Superficially elevated colonic adenoma changed to undetectable configuration on ordinary endoscopy during treatment with preferential cyclooxygenase-2 inhibitor.
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Adenoma↗
Biomedical subjects
Takahiro Fujii
Publications and source records attributed to Takahiro Fujii.
Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device.
BACKGROUND: Local endoscopic mucosal resection of rectal carcinoid tumors is often associated with margin involvement that requires further intervention. The efficacy of resection of these tumors with endoscopic submucosal resection with a ligation device (ESMR-L) was evaluated. METHODS: Fourteen rectal carcinoid tumors were treated by ESMR-L between 1999 and 2002. ESMR-L was performed with a conventional colonoscope with an attached band-ligator device. For comparison, 14 rectal carcinoid tumors, treated by either endoscopic mucosal resection or polypectomy between 1990 and 1997, were evaluated as historical controls. All tumors were estimated to be 1 cm or less in diameter. OBSERVATIONS: There were no differences between the 2 groups in terms of age, gender, or tumor size. For 6 (43%) patients in the control group, there was tumor involvement at the margin of the resection specimen, whereas all tumors removed by ESMR-L had histopathologically proven negative margins (p < 0.05). The mean vertical resection margin also was significantly deeper in the ESMR-L group (p < 0.05). There was no complication of any procedure. CONCLUSIONS: ESMR-L is technically simple, minimally invasive, and safe for treatment of small rectal carcinoid tumors contained within the submucosa. ESMR-L provides a deeper resection margin compared with that obtained with conventional endoscopic mucosal resection or polypectomy.
Aged↗
Flat and depressed colorectal neoplasms.
An increasing body of literature is available showing the existence of flat and depressed colorectal neoplasms in Western countries. The appreciation that colorectal neoplasms may present as flat or depressed lesions has important implications, as the risk of adenocarcinoma in depressed lesions has been found to be markedly higher than in flat or protruding lesions of similar size. There is concern that flat or depressed colorectal neoplasms might be easily missed during a colonoscopy and subsequently diagnosed as cancer within a few years after a clearing examination. In this review, we appraise advances in the study of flat and depressed colorectal cancers based on the English literature published in 2000 and subsequently, with emphasis on their epidemiology, diagnosis, and therapy.
Journal Article↗
[Reiter syndrome after intravesical Bacillus Calmette-Guerin (BCG) immunotherapy: a case report].
A 56-year-old man who had previously undergone transurethral resection and intra-arterial chemotherapy for bladder cancer developed irritable bladder, bilateral conjunctivitis and arthritis including the knees, ankles and sacroiliac joints after starting intravesical Calmette-Guerin bacillus (BCG) immunotherapy. These symptoms were in agreement with the features of Reiter syndrome. One month after cessation of the intravesical BCG immunotherapy and initiation of the treatment with a non-steroidal anti-inflammatory drug (NSAID), he was not complaining of symptoms. Reiter syndrome is an uncommon complication after intravesical BCG immunotherapy. Nevertheless, since the prolonged arthritis has a possibility to cause joint deformity, we must pay serious attention to this side effect.
Administration, Intravesical↗
[A case of ammonium urate urolithiasis with Crohn's disease].
A 28-year-old woman suffering from Crohn's disease since 15 years of age presented with left back pain. She had undergone a colectomy when she was 20 years old and an ileostomy when she was 25 years old. She had been treated with mesalazine and pernasal nutrition (Elental) Ultrasonography showed left side hydronephrosis and a renal stone in the left renal pelvis. Computed x-ray tomography revealed a stone measuring 1.5 x 1.0 cm2 at the ureteropelvic junction, which was radiolucent on an abdominal radiograph. The renal stone was successfully treated with 10 exposures of extracorporeal shockwave lithotripsy. Ninety eight percent of the passed stone was composed of ammonium urate. Crohn's disease-related poor nutrition and dehydration are presumed to have been possible induction factors in the forming of the ammonium urate stone in this case.
Adult↗
Adenocarcinoma in solitary large hyperplastic polyp diagnosed by magnifying colonoscope: report of a case.
We report a case of carcinoma in a hyperplastic polyp in a 78-year-old female that was diagnosed before resection using a magnifying colonoscope. The patient presented with fecal occult blood and underwent total colonoscopy, which revealed a 12-mm sessile polyp in the cecum. When seen in magnified view, an irregularly shaped pit was evident at the center of the polyp that was distinct from the asteroid-type pits observed over most of the lesion. We diagnosed this lesion as a hyperplastic polyp with a carcinoma component. The patient underwent endoscopic mucosal resection, and histologic section revealed a well-differentiated intramucosal adenocarcinoma in the hyperplastic polyp. Hyperplastic polyps of the colon are regarded as benign, nonneoplastic lesions. Few have reported carcinomas in or with hyperplastic polyps, and most of those were diagnosed after resection and histologic investigation. The literature suggests a precise observation and consideration of resection for large solitary hyperplastic polyps in the right side of the colon, because the risk of malignancy is high. Magnifying colonoscopy is helpful for observing the surface in detail and for correctly diagnosing and managing the lesion.
Adenocarcinoma↗
Significance of the four carboxyl terminal amino acid residues of bovine pancreatic ribonuclease A for structural folding.
The C-terminal amino acid residues of bovine pancreatic ribonuclease A (RNase A) form a core structure in the initial stage of the folding process that leads to the formation of the tertiary structure. In this paper, roles of the C-terminal four amino acids in the structure, function, and refolding were studied by use of recombinant mutant enzymes in which these residues were deleted or replaced. Purified mutant enzymes were analyzed for their secondary structure, thermal stability, and ability to regenerate from the denatured and reduced state. The C-terminal deleted mutant enzymes showed lower hydrolytic activity for C>p and nearly identical CD spectra compared with the wild-type enzyme. The rate of recovery of activity was significantly different among the C-terminal deleted mutant enzymes when air oxidation was employed in the absence of GSH and GSSG: the rates decreased in the order of des-124-, des-(123-124)-, and des-(122-124)-RNase A. It is noteworthy that the regeneration rates of mutant RNase A in the presence of GSH and GSSG were nearly the same. Des-(121-124)-RNase A failed to recover activity both in the presence and absence of glutathione, due to the mismatched formation of disulfide bonds. The mutant enzyme in which all of the C-terminal four amino acid residues were replaced by alanine residues showed lower hydrolytic activity and an indistinguishable CD spectrum compared with the wild-type enzyme, and also recovered its activity from the denatured and reduced state by air oxidation. The D121 mutant enzymes showed decreased hydrolytic activity and identical CD spectra compared with the wild type. The recovery rates of activity of D121A and D121K were determined to be lower than that of the wild-type enzyme, while the rate of recovery of D121E was comparable to that of the wild type. The C-terminal amino acids play a significant role in the formation of the correct disulfide bonds during the refolding process, and the interaction of amino acid residues and the existence of the main chain around the C-terminal region are both important for achieving the efficient packing of the RNase A molecule.
Amino Acids↗
Sequential methotrexate and 5-fluorouracil therapy for gastric cancer patients with bone metastasis.
BACKGROUND: Patients with bone metastasis of gastric cancer occasionally experience disseminated intravascular coagulation (DIC), with a very poor prognosis.METHODS: We treated 18 gastric cancer patients with bone metastasis with sequential methotrexate and 5-fluorouracil (sequential MTX/5-FU therapy). The treatment schedule comprised weekly administration of methotrexate (MTX; 100 mg/m(2), i.v. bolus) followed by 5-fluorouracil (5-FU; 600 mg/m(2), i.v. bolus) after an interval of 3 h. Calcium leucovorin (10 mg/m(2), p.o. or i.v.) was administered six times, every 6 h starting 24 h after the administration of MTX.RESULTS: In 11 patients with measurable metastatic lesions, the response rate was 64% (7/11). Nine patients (50%) had DIC before the initiation of chemotherapy, and 8 of them (89%) recovered from it. Two of these 9 patients (22%) survived for more than 1 year. The median survival times for all patients and for the 9 with DIC were 186 and 113 days, respectively. Grade 4 leukopenia was observed in 3 patients (17%). No treatment-related deaths occurred.CONCLUSION: Sequential MTX/5-FU therapy may have palliative potential and may be a feasible treatment for gastric cancer patients with bone metastasis with or without DIC.
Journal Article↗