Search PubMed⌕ Search

Biomedical subjects

H Ishida

Publications and source records attributed to H Ishida.

At least 361 records · Page 20Linked to original sources

Multinucleated variant endothelial cells (MVECs) of human aorta: expression of tumor suppressor gene p53 and relationship to atherosclerosis and aging.

Multinucleated variant endothelial cells (MVECs) generally exist in atherosclerotic human aorta and even in nonatherosclerotic aorta. Because the number of nuclei is increased in every MVEC, and because DNA instability was suspected, a series of oncogene expressions was conducted to clarify the nature of nuclear abnormality. The tumor suppressor gene p53 was found to be specifically expressed in the multinuclei of MVECs, while double nuclei were sometimes positive, and mononuclear typical endothelial cells were always negative for p53. Polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) revealed extra bands in exons 5 and 7 of the p53 gene, but no additional band in exons 6 and 8. In a BCL family, BCL-2 was coexpressed in one or two nuclei in the perinuclear space of the multinuclei of MVECs, whereas MCL-1, BCL-XS/L, and BAX were all negative, indicating that the BCL-2 coding gene is expressed only in the corresponding one or two nuclei of the multinuclei. Another oncogene, c-MET (hepatocyte growth factor receptor), was universally expressed in either type of endothelial cells, but other oncogenes, k-RAS and c-ERBB2, were not expressed in either type. MVECs were derived from human aorta and therefore non-tumorous somatic cells. No morphologic evidence of apoptosis was found. Although it is unclear that the extra bands came from the MVECs or just from ECs associated with atherosclerosis, combined immunocytological studies and PCR analysis suggest that MVECs express mutant type p53.

Adolescent↗

Effect of acarbose (alpha-glucosidase inhibitor) on disaccharase activity in small intestine in KK-Ay and ddY mice.

The hypoglycemic effect and the alpha-glucosidase activity inhibition of acarbose (AC:alpha-glucosidase inhibitor) were investigated in normal and KK-Ay mice, an animal model of noninsulin-dependent diabetes mellitus (NIDDM). AC improved hyperglycemia after an oral administration of maltose or sucrose, dose dependently in normal mice (1, 10, and 50mg/kg body weight) and in KK-Ay mice (50mg/kg). Furthermore, AC (50mg/kg) significantly inhibited maltase and sucrase activities in the small intestines of normal and KK-Ay mice (inhibitory efficacy: sucrase > maltase). The enzymatic inhibition in KK-Ay mice is stronger than in normal mice. However, AC (50 mg/kg) did not suppress the blood glucose in oral lactose tolerance and did not inhibit the lactase activity in either normal or KK-Ay mice. These findings indicate that the AC effect on the inhibition of alpha-glucosidase activity is selective for sucrase and maltase in normal and NIDDM mice.

Acarbose↗

[Immunohistochemical staining of thymidine phosphorylase in primary colorectal carcinoma and metastases].

Thymidine phosphorylase (TdRPase) is an enzyme involved in the pyrimidine metabolism. It was reported that many cancers contained higher levels of TdRPase than normal tissues. And TdRPase has been reported to be identical with the platelet-derived endothelial cell growth factor. To clarify the distribution of TdRPase in primary and metastatic colorectal cancer, we carried out immunohistochemical staining of formalin-fixed specimens. We investigated 35 primary colorectal cancers resected surgically, 27 hepatic metastases and 8 lung metastases from colorectal carcinoma. TdRPase was highly expressed in primary colorectal cancer with lung metastases (100.0%) and surgically resected lung metastases cancer (87.5%). The staining correspondence between primary colorectal cancer and metastases was 19 cases (70.4%) in the liver metastases and 7 cases (87.5%) in the surgically resected lung metastases. The above results suggested that immunohistochemical staining for primary colorectal cancer may provide information about the sensitivity of metastases to the chemotherapy.

Adult↗

[Successful removal of a giant ball thrombus in the left atrium in an aged patient with unusual course].

A case of left atrial ball thrombus associated with severe mitral stenosis was reported. This male patient, aged 78, came in the chief complaint of leg and facial edema. An echocardiographic examination revealed the presence of mitral stenosis and floating giant ball thrombus in the atrium. He suffered from acute thromboembolism in his right leg six years ago and had been treated with anticoagulant since then. Despite this a floating giant ball thrombus was observed. Emergency operation including mitral valve replacement and thrombectomy was successfully performed. Thrombus formation in the left atrium is not uncommon but it is very rare to encounter in patients receiving anticoagulant therapy. To manage these patients well, meticulous attention must be paid during induction of anesthesia, intra-operative procedures, perioperative care, and operative position.

Aged↗

[An infant with lobar emphysema requiring lobectomy after ventricular septal defect closure].

A 1-month-old male infant with respiratory distress was referred to our hospital for operation of the ventricular septal defect. A chest roentgenogram demonstrated pulmonary emphysema especially in the right upper and middle lobes. At 3 months, a perimembranous ventricular septal defect was closed. But the infant could not be weaned from the ventilator. On the 21st postoperative day, a right upper and middle bilobectomy was performed. Three days later, he was weaned from the ventilator and the postoperative course was uneventful. The pathologic diagnosis revealed no bronchial cartilagenous abnormality. Infantile lobar emphysema of the right upper lobe with congenital heart disease is rather rare. We emphasize the need for lobectomy simultaneous with, secondary to, cardiac surgery in these cases.

Heart Septal Defects, Ventricular↗

[Prostatectomy for prostate cancers].

Radical prostatectomy may afford cure in men in whom the malignancy is completely extirpable. Historical experiences as well as ours agreed that long term survival after radical prostatectomy was excellent if the disease was confined to the organ. Cure may also be expected in some selected patients with minimal extra-organ invasion. Furthermore, preoperative hormonal therapy may improve the cure rate in these invasive diseases. However, if cure means affording the patient the best chance of dying of some causes other than cancer, some of those extirpable diseases may be cured without surgery. This idea was supported by epidemiologic data on the natural history of the disease, and retrospective observations of conservatively treated patients. Challenging issues toward the 21st century are to expand the range of surgically curative diseases, and to identify diseases extirpable but predestined never to kill the host during the natural course of his life.

Aged↗

[Outcome of emergency surgery for Stanford type A aneurysms: selection of operative procedures and supported systems of cerebral protection].

Fourteen surgical cases of acute dissecting aneurysms of Stanford type A were reported. Clinical symptoms, operative methods, pathophysiology, cerebral protection, supported systems, and prognosis were examined. All patients underwent surgery within 5 days of symptom onset. The patient population consisted 8 males and 6 females with a mean age of 56.6 years. Ascending aortic replacement was performed using a vascular graft 12 patients. ECC was performed under deep hypothermia. Femoral artery cannulation and retrograde cerebral perfusions was performed in all cases. The ascending aorta was the site of entry in 13 of the 14 cases. Whenever feasible, enhanced CT and aortography were performed to confirm the entry lesion. Two patients expired. One patient died intraoperatively due to massive bleeding. The other patient, while hospitalized, experienced a cerebrovascular accident and died due to pneumonia. All other patients ran an uneventful post-operative course without cerebrovascular accident. In conclusion we think that although ascending aorta replacement using prosthetic grafts is not ideal for patients with Stanford type A dissecting aneurysms, it is a viable option for emergency cases. We found retrograde circulatory cerebroplegia (RCCP) to be satisfactory for brain protection during these emergency procedures.

Adult↗

First total synthesis of ganglioside GT1a alpha.

A first total synthesis of ganglioside GT1a alpha (IV3III6II3Neu5AcGg4Cer) is described. The suitably protected sialyl alpha-(2-->6) ganglioside was glycosylated with the phenylthio glycoside of sialic acid in the presence of N-iodosuccinimide-(NIS)-trimethylsily trifluoromethanesulfonate (TMSOTf), followed by further glycosylation with the methyl thioglycoside promoted by dimethyl(methylthio)sulfonium triflate (DMTST), to give the heptasaccharide. The oligosaccharide obtained was converted into the title ganglioside by the introduction of ceramide and then complete deprotection.

Antigens, Surface↗

[Neoadjuvant intraarterial chemotherapy for ten cases of inflammatory breast cancer by Seldinger's methods].

The conventional methods (CM) of intraarterial (IA) chemotherapy for inflammatory breast cancer were catheterizations from superior epigastric and brachial artery under general anesthesia. Since 1997, we selected the Seldinger's methods (SM) for ten cases of the disease to control local effects and simplify the technique. Complications of the SM were slight, and side effects were equal to those with CM. The postoperative pathological findings of the SM showed the direct effects of chemotherapy to tumor cells (degenerative and necrotic changes) as compared with the embolism-like effects of CM. But the overall histological effects of chemotherapy by SM were almost equal to those for CM. The strong points of the SM were as follows: 1) More selective IA chemotherapy is available, 2) one can find the passage of the aim vessels and no trouble related to catheter, 3) general anesthesia is not necessary, and the techniques are simple, 4) the wounds are not remarkable. The disadvantages are as follows: 1) Patients must rest the day of IA chemotherapy, 2) in 20% of the procedures, one can not search the vessels, and 3) in 4 cases complications of stiffness of Mj or Mn pectral muscles were found. In future, we expect more effective results by dose escalation or combination chemotherapy.

Adenocarcinoma↗

[Microwave tissue coagulation therapy with mini-laparotomy for hepatocellular carcinoma].

Recently microwave tissue coagulation therapy (MCT) has been established as a therapeutic procedure for hepatocellular carcinoma (HCC). The route of approach to penetrate the tumor is two-fold: By the percutaneous route (PMCT) or by conventional laparotomy. PMCT has the advantage of less invasive therapy, however, it is not applicable to a tumor that cannot be detected by ultrasonography. Therefore, we tried MCT with mini-laparotomy. The patient was a 57-year old man with HCC located in the S6 subsegment. The operation was performed at the semi-right side up position, and laparotomy was done by skin incision of 12 cm in the right hypochondral area. MCT was performed about 30 times, with an output of 60 watts for 45 seconds at a time. Abdominal CT image showed a low-density area of 7 x 4 cm on the 18th postoperative day. Slight damage to the liver and no obvious complications were observed. We concluded that a much wider range-coagulation than PMCT was able to be obtained by MCT with mini-laparotomy, and postoperative quality of life was better than MCT with conventional laparotomy.

Carcinoma, Hepatocellular↗

[Method of preventing hepatic artery occlusion during continuous intrahepatic arterial infusion chemotherapy of 5-FU].

A randomized clinical trial of combined use of steroids, which have a vascular endothelium-protecting action, was performed to develop a method to prevent hepatic artery occlusion during continuous intrahepatic arterial infusion chemotherapy with 5-FU. The steroid used was dexamethasone palmitate (Limethason), which has a high rate of uptake by endothelial cells. The 24 patients with advanced colorectal cancer were divided into 2 groups randomly and both were treated with 5-FU 250 mg/day by continuous hepatic arterial infusion for three weeks. The weekly dose was 5-FU 7 V (1,750 mg) adjusted to 50 ml with physiological saline in Group A and 5-FU 7 V (1,750 mg) adjusted to 50 ml with Limethason 1 A (4.0 mg of dexamethasone palmitate) in Group B. The reservoir was replaced every week. No changes in the mixture (appearance, pH, granule diameter, dexamethasone palmitate content) were observed up to one week. Hepatic arterial stenosis was observed in 8 cases in Group A (67%), but was not observed in any of the cases in Group B. The above results indicated that Limethason has a preventive effect against hepatic artery occlusion.

Anti-Inflammatory Agents↗

[Sarpogrelate hydrochloride for Raynaud's phenomenon of patients with collagen diseases].

OBJECTIVE: To evaluate clinical efficacy of sarpogrelate hydrochloride (SPG), a novel 5HT2- serotonergic receptor antagonist, for Raynaud's phenomenon associated with collagen diseases. PATIENTS AND METHODS: Thirty two patients with collagen diseases such as scleroderma, mixed connective tissue disease, systemic lupus erythematosus, Sjögren's syndrome, and rheumatoid arthritis were enrolled. SPG (300mg/day) was administered for 8 weeks. Patients were asked to record the frequency of Raynaud's phenomenon and subjective symptoms in a diary, and evaluations were made in weeks 4 and 8 of treatment. Thermography and determination of whole blood serotonin levels were also conducted in some patients. RESULTS: The frequency and duration of Raynaud's phenomenon and subjective symptoms such as coldness and pain significantly improved in weeks 4 and 8 compared to the pre-treatment baseline. Thermography showed significantly improvements of skin temperature recovery rate following cold water loading after treatment with SPG. Epigastric distress was reported by 3 patients, but no other adverse reaction or abnormal changes in laboratory tests were observed. Whole blood serotonin levels per platelet increased significantly after treatment with SPG, suggesting that administration of SPG might inhibit activation of the platelets. CONCLUSION: A global improvement rate ("markedly improved" + " moderately improved") of 66% was obtained and SPG was regarded as safe in 85% of patients and useful or very useful in 82%. SPG is expected to be a useful new therapy for Raynaud's phenomenon in patients with collagen disease.

Adolescent↗

[A pulmonary tumorlet with caseous granuloma associated with atypical mycobacterium].

We encountered a case of pulmonary tumorlet with caseous granuloma associated with atypical mycobacterium. A 73-year-old woman was admitted to the hospital because a chest x-ray film showed enlargement of an abnormal shadow in the middle lobe of the right lung. Primary lung cancer was suspected and right middle lobectomy was performed. Acid-fast bacilli (Gaffky 1) were found in a caseous lesion and examination of intraoperatively obtained frozen specimens showed caseous granulomas. The bacilli were later identified as Mycobacterium avium complex. The permanent specimen showed a minute lesion consisting of small clusters of epithelial cells resembling carcinoid tumor in contact with granulomatous tissue. Histopathological examination revealed argyrophilia on Grimelius stain and immunoreactivity to chromogranin-A in the clusters of epithelial cells. Although these results are consistent with small cell carcinoma or peripheral carcinoid tumor, pulmonary tumorlet was diagnosed because of the lesion's small and minimal cytologic atypia, and because of chronic pulmonary damage around the lesion. Pulmonary tumorlets are minute, usually microscopic, tumor-like lesions mostly found in damaged lung tissue obtained at autopsy or during surgery. Morphological diagnosis is sometimes very difficult, but recently these lesions have been regarded as hyperplastic lesions arising in pulmonary neuroendocrine cells (Kultschitzky cells) and caused by chronic pulmonary damage, such as hypoxia and inflammation. Pulmonary tumorlets must be considered in the differential diagnosis of minute lesions suspected to be small cell carcinoma or peripheral carcinoid tumor.

Aged↗

[Clinical staging of prostate cancer].

Clinical staging of prostate cancer was reviewed on the basis of TNM classification edited by UICC in 1997. In this revision, (1) T1c was newly categorized among T1 for cases of high PSA level without any abnormal sign of DRE, (2) T2 was subdivided into T2a and T2b in accordance with unilateral or bilateral nodule in the prostate, respectively, (3) T3 was also subdivided into T3a with capsular invasion and T3b with seminal vesicle invasion. It is hoped that present classification will become useful tools for the detection of the tumor burden cancer patients.

Humans↗

[A study on androgen deprivation therapy prior to radical prostatectomy with special reference to the tumor volume].

BACKGROUND: The aim of this study is to analyze correlation between the tumor volume (TV) and the final pathological stage in patients undergoing neoadjuvant therapy. PATIENTS AND METHODS: Twenty-six patients underwent radical prostatectomy alone (group S). The remaining 28 patients had undergone neoadjuvant therapy (group N) which mainly consisted of LH-RH agonist. TV and the final pathological stage were retrospectively reviewed. RESULTS: The likelihood of positive surgical margin was statistically higher in group S than in group N (p = 0.009). The correlation between TV and the pathological stage was observed not only in group S (rho = 0.646, p = 0.0012) but also in group N (rho = 0.716, p = 0.0002). The mean TV was statistically smaller in group N in patients with baseline PSA level more than 10.1 ng/ml (p = 0.024). CONCLUSION: A decrease in tumor volume caused by neoadjuvant therapy may play an important role in reducing the likelihood of positive surgical margin.

Antineoplastic Agents, Hormonal↗

[Consultation service for efficacious usage of laboratory tests based on logical reasoning and evidence].

To effectively respond to the desire for consultation in clinical practice, we must prepare logical reasoning and evidence which rationally supports laboratory test selection, the interpretation of test results and recommendation of certain tests to physicians. Standard of medical decision making can be used for logic issues such as posttest probability, test characteristics and receiver operating characteristics (ROC) curves and establishing appropriate cut-off points. Although we usually obtain evidence by consulting authorities or the literature, good evidence can also be obtained from meta-analysis. In addition, we can demonstrate the relationship of laboratory tests among several frequently occurring diseases and epidemiological tendencies such as frequency of causative organisms at several infection sites and bacterial sensitivities to antimicrobial agents, because we have access to a large-scale laboratory database. To construct a well-organized knowledge base with explicit evidence, cooperation among many facilities is necessary to develop system, which allows the free exchange of data.

Artificial Intelligence↗

Characteristics of Helicobacter pylori strains isolated from patients with different gastric diseases.

The pathogenesis of chronic gastritis, gastric ulcer, duodenal ulcer, gastric cancer, and remnant gastritis is considered to be related to infection by Helicobacter pylori. The purpose of this study was to investigate the characteristics of H. pylori strains isolated from patients with various gastric diseases. Fifty strains of H. pylori were clinically isolated at Keio University Hospital and were assessed for (i) vacuolating cytotoxin (VT) production, by cytotoxic assay using rabbit kidney (RK) 13 cells; (ii) the expression of cytotoxin associated gene (cagA), by polymerase chain reaction; and (iii) motility on a semi-solid plate. Positivity for VT production by H. pylori strains isolated from patients with chronic gastritis, gastric ulcer, duodenal ulcer, gastric cancer, and remnant gastritis, was 100%, 89%, 92%, 100%, and 60%, respectively. There was no significant difference in the incidence of positivity for cagA among the strains isolated from different gastric diseases. Swarming distances, which indicate motility of H. pylori strains, were 12.7, 13.2, 12.8, 16.6 and 9.2mm in strains from chronic gastritis, gastric ulcer, duodenal ulcer, gastric cancer, and remnant gastritis, respectively, with H. pylori isolated from remnant gastritis showing significantly less motility than H. pylori isolates from other diseases. There were no significant differences in VT production and cagA positivity among the H. pylori strains.

Animals↗

Place of the Hokkaido Ainu (northern Japan) among circumpolar and other peoples of the world. A comparison of the frequency variations of discrete cranial traits.

Fifteen discrete cranial variations were studied in Ainu and a number of populations from around the world. The major findings, extracted by B-squared distance analysis and Fisher's exact probability test, are as follows: A) The five key traits which distinguish Ainu from the predominant eastern Asians are (1) medial palatine canal, (2) hypoglossal canal bridging, (3) supraorbital foramen, (4) transverse zygomatic suture vestige, and (5) mylohyoid bridging. The frequency of the first trait is comparable to those of Africans, especially Subsaharan Africans, the second and fifth conform to those of the New World peoples, the third is similar to Australians and Subsaharan Africans, and the fourth is the only one aligning the Ainu to Northeast Asians. B) The frequencies of a few wormian bones in Ainu are significantly different from those of many Southeast Asians. The frequencies favour rough clinality from the south to as far north as the arctic area of Northeast Asia in the regions of western Oceania and eastern Asia. The present study confirms that Ainu and Jomon are certainly members of populations originated in Asia but possibly outliers of more predominant Asian populations.

Anthropology, Physical↗