Masakazu Tada

Serum Levels of Tissue Inhibitor of Metalloproteinases-1 (TIMP-1) in Colorectal Cancer Patients

PurposeExpression of tissue inhibitor of metalloproteinases (TIMP)-1 in colorectal cancer tissue is known to be related to disease progression; however, the clinical significance of measuring the blood level of TIMP-1, which we evaluate herein, has not yet been clarified.MethodsThe serum level of TIMP-1 was measured by a one-step enzyme immunoassay in 123 patients who underwent resection of primary colorectal cancer.ResultsAn elevated level of serum TIMP-1 was associated with advanced Dukes’ stage (P = 0.03), greater diameter of the primary tumor (P = 0.03), more lymph node metastasis (P = 0.04), and liver metastasis (P ≪ 0.001). There was a weakly positive correlation between the serum carcinoembryonic antigen (CEA) level and the serum TIMP-1 level. In patients who underwent potentially curative resection, the disease-free survival was not different between those with a high TIMP-1 level (≧203.5 ng/ml, n = 32) and those with a low TIMP-1 level (≪203.5 ng/ml, n = 66, P = 0.62). In patients with Dukes’ stage D cancer who underwent noncurative resection, the survival times were not different between those with a high TIMP-1 level (n = 13) and those with a low TIMP-1 level (n = 10, P = 0.20).ConclusionsElevated levels of serum TIMP-1 reflect the extent of colorectal cancer, without a close correlation with the serum CEA level. These findings suggest that measuring the serum TIMP-1 level would not help to predict the prognosis of patients with colorectal cancer.

A New Simple Technique for Performing Intraoperative Endoscopic Resection of Small-Bowel Polyps in Patients with Peutz-Jeghers Syndrome

We describe herein a simple method for performing intraoperative endoscopic resection of small-bowel polyps associated with Peutz-Jeghers syndrome, using a corrugated anesthetic tube. A 34-year-old man with Peutz-Jeghers syndrome underwent emergency surgery for an ileo-ileo-colic intussusception. A sterile corrugated anesthetic tube was inserted into the small-bowel, proximal to the affected lesion. The small bowel was then telescoped sequentially over the tube using a pleating technique. Consequently, a colonoscope inserted through the tube was easily able to reach the duodeno-jejunal junction, and ten small-bowel polyps were removed using a wire snare and electrocauterization. All resected specimens were washed out by the instillation of saline through a nasogastric tube, then collected on gauze placed near the outlet of the tube. Our technique has the following merits: it is feasible even in emergency surgery; it prevents contamination of the surgical field; and it facilitates the easy collection of polypectomized specimens.

Pro-MMP-9 is associated with poor prognosis in gastric cancer

Department of Physiological Chemistry and Metabolism, Graduate School of Medicine, University of Tokyo, Tokyo, Japan, Department of Chemistry, College of Engineering, Kanto Gakuin University, Yokohama, Japan, Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan, Department of Surgery, Breast Center, Mita Hospital, International University of Health and Welfare, Tokyo, Japan, Department of Surgery, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki City, Kanagawa, Japan, Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Komaba, Tokyo, Japan, and Department of Surgery, Asahi General Hospital, Chiba, Japan

Usefulness of Postoperative Spiral Computed Tomography Combined with Drip Infusion Cholangiography in Patients with Congenital Biliary Dilatation.

近年, 経静脈性胆道造影 (drip infusion cholangiography) 併用下のspiral computed tomography (以下, DIC-SCT) が, 胆道系疾患の新しい非侵襲検査として普及した. そこで今回, 先天性胆道拡張症術後症例におけるDIC-SCTの有用性について検討を行った.先天性胆道拡張症の診断で, 以前に胆嚢・拡張胆管切除, 肝管腸吻合術を施行した7例を対象にDIC-SCTを行った. 手術時の年齢は, 4か月～40歳2か月で, 術後の経過観察期間は, 1年6か月～10年7か月であった.全例において, 肝内胆管1次分枝, 吻合部, および吻合部以下の腸管が描出され, 吻合部の横径は4mm～25mm, 前後径は3mm～20mmと測定できた. IV-A型の1例では, 右枝に拡張を認め, 左枝は描出されなかった.DIC-SCTは, 先天性胆道拡張症術後症例における吻合部の形態や胆汁うっ滞の有無を簡便に知る方法として優れていた.