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Biomedical subjects

F Konishi

Publications and source records attributed to F Konishi.

At least 37 records · Page 2Linked to original sources
PubMed2000

Apoptosis and its regulation in flat-type early colorectal carcinoma: comparison with that in polypoid-type early colorectal carcinoma.

PURPOSE: The aim of this study was to investigate the relationship among apoptotic cell death, proliferative activity, and the expression of apoptosis-regulating proteins (p53, p21 (WAF1/CIP1), and bax) in flat-type early colorectal carcinoma and to compare these factors with those in polypoid-type early colorectal carcinoma. METHODS: Formalin-fixed, paraffin-embedded tissues of 11 flat-type early colorectal carcinomas and 17 polypoid-type early carcinomas were studied. The histologic diagnosis was either well-differentiated adenocarcinoma or carcinoma in adenoma, and the depth of invasion was limited to mucosa or submucosa. Apoptotic cells were detected by terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling method, and proliferative activity was determined by Ki-67 immunohistochemistry using monoclonal antibody MIB-1. Apoptosis-regulating proteins were determined by immunohistochemistry using antibody DO-7 (p53), Cip1 (p21 (WAF1/CIP1)), and Bax (bax). RESULTS: There was no significant difference in terminal deoxynucleotide transferase-mediated deoxy-uridine triphosphate-biotin nick end-labeling index between flat-type early colorectal carcinoma and polypoid-type early carcinoma, at 1.9 vs. 1.1, respectively. In flat-type carcinoma terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling index in the p53 protein overexpression group was significantly smaller than that in the p53 protein-negative group (P < 0.05). The Ki-67 labeling index/terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling index ratio in the p53 protein overexpression group was significantly higher than that in the p53 protein-negative group (P < 0.05). In polypoid-type carcinoma, the terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling index and Ki67/terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate-biotin nick end-labeling index ratio showed no significant difference between the p53 protein overexpression group and p53 protein-negative group. CONCLUSION: p53-dependent apoptosis may contribute to the development of flat-type early colorectal carcinoma. Apoptosis and its regulation in flat-type early colorectal carcinoma may differ from those in polypoid-type carcinoma.

Apoptosis↗
PubMed2000

Predictive factors for detecting colorectal carcinomas in surveillance colonoscopy after colorectal cancer surgery.

PURPOSE: The aim of this study was to identify the high-risk groups for metachronous colorectal carcinoma among patients who undergo colorectal cancer surgery. METHODS: Three hundred forty-one patients undergoing colorectal cancer surgery who had undergone surveillance colonoscopy at least twice during a period of more than three years were analyzed. A metachronous colorectal carcinoma was defined as a new colorectal carcinoma detected by surveillance colonoscopy after surgery. RESULTS: Surveillance colonoscopy was performed 4.6 times per patient during an average of 6.2 years. Twenty-two metachronous colorectal carcinomas in 19 patients were detected, and 14 (64 percent) of 22 were detected within five years of surgery. The cumulative incidence of developing colorectal carcinomas during a five-year period was 5.3 percent. Seventeen (77 percent) of 22 carcinomas were 10 mm or less in size. Ten (71 percent) of the 14 carcinomas in early stages showed a flat appearance. Univariate analysis showed that extracolonic malignancy, coexistence of adenoma, and synchronous multiple colorectal carcinoma were significant predictive factors for detecting colorectal carcinomas in surveillance colonoscopy and that family history of colorectal carcinoma was a possible predictive factor. Multivariate analysis performed with Cox proportional hazards regression model showed that extracolonic malignancy and the coexistence of adenoma were significant predictive factors. CONCLUSION: We recommend that patients with the above predictive factors receive surveillance colonoscopy meticulously and regularly.

Adult↗
PubMed2000

Variations in motor evoked potential latencies in the anal sphincter system with sacral magnetic stimulation.

PURPOSE: The anal sphincter system of the skeletal musculature consists of various parts but functions as a single unit. The motor latencies measured at the puborectalis, deep external anal sphincter, superficial external anal sphincter, and subcutaneous external anal sphincter have yet to be clearly elucidated. This study was designed to measure the motor latencies of these sphincters separately and to investigate the electrophysiologic heterogeneity of the anal sphincter system. METHODS: In 20 preoperative patients with colon cancer without either neurologic or anorectal diseases, motor evoked potentials were taken separately bilaterally at levels measuring approximately 5, 3.8, 2.6, and 1.5 cm from the perineal skin using a concentric needle electrode after magnetic stimulation on the sacral region. These latencies were considered to be separately measured at the puborectalis, deep, superficial, and subcutaneous external anal sphincter. RESULTS: The motor latencies (median (95 percent confidence interval)) were 4.33 (4.1-4.93; right) and 4.24 (3.97-5.22; left) ms at the 5 cm level; 5.96 (5.45-7.32; right) and 6.44 (5.49-8.20; left) ms at the 3.8 cm level; 9.28 (7.99-11.21; right) and 8.88 (7.68-10.93; left) ms at the 2.6 cm level; and 11.06 (9.69-14.13; right) and 9.18 (8.09-10.31; left) ms at the 1.5 cm level. Significant differences were seen in the latencies between the 5 cm level and the other levels and between the 3.8 cm level and the other levels. CONCLUSIONS: The motor latencies in the anal sphincter system significantly varied depending on the distance from the skin. The latency may be shortest in the puborectalis and increasingly longer in the deep, superficial, and subcutaneous EAS, in that order.

Aged↗
PubMed2000

Multifocal micronodular pneumocyte hyperplasia in a postmenopausal woman with tuberous sclerosis.

We report a peculiar case of multifocal micronodular pneumocyte hyperplasia (MMPH) without association of pulmonary lymphangioleiomyomatosis (LAM) in a 56-year-old postmenopausal woman with tuberous sclerosis. This case is surmised to be a forme fruste of tuberous sclerosis. Computed tomography demonstrated multiple micronodules, measuring up to 5 mm in size, present in the bilateral lung fields, but no cystic changes. A proliferation of pleomorphic type-II pneumocytes lining the thickened alveolar septa in an adenomatoid pattern, with an associated increase in alveolar macrophages, was observed without typical nuclear atypia. In fully developed lesions, the ingrowth of more proliferating type-II pneumocytes into the thickened alveolar septa and macrophages filling the alveolar lumens were characteristic findings. Proliferation of immature smooth muscle cells suggesting LAM was not observed. Positive immunohistochemical stains for cytokeratin, epithelial membrane antigen, and surfactant apoproteins A and B, and negative staining for HMB45, alpha-1 smooth muscle actin, desmin, and carcinoembryonic antigen confirmed the characteristics of alveolar lining cells in each MMPH lesion. MMPH associated with tuberous sclerosis in the postmenopausal woman appears to be similar to that described in premenopausal women. The present case is familial rather than sporadic and suggests no relationship between the development of MMPH and the underlying hormonal state.

Female↗
PubMed2000

Cytokine and hormonal responses in laparoscopic-assisted colectomy and conventional open colectomy.

Interleukin-6 (IL-6) is an important mediator of the acute phase response and a sensitive marker of tissue damage. This study was conducted to investigate the fluctuation of serum cytokine and hormonal levels during the perioperative period after laparoscopic-assisted colectomy (LAC), and the data were compared with those after conventional open colectomy (OPEN). The subjects comprised eight patients who underwent OPEN and eight who underwent LAC. Blood samples were obtained by peripheral vein puncture before the induction of anesthesia, then 2, 4, 6, 8, 24, 48, and 72 h after skin incision to measure the levels of serum IL-6, adrenocorticotropic hormone (ACTH), cortisol, and antidiuretic hormone (ADH). The level of serum IL-6 increased significantly during the perioperative course in both groups; however, the level 4 h after the commencement of surgery and the peak level were significantly lower in the LAC group than in the OPEN group (P < 0.05). Plasma ACTH, cortisol, and ADH rapidly increased in both groups, but there was no significant difference between them. The IL-6 levels in collected ascites samples were not significantly different between the two groups. The changes in serum IL-6 levels indicate that LAC is less invasive than conventional open colectomy. These findings corresponded well with the clinical courses of the patients who underwent the two types of operations.

Adrenocorticotropic Hormone↗
PubMed2000

Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer.

BACKGROUND: Curativity and indications for limited resection of small peripheral lung cancer remain controversial. METHODS: Pathologic investigations of segmental lymph node metastases and intrapulmonary metastases in the resected lobe were performed for 94 small peripheral lung cancers (3.0 cm or less in diameter). RESULTS: Nine patients had segmental lymph node metastases, 1 had intrapulmonary metastases, and 1 had both. Of these 11 patients, 5 had metastases limited to the primary tumor-bearing segments, 2 had metastases in nonprimary tumor-bearing segments, and 4 had metastases in both. Of the 10 patients with segmental lymph node metastases, 7 had metastases in both lobar-hilar and mediastinal lymph nodes, and 3 of 8 with adenocarcinoma had a tumor 2.0 cm or less. CONCLUSIONS: Segmentectomy seems more favorable than wedge resection, but the risk of remnant tumor remains as compared with lobectomy. Evaluation of lobar-hilar or mediastinal lymph nodes is helpful to determine the presence or absence of segmental lymph node metastases. Limited resection can be undertaken with smaller tumors to allow preservation of more lung function while accepting a somewhat enhanced risk of recurrence.

Adenocarcinoma↗
PubMed2000

Enhanced blood pressure sensitivity to DOCA-salt treatment in endothelin ET(B) receptor-deficient rats.

The role of endothelin ET(B) receptor-mediated action in the development and maintenance of deoxycorticosterone acetate (DOCA)-salt-induced hypertension was evaluated using the spotting-lethal (sl) rat which carries a naturally occurring deletion in the ET(B) receptor gene. Homozygous (sl/sl) rats treated with DOCA-salt for 1 week exhibited an earlier onset of hypertension than heterozygous (sl/+) and wild-type (+/+) rats (systolic blood pressure, SBP; 156.7+/-3.4 versus 128.8+/-5.3 and 132.9+/-3.7 mmHg, respectively). Four weeks after the start of DOCA-salt treatment, homozygous rats developed marked hypertension, with a SBP of 206. 0+/-4.5 mmHg, compared with 184.8+/-10.7 mmHg in heterozygous and 164.3+/-4.8 mmHg in wild-type rats. Cardiovascular hypertrophy and renal dysfunction observed after 4-weeks treatment with DOCA-salt were more severe in homozygous rats, compared to wild-type and heterozygous animals. These evidences support strongly the view that ET(B) receptor-mediated actions are a protective factor in the pathogenesis of DOCA-salt-induced hypertension.

Animals↗
PubMed2000

End-to-side pudendal nerve anastomosis for the creation of a new reinforcing anal sphincter in dogs.

BACKGROUND: An ideal reinforcing neo-sphincter should be innervated by the pudendal nerve to work in coordination with the external anal sphincter. The aim of this study was to create a skeletal muscle innervated by the pudendal nerve without inducing external anal sphincter morbidity. METHODS: Seven dogs were used. On the right side of each dog, the distal end of the transected nerve innervating the biceps femoris muscle was anastomosed to the perineural window of the pudendal nerve, where the epineurium was excised over a small area without injuring the funiculus. Reinnervation was studied 5 months after the operations. The left side of the dogs was used as a control. RESULTS: For all 7 dogs, there was no macroscopic difference detected in the external anal sphincter. For 6 dogs, the biceps femoris muscle was preserved after end-to-side pudendal nerve anastomosis. After the pudendal nerve central to the anastomosis site was electrically stimulated, the external anal sphincter contracted in all dogs. After end-to-side pudendal nerve anastomosis, the biceps femoris muscle contracted with the evoked potential in 5 dogs (71%) and demonstrated electric activity at rest in 3 dogs (43%), but there was no reflex activity after anal stimulation. The ratio of type 1 to type 2 muscle fiber in the biceps femoris muscle after end-to-side pudendal nerve anastomosis significantly changed and became the same as that in the external anal sphincter. The diameter of type 2 muscle fibers in the biceps femoris muscle significantly decreased after surgery. In addition, regenerated myelinated axons were observed in a cross section of the anastomosed nerve in 6 dogs. CONCLUSIONS: End-to-side pudendal nerve anastomosis is a promising technique for the creation of an anal sphincter in patients who have fecal incontinence. The technique preserved the original external anal sphincter and created a skeletal muscle that was innervated by the pudendal nerve in 71% of the dogs studied. This newly innervated skeletal muscle was capable of contracting in coordination with the original external anal sphincter on electric stimulation and also demonstrated characteristics closely similar to those of the external anal sphincter.

Anal Canal↗
PubMed2000

Increased susceptibility to deoxycorticosterone acetate-salt-induced hypertension in endothelin-B-receptor-deficient rats.

We evaluated the role of endothelin-B- (ET(B)) receptor-mediated action in the development and maintenance of deoxycorticosterone acetate (DOCA)-salt-induced hypertension, cardiovascular hypertrophy and renal damage, using the spotting lethal (sl) rat which carries a naturally occurring deletion in the ET(B)-receptor gene. Homozygous (sl/sl) rats exhibit abnormal development of the neural crest-derived epidermal melanocytes and the enteric nervous system (ENS), and do not live beyond 1 month because of intestinal aganglionosis and resulting intestinal obstruction. Therefore, the dopamine-beta-hydroxylase (D betaH) promoter was used to direct ET(B) transgene expression in sl/sl rats to support normal ENS development. D betaH-ET(B) sl/sl rats live into adulthood and are healthy, expressing ET(B)-receptor in adrenals and other adrenergic neurons. When homozygous (sl/sl) and wild-type (WT) (+/+) rats, all of which were transgenic, were treated with DOCA and salt for 4 weeks, the homozygous rats exhibited significantly earlier and higher increases in systolic blood pressure than WT rats. The daily oral administration of ABT-627, a selective ET(A)-receptor antagonist, almost completely suppressed the DOCA-salt-induced hypertension in both groups. Renal dysfunction and histological damage induced by DOCA-salt treatment were more severe in homozygous than in WT rats. Increased and marked vascular hypertrophy of the aorta was also observed in homozygous rats, compared with WT rats. Renal and vascular injuries induced by DOCA and salt were significantly improved by ABT-627 administration. We propose that ET(B)-receptor-mediated actions are protective factors in the pathogenesis of DOCA-salt-induced hypertension. ET(A)-mediated actions are at least partly responsible for the increased susceptibility to DOCA-salt-induced hypertension and related tissue injuries in ET(B)-receptor-deficient rats.

Animals↗
PubMed2000

Pathogenesis of non-familial colorectal carcinomas with high microsatellite instability.

AIMS: Microsatellite instability (MSI) was first observed in hereditary non-polyposis colorectal carcinoma (HNPCC) and was subsequently seen in non-familial colorectal carcinoma. The relation between MSI and cancer associated genes in non-familial colorectal carcinomas has yet to be evaluated. To clarify this matter, changes in cancer associated genes were examined in non-familial colorectal carcinomas. METHODS: Alterations in the adenomatous polyposis coli (APC), p53, and Ki-ras genes were analysed in 24 MSI high (alterations in four to seven of seven loci), nine MSI low (alterations in one to three of seven loci), and 31 MSI negative non-familial carcinomas. The hMSH2 and hMLH1 genes were also analysed in 24 MSI high carcinomas. RESULTS: Both the frequencies and types of alterations in the APC and p53 genes in MSI high carcinomas were the same as those in MSI low and MSI negative carcinomas; however, they were different from those seen in HNPCC. The frequency of Ki-ras mutation was significantly lower in the MSI high cases (two of 24; 8%) than in the others (15 of 38; 39%). Somatic mutation of hMSH2 or hMLH1 was detected in six of 24 (25%) of the MSI high cases. CONCLUSIONS: These results suggest that APC and p53 alterations occur irrespective of microsatellite instability status in non-familial colorectal carcinomas, and that Ki-ras mutation is not involved in MSI high non-familial colorectal carcinoma. The pathogenesis of these carcinomas may differ from both the usual adenoma-carcinoma sequence and HNPCC carcinogenesis.

Base Sequence↗
PubMed2000

A family with cases of adult onset Still's disease and psoriatic arthritis.

Adult onset Still's disease is recognized as an adult variant of the systemic form of juvenile rheumatoid arthritis, whose disease-predisposition is still debated. On the other hand, the association between HLA subtypes and several groups of seronegative arthritis including psoriatic arthritis has been well documented. This report describes a family where adult onset Still's disease in a young man and psoriatic arthritis in his father were seen. Both patients were HLA-B39-positive, which was likely playing important pathogenic roles in the latter case. Clinical and immunological aspects of HLA-B39-related inflammatory diseases are also discussed.

Adult↗
PubMed2000

[Recent advances in colorectal cancer surgery].

Recent advances in colorectal cancer surgery have been made in improving the cure rate after surgery, the preservation of postoperative function, and the development of minimally invasive procedures. Indication for wide lymph node dissection in rectal cancer surgery is now limited to a smaller number of cases. Functional outcome is being improved thanks to the introduction of autonomic nerve preserving operations as well as the increasing number of sphincter preserving operations. Laparoscopic colectomy for cancer has been practiced for 7-8 years, and the advantages and disadvantages of this procedure are being clarified. Transanal endoscopic microsurgery (TEM) is a minimally invasive surgery for rectal tumors in early stages. The procedure is now overtaking the posterior surgical approach, which is used less and less in recent years. Future goals in colorectal cancer surgery are further improvements in the cure rate and the functional results. Minimally invasive surgery may become the established procedure after a careful assessment of its cure rate compared to the open surgical procedure.

Colorectal Neoplasms↗
PubMed2000

[Laparoscopic colectomy for colorectal carcinoma].

Laparoscopic-assisted colectomy is considered to be a less invasive technique, and patients experience less pain and more rapid postoperative recovery. This operation has been indicated for large sessile adenomas or for early invasive carcinomas in Japan. The indications for this procedure in more advanced colorectal carcinomas is controversial. However, based on our experience with 130 cases, laparoscopic-assisted colectomy can be as curative as open colectomy provided that the patients are properly selected. In this review, the technical difficulties of this procedure are also discussed.

Colectomy↗
PubMed1999

DNA replication error in endometrial carcinoma and complex atypical endometrial hyperplasia.

We attempted to define the relation between DNA replication errors (RERs) in endometrial carcinomas and the precancerous lesion complex atypical endometrial hyperplasia (ATH) and clinicopathological characteristics. Tissue samples from 93 patients with endometrial carcinoma diagnosed as endometrioid adenocarcinoma and 26 patients with ATH (including 21 in whom endometrial carcinoma also was found) were prepared as formalin-fixed, paraffin-embedded sections. The samples were examined for the presence of RERs by the polymerase chain reaction with the use of five microsatellite markers. RERs were observed at > or = 1 loci in 32 endometrial carcinoma patients (34%); all 26 ATH patients were RER negative. RERs were observed in 25% of stage I and stage II cancer patients (16/64) and in 55% of stage III and stage IV cancer patients (16/29) (P = 0.009), as well as in 63% (10/16) of cancer patients with and in 27% (20/75) of patients without lymph-node metastases (P = 0.013). The incidence of RERs was not related to patient age, histological tumor grade, or prognosis. These results suggest that RER may be involved in the advanced rather than the early stages of endometrioid adenocarcinoma. There appears to be little association between RER and ATH.

Adult↗
PubMed1999

The significance of microsatellite instability in predicting the development of metachronous multiple colorectal carcinomas in patients with nonfamilial colorectal carcinoma.

BACKGROUND: Patients with metachronous multiple colorectal carcinomas have been reported to have a higher frequency of a family history of colorectal carcinoma, associated colorectal adenomas, and extracolonic malignancies. These clinicopathologic factors also are considered to be related to the development of metachronous multiple colorectal carcinomas after surgery for colorectal carcinoma. In this article, the authors investigated whether genetic markers such as microsatellite instability (MSI) were helpful in predicting the development of metachronous multiple colorectal carcinomas. METHODS: Between 1990-1997, 312 colorectal carcinoma patients underwent yearly surveillance colonoscopy after surgery. Among these patients, there were 19 with nonfamilial colorectal carcinoma in whom metachronous multiple colorectal carcinomas were diagnosed during the yearly surveillance colonoscopy. A control group was comprised of 28 patients who did not demonstrate either synchronous or metachronous carcinomas over a period of > or =5 years. Six microsatellite markers (D2S123, D3S1029, D3S1611, TP53, Mfd26, and Mfd36) were used to determine MSI by polymerase chain reaction. RESULTS: The frequency of MSI positive cases was significantly higher in patients with sporadic metachronous multiple colorectal carcinomas than in those with a single carcinoma (17/19 [89%] vs. 4/28 [14%]; P<0.0001). In tumors occurring in the distal colon and rectum, the percentage of MSI positive carcinomas was significantly higher in the patients with metachronous multiple carcinomas than in those with a single carcinoma (13/15 [87%] vs. 0/19 [0%]; P<0.0001). No such difference was observed in the proximal colon. CONCLUSIONS: Based on the findings of the current study, the analysis of MSI in sporadic carcinomas of the distal colon and rectum may be helpful in predicting the development of metachronous multiple colorectal carcinomas.

Colonoscopy↗
PubMed1999

Muscle change after anal sphincter reinnervation by a normal somatic peripheral nerve: preliminary study.

INTRODUCTION: Pudendal neuropathy causes idiopathic fecal incontinence. We thus designed a new operation for idiopathic fecal incontinence based on the hypothesis that a conversion from innervation by the neuropathic pudendal nerve to that by the normal somatic peripheral nerve innervating a larger skeletal muscle might enable the anal sphincter to recover from neuropathic muscular atrophy. This study was undertaken to investigate the muscular change of the external anal sphincter after such an operation. METHODS: On 14 sides of eight dogs, the transected proximal end of the nerve innervating the biceps femoris muscle was microsurgically cross-transferred to the distal end of the transected pudendal nerve. The external anal sphincter was analyzed by electromyography and adenosine 5'-triphosphatase staining at three months after surgery. RESULTS: On 13 of 14 sides, the external anal sphincter was well preserved and the evoked potential was clearly recorded. The external anal sphincter in these dogs, however, had neither any basal electrical activity nor any increased electrical activity. The percentage of Type 1 muscle fibers of the external anal sphincter innervated by the nerve to the biceps femoris muscle (30.9 +/- 9.8 percent) was significantly higher than that of the normal external anal sphincter (15.2 +/- 8.5 percent; P < 0.001) and also significantly lower than that of the normal biceps femoris muscle (38.5 +/- 7.5 percent; P = 0.006). The diameter of the muscle fibers (Types 1 and 2) of the external anal sphincter (expressed as mean +/- standard deviation) innervated by the nerve to the biceps femoris muscle (32.9 +/- 6.2 microm) was also significantly larger than that of the normal external anal sphincter (29.9 +/- 5.1 microm; P = 0.021) and significantly smaller than that of the normal biceps femoris muscle (36.1 +/- 6.1 microm; P = 0.028). CONCLUSIONS: The cross-nerve transfer procedure in a dog model was found to prevent muscular atrophy of the external anal sphincter when performed immediately after pudendal nerve transection.

Anal Canal↗