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Biomedical subjects

T Yao

Publications and source records attributed to T Yao.

412 records · Page 23Linked to original sources

Minute lesions of the rectum and sigmoid colon in patients with Crohn's disease.

Sigmoidoscopy with a spray of 0.1% indigocarmine was performed on 20 patients with Crohn's disease whose main lesions were located proximal to the transverse colon and on 10 age-matched healthy volunteers. Minute lesions such as apthoid lesions, areas of erythema, and small ulcers were found in 90% of patients with Crohn's disease and in 0% of healthy volunteers (p less than 0.001). Among the minute lesions, aphthoid lesions were found in the highest incidence (85%). It was difficult to determine the presence of aphthoid lesions without the spray of indigocarmine, which facilitated detection. Histologically, granulomas were found in 15% of patients with Crohn's disease. Aphthoid lesions were not associated with superficial erosions and lymphoid follicles. The presence of aphthoid lesions in the rectum and sigmoid colon would be a strong indication of the presence of Crohn's disease.

Adolescent↗

Endoscopic features of gastric carcinoids.

Endoscopic findings were studied in eight patients with gastric carcinoid tumors. Five patients had a single tumor and the remainder had multiple tumors. Endoscopic examinations revealed smooth, submucosal masses rounded in shape in all patients. In six patients, the lesion was accompanied by an irregularly shaped erythematous depression or ulceration, which was considered to be a characteristic endoscopic finding of gastric carcinoid. An accurate preoperative diagnosis was made in six patients by endoscopy in combination with biopsy.

Adult↗

Endoscopic ultrasonography in rectal carcinoid tumors: contribution to selection of therapy.

To assess the clinical value of endoscopic ultrasonography (EUS) in carcinoid tumors of the rectum, we studied endoscopic and EUS findings in five patients whose tumors were relatively small in size. Endoscopy revealed sessile or semi-pedunculated smooth elevations, with mucosa of normal appearance. The elevations ranged from 5 to 15 mm in diameter, and were yellowish to white in color. EUS failed to demonstrate a small tumor in two patients whereas in the remaining three patients, a homogeneously hypoechoic mass, which was restricted to the submucosal layer, was detected. All patients were treated by endoscopic excision or local resection of the tumor, which resulted in complete removal of the tumor. We believe that even though EUS is not efficacious in cases of very small carcinoid tumors of the rectum, it can provide clinically important information in choosing therapy.

Aged↗

Minute non-polypoid adenoma of the colon detected by colonoscopy: correlation between endoscopic and histologic findings.

To characterize the endoscopic features of minute non-polypoid neoplastic lesions of the colon, we investigated the endoscopic, macroscopic, and histologic findings in 34 lesions detected by colonoscopy, which were smaller than 5 mm and were endoscopically recognized as flat or depressed lesions. The lesions were divided into two groups according to their endoscopic features; 8 lesions were completely flat and the remaining 26 lesions were flat-topped elevations with a central depression. Macroscopic examinations revealed that the center of the endoscopically flat lesion was slightly elevated, whereas the center of the flat-topped elevation was characterized by a central depression. All of the lesions were histologically diagnosed as tubular adenomas. The flat lesions were composed of flatly elevated adenomatous glands, while the flat-topped elevations with a depression were characterized by surrounding hyperplasia arising from normal glands. The whole thickness of the mucosa was replaced by adenomatous glands in the lesions with an obvious central depression, while the adenomas tended to spread superficially in the lesions with a shallow depression. These findings suggest that pre-cancerous lesions other than small polyps do exist in the colon and that colonoscopic examination provides some clue toward a prediction of the histologic architecture of the lesions.

Adenoma↗

Endoscopic ultrasonography in primary gastric lymphoma: correlation with endoscopic and histologic findings.

To evaluate the potential value of endoscopic ultrasonography in primary gastric lymphoma, we compared endoscopic ultrasonography findings with endoscopic and histologic findings in 15 patients in whom the diagnosis had been established by radiography and endoscopy, including forceps biopsy. The patients were divided into four groups according to the endoscopic ultrasonography findings. The groups included the following: superficially spreading type (six patients), diffusely infiltrating type (three patients), mass-forming type (four patients), and mixed type (two patients). The endoscopic ultrasonography findings correlated well with the endoscopic, macroscopic, and histologic findings. The histologic findings in nine patients with the endoscopic ultrasonography superficially spreading type or diffusely infiltrating type revealed B-cell lymphoma arising from mucosa-associated lymphoid tissue, which shows slowly infiltrative growth. In four patients with the endoscopic ultrasonography mass-forming type, on the other hand, the tumor histologic finding consisted of diffuse large-cell or diffuse mixed-cell type. Our results indicate that endoscopic ultrasonography may provide information helpful for the management of primary gastric lymphoma.

Adult↗

Endoscopic features in amyloidosis of the small intestine: clinical and morphologic differences between chemical types of amyloid protein.

Thirty patients with amyloidosis of the small intestine were studied to determine the correlations between the chemical types of amyloid protein and endoscopic, histologic, or clinical features. Endoscopic examinations of the jejunum revealed various findings such as a fine granular appearance, erosions and mucosal friability, thickening of the valvulae conniventes, and multiple polypoid protrusions in 23 cases. Immunohistochemical study of the biopsy specimens identified the following chemical types of amyloid protein: amyloid A protein (AA) in 20 cases, light chain protein (AL) in 8, beta 2-microglobulin (AH) in 1, and prealbumin (AF) in 1. The fine granular appearance was found significantly more often in the AA cases (p < 0.001), whereas multiple polypoid protrusions and thickening of the valvular conniventes were observed only in the AL cases (p < 0.001). Histologically, wide granular amyloid deposits in the propria mucosae were seen significantly more often in the AA cases (p < 0.01), whereas massive amyloid deposits in the muscularis mucosae, submucosa, and muscularis propria were the more dominant findings in the AL cases (p < 0.001). Clinically, a more frequent occurrence of diarrhea, malabsorption, and occult blood in stools was present in the AA cases, whereas mechanical obstruction and chronic intestinal pseudo-obstruction were evident only in the AL and the AH cases. These results suggest that clinicopathologic differences between the amyloid proteins exist in small intestinal amyloidosis and that endoscopic appearance relates to the specific accumulation pattern of each type of amyloid protein.

Adult↗

Rapidly and infiltratively growing Crohn's carcinoma of the small bowel: serial radiologic findings and a review of the literature.

We carried out a retrospective evaluation of serial changes in the small bowel radiographs of a patient with small bowel cancer accompanied by long-standing Crohn's disease. During the 8 months before diagnosis, marked morphological changes were noted. A solitary and irregular protrusion, and rapidly growing stricture under careful medical management of the underlying disease may indicate the development of cancer.

Adenocarcinoma↗

Giant proteases: beyond the proteasome.

Proteasomes and related proteases are thought to be the principal machinery responsible for intracellular protein degradation. A new class of giant proteases has been discovered that can augment the catabolic functions of proteasomes and, under some conditions, may even substitute for proteasomes altogether.

Aminopeptidases↗

Phenotypical characteristics of undifferentiated carcinoma of the pancreas: a comparison with pancreatic ductal adenocarcinoma and relevance of E-cadherin, alpha catenin and beta catenin expression.

The characteristics of undifferentiated (anaplastic) carcinoma (UC) of the pancreas were analysed and compared with those of poorly differentiated adenocarcinoma (PA). Eight cases of UC of the pancreas were evaluated by clinicopathological and immunohistochemical methods and compared with 20 cases of PA. Large size of the tumor, local invasion and lymph node metastasis were frequently seen in UC, leading to a significantly worse prognosis compared to that of PA (p=0.022). Immunohistochemically, E-cadherin expression was completely lost in 7/8 UC cases, whereas half the PA cases revealed a strong reactivity for E-cadherin. alpha- and beta-catenin expressions tended to be impaired in UC compared with PA. The results suggest that the altered expression of adhesion molecules is correlated with dedifferentiated change and is contributory to its aggressive biological behaviour.

Adenocarcinoma↗

Different characteristics of carcinoma in the gastric remnant: histochemical and immunohistochemical studies.

Seventy cases of cancer of the gastric remnant were divided into three groups: 33 cases following surgery for benign disease (group A), and 15 cases occurring more than 10 years and 22 cases occurring within 10 years after the first gastrectomy for malignant disease (groups B and C, respectively). Then mucin histochemical and immunohistochemical studies were undertaken. Billroth-II procedure for anastomosis was most frequently performed in group A. Intestinal metaplasia within the mucosa surrounding the carcinomas was more frequently present in groups A and C with a diffuse distribution. Intestinal-type surrounding mucosa was significantly more frequent in group C. The immunohistochemical expression of p53 protein was most frequently expressed in group B. We conclude that a different mechanism of carcinogenesis exists in these three groups; i) group A: the reflux of duodenal juice especially following B-II procedures leads to progression of the carcinoma. ii) group B: some genetic factor such as p53 may be related to the metachronous multiple carcinogenesis. iii) group C: metachronous multiple carcinogenesis within the short interval may be closely associated with diffuse intestinal metaplasia in the surrounding mucosa.

Adenocarcinoma↗

Surgical approaches in primary gastric lymphoma and carcinoma.

Data on 29 patients with primary gastric lymphoma and on 1655 with gastric carcinoma were compared with respect to the local extension and the results of surgery. More than two-thirds of the gastric area was involved due to multiple or widespread lesion in 25.9% and 7.0% of the patients with gastric lymphoma and carcinoma, respectively. Maximum tumor dimension exceeded 10 cm in 33.3% and 9.5% of gastric lymphomas and carcinomas respectively. Involvement of the extra-perigastric lymph nodes was evident in 51.8% and 26.2% of the patients with gastric lymphoma and carcinoma respectively. Therefore, wide and extended resection, including total gastrectomy, would be required more often for the surgical excision of gastric lymphoma. Peritoneal dissemination and liver metastasis were much less common in those patients with gastric lymphoma and hence, benefiting most from surgery. The five year survival rate after curative resection was somewhat better in patients with a gastric lymphoma (79.3% as compared to 65.6%), whereas the prognosis after non-curative surgery was equally unfavorable. Aggressive surgical excision is thus recommended for the treatment of patients with a primary gastric lymphoma.

Carcinoma↗

Gastric syphilis: case report and review of the literature.

A 35-year-old Japanese woman consulted our clinic with a one-month history of epigastric pain. Although a superficial depressed type of early gastric carcinoma was highly suspected from the results of upper gastrointestinal barium studies and gastroscopy, there was no evidence of malignancy in the biopsy specimen. Gastric syphilis was then considered based on skin lesions and serological studies. Diagnostic antisyphilitic therapy improved the symptoms and gastric lesion promptly. A review of the recent reports indicated that most cases of early phase gastric syphilis seem to present morphologically either as a narrowing lesion or shallow ulcero-nodular lesion at the pyloric antrum. Therefore, whenever such findings are recognized either radiologically or gastroscopically and no malignant cells are found in biopsy specimens, gastric syphilis and diagnostic antisyphilitic therapy should be considered.

Adult↗

Epidermal growth factor in gastric carcinoma as a risk factor of postoperative recurrence.

The expression of epidermal growth factor (EGF) was immuno-histochemically examined in the primary lesions of 201 patients with advanced gastric cancer who underwent curative resection. EGF-positive tumor cells were detected in the specimens of 75 patients (37.3%). A significant correlation was observed between the extent of lymph node metastasis and EGF expression (p < 0.01), indicating that EGF-positive cancer has a tendency to lymph node metastasis. The 2-year and 5-year survival rates of the patients with EGF-negative tumors were 77.2% and 63.0%, respectively, while those with EGF-positive tumors were 59.1% and 47.5% respectively. The difference in survival rates reached a maximum 2 years after surgery, indicating that the patients with EGF-positive gastric cancer had a higher risk of early recurrence. Therefore, the amount of EGF produced by a tumor may play some role in the growth of metastatic tumors and residual tumor cells after surgery, and thus be a potential risk factor in recurrence.

Adenocarcinoma↗

Solitary Peutz-Jeghers type polyp of the duodenum containing a focus of adenocarcinoma.

The case of an 84-year-old woman with evidence of continuous gastrointestinal bleeding is presented. A barium study and endoscopy showed a 25 x 20 mm sized semipedunculated polyp in the second portion of the duodenum. No other lesion was found throughout the entire gastrointestinal tract, and endoscopic resection of the duodenal polyp was performed. The resected polyp showed typical histologic features of a Peutz-Jeghers type hamartomatous polyp, although the patient lacked any familial history and signs related to the Peutz-Jeghers syndrome. A focus of adenocarcinoma was also found within the polyp. The present case would appear to be the first demonstration of a solitary Peutz-Jeghers type hamartomatous polyp of the duodenum containing a focus of adenocarcinoma.

Adenocarcinoma↗

Characteristic endoscopic features of intestinal lymphangiectasia: correlation with histological findings.

Six patients with histologically proven intestinal lymphangiectasia were evaluated for the endoscopic features. White villi and/or spots, previously reported as endoscopic findings, were seen. Furthermore, white nodules and submucosal elevations with or without white mucosa were observed. All patients demonstrated the appearance of submucosal elevations. The four characteristic endoscopic features were correlated with histological findings. It is considered that these endoscopic features are of value for the diagnosis of intestinal lymphangiectasia in patients with protein-losing enteropathy.

Adolescent↗