A 51-year-old Japanese female was referred to us with a left lower quadrant pain and palpable mass. The CT and MRI study showed a 10x8x8 cm of well-circumscribed, multicystic mass adjacent to the left iliac bone. The mass was excised and consisted of multiple cysts containing bloody viscous material surrounded by thin-ring of eggshell-like tissue. The histological findings correlated with those of an aneurysmal bone cyst. This extraosseous case might be the first reported case observed in the pelvic cavity.

Bone Cysts, Aneurysmal↗

PubMedDate not supplied

Fundic adenomyomatosis bulged with the subserosal excessive fat of the gallbladder mimicking polypoid carcinoma: a case report with unusual imaging and morphological features.

This report describes a 41-year-old female who presented with adenomyomatosis of the gallbladder mimicking polypoid carcinoma, on the diagnostic imaging findings and revealing unusual histologic features for such a localized adenomyomatosis. The mass was located on the gallbladder liver-side wall at the fundus and papillary hyperechoic growth showed no clear ultrasonographic features of adenomyomatosis. The patient underwent a laparoscopic cholecystectomy with a tentative diagnosis of superficial polypoid carcinoma. Histologically, the tumor bulged due to subserosal excessive fat tissue.

Adenomyoma↗

PubMedDate not supplied

Pedunculated exogastric leiomyosarcoma: case report and brief literature review.

A case report and review of the literature on pedunculated exogastric leiomyosarcomas are presented. Although about one-fourth of the stromal tumors (common leiomyomas and leiomyosarcomas) of the stomach grow in an exogastric configuration, pedunculated exogastric leiomyosarcomas are extremely rare. At present there is no evidence of intraperitoneal seeding from exogastric leiomyosarcomas. Consequently, a local resection with an adequate margin is sufficient when no invasion to the adjacent structures, is observed.

Diagnosis, Differential↗

PubMedDate not supplied

Changes in serum and hepatic levels of immunoreactive prolyl hydroxylase in two models of hepatic fibrosis in rats.

Changes in serum and hepatic levels of immunoreactive prolyl hydroxylase (IRPH) as well as cellular localization of the enzyme were studied in 2 models of hepatic fibrosis, which was induced in male rats either by subcutaneous administration of CCl4 (Group A) or by intraperitoneal injection of porcine serum (Group B). Hepatic fibrosis appeared at the 8th week in Group A and at the 12th week in Group B, and liver cirrhosis developed at the 16th week in both models. Although tissue contents of hydroxyproline (HP) and IRPH increased in both models, only HP levels correlated with the degree of fibrosis. Serum IRPH levels and serum asparate aminotransferase (AST) activities increased, showing a significant positive correlation, in group A, whereas both remained in a control range in Group B. Moreover, in another model which received a single intraperitoneal injection of CCl4, serum IRPH showed a marked increase and then a rapid decrease in parallel with the change in serum AST. Immunohistochemical analysis also showed a difference between the two fibrosis models: in group A, IRPH was positive mainly in parenchymal cells in the peripheral zone of the pseudolobulus, while in group B the staining was diffuse. These results indicate that the elevation of serum IRPH is, at least in part, due to the parenchymal cell damage, and that IRPH levels should be carefully evaluated when being used as a parameter to estimate the activity of fibrogenesis in the liver.

Alanine Transaminase↗

PubMedDate not supplied

Role of the Fas system in liver regeneration after a partial hepatectomy in rats.

Apoptosis is involved in the homeostatic control of organs. The aim of this study was to define the in vivo role of apoptosis-related proteins including the Fas system and Bcl-2 in liver regeneration following a partial hepatectomy (PH). We used 70% hepatectomized rats which were serially sacrificed from 12 h to 28 days. The expressions of Fas, Fas ligand, and Bcl-2 were examined by semiquantitative RT-PCR and immunohistochemistry. Liver regeneration, as examined by PCNA staining, peaked from 24 h to day 3, and declined from day 5. On the other hand, hepatocyte apoptosis, as examined by TUNEL staining, was seldom observed until 24 h, but increased from 1 week after PH. In the RT-PCR study, Fas showed an early decline by 24 h, followed by a later peak from days 3 to 5, and then a constant expression thereafter. Meanwhile, the Fas ligand was also low until day 3, but showed a remarkable increase from days 5 to 7, followed by a gradual decrease. On the other hand, Bcl-2 showed an early peak until 24 h, followed by a decline from day 5. In an immunohistochemical study, the time courses of these protein expressions were almost synchronous with their mRNAs in the RT-PCR study. We thus conclude that the coordinated interplay between these apoptosis-related proteins and hepatocyte apoptosis suggests the possible involvement of these proteins in the course of liver regeneration.

Animals↗

PubMedDate not supplied

Effects of a synthetic polyprenoic acid (E-5166) on the gap junction of rat hepatocytes treated with liver tumor promoters, phenobarbital, and p,p'-dichlorodiphenyltrichloroethane.

Effects of in vivo exposure to the synthetic polyprenoic acid, 3,7,11,15-tetramethyl-2,4,6,10,14-hexadecapentaenoic acid (E-5166) using 6 groups of rats treated simultaneously or individually with phenobarbital (PB) or with p,p'-dichlorodiphenyltrichloroethane (DDT) on the gap junctions of hepatocytes were examined by freeze-fracture analysis. Experimental groups were as follows: Group 1, basal diet alone; Group 2, E-5166 treatment; Group 3, 0.05% PB diet; Group 4, PB diet and E-5166 treatment; Group 5, 0.05% DDT diet; and Group 6, DDT diet and E-5166 treatment. E-5166 was given by gavage (40 mg/kg body weight, 3 times/wk). Experimental diets and E-5166 were started at 6 wk of age. All animals were sacrificed at 2 wk after the start of the experiments. The density of gap junctions in PB- or DDT-treated rats was higher and that in E-5166-treated rats was lower than that in controls. The density of gap junctions in rats given PB and E-5166-/or DDT and E-5166-treated rats was slightly increased when compared to controls. The average area of gap junctions in DDT- or PB and E-5166-treated rats was significantly smaller than in controls (p < 0.005), although no statistical differences were found among PB-, E-5166-, and DDT and E-5166-treated rats and controls. Unit area of gap junctions to membrane area in rats given E-5166, DDT, or PB and E-5166 was lower than in controls. However, the unit area of gap junctions in DDT and E-5166-treated rats did not differ from in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

The potential risk for upper extremity thromboembolism in patients with occluded axillofemoral bypass grafts: two case reports.

Axillofemoral bypass grafts (AxFG) are widely used in the management of poor-risk patients with aortoiliac occlusive disease. On the other hand, AxFGs are associated with a variety complications to the upper extremity (UE). UE thromboembolism represents a significant and specific complication of occluded AxFGs in our series (2.6% of patients, 33.3% of occluded grafts). This article describes two cases of late axillary artery thrombosis caused by the occlusion of externally-supported AxFGs. The two patients were treated by graft disconnection, a distal embolectomy, and patch angioplasty of the axillary artery. Their postoperative courses were uneventful. Based on the authors' experience and a review of the literature, they suggest that an occluded AxFG represents a high risk for use of a donor artery and that such patients must therefore be very carefully followed. To prevent late UE thromboembolism in patients with occluded grafts, the authors strongly advise that such patients undergo a surgical operation with careful follow-up after surgery.

Aged↗

PubMedDate not supplied

Resection of triple synchronous cancers: a case report.

We herein present a case of synchronous triple cancer, which was successfully resected in a curative manner. These cancers consisted of primary duodenal, pancreatic and lung cancers, which were diagnosed in an asymptomatic 74 year-old male, who was referred to our department on December 14, 1996. On admission, his laboratory data showed no abnormality, including tumor markers (CEA 1.0, CA 19-9 1.0, AFP 8.1 U/ml), but he did show an impaired pulmonary function (FEV1.0: 57%). Upper gastrointestinal endoscopy showed a smooth surfaced duodenal tumor measuring 4 cm in size. The second tumor was found at the head of the pancreas by computed tomography (CT), showing a hypervascular mass measuring 3.0 cm, along with neighboring multiple cysts. In endoscopic retrograde cholangiopancreatography (ERCP), marked mucous secretion was observed through the papilla, while a filling defect was found in the dilated pancreatic duct. In a routine chest X-ray, a third tumor, which measured 1.5 cm in diameter, was recognized in the right upper lobe of the lung, and a moderately differentiated squamous cell carcinoma was also detected by a percutaneous CT guided biopsy. The pancreatic and duodenal tumors were surgically resected by a pancreatoduodenectomy (Stage I) in January 1997 and, 5 months later, a lung tumor underwent partial resection (Stage I). This patient tolerated these surgical procedures well and presently leads a normal, healthy life after discharge. In summary, a successful resection of synchronous triple cancers, which has never been previously reported in this specific combination, is described.

Adenocarcinoma↗