Biomedical subjects

H Kuwano

Publications and source records attributed to H Kuwano.

At least 325 records · Page 18Linked to original sources

PubMedDate not supplied

Phospholipase D activity in human gastric carcinoma.

Growth factor-stimulated phospholipase D (PLD) catalyzes the hydrolysis of phosphatidylcholine, generating phosphatidic acid which may act as a second messenger during cell proliferation, therefore PLD is believed to play an important role in tumorigenesis. Thus we measured PLD activity in human gastric carcinoma to evaluate its role in gastric carcinogenesis. PLD activity was assayed by a unique transphosphatidylation reaction using microsomal fraction of 21 pairs of surgically resected human gastric carcinomas and adjacent noncancerous mucosas. The mean PLD activities in gastric carcinoma and adjacent noncancerous mucosa were 63.0 +/- 69.5, 44.2 +/- 60.1 pmol/min/mg, respectively (p < 0.01; Wilcoxon signed rank test). The mean ratio of PLD activity in gastric carcinoma and adjacent noncancerous mucosa was 1.63. This ratio was significantly higher in patients with larger tumors (> or = 5 cm) (p < 0.01; Mann-Whitney U-test). Our results indicate that the elevation of PLD activity plays an important role in the promotion of gastric carcinoma.

Adenocarcinoma↗

PubMedDate not supplied

Spindle cell carcinoma of the pancreas: a case report.

We report on a resected case of spindle cell carcinoma of the pancreas in a 73 year-old Japanese male who has a history of diabetes mellitus. The patient visited his neighborhood hospital complaining of abdominal pain and was referred to our hospital for further examination of a pancreatic tumor discovered by abdominal ultrasonography. Upon the diagnosis of ductal carcinoma, a distal pancreatectomy with splenectomy was performed. Microscopically, the tumor was composed of spindle cells arranged in interlacing bundles with frequent mitotic figures. The diagnosis of spindle cell carcinoma of the pancreas was confirmed by immunohistochemical studies. To our knowledge, our case is the first resected case of spindle cell carcinoma arising from the pancreas in the English literature.

Aged↗

PubMedDate not supplied

Free jejunal pouch graft reconstruction after a resection of hypopharyngeal or cervical esophageal cancer.

BACKGROUND/AIMS: Pharyngoesophageal reconstruction using the free vascularized jejunal graft sometimes results in dysphagia and this may be caused by anastomotic stenosis at either the distal or proximal anastomotic site, graft contractility and the entrapment of food in the blind loop after an end-to-side pharyngojejunostomy. We therefore applied pouch procedures to the free jejunal graft in order to improve the ability for such patients to consume normal food. METHODOLOGY: We performed this procedure on 4 patients with pharyngoesophageal cancer located within the cervical regions. RESULTS: As a result, the following post-operative complications occurred in 1 case each: anastomotic leakage at the pharyngojejunostomy (proximal anastomosis) which healed spontaneously, and anastomotic stenosis in jejunoesophagostomy (distal anastomosis) which improved after performing endoscopic dilatation. CONCLUSIONS: However, these complications were not thought to be due to the pouch procedures and the passage of food was found to be excellent in all cases at the time of discharge.

Anastomosis, Surgical↗

PubMedDate not supplied

Immunological analysis in xenogeneic fetal porcine liver transplantation into a beagle.

BACKGROUND/AIMS: While allogeneic organ transplantation has been performed safely, a major barrier in xenogeneic transplantation is how to inhibit hyperacute rejection. METHODOLOGY: We challenged xenogeneic fetal liver transplantation from pig to dog. The graft was investigated by immunohistochemical analysis on recipient's IgG, IgM and C3. RESULTS: In 1 of 4 cases, the graft escaped hyperacute rejection for about 4 hours after transplantation, however, the recipient died next day due to hemorrhage from the torn capsule of the liver due to the arterial blood pressure of the recipient. Histologically, the parenchyma showed good countenance and no congestion nor hemorrhage was shown in the vessels. On immunohistochemical analysis, canine IgG, IgM and C3 were deposited on the sinusoidal epithelium of the fetal liver more moderately than that of adult control. Fetal porcine liver showed less expression of major histocompatability complex class I antigen than that of the adult one. CONCLUSIONS: We consider that the hyperacute rejection occurred more slowly in xenogeneic fetal liver transplantation than in the adult one due to not only less expression of major histocompatability complex class I, but also lower expression of the epitope recognized by a natural antibody of the recipient.

Animals↗

PubMedDate not supplied

An immunohistochemical study of p16, pRb, p21 and p53 proteins in human esophageal cancers.

BACKGROUND: Cell cycle-associated proteins, p16, pRb, p21 and p53 are important in regulating the G1-S checkpoint in the cell cycle, and their functional alterations play key roles in carcinogenesis and cell proliferation. MATERIALS AND METHODS: We immunohistochemically examined the expression of p16, pRb, p21 and p53 proteins by using surgically resected tissues from 35 patients with primary esophageal cancers. RESULTS: In 35 esophageal cancers, the expressions of p16, pRb, p21 and p53 proteins were detectable in 4(11.4%), 25(71.4%), 11(31.4%) and 20(57.1%) respectively. Interestingly, 24 of 25 pRb positive cancers (96.0%) had negative p16, whereas three of ten pRb-negative cancers (30.0%) had high levels of p16 (p < 0.05). In 11 cases of p21 positive immunostaining, there was lymph node metastasis (pN1) in 9 (81.8%). CONCLUSIONS: These results suggest that abnormalities of p16 protein may be closely associated with the carcinogenesis or cell proliferation of esophageal cancers.

Adult↗

PubMedDate not supplied

Immunohistochemical status of the p53 protein and Ki-67 antigen using biopsied specimens can predict a sensitivity to neoadjuvant therapy in patients with esophageal cancer.

BACKGROUND/AIMS: The prediction of an effective adjuvant therapy is essential in order to increase the number of esophageal cancer cases demonstrating an excellent response. Correlation of the immunohistochemical expression of p53 protein and Ki-67 antigen were studied using biopsied specimens of advanced esophageal cancer. The combined staining status of both can help predict the efficacy of neoadjuvant therapy in patients with esophageal cancer. METHODOLOGY: The overexpression of p53 protein and the Ki-67 labeling percentage were immunohistochemically investigated in 95 biopsied specimens of advanced esophageal carcinoma resected between 1988 and 1996. All patients preoperatively received 1 course of either chemoradiotherapy or hyperthermo-chemoradiotherapy. RESULTS: Thirty-nine specimens were positive for p53 protein staining (41.1%), and the treatment modalities were histopathologically effective in 71.8% of these 39 patients (28/39), while the efficiency rate was 58.9% (33/56) in patients with p53(-). On the other hand, the efficiency rate of patients with a high Ki-67 labeling percentage (> or = 30%) was 73.9%, which was significantly higher than that of those with a low Ki-67 labeling percentage (< 30%) (38.5%, P = 0.0013). The efficacy rate of the patients with both a high Ki-67 labeling percentage and p53(+) was 80%, while that of the patients with a low Ki-67 labeling percentage and p53(-) was only 35.3% (P = 0.0098). The combination of a high Ki-67 labeling percentage and p53(-) particularly showed a high sensitivity to hyperthermo-chemoradiotherapy since the efficiency rate of these patients with hyperthermo-chemoradiotherapy was 81.5%, while the rate for those with chemoradiotherapy was 41.7% (P = 0.0129). CONCLUSIONS: An immunohistochemical analysis of p53 and the Ki-67 labeling percentage using biopsied specimens was thus found to effectively predict the efficacy of neoadjuvant therapies in patients with esophageal cancer.

Adult↗

PubMedDate not supplied

Gallbladder hematoma in a patient with hemophilia B, report of a case.

The authors report the case of a 49-year-old man, hematoma of the gallbladder associated with hemophilia B. The patient was diagnosed incidentally by abdominal computed tomography with a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed negative gallbladder and angiography showed no obvious abnormality in the cystic artery. Magnetic resonance imaging showed a mass of mixed intensity on T2-weighted image and a mass of mixed intensity on the lining of the gallbladder wall. Hemorrhage in the gallbladder was thought to be most likely, however, the gallbladder tumor could not to be neglected. Cholecystectomy was performed on the patient and the pathological diagnosis was of a hemorrhage in the gallbladder. Hematoma of the gallbladder is a rare complication in patients with hemophilia B, however, it leads sometimes to a fatal course and magnetic resonance imaging is very useful to diagnose hemorrhage in the gallbladder.

Cholangiopancreatography, Endoscopic Retrograde↗

PubMedDate not supplied

Double cystic duct detected by endoscopic retrograde cholangiopancreatography and confirmed by intraoperative cholangiography in laparoscopic cholecystectomy: a case report.

A case of double cystic duct with cholecystolithiasis detected by preoperative endoscopic retrograde cholangiopancreatography and confirmed by intraoperative cholangiography which was treated successfully by laparoscopic surgery is reported. The patient was a 74-year-old woman who complained of abdominal pain in the right upper quadrant. On admission, ultrasonography revealed hyperechoic areas accompanied by obscure acoustic shadows in the gallbladder. Preoperative endoscopic retrograde cholangiopancreatography showed 2 cystic ducts; 1 branched from the common bile duct and the other from the right hepatic duct. After a diagnosis of double cystic ducts, we chose laparoscopic cholecystectomy. Intraoperative cholangiography via 1 of the cystic ducts revealed the presence of the other. We were able to perform laparoscopic cholecystectomy without any complications and the postoperative course was uneventful. This case suggests that preoperative endoscopic retrograde cholangiopancreatography and intraoperative cholangiography is required to avoid complications during laparoscopic cholecystectomy.

Aged↗

PubMedDate not supplied

Epidermoid cyst of an intrapancreatic accessory spleen--a case report.

We report an extremely rare case of a splenic epidermoid cyst of the pancreas in a 51-year-old Japanese male with no clinical symptoms. A cystic tumor of the pancreatic tail was detected incidentally by abdominal ultrasonography. The patient was referred to the Gunma University Hospital for further examination of the pancreatic tumor. Upon diagnosis of a benign cystic tumor, a distal pancreatectomy with splenectomy was performed. Microscopically, the multicystic tumor, which was surrounded by the splenic tissue, was located within the pancreatic tissue. The cysts were lined by non-keratinizing squamous epithelium. The diagnosis of an epidermoid cyst occurring in an intrapancreatic accessory spleen was confirmed. To our knowledge, this is the 4th case ever reported in the English literature.

Choristoma↗

PubMedDate not supplied

Significance of the measurement of serum trypsin in patients surgically treated for gastric cancer.

BACKGROUND/AIMS: The influence of standard lymphadenectomy on the occurrence of damage to the pancreas was evaluated in 107 patients with gastric cancer, by analyzing related serum trypsin and amylase levels, pre- and postoperatively. METHODOLOGY: We divided the patients into two groups: Group A included 59 patients who underwent a standard D1 gastrectomy, according to the classification outlined by the Japanese Research Society for Gastric Cancer. Group B included 48 patients who underwent a D2 gastrectomy. RESULTS: Group B patients had significantly elevated serum trypsin levels on the 7th and 14th postoperative days (P < 0.01). The percent increase in serum trypsin in Group B patients was also significantly elevated on the 7th and 14th postoperative days (P < 0.01). However, there were no significant difference between the two groups in the percent increase or level of serum amylase. CONCLUSIONS: These findings indicate that the measurement of serum trypsin may useful to predict the degree of pancreatic micro-damage caused by lymphadenectomy.

Adult↗

PubMedDate not supplied

Laparoscopic Nissen fundoplication using laparosonic coagulating shears: report of a case.

A 64-year-old man was admitted to Gunma University Hospital because of gastroesophageal reflux disease and hiatus hernia. Endoscopic examination showed a linear ulcer and mucosal redness in the lower esophagus. Gastrointestinal contrast study revealed a large esophageal hiatal sliding hernia. Laparoscopic Nissen fundoplication was then performed. Short gastric vessels were divided and lesser omentum was ablated with laparosonic coagulating shears, and the fundus of the stomach was used to construct the wrap around the esophagus. Three hundred and sixty degree fundoplication was undertaken using four sutures to secure the wrap. The patient is well and is currently free from reflux symptoms. Laparoscopic Nissen fundoplication is effective in the control of gastroesophageal reflux in the patient with hiatus hernia. This case report demonstrates that the use of laparosonic coagulating shears is effective for the division of the short gastric vessels.

Cautery↗

PubMedDate not supplied

Antiemetic effect of ramosetron during hyperthermo-chemo-radiotherapy for esophageal cancer.

BACKGROUND: The antiemetic effects of serotonin receptor antagonists during chemoradiotherapy for solid tumors have never been reported. We have developed hyperthermo-chemo-radiotherapy (HCR) for esophageal cancer. However, with this treatment, the more potent the chemotherapy was, the more frequently emesis was experienced. MATERIALS AND METHODS: Fifteen patients with esophageal cancer underwent HCR (6 courses of hyperthermia, cisplatin 20 mg/m2 x 6, 5-FU 300 mg/m2 x 15 and radiation 1.5 Gy x 30). Ramosetron was administered intravenously (0.3 mg x 15). The emesis inhibition rate was defined as the rate of patients having neither vomiting nor severe nausea. RESULTS: The incidence of patients without nausea gradually decreased to 60% at the end of chemotherapy. However, vomiting was completely avoided except in one patient for two days. The emesis inhibition rates of weeks 1, 2, 3 and 4 were 100.0, 93.3, 89.5 and 95.2%, respectively. The overall inhibition rate was 94.5% and the rate of "well inhibited" was 79.0%. There were no ramosetron-related adverse reactions. CONCLUSIONS: These findings suggest that ramosetron is a useful antiemetic agent for nausea and vomiting induced by chemoradiotherapy for solid tumors.

Aged↗

PubMedDate not supplied

Pathogenesis of esophageal squamous cell carcinoma with lymphoid stroma.

BACKGROUND/AIMS: Lymphocyte infiltration in esophageal cancer, especially when beneath intraepithelial carcinoma, is frequently seen. However, cases of esophageal cancer with a dense stromal infiltration of lymphocytes are rare and the pathogenesis of such cases has yet to be clearly demonstrated. The objective of this study is to clarify its pathogenesis. METHODOLOGY: Four cases of esophageal squamous cell carcinoma with lymphoid stroma were investigated by immunohistochemical staining for the detection of Epstein-Barr virus, human papillomavirus, human leukocyte antigen-DR, as well as T and B cells in cancer tissue. RESULTS: In these four cases, neither positive staining of Epstein-Barr virus nor human papillomavirus infection was detected. On the other hand, the expression of human leukocyte antigen-DR antigen was evident in all cases with dense T-cell infiltration in the tumor tissue and moderate B-cell infiltration around the tumor. CONCLUSIONS: The expression of human leukocyte antigen-DR antigen without Epstein-Barr virus or human papillomavirus infection could thus be one possible pathogenesis of patients demonstrating esophageal squamous cell carcinoma with a lymphoid stroma.

Aged↗

PubMedDate not supplied

Obstruction due to persimmon bezoars: computed tomography detection.

BACKGROUND/AIMS: Small-bowel obstructions caused by persimmon bezoars are uncommon, and the diagnosis is difficult before operation. The aim of this study was to present computed tomography findings of persimmon bezoars in the small bowel. METHODOLOGY: We reviewed 3 cases diagnosed with small-bowel obstruction caused by persimmon bezoars between April 1997 and March 1999 at Chikamori Hospital. RESULTS: The cause of the small-bowel obstruction was bezoars in the 3 patients. Abdominal computed tomography performed before operation revealed a well-defined, intraluminal inhomogeneous mottled mass containing gas bubbles. CONCLUSIONS: Computed tomography is useful for diagnosing obstructed small-bowel persimmon bezoars.

Adult↗

PubMedDate not supplied

Expression of nitrotyrosine is associated with angiogenesis in esophageal squamous cell carcinoma.

BACKGROUND: In our previous study, it was suggested that nitrotyrosine, a product of nitrogen species, found in esophageal squamous cell carcinoma (ESCC), may contribute to the progression of esophageal cancer. MATERIALS AND METHODS: To clarify whether nitrotyrosine expression is associated with apoptosis and/or angiogenic factors in ESCC, we have analyzed the relationship between nitrotyrosine presence and the apoptosis-related proteins, Bcl-2 and Bax, or CD34, the marker of vascular endothelial cells, by an immunohistochemical approach. RESULTS: Nitrotyrosine was detected in 21 out of 55 esophageal cancers. The correlation between nitrotyrosine presence and Bcl-2, Bax expression or apoptotic index (AI) was not significant. In contrast, nitrotyrosine presence was significantly correlated with the microvessel density (MVD); nitrotyrosine-positive specimens tended to show a high MAD, while nitrotyrosine-negative specimens tended to be associated with a low MVD (p<0.05). CONCLUSION: Our data suggest that NO induces progression of esophageal carcinoma through its effect on angiogenesis, rather than its effect on tumor apoptosis.

Adult↗

PubMedDate not supplied

The nature of inner cellular lining of the expanded polytetrafluoroethylene vascular graft: immunohistochemical study.

Histological and immunohistochemical studies of the healing processes of expanded polytetrafluoroethylene (PTFE) vascular graft were performed. In the animal experiment, endothelial cell lining, confirmed by immunohistochemical staining for anti-Factor VIII related antigen, existed nearly over all of the pannus. The endothelial cells also formed to some extent over the graft without pannus. Endothelialization showed a close dependency on the surface condition of the underlying tissue rather than on a time factor. In the human experiment, an endothelial island was observed in the middle portion of the graft in one case, supporting the hypothesis of the blood stream origin of endothelial cells.

Aged↗

PubMedDate not supplied

Hyperthermochemoradiotherapy for esophageal cancer (review).

Hyperthermia is effective for the treatment of cancer when applied concomitantly with chemotherapy and irradiation. However, it is difficult to heat deep portions of the body including the esophagus. Cancer of the esophagus still poses considerable treatment problems, with a poor 5-year survival rate after surgery, an even worse outlook after radiation and surgery, and a not very satisfactory response to chemotherapy. We, therefore, devised an electrode for radio frequency, and we have been successfully using this electrode in the treatment of esophageal cancer. The 5-year survival rates of patients with esophageal cancer, given either preoperative hyperthermochemoradiotherapy or chemoradiotherapy, were 43.2 and 14.7%, respectively. Immediate improvement of subjective complaints and decrease or elimination of the cancer lesion are so distinct that this treatment, by means of an endotract antenna, shows promise as a modality for esophageal lesions.

Esophageal Neoplasms↗

PubMedDate not supplied

Different chemosensitivities of rat 3Y1 fibroblasts transformed by various agents in vitro.

Alterations of chemosensitivities associated with transformation of rat 3Y1 fibroblasts were compared among various agents, including either adenovirus type 12 (Ad12-3Y1), the E1A region of adenovirus type 12 (E1A-3Y1), mouse polyoma virus (Py-3Y1), Simian virus 40 (SV-3Y1), Rous avian sarcoma virus (SR-3Y1), plasmid DNA carrying v-Ha-ras oncogene (HR-3Y1), or N-methyl-N'-nitro-N-nitrosoguanidine (NG-3Y1), with untransformed 3Y1 fibroblasts, using a semiautomated non-clonogenic MTT assay. IC50 values were compared for each drug in each cell line. Among the different cell lines, untransformed 3Y1 cells were the most resistant to cisplatin (CDDP), adriamycin (ADM), carboquone (CQ), bleomycin (BLM), mitomycin C (MMC) and 4-hydroperoxy cyclophosphamide (4-hp-CPA). On the other hand, E1A-3Y1 cells were more resistant to vincristine (VCR) and NG-3Y1 and Ad12-3Y1 were more resistant to 5-fluorouracil (5-FU) than untransformed 3Y1 cells. These transformed lines did not display any cross-resistance to other drugs. The dissociation of chemosensitivities between Ad12-3Y1 and E1A-3Y1 to ADM, VCR and 5-FU was recognized. These results suggested that some of these transforming agents may alter the chemosensitivities of anticancer drugs.

Animals↗