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Biomedical subjects

K Shirouzu

Publications and source records attributed to K Shirouzu.

At least 163 records · Page 9Linked to original sources
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↗
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

[MR imaging in paranasal and intracranial aspergillosis].

The MR findings in three patients with paranasal and intracranial aspergillosis were analyzed. Two patients had sphenoid sinus aspergillosis with mucocele, and one had aspergillosis in the maxillary sinus and pachymeningitis in the posterior fossa. In all patients with aspergillosis of the paranasal sinuses, a markedly hypointense area was present within the lesion on T2-weighted images. In the patient with pachymeningitis, contrast-enhanced MR images clearly demonstrated the extent of the lesion.

Aspergillosis↗
PubMed1991

[MRI of brain abscesses].

Four cases of brain abscess were examined on 1.5T MR and their findings were evaluated retrospectively. Preoperative cases had relatively characteristic findings, such as 1) peripheral edema producing hypointensity on T1-weighted images (T1WI) and hyperintensity on T2-weighted images (T2WI); 2) central necrosis with abscess fluid hypointense relative to white matter on T1WI and hyperintense on T2WI; 3) abscess rim iso- to hypointense on T2WI. Gd-DTPA enhanced T1WI carried further information; comparison of iso- to hypointense rim on T2WI (abscess rim) and enhanced area by Gd-DTPA on T1WI suggested that the former represented zone of macrophage infiltration.

Adult↗
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↗
PubMed1991

[Lymphatic permeation of colorectal cancer--evaluation as a prognostic factor by prospective studies].

To evaluate lymphatic permeation as a prognostic factor in colorectal cancer, long-term prospective studies were conducted and the following results were obtained. 1) The degree of lymphatic permeation increased as the depth of invasion, lymph node metastasis, and stage advanced. 2) Moderate or marked lymphatic permeation (ly2 or ly3) was observed at a high rate in moderately and poorly differentiated adenocarcinoma. 3) Recurrence was more common in the patients with ly2 or ly3. 4) In stage 2 and 3 patients with slight plus no lymphatic permeation (ly0 or ly1), the seven-year survival rates were 89.8% and 85.6%, respectively. In the ly2 + ly3 group, the rates were 67.1% and 66.1%, respectively and a significant difference was noted. In stage 4, however, there was no significant difference between the two groups. Conclusions were as follows. 1) The degree of lymphatic permeation was considered to be extremely closely related to the progression of cancer, histological type and recurrence. 2) In stage 2 and stage 3, the degree of lymphatic permeation was an important prognostic factor, but in stage 4 it was not. 3) It was shown that lymphatic permeation as classified by the authors was a reliable index for survival rates.

Adenocarcinoma↗
PubMed1991

[Clinicopathological studies on perineural invasion of rectal cancer with special reference to the prognosis and nerve preserving operation].

Prospective studies on rectal cancer have been continued since 1982 in our department and in the present study, the significance of perineural invasion was investigated clinicopathologically in 432 cases of rectal cancer. (1) Perineural invasion in rectal cancer appeared to be closely related to the degree of progress of the cancer (depth of penetration, lymph node metastasis, liver metastasis and peritoneal dissemination), the degree of malignancy of the cancer (histologic type, lymphatic invasion and venous invasion) and the degree of inflammatory cell infiltration. (2) It was proven to be an important prognostic factor which influences recurrences and the survival rate. (3) If cases indicated for nerve preserving operation are considered to be those with no perineural invasion or with a low frequency of such invasion, it was assumed that such cases are those with well differentiated adenocarcinoma, a penetration depth of ss (a1) or less and no lymph node metastasis.

Humans↗
PubMed1990

Treatment of rectal carcinoid tumors.

We investigated the treatment of 24 rectal carcinoid tumors from both the clinicopathologic and prognostic viewpoints. All tumors less than 2 cm in diameter had neither muscle layer invasion nor lymph node metastasis, except for an atypical carcinoid tumor that had both lymphatic permeation and intramural metastasis. One typical carcinoid tumor larger than 2 cm had both several lymphatic permeations and urinary bladder invasion. All cases had a good prognosis with no recurrence and no new metastases. For rectal carcinoid tumors less than 2 cm in diameter, local resection is sufficient, whereas radical operation is required for tumors larger than 2 cm in diameter. For atypical rectal carcinoid tumors, radical operation should be considered even if the diameter is less than 2 cm.

Adult↗
PubMed1990

Survival of rectal carcinoma patients studied with flow cytometric DNA analysis.

The cellular DNA content was measured with flow cytometry from paraffin-embedded materials in 197 patients with primary rectal cancer who had had "curative" resection. All patients were followed clinically for from 2.5 to 7 years. There was a significant difference in recurrent rate between DNA diploid and aneuploid tumors. The cumulative survival rate (Kaplan-Meier) of curative operative rectal carcinomas was worse in DNA aneuploid than in DNA diploid tumors (p less than 0.05). These data suggest that tumor DNA content is an important prognostic indicator for both recurrence and overall survival in patients with primary rectal carcinoma.

DNA, Neoplasm↗