Teruyuki Ikehara

Cyclin D1 Overexpression and Prognosis in Colorectal Adenocarcinoma

Recently, it has been reported that cyclin D1 plays a major role in oncogenesis in various cancers; however, there have been few studies on the association of cyclin D1 overexpression and prognosis of patients with malignant tumors. We evaluated the prognostic significance of cyclin D1 overexpression in colorectal adenocarcinoma. One hundred twenty-three specimens resected from patients with colorectal adenocarcinomas were investigated by staining with a monoclonal antibody against cyclin D1. As a result, both overall survival and disease-free survival were significantly poorer in the patients with tumors strongly positive for cyclin D1 than in those with cyclin-D1-negative or weakly positive tumors. The 5-year survival rate of the patients with tumors strongly positive for cyclin D1 was 53.3%, while the 5-year survival rates of patients with cyclin-D1-negative and weakly positive tumors were 96.2 and 78.8%, respectively. Moreover, multivariate analysis indicated that cyclin D1 overexpression is an independent predictor of disease recurrence in our patients. In conclusion, cyclin D1 overexpression may be useful as a predictor of disease recurrence in colorectal adenocarcinoma.

Overexpression of cyclin D1 and p53 associated with disease recurrence in colorectal adenocarcinoma

Multiple genetic changes occur during the evolution of normal cells into cancer cells. It has been reported that both cyclin D1 and p53 genes play major roles in oncogenesis and/or cell cycle control in various cancers. In this study, we examined the overexpression of cyclin D1 and p53 by the immunohistochemical method and investigated the correlation between expression of these antigen and prognosis in patients with colorectal adenocarcinoma. Disease‐free survival was significantly lower in the patients with cyclin D1‐strongly positive tumors than in those with cyclin D1‐negative tumors. Similarly, disease‐free survival of the patients with p53‐strongly positive tumors was significantly lower than that of those with p53‐negative tumors. Moreover, multivariate analysis indicated that both cyclin D1 and p53 overexpression are independent prognostic factors in patients with colorectal adenocarcinoma. In conclusion, both cyclin D1 and p53 overexpression may be useful predictors of disease recurrence in patients with colorectal adenocarcinoma. Int. J. Cancer 74:310‐315, 1997.

Serum fatty acid concentrations in patients on postoperative parenteral nutrition with and without fat

To examine changes in fatty acid composition of serum lipids, sixteen patients with gastric cancer were maintained on total parenteral nutrition (TPN) or intravenous feeding immediately after total gastrectomy. Subjects receiving no fat showed decreases in linoleic acid, linolenic acid and arachidonic acid and increases in palmitoleic acid and oleic acid, whereas those receiving fat emulsion showed no detectable changes. Decrease in the linoleic acid content was greater in subjects on a higher carbohydrate intake, but less in those on a higher fat intake. Multiple regression analysis of the relationships among carbohydrate intake (X1) and fat intake (X2) and changes in the linoelic acid percentage of total serum fatty acids (Y) in each case yielded an equation: Y=−4.75 X1+69.0 X2−27.9 (R=0.885, p<0.05). Approximately 1 g/kg/day of fat provided in 40–50 kcal/kg/day of nonprotein energy intake was estimated to prevent decrease in the linoleic acid content in the serum fatty acid pattern during the postoperative catabolic stage.

Cervical impalement injury to a child by a chopstick diagnosed with computed tomography and ultrasonography

Injuries penetrating into the floor of the mouth in the oral cavity caused by chopsticks are rare. We report a case of neck impalement injury caused by a wooden chopstick fragment penetrating all the way through the base of the tongue. An 18-month-old boy fell off his chair when he was biting on a wooden chopstick. Four centimeters of the chopstick broke off but could not be found, so he was brought to our emergency department with minor bleeding from the tongue. Computed tomography (CT) revealed that the fragment had penetrated through the tongue into the neck. Ultrasonography (US) revealed that the fragment was in close proximity to the common carotid artery. Surgery for the removal of the chopstick tip was uneventful, with minimal soft tissue trauma. Postoperative progress was satisfactory and without complications. Of particular interest is the sensitivity of US in outlining the broken chopstick fragment lodged in the neck. It is noteworthy that the contrast of the chopstick greatly varied between CT and US.

Surgical treatment for Crohn's disease.

当科で外科的治療が行われたCrohn病9例の手術適応および手術成績について検討した, 病型分類は小腸型3例, 小腸大腸型5例, 大腸型1例であり, 手術適応は穿孔2例, 瘻孔2例, 難治性狭穿2例, S状結腸癌疑診1例, 盲腸単純性潰瘍1例, 内科的治療抵抗1例であった, 手術術式は全例に主病巣の腸管切除がなされた. 穿孔2例はともに術前1ヵ月以上におよぶtotal parenteral nutritionを受けていたが, 病態の改善をみることなく穿孔した. 瘻孔2例は1例が回腸臍瘻であり, 1例が回腸S状結腸瘻および回腸膀胱瘻であった. 痔瘻を有する症例では再発率, 再手術を要する率が高かった. 術後は7例においてほぼ満足する社会生活を営んでいた.

Clinical and histopathological study on colorectal carcinoma in young adults.

当教室で最近13年間に経験した大腸単発癌手術施行例570例を対象とし, 39歳以下の若年者大腸癌の臨床病理学的所見ならびに手術成績について検討した.若年者大腸癌は570例中57例 (10.0%) であり, 女性が多かった.若年者大腸癌では, 組織型は粘液癌が多く, 壁深達度, リンパ節転移率, 腹膜播種, 組織学的進行程度において進行度の進んだ症例が有意に多かった.若年者の全手術例の累積5年率は41.0%と非若年者とくらべ有意に低率であったが, 治癒切除例の累積5年率は71.6%と非若年者の76.3%とくらべ有意差はなかった.若年者における大腸癌の早期診断ならびに治癒手術への努力が重要であると思われた.