Famotidine-induced acute interstitial nephritis.
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Acute Kidney Injury↗
Biomedical subjects
M Itabashi
Publications and source records attributed to M Itabashi.
[A case report of gastric duplication cyst with difficult differential diagnosis from liver cystadenoma].
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Adult↗
Differences in diagnostic criteria for gastric carcinoma between Japanese and western pathologists.
BACKGROUND: There have been many studies on gastric carcinoma in populations with contrasting cancer risks. We aimed to find out whether the criteria for the histological diagnosis of early gastric carcinoma were comparable in Western countries and Japan. METHODS: Eight pathologists from Japan, North America, and Europe individually reviewed 35 microscope slides: 17 gastric biopsy samples and 18 endoscopic mucosal resections taken from 17 Japanese patients with lesions ranging from early gastric cancer to adenoma, dysplasia, and reactive atypia. The pathologists were given a list of pathological criteria and a form on which they were asked to indicate the criteria on which they based each diagnosis. FINDINGS: For seven slides most Western pathologists diagnosed low-grade adenoma/dysplasia, whereas the Japanese diagnosed definite carcinoma in four slides, suspected carcinoma in one, and adenoma in only two. Of 12 slides with high-grade adenoma/dysplasia according to most Western pathologists the Japanese gave the diagnosis of definite carcinoma in 11 and suspected in one. Of six slides showing high-grade adenoma/dysplasia with suspected carcinoma according to most Western pathologists the Japanese diagnosed definite carcinoma in all. There were no major differences in the diagnoses of three slides showing reactive epithelium and seven slides with clearly invasive carcinoma. When the opinion of the majority of the pathologists was taken as the final diagnosis there was agreement between Western and japanese in 11 of the 35 slides (kappa coefficient 0.15 [95% CI 0.01-0.29]). Presence of invasion was the most important diagnostic criterion for most Western pathologists whereas for the Japanese nuclear features and glandular structures were more important. INTERPRETATION: In Japan, gastric carcinoma is diagnosed on nuclear and structural criteria even when invasion is absent according to the Western viewpoint. This diagnostic practice results in almost no discrepancy between the diagnosis of a superficial biopsy sample and that of the final resection specimen. This may also contribute to the relatively high incidence and good prognosis of gastric carcinoma in Japan when compared with Western countries.
Adenoma↗
Expression of Bcl-2 in human breast cancer: correlation between hormone receptor status, p53 protein accumulation and DNA strand breaks associated with apoptosis.
The expression of Bcl-2, a suppressor of apoptotic cell death, was investigated in 52 invasive carcinomas of the breast using reverse transcription-polymerase chain reaction and immunohistochemical methods. After consideration of both sets of results, 42 tumors (80.8%) were confirmed to be positive (Bcl-2(+)) and 10 (19.2%) were judged negative (Bcl-2(-)) for Bcl-2 expression. Related factors (p53 protein accumulation, hormone receptor status and apoptotic cell index) were also examined using immunohistochemical and in situ end-labeling methods to elucidate their correlations with Bcl-2 expression. Bcl-2 expression correlated significantly with the hormone receptor status, whereas it showed significant inverse correlations with p53 accumulation and the apoptotic index. It was concluded that estrogen and mutant p53 are related to the regulation of Bcl-2 expression and that the ability to prevent tumor cell death due to Bcl-2 can be developed by breast cancers.
Apoptosis↗
Comparison of hypervariable regions (HVR1 and HVR2) in positive- and negative-stranded hepatitis C virus RNA in cancerous and non-cancerous liver tissue, peripheral blood mononuclear cells and serum from a patient with hepatocellular carcinoma.
Hepatitis C virus (HCV) infection is associated with a wide spectrum of liver diseases including cirrhosis and hepatocellular carcinoma (HCC). Although the biological relation between the virus and cirrhosis or HCC is unclear, such variable pathogenicity may be related to the genetic heterogeneity of HCV. Genetic variability of HCV was assessed by determining the nucleotide sequence corresponding to the hypervariable regions (HVR1 and HVR2) of the putative envelope protein (E2/NS1) in positive- and negative-stranded HCV RNA from the cancerous and surrounding non-cancerous liver tissue, peripheral blood mononuclear cells and serum of a patient with HCC. Nineteen distinct HVR1 amino acid sequences (deduced from the nucleotide sequences) were obtained from the patient and could be classified into 5 groups on the basis of the site and time of detection. Some viral isolates with the same HVR1 sequence were shown to replicate in both cancerous and non-cancerous liver tissue, whereas others replicated in HCC tissue only.
Amino Acid Sequence↗
Image quantitation of intestinal metaplasia in entire gastrectomy specimens from Swedish and Japanese patients.
The aim of this work was to investigate the extension of intestinal metaplasia (IM), as well as to quantitate various components of IM (namely sialomucins, sulfomucins and Paneth cells), in entire gastrectomy specimens from Swedish and Japanese patients. The length of the gastric mucosa was assessed by morphometry. The percent of sections with IM was regarded as the extension of IM in the specimens. Histochemically labeled sialomucins, sulfomucins and Paneth cells (the 3 main findings in gastric IM) were quantified in separate sections with the aid of an image analyzer. In total, 1,321 sections corresponding to 6 gastrectomy specimens were quantified. Sialomucins and sulfomucins were more extensively distributed in the 4 specimens with carcinoma than in the 2 without carcinoma (one having a peptic ulcer and the other, hereditary gastric cancer syndrome (HGCS) without carcinoma). On the other hand, quantitative analysis in Swedish specimens indicated that the highest values for sialomucins, sulfomucins and Paneth cells were present in HGCS. When Swedish and Japanese specimens with adenocarcinoma were compared, only sulfomucins (denoting Types II and III IM) were significantly higher in those carrying an intestinal-type carcinoma (ITC) than in those with diffuse-type carcinoma (DTC). The results substantiate those obtained with gastric biopsies by other authors. On the other hand, the mucosal extension and the amount of sulfomucins are not comparable parameters (since that mucin was not equally distributed, but "concentrated" in certain areas in the mucosa). One possible conclusion is that the focal distribution of acidic mucins and of Paneth cells in the gastric mucosa may strongly influence their detection rate in gastric biopsies. Thus, haphazard biopsy of the gastric mucosa may fail to sample areas with sulfomucins in population studies aiming to detect individuals at risk. Such sampling errors in gastric biopsies may explain the conflicting results on this subject appearing in the literature.
Gastrectomy↗
Application of three-dimensional spiral computed tomographic angiography to pancreatoduodenectomy for cancer.
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Angiography↗
Liver injuries induced by herbal medicine, syo-saiko-to (xiao-chai-hu-tang).
Four patients treated with the herbal medicine syo-saiko-to (xiao-chai-hu-tang) exhibited acute drug-induced liver injury. The latent period was one and a half to three months. All of the patients showed a rise in aminotransferases after readministration or challenge test. The liver histology revealed centrilobular confluent necrosis or spotty necrosis, microvesicular fatty change, acidophilic degeneration, and a granuloma. Cholestasis was seen in two patients. The results of the [13C]aminopyrine breath test, performed in one patient, were low before the challenge test and even lower after the challenge. These findings suggest that the herbal medicine syo-saiko-to may induce acute injury or the hepatocellular pattern with variable cholestasis.
Chemical and Drug Induced Liver Injury↗
Pulmonary artery reconstruction using a great saphenous vein autograft in the treatment of bronchogenic cancer.
Sleeve resection of the pulmonary artery, followed by reconstruction with or without bronchoplasty, for bronchogenic carcinoma located at a major lobar orifice has been reported as an alternative to pneumonectomy in patients with poor respiratory functional reserve. We describe herein what is, to our knowledge, the first report of a successful pulmonary arterial reconstruction using a saphenous vein autograft. This operation was performed in a 63-year-old man with poor pulmonary functional reserve who was diagnosed as having a large bronchogenic cancer in the left lower lobe of the lung, located close to the pulmonary hilum. First, a left lower lobectomy was performed with segmental resection of the pulmonary artery, from the basal artery to the lingular artery, after which pulmonary arterial continuity was reconstructed using a saphenous vein autograft. The patient had an uneventful recovery and remains well without any sign of recurrence 4 months after his operation.
Carcinoma, Bronchogenic↗
Case report: ectopic hepatocellular carcinoma arising from the left diaphragm.
A 57-year-old man with high alpha-fetoprotein (AFP) and suspected submucosal tumour of the stomach was referred for investigation. A 6 cm hypervascular tumour with tumour vessels in the left diaphragm was diagnosed by a combination of angiography and computed tomography. At laparotomy, the tumour was confirmed to be located just beneath the left diaphragm and to be isolated from the liver parenchyma. The resected specimen was histopathologically hepatocellular carcinoma. The level of AFP returned to normal, and the patient is free of recurrence 8 years after operation.
Carcinoma, Hepatocellular↗
Flow cytometric DNA analysis of submucosal carcinoma of the esophagus.
Carcinoma of the esophagus confined to the submucosa presents clinicopathologic features different from those of either carcinoma limited to the mucosa or more advanced lesions. The present study was designed to find out whether or not analysis of DNA content would yield prognostic information allowing the clinical outcome of carcinoma of the esophagus confined to the submucosa to be predicted. Cell nuclear DNA content was determined by flow cytometry in paraffin-embedded blocks from 55 patients with carcinoma of the esophagus confined to the submucosa. This allowed classification of DNA content into diploid and aneuploid patterns based on combined DNA histogram and cytogram data. The aneuploid pattern included typical, multiple clone and small clone aneuploid subtypes, as classified by our new criteria. A DNA aneuploid pattern was identified in 26 cases (47.3%) and found to correlate significantly with lymph node metastasis (P < 0.01). The incidence of distant metastasis was significantly higher in the aneuploid (4/26) than in the diploid (0/29) group (P < 0.05). The mortality from cancer within two years of surgery was significantly higher in the aneuploid (4/26) than in the diploid (0/29) group (P < 0.05). In conclusion, flow-cytometric DNA analysis is a valuable method for predicting malignant potential in carcinoma of the esophagus confined to the submucosa.
Adult↗
Morphometric analysis of colorectal dysplasia with image processing.
Nuclear and structural abnormalities on the histological specimens of colorectal dysplasias were quantified by using 10 parameters. From the measured values, the following histological findings were obtained: progression from mild to severe dysplasia was associated with an increase in nuclear size, and nuclear arrangement became more irregular. There was, however, no difference between the nuclear size and arrangement in severe dysplasia and those in carcinoma. The nuclei were spindle shaped in mild and moderate dysplasia. On the other hand, they were relatively round in severe dysplasia and carcinoma. Structural abnormalities tended to increase with the histological abnormalities. These results correspond well with the histological abnormalities by which the pathologists grade dysplasia and diagnose carcinoma subjectively. Therefore, these 10 parameters might be useful for quantifying histological characteristics of colorectal dysplasias.
Cell Nucleus↗
Prognostic factors for local recurrence in breast conservation therapy: residual cancers after lumpectomy.
In order to evaluate the local residual cancer following breast conservation therapy (BCT) with lumpectomy, we investigated the relationships between residual cancer and age, tumor location, tumor diameter (T), mammography findings, nipple discharge findings, histopathological type, lymphatic and/or vascular invasion by tumor cells, histological grading, histological lymph node metastases (n), and estrogen receptor (ER) status, in 1494 patients with breast cancer that involved diagnostic excisional biopsy. Residual cancers were found in 581 of 1448 (40%) mastectomy specimens, after 46 (3.1%) with multicentricity had been excluded. No correlation was observed between residual cancer and age, histological grading, and ER. However, residual cancer rates were significantly higher in patients with: (1) tumor diameters of 3.1 cm or larger; (2) tumors beneath or in the vicinity of the nipple-areola; (3) malignant calcifications noted in mammography findings; (4) serous or bloody nipple discharge, particularly with positive cytologic findings; (5) papillotubular carcinoma diagnosed by biopsy, (6) lymphatic invasion by tumor cells; or (7) a high degree (n > or = 4) of lymph node metastases. The above seven clinicopathologic factors are thus considered useful prognostic indicators for local recurrence in BCT with lumpectomy.
Adult↗
Self-expanding stainless steel stent application in rectosigmoid stricture.
In recent years, several reports on the experimental and clinical applications of the Gianturco stent (self-expanding stainless steel stent) have been published. However, to our knowledge, the use of stents in rectosigmoid strictures has not been reported. We used self-expanding stainless steel stents to dilate rectosigmoid strictures caused by nonresectable recurrent neoplasm. Insertion and dilation (sigmoid colon and rectum) in two patients were successful. Accordingly, these patients were able to maintain bowel activity and avoid palliative loop colostomy. We believe that this procedure is effective for nonresectable rectosigmoid stricture due to recurrent neoplasm.
Colon, Sigmoid↗
Multiple primary carcinoma of the oesophagus.
A retrospective evaluation of 239 patients with primary oesophageal carcinoma who underwent oesophagectomy without preoperative treatment revealed 45 cases (18.8%) of multiple primary oesophageal carcinoma (MPEC). The average age of the patients with MPEC was significantly lower than that of patients with single primary oesophageal carcinoma (SPEC) (P = 0.005). The incidence of association with pharyngeal malignancy was higher in patients with MPEC than in those with SPEC (P = 0.080). The number of patients in the category representing a combination of heaviest alcohol and cigarette use was significantly higher in the MPEC patients (P = 0.035). The high incidence of MPEC points to a need for careful checking of the oesophagus at the time of surgical treatment for oesophageal carcinoma. Low age at onset, a combination of heavy smoking and drinking, and association with pharyngeal malignancy are considered to be high-risk factors for MPEC.
Aged↗
Relationship between development of diarrhea and the concentration of SN-38, an active metabolite of CPT-11, in the intestine and the blood plasma of athymic mice following intraperitoneal administration of CPT-11.
Severe diarrhea occurred during daily intraperitoneal administration of 7-ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxycamptothecin (CPT-11) at a dose of 50 mg/kg in athymic mouse. Serial determination of CPT-11 and 7-ethyl-10-hydroxycamptothecin (SN-38), with the use of an on-line solid extraction HPLC system, demonstrated that much higher levels of the compounds are retained in the intestine and the blood plasma after five consecutive daily injections than after a single injection. Histologic examination of the gastrointestinal tract showed hemorrhagic colitis on day 7 and later after five consecutive daily injections of CPT-11. The direct cause of diarrhea associated with CPT-11 administration is considered to be enterocolitis caused by high levels of SN-38 and/or CPT-11 retained for a long period in the intestine.
Animals↗
Surgical treatment of thoracic esophageal carcinoma directly invading the lung.
BACKGROUND: The authors examined 63 patients with thoracic esophageal carcinoma directly invading the adjacent lung. Four of them had esophago-pulmonary fistulas. One patient received exploratory thoracotomy and exposure to radiation, and 62 underwent esophagectomy with mediastinal and abdominal lymph node dissection. A resection of the seized lung and the esophagus was performed in 39 patients (Group A), and 23 received esophagectomy with part of the tumor remaining intact (Group B). METHODS: The results of treatment were compared between the two groups. RESULTS: Operative blood loss, mortality, and complications in both groups showed no difference. The average number of dissected lymph nodes in Group A was significantly larger than that in Group B (P less than 0.01). Histologic examination revealed that 22 (56.4%) lesions in Group A invaded the pulmonary parenchyma, a finding that indicates the difficulty of gross diagnosis of tumor infiltration. Five-year survival rates for patients in Groups A and B were 21.1% and 8.7%, respectively. The survival curve for patients in Group A was significantly better than for those in Group B (P less than 0.05). CONCLUSIONS: Pulmonary resection and aggressive lymph node dissection are recommended for patients with esophageal carcinoma that invades the adjacent lung.
Aged↗
Diffusely infiltrating primary colorectal carcinoma of linitis plastica and lymphangiosis types.
A review of 2369 cases of resected primary colorectal carcinoma identified 15 cases of diffusely infiltrating colorectal carcinoma. Depending on the histologic pattern and extent, these cases were classified as linitis plastica (LP) type (seven cases) or lymphangiosis (LA) type (eight cases). The LP type consisted of poorly differentiated adenocarcinoma or signet ring cell carcinoma; it showed an annularly thickened and rigid bowel wall. The LA type consisted of moderately differentiated adenocarcinoma. The colon wall of the LA type was hemilaterally thickened at the mesenteric side. The prognosis was extremely poor for both types. The LP type mainly had peritoneal dissemination (70%), but the LA type frequently had distant metastasis (88%). Early diagnosis and curative operation are important for both types; however, the LA type also requires therapy for distant metastasis.
Adenocarcinoma↗