ABSTRACT
An 89-year-old woman with a history of traumatic injury was referred to our hospital for further evaluation of anemia. Two days after colonoscopy, she complained of intermittent abdominal pain. An abdominal computed tomography confirmed a left diaphragmatic defect with a herniated transverse colon. She underwent elective laparoscopic repair of the diaphragmatic hernia. Colonoscopy rarely causes or worsens a diaphragmatic hernia. This is a rare case where we observed the development and exacerbation of a diaphragmatic hernia. It is important to pay attention to the development of a diaphragmatic hernia after colonoscopy for patients with a history of traumatic injury.
Subject(s)
Colonoscopy , Hernia, Diaphragmatic, Traumatic/diagnosis , Aged, 80 and over , Female , Hernia, Diaphragmatic, Traumatic/surgery , Hernia, Hiatal , Humans , LaparoscopyABSTRACT
BACKGROUND/AIM: We studied the effects of CO(2) concentration changes on the invasive ability of colon cancer cells. MATERIALS AND METHODS: Colon cancer cell lines and human samples derived from a peritoneal metastasis were incubated in a hypercapnic environment, followed by incubation in 5% CO(2). The invasive ability of colon cancer cells incubated with CO(2) were analyzed using an invasion assay system. RESULTS: In comparison with the colon cancer cell lines incubated in 5% CO(2) only, the invasive ability of cells increased in all the colon cancer cell lines subjected to incubation in 20% CO(2) followed by incubation in 5% CO(2), with a concomitant increase in the mRNA expressions of matrix metalloproteinase-2 (MMP2) and MMP9. The invasive capability of peritoneal metastatic cells in the human-derived specimen also increased on CO(2) concentration changes. CONCLUSION: CO(2) concentration changes enhanced the invasive capacity of colon cancer cells.
Subject(s)
Carbon Dioxide/metabolism , Cell Movement , Colonic Neoplasms/pathology , Hypercapnia/physiopathology , Peritoneal Neoplasms/secondary , Apoptosis , Cell Adhesion , Cell Proliferation , Colonic Neoplasms/genetics , Colonic Neoplasms/metabolism , Humans , Matrix Metalloproteinase 2/genetics , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/genetics , Matrix Metalloproteinase 9/metabolism , Peritoneal Neoplasms/genetics , Peritoneal Neoplasms/metabolism , RNA, Messenger/genetics , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Tumor Cells, CulturedABSTRACT
The patient was a 71-year-old woman with sigmoid colon cancer with urinary bladder invasion, for which sigmoidectomy with D 3 lymphadenectomy and partial cystectomy was performed. After surgery, the patient was started on 4 courses of 6-week systemic chemotherapy (500 mg/m(2) 5-FU and 200 mg/m(2) l-LV weekly). However, 4 months later, CT revealed local recurrence in the urinary bladder and recurrence in the para-aortic lymph nodes and spleen. Therefore, low-dose CPT-11 therapy (40 mg/m(2) once per week) was instituted, which achieved a complete response as revealed by CT for response evaluation 5 months after the start of therapy. Up to the present, after 8 months no recrudescence or recurrent lesions in other organs have been observed. The patient developed mild side effects such as grade 1 nausea, anorexia, and leukopenia, but has a well-maintained QOL.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents, Phytogenic/administration & dosage , Camptothecin/analogs & derivatives , Lymph Nodes/pathology , Sigmoid Neoplasms/drug therapy , Splenic Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Aged , Aorta , Camptothecin/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Female , Humans , Irinotecan , Lymphatic Metastasis , Neoplasm Invasiveness , Quality of Life , Remission Induction , Sigmoid Neoplasms/pathology , Sigmoid Neoplasms/surgery , Splenic Neoplasms/drug therapy , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/surgeryABSTRACT
Histopathologically, the incidence of mucinous carcinomas in Europe and the United States is approximately 10% and that in Japan is low, at 2.9% to 7.4%. The prognosis of mucinous carcinomas is generally thought to be poor, but their clinical and histological features are not well known. In this study, we attempted to clinicopathologically characterize colorectal mucinous carcinomas. Of the 607 colorectal cancer patients, a group of 20 mucinous carcinoma patients (3.3%) and a group of 553 control patients were included in this study. The mucinous carcinomas were subclassified into the following two types to analyze clinicopathological parameters and outcomes: the papillotubular (PT) type and the mucocellular (MC) type. Clinicopathologically, the MC type showed higher rates of venous invasion, lymph node metastasis, liver metastasis, and peritoneal dissemination and higher frequencies of TNM stage III and IV cancers than the PT type. The MC type had a significantly poorer 3-year survival rate of 27% compared with 60% for the PT type. The MC-type mucinous carcinomas showed a significantly higher expression rate (37.5%) of MMP-9 than that (16.6%) in the PT-type mucinous carcinomas. Overall, the colorectal mucinous carcinomas progressed more rapidly and had a poorer prognosis than the control (nonmucinous) cancers. The histological subclassifications MC and PT tended to be molecular-biologically different, and the MC type was poorer in terms of clinicopathological parameters and outcomes.
