Anterior Transhepatic Approach for Isolated Resection of the Caudate Lobe of the Liver

RID=" ID=" <E5>Correspondence to:</E5> J. Yamamoto, M.D.     

Morphologic and biochemical characterization of erythrophoromas in goldfish (Carassius auratus).

The properties of spontaneous cutaneous erythrophoromas that occurred in 17 adult goldfish (Carassius auratus) were described. This study was based on combined histology, cytochemistry, electron microscopy, and biochemical analysis. Tumors that varied from 0.4 to 2.7 cm in maximum diameter were located on various parts of the skin. As shown by light microscopy, tumors were composed of red- to orange-pigmented, dendritic, stellate, or spindle-shaped cells, which coalesced into an excrescence in the dermal layer. No metastasis was observed. Evidence of invasiveness in five examples and local recurrence in three examples indicated that some of these tumors were malignant. Electron microscopy revealed numerous round cytoplasmic organelles (pterinosomes), which measured 0.4--0.7 mu, and well-developed tubular, smooth endoplasmic reticulum in the tumor cells. Biochemical analysis showed that red pigmentation of tumor cells was imparted by pteridines and carotenoids, most of which were detectable in normal adult erythrophores. These data indicate that tumors were comprised of neoplastic erythrophores.     

Effect of UDP-glucuronic acid on the microsome-mediated binding of benzo(a)pyrene metabolites to calf thymus DNA

The binding of benzo(a)pyrene (BP) to DNA in the presence ofliver microsomal preparations from 3-methylcholanthrene-treatedrats was increased 28.5% (P < 0.001) by addition of UDP-glucuronicacid to the incubation mixture at a 100 µM concentrationof BP. However this increase was not observed at lower concentrationsof BP. Analysis of DNA-hydrolysates by column chromatographyon Sephadex LH-20 indicated that this increase was due to greaterbinding of benzo(a)pyrene-7, 8-dihydrodiol-9, 10-epoxide. Theamount of bound adducts derived from 9-hydroxybenzo(a)pyrene(9-OH BP) was not significantly affected by UDP-glucuronic acid.Addition of UDP-glucuronic acid to incubation mixtures containingmicrosomes from untreated rat liver caused only a slight increasein total binding. These findings suggest that UDP-glucuronyltransferase may be involved in the activation of BP.     

Thickening at the root of the superior mesenteric artery on sonography: evidence of vascular involvement in patients with cancer of the pancreas.

Thickening of the root of the superior mesenteric artery (SMA) was studied by using preoperative sonography in 23 patients with pancreatic cancer and in 10 healthy control subjects. Of the 23 with cancer, 11 had neoplastic involvement of the SMA and 12 did not. Prominent thickening of the area around the SMA with (six patients) or without (five patients) decreased echogenicity compared with the adjacent retropancreatic connective tissue was observed in patients with involvement of the SMA, a finding called the "cuff sign." Mean thickness of the periarterial area in the cancer patients with and without involvement of the SMA and in control subjects were 8.5 mm, 4.0 mm, and 2.9 mm, respectively. With an upper limit of normal of 7.0 mm for the thickness of the SMA, the sensitivity, specificity, and overall accuracy of this sign in the evaluation of involvement of the SMA were 91%, 100%, and 96%, respectively. Decreased echogenicity of the periarterial area was not observed in patients without involvement of the SMA or in control subjects. Our results show that sonographic evidence of periarterial thickening of the root of the SMA (cuff sign), especially with decreased echogenicity, is a reliable finding of tumor infiltration of the SMA in patients with pancreatic carcinoma.     

A case of reflux nephropathy associated with pheochromocytoma]

A 26-year-old female patient complicated with reflux nephropathy and pheochromocytoma is reported. We could not find either intrinsic or extrinsic factor of urinary tract obstruction. The open bilateral renal biopsy was performed at the time of resection of the tumor. The renal biopsy specimen demonstrated minor glomerular change, severe tubular "thyroid-like" appearance and cast formation in the obvious reflux side. Otherwise focal glomerular sclerosis (FGS) lesion was found in less reflux side. In reflux nephropathy, FGS lesion is reported as main cause of progression, but mechanism of FGS lesion is unknown. This case which has both vesicoureteral reflux the high plasma nor-epinephrine concentration was considered to be important to emphasize circulative factor in the pathogenesis of FGS like lesion.     

Extent and zonal distribution of prostatic intraepithelial neoplasia in patients with prostatic carcinoma in Japan: analysis of whole-mounted prostatectomy specimens

BACKGROUND: Prostatic intraepithelial neoplasia (PIN), an intraluminar proliferation of epithelial cells in ducts and acini, is divided into high-grade (HGPIN) and low-grade (LGPIN), based on morphologies. HGPIN is considered to be a putative precursor of prostatic adenocarcinoma (PCA). Information on PIN has been limited in Japan, because PIN had not been regarded as a precursor lesion for PCA. METHODS: In this study, extent and zonal distribution of PIN together with its relationship with PCA were examined in totally embedded radical prostatectomy specimens obtained from 70 patients with PCA. Fifty-three patients received androgen deprivation therapy (castrated) and remaining 17 did not (noncastrated). RESULTS: Frequency of HGPIN in noncastrated cases (76%) was much higher than that in castrated cases (26%) (P < 0.001). LGPIN showed the same tendency, but the difference was smaller. Difference in mean number of HGPIN in noncastrated and castrated cases (12.0 and 6.4, respectively) was more marked than in LGPIN (6.4 and 5.1, respectively). Reduction rate of mean size in HGPIN (26%) by the androgen deprivation therapy was larger than in LGPIN. When evaluated in noncastrated cases, the coexistence of PCA and HGPIN was found in 76% of cases in the nontransition and 53% in the transition zone. Close association of PCA and PIN (相似文献   

Left hemihepatectomy in living donors with a thick middle hepatic vein draining the caudal half of the right liver

Donor safety is the first consideration in living related liver transplantation. Left hemihepatectomy including the middle hepatic vein is a reasonable donor procedure for obtaining a large graft for living related liver transplantation. This procedure, however, needs to be modified in donors with hepatic venous variation. While carrying out donor hepatectomy, we encountered two cases showing a variant form of hepatic venous drainage comprising a thick middle hepatic vein draining segment 6 of the liver. This variation made it necessary to preserve the middle hepatic vein in the donor liver remnant. Failure to recognize such a variant would result in congestion in the remaining right liver of the donor. To guarantee donor safety, evaluation of the drainage area of the corresponding hepatic vein is a matter of great importance in donor hepatectomy.