[Clinical examinations. (23). "Screening" tests].
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Blood Chemical Analysis↗
Biomedical subjects
H Shibata
Publications and source records attributed to H Shibata.
Hepatic glucronyl transferase activity and bilirubin Tm in pregnancy in the rat.
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Animals↗
[Processing of the specimen and staining technics].
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Histological Techniques↗
Endoscopic sonography in the diagnosis of xanthogranulomatous cholecystitis.
Xanthogranulomatous cholecystitis (XGC) is an unusual inflammatory disease of the gallbladder that may simulate gallbladder cancer. We report the findings with conventional sonography, endoscopic sonography (EUS), and CT in 3 cases of XGC. EUS could visualize hyperechoic nodules in the gallbladder wall, probably representing xanthogranulomas, but loss of the multilayered structure of the gallbladder wall and infiltration into adjacent organs make differentiating XGC from gallbladder cancer difficult with EUS alone.
Aged↗
Expression profiles of COUP-TF, DAX-1, and SF-1 in the human adrenal gland and adrenocortical tumors: possible implications in steroidogenesis.
Chicken ovalbumin upstream promoter-transcription factor (COUP-TF), DAX-1, and steroidogenic factor-1 (SF-1) are orphan members of the nuclear hormone receptor superfamily. COUP-TF and DAX-1 have been shown to negatively regulate the transcriptional activity of SF-1, a steroidogenic cell-specific activator of various steroidogenic cytochrome P450 genes. We therefore examined the expression levels and immunolocalization of COUP-TF, DAX-1, and SF-1 in human adrenal gland (NL) and adrenocortical adenomas, and compared the results with CYP17 expression levels and its enzyme activities to study their potential correlation with adrenocortical steroidogenesis. In NL (n = 10), expressions of COUP-TF, DAX-1, and SF-1 were detected in the nuclei of adrenocortical cells, but not in the medulla. In cortisol-producing adenomas causing Cushing syndrome (CS, n = 20), CYP17 expression was upregulated (298 +/- 2% vs NL 98 +/- 4%), whereas expression levels of both COUP-TFs (COUP-TFI, 52 +/- 5% vs NL 98 +/- 4%; COUP-TFII, 18 +/- 4% vs NL 98 +/- 4%) and DAX-1 (42 +/- 4% vs NL 100 +/- 4%) were reduced. In deoxycorticosterone-producing adenomas (DOC, n = 2), on the other hand, CYP17 expression was extremely reduced (8 and 12% vs NL 98 +/- 4%), whereas DAX-1 expression increased markedly (350 and 360% vs NL 100 +/- 4%). Expression levels of SF-1 did not differ between NL (100 +/- 8%) and CS (106 +/- 10%), but its expression appeared to be decreased in DOC (25 and 20%). These results showed CYP17 expression to be upregulated and downregulated in CS and DOC, respectively, in a manner reciprocal to that of its repressors, COUP-TF and/or DAX-1. In summary, the results indicate that co-localization of COUP-TF, DAX-1, and SF-1 in NL was lost in adrenocortical tumors and that these orphan receptors play an important role in the regulation of steroidogenesis in human adrenals.
Adenoma↗
Measurement of competence: reliability and validity of the TMIG Index of Competence.
The reliability and validity of a multidimensional 13-item index of competence, called the TMIG Index of Competence, were tested with data of 6776 elderly community residents. The index was designed to measure the higher-level competence which could not be adequately assessed by existing scales. A well-fitted second-order factor model was established. Three first-order factors in the model were named Instrumental Self-Maintenance, Intellectual Activity, and Social Role, and the second-order factor was Competence. The results confirmed high reliability of the index with reliability coefficients of Alpha, test-retest, and correlation between the second-order factor score and the total score, and high validity in terms of construct, discriminant, and predictive validity.
Journal Article↗
Predictors of 10-year change in physical, cognitive and social function in Japanese elderly.
Data from the longitudinal Koganei Study, Japan, have been used to predict long-term rate of change in three aspects of quality of life in community living elderly: physical, cognitive and social functioning. Two hundred and forty of the initially 69-71-year-old individuals (75% of the survivors) participated in all three examinations which took place in 1976, 1981 and 1986. Physical function was expressed by mobility and grip strength, cognitive function by visual memory, and social function by six social activities. Rate of change was defined as the regression coefficient of each function on time for each individual. Predictors at baseline of subsequent rate of change were calculated using multiple regression models controlling for initial level of functioning. Several predictors were common to rate of change in more than one function: socio-economic status, activity level, aspects of life style and precursors of chronic disease such as stroke. Rates of change were also affected by specific living arrangements, which suggests culture-specific mechanisms. Despite the variety of patterns of change observed, these results provide some indication that decline in important aspects of quality of life can be prevented.
Journal Article↗
Predictors of all-cause mortality between ages 70 and 80: the Koganei study.
The present paper explores predictors of all-cause mortality based on a longitudinal multidisciplinary study of 422 community residents (197 men, 225 women) aged 69-71 years at baseline examination. The 422 subjects were followed up for 10 years (1976-1986), during which time 102 (59 men, 43 women) died. The Cox proportional hazards model was used to examine the effects of baseline variables on a time-dependent 10-year mortality. Body mass showed a U-shaped relationship to mortality in both sexes. Ex-drinking, current-smoking, history of stroke, history of diabetes mellitus, low ADL and ST and/or T changes in ECG had significant and direct effects on mortality in both sexes or either sex. Whereas, level of education, current-drinking, grip strength, visual retention, and serum albumin revealed significantly inverse relationships to mortality.
Journal Article↗
Incidence of hepatitis C virus (HCV) antibodies and HCV-RNA in blood donors and patients with liver diseases in the inshore area of the Yangtze River.
The Nantong area is a high risk region for primary hepatocellular carcinoma (PHC) in the inshore area of the Yangtze River. However, no detailed data are available about hepatitis C virus (HCV) infection in this area. We examined the incidences of anti-HCV and HCV-RNA in blood donors with hepatitis B surface antigen (HBsAg)- and hepatitis B core antibody (HBcAb)-negative and patients with chronic liver diseases in the Nantong area at Nantong Medical College, Jiangsu Province, the People's Republic of China. The incidences of HBV markers (HBsAg and/or HBcAb), anti-HCV (C100-3), second generation anti-HCV, HCV-RNA and any marker of HCV in the Nantong area were found to be: 0.0, 0.7, 0.4, 0.2 and 0.7% in donor bloods; 16.9, 0.0, 3.4, 15.7 and 16.9% in patients with acute hepatitis; 82.8, 2.7, 4.8, 7.5 and 10.2% in those with chronic hepatitis; 86.4, 4.5, 9.1, 4.5 and 11.4% in those with liver cirrhosis; 87.5, 6.3, 0.0, 0.0 and 6.3% in those with PHC; and 21.8, 1.3, 1.3, 0.0 and 1.3% in patients without liver diseases, respectively. Although the Nantong area is a high risk region for PHC, these data suggest that HCV infection is not an important aetiological factor for PHC in this area.
Blood Donors↗
Effects of a long-term inhalation of fragrances on the stress-induced immunosuppression in mice.
The aim of this study was to determine the effects of the long-term application of various fragrances on the suppression of immune response induced by high-pressure stress in mice. The immune response was analyzed based on plaque-forming cell (PFC) count, using mice sensitized with sheep red blood cells. The decreased PFC involving thymic involution induced by high-pressure stress in mice was restored by exposing the stressed mice to tuberose, lemon, oakmoss and labdanum for 24 h following exposure to stress. The decreased PFC and thymic involution from stress were restored by exposure to lemon and oakmoss, but not to tuberose and labdanum when the mice were exposed to those fragrances continuously for 3 weeks before the stress was given, followed by exposure to the same fragrances for 24 h after the stress. The decreased PFC and thymic involution from stress were restored by exposure to lemon and labdanum for 24 h after the stress, but not to tuberose over 3 weeks before the stress was given. These data suggest that the neuroimmunomodulatory effects of fragrances may be affected by tolerance depending on the kinds of fragrances in the case of a long-term application.
Animals↗
Suballeles of the ABO blood group system in a Japanese population.
The nucleotides (nt) at positions 467 and 646 of the ABO blood group system were analyzed in a Japanese population by means of the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. Two types at nt467, tentatively designated 'Pro' and 'Leu', were found in the common A (= A1) alleles, and two types at nt646 named 'T' and 'A' were found in O alleles. The types at nt467 of B and O alleles were Pro and those at nt646 of A and B alleles were T. Therefore, A alleles were divided into A(Leu) and A(Pro) suballeles and O alleles were divided into O(T) and O(A). The allele frequencies in the present survey were calculated as ABO*A(Pro) = 0.0712, ABO*A(Leu) = 0.2163, ABO*B = 0.1779, ABO*O(T) = 0.2731 and ABO*O(A) = 0.2615. No O2 (or O(3)) allele was observed in the population samples. At least five alleles with polymorphic frequencies and 15 genotypes are present in the Japanese sample.
ABO Blood-Group System↗
Differential expression of an orphan receptor COUP-TFI and corepressors in adrenal tumors.
Recently, it has been shown that CYP17 gene transcription is activated by SF-1 (Steroidogenic Factor-1) binding to a cyclic AMP-responsive sequence within the promoter region of the gene, whereas it is inhibited by COUP-TF (Chicken Ovalbumin Upstream Promoter-Transcription Factor) binding to the sequence. We have shown that transcriptional repression by COUP-TFI is mediated by corepressors, N-CoR (nuclear receptor corepressor) and SMRT (silencing mediator for retinoid and thyroid hormone-receptor). Therefore, we compared the expression of COUP-TFI, N-CoR and SMRT in non-hyperfunctioning adrenocortical adenomas and normal adrenal glands. We found significantly higher expression of COUP-TFI mRNA in non-hyperfunctioning adenomas (n=5, 227+/-18%) than in normal adrenals (n=5, 96+/-4%). Interestingly, the pattern of N-CoR and SMRT expression was different compared with COUP-TFI expression. These data suggest that COUP-TFI, N-CoR, and SMRT may play a differential role in steroid biosynthesis of non-hyperfunctioning adenomas.
Adenoma↗
The possible role of apoptosis-suppressing genes, bcl-2 and mcl-1/EAT in human adrenal tumors.
The expression levels of bcl-2, mcl-1/EAT, and bax were examined by Northern blot analysis and semi-quantitative RT-PCR method in 25 adrenal tumors, including seven adrenal pheochromocytomas (PHE), seven aldosterone-producing adenomas (APA), four adrenal cortisol-producing adenomas (CS), one deoxycorticosterone-producing adenoma (DOC) and six non-hyperfunctioning adrenal cortical adenomas (NF). Northern blot analysis revealed both bcl-2 and mcl-1/EAT mRNAs in all of the adrenal tumors. The expression levels differed greatly among the tumor samples. Mcl-1/EAT mRNA levels were enhanced in APA and CS compared with those in NF. In contrast, bcl-2 levels in NF were higher than in other tumors. Our results suggest that deregulation of such apoptosis-suppressing genes may contribute to the multistep tumorigenesis of human adrenal tumors and that mcl-1/EAT, one of the bcl-2 family genes, has a different role from that of bcl-2 in such pathways.
Adrenal Gland Neoplasms↗
[Research on nursing of bedridden elderly persons (1). Epidemiological studies on "bedridden period prior to death" in the elderly].
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Aged↗
Radiation therapy for primary non-Hodgkin's lymphoma of the head and neck.
From October 1977 through September 1986, a total of 77 patients (Stage I, 26; II, 35; and III-IV, 16) with primary non-Hodgkin's lymphoma (NHL) of the head and neck were treated with radiation therapy and chemotherapy (CVP or CHOP regimen) or radiation therapy alone. Actuarial 5-year survival rates by stage were 79% in Stage I, 35% in II, and 8% in III-IV. Significant prognostic factors were clinical stage (p = 0.0001), histological grade by the Working Formulation (p = 0.0089), and surface marker (T and B cell analysis) (p = 0.0001). In Stage II patients, the serum lactate dehydrogenase (LDH) level (p = 0.0286), the number of cervical lymph nodes involved (p less than 0.03), and maintenance chemotherapy after initial treatment (p = 0.0077) were significant prognostic factors. In conclusion, more intensive chemoradiotherapy is necessary as the first-line treatment in those with poor prognosis, especially those with T-cell type and high grade histology. In addition, maintenance chemotherapy after initial chemoradiotherapy is very important for Stage II NHL patients, especially those with a high LDH value or multiple cervical lymph node involvement.
Antineoplastic Combined Chemotherapy Protocols↗
Cerebrospinal fluid cytology in immature teratoma of the central nervous system. A case report.
The present case shows the usefulness of cerebrospinal fluid (CSF) cytology in the diagnosis of leptomeningeal dissemination by immature teratoma. The tumor arose in the thoracolumbar spinal cord of a 14-year-old male. The initial histopathologic diagnosis was made on the tumor tissue taken at laminectomy. Postoperatively, CSF cytology revealed epithelial cell clusters, scattered squamous epithelial cells and small bundles of striated muscle fibers in the background of many histiocytes and inflammatory cells. Although these cells showed only slight cytologic atypia, their presence in the subarachnoid space suggested the leptomeningeal spread of well-differentiated portions of the immature teratoma. The postmortem examination revealed the primary tumor in the spinal cord and multiple metastatic nodules in the brain.
Adolescent↗
A phase II study of epirubicin in acute leukemia: a cooperative group study.
A new doxorubicin analogue, epirubicin (EPI), was evaluated in 41 patients with acute leukemia at 11 Japanese institutions participating in a phase II study between January 1983 and July 1985; during this period 35 patients were considered evaluable. There were 25 males and 10 females with a median age of 43 years (range, 19-71 years) and the median PS of 2 (range, 0-4). EPI was given to 25 patients who had previously been treated with intensive combination chemotherapy, of whom 22 had already received anthracyclines. Ten patients had not been treated previously. Two dose schedules were explored. The higher dose schedule (18 cases) consisted of the administration of 24 to 60 mg/m2 for 3 to 5 consecutive days, and the lower dose schedule (17 cases) consisted of 11 to 20 mg/m2 for 5 to 7 days. Remissions were obtained in 7 patients (20%), 2 of whom showed complete remission and 5 partial remission. The remission duration was 2, 2, 3, 5, 16, 16 and 29+ weeks, respectively. The expected myelosuppression was universal. Stomatitis occurred in 15 patients, of which 7 cases were severe. This stomatitis occurred frequently in the higher dose schedule, and was thought to be a dose-limiting factor. In others, alopecia, G.I. symptoms, and diarrhoea (4 patients) were seen. These results from a cooperative group study indicated that EPI was an effective drug for the treatment of acute leukemia.
Acute Disease↗
Acute toxicity during adjuvant chemotherapy for breast cancer: the National Surgical Adjuvant Breast and Bowel Project (NSABP) experience from 1717 patients receiving single and multiple agents.
Since 1972, the National Surgical Adjuvant Breast and Bowel Project (NSABP) has carried out a series of clinical trials evaluating the worth of adjuvant chemotherapy in the management of patients with primary breast cancer. This report provides information concerning (a) protocol compliance relative to drug administration and (b) acute toxicity encountered by patients in three separate trials who were given one-, two- or three-drug chemotherapy within 1 month of operation. The findings are derived from 1548 women who received 20,765 courses of chemotherapy, the most extensively documented experience yet reported. They indicate that despite the large number of physicians and the heterogeneity of the institutions participating, large cooperative efforts can be accomplished with credibility. Only 13 (0.8%) of the women failed to complete all courses of therapy for reasons directly related to nonprotocol compliance by physicians. Only 4.3% failed to complete therapy for miscellaneous reasons other than toxicity, treatment failure, occurrence of a second primary, or death unrelated to tumor. While almost all patients experienced toxic reactions during the therapy, only 3%--4% of recipients of melphalan (L-PAM; P) and 4%--5% of recipients of L-PAM + 5-FU(F)(PF) failed to complete 2 years of therapy because of toxicity. Of those patients receiving PF + methotrexate (MTX; M) (PMF), 15% did not finish their treatment for that reason. While there was little difference in hematologic and nonhematologic toxicity between those patients receiving P or PF, and such toxicity was generally acceptable to both patients and physicians, the addition of MTX (PMF) resulted in greater toxicity (vomiting, stomatitis, and alopecia) which was less readily accepted. Tolerance of any of these regimens was unrelated to patient age, despite the belief that older women are less tolerant of chemotherapy. The earlier toxicity occurred, the greater was the number of subsequent courses associated with toxicity, and the lower was the total amount of drug received. The extent of the toxicity produced by the NSABP regimens and the end results obtained with them, must be compared with the end results and toxicity obtained by other regimens before making a choice of the adjuvant therapy to be used.
Aged↗