Chika Shigemori

An intestinal fistula in a 3-year-old child caused by the ingestion of magnets: Report of a case

We describe herein the case of a 3-year-old child in whom a jejunoileal fistula was caused by the ingestion of magnets. This case report demonstrates that if more than one magnet is found as a foreign body in the intestine, they should not be left untreated even if there are no sharp edges and, it seems they could be evacuated spontaneously. This recommendation is made because the magnets will attract each other and hold the intestinal walls between them, causing necrosis and resulting in intestinal perforation or a fistula.

Correlation of p53 with the clinicopathologic features and prognosis of colorectal adenocarcinoma

Immunohistochemical staining of p53 was performed using an anti-p53 mouse monoclonal antibody, Pab1801, on 67 colorectal adenocarcinoma specimens to determine the prognostic value of p53 in colorectal cancer patients. Of a total of 67 tumors examined, p53 was detected in 34, but the rate of positive staining for p53 did not correlate with the clinical stage of disease. In 59 patients undergoing curative resection of the tumor, there was no significant difference in the recurrence rate (P = 0.137) or the disease-free survival rate between 28 patients with p53 positive tumors and 31 with p53 negative tumors (P = 0.135).

Constant infusion rates of lipid emulsions to stabilize plasma triglyceride concentrations: medium-chain triglyceride/long-chain triglyceride emulsions (MCT/LCT) versus LCT.

As medium-chain triglyceride emulsions (MCT) are more rapidly hydrolyzed than long-chain triglyceride emulsions (LCT), MCT/LCT tends to be infused faster than LCT. The purpose of the present study was to determine the most appropriate infusion rate for MCT/LCT to stabilize plasma concentrations of triglyceride (TG), being equivalent to the optimal infusion rate of the emulsion. A TG clamp was set up by raising the mean ± SD concentrations of TG in plasma, being 1.08 ± 0.18Δ mmoll−1 for LCT, and 1.65 ± 0.31 Δ mmoll−1 for MCT/LCT after a 50-min priming infusion of each emulsion. Thereafter, the infusion rate of lipid was controlled every 10 min to maintain a steady concentration of TG for a period of 150 min. A constant infusion of glucose at 0.32 g/kg body weight (BW) per h was administered for the test period. The weight-based rate of the infusion to maintain a steady state of plasma TG concentrations did not differ between MCT/LCT and LCT, being 0.125 ± 0.013vs 0.117 ± 0.021 g/kg BW per h, while the molar-based infusion rate was 0.203 ± 0.021 mmol/kg BW per h for MCT/LCT and 0.132 ± 0.023 mmol/kg BW per h for LCT (P < 0.05). These results suggest that although 54% more molar MCT/LCT-TG can be hydrolyzed during a constant infusion, MCT/LCT should not be infused at a rate faster than 0.1 g/kg BW per h under a steady state.

Immunoreactive Transforming Growth Factor β‐1, Its Receptor, bcl‐2 Protein, and p53 Protein in Colorectal Adenomas

Abstract: Immunoreactive transforming growth factor‐β1 (TGF‐β1), its receptor (TGFR), bcl‐2 protein, and p53 protein were stained in 47 samples of normal colonic mucosa and 33 samples of colorectal adenoma, with the aim of exploring an alternate, novel pathway of colorectal tumorigenesis. There was no difference in the percentage of cells positive for TGF‐β1 immunoreactivity between normal mucosae and adenomas. TGFR immunoreactivity was detected in a significantly higher percentage of normal mucosae than of adenomas (p ±0.05). Bcl‐2 protein and p53 protein immunoreactivities were detected in a significantly higher percentage of adenomas than of normal mucosae (p ±0.01). Expression of these immunoreactive proteins did not correlate with any of the clinicopathological features of adenomas, except for a significant negative correlation between TGFR expression and large tumor size (p±0.05) and a positive correlation between p53 protein expression and the grade of dysplasia (p±0.05). These findings indicate that (1) TGF‐β1 plays little role in the tumorigenesis of colorectal adenomas, (2) TGFR is lost in most adenomas during tumorigenesis, (3) bcl‐2 protein plays an important role in transformation of normal mucosa into adenoma, and (4) p53 protein is involved in the very early phase of malignant transformation from adenoma to carcinoma.

Serum levels of tissue factor in colorectal cancer patients

AbstractBackground. The expression of tissue factor (TF), the cellular receptor of clotting factor VII/VIIa, is a feature of certain malignant tumors, but the clinical significance of TF in colorectal cancer has not yet been clarified. Methods. The serum levels of TF and tissue factor pathway inhibitor (TFPI) were determined in 20 healthy persons and 66 colorectal cancer patients. Results. TF levels in colorectal cancer patients (median, 185.7; range, 64.5–420pg/ml) were significantly higher (P = 0.03) than in controls (median, 180.8; range, 65.2290.9 pg/ml). There was a significant correlation between serum levels of TF and TFPI, both in healthy persons (Spearmanr = 0.509;P = 0.02) and colorectal cancer patients (Spearmanr = 0.425;P = 0.0004). There was no significant correlation between levels of TF and the largest diameter of colorectal cancer, and no correlation of TF with any cancer stage. However, serum levels of TF in patients with poorly differentiated adenocarcinoma (median, 315.7; range, 281.4–367.9pg/ml) were significantly higher (P = 0.002) than levels in patients with well differentiated adenocarcinoma (median, 176.0; range, 64.5–401.3 pg/ml). There was no significant difference between TFPI levels in colorectal cancer patients and those in healthy persons. Serum levels of TFPI did not correlate with any clinicopathologic features of colorectal cancer. Conclusions. These results suggest that TF in serum is related to the differentiation of colorectal carcinoma, but that neither TF nor TFPI in the serum has prognostic significance in colorectal cancer patients.