Hideaki Murai

Serum Soluble Interleukin-2 Receptor in Colorectal Cancer

Preoperative serum soluble interleukin-2 receptor (IL-2R) levels were measured in patients with colorectal cancer, and correlated with various factors as stage, lymph node metastasis, liver metastasis, grade, serum CEA and IAP (immunosuppressive acidic protein). The levels of serum soluble IL-2R in Dukes stage C were significantly higher than in normal control and in Dukes stage A. Serum levels were also significantly higher in patients with lymph node metastasis than in patients without such metastasis, and in IAP positive patients compared to IAP negative patients. Preoperative serum IL-2R levels thus seem to reflect the stage of the disease.

Serum-soluble interleukin-2 receptor concentrations in patients with gastric cancer.

Background. Serum concentrations of soluble interleukin‐2 receptor (IL‐2R) were found to be high in patients with autoimmune diseases, lung cancer, malignant lymphoma, tuberculosis, and other diseases. Serum‐soluble IL‐2R was evaluated as a tumor maker in patients with gastric cancer.

Neonatal Ovarian Cysts: Management with Reference to Magnetic Resonance Imaging

OBJECTIVE Ultrasound (US) has been used as a tool to determine the indication for surgery for neonatal ovarian cysts. The purpose of this study was to investigate whether magnetic resonance imaging (MRI) contributes to optimal management. METHODS Between 1993 and 2001, US and MRI studies were simultaneously performed on 13 consecutive infants younger than 2 months of age with ovarian cysts. The US Patterns were classified as complex or simple. Signal intensity (SI) of the cysts on MRI was compared with that of the liver on T1-weighted images (T1WI) and with urine on T2-weighted images (T2WI). We assumed that high SI on T1WI and iso or low SI on T2WI indicated complications. RESULTS There were 10 complex and three simple cysts on US. Of the 10 complex cysts, two had no complications at surgery or resolved spontaneously. These two cysts showed low SI on T1WI. Eight complex cysts showed high SI on T1WI and all were haemorrhagic. The US diagnosis corresponded to the MRI findings in three simple cysts. The sensitivity of US for haemorrhage was 80%, and that of MRI was 100%. CONCLUSIONS We found that MRI was a more reliable diagnostic modality than US for diagnosing neonatal ovarian cysts.

Tissue superoxide dismutase (SOD) activity and immunohistochemical staining in acute appendicitis: Correlation with degree of inflammation

The mechanism of progression of appendicitis has not been clarified. We esamined tissue superoxide dismutase (SOD) activity, thiobarbituric acid reactive substance (TBARS), and the localization of Cu, Zn-SOD in 56 inflamed appendices in relation to histopathological classification. There was a significant difference in SOD activity between catarrhal appendix and phlegmonous and gangrenous appendix (2.3±0.1 vs 5.0±0.2 and 4.6±0.6 units/mg protein, respectivelyP<0.05). TBARS value was highest in gangrenous appendix, being significantly different from the levels in the other two types (0.47±0.40 vs 0.19±0.01 n mol/mg protein, in catarrhal and 0.20±0.02, in phlegmonous appendixP<0.05). Positive staining for Cu, Zn-SOD was demonstrated in 64% of catarrhal appendices, 96% of phlegmonous appendices, and 75% of gangrenous appendices, and intense positive staining was recognized in 9%, 28%, and 40% of these appendices, respectively. These results indicated that active oxygen influences the degree of inflammation in phlegmonous and gangrenous appendicitis. Gangrenous appendicitis and the other two types of appendicits seemed to be different entities.

One-Port Laparoscopy-Assisted Appendectomy in Children with Appendicitis: Experience with 100 Cases

Purpose: We describe our technique for laparoscopic appendectomy via a single umbilical incision (one-port method). Patients and Methods: One hundred children with acute appendicitis were operated on using this method. Two, both of whom had pelvic abscesses, required conversion to open appendectomy. Results: There were neither immediate nor late complications. The operating time was 15 to 130 minutes, with an average of 45 minutes. The histologic findings were appendicitis of the catarrhal type in 12 cases, of the phlegmonous type in 42, and of the gangrenous type in 46. Twenty-six cases were associated with pelvic abscesses. The patients were discharged within 2 to 17 days. The umbilical incision was invisible at 3 months. Conclusions: The key point of this technique is that the abdominal lift must be released and the abdomen deflated before the appendix is delivered through the umbilical incision, because the abdominal cavity is deep. Without release of the Laparolift, delivery of the appendix is diffic...

Usefulness of Introducer Technique Combined with a Commercially Available Anchoring Device for Percutaneous Endoscopic Gastrostomy

Background and Purpose: The pull or push technique for percutaneous endoscopic gastrostomy (PEG) placement has some disadvantages. We have safely performed PEG with the introducer technique using an anchoring device that secures the stomach to the abdominal wall. Patients and Methods: Two patients with neurologic impairment and one with lockjaw underwent PEG with the introducer technique because of feeding difficulties. In the former patients, retroflexion of the neck developed excessively, and periodic changing of the feeding tube was hard to perform. With the patient under general anesthesia, two fixing sutures for gastropexy were placed 2 cm apart using the anchoring device. Between the fixing sutures, a puncture needle with a peel-away sheath was passed into the stomach, and a 13F Silastic catheter was passed through the sheath. The catheter was secured after a balloon was inflated. Feeding was started 24 hours after the catheter insertion. Results: The operative times for the various cases were 42, 6...

Reactive oxygen species and progression of metastasis of VX2 carcinoma implanted in liver

We examined the electron spin resonance (ESR) spectra, tissue superoxide dismutase (SOD) activity, and the capacity of neutrophils to produce active oxygen in a liver metastasis model of VX2 carcinoma. The ESR spectra were similar to the signal of the oxygen radical recognized in liver tissue subjected to transcatheter hepatic arterial embolization. The signal intensity was lower in the metastatic than in the non-metastatic region, and there was a significant difference between the regions 2 weeks after the injection of the carcinoma cells. There were no differences between the SOD activity of the metastatic and non-metastatic regions, assayed weekly. The capacity of neutrophils to produce active oxygen decreased with the progression of metastasis. Our results suggest that the injection of VX2 carcinoma cells into the portal vein induces ischemia after injection. Metastatic cancer cells generated active oxygen (endogenous), at levels that were virtually constant, from 2 to 4 weeks after the injection of cancer cells. After the injection, the progress of metastasis was affected by endogenous active oxygen and by the capacity of neutrophils to produce active oxygen.