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doi: 10.1046/j.1440-1746.1999.01983.xpmid: 10634149
Peripheral cholangiocarcinoma is a relatively rare cancer. However, it is known to have an unfavourable prognosis compared with that of hepatocellular carcinoma. Little is known about its aetiology, clinical or pathological features. Recently, with the development of imaging modalities, early staged cholangiocarcinoma has been diagnosed with relative ease. Surgery is the optimal therapy. Total hepatectomy does not provide survival benefit. Conventional surgery remains the only effective treatment, even for patients with advanced‐stage tumours. Factors influencing survival after hepatectomy were tumour‐free margin, lymphnodes metastasis and histopathology of tumour. Palliative intrahepatic tubing or percutaneous transhepatic biliary drainage and brachytherapy can alleviate jaundice and cholangitis, thereby prolonging survival in some cases. © 1999 Blackwell Science Asia Pty Ltd
Chan, Annie On‐On; Luk, John Mc; Hui, Wai‐Mo; Lam, Shiu‐Kum
doi: 10.1046/j.1440-1746.1999.02000.xpmid: 10634150
Although the advancement of molecular oncology in gastric cancer lags behind that of colorectal cancer, the rapid developments witnessed in recent years have improved our understanding of the carcinogenesis, aetiology, progression and metastasis of gastric cancer. The different molecular genetic alterations in intestinal and diffuse types of gastric cancer have further supported the concept that these two pathological types are different disease entities. The association of telomerase and cadherin changes with Helicobacter pylori infection reinforces its aetiological role. The mutated cadherin gene identified in familial gastric cancer has shone light onto the pathogenesis. Adhesion molecules have already been applied to daily clinical practice as prognostic markers. Future molecular studies will contribute to the screening, classification, disease monitoring and therapeutics of gastric cancer. © 1999 Blackwell Science Asia Pty Ltd
Inaba, Tomoki; Mizuno, Motowo; Kawai, Kozou; Okada, Hiroyuki; Tsuji, Takao
doi: 10.1046/j.1440-1746.1999.02001.xpmid: 10634151
Background : Diffuse submucosal cysts of the stomach have been suggested as a predisposing condition for the development of gastric cancer, especially multiple cancers. We report here two cases of diffuse submucosal cysts of the stomach associated with multiple gastric cancers which were detected during endoscopic follow‐up. Methods and Results : The first patient was a 75‐year‐old man and the second patient was a 72‐year‐old man. In the first case, we performed an endoscopic examination every year and detected an advanced cancer and two early cancers on the fifth year of the follow up. Because one of these cancers was advanced, we examined the second patient endoscopically every six months. In this patient, we detected two early cancers after 1.5 years follow up. Conclusions : We suggest that patients with this disorder should be examined regularly by endoscopy for the detection of gastric cancer, preferably every six months. © 1999 Blackwell Science Asia Pty Ltd
Kanauchi, Osamu; Andoh, Akira; Iwanaga, Toshihiko; Fujiyama, Yoshihide; Mitsuyama, Keiichi; Toyonaga, Atsushi; Bamba, Tadao
doi: 10.1046/j.1440-1746.1999.02025.xpmid: 10634153
Background : Germinated barley foodstuffs (GBF), which are derived from brewer’s spent grain and are a highly safe food substance, increased butyrate production in the lower intestine and prevented mucosal damage and bloody diarrhoea in an acute experimental colitis model. As human histocompatibility leucocyte antigen (HLA)‐B27 transgenic rats develop spontaneous and chronic intestinal inflammation resembling ulcerative colitis, we investigated the mechanisms underlying the preventive effects of GBF against a spontaneous and chronic colitis model. Specifically, the production of bacterial butyrate and the regulation of proinflammatory cytokine production were examined. Methods : A GBF diet and a cellulose (CE) diet were fed to HLA‐B27 transgenic rats for 13 weeks. The presence of faecal occult blood, colonic mucosal protein, DNA and RNA content, colonic myeloperoxidase activity, nuclear factor kappa B (NFκB) DNA binding activity, the depth of the crypts and serum inflammatory parameters were then evaluated. Butyrate production in the caecal contents was also determined. Results : Feeding GBF significantly increased bacterial butyrate production and simultaneously attenuated the presence of faecal occult blood and colonic mucosal hyperplasia. Colonic mucosal NFκB‐DNA binding activity and the production of interleukin‐8 were also suppressed by the butyrate produced from GBF. Conclusions : Germinated barley foodstuffs feeding promotes bacterial butyrate production and attenuated inflammation in both spontaneous and chronic colitis in HLA‐B27 transgenic rats. © 1999 Blackwell Science Asia Pty Ltd
Porter, Anthony J; Wattchow, David A; Brookes, Simon Jh; Costa, Marcello
doi: 10.1046/j.1440-1746.1999.02026.xpmid: 10634154
Background : The submucosal plexus is important in the control of secretomotor and motor function of the intestine. Our aim was to describe the projections of submucosal neurons to the mucosa within the submucosal plexus and to the circular muscle of human colon and to determine whether submucosal neurons that projected to different layers were located at different levels of the submucosa. Methods : A retrogradely transported fluorescent dye was applied to the mucosa, submucosa or circular muscle layer of human colon which was then maintained in organotypic culture for 5 days. The submucosa was then dissected into two preparations, one containing the inner layer of the submucosal plexus and the other containing both the intermediate and outer layers. The dissected preparations were labelled with antibodies to nitric oxide synthase (NOS) or vasoactive intestinal peptide (VIP). Results : Submucosal neurons projected to the mucosa, submucosa and circular muscle layers for mean distances of 3.7, 3.0 and 4.3 mm, respectively. Ninety‐seven per cent of submucosal neurons labelled from the circular muscle were located in the outer or the intermediate layers, while 51% of those projecting to the mucosa were in inner layer and 49% in the intermediate/outer layers of the submucosal plexus. Eleven per cent of submucosal neurons projecting to the circular muscle were immunoreactive for NOS and 12% were immunoreactive for VIP. Forty‐five per cent of those projecting within the submucosa were immunoreactive for VIP and 38% of those projecting to the mucosa were immunoreactive for VIP. Conclusions : Submucosal neurons in the human colon innervate the mucosa, circular muscle and submucosa and different functional classes of neurons are located in different layers of the submucosal plexus. © 1999 Blackwell Science Asia Pty Ltd
Macdonald, Graeme A; Tarish, Jabsar; Whitehall, Vicki Jl; M, Sally J; Mellick, George D; Buttenshaw, Ron L; Johnson, Anthony G; Young, Joanne; Leggett, Barbara A
doi: 10.1046/j.1440-1746.1999.02027.xpmid: 10634155
Poddar, Ujjal; Thapa, Babur R; Vashishta, Rakesh K; Girish, Chakkodbail S; Singh, Kartar
doi: 10.1046/j.1440-1746.1999.02028.xpmid: 10634156
Background : Congenital hepatic fibrosis (CHF) is an uncommon cause of portal hypertension in children. So far, there is no report of this from the subcontinent. We have studied the clinical spectrum of CHF in North Indian children. Methods : Fifteen children were diagnosed with CHF on the basis of their liver histology over a period of 6.5 years. Their clinical details were recorded. Oesophagogastroduodenoscopy and abdominal ultrasonography were performed in all cases. All siblings were examined clinically; and ultrasonography, endoscopy and liver biopsy were performed if there was firm hepatomegaly. Children with variceal bleeding were managed by endoscopic sclerotherapy. The median age of these children was 8 years with a male to female ratio of 1.5:1. Results : Only one sibling (of 33) was diagnosed as having CHF. The predominant presentations were variceal bleeding in six, abdominal distension in seven and incidental detection of organomegaly in two. Hepatomegaly was present in all patients and splenomegaly in all but one. Liver function and renal function tests were normal in all children, except for a raised serum alkaline phosphatase in six. Two children had associated renal cysts, two had choledochal cysts, one each had Caroli’s disease and biliary atresia and two children had portal vein thrombosis. Variceal obliteration was achieved in five children after an average 4.8 sclerotherapy sessions and one required a mesocaval shunt. On follow up (median 41 months, range 1–80 months) all are doing well. Conclusions : Congenital hepatic fibrosis is mainly sporadic in India and associated renal lesions are uncommon. Endoscopic sclerotherapy is effective in controlling variceal bleed and the prognosis is universally good in the absence of renal diseases. © 1999 Blackwell Science Asia Pty Ltd
Kiso, Shinichi; Kawata, Sumio; Tamura, Shinji; Miyagawa, Jun‐Ichiro; Ito, Nobuyuki; Tsushima, Hirofumi; Yamada, Akira; Umeki, Shinobu; Higashiyama, Shigeki; Taniguchi, Naoyuki; Matsuzawa, Yuji
Showing 1 to 10 of 16 Articles
Background : It is important to develop an appropriate animal model for further investigation into inflammatory bowel disease (IBD). We therefore investigated a trinitrobenzene sulfonic acid (TNBS) ileitis model. Dietary fat in Crohn’s disease is still a controversial risk factor for IBD. We therefore also studied the effects of medium‐chain triglycerides (MCT) and long‐chain triglycerides (LCT) on TNBS ileitis. Methods and Results : An intraileal injection of TNBS induced ulceration and inflammation with thickening of the intestinal wall, which were characterized histologically by infiltration of polymorphic nuclear leucocytes and by granuloma formation. The mucosal damage score and serum sialic acid levels reached their highest 7 days after the TNBS injection and then gradually decreased. The mucosal damage series in the MCT group was significantly lower than in the LCT group, and levels of tumour necrosis factor‐α (TNF‐α) and leukotriene B4 (LTB4) tended to be lower in the MCT group. Conclusions : These results suggested that TNBS enteritis might be useful as an IBD animal model and that MCT modulates intestinal inflammation and is less damaging than LCT. © 1999 Blackwell Science Asia Pty Ltd
Background and Aims : Previous studies have suggested that increased body iron stores and heterozygosity for haemochromatosis are associated with an increased risk of colorectal carcinoma. The aim of this study is to determine if there is an association between (i) colorectal carcinoma and heterozygosity for the Cys282Tyr mutation of the haemochromatosis gene (HFE) and (ii) this mutation and tumour site or stage. Methods : Two hundred and twenty‐nine unselected patients (127 males, 102 females, mean age 68.0 years) with sporadic colorectal carcinoma and 228 controls (145 males, 83 females, mean age 69.7 years) were studied. DNA was tested for the presence of the Cys282Tyr mutation by digestion with Rsa1 and fragments separated by electrophoresis. Results : Twenty‐one patients with colorectal cancer and 23 control subjects were heterozygous for the Cys282Tyr mutation of HFE (relative risk 0.90). There was no association between heterozygosity of the Cys282Tyr mutation and tumour site or stage. Conclusions : Heterozygosity for the Cys282Tyr mutation of HFE does not appear to be a risk factor for colorectal carcinoma. © 1999 Blackwell Science Asia Pty Ltd
Background : Heparin‐binding epidermal growth factor‐like growth factor is an hepatotrophic factor expressed in non‐parenchymal liver cells but not in hepatocytes in regenerating rat liver after partial hepatectomy. Human hepatocellular carcinoma cells also produce this growth factor. In this study, the expression of the growth factor in the hepatocytes of fibrotic liver during hepatocarcinogenesis was investigated. Methods : Hepatic fibrosis was induced in rats by oral administration of 0.05% thioacetamide. Hepatocytes were isolated by in situ perfusion methods. Growth factor gene and protein expression were investigated by northern hybridization and immunohistochemistry, respectively. Expression of glutathione S‐transferase P, which is expressed when hepatocytes undergo neoplastic transformation, was also investigated. Results : Some hepatocytes in fibrotic liver, but not in normal liver, stained positively by immunohistochemistry for heparin‐binding epidermal growth factor‐like growth factor. The growth factor and glutathione S‐transferase P gene transcript were present in hepatocytes isolated from fibrotic liver, but not in those isolated from normal liver. Immunohistochemical localization of both proteins in fibrotic liver revealed similar patterns. Conclusions : In essence, hepatocytes in fibrotic rat liver produce heparin‐binding epidermal growth factor‐like growth factor. Expression of this growth factor may occur as hepatocytes are transformed to a neoplastic phenotype. © 1999 Blackwell Science Asia Pty Ltd