1.The Necessity of Simulation Specialist
Tomoko Miyoshi ; Yoshimi Kozai ; Ueda Junko ; Yasuhiro Mandai ; Toshiko Yoshida ; Manabu Suno ; Naoki Shiba ; Mitsune Tanimoto
Medical Education 2014;45(5):378-380
Simulation specialist who masters simulators is important for a management of simulation center. Okayama university medical school started to train simulation specialists. Now simulation training are familiar in our university through the simulation specialists helps course directors.
2.Management of Ruptured Isolated Aneurysms of the Iliac Artery.
Michio Tobe ; Jiro Kondo ; Kiyotaka Imoto ; Shinichi Suzuki ; Susumu Isoda ; Naoki Hashiyama ; Yoshimi Yano ; Yoshinori Takanashi
Japanese Journal of Cardiovascular Surgery 2001;30(3):118-121
Fourteen patients with 22 solitary aneurysms of the iliac artery were operated in a 16-year period (1983 to 1999). Patients were divided into two groups. The non-ruptured group consisted of 6 patients who underwent surgical intervention before aneurysm rupture, and their mean age was 78.5 years. The ruptured group consisted of 8 patients who underwent surgical intervention for aneurysm rupture, with a mean age of 68.5 years. Although seven patients underwent emergency surgery for aneurysm rupture, less than half of them were operated upon within 24hr after the onset of aneurysm rupture. The average size of aneurysms was similar in the two groups (common iliac artery aneurysms: non-ruptured 47mm vs. ruptured 44mm in diameter, internal iliac artery aneurysms: non-ruptured 55mm vs. ruptured 55mm). Two patients died in the ruptured group, in which the operative mortality rate was 25%. Six patients (75%) of the ruptured group had hypovolemic shock, and two of them died during surgical repair. Of the patients with shock, two patients had intestinal ischemia after operation. Intestinal ischemia was one of the serious complications of ruptured iliac aneurysms. These results suggest that in patients with shock from ruptured iliac artery aneurysms, strategy for treatment is an important determinant of the outcome.
3.Study on Telomerase Activity in Bronchoalveolar Lavage Fluid.
Tadashi ARAI ; Yo YASUDA ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Satoshi TOSHIMA ; Chiken SHIBUYA ; Naoki YOSHIMI ; Yoshitomo KASHIKI
Journal of the Japanese Association of Rural Medicine 1997;46(4):679-682
Telomerase has been reported to increase its activity in more than 80% of human pulmonary cancer tissue samples, thus potentially contributing to cancer diagnosis. This led us to try the measurement of telomerase activity in bronchoalveolar lavage fluid in cases clinically suspected to be primary pulmonary cancer. Methodologically, the measurement was made by means of TRAP (telometric repeat amplification protocol) assay, a high-sensitivity assay system using the technique known as polymerase chain reaction (PCR). The resultsshowed that telomerase activity in all the 6 cases, diagnosed as primary lung cancer histologically, was positive. On the other hand, on cytologic examination, 4 out of these 6 cases were positive, and the remaining 2 cases (squamous cell carcinoma and adenocarcinoma) were negative. Histologic examination revealed that of these 4 cases, 2 and 2 were pulmonary cancers and pulmonary tuberculoses, respectively. The above results suggested that examination of telomerase activity in bronchoalveolar lavage fluid may be useful for cancer diagnosis clinically.
4.Histopathological Case of Uterine Carcinoid Tumor Metastasized to the Lung.
Satoshi TOSHIMA ; Yo YASUDA ; Tadashi ARAI ; Yuji ITO ; Kazuyoshi HAYAKAWA ; Tadatake TAKAYA ; Momoe DOI ; Chiken SHIBUYA ; Toshiya ITO ; Yoshitomo KASHIKI ; Naoki YOSHIMI
Journal of the Japanese Association of Rural Medicine 1999;48(1):48-53
With the diagnosis of metastatic tumor of the lung suspected, we had a chance to experience a histopathological case of carcinoma of the uterine cervix (adenoid squamous cell carcinoma), which was thought to coexist with carcinoid tumor. In this paper, we report the results of cytological as well as histological examinations of the case.
The patient was as 43-year-old woman. She visited our hospital, complaining about abnormally prolonged uterine bleeding (metrorrhagia). Cytodiagnosis was performed with a Papanicolaou smear. A microscopic examination revealed squamous cell carcinoma occurring together with adenocarcinoma. A similar finding was obtained by cervical biopsy. Thus, the case was diagnosed as adenoid squamous cell carcinoma.
Then the patient underwent radical hysterectomy and lymphadenectomy, followed by chemotherapy. After leaving the hospital, she was put under doctor-monitored observation. About 4 years after the surgery, a chest x-ray examination found abnormal shadows. For inspection, bronchoscopy was performed. Carcinoid of the lung was diagnosed through histopathological as well as electron microscopic examination of specimens taken from bronchial polyps during bronchoscopy. At the same time a cytologic study was conducted. It also revealed neoplasms strongly suspected of caricinoid tumors. Retrospective studies of cytological and histopathological images of the uterine cervix when the patient first visited us found only adenocarcinoma and squamous cell carcinoma, but no signs of carcinoid tumors. However, the immunohistological staining of NSE and chromoganins A, both neuroendocrine markers, showed positive findings in some adenocarcinomatous parts of the tissues of the unterine cervix. Therefore, we considered that the cervical cancer is compounded of adenoid squamous cell carcinomas and tumors having properties of neuroendocrine cells.
From this, we concluded that it is necessary to take into account a differential diagnosis of neuroendocrine tumors including carcinoid of the uterine cervix when less differentiated adenocarcinoma and squamous cell carcinoma are suspected in histological and cytological examinations. Furthermore, we thought it important to make a definite diagnosis after meticulous examinations by immunohistological staining and electron microscopy.
5.Twin Rectal Tonsils Mimicking Carcinoid or Mucosa-Associated Lymphoid Tissue Lymphoma.
Masanori TAKEHARA ; Naoki MUGURUMA ; Shinji KITAMURA ; Tetsuo KIMURA ; Koichi OKAMOTO ; Hiroshi MIYAMOTO ; Yoshimi BANDO ; Tetsuji TAKAYAMA
Clinical Endoscopy 2017;50(5):500-503
The rectal tonsil is a rare polypoid lesion exclusively found in the rectum and is considered a reactive proliferation of the lymphoid tissue. Although this lesion is benign, we recommend that it should be differentiated from carcinoid or polypoid type of mucosa-associated lymphoid tissue lymphomas, based on gross findings. In this case report, we describe a case of rectal lesions with a unique appearance in a 41-year-old man. Colonoscopy revealed two 5-mm-sized nodules located opposite from each other on the left and right sides of the lower rectum. Endoscopic mucosal resection was conducted. Histopathologically, both lesions were mainly located in the submucosa and consisted of prominent lymphoid follicles with germinal centers of various sizes. No immunoreactivity of Bcl-2 was seen in the germinal centers. Immunohistochemical staining for kappa and lambda light chains revealed a polyclonal pattern. Therefore, these lesions were diagnosed as rectal tonsils.
Adult
;
Carcinoid Tumor*
;
Colonoscopy
;
Germinal Center
;
Humans
;
Lymphoid Tissue
;
Lymphoma, B-Cell, Marginal Zone*
;
Palatine Tonsil*
;
Rectum
;
Twins*