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H Nakano

Publications and source records attributed to H Nakano.

At least 289 records · Page 16Linked to original sources
PubMed1999

Spontaneous rupture of a nonparasitic liver cyst complicated by intracystic hemorrhage.

a case of spontaneous rupture of simple liver cyst complicated by intracystic hemorrhage is described. This rare condition was detected in a 61-year-old man who underwent left trisegmentectomy of liver under a suspected diagnosis of cystadenocarcinoma because of elevated serum levels of carbohydrate antigen (CA) 19-9 and DUPAN 2, and the presence of an intracystic structure. The resected specimen showed a benign liver cyst with intracystic hematoma and high levels of CA19-9 and DUPAN 2 in the cystic fluid. It is suggested that cyst rupture may increase serum levels of tumor markers whose levels are high in the cystic fluid, and that repeated observations of an intracystic structure may be the most reliable method to distinguish intracystic hemorrhage from cystic neoplasm.

Antigens, Neoplasm↗
PubMed1999

Tumor angiogenesis predicts recurrence with normal serum carcinoembryonic antigen in advanced rectal carcinoma patients.

Many studies have established the usefulness of serum carcinoembryonic antigen (CEA) oriented serial monitoring for predicting recurrence and prognosis; however, few studies have so far investigated serum CEA-negative recurrence. The aim of this study was to elucidate the nature of CEA-negative recurrence regarding tumor angiogenesis. Fifty-seven patients with T3/T4 rectal cancer were divided into the two groups according to the serum CEA status. Angiogenesis was defined as the intratumoral vessel count by immunohistochemical staining using CD31. The CD31 count was significantly higher in the recurrent patients in both groups and the ratio of nodal involvement was significantly higher in the recurrent patients of the CEA-negative group. Local recurrence mainly developed in the CEA-negative group; however, the CD31 count did not predict the sites of recurrence nor the relapse period in the both groups. A multivariate analysis showed a high CD31 count >26) to be a prognostic factor not only for recurrence but also for survival (P = 0.001, 0.043, respectively). These results suggest that a high degree of tumor angiogenesis in sections of T3/T4 rectal cancer may therefore be an important predictor for CEA-negative recurrence.

Adenocarcinoma↗
PubMed1999

Phase II study of limited surgery for early gastric cancer: segmental gastric resection.

BACKGROUND: Endoscopic resection for treatment of early gastric cancer (EGC) is widely performed. Recently, however, surgeons began performing a limited operation for EGC when endoscopic resection was not indicated. This report discusses the surgical technique and the results of the limited operation, which is generally referred to as "segmental resection" (SR). METHODS: Since 1990, a total of 50 patients with intramucosal invasive EGC of the middle stomach underwent SR. The procedure included a limited gastrectomy, limited lymph node dissection, and preservation of the vagal nerve. We examined the surgical risk, postoperative complications, and patient survival rates and compared the results for the SR-treated patients (group A) with results for patients with EGC who underwent subtotal gastrectomy and systemic lymph node dissection (group B). RESULTS: Blood loss was less in group A (239 +/- 180 ml) than in group B (342 +/- 176 ml) (P < .05). The incidence of postoperative complications was also lower in group A (2.0%) than in group B (14.0%) (P < .05). The incidence of postoperative cholelithiasis was lower in group A (4.0%) than in group B (18.0%) (P < .05). All patients in both groups are alive without recurrence. CONCLUSIONS: Compared with distal gastrectomy, SR for EGC of the middle stomach decreased the surgical risk and postoperative complications without increasing the recurrence rate.

Female↗
PubMed1999

Hyperthermic isolated regional perfusion for the treatment of osteosarcoma in the lower extremity.

BACKGROUND: In order to reduce the systemic toxity of cisplatin and to increase the effect on the local tumor, facilitating limb-preserving procedures, we have been using hyperthermic isolated regional perfusion (HIRP) for the treatment of osteosarcoma in addition to preoperative chemotherapy. MATERIALS AND METHODS: Twenty patients with an osteosarcoma in a lower extremity were treated with both preoperative chemotherapy and HIRP. RESULTS: The chemotherapeutic effects of preoperative chemotherapy with HIRP was grade III in 6, and grade IV (no viable cell areas observed) in 7. The surgical margins could be reduced in these 13 cases of good responders showing over 90% necrosis (grade III or grade IV), which mainly involved postnecrotic fibrosis and osteosclerosis. CONCLUSION: HIRP can help to control the tumor locally. A more conservative operation was then possible in cases of good responders to preoperative chemotherapy with HIRP.

Adolescent↗
PubMed1999

Liver scintigraphy is useful for selecting candidates for preoperative transarterial chemoembolization among patients with hepatocellular carcinoma and chronic liver disease.

BACKGROUND: The indications for preoperative hepatic transarterial chemoembolization (TACE) have not been clarified by recent studies in patients with hepatocellular carcinoma (HCC) complicated by chronic liver diseases. The aim of the present study was to investigate which patients benefit most from preoperative TACE on the basis of hepatic functional reserve. Technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin (Tc-GSA) liver scintigraphy was used to assess hepatic functional reserve before and after TACE. PATIENTS AND METHODS: Liver scintigraphy was performed before and several weeks after TACE in 64 patients with HCC complicated by chronic hepatitis or cirrhosis. The ratio of liver to heart-plus-liver radioactivity of Tc-GSA 15 minutes after injection (LHL15) was calculated. Conventional hepatic functional tests were also performed. Whether to perform hepatectomy after TACE was decided mainly on the basis of the previously reported value of LHL15 > or =0.91. RESULTS: LHL15, prothrombin time, and serum concentration of cholinesterase significantly decreased after TACE in patients with LHL15 > or =20.91 (P <0.01, P <0.05, and P <0.05, respectively). In patients with LHL15 <0.91, LHL15 and functional liver volume significantly increased after TACE (both P <0.05). Eight patients with LHL15 > or =0.91 did not undergo hepatectomy because LHL15 decreased to less than 0.91 after TACE, whereas 7 patients with LHL15 <0.91 underwent hepatectomy because LHL15 increased to more than 0.91 after TACE. Three major postoperative complications occurred in patients with LHL15 > or =0.91, and no major complications occurred in patients with LHL15 <0.91. CONCLUSIONS: The results suggest that preoperative TACE should be performed in HCC patients only when LHL15 is less than 0.91, and that preoperative TACE is not an appropriate treatment for patients with LHL15 > or =0.91 when HCC is resectable.

Adult↗
PubMed1999

Fetal stabilization for antenatally diagnosed diaphragmatic hernia.

BACKGROUND/PURPOSE: Infants with congenital diaphragmatic hernia have pulmonary hypoplasia resulting in persistent pulmonary hypertension of neonates (PPHN), which is the main contributor to both high mortality and morbidity. The pulmonary artery bed in patients with congenital diaphragmatic hernia (CDH) is underdeveloped and is very sensitive to slight stimuli. It is, therefore, vital to avoid any factors that might increase pulmonary vascular resistance during the perinatal treatment of these patients. Recently, fetal anesthesia for perinatal stabilization in patients with CDH has been reported. However, the efficacy of this method remains controversial. The aim of this study is to analyze the benefits of fetal stabilization using fetal anesthesia in patients with CDH. METHODS: The authors have seen 9 cases of antenatally diagnosed CDH and attempted fetal stabilization. The indication for fetal stabilization was a lung thoracic ratio of less than 0.2, without any severe associated anomalies. The protocol for fetal stabilization was (1) monitoring the fetal respiratory movement and heart beat by ultrasonography, (2) the administration of morphine (20 to 30 mg) and diazepam (5 mg) to the mother, (3) the confirmation of any interruptions in fetal movement followed by a cesarean section, (4) pancuronimum (0.5 mg) was given through the umbilical vessels, (5) intubation before clamping of the umbilical cord, and (6) high-frequency oscillatory ventilation (HFO) without bagging. RESULTS: The lung-thratic ratio (LTR) was between 0.06 to 0.17 (average, 0.10+/-0.04). Operation was performed in 7 of 9 patients at between 2.5 and 27 hours after birth. The overall survival rate was 66.7% (6 of 9). All of the patients who underwent operation within 5 hours after birth survived. CONCLUSIONS: Perinatal stabilization using fetal anesthesia was found to be effective in preventing PPHN and shortening the period of preoperative stabilization. It also improved the survival rate of patients with severe CDH.

Female↗
PubMed1999

Dextran sulfate inhibits E-selectin-mediated neutrophil adhesion to endotoxin-activated vascular endothelial cells.

Effects of heparin-like glycosaminoglycans (h-GAGs) on neutrophil adhesion to endothelial cells (ECs) were investigated under physiological flow conditions using human umbilical vein ECs. Neutrophil adhesion to lipopolysaccharide-activated ECs was assayed under rotating conditions with addition of h-GAGs or monoclonal antibodies (mAbs) against selectins. Neutrophil adhesion to activated ECs under rotating conditions was suppressed completely by anti-E-selectin mAb and partially by anti-L-selectin mAb. Addition of dextran sulfate or heparin also significantly inhibited neutrophil adhesion to ECs under the same conditions. Moreover, effects of h-GAGs on neutrophil adhesion to recombinant E-selectin-coated plates were analyzed. Anti-E-selectin mAb and dextran sulfate, but not heparin, significantly inhibited neutrophil adhesion to E-selectin-coated plates. Results suggest that dextran sulfate inhibited E-selectin-mediated neutrophil adhesion to endotoxin-activated ECs under physiologic flow conditions.

Antibodies, Monoclonal↗
PubMed1999

Diffusion-weighted images and vasogenic edema in eclampsia.

BACKGROUND: In eclampsia, it is mandatory to recognize specific cerebrovascular complications before initiation of treatment. Diffusion-weighted magnetic resonance imaging (MRI) is a new technique that differentiates between cerebral infarction and hypertensive encephalopathy with vasogenic edema. CASE: A 23-year-old primigravida developed eclampsia at 29 weeks' gestation. Focal neurologic signs and neuroimaging findings by computed tomography and MRI were consistent with acute infarction or vasogenic edema. Diffusion-weighted MRI did not show an abnormal signal, indicating vasogenic edema. Control of the severe hypertension without anticoagulation therapy was begun. After delivery, the woman's neurologic abnormalities disappeared. CONCLUSION: Diffusion-weighted MRI differentiated between cerebral infarction and vasogenic edema, helping in the management of eclampsia.

Adult↗
PubMed1999

Rhythmic changes in the stomach movement of the human fetus with congenital duodenal obstruction during the third trimester of pregnancy.

In order to reveal whether or not rhythmic changes exist in fetal stomach movement (FSM), in utero FSM was assessed in three fetuses between 27 and 33 weeks' gestation with congenital duodenal obstruction. A total of four observations, one each at 27, 29, 31 and 33 weeks' gestation, was obtained. The longitudinal transection of each fetal stomach was continuously observed for 60 min using real-time ultrasound. The configuration and the area of the stomach were analyzed for each 15-s epoch. The complexity of the stomach configuration was quantified and defined as stomach complexity. For each case, the chronological changes of the stomach complexity were analyzed using the least median square of regression. The correlation between changes of the stomach complexity and the area of the stomach was analyzed using the cross-correlation method. (1) For gestational ages of 27, 29, 31 and 33 weeks, the 240 sequential measurements of the stomach complexity were significantly stratified into outlying and non-outlying points. The outlying points were 13.3% (32/240), 30.8% (74/240), 32.9% (79/240) and 36.3% (87/240) of the total observation points, respectively. (2) The percentages in which outlying points lasted 3 min (12 points) or more were 0% (0/240), 5.0% (12/240), 28.3% (68/240) and 30.4% (73/240) of the total observation points, respectively. (3) For each gestational age, no significant time series correlation was found between the stomach complexity and the area of the stomach. These findings suggest that: (1) two different conditions emerge in the FSM, at the latest at 27 weeks' gestation, and begin manifesting from 29 weeks' gestation onwards. (2) These chronological changes cluster into 'active' and 'quiet' phases from 31 weeks' gestation onwards. (3) FSMs are not related to the changes in the stomach area throughout the observation periods. The underlying mechanism of this rhythmicity may represent the development of ultradian rhythm of the stomach movement, generated by the central nervous system.

Duodenal Obstruction↗
PubMed1999

Mechanical properties of several nickel-titanium alloy wires in three-point bending tests.

The purpose of this study was to clarify the mechanical properties of 42 brands of nickel-titanium alloy orthodontic wires from 9 manufacturers by conducting three-point bending tests under uniform testing conditions. Manufacturers included A-Company, Hoya Medical, Lancer, Ormco, Rocky Mountain, Sankin, Tomy (GAC), TP, and 3M/Unitek. Cobalt-chrome, and titanium-molybdenum alloy wires were also tested as a reference for comparison of force levels. All reported data were recorded during the unloading process to simulate the force that a wire exerts on a tooth as it is moved into the dental arch from a position of malocclusion. The following results were obtained for the nickel-titanium wires tested. (1) Among the 0.016 inch round wires tested under a maximum deflection of 1.5 mm, the difference between the smallest (Copper nickel-titanium 35) and the largest (Aline) load values was 136 g. For the 0.016 x 0.022 inch rectangular wires tested, the difference between the smallest (Copper nickel-titanium 40) and the largest (Aline) load values was 337 g. (2) The change in load between 1.5 and 0.5 mm of deflection was examined to clarify the superelastic properties of the wires tested. For the 0.016 inch wires, 17 wire brands produced a load difference of less than 100 g, and two brands produced a difference of at least 100 g (Aline and Titanal = 100 g). For the 0.016 x 0.022 inch wires, 15 brands produced a load difference of less than 100 g, and eight brands produced a difference of over 100 g. The smallest and largest load differences were 3 g (Copper nickel-titanium 35) and 200 g (Aline). (3) The majority of the samples with a smaller load difference between deflections of 1.5 mm and 0.5 mm in the unloading process were found among super-elastic wires, while samples with a larger load difference were predominantly found among work-hardened wires. Compared with cobalt-chrome and TMA wires, nickel-titanium alloy wires exert significantly less force. However, the amount of force varies greatly from brand to brand. Consequently, when using nickel-titanium alloy wires, brands must be selected carefully by taking into consideration the severity of the malocclusion and the stage of orthodontic treatment in each case. It is the intent of this study to offer clinicians an unbiased guide for the selection of appropriate nickel-titanium alloy wires.

Dental Alloys↗
PubMed1999

Bronchocentric granulomatosis due to Aspergillus terreus in an immunocompetent and non-asthmatic woman.

This is the first report of bronchocentric granulomatosis due to Aspergillus terreus in a healthy and non-asthmatic 74-year-old Japanese woman. Following identification of the fungus, oral itraconazole therapy was begun after intrabronchial infusion of amphotericin B. No recurrence has occurred after treatment for 24 months. We should consider the possibility of bronchocentric granulomatosis including Aspergillus terreus, when an intrabronchial lesion is found even in a healthy and non-asthmatic person. Oral itraconazole after intrabronchial infusion of amphotericin B seems to be effective in such cases.

Aged↗
PubMed1999

Cell-retained isoforms of vascular endothelial growth factor (VEGF) are correlated with poor prognosis in osteosarcoma.

Vascular endothelial growth factor (VEGF) is a major angiogenic factor. Osteosarcoma is characterised by hypervascularity and metastatic potential. We examined VEGF mRNA expression, VEGF isoform pattern and VEGF receptor (flt-1 and KDR) by RT-PCR analysis in 30 osteosarcomas. All 30 osteosarcomas expressed VEGF mRNA. 17 osteosarcomas (57%) expressed flt-1 mRNA, whilst 20 (67%) expressed KDR mRNA. 6/30 (20%) osteosarcomas were positive for VEGF121 only, 8 (27%) for VEGF121 + VEGF165, and 16 (53%) for VEGF121 + VEGF165 + VEGF189. Patients with osteosarcomas with VEGF165 (n = 24) had significantly poorer prognosis in comparison with those without VEGF165 (P = 0.022, Wilcoxon's test). The osteosarcomas with VEGF165 had significantly increased vascularity assessed on sections immunostained for CD34 (P < 0.001, Mann-Whitney U test). Although VEGF165 is a soluble isoform, it is also retained on the cellular surface. These results suggest that cell-retained VEGF isoforms (VEGF165, VEGF189) might be essential for neovascularisation in osteosarcoma, whilst the soluble VEGF121 isoform is not sufficient to stimulate neovascularisation in this type of neoplasm.

Adult↗
PubMed1999

Synthesis of oligonucleotides containing a new azobenzene fragment with efficient photoisomerizability.

The azobenzene derivatives possessing substituents of ROCH2CH2O- and-CH2CH2OR' or -CONHCH2CH2OR' at p,p'-positions, where R and R' are 4,4'-dimethoxytrityl and 2-cyanoethyl-N,N'-diisopropylphophoramidite, have been synthesized for linking two oligonucelotide segments. It has been found that the azobenzene linkers efficiently undergo trans-cis isomerization by exposing to UV light. The conversion efficiency showed slight dependence on structure or conformation of oligonucleotides attached to the azobenzene chromophore. The cis-form of the azobenzene in oligonucleotides was sufficiently stable at low temperature under dark. The present findings would open the way for light switch of nucleic acid structures.

Azo Compounds↗
PubMed1999

Ku in the cytoplasm associates with CD40 in human B cells and translocates into the nucleus following incubation with IL-4 and anti-CD40 mAb.

CD40 plays a critical role in survival, growth, differentiation, and class switching of B lymphocytes. Although Ku is required for immunoglobulin class switching, how CD40 signal transduction is coupled to Ku is still unknown. Here, we show that CD40 directly interacts with Ku through the membrane-proximal region of cytoplasmic CD40. Ku was confined to the cytoplasm in human primary B cells, and the engagement of CD40 on the B cells cultured in the presence of IL-4 resulted in the dissociation of Ku from CD40, translocation of Ku into the nucleus, and increase in the activity of DNA-dependent protein kinase. These findings indicate that Ku is involved in the CD40 signal transduction pathway and may play an important role in the CD40-mediated events.

Antibodies, Monoclonal↗
PubMed1999

Caspase-1-independent, Fas/Fas ligand-mediated IL-18 secretion from macrophages causes acute liver injury in mice.

IL-18, produced as a biologically inactive precursor, is processed by caspase-1 in LPS-activated macrophages. Here, we investigated caspase-1-independent processing of IL-18 in Fas ligand (FasL)-stimulated macrophages and its involvement in liver injury. Administration of Propionibacterium acnes (P. acnes) upregulated functional Fas expression on macrophages in an IFNgamma-dependent manner, and these macrophages became competent to secrete mature IL-18 upon stimulation with FasL. This was also the case for caspase-1-deficient mice. Administration of recombinant soluble FasL (rFasL) after P. acnes priming induced comparable elevation of serum IL-18 in parallel with elevated serum liver enzyme levels. However, liver injury was not induced in IL-18-deficient mice after rFasL administration. These results indicate a caspase-1-independent pathway of IL-18 secretion from FasL-stimulated macrophages and its critical involvement in FasL-induced liver injury.

Amino Acid Chloromethyl Ketones↗
PubMed1999

Modulator-mediated synthesis of active lipase of Pseudomonas sp. 109 by Escherichia coli cell-free coupled transcription/translation system.

Catalytically active lipase was synthesized using Escherichia coli S30 extract from the signal-deleted lipL gene (lipL) in the presence of its N-terminal hydrophobic fragment-truncated modulator (rLimL) that was purified from the overexpressing E. coli cells. The specific activity of the lipase thus synthesized was 125 times higher than that of the purified one from Pseudomonas sp. 109. No lipase activity was detected in the absence of rLimL, even though the lipase protein itself was synthesized. Active lipase was also produced in vitro by coexpression of rlipL and the modulator gene (rlimL), although a much smaller amount of the lipase was formed. In the absence of rLimL, aggregates of the lipase were formed during its folding process. The addition of rLimL proportionally raised both lipase solubility and enzyme activity. An unstable but high activity peak of the lipase was found during its folding process.

Journal Article↗
PubMed1999

Ultrasonic tissue characterization in patients with dilated cardiomyopathy: comparison with findings from right ventricular endomyocardial biopsy.

AIM: The clinical usefulness of integrated backscatter (IB) imaging was compared with right ventricular endomyocardial biopsy for assessing myocardial damage in patients with dilated cardiomyopathy (DCM). METHODS: We examined 15 patients with DCM and 20 healthy controls. In addition to the conventional M-mode echocardiographic parameters, we determined the cyclic variation in IB values (CV-IB) obtained from parasternal short axis views of the left ventricle just under the transducer for both the interventricular septum (IVS) and the left ventricular posterior wall (PW). The per cent fibrosis area (%) and the transverse diameter of myocytes (microm) were measured in right ventricular endomyocardial biopsy specimens by computer image analysis. To analyze the relationship between pathological findings and CV-IB, we divided patients into four subgroups on the basis of the pathological characteristics of endomyocardial biopsy specimens as follows: degeneration dominant group (n = 5), fibrosis dominant group (n = 5), dilated phase hypertrophic cardiomyopathy (n = 2), and mixed type (n = 3). RESULTS: CV-IB in the IVS and the PW was lower in patients with DCM (8.8 +/- 2.9, 8.3 +/- 2.7 dB, respectively) than in normal subjects (14.4 +/- 2.9, 13.6 +/- 2.6 dB, respectively). Biopsy findings showed a mean per cent fibrosis area of 24.0 +/- 12.3%, and a mean myocyte diameter of 14.3 +/- 2.9 microm in patients with DCM. CV-IB was correlated with both of these findings: per cent fibrosis area (r = -0.56 in IVS, r = -0.56 in PW) and myocyte diameter (r = 0.67 in IVS, r = 0.71 in PW). CV-IB was decreased in all DCM subgroups compared with normal subjects, but there was no significant difference between subgroups. CONCLUSIONS: CV-IB was correlated with both the extent of fibrosis in myocardial tissue and the myocyte diameter. These findings suggest that ultrasonic tissue characterization is a good indicator of the severity of fibrosis and myocyte atrophy in patients with DCM.

Biopsy↗