Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report here on a patient with recurrent sigmoid colon carcinoma. Postmortem examination revealed a fist-sized tumor in the retroperitoneum, invasive to the left ureter obstructing its lumen causing hydronephrosis of the ipsilateral kidney. Histological examination of the kidney showed multiple foci of adenocarcinoma cells on the pelvic surface. Invasion into the underlying tissue was not observed, and there was no tumor in the submucosal tissue of the pelvis or in the parenchyma of the left kidney. Cancer cells on the renal pelvic mucosa showed strong immunoreactivities for CEA and CA 19-9. These findings suggest that the tumor foci in the pelvis are formed by the intraluminal implantation of colon cancer cells detached from the ureteric metastasis. Our case presents the possibility of the implantation of carcinoma cells in the human urinary tract.
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PMID:Implantation of colon cancer cells onto renal pelvic mucosa. A case report. 292 Jan 5

Ureterosigmoidostomy (US) is an acceptable procedure for urinary diversion. Despite problems with ascending pyelonephritis, anal incontinence, and recently a reported 100- to 500-fold increase in the incidence of colonic carcinoma, the popularity of US is predicted to increase. The records of 110 patients who have undergone US at our institution have been reviewed. Invasive colon cancer developed at the site of ureter implantation in three of these patients. All patients had rectal bleeding and obstipation as initial symptoms. We have located 17 of our US patients and all consented to colonoscopy and urologic follow-up. At colonoscopy 41% of these patients had one to three polyps (0.5 to 6 cm) involving or near the site of the US. No polyps were seen proximal to the US sites. Polyps were histologically defined as tubovillous adenomas or mixed tubovillous-transitional cell adenomas. A single patient with three 4 to 6 cm polyps had superficial adenocarcinoma found in two of the polyps. Recurrent polyps or dysplasia has not been found on follow-up examination. Despite the disadvantages of US, the likely increased popularity of this procedure mandates that all patients be followed regularly for polyps and cancer. Our data support the following recommendations: (1) surveillance colonoscopy should be started soon after US, and (2) conversion to an alternative diversion should be made if recurrent polyps, cancer, or dysplasia is found. Yearly colonoscopy and screening for occult blood must be part of the comprehensive follow-up on all patients after US.
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PMID:Value of colonoscopy after ureterosigmoidostomy. 648 15

A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.
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PMID:Extensive colonic stricture due to pelvic actinomycosis. 757 94

Research on the genetic, molecular genetic, clinical features, and natural history of HNPCC has shown tremendous progress and evolution during the past 25 years. Specifically, HNPCC's autosomal dominant mode of genetic transmission has now been documented through linkage studies of the gene at 2p (MSH2) and at 3p (MLH1) with the cloning of these genes. Also, the tumor spectrum has increased, which now, in addition to carcinoma of the colon, endometrium, stomach, and ovary, includes transitional cell carcinoma of the ureter and renal pelvis, and adenocarcinomas of the small bowel and pancreas. Surveillance and management protocols for patients at high risk should include full colonoscopy since 70% of the colon cancers occur in the proximal colon. Because of the marked excess of synchronous and metachronous colorectal cancers (CRC), no less than a subtotal colectomy should be performed at the time of initial CRC. Women, in addition to colonoscopy, require endometrial aspiration biopsy. Should they develop CRC and if their procreation is completed, we recommend that they consider prophylactic hysterectomy and bilateral salpingo oophorectomy at the time of their subtotal colectomy. Now that the deleterious genes at 2p and 3p have been identified, we are offering candidates, in whom the MSH2 or MLH1 mutation has been verified, an option of prophylactic subtotal colectomy as opposed to annual life time colonoscopy. With the development of the International Hereditary Nonpolyposis Colorectal Cancer Collaborative Group, knowledge can be disseminated worldwide about the public health importance of HNPCC and the need to implement highly targeted surveillance and management strategies in all clinical practice settings.
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PMID:25 years of HNPCC. 797 96

In both animal models and humans, the first and obligatory step in the activation of arylamines is N-hydroxylation. This pathway is primarily mediated by the phase-I enzymes CYP1A1, CYP1A2 and CYP4B1. In the presence of flavonoids such as alpha-naphthoflavone and flavone, both CYP3A4 and CYP3A5 have also been shown to play a minor role in the activation of food-derived heterocyclic amines. The further activation of N-hydroxyarylamines by phase-II metabolism can involve both N, O-acetylation and N, O-sulfonation catalyzed by N-acetyltransferases (NAT1 and NAT2) and sulfotransferases, respectively. Using an array of techniques, we have been unable to detect constitutive CYP1A expression in any segments of the human gastrointestinal tract. This is in contrast to the rabbit where CYP1A1 protein was readily detectable on immunoblots in microsomes prepared from the small intestine. In humans, CYP3A3/3A4 expression was detectable in the esophagus and all segments of the small intestine. Northern blot analysis of eleven human colons showed considerable heterogeneity in CYP3A mRNA between individuals, with the presence of two mRNA species in some subjects. Employing the technique of hybridization histochemistry (also known as in situ hybridization), CYP4B1 expression was observed in some human colons but not in the liver or the small intestine. Hybridization histochemistry studies have also demonstrated variable NAT1 and NAT2 expression in the human gastrointestinal tract. NAT1 and NAT2 mRNA expression was detected in the human liver, small intestine, colon, esophagus, bladder, ureter, stomach and lung. Using a general aryl sulfotransferase riboprobe (HAST1), we have demonstrated marked sulfotransferase expression in the human colon, small intestine, lung, stomach and liver. These studies demonstrate that considerable variability exists in the expression of enzymes involved in the activation of aromatic amines in human tissues. The significance of these results in relation to a role for heterocyclic amines in colon cancer is discussed.
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PMID:The role of xenobiotic metabolizing enzymes in arylamine toxicity and carcinogenesis: functional and localization studies. 920 51

A combined aortectomy was performed on a patient with recurrence of sigmoid colon cancer in the paraaortic lymph nodes. The 48-year-old woman was found to have tumor recurrence in the lymph nodes in the area between the aortic bifurcation and the paraaortic area, accompanied by left hydronephrosis, four years after surgery for sigmoid colon cancer (H0, P0, ss, n3, stage IIIb). No metastasis to distant areas was detected at that time. The woman thus underwent a reoperation. Intraoperatively, the aortic bifurcation and the lymph nodes were seen as a mass. The mass involved the left common iliac vein and the left ureter, as well. Therefore, we resected the area from the aortic bifurcation to the bilateral common iliac arteries, the left common iliac vein, the left ureter and the left kidney en bloc, and replaced them with a Y-shaped graft. One year after the reoperation, a tumor metastasis to the liver was detected, and a partial hepatectomy was performed. At present, the patient is being managed at our outpatient clinic. The results suggest that extended resection, involving the aorta as well, is sometimes useful when dealing with tumor recurrence in the paraaortic lymph nodes, unaccompanied by blood-borne metastasis.
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PMID:[A case of a combined aortectomy with dissection of recurrent paraaortic lymph nodes of sigmoid colon cancer]. 1108 64

A 49-year-old woman was admitted with profuse bleeding from the urostoma. She had been treated for a gynaecological and colon cancer and had a sigmoidostomy, an ileal conduit, and bilateral ureteral stents. Perioperatively, an aorto-ureteral fistula was found at the cross-point between the left ureter and the aorta. Strictures and fistulae are generally caused by ischaemia, radiation therapy, urinary leak, or infection. Surgery and ureteral stenting are the major risk factors. The optimal investigation is a retrograde pyelogram with digital subtraction angiography.
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PMID:[Aorto-ureteral fistula. A rare cause of hematuria]. 1137 16

MMR gene mutations and MSI are not found in all clinically diagnosed HNPCC families. We evaluated whether MMR genotyping and tumor MSI analysis could identify distinct clinical subgroups among HNPCC families. Twenty-nine clinical HNPCC families were divided into 3 groups: A, families with hMLH1 or hMSH2 gene mutations; B, MMR gene mutations not present but MSI present in at least 50% of tumors tested; C, mutational and MSI analyses negative. We evaluated tumor spectrum, age at onset, risk of cancer in the follow-up and survival for CRC in the 3 groups. Tumors of the target organs in HNPCC (colon and rectum, endometrium, ovary, small bowel, stomach, renal pelvis and ureter) were more frequent in the first 2 groups than in the latter. Colon cancer was more frequently located in the proximal colon and showed an earlier age at onset in families with MMR gene mutation or with MSI than in families with stable tumors. Comparing the occurrence of tumors in the follow-up, in the first 2 groups patients younger than 50 years had a higher RR, which was particularly marked for CRC (RR = 18.6 for group A vs. group C, RR = 16.7 for group B vs. group C). CRC patients in the first 2 groups had a better clinical prognosis. The results of molecular analysis could distinguish, within clinically defined HNPCC families, different subgroups to which specific programs of surveillance could be addressed.
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PMID:Clinical and biologic heterogeneity of hereditary nonpolyposis colorectal cancer. 1149 33

The metastasis sites of colon cancer are the liver, lungs, bones, peritoneum, and lymph nodes. Lymph node recurrences, however, are seldom resected metachronously. We report here a case of en-bloc resection of paraaortic lymph node recurrence together with the invaded abdominal aorta, left kidney and ureter 4 years after curative resection of sigmoid colon cancer. Combined resection of the metastatic lymph nodes and the abdominal aorta would be an even more radical procedure and treatment for cancer because of lymphatic spread around the aorta. The slow growth of the cancer might justify this aggressive resection. This is the first report of resection of late paraaortic lymph node metastasis and simultaneous abdominal aortic graft replacement.
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PMID:Resection of paraaortic lymph node metastasis of colon cancer with graft replacement. 1282 66

Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant disorder characterized by an excess of extracolonic malignancies including those of the urinary tract. We report a case of metachronous bilateral ureteral cancer associated with HNPCC. A 51-year-old man was referred to Nara National Hospital for further examination of left hydronephrosis on excretory urography performed on the periodical follow-up for colon cancer. Computed tomography showed a mass in the left lower ureter and urine cytology was demonstrated class V. The operation was performed under the diagnosis of left ureteral cancer. The histopathological diagnosis was transitional cell carcinoma, grade 2, pT1. After 4 months of the operation, he presented with gross hematuria. Retrograde pyelography demonstrated tumors in the right side (ureter and renal pelvis) and the histopathological diagnosis of the biopsy specimens revealed transitional cell carcinoma, grade 2. We performed 4 times of BCG instillation followed by laser ablation of the tumor. The reported case was compatible for Japanese clinical criteria, group B for HNPCC.
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PMID:[Metachronous bilateral ureteral cancer in patient with hereditaly nonpolyposis colorectal cancer]. 1497 44


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