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Surg Case Rep ; 8(1): 2, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982288


BACKGROUND: Perforation of the ileal J-pouch after restorative proctocolectomy and ileal pouch-anal anastomosis are extremely rare. There has been no report of perforation of the ileal J-pouch occurring twice over several years. We report the first case of perforation at 6 and 18 years following restorative proctocolectomy. CASE PRESENTATION: The patient was a 52-year-old man who underwent a two-stage restorative proctocolectomy with a hand-sewn ileal J-pouch anal anastomosis due to familial adenomatous polyposis and sigmoid colon cancer at 34 years of age. At the age of 40, he underwent ileal pouch resection at its blind end, abdominal drainage, and anastomotic dilatation. The patient had a perforation of the blind end of the ileal J-pouch from increased intraluminal pressure, with anastomotic stricture and pervasive peritonitis. The patient had no symptoms for a few years; however, 18 years after the initial surgery and 12 years after the first perforation, the patient presented with severe abdominal pain. Computed tomography demonstrated pneumoperitoneum; accordingly, laparotomy was performed. Upon opening the abdominal cavity, contaminated ascites and inflammatory changes were documented involving the ileum. A 2-mm perforation involving the blind end of the ileal J-pouch was also observed and repaired, followed by temporary loop ileostomy creation. Postoperative endoscopy revealed an ulcer in the ileal J-pouch and a stricture located directly at the anastomosis. CONCLUSIONS: The blind end of the J-pouch repeatedly perforated over the years due to recurrent anastomotic stricture. Regular surveillance is, therefore, considered necessary for the release of stricture, maintenance of anastomotic patency, and prevention of ileal J-pouch perforation.

Int J Surg Case Rep ; 19: 4-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26701843


INTRODUCTION: Anorectal abscess is one of the most common anorectal conditions encountered in practice. However, such abscesses may rarely extend upward and cause life-threatening medical conditions. PRESENTATION OF CASE: A 53-year-old woman presented with symptoms of anorectal abscess and evidence of severe inflammatory response and acute kidney injury. Computed tomography revealed a widespread abscess extending to the bilateral retroperitoneal spaces. Surgical drainage was performed via a totally extraperitoneal approach through a lower midline abdominal incision, and the patient had a rapid and uncomplicated recovery. DISCUSSION: Although retroperitoneal abscesses originating from the anorectal region are rare, they are life-threating events that require immediate treatment. Percutaneous abscess drainage has been recently evolved; however, surgical drainage is required sometimes that may be challenging, particularly in the case of widespread abscesses, as in our case. CONCLUSION: The midline extraperitoneal approach reported here might be an effective surgical option for patients with bilateral widespread retroperitoneal abscesses.

Exp Ther Med ; 1(5): 833-839, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22993607


To facilitate the development of a peptide-based cancer vaccine for prostate cancer patients, we examined whether any of the 13 peptides previously reported to induce HLA-class I-restricted cytotoxic T lymphocyte (CTL) activity in HLA-A3 supertype (-A3, -A11, -A31 and -A33)-positive prostate cancer patients are also capable of inducing CTLs restricted to HLA-A2, HLA-A24 or HLA-A26 alleles. Among the 13 peptides tested, a peptide at positions 309 to 318 of ß-tubulin 5 exhibited binding activity to the HLA-A(*)2402 molecule and induced HLA-A24-restricted CTL activity against prostate cancer cells derived from peripheral blood mononuclear cells of prostate cancer patients. The CTL activity was determined to be specific to this peptide and was mediated by CD8(+) T cells in an HLA-class I-restricted manner. These results suggest that this peptide could be applicable as a peptide vaccine, not only for HLA-A3 supertype-positive, but also for HLA-A24-positive prostate cancer patients.

Cancer Sci ; 100(11): 2167-74, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19689476


One-fifth of the Japanese population is positive for HLA-A26, but few peptides are available as potential cancer vaccines for HLA-A26-positive cancer patients. The objective of this study was to identify peptide vaccine candidates for HLA-A26-positive cancer patients. The HLA-A*2601-crossbinding activity of 24 peptides currently under clinical trial as vaccines for HLA-A2, -A24, or HLA-A3 supertype-positive cancer patients was evaluated by stabilization assay. Three peptides with HLA-A2-binding activity could bind the HLA-A*2601 molecule. These three peptides induced HLA-A26-restricted cytotoxic T lymphocytes from HLA-A*2601-, -A*2602-, or -A*2603-positive prostate cancer patients against HLA-A*2601- and HLA-A*2603-positive cancer cells in CD8-dependent and peptide-specific manners. In addition, one peptide with HLA-A24-binding activity could bind to HLA-A*2601 and induced HLA-A26-restricted cytotoxic T lymphocytes from HLA-A*2601-, -A*2602-, or -A*2603-positive prostate cancer patients against HLA-A*2603-positive cancer cells. These results may provide novel information for the development of a peptide-based cancer vaccine for HLA-A26-positive patients.

Vacinas Anticâncer/imunologia , Antígenos HLA-A/imunologia , Neoplasias/imunologia , Animais , Linhagem Celular Tumoral , Antígenos HLA-A/análise , Antígeno HLA-A2/análise , Antígeno HLA-A2/imunologia , Antígeno HLA-A24 , Humanos , Camundongos , Linfócitos T Citotóxicos/imunologia
Cancer Immunol Immunother ; 58(11): 1877-85, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19330328


We previously reported peptide vaccine candidates for HLA-A3 supertype (-A3, -A11, -A31, -A33)-positive cancer patients. In the present study, we examined whether those peptides can also induce cytotoxic T lymphocyte (CTL) activity restricted to HLA-A2, HLA-A24, and HLA-A26 alleles. Fourteen peptides were screened for their binding activity to HLA-A*0201, -A*0206, -A*0207, -A*2402, and -A*2601 molecules and then tested for their ability to induce CTL activity in peripheral blood mononuclear cells (PBMCs) from prostate cancer patients. Among these peptides, one from the prostate acid phosphatase protein exhibited binding activity to HLA-A*0201, -A*0206, and -A*2402 molecules. In addition, PBMCs stimulated with this peptide showed that HLA-A2 or HLA-A24 restricted CTL activity. Their cytotoxicity toward cancer cells was ascribed to peptide-specific and CD8+ T cells. These results suggest that this peptide could be widely applicable as a peptide vaccine for HLA-A3 supertype-, HLA-A2-, and -A24-positive cancer patients.

Fosfatase Ácida/imunologia , Antígenos HLA-A/imunologia , Antígeno HLA-A2/imunologia , Antígeno HLA-A3/imunologia , Fragmentos de Peptídeos/imunologia , Próstata/enzimologia , Linfócitos T Citotóxicos/imunologia , Alelos , Linhagem Celular Tumoral , Testes Imunológicos de Citotoxicidade , Antígenos HLA-A/genética , Antígeno HLA-A2/genética , Antígeno HLA-A24 , Humanos , Masculino
Int J Oncol ; 34(2): 529-36, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19148489


We previously reported the SART3 gene to be a tumor-rejection antigen gene encoding a peptide at positions 109-118 (SART3(109-118)) with the ability to induce HLA-A24-restricted cytotoxic T lymphocytes. In this study, we investigated both humoral and cellular responses to this peptide in cancer patients with alleles other than HLA-A24 to explore the possibility of using this peptide as a cancer vaccine for these patients. IgG reactive to SART3(109-118) peptide was identified in sera of the vast majority of non-cancer subjects (n=50) and all cancer patients (n=50) tested without apparent HLA-A association. Levels of anti-SART3(109-118) peptide antibody in cancer patients were significantly higher than those of non-cancer subjects, but no difference was found between HLA-A24+A2- and HLA-A24-A2+ cancer patients. This peptide induced cancer cell-reactive cytotoxic T lymphocytes from peripheral blood mononuclear cells of both healthy donors and prostate cancer patients with HLA-A11, HLA-A31 and HLA-A33 alleles, but not with HLA-A2. These results suggest that this peptide can be applicable as a cancer vaccine not only for HLA-A24+, but also for HLA-A11+, HLA-A31+ and HLA-A33+ prostate cancer patients.

Antígenos de Neoplasias/química , Antígenos de Neoplasias/fisiologia , Antígenos de Histocompatibilidade Classe I/genética , Fragmentos de Peptídeos/imunologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/imunologia , Proteínas de Ligação a RNA/química , Proteínas de Ligação a RNA/fisiologia , Linfócitos T Citotóxicos/imunologia , Actinas/genética , Sequência de Aminoácidos , Linhagem Celular Tumoral , Primers do DNA , Antígenos HLA-A/genética , Antígenos HLA-A/imunologia , Humanos , Imunoglobulina G/imunologia , Leucócitos Mononucleares/imunologia , Masculino , Fragmentos de Peptídeos/farmacologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa