Yoshito Arisawa

Scarless endoscopic thyroidectomy: breast approach for better cosmesis.

An original technique for performing endoscopic thyroidectomy using a breast approach to avoid an operative scar in the neck was developed. The subcutaneous space in the breast area and the subplatysmal space in the neck were bluntly dissected through a 15-mm incision between the nipples, and CO2 was insufflated at 6 mm Hg to create the operative space. Three trocars were inserted at the breast, and dissection of the thyroid and division of the thyroid vessels and parenchyma were performed endoscopically using an ultrasonically activated scalpel. Four hemithyroidectomies and one partial resection of the thyroid for five female patients with thyroid adenomas 5 to 7 cm in diameter were successfully performed using this procedure. There were no conversions to open surgery or complications. No scars were apparent in the neck, and all patients were fully satisfied with the cosmetic results. Endoscopic thyroidectomy using a breast approach and low-pressure subcutaneous CO2 insufflation is a feasible and safe procedure, which results in satisfactory cosmetic results.

Nude mouse resists hepatic metastasis of the allogeneic tumor, colon-26

The ability of the host-immune defense mechanism of nude mice and their immunocompetent littermates to prevent liver metastases from the murine colon carcinoma, colon-26, was assessed. Give thousand tumor cells suspended in 0.05 ml of Hanks balanced salt solution were inoculated into the spleens of BALB/c nu/+and BALB/c nu/nu mice. On the 21st day after inoculation, all the mice were sacrificed, and the liver metastases counted and the livers weighed. All the BALB/c nu/+mice were found to have developed hepatic metastases with a mean of 10 nodules, whereas no hepatic metastases were observed in any of the 10 BALB/c nude mice. On the other hand, 4 of 6 nude mice developed hepatic metastases after treatment with anti-asialo GM1 antibody. These results indicate that the BALB/c nude mouse has an excellent host-immune defense mechanism for preventing liver metastasis, with NK cells in the liver and/or blood circulation perhaps playing an important role.

Human breast carcinoma (ZR-75-1) serially transplanted into nude mice--with reference to estradiol dependency and sensitivity to tamoxifen.

Tumor cells of the ZR-75-1 line (1×107 in 0.5 ml) were inoculated into the right thigh muscles of BALB/c female nude mice which were, at the same time, given 1.0 mg of estradiol subcutaneously. After the transferable strain had been established, the tumors were then transplanted into female and male nude mice either with or without estradiol treatment. Although no exponential tumor growth was observed in the untreated male and female nude mice, no complete rejection was found during the experiments. The estrogen receptor of this strain was positive and the growth of ZR-75-1 was dependent on exogenous estradiol. ZR-75-1 in the nude mouse was insensitive to tamoxifen treatment, given as 5 mg/kg intramuscularly twice a week, suggesting that dependency on estradiol is not necessarily correlated with endocrine sensitivity to tamoxifen.

A Case of Gangrenous Ischemic Colitis. Speculation of the Mechanism behind Elevated Serum CEA.

症例は84歳の女性. 平成14年2月腹痛・嘔吐・下痢・血便を主訴に入院. 既往歴として高血圧・狭心症・糖尿病があり内服治療中であった. 便細菌培養にて病原性大腸菌O-1を検出, CT・下部消化管内視鏡検査にて下行結腸に壊死を伴う炎症を認め, 細菌性腸炎による脱水を誘因とした虚血性大腸炎と診断した. 入院翌日のCEAが106.1ng/mlと異常高値を示し, 悪性腫瘍の検索を行ったが病変を認めず. 26日後のCEA再検査では正常化していた. 3月13日下行結腸切除術および人工肛門造設術施行した. 病理診断上悪性所見を認めず, 免疫組織化学染色によるCEA局在も正常であった. 検索上, 虚血性腸炎におけるCEA上昇は, 今らの1例報告のみであった. CEA高値を呈した機序は不明であった. 発症時に細菌性腸炎に罹患していたことによるCEA産生活性化の可能性や, 膿瘍腔内に便汁が多量に貯留した可能性などの複合的な要素の関与が考えられた.