately recognized in the tumor, she underwent radical operation (Miles' operation) with lymphadenectomy. Microscopic findings of the resected rectum revealed an intramural metastatic lesion with marked lymphatic permeations in the submucosal layer 2 cm distant from the primary lesion. Up to date, there is no evidence of local recurrence or liver metastasis. Small (oat) cell carcinoma of the rectum easily metastasizes lymphogenously through the lymph system from an early stage of the development. Wide surgical resection will be needed to give a long term survival even if the tumor is extremely small.

Adult↗
PubMed1987

Intraoperative ultrasonography in screening for liver metastases from colorectal cancer: comparative accuracy with traditional procedures.

As a new screening procedure, intraoperative ultrasonography using high-resolution real-time instruments was used routinely in 84 colorectal cancer operations to scan the entire liver for liver metastases. In 10 operations (11.9%), intraoperative ultrasonography identified 14 previously unrecognized metastatic tumors, all of which were less than 2 cm in size and were nonpalpable. The sensitivity of this technique in detecting metastatic liver lesions (97.8%) was significantly superior (p less than 0.01) to that of preoperative ultrasound (41.3%), computed tomography (47.8%), and surgical exploration (58.7%), while the specificity of each test was comparable (approximately 90%). High-resolution intraoperative ultrasonography is safe, simple to perform and more accurate than preoperative imaging and surgical exploratory methods. Therefore its use is encouraged during colorectal cancer surgery for screening of liver metastases.

Adult↗
PubMed1987

Exstrophy of the cloacal membrane. A pathologic study of four cases.

Exstrophy of the cloaca is a rare congenital anomaly. The authors add the pathologic findings of four distinct cases reported in this article to those reported in the literature. In all cases, common anomalies were recognized. In addition, there were rare anomalies, such as single umbilical artery, vestige of the left superior vena cava, common mesenterium, calcification of the cerebellum, incomplete segmentation of the left lung, abnormal shape of the liver, and knock-knee. The embryology of this complex anomaly is difficult. It is considered that this anomalous condition results from breakdown and mesodermal invasion of the cloacal membrane.

Abnormalities, Multiple↗
PubMed1986

Detection of unrecognized liver metastases from colorectal cancers by routine use of operative ultrasonography.

The importance of diagnosis and detection of liver metastases cannot be overemphasized for the treatment and prognosis of colorectal cancers. As a new diagnostic technique, operative ultrasonography has been performed during 33 operations for colorectal cancers including three operations for metachronous liver metastases. Of these, in five patients (15.2 percent) ultrasonography using 5- or 7.5-MHz instruments identified metastatic tumors that had not been diagnosed during preoperative imaging studies or at exploration. Most of these tumors were approximately 1 cm in size and nonpalpable. Cases of these five patients are presented in this report. High-resolution operative ultrasonography is considered to be a valuable method for detection of unrecognized metastatic tumors and for precise localization and spatial assessment of these hepatic lesions. Because it is safe, simple, and highly sensitive, the routine use of operative ultrasound is encouraged during surgery upon colorectal cancers for systematic screening of metastatic liver tumors.

Adult↗
PubMed1985

Small-cell carcinoma of the rectum. Clinicopathologic study.

Three cases of small-cell carcinoma of the rectum are presented. Our conclusions are as follows: small-cell carcinoma and carcinoid tumor of the rectum might have a common origin; indications for surgical intervention for small-cell carcinoma of the rectum should be considered seriously; small-cell carcinoma of the rectum should be classified as an aggressive type of rectal tumor that metastasizes easily to distant organs.

Adult↗
PubMed1985

Vibrio vulnificus septicemia.

A 33-year-old Japanese male, who had a three year history of biopsy-proved liver cirrhosis, was admitted to the hospital on June, 24, 1983 with a sudden onset of fever (38.6 degrees C), chills, generalized pain, nausea, anorexia, weakness, and eruption over the entire body. The patient went into shock and died about 7 hours after admission. Blood cultures before death were positive for V. vulnificus. Postmortem microscopic examination revealed "necrotizing vasculitis" in the small and large intestines, stomach, and skin, and also showed marked toxic epidermal necrolysis. This case matches the primary septicemia caused by V. vulnificus described by Blake et al. In addition, this case suggests that the septicemia was acquired through the gastrointestinal tract, especially the small intestine, because the V. vulnificus was isolated from blood and numerous Gram-negative bacilli around the submucosal vessels were observed in the area with acute necrotizing vasculitis.

Adult↗
PubMed1985

Gross and microscopic characteristics of stomach cancer with microangiopathic hemolytic anemia and/or disseminated intravascular coagulopathy.

We described gross and microscopic characteristics of 11 autopsied cases of stomach cancer with microangiopathic hemolytic anemia and/or disseminated intravascular coagulopathy. They were divided into two groups grossly. One was superficial carcinoma and the other diffuse infiltrating and fungating carcinoma. Superficial carcinoma arose multicentrically and showed figures of signet ring cell carcinoma. This condition was accompanied by marked pulmonary tumor emboli and bone marrow dissemination in the initial stage of cancer evolution. Diffuse infiltrating and fungating carcinoma arose in the corpus and showed variable histological features. Dissemination of tumor cells to the bone marrow was seen in the terminal stage. Stomach cancer in this series consisted of two different groups on gross, microscopic and metastatic features. Signet ring cell of superficial carcinoma showed characteristic biological features with respect to local extension and metastasis.

Adult↗
PubMed1985

Somatostatinoma of the pancreas.

A case of a pancreatic somatostatinoma in a 74-year-old male is presented. It was very difficult to establish the clinical diagnosis because of absence of typical symptoms. However, it was very easy to establish the histological diagnosis because typical cytoplasmic neurosecretory granules (D-cell granules) and immunoreactivity for somatostatin were demonstrated. Moreover, immunoassay of tumor tissues enables one to not only establish a definitive diagnosis but also to demonstrate multiple hormone production.

Adenoma, Islet Cell↗
PubMedDate not supplied

Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from colorectal cancer: evaluation with postoperative follow-up results.

The accuracy of intraoperative ultrasonography in diagnosing liver metastasis was evaluated at the time of surgery and at follow-up in 189 patients with colorectal cancers. Evaluation at the time of operation revealed that the sensitivity of intraoperative ultrasonography (93.3%) was significantly (p less than 0.0001) higher than that of preoperative ultrasonography (41.3%), conventional computed tomography (47.1%), and surgical exploration (66.3%). Twenty-two of 104 metastatic liver tumors were detected solely by intraoperative ultrasonography in 18 patients (9.5% of total patients). These 22 tumors were small in size (4 x 4 mm to 15 x 18 mm) and nonpalpable during operation. During the postoperative follow-up period of 18 months or more (mean 35.6 months, median 37.1 months) after colorectal surgery, liver metastases that were unrecognized during surgery appeared in 13 (6.9%) patients. Re-evaluation based on these follow-up results indicated that the sensitivity of intraoperative ultrasonography decreased to 82.3%, which was still significantly (p less than 0.0005) better than that of other methods. Intraoperative ultrasonography was capable of identifying 18 of 31 (58.1%) patients in whom liver metastases were otherwise unrecognized at the time of operation. Intraoperative ultrasonography is more accurate in diagnosing liver metastasis than traditional screening methods, and may have a beneficial impact on the management of colorectal cancer.

Colorectal Neoplasms↗
PubMedDate not supplied

Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus.

Factors responsible for recurrence of esophageal cancer were investigated in 90 patients who underwent extended radical esophagectomy with three-field dissection for a squamous cell carcinoma in the thoracic esophagus. The initial tumor recurrence was grouped as either locoregional (site of the primary tumor, anastomotic site, or lymph nodes) or as distant (distant organs, pleura, or peritoneum). Nineteen patients (21%) developed a locoregional recurrence, and 19 (21%) developed a distant recurrence. One (1%) developed both recurrences simultaneously and was classified as a distant recurrence. The locoregional recurrence was correlated with the stage factors, particularly the number of metastasis-positive nodes. For the distant recurrence, vascular invasion was found to have been the most important prognostic factor. Our findings suggested that locoregional recurrence was due to tumor progress related to the extent of lymph node metastasis, whereas distant recurrence was due to the oncologic behavior of the tumor. Locoregional recurrence in patients with limited disease may be reduced by extended radical esophagectomy with three-field dissection. Distant recurrence cannot be controlled by surgery. Adopted postoperative adjuvant therapies showed no effect on recurrence.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Impact on outcome of additional microvascular anastomosis--supercharge--on colon interposition for esophageal replacement: comparative and multivariate analysis.

The impact on the outcome of an additional microvascular anastomosis--supercharge--on colon interposition for esophageal replacement was retrospectively evaluated by comparing it with colon interposition without supercharge. A series of 53 patients had undergone colon interposition for esophageal replacement at Kurume University Hospital from 1981 to 1996. The postoperative courses and the morbidity and mortality rates were compared between the 24 patients who underwent colon interposition without supercharge from 1981 to 1988 and the other 29 patients who underwent colon interposition with supercharge from 1989 to 1996. Risk factors for leakage of the esophagocolostomy and for hospital mortality after colon interposition were evaluated by multivariate analysis. Colon interposition with supercharge required a longer operation time but resulted in a lower incidence of necrosis in the colon graft and leakage in the esophagocolostomy (Odds ratio = 34), a shorter duration until peroral intake, and a shorter hospital stay compared to colonic interposition without supercharge. The addition of supercharge to colon interposition for esophageal replacement has been an effective option that has prevented serious complications caused by graft ischemia.

Aged↗