[Marshall-Marchetti-Krantz operation for urinary stress incontinence].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
N Tsukamoto
Publications and source records attributed to N Tsukamoto.
Arterio-venous fistulas involving the uterus and lung.
A case of arterio-venous fistulas (AVF) involving the uterus and lungs is described. A 57-year-old Japanese woman developed profuse uterine bleeding during endometrial curettage, and underwent emergency abdominal hysterectomy. Postoperatively, she complained of exertional dyspnea and palpitation. Pulmonary angiography revealed multiple AVFs in both lungs. The surgical resections of the lung lesions were performed and her pulmonary symptoms improved.
Arteriovenous Fistula↗
Efficacy of second-look laparotomy for patients with epithelial ovarian carcinoma.
Second-look laparotomies (SLL) were performed on 42 patients with ovarian carcinoma. Ten (24%) had residual disease. Serum CA 125 values before SLL predicted the presence of residual tumors, but its relatively high false negative rate made it unable to take place of SLL. Positive peritoneal cytology at initial surgery significantly influenced SLL results in patients with early disease. Residual pelvic lesions at initial surgery seemed to resist subsequent chemotherapy. Salvage therapy with external pelvic irradiation was effective on lesions confined to the pelvis without serious toxicity. Patients with advanced disease, undergoing SLL achieved better survival than without SLL. This study shows SLL is still the most accurate procedure in assessing the efficacy of treatment, and useful in selecting second-line therapy.
Adult↗
Distribution of basement membrane antigens in the uterine cervical adenocarcinomas: an immunohistochemical study.
The distribution of laminin and collagen type IV in the basement membrane of 45 uterine cervical adenocarcinomas was studied using immunohistochemical techniques. Staining patterns of basement membranes were divided into three types, according to the intensity of staining: thick and discontinuous (type I), thin and discontinuous (type II), and fragmentary (type III). In well-differentiated adenocarcinomas, 17 of 24 cases (71%) showed type I and the remaining 7 showed type II. In contrast, in poorly differentiated adenocarcinomas 4 of 5 cases (80%) showed type III. Five of six cases (83%) of adenoma malignum, even though extremely well differentiated, showed type III. Staining patterns of the basement membranes correlated with histological grade. Five-year survival rate of patients with type I and II staining (74%) was better than that of patients with type III (55%).
Adenocarcinoma↗
Squamous cell carcinoma arising in a cystic teratoma presenting as a vulvar mass.
A case of squamous cell carcinoma arising in a cystic teratoma presenting as a vulvar mass is reported. This appears to be the first report of such a case.
Carcinoma, Squamous Cell↗
Glassy cell carcinoma of the endometrium.
A case of glassy cell carcinoma of the endometrium in a 62-year-old woman is reported. Microscopically, a cytoplasm of ground-glass appearance was observed with a distinct cell wall and large nuclei containing prominent nucleoli. These histologic characteristics are consistent with those of glassy cell carcinoma of the cervix. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection followed by external irradiation to the whole pelvis. The patient was alive without evidence of disease at 5 1/2 years.
Adenocarcinoma↗
Malignant hemangiopericytoma of the omentum presenting as an ovarian tumor.
Malignant hemangiopericytomas are usually found in the musculature of the extremities, the retroperitoneum, and the pelvis. Malignant hemangiopericytoma arising in the omentum is extremely rare. We recently experienced such a case, in which a malignant ovarian tumor was suspected preoperatively on the basis of the sonogram, CT scan, magnetic resonance image, and increased CA-125 value. Microscopically, the tumor showed many mitoses, increased cellularity, and cytologic atypia. The patient was treated with CAP combination therapy following resection of the tumor; however, an intraperitoneal recurrence probably due to implantation was recognized 11 months later.
Diagnosis, Differential↗
Biochemical changes in the rat lung and liver following intratracheal instillation of cadmium oxide.
Acute biochemical changes in the rat lung and liver following intratracheal instillation of cadmium oxide (CdO) were observed at a dose of 5 micrograms Cd/rat to investigate the defense mechanism to Cd intoxication via airway. In the lung metallothionein (MT) was induced, reaching a maximum at 2 days. A slight increase in reduced glutathione (GSH) concentration was observed at 4 days. The activity of glucose-6-phosphate dehydrogenase (G6PDH) was increased and superoxide dismutase (SOD) activity was slightly decreased, but glutathione peroxidase (GPx) and glutathione reductase (GR) activities were not changed. These observations suggested that MT played a key role in detoxification of instilled CdO, but that the antioxidant enzymes had a minimal role. In the liver MT and GSH concentrations were diminished 7 h after instillation and returned to their control levels. Hepatic GPx activity was increased 1 day after instillation and the significantly elevated level lasted up to 7 days, while hepatic GR activity was decreased. These hepatic biochemical changes are suggested to be due to the secondary effects of the lung injury.
Animals↗
Pro-opiomelanocortin gene expression in silent corticotroph-cell adenoma and Cushing's disease.
The silent corticotroph-cell adenoma (SCCA) is characterized by the presence of immunoreactive adrenocorticotropic hormone (ACTH) in the tumor tissue in patients without symptoms of Cushing's disease. To elucidate the pathophysiology of SCCA, the expression of pro-opiomelanocortin (a ACTH precursor) genes was studied in a patient with SCCA and in three patients with Cushing's disease. Pro-opiomelanocortin messenger ribonucleic acid (mRNA) was found in the SCCA tissue to a greater degree than in the adenomas of the patients with Cushing's disease. Northern blot analysis revealed that the size of pro-opiomelanocortin mRNA present in the SCCA tissue was indistinguishable from that in the adenomas associated with Cushing's disease. A ribonuclease mapping study indicated that there were no point mutations in the coding sequence of pro-opiomelanocortin mRNA present in the SCCA tissue. Because of the presence of pro-opiomelanocortin mRNA and immunoreactive ACTH in the adenoma tissue, it is proposed that translation of the mRNA and subsequent accumulation of ACTH precursor occurred in the SCCA. Thus, the absence of Cushing's disease symptoms in this SCCA could not be caused by abnormality in the coding sequence of the pro-opiomelanocortin gene or in ribonucleic acid processing. The occurrence of abnormality at or after the translational steps was strongly suggested.
Adenoma↗
Prolactin gene expression in human growth hormone-secreting pituitary adenomas.
To elucidate the mechanism of hyperprolactinemia often observed in patients with growth hormone (GH)-secreting pituitary adenomas, the presence of immunoreactive prolactin (ir-PRL) and prolactin (PRL) messenger ribonucleic acid (mRNA) in the tumor tissue was examined by immunohistochemistry and cytoplasmic dot hybridization. Hyperprolactinemia was observed in three of 18 patients with GH-secreting adenoma. The tumor tissue was demonstrated to contain ir-PRL in nine patients and PRL mRNA in 13. The presence of ir-PRL in the tumor tissue was always associated with positive PRL mRNA, indicating production of PRL in GH-secreting tumors. Among the three patients with hyperprolactinemia, both ir-PRL and PRL mRNA was revealed in the tumor tissue of one, PRL mRNA but not ir-PRL was detected in the adenoma tissue of another, and neither PRL mRNA nor ir-PRL was found in the tumor tissue of the third. The association of hyperprolactinemia with the presence of both ir-PRL and PRL mRNA or PRL mRNA alone is indicative of PRL production and secretion. However, the absence of ir-PRL and PRL mRNA in the tumor tissue may indicate that hyperprolactinemia is caused by the suppression of PRL inhibitory factor due to hypothalamic dysfunction by the tumor mass. Thus, the study of PRL gene expression and immunohistochemistry in GH-secreting adenomas is valuable to understanding the pathophysiology of pituitary tumors.
Adenoma↗
[Surgical treatment of endometrial cancer].
The main treatment of endometrial cancer is surgery. Total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) is the principal surgery for stage I disease. Recently, pelvic lymph node dissection and para-aortic node biopsy is also being performed. For stage II, many surgeons in Japan prefer to do radical hysterectomy, however, its validity is questioned. For stages III and IV, surgery, radiation, chemotherapy and/or hormone therapy are combined, however, TAH and BSO should be performed at least. In 1988, FIGO changed the endometrial cancer staging system from clinical to surgical. According to this new staging, laparotomy should be done first and treatment plans made depending on the result of surgical finding.
Combined Modality Therapy↗
[Radiation enteritis: mucosal regeneration and stromal reaction of the small intestine after irradiation].
D-glucose absorption in vivo in mice decreased as a function of dose and time after irradiation returning to normal within a week after irradiation. The lamina propria is seen full of polymorphonuclear leukocytes, other infiltrative cells, capillary and lymphatic network, which seem closely related to chronic enteritis. Since acute and chronic diarrhea after irradiation can be reduced by cholestyramine or acetylsalicylate, malabsorption of bile salts or prostaglandin E of the luminal content has been regarded as a cause of radiation-induced diarrhea. LD 50 of irradiated mice was increased by SOD. From the clinical data, thin physique, previous operation, and total dose of more than 50 Gy could be predisposing factors of radiation-related enteritis.
Adult↗
Anesthesia for a patient with recessive dystrophic epidermolysis bullosa.
Two different anesthetic methods were employed for a patient with recessive dystrophic epidermolysis bullosa (R-DEB). One was plexus brachial block in combination with ketamine infusion. The other was general anesthesia with N2O-O2-halothane via a face mask. In the former, no particular problem developed. In the later, however, some blisters were newly formed on the region where the anesthesist's fingers were attached to hold a face mask. Although mask anesthesia was considered to be not always suitable for patients with DEB, we chose it because tracheal intubation may cause more serious damage to the upper airway leading to airway obstruction.
Journal Article↗
[Seven cases of primary adenocarcinoma of the fallopian tube].
Seven patients with primary adenocarcinoma of the fallopian tube were treated at Kyushu University Hospital from 1978 to 1987. They were 0.59% of all patients with gynecologic malignancies in our hospital. Their mean age was 56.0 years old. Four of 7 patients presented with abnormal genital bleeding. Pelvic mass was detected in 6 of 7 patients. One patient showed abnormal cervical cytology and 3 of 6 patients had positive endometrial cytology and/or histology. No diagnosis of tubal cancer was made preoperatively. Primary surgical treatments were performed in all patients. Four patients, who underwent dissection and/or biopsy of pelvic and paraaortic lymph nodes, had no metastasis. However, at the time of recurrence, paraaortic and/or neck lymph nodes metastases were present in 3 of 4 patients. Following surgery, combination chemotherapy with cyclophosphamide, doxorubicin and cisplatin (CAP) was administered to 6 of 7 patients. Partial responses were obtained in 2 patients with recurrent and evaluable lesions. The mean survival time of 7 patients as yet was 36.0 months after diagnosis. In conclusion, the difficulty of preoperative diagnosis of tubal cancer was reconfirmed. CAP combination chemotherapy seemed to be effective for the treatment of tubal cancer and further study with more cases is warranted.
Adenocarcinoma↗
Pulmonary clearance and toxicity of zinc oxide instilled into the rat lung.
Pulmonary toxicity of zinc oxide (ZnO) was evaluated by investigating the metabolic fate and inflammatory potency of ZnO instilled into the rat lung. Groups of three rats received single intratracheal instillations of ZnO suspension at a dose of 100 micrograms Zn/rat in the time-course experiment or received 20, 50, 100, 200, 500 and 1000 micrograms Zn/rat and were killed 2 days after treatment in the dose-response experiment. It was suggested that ZnO particles were solubilized in the bronchoalveolar milieu and cleared from the lung with a half-life of 14 h. Metallothionein (MT) was induced with a peak at 2 days. The content of MT was proportional to the dose of ZnO, but contributed little for the accumulation of Zn in the lung. A dose of 20 micrograms Zn/rat was sufficient to develop maximum responses for beta-glucuronidase activity and surfactant content in the bronchoalveolar lavage fluid. Moreover, the activity of lactate dehydrogenase and protein content in the lavage fluid increased significantly at 20 micrograms Zn/rat. These results suggest that the recommended ZnO concentration in the work-place atmosphere of 5 mg/m3 might not be adequate.
Animals↗
Hyperreactio luteinalis in normal singleton pregnancy.
A case of hyperreactio luteinalis in a patient with normal singleton pregnancy is reported. The course of pregnancy had been normal until the 24th week of gestation, when the mother developed lower abdominal pain and signs of virilization. She delivered of a normal female infant at 39 weeks' gestation. The baby did not show any signs of masculinization. Serum testosterone, delta 4-androstene-dione, and 5 alpha-dihydrotestosterone of the mother were markedly elevated. They remained high after the delivery but returned to the normal ranges soon after the partial resection of the enlarged ovaries. Reported causes of hyperreactio luteinalis are reviewed. Their maternal serum androgen levels were compared with cases of luteoma of pregnancy.
Adult↗
Malignant ovarian tumors associated with pregnancy: report of six cases.
Six cases of pregnancy associated malignant ovarian tumors, four epithelial cancers, one immature teratoma and one metastatic cancer of colon origin, are reported. One patient with mucinous cystadenocarcinoma had a history of persistent ovarian tumor during her past three pregnancies. Another patient was found to have mucinous cystadenocarcinoma after an emergency operation for twisted ovarian tumor. Immature teratoma associated with pregnancy is very rare and our case seems to be the 8th reported such case.
Adult↗
Early adenocarcinoma of the uterine cervix--its histologic and immunohistologic study.
Eight cases of early adenocarcinoma selected from 101 adenocarcinomas of the uterine cervix were studied to establish the criteria of early adenocarcinoma. Lesions of these 8 cases were small in size. In 7 of 8 cases, these tumors originated in the area of the squamocolumnar junction (SCJ). Tumor cells consisted of two types of atypical columnar cells, i.e., tall columnar cells with enlarged and deeply eosinophilic cytoplasm and clear cells with enlarged and clear vacuoles. Tall columnar cells showed weak or negative reaction to high iron diamine (HID) stain and negative to Alcian blue (AB) stain. Clear cells showed negative reaction to HID stain and positive to AB stain. Although normal endocervical columnar cells showed markedly positive reaction to HID stain and negative reaction to AB stain, invasive adenocarcinoma cells showed similar reaction to early adenocarcinoma cells. From this study, it is surmised that early adenocarcinoma of the uterine cervix originates in the area of the SCJ and consists of tall cells in all cases and clear cells in 4 of 8 cases, and that HID-AB stain is useful in differentiating early adenocarcinoma cells from normal endocervical columnar cells.
Adenocarcinoma↗