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Biomedical subjects

A Nakagawa

Publications and source records attributed to A Nakagawa.

At least 19 recordsLinked to original sources

Gender differences in attitudes toward AIDS clinical trials among urban HIV-infected individuals from racial and ethnic minority backgrounds.

Racial/ethnic minorities and women are under-represented in AIDS clinical trials (ACTs). We examined gender differences in willingness to participate in ACTs among urban HIV-infected individuals (N = 286). Sixty percent of participants were male, and most were from racial/ethnic minority backgrounds (55% African-American, 34% Latino/Hispanic, 11% White/other). Knowledge of ACTs was poor. Males and females did not differ substantially in their distrust of AIDS scientists, or in barriers to ACTs. Almost all (87%) were somewhat or very willing to join ACTs. Females were less willing than males to join, including trials testing new medications or new medication combinations. Males and females differed in correlates of willingness to participate in ACTs. Despite long-standing barriers to medical research among minorities and women, willingness to participate was substantial, particularly for men, although the factors that might motivate them to join differed by gender. Women appeared more averse to trials involving new anti-retroviral regimens than men. Gender-specific outreach, behavioural intervention, and social marketing efforts are needed.

Adult↗

Development of shock wave assisted therapeutic devices and establishment of shock wave therapy.

In order to exploit systems for shock wave therapy, we are working for the development of clinical devices that are based on the concept of shock waves or related phenomena. The paper describes these new therapeutic devices designed for the minimally invasive approach to vascular thromboloysis, selective dissection of tissues, and drug or DNA delivery. To investigate the response of cells to shock loading, a precise method of shock waves generation in space and time has been developed. This method has been studied for application in cardiovascular therapy, cancer treatment, and cranioplasty in close vicinity of the brain. A laser ablation shock wave assisted particle acceleration device has been developed for delivering drug and DNA into soft targets in the human body. The penetration depth of microparticles observed in the experimental targets is believed to be sufficient for pharmacological treatments. In order to achieve an efficient method for rapid revascularization of cerebral thrombosis, a laser induced liquid jet (LILJ) system has been developed. The LILJ has been successfully applied for selective dissection of soft tissue preserving nerve and blood vessels. The system has been further improved by using piezoelectric actuators to drive the liquid jets, as an alternative to pulse laser.

Animals↗

Energy expenditure during walking in amputees after disarticulation of the hip. A microprocessor-controlled swing-phase control knee versus a mechanical-controlled stance-phase control knee.

We have compared the energy expenditure during walking in three patients, aged between 51 and 55 years, with unilateral disarticulation of the hip when using the mechanical-controlled stance-phase control knee (Otto Bock 3R15) and the microprocessor-controlled pneumatic swing-phase control knee (Intelligent Prosthesis, IP). All had an endoskeletal hip disarticulation prosthesis with an Otto Bock 7E7 hip and a single-axis foot. The energy expenditure was measured when walking at speeds of 30, 50, and 70 m/min. Two patients showed a decreased uptake of oxygen (energy expenditure per unit time, ml/kg/min) of between 10.3% and 39.6% when using the IP compared with the Otto Bock 3R15 at the same speeds. One did not show any significant difference in the uptake of oxygen at 30 m/min, but at 50 and 70 m/min, a decrease in uptake of between 10.5% and 11.6% was found when using the IP. The use of the IP decreased the energy expenditure of walking in these patients.

Artificial Limbs↗

Pathology review for paediatric non-Hodgkin's lymphoma patients in Japan; a report from the Japan association of childhood leukaemia study (JACLS).

A central pathology review system with an immunophenotyping laboratory was established in Japan to support the clinical trial, the Japan Association of Childhood Leukaemia Study (JACLS) NHL-98, for patients with paediatric non-Hodgkin's lymphoma (NHL). Pathology samples from 155 clinically-suspected NHL cases were evaluated centrally initially using the Revised European-American Lymphoma (REAL) classification in a rapid review (within 2 weeks after surgery/biopsy) and then later at the consensus review (once a year). The samples were subsequently re-classified according to the new World Health Organisation (WHO) classification. After the pathology review, 96 (62%) patients were eligible for the study, and 58 of them (60%) had extra-nodal primaries. These NHL cases included B-cell lymphomas (precursor B-cell, 11; Burkitt, 18; diffuse large B-cell, 18; not otherwise specified, 3) and T/Natural Killer (NK)-cell lymphomas (precursor T-cell, 23; anaplastic large cell, 20; others, 3). There was excellent concordance in making the diagnoses (95/96, 99%) and typing (93/96, 97%) of NHL between the rapid and consensus reviews. Five cases, initially diagnosed as diffuse large B-cell lymphoma by the review, were re-classified as Burkitt lymphoma according to the immunocytochemical criteria by the WHO classification. A total of 59 (38%) cases were excluded from the study: they were Hodgkin lymphoma (7), leukaemias (11), reactive lymphoid hyperplasia (20), necrotizing lymphadenitis (7), no consensus diagnosis (1), insufficient materials (2), and others (11). This is the first report of the central pathology review from the paediatric NHL group study in Japan. Because various diseases, either neoplastic or reactive, mimicked NHL, clinically and histopathologically, the central pathology review system was critical and essential for patient enrollment and protocol assignment in our clinical trial. Through the two-step review system, highly reliable data were generated to support this study.

Adolescent↗

Use of intraoperative dynamic infrared imaging with detection wavelength of 7-14 microm in the surgical obliteration of spinal arteriovenous fistula: case report and technical considerations.

BACKGROUND AND OBJECTIVE: Although improvements of spatial and temporal resolution in infrared (IR) imaging have enabled intraoperative real-time acquisition of physiological and pathological information on living organs, the imaging qualities of anatomical delineation of blood vessels and functional delineation of blood flow were insufficient to serve as visual monitoring. The main reason was partly due to the lack of an appropriate IR detection IR band (formerly 3 - 5 micro m), and the broad dynamic range in previous modalities. METHODS: To make a good contrast between blood vessels and surrounding tissues, the detection wavelength was shifted to the long-wave (7 - 14 micro m) part of IR spectrum, which includes the peak IR wave from living tissue (9 - 10 micro m), and the dynamic range was confined to +/- 10 degrees C around 35 degrees C. The novel camera system (IRIS IV infrared imaging system) was used for the visual monitoring of blood flow during the obliteration of a spinal perimedullary arteriovenous fistula at Th 7 in 71-year-old male patient. The temperature resolution of camera was 0.15 degrees C, with its intensity resolution of 16 bit (320 x 240 pixels), and data were stored at a rate of 30 frames/second. High-quality delineation of blood vessels and blood flow was obtained all through the procedure without use of cold saline, which was an inevitable procedure to make contrast in the previously used thermography. However, the occasional use of an air blower was helpful to achieve adequate images in the deep and narrow area of the surgical field. The amount of shunt flow reduction was visualized by the intensity in the acquired imaging, which was also confirmed later by digital subtraction angiography. CONCLUSION: From the present experience, it is considered that this type of imaging may be able to substitute intraoperative blood vessel and blood flow monitoring in spinal and other neurosurgical disorders.

Aged↗

Usefulness of constructive interference in steady state (CISS) imaging for the diagnosis and treatment of a large extradural spinal arachnoid cyst.

We present a rare case of a symptomatic large extradural arachnoid cyst extending from the lower thoracic to sacral region in a 12-year-old boy, who presented with the signs and symptoms of spinal cord compression over 4 years. Since the pedicle of the cyst could not be delineated using conventional magnetic resonance imaging (MRI), cine-mode MRI, and computed tomography scan, partial resection of the cyst was initially performed, which significantly improved motor function. After the first operation, a single pedicle was clearly demonstrated by 3D constructive interference in steady state (CISS) MRI. Thus, additional surgery aimed at closing the dural defect was performed to prevent future enlargement of the cyst. The operative findings were consistent with those of 3D CISS imaging. Clinical and radiological features of this lesion are discussed, focusing on the usefulness of 3D CISS MRI for preoperative evaluation, and especially for delineating the pedicle in cases of large extradural spinal arachnoid cysts.

Arachnoid Cysts↗

Vestibular function and vasopressin.

OBJECTIVE: To investigate the relation between the vestibular system and vasopressin (AVP). MATERIAL AND METHODS: We examined the effects of electrical and caloric vestibular stimulation on plasma AVP levels in anesthetized rats. Plasma AVP levels of patients with intractable Ménière's disease who were subjected to endolymphatic drainage and steroid instillation surgery (EDSS) or intratympanic gentamicin (GM) injection were measured before and after these interventions. RESULTS: Electrical vestibular stimulation increased plasma AVP levels in a current intensity-dependent manner. Plasma AVP levels were also increased by caloric stimulation with cold water. Plasma AVP levels decreased rapidly after EDSS, and were maintained at a low level even 6-12 months following EDSS or intratympanic GM injection. CONCLUSIONS: Vestibular activation or inhibition-induced imbalance of intervestibular activities increased plasma AVP levels in rats. Therefore, vestibular disorder would seem to increase plasma AVP and thus worsen endolymphatic hydrops. EDSS rapidly decreased plasma AVP and would seem to reduce hydrops. Inhibition of vertigo spells by EDSS or intratympanic GM injection would reduce a possible stress response, resulting in a decrease in plasma AVP levels a long time after the treatments. This resultant decrease in AVP would beneficially inhibit the formation and/or maintenance of hydrops and thus prevent vertigo spells.

Animals↗

Cyclooxygenase-2 is a possible target of treatment approach in conjunction with photodynamic therapy for various disorders in skin and oral cavity.

BACKGROUND: Anti-cancer effects of cyclooxygenase (COX)-2 inhibitors have been reported, but not fully investigated in skin and oral diseases. 5-aminolaevulinic acid (ALA)-based photodynamic therapy (PDT) for treating those patients with skin and oral lesions is a highly sophisticated procedure, but the incidence of disease recurrence after treatment is rather significant. OBJECTIVE: To confirm that COX-2 could be a molecular target in adjunctive therapy to ALA-based PDT, we investigated (i) COX-2 expression in various skin and oral diseases, and (ii) the inhibitory effects on cellular growth of COX-2 selective inhibitor (nimesulide), ALA-based PDT and their combination on human oral squamous cell carcinoma (SCC) cell lines. METHODS: A total of 129 biopsy samples from the skin and oral mucosal lesions were tested immunohistochemically for COX-2 expression. Then the in vitro effects of nimesulide, ALA-based PDT, and their combination were determined on two SCC cell lines, HSC-2 and HSC-4. Three different methods (MTT assay, double-staining for annexin V and propidium iodide, caspase-3/CPP32 fluorometric protease assay) were applied for evaluation of their inhibitory effects on these two cell lines. RESULTS: Among the skin diseases, a considerable number of COX-2 high expressers were found in actinic keratosis (15 of 25, 60%), Bowen's disease (13 of 17, 76%) and extramammary Paget's disease (15 of 15, 100%). In contrast, only one of 33 (3%) basal cell carcinoma tumours was a COX-2 high expresser. Among the oral mucosal biopsies, the proportion of COX-2 high expressers increased gradually from hyperplasia (one of six, 17%) through mild dysplasia (five of eight, 63%) and moderate dysplasia (20 of 23, 87%) to severe dysplasia (two of two, 100%). Nimesulide had an inhibitory effect in vitro on HSC-2 (proven to be a COX-2 high expresser), but not on HSC-4 (a COX-2 non-expresser). While ALA-based PDT showed an inhibitory effect on both HSC-2 and HSC-4, most importantly the combination of nimesulide and ALA-based PDT demonstrated a significant synergistic effect on the cellular growth inhibition of only HSC-2, but not of HSC-4. CONCLUSIONS: Our study strongly suggests that COX-2 can be one of the molecular targets in treating various skin and oral diseases. The results from our in vitro experiments also prompt us to develop a new protocol with a combination of COX-2 selective inhibitor and ALA-based PDT for more effective treatment of those diseases.

Aminolevulinic Acid↗

Pulsed liquid jet dissector using holmium:YAG laser--a novel neurosurgical device for brain incision without impairing vessels.

BACKGROUND: Neurosurgery has long required a method for dissecting brain tissue without damaging principal vessels and adjacent tissue, so as to prevent neurological complications after operation. In this study we constructed a prototype of such a device and used it in an attempt to resect beagle brain cortex. METHOD: The prototype device consisted of an optical fibre, a Y adaptor, and a nozzle whose internal exit diameter was 100 microm. Cold physiological saline (4 degrees C) was supplied to it at a rate of 40 ml/h. Pulsed liquid jets were ejected from the nozzle by a pulsed Holmium:YAG) (Ho:YAG) laser at an irradiation energy of 300 mJ/pulse. The profile of the liquid jet was observed with a high-speed camera while changing the distance between the optical fibre end and nozzle exit (equivalent to the standoff distance). With this device (3 Hz operation), brain dissection of anaesthetized beagles was attempted while measuring the local temperature of the target. A histological study of the incised parts was also performed. FINDINGS: When the standoff distance was 24 mm, the liquid jet was emitted straight from the nozzle at a maximum initial velocity of 50 m/s. The brain parenchyma was cut with this device while preserving vessels larger than 200 microm in diameter and keeping the operative field clear. The local temperature rose to no more than 41 degrees C, below the functional heat damage threshold of brain tissue. Histological findings showed no signs of thermal tissue damage around the dissected margin. INTERPRETATION: The Ho:YAG laser-induced liquid jet dissector can be applied to neurosurgery after incorporating some minor improvements.

Animals↗

Holmium:YAG laser-induced liquid jet dissector: a novel prototype device for dissecting organs without impairing vessels.

BACKGROUND AND OBJECTIVE: Neurosurgery has long required a method for dissecting brain tissue without damaging principal vessels and adjacent tissue, so as to prevent neurological complications after operation. In this study we fabricated such a prototype device and used it in an attempt to resect an animal liver, which, like the brain, contains many vessels. MATERIALS AND METHODS: The prototype device consisted of a jet nozzle and a suction tube. Pulsed liquid jets at 3 Hz were ejected from the nozzle by a pulsed holmium:YAG (Ho:YAG) laser at an irradiation energy of 230 mJ/pulse. The profile of the liquid jet was observed with a high-speed camera. With this device, liver dissections of anesthetized rabbits were attempted while measuring the local temperature of the target. A histological study of the incised parts was also performed. RESULTS: The liquid jet was emitted straight from the nozzle at an initial velocity of 38 m/sec. The liver parenchyma was cut with the device while preserving the tiny vessels and keeping the operative field clear. The local temperature rose to no more than 314 K (below the heat damage threshold of brain tissue). In the histological findings, there were no signs of hepatic degeneration or necrosis around the dissected margin. CONCLUSIONS: The Ho:YAG laser-induced liquid jet dissector can be applied to neurosurgical operations after incorporating some minor improvements.

Animals↗

Intraoperative thermal artery imaging of an EC-IC bypass in beagles with infrared camera with detectable wave-length band of 7-14 microm: possibilities as novel blood flow monitoring system.

OBJECTIVE: In the past, the usefulness of thermal arterial imaging during coronary bypass surgery using an infrared camera has been reported by several investigators. The goal of this study is to apply this novel imaging system for intraoperative arterial imaging, as well as to develop new utilizations for a neurosurgical procedure. MATERIALS: We have attempted real-time imaging of anastomotic and flow status in an external carotid-internal carotid artery (EC-IC) bypass surgery using a new-generation infrared camera (IRIS IV thermographic imaging system) in beagles. No contrast medium or radiation was used to obtain the images. The detectable wave-length band of the infrared lens was 7-14 microm. After completion of bypass monitoring, an additional teflon tube was inserted into a branch of the STA to inject physiological saline of different temperatures to see the changes in cortical images. RESULTS: Anastomotic and flow status were clearly visualized throughout the operation without local surface cooling, which had been an inevitable procedure in coronary imaging to make a pronounced temperature difference between artery and adjacent tissue. In addition, cortical flow territory was visualized after injection of either cold or warm physiologic saline into the artery from an additionally inserted teflon tube into a branch of STA via bypass artery. CONCLUSION: From the present experience, it is considered that infrared imaging using a detectable wave length band of 7-14 microm may be applicable to a wide variety of near surface lesions, providing a non-invasive functional angiography.

Animals↗

Clinical outcome following ultra-early operation for patients with intracerebral hematoma from aneurysm rupture--focussing on the massive intra-sylvian type of subarachnoid hemorrhage.

Of 250 patients admitted with aneurysmal subarachnoid hemorrhage (SAH) from 1994 to 2000, 16 had massive intra-sylvian hematomas. To predict the useful determinants of the clinical outcome for such patients we analyzed our last 16 cases. The study was performed in 2 parts. Part 1 covered the period from 1994 to 1996 and included 5 patients who underwent early surgery. Immediately before operation, Hunt & Kosnik grade (H&K) III was observed in 1, IV in 3 and V in 1 patient. Part 2, from 1997 to 2000, included 11 patients who underwent ultra-early surgery (within 3 hours after admission) with ventriculostomy and with 2 weeks' postoperative management in the ICU. Preoperatively, there were 2 patients with H&K III, 7 with IV, and 2 with V. The results in part 1 showed that 3 out of the 5 patients had poor outcome with symptomatic vasospasm. While in Part 2, seven returned to work, 2 had minimal and 1 had severe neurological deficits with symptomatic vasospasm, and 1 died. We therefore suggest that ultra-early surgery with ventriculostomy and postoperative management in the ICU is the most useful determinant to improve the clinical outcome in the treatment of SAH patients with massive intra-sylvian hematoma.

Aged↗

%VO2max as an indicator of prosthetic rehabilitation outcome after dysvascular amputation.

In this study, independent ambulation of at least 100 metres with/without a cane was regarded as successful prosthetic rehabilitation. The subjects were classified into two groups according to this criterion at the time of discharge. The successful group attained this performance, the other group failed to reach this level. The successful group included 8 unilateral trans-femoral amputees aged 72.2 +/- 2.1 years who underwent amputation at more than 70 years, and succeeded in walking with a prosthesis. The group which failed included 9 unilateral trans-femoral amputees aged 63.2 +/- 2.1 years who underwent amputation between the ages of 60-65 years, and had great difficulty in walking with a prosthesis. The purpose of this research was to investigate whether or not %VO2max as an indicator of physical fitness is useful in predicting prosthetic rehabilitation outcome after dysvascular amputation by comparing these two groups. Evaluation of physical fitness was conducted before the subjects began prosthetic rehabilitation. Information about each subject before fitting with a prosthesis was collected retrospectively from clinical charts made during admission. The successful group were capable of strenuous exercise, reaching the intensity of 50% VO2max or more. In the group which failed only one reached the intensity of 50% VO2max. The working capacity of 50% VO2max or greater would appear to be a valid initial guideline level of physical fitness at which an amputee can expect to succeed in walking with a prosthesis. Apart from physical fitness, a lesser number of comorbidity, good ability to stand on the remaining leg, and a strong will to walk were found to be important factors contributing to successful prosthetic rehabilitation. This study also showed that age alone was not an important factor.

Aged↗

International neuroblastoma pathology classification for prognostic evaluation of patients with peripheral neuroblastic tumors: a report from the Children's Cancer Group.

BACKGROUND: The International Neuroblastoma Pathology Classification was established in 1999 for the prognostic evaluation of patients with neuroblastic tumors (NTs). METHODS: Pathology slides from 746 NTs (the Children's Cancer Group [CCG]-3881 and CCG-3891 studies) were evaluated according to the International Classification. First, prognostic effects of the morphologic indicators (grade of neuroblastic differentiation: undifferentiated [U], poorly differentiated [PD] and differentiating [D]; and mitosis-karyorrhexis index [MKI]: low [L-MKI], intermediate [I-MKI], and high [H-MKI]) for tumors in the neuroblastoma (NB) category were tested. Then, prognostic significance of the International Classification for all NTs in four categories (neuroblastoma [NB]; ganglioneuroblastoma, intermixed [GNBi]; ganglioneuroma [GN]; and ganglioneuroblastoma, nodular [GNBn]) was analyzed. Finally, age distribution of the patients in the four categories as well as three subtypes (based on the grade of differentiation) in the NB category was compared. RESULTS: There were 630 NB tumors, 30 GNBi tumors, 10 GN tumors, and 76 GNBn tumors. In the NB category, prognostic effects of the indicators (three grades of differentiation and three mitosis-karyorrhexis index [MKI] classes: low [L], intermediate [I], and high [H]) were affected significantly by the age of the patients. The age-linked evaluation of the indicators according to the International Classification successfully distinguished two prognostic subgroups: the favorable histology (FH) subgroup (PD/D and L/I-MKI tumors in patients age < 1.5 years, D and L-MKI tumors in patients ages 1.5-5.0 years; 90.4% 5-year event free survival [EFS]) and the unfavorable histology (UH) subgroup (U and/or H-MKI tumors in patients of any age, PD and/or I-MKI tumors in patients ages 1.5-5.0 years, any grade of differentiation, and any MKI class in patients age > or = 5 years; 26.9% EFS) (P < 0.0001). The International Classification also distinguished the FH group (FH subgroup with NB, GNBi, and GN tumors) and the UH group (UH subgroup with NB and GNBn tumors) for all NTs (90.8% EFS and 31.2% EFS, respectively; P < 0.0001) and provided independent prognostic information on both patient age and disease stage (P < 0.0001). Among patients with FH tumors, the median ages of patients with the PD and D subtype tumors in the NB category were 0.43 years (range, 0-1.50 years) and 1.50 years (range, 0.02-4.65 years), respectively, and the median ages of patients with GNBi and GN tumors were 3.51 years (range, 0.96-14.85 years) and 4.80 years (range, 1.94-17.05 years), respectively. In contrast, patients with UH tumors generally were older when they were diagnosed, and with median ages of 2.99 years (range, 1.30-8.84 years) for patients with U subtype tumors, 2.59 years (range, 0.0-12.57 years) for patients with PD subtype tumors, 2.16 years (range, 0.35-9.90) for patients with D subtype tumors, and 3.26 years (range, 0.57-15.90 years) for patients with GNBn tumors. CONCLUSIONS: This study confirmed the prognostic significance of the International Classification, substantiated age-linked prognostic effects of the morphologic indicators for patients with the tumors in the NB category, and supported the concept of an age-appropriate framework of maturation for patients with the tumors in the FH group.

Adolescent↗

Opsoclonus-myoclonus-ataxia syndrome in neuroblastoma: histopathologic features-a report from the Children's Cancer Group.

BACKGROUND: Opsoclonus-myoclonus-ataxia (OMA) is a paraneoplastic syndrome that occurs in about 2-3% of all cases of neuroblastoma. The histopathologic characteristics of neuroblastoma tumors associated with this syndrome were evaluated in a series of cases and controls. PROCEDURE: Pathology slides from a total of 54 neuroblastoma tumors were reviewed blindly. They included 13 tumors associated with opsoclonus-myoclonus and 41 age- and stage-matched controls. All tumors were classified into either the favorable (FH) or unfavorable histology (UH) group according to the International Neuroblastoma Pathology Classification (the Shimada system). Grade of lymphocytic infiltration was evaluated and presence or absence of lymphoid follicles was recorded in the individual tumor tissues. RESULTS: Twelve of 13 cases with opsoclonus-myoclonus were in the FH group. Twelve of 13 cases had diffuse (found in every section prepared from the multiple portions of the primary tumor) and extensive (occupying more than 50% of a single of multiple microscopic fields with x 100 magnification) lymphocytic infiltration with lymphoid follicles. Of the 41 control cases (27 FH and 14 UH tumors), 18 had focal areas of lymphocytic infiltration and six showed lymphoid follicles, but none had diffuse or extensive infiltration in their primary tumors. CONCLUSIONS: Diffuse and extensive lymphocytic infiltration with lymphoid follicles is a characteristic histologic feature of neuroblastic tumors with opsoclonus-myoclonus. This observation suggests an immune-mediated mechanism for this rare paraneoplastic syndrome.

Adolescent↗

Immunohistochemical analysis of distribution of RON receptor tyrosine kinase in human digestive organs.

The immunohistochemical distribution of RON receptor tyrosine kinase in digestive organs of both human fetus and adult, including the esophagus, stomach, duodenum, small intestine, colon, rectum, liver, gallbladder, pancreas, and spleen, was investigated semiquantitively using an affinity-purified rabbit polyclonal antibody. RON was observed to be widely distributed throughout various digestive organs and cell types in humans. The immunoreactivity for RON was observed in the epithelium of the esophagus, small intestine, colon, hepatocytes, Kupffer cells, and splenic macrophages both in the adult and the fetus, suggesting that the MSP/RON signaling pathway possesses the proper biological properties to possibly be involved in morphogenesis or differentiation of cells in these organs and cell types. Several organs differed in immunoreactivity between adult and fetus. No immunoreactive cells were found in the pancreas of adults; however, immunoreactivity was observed in acinar cells and in some of the duct or ductular cells and endocrine cells of the islet of the fetus. Similarly, immunoreactivity was not observed in gastric mucosa except in the intestinal metaplastic cells in adults; however, immunoreactivity was found in the foveolar epithelium of the stomach of the fetus. Although the biological significance of RON in malignancy is unclear, the presence of RON immunoreactivity in the fetus and it lack in the adult may indicate that RON is a oncofetal substance in human pancreas and stomach.

Adult↗