Showing papers in "Surgery Today in 1986"
TL;DR: The persistence of the tensile strength of the chitin was better than Dexon (TM) or catgut in bile, urine and pancreatic juice but weakening occurred early in the presence of gastric juice.
Abstract: Chitin is an absorbable suture material with suitable mechanical properties. Tissue reaction is not specific and the good healing which ensued provided evidence for a satisfactory biocompatibility. Toxicity tests, including acute toxicity, pyrogenicity, mutagenicity were negative in all respects. The chitin suture was absorbed in about four months in rat muscles. The persistence of the tensile strength of the chitin was better than Dexon (TM) or catgut in bile, urine and pancreatic juice but weakening occurred early in the presence of gastric juice. Application in 132 patients proved satisfactory. Adverse effects were nil.
67 citations
TL;DR: The decline in BMC was age-related; it was pronounced in females and in totally gastrectomized patients this finding was made at less than 5 years postoperatively.
Abstract: To study post-gastrectomy metabolic bone disorders, we measured the radial bone mineral content (BMC), serum levels of calcium, inorganic phosphorus, alkaline phosphatase, and 25-hydroxyvitamin D(25-OH-D) in 59 patients with partial- and 39 patients with total gastrectomy. Total gastrectomy patients manifested a higher incidence of decreased BMC levels than did partial gastrectomy patients (56 per centvs. 25 per cent). Patients subjected to the Billroth II procedure, especially females, manifested abnormally low BMC values. The decline in BMC was age-related; it was pronounced in females. At 10 years postoperatively, many of the partial gastrectomy patients manifested markedly low BMC levels; in totally gastrectomized patients this finding was made at less than 5 years postoperatively. Approximately 30 per cent of our patients showed abnormalities in serum minerals, alkaline phosphatase or 25-OH-D.
35 citations
TL;DR: In patients given MMC and put on oral futraful for one year, the 5 year survival rate for those with stage III gastric cancer or for Those with positive lymphnode metastasis plus obvious serosal invasion seemed to be improved.
Abstract: The effectiveness of combination chemotherapy with mitomycin-C (MMC) plus futraful (N1-(2′-tetrahydrofuryl)-5-fluorouracil), as an adjunct to surgery for gastric cancer was investigated in a prospective randomized controlled study. Three thousand and thirty-three Japanese patients in 344 hospitals were entered and 2873 could be followed for 5 years. All patients had undergone gastrectomy from April 1977 to May 1979 and were assigned, at random, to either Groups A, B or C. In Group A, bolus MMC was administered with no further treatment. In Group C, oral futraful was given for one year, without MMC induction. In Group B, both a bolus MMC injection and oral futraful were prescribed. This randomized study showed no statistical difference in the 5 year survival rate among the three groups. However, in patients given MMC and put on oral futraful for one year, the 5 year survival rate for those with stage III gastric cancer or for those with positive lymphnode metastasis plus obvious serosal invasion seemed to be improved.
30 citations
TL;DR: It is shown that in patients all doing well clinically one year after DSRS, there are markedly different hemodynamic responses, and further studies on cirrhosis aimed at improving therapy for its complications should include some objective, quentitative assessment.
Abstract: Quantiative measurement is required to define the severity of chronic liver disease and the effects of therapy on its complications. This paper presents a method of such assessment based on measurement of hepatocyte function, liver volume, functional liver blood flow, portal perfusion and cardiac output. Data are presented on 54 patients evaluated prior to, and one year after DSRS for variceal bleeding. Preoperative testing showed that alcoholics (n=24) had significantly (p<0.05) larger liver and smaller spleen volumes than nonalcoholic cirrhotics (n=22) and patients with portal vein thrombosis (n=8), but that the other parameters were not significantly different by etiologies. At one year after DSRS: all groups showed a significant (p<0.01) reduction of 41 per cent in spleen size: liver volume was significantly (p<0.05) reduced in cirrhotics: there was a significantly (p<0.01) greater loss of portal perfusion in alcoholic cirrhosis: liver blood flow showd a significant (p<0.05) rise in alcoholics when compared to nonalcoholics and portal vein thrombosis patients: cardiac output ros in alcoholic cirrhosis: hepatocyte function was not significantly different in any group. This study shows that in patients all doing well clinically one year after DSRS, there are markedly different hemodynamic responses. Further studies on cirrhosis aimed at improving therapy for its complications should include some objective, quentitative assessment, first to define the study population, and second to measure the effect of the therapy.
23 citations
TL;DR: The tumor of the mediastinum was diagnosed as a benign lipoma when it was first resected, but subsequently proved to be a liposarcoma when it re-appeared 2 years and 10 month later.
Abstract: Liposarcoma of the mediastinum is a rare disease. A 59 year old woman was seen with the complaint of dizziness. A chest radiogram taken during the course of investigation for hypertension revealed a large mass shadow 24×18.5×12 cm located in the anterior mediastinum. The tumor of the mediastinum was diagnosed as a benign lipoma when it was first resected, but subsequently proved to be a liposarcoma when it re-appeared 2 years and 10 month later. Based on the WHO classification, the mixed type of liposarcoma was diagnosed. The salient and pathological features of mediastinal liposarcoma are reviewed and compared with those nine cases reported in Japan and fifty in North America and European countries. Treatment by simple enucleation or shelling out of the tumor should be discouraged, since this seems to be the main cause of local recurrence. Surgical wideen bloc excision is the treatment of choise.
23 citations
TL;DR: Evidence is provided that a highly malignant type of early gastric carcinoma, Pen A type, could be differentiated in gastroendoscopically biopsied materials by a cytophotometric DNA analysis.
Abstract: A cytophotometric DNA analysis was made of gastroendoscopically biopsied materials of 43 patients with early gastric carcinoma and the data were compared with the DNA patterns of the resected specimens of these patients. The DNA patterns could be classified into two types, Low Ploidy and High ploidy, according to the degree of dispersion of the DNA value. The Ploidy to Ploidy coincidence of the DNA patterns between biopsied material and the resected specimen in the same lesion was noted in 93 per cent (39/42). The DNA patterns of the resected specimens were consistent in the majority of cases, regardless of the areas examined, center or periphery, and mucosa or submucosa of the same lesion. This study provides evidence that a highly malignant type of early gastric carcinoma, Pen A type, could be differentiated in gastroendoscopically biopsied materials by a cytophotometric DNA analysis.
19 citations
TL;DR: The immunohistochemical localization of CEA may be helpful in the diagnosis of borderline lesions and in determining the distribution of benign and malignant epithelium in cystadenocarcinomas.
Abstract: Cystadenomas and cystadenocarcinomas of the liver are rare tumors. The distribution of carcinoembryonic antigen (CEA) in two cystadenomas and a cystadenocarcinoma was examined immunohistochemically by the peroxidase-labeled antibody method, at the light microscopic level. In the cystadenomas and areas consisting of benign-appearing cells in the cystadenocarcinoma, CEA was localized to the luminal surfaces of the glandular cells appearing as thin linear stains. In malignant epithelial cells forming nests and daughter cysts of the cystadenocarcinoma, CEA was demonstrated throughout the cytoplasm, in a diffuse pattern. Thus, the immunohistochemical localization of CEA may be helpful in the diagnosis of borderline lesions and in determining the distribution of benign and malignant epithelium in cystadenocarcinomas. The etiology, clinical features, pathology and treatment of these rare tumors are discussed.
18 citations
TL;DR: It is suggested that CA 125 is useful for differentiation between benign ovarian tumor and ovarian cancer, because the positive ratio of CA 125 level is high in patients with recurrences of uterine cervical adenocarcinoma, those with tubal cancer, endometriosis, early pregnancy, abnormal pregnancy plus intrauterine fetal death and menstruating women, such situations must be given due attention when CA 125 was used as a tumor marker of ovarian cancer.
Abstract: To study the clinical usefulness and false-positive results of CA 125 as a tumor marker of ovarian cancer, we measured serum CA 125 levels in 197 patients with gynecological diseases, 274 normal, pregnant and postpartum women, 14 patients with abnormal pregnancy, 82 healthy women with a normal ovulatory menstrual cycle and 107 healthy non-pregnant subjects, using RIA kits. A level below 34 U/ml was considered the normal CA 125 range. The positive ratio of serum CA 125 in patients with malignant ovarian tumor was 81.3 per cent, and in those with serous cystadenocarcinoma the rate was 100 per cent. On the other hand, only one patient with benign ovarian tumor had a positive CA 125 value. Therefore, we suggest that CA 125 is useful for differentiation between benign ovarian tumor and ovarian cancer. However, because the positive ratio of CA 125 level is high in patients with recurrences of uterine cervical adenocarcinoma, those with tubal cancer, endometriosis, early pregnancy, abnormal pregnancy plus intrauterine fetal death and menstruating women, such situations must be given due attention when CA 125 is used as a tumor marker of ovarian cancer.
16 citations
TL;DR: Nine patients, including 4 with primary advanced breast cancer (stage IV) and 5 with local recurrent cancer, underwent chest wall reconstruction using an omental flap and mesh skin grafting, except for a slight necrosis on the transposed mesh skin.
Abstract: Nine patients, including 4 with primary advanced breast cancer (stage IV) and 5 with local recurrent cancer, underwent chest wall reconstruction using an omental flap and mesh skin grafting. In 2 of these patients the defect of bony chest wall was reconstructed with an acryl-resin plate and omental flap. The postoperative course in all patients was uneventful, except for a slight necrosis on the transposed mesh skin. Flail chest or dypsnea did not occur in those with a bony chest wall reconstruction. The immediate postoperative performans status in 6 of 9 patients and also quality of life improved.
15 citations
TL;DR: Positive findings were obtained in the assay of estrogen and progesterone receptor and Modified radical mastectomy was carried out and the patient is doing well with no evidence of recurrence at 25 months later.
Abstract: We report a case of secretory carcinoma of the breast in a 33 year old woman. Secretory carcinoma is a rare tumor and has distinctive pathological characteristics. This tumor usually occurs in children or adolescents. Modified radical mastectomy was carried out and the patient is doing well with no evidence of recurrence at 25 months later. Negative findings were obtained in the assay of estrogen and progesterone receptor.
15 citations
TL;DR: In the radiotherapy prescribed group, leukemia was as frequent as esophageal cancer, and in those given endocrine therapy, breast cancer strongly inhibited the current one and in the chemotherapy (+) group, the occurrence of the second cancer seemed to be strongly influenced by mitomycin C.
Abstract: Out of a total of 47,005 cases of primary breast cancer with curative surgery recorded in Japan in the 20 year period from 1963 to 1982, 764, or 1.6 per cent had a second primary cancer occurring during the same period. The distribution of the second site was gastric cancer in 200 (26.2 per cent), breast cancer in 200 (26.2 per cent), colorectal cancer in 59 (7.7 per cent), cancer of the cervix uteri in 54 (7.1 per cent) and thyroid cancer in 37 (4.8 per cent). The gastric cancer was the Borrmann type 4, and the poorly differentiated scirrhous type. Incidence of the second cancer was enhanced, in the first period before 1971 and by contrast, in the second period after 1971 it was diminished. In the chemotherapy (+) group, the occurrence of the second cancer seemed to be strongly influenced by mitomycin C. In the radiotherapy prescribed group, leukemia was as frequent as esophageal cancer, and in those given endocrine therapy, breast cancer strongly inhibited the current one.
TL;DR: Analysis of the time course of postoperative serum CEA concentrations made it possible to differentiate local tumor recurrence and generalized metastasis, regardless of the histologic type or primary site of the tumor.
Abstract: We analyzed the time course of postoperative serum CEA concentrations in 229 patients with histologically confirmed colorectal carcinoma. Preoperative CEA levels were correlated with Dukes' stages, however, the preoperative CEA value was of limited value as a screening procedure. In 42 patients with tumor recurrence after radical resection, a diagnosis of relapse, based on a rise in the CEA concentration, preceded the positive clinical symptoms. Analysis of the CEA time course made it possible to differentiate local tumor recurrence and generalized metastasis, regardless of the histologic type or primary site of the tumor.
TL;DR: Tumours of low mitotic rate, less than 5 per 10 high power fields with a lesser degree of cellularity and anaplasia tend to follow a more indolent course than those with moderate to high grades with higher mitotic rates.
Abstract: Dermatofibrosarcoma protuberans is a low grade soft tissue tumour of skin and frequently recurs. It is a locally invasive tumour and hence wide excision is required to minimize recurrences. Tumours of low mitotic rate, less than 5 per 10 high power fields with a lesser degree of cellularity and anaplasia tend to follow a more indolent course than those with moderate to high grades with higher mitotic rates.
TL;DR: A higher rate of liver metastasis with lymph node involvement in the early stage of the disease was peculiar to cases of pancreatic cancer, and early metastases to the liver, lung, cerebellum and ovarium were evident.
Abstract: Out of 272 pancreatic cancer patients, 94 with hematogenous metastasis were clinicopathologically analyzed. The incidence of hematogenous metastases on laparotomy was 31.3 per cent in the liver, 1.8 per cent in the lung, 1.1 per cent in the adrenal gland and 0.4 per cent in the navel, respectively. The incidence of liver metastasis, in 22.9 per cent of the patients with carcinoma of the head of the pancreas and in 47.3 per cent of those of the body and tail of the pancreas, was higher than that of carcinomas of the other digestive organs. In autopsy findings, early metastases to the liver, lung, cerebellum and ovarium were evident. A higher rate of liver metastasis with lymph node involvement in the early stage of the disease was peculiar to cases of pancreatic cancer.
TL;DR: In a patient with metachronous multiple primary lung cancer, bilateral lobectomy was performed, using bronchoplastic procedures, and the patient is well with no signs of recurrence 6 years and 10 years after the first operation and 19 months after the second sleeve lobectomy.
Abstract: In a patient with metachronous multiple primary lung cancer, bilateral lobectomy was performed, using bronchoplastic procedures. This case may be one of very few such cases reported in the literature. A 56-year-old man with squamous cell carcinoma was surgically treated for lung cancer. At the first operation, right upper lobectomy with wedge resection of the right main bronchus was performed, as the tumor occupied the orifice of the right main bronchus. Six months later, re-operation for stricture at the anastomotic line was done because of granulation. By means of sleeve resection of the strictured right main bronchus, the airway was reconstructed. The patient remained well for five years, then a similar cancer at the orifice of the left lower lobe and bulging into the left main bronchus became evident. Left lower sleeve lobectomy was done for the second primary cancer. The postoperative course was uneventful and he is well with no signs of recurrence 6 years and 10 months after the first operation and 19 months after the second sleeve lobectomy
TL;DR: Findings suggest that AFP in primary liver cancer and metastatic liver cancer is glycosylated in a different manner and indicates that different patterns of AFP subfractions identified by the combination of Con A, LCH or PHA-E ACIE facilitate a differential diagnosis of these hepatic malignancies.
Abstract: Using a modified method of concanavalin A (Con A), lentil lectin (LCH) or phytohemagglutinin-E (PHA-E) affinity crossed-line immunoelectrophoresis (ACIE), we studied alpha-fetoprotein (AFP) subfractions in 69 sera, including 58 from patients with primary liver cancer and 11 from patients with hepatic metastasis of gastric cancer. We found that Con A non-reactive subfraction (type b) or LCH weakly-reactive subfraction (type B) was more frequently detected in metastatic liver cancer, as compared with liver cancer hepatoma. The amount of Con A non-reactive subfraction (type b) or of PHA-E reactive subfraction (type X) was significantly higher in case of metastatic liver cancer than in primary liver cancer. Since different affinities between AFP and lectins are due to the microheterogeneity in AFP sugar chain, our findings suggest that AFP in primary liver cancer and metastatic liver cancer is glycosylated in a different manner. It is also indicated that different patterns of AFP subfractions identified by the combination of Con A, LCH or PHA-E ACIE facilitate a differential diagnosis of these hepatic malignancies.
TL;DR: DSRS was found to be superior to a total shunt in shunt patency, prevention of variceal bleeding, preserving hepatic cell function, preserving the quality of life and patient survival, and results were particularly evident in the non-alcoholic patients.
Abstract: A prospective randomized trial of selective distal splenorenal shunt (DSRS)versus H-graft interposition total shunt at Emory Hospital in 1971 showed DSRS to be superior to a total shunt in shunt patency, prevention of variceal bleeding, preserving hepatic cell function, preserving the quality of life and patient survival. These results were particularly evident in the non-alcoholic patients. In the alcoholic patients, there was a greater loss of hepatic portal perfusion. In a later phase of the study, it was found that pancreatic veins formed a pathway of collaterals to the shunt, that is a socalled pancreatic siphon. In order to prevent loss of portal and pancreatic flow through the siphon, a total spleno-pancreatic disconnection was developed, whereby the hormone diversion is expected to be diminished.
TL;DR: A mucus-secreting presarcal cyst was found in a 49-year-old woman who complained of dysuria and was found through a transsacral approach.
Abstract: A mucus-secreting presarcal cyst was found in a 49-year-old woman who complained of dysuria. A routine rectal digital examination revealed a retrorectal mass. Diagnostic imaging demonstrated a large presacral cystic tumor. The cyst was removed through a transsacral approach. Histologically, the cyst membrane consisted of squamous and columnar mucus-secreting epithelium, and was diagnosed as a mucus-secreting presacral cyst.
TL;DR: Investigating plasma endotoxin levels and granulocyte functions in patients with postoperative sepsis concluded that endotoxin in the plasma probably plays an important role in marked changes in peripheral granulocytes functions in Patients with respiratory distress syndrome.
Abstract: Plasma endotoxin levels and granulocyte functions (chemiluminescence and chemotaxis) were determined in fifty-two patients with postoperative sepsis. Seventeen had concurrent respiratory distress syndrome (RDS group) and the remaining thirty-five were free of the syndrome (non-RDS group). The plasma endotoxin concentrations were higher in the RDS group than in the non-RDS group (p 80 pg) belonged to the RDS group. We noted a positive correlation in chemiluminescence (p<0.001, r=0.67) and a negative correlation in chemotactic activity (p<0.001, r=−0.69). To determine whether endotoxin alters normal granulocyte functionsin vitro, healthy granulocytes were treated by the endotoxin (E. coli 0111:B4). There was an increase in chemiluminescence and a decrease in chemotactic activity, as observedin vivo. Furthermore, normal granulocytes chemiluminescence was increased by pretreatment of RDS plasma showing high endotoxin levelsin vitro (n=4, p<0.05). Thus, endotoxin in the plasma probably plays an important role in marked changes in peripheral granulocyte functions in patients with respiratory distress syndrome.
TL;DR: A unique case of hepatolithiasis associated with cholangiocarcinoma where the intrahepatic calculi consisted mainly of cholesterol rather than calcium bilirubinate and the bacteriological study of the intra hepatic and gallbladder bile was negative.
Abstract: A unique case of hepatolithiasis associated with cholangiocarcinoma is described. The intrahepatic calculi consisted mainly of cholesterol rather than calcium bilirubinate. A bacteriological study of the intrahepatic and gallbladder bile was negative, though bacterial infection of the bile duct has been considered a main factor responsible for formation of intrahepatic calculi.
TL;DR: Of fifty-eight consecutive patients surgically treated for aneurysm of the abdominal aorta, twenty were emergency cases following the rupture; comparison of the mortality rate in elective surgery of abdominalAorticAneurysms with that in ruptured aneurYSms suggests the necessity for early elective operations whenever abdominal a Mortality rates are diagnosed.
Abstract: Of fifty-eight consecutive patients surgically treated for aneurysm of the abdominal aorta, twenty were emergency cases following the rupture. Associated diseases were found in 85 per cent of patients; hypertension being the most common. Fifty per cent of patients were in shock on admission. The duration between rupture and operation was three hrs to two weeks with the average of 115.5 hrs. In six patients, the diagnosis of abdominal aortic aneurysm was known for over six months. The operative mortality rate in case of ruptured abdominal aortic aneurysm was 45 per cent. The most important determinants of survival were the incidence of shock on admission, the incidence of associated disease, the known duration of the aneurysm, and the time interval from rupture to admission. The intraoperative factors most influencing survival were the type of rupture, intraoperative hypotension, and total blood loss. Comparison of the mortality rate in elective surgery of abdominal aortic aneurysms (5.3 per cent) with that in ruptured aneurysms (45.0 per cent) suggests the necessity for early elective operations whenever abdominal aortic aneurysms are diagnosed.
TL;DR: The results suggest that estrogen and progesterone may relate to the growth of the scirrhous type of gastric cancer.
Abstract: Tissue specimens from patients with the scirrhous type of gastric carcinoma were stained using the peroxidase-antiperoxidase (PAP) method. Nine out of thirty-seven specimens (24 per cent) showed positive estrogen staining, and here tissues from male or older patients were usually stained. Cumulative survival rate in patients whose tissue showed a positive estrogen staining was higher than that in case of a negative estrogen staining. Four out of thirty-one specimens (13 per cent) stained positively for progesterone, all four patients being male. These results suggest that estrogen and progesterone may relate to the growth of the scirrhous type of gastric cancer.
TL;DR: It is concluded that the generation of suppressor precursors in the spleen is dependent on the location of tumors and that the maturation of suppression cells occurs in theSpleen by factors released from splenic adherent cells, then migrates into the peripheral blood.
Abstract: To elucidate the role of the spleen on immunosuppression of gastric and esophageal cancer, suppressor cell activities of spleen cells (SCs), splenic vein lymphocytes (SVLs) and peripheral blood lymphocytes (PBLs) were investigated. Concanavalin-A induced susppressor cell (Con-AS) activity of SCs was significantly higher in patients with gastric cancer than in those with benign diseases. Higher Con-AS activity of SCs was observed in esophageal cancer patients with tumors located in the lower portion of the esophagus. In comparison with suppressor activities of SCs and SVLs, the decrease of the predominance of suppressor precursors in SCs and the increase of the spontaneously activated suppressor cells in SVLs were noted with the advance of the tumors. Culture supernatants from splenic adherent cells significantly induced suppressor cell activities as well as did sera from splenic venous blood. From these results, it is concluded that the generation of suppressor precursors in the spleen is dependent on the location of tumors and that the maturation of suppressor cells occurs in the spleen by factors released from splenic adherent cells, then migrates into the peripheral blood.
TL;DR: A 34-year-old man with primary hepatic lymphoma was treated by right hepatic lobectomy, including right hemicolectomy and nephrectomy, and the histological diagnosis was a small cell diffuse histiocytic lymphoma.
Abstract: Primary lymphoma of the liver is an extremely rare entity; only eight cases have been reported in the literature. We treated a 34-year-old man with primary hepatic lymphoma by right hepatic lobectomy, including right hemicolectomy the nephrectomy. The histological diagnosis was a small cell diffuse histiocytic lymphoma. Details of this case plus that of others in the literature are described in this report.
TL;DR: It is suggested that cells from malignant effusions in patients with various carcinomas were more sensitive to adriamycin or MMC, under condition of a higher temperature (42°C).
Abstract: Utilizing a clonogenic assay, the effects of hyperthermia and selected chemotherapeutic drugs on growth of cells from malignant effusions were studied. Fourteen of 25 samples obtained from 25 patients with various carcinomas formed at least 30 colonies per plate. Exposure of the cells to heat at 42°C for 1 hr before the plating slightly inhibited the colony growth. The drugs, adriamycin (AM) and mitomycin C (MMC), were tested at 3 different concentrations. When the cells were treated with these two drugs for 1 hr at 42°C, the percent of surviving colonies was significantly decreased, as compared to findings at 37°C, in both groups, at 3 different concentrations. The combination of drugs and hyperthermia appeared to function synergistically in one-third of such cases. These results suggest that cells from malignant effusions in patients with various carcinomas were more sensitive to AM or MMC, under condition of a higher temperature (42°C).
TL;DR: A 50-year-old Japanese man who had abscesses and draining fistulas in the perianal region recurred, despite surgical treatment such as incision and drainage over a 30 year period, died 4 months later with a hepatoma and multiple metastases.
Abstract: A 50-year-old Japanese man had had abscesses and draining fistulas in the perianal region. These lesions recurred, despite surgical treatment such as incision and drainage over a 30 year period. “Sulfur granules” were found in the pus from the abscess and Actinomyces israelii was cultured. Ampicillin-cloxacillin treatment lead to healing. The patient died 4 months later with a hepatoma and multiple metastases.
TL;DR: The case suggests that constant local secretion of catecholamines may be responsible for the development of renal artery stenosis.
Abstract: An unusual case of pheochromocytoma associated with renal artery stenosis is described. Despite the removal of bilateral adrenal pheochromocytoma, laboratory findings suggested the presence of residual pheochromocytoma and abdominal aortography revealed more pronounced stenosis of the right renal artery. Two months later, the undetected residual pheochromocytoma underwent hemorrhagic necrosis with acute cessation of catecholamine release. Thereafter, the patient's blood pressure decreased to a normal level with marked improvement in hypertensive symptoms. No remaining stenosis was demonstrated on follow up renal angiography. Our case suggests that constant local secretion of catecholamines may be responsible for the development of renal artery stenosis.
TL;DR: The terminal structure of splenic arterial capillaries, studied by scanning transmission electron microscopy, provided a three-dimensional view of the microarchitecture of human and dog spleens and indicated the possibility of a closed circulation in humans and dogs.
Abstract: The terminal structure of splenic arterial capillaries, studied by scanning transmission electron microscopy, provided a three-dimensional view of the microarchitecture of human and dog spleens. There are reports that the terminal arterial capillaries end “openly” in the cord, however, our microphotographs indicate the possibility of a closed circulation in humans and dogs. In the human spleen, we found two types of arterial capillaries, one with a flat and continuous endothelium, and the other with discontinuous rod-shaped endothelial cells and a sheath-like structure. The microarchitecture and the termination of these arterial capillaries differ markedly among species.
TL;DR: Treatment of Crohn's disease of the esophagus should primarily be medical and esophagectomy should only be considered in cases of complications, intractability or a suspicion of malignancy in the biopsied specimen.
Abstract: We treated a 46-year-old Japanese man with Crohn's disease of the esophagus and for whom medical therapy was adequate. Crohn's disease of the esophagus is a rare disease without specific clinical features and establishment of the diagnosis with guided biopsy is extremely difficult. Therefore, Crohn's disease of the esophagus should be considered in the differential diagnosis of biopsy-negative carcinoma of the esophagus in order to avoid major surgery. Treatment of Crohn's disease of the esophagus should primarily be medical and esophagectomy should only be considered in cases of complications, intractability or a suspicion of malignancy in the biopsied specimen.
TL;DR: Histologic diagnosis was predictable by ABC in eighty per cent of cases, but difficulty was experienced in predicting the histologic diagnosis in cases of a poorly differentiated malignancy.
Abstract: Aspiration biopsy cytology (ABC) was done on one hundred and forty-five patients with cervical tumors, excluding primary tumors of the thyroid and local metastasis of thyroid cancer, during the period of 44 months from 1981–85. Surgery was done on a total of fifty-five patients with lesions evaluated to be malignant and requiring resection. A correlation was determined between the histological diagnosis based on permanent paraffin sections and the diagnosis made by aspiration biology cytology in order to evaluate ABC in terms of accuracy together with its complications and limitations. The false positive rate was 6.6 per cent and the false negative rate was 8.3 per cent. Histologic diagnosis was predictable by ABC in eighty per cent of cases, but difficulty was experienced in predicting the histologic diagnosis in cases of a poorly differentiated malignancy. A few cases of slight subcutaneous bleeding occurred, but seeding implantation of cancer cells was nil. It was confirmed that ABC is a highly diagnostic procedure for assessing cervical tumors. The method is simple, safe and economical.