Tetsuro Shimizu

Effects of Apple Pectin on Fecal Bacterial Enzymes in Azoxymethane‐induced Rat Colon Carcinogenesis

Because of the potential significance of colonic bacteria in colon carcinogenesis, we investigated the effect of pectin of different types on fecal bacterial enzymes (β‐glucuronidase, β‐glucosidase and tryptophanase) at various periods of time after feeding rats with pectin‐containing diets during azoxymethane‐induced colon carcinogenesis. The diet supplemented with 20% apple pectin or 20% citrus pectin decreased the multiplicity of colon tumors, and the number of tumors was significantly decreased in the group fed apple pectin. The incidence of colon tumors in the apple pectin group was lower than that in the control group. The mean tumor size was similar among the three groups. Apple pectin feeding decreased fecal β‐glucosidase and tryptophanase levels. Furthermore, a significant decrease in the activity of β‐glucuronidase was observed in the apple pectin group during the initiation phase. These findings suggest that the protective effect of pectin on colon carcinogenesis may be dependent on the type of pectin and be related to the decrease of β‐glucuronidase activity in the initiation stage of carcinogenesis.

Splenic artery aneurysm associated with systemic lupus erythematosus: Report of a case

We herein report on a 64-year-old Japanese female patient who presented with a splenic artery aneurysm (SAA) associated with systemic lupus erythematosus (SLE). The saccular aneurysm, which measured 3 cm in diameter, was located in the proximal third of the splenic artery from the pancreas with a portosystemic shunt. A double ligation of the splenic artery (the distal and proximal sides of the aneurysm) was performed without a splenectomy. The postoperative course showed acute pancreatitis without either splenic infarction or portal thrombus. To our knowledge, the closed association of SLE with an aneurysmal dilatation of the splenic artery has not been previously reported. Both the pathogenesis and the management of SAA associated with SLE are discussed following the presentation of this case. This is the first reported case of SAA associated with SLE.

Antitumor activity of selective hyperthermia in tumor-bearing rats using thermosensitive magnetoliposomes as a new hyperthermic material

AbstractThe antitumor activity of dextran magnetite (DM)-incorporating thermosensitive liposomes, namely thermosensitive magnetoliposomes (TMs), as a new hyperthermic material was examined in rats bearing AH60C tumors. TMs were injected at an iron concentration of 15 mg per cm3 tumor into AH60C tumors placed subcutaneously in the backs of Donryu rats. After injection, the whole body of the rat (treated group) was exposed to a 500-kHz electromagnetic field generated by inductive heating. The treated group was further divided into once- and twice-treated groups in order to examine whether repetitive hyperthermia is possible after a single TM injection. A control group also received a TM injection but was not treated with hyperthermia. In the heated groups, there was a marked temperature rise inside the tumor up to 42°C within 7 min, but surrounding tissues were not heated. The inhibition of the growth of AH60C tumor in the treated groups was significantly greater than in the control group (P <. 01). Histolo...

Predication of axillary lymph node metastasis by intravenous digital subtraction angiography in breast cancer, its correlation with microvascular density

Accurate predication of axillary node status by non-invasive diagnostic method would be of great value in cases of breast cancer. There have been few reports advocating digital subtraction angiography (DSA) as specifically advantageous for the detection of lymph node metastasis. IV (intravenous)-DSA was carried out on 42 patients with breast carcinoma using a DSA system with a matrix of 1024 × 1024×pixels. When a mass became stained in the axilla, it was considered to be metastatic. An immunohistochemical technique with JC70 antibody to platelet/endothelial cell adhesion molecules was used to evaluate the microvascular density (MVD) of the axillary lymph nodes. IV-DSA achieved a 76.2% sensitivity, 85.7% specificity, and 81.0% accuracy. The average MVD with JC70 antibody was 97.7 ± 44.4 in metastatic and 62.9 ± 23.6 in nonmetastatic nodes. MVD was significantly higher in the cancerous than in the noncancerous regions within lymph nodes. The MVD was 105 ± 38.4 in DSA-N(+) cases and was 57.8 ± 21.9 in DSA-N(−) cases, and the difference was statistically significant. In conclusion, IV-DSA is a useful diagnostic modality for detection of axillary lymph node metastasis. This new modality predicts lymph node status by assessing the neovascularization of the lymph node.

Primary Adenoid Cystic Carcinoma of the Esophagus : An Immunohistochemical and Electron Microscopic Study

Immunohistochemical and electron microscopic findings of a primary adenoid cystic carcinoma of the esophagus from a 71-year-old male patient are described. An oval tumor in the middle intrathoracic esophagus was resected. The tumor appeared similar to a submucosal tumor and was histologically diagnosed as primary adenoid cystic carcinoma (ACC) of the esophagus. The patient has survived for 10 years postoperatively with no evidence of recurrence. Histologically, the tumor showed a cribriform, tubular or solid pattern. A small focus of squamous cell carcinoma (SCC) was found independently. Immunohistochemical results for keratin groups, S-100 protein and smooth muscle actin (αSMA) revealed similar profiles in the ACC tumor tissues and small ducts of the normal esphageal glands. By electron microscopy, tumor cells were found markedly similar to the small duct cells of the normal esophageal gland. These findings. indicate that ACC may originate from the esophageal glands, especially from cells of the small duct including intercalated duct.

Effect of Apple Pectin on Azoxymethane-Induced Colon Carcinogenesis — Fecal Enzyme Activities and Prostaglandin E2 Level in Colonic Mucosa

The diet including 10 or 20% apple pectin decreased dependently the multiplicity and occupied area of colon tumors. Furthermore, prostaglandin (PG) E2 level in distal colonic mucosa in 20% pectin-fed rats were significantly lower than those in basal diet group. In a separate experiment, apple and citrus pectin induced a 2-fold increase in fecal β-glucuronidase activity after dosing Azoxymethan (AOM) treatment. Fecal β-gluco-sidase and azoreductase activity, however, decresed in only apple pectin-fed rats. These results thus indicate that the effect of pectin on the colon carcinogenesis may depend on the type of pectin and be related to fecal enzyme activities, especially β-glucosidase and azoreductase.

Spontaneous mesenteric hematoma of the sigmoid colon associated with rivaroxaban: A case report

Highlights • Mesenteric hematoma is a rare condition without specific symptoms.• Rivaroxaban is not affect to the value of PT or APTT.• It is difficult to diagnose mesenteric hematoma.

Gastric Leiomyoblastoma Showing Exogastric Pedunculated Development.

症例は69歳の女性. 肝嚢胞, 脂肪肝の経過観察目的で行った腹部CTで, 胃体上部大彎の胃壁外に4cm大の充実性腫瘍を指摘された. 胃内視鏡検査ならびに超音波内視鏡検査にて胃固有筋層と連続する平滑筋腫と診断した. さらに, 入院時の胃内視鏡検査で認められた胃壁圧排所見が, 術直前の再検査で消失していたことから有茎性の腫瘍であると判断し, 手術は腹腔鏡下に胃楔状切除を行った. 術後病理組織学的に胃平滑筋芽細胞腫, 免疫組織学的には狭義のstromal tumorに該当する腫瘍と診断された. 術後2年再発なく生存中である. 本腫瘍は約30%が胃壁外性に発育するとされている. 術前診断率が低く, 特に有茎性に発育することはまれであり, その術前診断, 術式および悪性度診断の問題点を中心に文献的考察を加えて報告した.

Efficacy of Endoscopic Prosthesis in T4 Cancer of the Intrathoracic Esophagus

No remarkable improvement has yet been achieved in the survival of patients with advanced intrathoracic esophageal cancer. In particular, patients with complications such as esophago‐bronchial fistula or invasion into the mediastinum have an especially miserable prognosis, even with surgical treatment. To improve the quality of life (QOL) of such patients, extensive palliative therapy should be provided. Thus, we have introduced an endoscopic esophageal intubation technique for the treatment of stenosis or perforation in patients with T4 esophageal cancer.

Efficacy of Hyperthermia for Advanced Esophageal Carcinoma

The prognosis of patients with advanced cancer of the esophagus is very poor. To control advanced esophageal carcinoma nonoperatively, irradiation and chemotherapy have been applied. However, the clinical effectiveness of these treatments has not been satisfactory. Hyperthermia has recently received attention since neoplastic cells have been reported to have greater heat-sensitivity than normal cells, and because this method has been confirmed to enhance the anticancer effect of radiation and some anticancer drugs. We have employed multidisciplinary treatment consisting of radiotherapy, chemotherapy, and hyperthermia, since 1985 [1]. This treatment protocol was derived from basic experiments using cultured cells of human cancer of the esophagus. This is a report of our study on the efficacy of hyperthermia in combined treatment.