Publications (300) View all
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Article: Granulocyte-colony stimulating factor-producing esophageal carcinosarcoma: a case report
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ABSTRACT: An 80-year-old man presented at our hospital with chest oppression and vomiting. An endoscopic examination revealed a tumor in the lower portion of the esophagus, and the patient was diagnosed as possibly having esophageal carcinosarcoma based on a histological examination of endoscopic biopsy specimens. During the initial medical examination, the patient had a high leukocyte count and a high level of serum granulocyte-colony stimulating factor (G-CSF). Moreover, immunohistochemical examination revealed cells that were positive for antibodies against G-CSF. Therefore, we diagnosed the patient as possibly having a G-CSF-producing esophageal carcinosarcoma. The patient died of tumor 4 months after the initial diagnosis.Esophagus 04/2012; 4(3):117-120. · 0.66 Impact Factor -
Article: Cardiac tamponade due to metastasis from early gastric cancer
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ABSTRACT: We report a case of cardiac tamponade caused by metastasis from early gastric cancer. A 44-year-old woman was detected to have an abnormality of the stomach on barium meal during an annual medical checkup. Gastroendoscopy disclosed superficial depressed gastric lesions, and histopathological examination of biopsy specimens revealed the diagnosis of poorly differentiated adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT) and ultrasonography (US) revealed no evidence of metastasis. We performed distal gastrectomy with regional lymph node dissection. Histopathological examination revealed poorly differentiated adenocarcinoma and signet-ring cell carcinoma confined to the mucosal layer. Lymphatic invasion was detected only in the mucosal region beneath the tumor; however, lymph node metastasis was found in almost half of dissected lymph nodes. Adjuvant chemotherapy was administered on an outpatient basis with 36 courses of mitomycinC infused (8mg/day) once every 4weeks. However, 3years after the surgery, the patient developed cardiac tamponade due to carcinomatous pericarditis. We performed drainage of the malignant effusion and initiated treatment with S-1 and docetaxel. Although the patient showed some clinical improvement, the patient died 15months after the occurrence of cardiac tamponade.Clinical Journal of Gastroenterology 04/2012; 1(3):100-104. -
Article: The cytotoxic effects of bile acids in crude bile on human pancreatic cancer cell lines
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ABSTRACT: Pancreatic cancer frequently causes extrahepatic cholestasis. To identify the direct effects of bile acids in jaundiced serum on pancreatic cancer, the proliferation of PANC-1 and MIA PaCa-2 cells as well as the ultrastructural alteration of PANC-1 cells cultured in crude bile modified media were studied. The growth of these cells in the RPMI-1640 media with or without 1%, 2%, and 4% of the refined crude bile was assessed after 48 and 96 h of incubation. The ultrastructure of PANC-1 cells was investigated by scanning and transmission electron microscopy after 24 and 48 h of incubation. The proliferation of both cell lines in the bile-treated media was greatly inhibited. The inhibitory rates of bile on PANC-1 ranged from 24.1%±3.3% to 66.9%±6.6% (P < 0.01) and those on MIA PaCa-2 ranged from 16.7%±3.8% to 50.7%±5.5%. (P < 0.01). When the bile-added media were replaced, the cells were able to restore their proliferating ability. The PANC-1 cells incubated in the bile-supplied media indicated that the mirovilli, mitochondria, and other organelles had thus been injured. These results suggest that bile acids appear to inhibit the proliferation of PANC-1 and MIA PaCa-2 cells, and the probable inhibitory mechanism is mainly considered to be due to the cytotoxicity of such bile acids. Key wordsBile acid–Extrahepatic cholestasis–Cytotoxicity–Pancreatic cancer cell lineSurgery Today 04/2012; 30(10):903-909. · 1.22 Impact Factor -
Article: Rapidly enlarging hepatobiliary cystadenoma
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ABSTRACT: An unusual case of a hepatobiliary cystadenoma caused severe abdominal pain and obstructive jaundice by rapid enlargement in a woman aged 73 years. Magnetic resonance imaging revealed a 12 cm cystic lesion in the left medial segment of the liver and dilatation of the intrahepatic bile ducts. The abdominal pain was worse 4 days later, when magnetic resonance imaging demonstrated enlargement of the cystic lesion, to 14 cm in diameter. Laboratory tests on admission revealed serum alkaline phosphatase, 1342 IU/L; gamma glutamic transpeptidase, 672 IU/L; total serum bilirubin, 7.4 mg/dL; direct bilirubin, 5.8 mg/dL; and carbohydrate antigen 19-9, 37U/mL. Serosanguineous fluid was obtained by emergency percutaneous transhepatic drainage of the cyst, which resolved the patient's abdominal pain. Culture and cytologic examination of the fluid were nondiagnostic. The discharged fluid through dramage tube turned brown, and the total serum bilirubin concentration gradually decreased. Cystography and endoscopic retrograde cholangiography demonstrated communication between the cyst and the intrahepatic bile ducts on the left side of the liver. The cyst was removed by left hepatectomy 14 days after it had been drained. Pathologic examination of the resected specimen confirmed the presence of a hepatobiliary cystadenoma. Although hepatobiliary cystadenoma is a rare benign cystic tumor of the liver, it can become malignant and should thus be excised.Journal of Medical Ultrasonics 04/2012; 30(4):257-262. · 0.33 Impact Factor -
Article: Esophagoscopy-guided thoracoscopic resection of large epiphrenic esophageal diverticulum
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ABSTRACT: A diverticulum in the lower third of the esophagus is rare. A 62-year-old woman presented with symptoms of dysphagia and regurgitation associated with recurrent aspiration. Endoscopic examination disclosed a large epiphrenic diverticulum, for which esophagoscopy-guided thoracoscopic surgery was performed. The postoperative course was uneventful. It is proposed that this method could be a possible alternative to the standard classical thoracotomy approach for a large epiphrenic diverticulum of the esophagus.Esophagus 04/2012; 5(4):225-228. · 0.66 Impact Factor
