Takao Aikawa

Identification of potential breast cancer markers in nipple discharge by protein profile analysis using two-dimensional nano-liquid chromatography/nanoelectrospray ionization-mass spectrometry.

This research aimed to establish a diagnostic technique for breast cancer using nipple discharge (ND), with the objective of preventive diagnosis. ND has been proposed as a source of secreted proteomes that reflect early pathological changes in the ductal‐lobular epithelial microenvironment, and could thus provide breast‐specific cancer biomarkers that could be accessed noninvasively as a new clinical diagnostic technique.

Pyrimidine nucleoside phosphorylase activity and 5-fluorouracil concentration in tissue from breast cancer patients after administration of 5′-deoxy-5-fluorouridine

Abstract To better understand the mechanism of action of the chemotherapeutic agent 5′-deoxy-5-fluorouridine (5′-DFUR), we attempted to establish histopathologically whether a correlation exists between pyrimidine nucleoside phosphorylase (PyNPase) activity, 5-fluorouracil (5-FU) concentration in breast tissue, and the antitumor effects of 5′-DFUR. Ninety-nine patients with breast cancer received oral 5′-DFUR for 1 week preoperatively at daily doses of 600 mg (group A), 800 mg (group B), and 1200 mg (group C). PyNPase activity and 5-FU concentration were measured in tumors, neighboring normal breast tissue, and axillary lymph nodes with or without metastases. PyNPase activity was higher in breast cancer tissue, involved lymph nodes, and normal lymph nodes than in normal breast tissue. 5-FU concentrations were also higher in tumor tissue than in normal mammary gland tissue in all three groups. In the lymph nodes, 5-FU concentrations were higher in patients with metastases than in those without metastases. Of the 89 evaluated patients, 12 (13.5%) showed histologic improvement. PyNPase activity was higher and 5-FU concentrations were lower in the improved patients than in those who showed little or no improvement. Although these findings were not statistically significant, they suggest that the level of PyNPase activity may be directly related to the antitumor effect of 5′-DFUR.

A Case of Gangrenous-Type Ishemic Colitis.

盲腸からS状結腸におよぶ広範囲の壊死型虚血性大腸炎を経験した.症例は59歳の女性で, 腹痛・嘔吐を主訴に入院した.翌日腹膜炎症状が出現し, 緊急開腹術を施行した.盲腸からS状結腸まで連続性壊死に陥っており, 壊死型虚血性大腸炎の診断のもと, 結腸亜全摘・回腸人工肛門およびS状結腸痩造設術を施行し, 救命しえた.本邦における壊死型虚血性大腸炎49例の集計では, 年齢34～90歳 (平均年齢70.2歳) で60歳代から80歳代に多く, 性差はほとんど認められなかった.好発部位は下行結腸・S状結腸であり, この範囲で半数以上を占める.予後不明11例を除く38例の死亡率は44.7%で, そのうち切除施行例36例においても死亡率は41.7%と予後不良である.唯一の治療法は病変部の切除であるが, この際切除断端粘膜面を観察しつつ十分広範囲に切除する必要がある.