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Biomedical subjects

H Iwase

Publications and source records attributed to H Iwase.

At least 73 records · Page 4Linked to original sources

Local hemostatic effects of microcrystalline partially deacetylated chitin hydrochloride.

The hemostatic effects of microcrystalline partially deacetylated chitin hydrochloride (DAC-HCl) were compared with those of cotton and collagen hydrochloride (collagen-HCl). The DAC-HCl had excellent physical properties as a hemostatic agent such as its ability to absorb and retain blood. In canine blood it induced the release of substances involved in the process of platelet activation, such as beta-thromboglobulin and platelet factor 4, and it also had excellent hemoagglutinative properties. Moreover, in a hemostatic study on bleeding from cancellous bone in canines it exhibited a hemostatic effect comparable to that exhibited by collagen-HCl. Because it also has an intrinsic promotive effect on wound healing, chitin hydrochloride is considered to be a promising hemostatic material.

Animals↗

A proposal for the histopathological diagnosis of ductal carcinoma in situ of the breast.

BACKGROUND: As the incidence of ductal carcinoma in situ (DCIS) is increasing, it is necessary to make a guideline for the pathological examination and diagnosis of DCIS, by creating criteria based on clinical and biological aspects of the disease. METHOD: We collected biopsy specimens originally diagnosed as benign lesions, from patients who subsequently developed invasive carcinoma in the ipsilateral breast. The histology of the biopsy specimens was re-evaluated principally according to the 1995 Philadelphia Consensus on DCIS. Histopathological agreement on each biopsy specimen was made by the JBCS Study Group members under a multiviewer microscope. In the course of making conclusive agreements among the pathologists, we developed a consensus for the histopathological diagnosis of DCIS, especially non-comedo types. RESULTS: DCIS is defined as a carcinoma of ductal epithelial origin, without any evidence of stromal invasion. It is necessary to note the methods of pathologic examination required to diagnose DCIS. Stromal invasion is an important prognostic factor, and should be diagnosed with caution. Classification of proliferative ductal lesions as benign or malignant (DCIS), the subtype of DCIS (nuclear grade, architecture, and necrosis), and the histological grading of DCIS are proposed and recommended. CONCLUSION: Although we have made a new proposal according to current concepts, there are still several unresolved problems. Thus further examination and modification will be necessary in the future.

Breast Neoplasms↗

Expression of estrogen receptor alpha exon 5 and 7 deletion variant in human breast cancers.

BACKGROUND: An exon deletion variant of estrogen receptor (ER) mRNA has been reported, as one of the possible mechanisms of loss of ER function. METHODS: We examined the expression of exons 3, 5, and 7 in ER alpha mRNA and the frequency of exon deletion variant expression in 64 cases of human breast cancers and in 8 non-cancerous breast tissues using reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Approximately the same amount of wild-type (wt) mRNA was detected in all the non-cancerous breast tissues. In cancers, expression of wild-type exon 3 (w3), exon 5 (w5), and exon 7 (w7) was detected in 93.5%, 93.5%, and 91.3% of ER alpha protein (pER) positive cases, respectively, and 27.8%, 38.9%, and 44.4% in negative cases, respectively (p < 0.0001, p = 0.0035, and p = 0.0002). Although the variants for exon 5 (d5) and 7 (d7) were detected in both non-cancerous and cancerous tissues respectively, the variant for exon 3 was not detected at all. Comparatively, the ratio of d5/w5 was significantly higher in pER positive and progesterone receptor protein (pPgR) negative cases. CONCLUSIONS: We suspect that the exon 5 deletion does not work as a dominant positive.

Breast↗

Comparison of five different antibodies in the immunohistochemical assay of estrogen receptor alpha in human breast cancer.

BACKGROUND: Estrogen receptor alpha (ER) expression is the best prognostic and predictive factor of hormone dependency of human breast cancers. Unlike enzyme immunoassay (EIA), which has been widely used to evaluate ER status in breast cancer, immunohistochemical assay (IHC) can detect ER in a small amounts of tissue with detailed localization. Although there is a sufficient number of ER antibodies against various regions of the protein, the reliability of IHC staining is only well understood for a few. IHC and EIA for the evaluation of the ER status of human breast cancer, therefore, should be compared using the same breast cancer tissues. METHODS: Five different ER antibodies (1D-5, C-314, G-20, C-311 and HC-20) that identify different amino acid sequences were used. The evaluation of ER status by IHC using these antibodies was compared with EIA concomitantly in 97 primary human breast cancer tissues RESULTS: The positivity rate for EIA was 68%. That of IHC for antibodies 1D-5, C-314, G-20, C-311 and HC-20 was 50.5%, 47.4%, 46.4%, 44.3% and 57.7%, respectively. The concordance between EIA was 76.3% for 1D-5 and 77.3% for HC-20, which is statistically highly significant (p<0.0001); Other antibodies were not. CONCLUSIONS: HC-20 is most suitable in the evaluation of the ER status of human breast cancers using the IHC method. Although antibody 1D-5 is also available, C-314, G20 and C-311 are unreliable in such an evaluation.

Antibodies↗

Readministration of tamoxifen after adjuvant therapy for recurrent breast cancer.

BACKGROUND: Previous series concerning tamoxifen (TAM) rechallenge did not obtain satisfactory results. Using stricter criteria, we now assess the usefulness of readministration of TAM as an initial therapy for patients with recurrent breast cancer. METHOD: The eligibility criteria were postmenopausal, estrogen receptor (ER) positive or unknown, at least 12 months of adjuvant TAM, a 6-month or longer drug-free period and no previous therapy after recurrence. A total of 10 patients were enrolled. TAM was administered in daily doses of 20 or 30 mg. RESULTS: The mean age of the patients at the time of recurrence was 64.8 years. The receptor status was positive in 8 patients and unknown in 2. The median disease-free interval (DFI) after mastectomy was 71.7 months. A complete response was observed in one patient, a partial response in 6, stable disease in 2, and progression in one. The response rate was thus 70%, with an additional two patients showing no progression over 6 months. Although only one patient with a DFI of less than 48 months showed a positive response, all patients with a DFI longer than 48 months showed a clinical response. The duration of response was less than 12 months in 3 patients and longer in 4. CONCLUSION: The post-adjuvant readministration of tamoxifen is a useful first choice therapy for postmenopausal recurrent breast cancer patients with positive ER and longer DFI.

Aged↗

The initial fixation of the press-fit acetabular shell--clinical observation and experimental study.

The initial solid fixation of an uncemented acetabular component affects the amount of bone ingrowth. We had several problems with broken screws in cases of acetabular revision. In recent years, the development of uncemented components without screws has attempted to improve these problems. We started to use "press-fit"-type acetabular shells in November 1996. Our thirty cases undergoing 2 mm under-reaming show good initial stability. The aim of our biomechanical study was to assess the most suitable degree of under-reaming of the bony acetabulum for the implantation of an uncemented hemispherical porous coated component.

Acetabulum↗

Onset of rigor mortis is earlier in red muscle than in white muscle.

Rigor mortis is thought to be related to falling ATP levels in muscles postmortem. We measured rigor mortis as tension determined isometrically in three rat leg muscles in liquid paraffin kept at 37 degrees C or 25 degrees C--two red muscles, red gastrocnemius (RG) and soleus (SO) and one white muscle, white gastrocnemius (WG). Onset, half and full rigor mortis occurred earlier in RG and SO than in WG both at 37 degrees C and at 25 degrees C even though RG and WG were portions of the same muscle. This suggests that rigor mortis directly reflects the postmortem intramuscular ATP level, which decreases more rapidly in red muscle than in white muscle after death. Rigor mortis was more retarded at 25 degrees C than at 37 degrees C in each type of muscle.

Adenosine Triphosphate↗

Reconstruction of rabbit Achilles tendon with three bioabsorbable materials: histological and biomechanical studies.

This study investigated whether three biodegradable materials, poly-N-acetyl-D-glucosamine (chitin), poly-epsilon-caprolactone (p-CL), polylactic acid (PLA), and chitin/p-CL composite could be used as scaffold implants in the reconstruction of extra-articular ligaments or tendons. Braided artificial tendons made from these materials were soaked in phosphate-buffered saline or implanted in the subcutaneous tissue of 31 Japanese white rabbits and then subjected to load at failure testing. There was no significant loss of load at failure when chitin tendons were soaked in saline for 26 weeks, but a rapid decrease occurred in vivo. The other two types of tendons showed significant loss of strength after 26 weeks both in vitro and in vivo. Another 111 rabbits were used to assess Achilles tendon reconstruction with the braided tendon implants. The tendon regeneration process was assessed macroscopically, histologically, immunohistochemically, and mechanically (maximum load at failure). Chitin showed more rapid degradation than the other materials on histological examination. There was good formation of fibrous tissue composed of type I and type III collagen around the chitin, PLA, and chitin/p-CL fibers in comparison with p-CL fibers, but chitin tendons showed more rapid loss of strength after implantation. Both PLA and the chitin/p-CL composite tendons had good initial strength and showed increased ingrowth of fibrous tissue, suggesting that these materials are promising as artificial tendons.

Achilles Tendon↗

Gelatinolytic activity of matrix metalloproteinase-2 and -9 in oesophageal carcinoma; a study using in situ zymography.

In this study, we investigated the activity of matrix metalloproteinase (MMP)-2 and -9 by gelatine zymography, immunostaining and in situ gelatine zymography in 30 oesophageal squamous-cell carcinomas. The gelatinolytic activity in situ was detected in all cases with different patterns of localisation. Significant gelatinolysis by stromal cells adjacent to tumour nests was found in 12 cases. Strong gelatinolytic activity appeared within the tumour nest itself in 13 cases. In the other 5 cases, both stromal cells and tumour cells showed the gelatinolytic activity. Gelatine zymography demonstrated a correlation between vascular invasion and activation of MMP-9. It also demonstrated a correlation between lymph node metastasis, lymphatic or vascular invasion and activation of MMP-2. These results suggest that MMPs play an important role in the invasion of oesophageal carcinoma.

Aged↗

Transdermal absorption of L-dopa from a new system composed of two separate layers of L-dopa and hydrogel in rats.

To maintain the stability of L-dopa in hydrogel, a new system composed of two separate layers of L-dopa and hydrogel was developed. L-Dopa sheets were made by immersing L-dopa solution into wiper sheets and by lyophilizing them. Examination for stability of L-dopa in the L-dopa sheet revealed that its stability was maintained for at least 12 weeks, providing the sheet was kept at room temperature in a dark box. In a cutaneous absorption study of L-dopa in rats, an L-dopa sheet was attached to the shaved abdominal skin. A hydrogel composed of cutaneous absorption enhancers, water and ethanol, was spread on vinyl tape (hydrogel sheet), and this sheet was placed over the L-dopa sheet. L-Dopa that was administered transdermally effectively penetrated through the skin: The plasma level of L-dopa peaked at 30 min and remained high between 60 and 180 min after the cutaneous application. Our system, composed of two separated layers of L-dopa and hydrogel, enabled the stability of L-dopa to be maintained without losing transdermal absorption of L-dopa.

Administration, Cutaneous↗

Humoral immunity against the proline-rich peptide epitope of the IgA1 hinge region in IgA nephropathy.

BACKGROUND: The human IgA1 hinge region is a unique mucin-like O-linked proline-rich glycopeptide, and its core peptide was found to be exposed aberrantly by the underglycosylation in IgA nephropathy (IgAN). We describe here the presence of humoral immunity against the IgA1 hinge peptide epitope in IgAN and evaluate the relationship between the underglycosylation of the IgA1 hinge region and humoral immunity. METHOD: The serum anti-IgA1 hinge peptide antibody (anti-alpha1HP ab) titre was measured and compared between the IgAN (n=37) and control groups (n=34) by enzyme-linked immunosorbent assay (ELISA) using a synthetic peptide corresponding to the human IgA1 hinge region, PVPSTPPTPSPSTPPTPSPS, as an antigen. Next, to evaluate the relationship between the underglycosylation of the IgA1 hinge region and the humoral immunity, the reactivity of the serum IgG from the patients with IgAN against monoclonal IgA1 which had been digested enzymatically to remove the carbohydrates from the IgA1 hinge region was measured by ELISA. RESULTS: The anti-alpha1HP ab titre was significantly higher in the IgAN group than in the control group (OD value: IgG class, 0.564+/-0.344 vs 0. 331+/-0.154, P=0.0014; IgM class, 0.272+/-0.148 vs 0.141+/-0.072, P<0.0001) and it was positive in approximately 40% of the patients with IgAN. In addition, the reactivity of the serum IgG from the IgAN patients against the monoclonal IgA1 was found to be increased as the carbohydrates were enzymatically removed from the IgA1 hinge region (when native=100; asialo, 122+/-9.5; agalacto, 167+/-11.5; naked, 188+/-3.9). CONCLUSION: These results suggested that the peptide epitope of the IgA1 hinge region which was aberrantly exposed by underglycosylation could induce the humoral immune response in IgAN.

Adolescent↗

Post-translational modification of alphaB-crystallin of normal human lens.

The current study reports several post-translational modifications of alphaB-crystallin in normal human lenses. The isoforms of post-translational modified alphaB-crystallin were isolated from the normal human lenses of >70-age group by ion exchange chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The isoform modifications were determined in detail by fast atom bombardment mass spectroscopy and amino acid sequence analysis. As the criterion of non-modified alphaB-crystallin, alphaB-crystallin from 1-d-old infant lenses were used. The modifications found in this study involve oxidation of the N-terminal methionine-1 residue, phosphorylation of the serine-59 residue, and truncation of four amino acids from the C-terminal position of the crystallin. The oxidation of methionine-1 was found in the early stage of human life in 1-d-old lens, although other modification of alphaB-crystallin were usually only found in old lenses (>70-age group).

Amino Acid Sequence↗

Scirrhous cancer of the stomach which survived for more than five years after neoadjuvant chemotherapy with UFT (uracil and tegafur) and cisplatin.

A 68-year-old man was diagnosed as having a scirrhous cancer of the stomach. Carcinomatous peritonitis was suspected on abdominal CT examination. Three courses of uracil and tegafur (UFT)/cisplatin (CDDP) chemotherapy were administered. The primary foci were reduced in size, then total gastrectomy was performed. Histological findings revealed a poorly differentiated adenocarcinoma with scirrhous invasion into the subserosa. Histological efficacy of the chemotherapy was judged to be grade 2. The patient has been alive without disease for more than five years after total gastrectomy. Neoadjuvant chemotherapy with UFT and CDDP may have contributed to the favorable clinical outcome in this patient.

Adenocarcinoma, Scirrhous↗

[Effects of the expression of the expert opinion on prosecution].

We carried out a questionnaire survey on judicial apprentices with a case died of subarachnoid hemorrhage to examine whether the expression of the text and supplementary explanation of the expert opinion affect judicial decisions and findings of facts. The survey results suggest that both the expressions of the text and the supplementary explanation may have an effect on the decision. That is, judicial apprentices who read the text expressed that "it was not clear whether the subarachnoid hemorrhage was traumatic or not" with the explanation are less likely to indict for injury resulting in death than those who read the text expressed that "it was not contradictory that the subarachnoid hemorrhage was traumatic" without the explanation. Additionally, we found that these two factors affected the reader's findings of fact. Particularly, the text expressed that "it was not contradictory" without a supplementary explanation is prone to give a conclusive conviction to readers. These results suggest that how a medical diagnosis would be legally interpreted in court depend to some extent upon the expression and the supplementary explanation of the expert opinion. The text of an expert opinion should be expressed to report the medical diagnosis exactly. When autopsy cannot determine the definitive cause of the death, detailed explanation should be supplemented lest the expert opinion give a conclusive conviction. Moreover, we suggest that it is necessary to standardize the form and expression of the expert opinion hereafter.

Cause of Death↗