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Biomedical subjects

H Shimada

Publications and source records attributed to H Shimada.

At least 127 records · Page 7Linked to original sources
PubMed2001

Acute abdominal pain preceding cutaneous manifestations of varicella zoster infection after allogeneic bone marrow transplantation.

The current communication describes clinical findings in two recipients of allogeneic bone marrow transplantation (BMT) with varicella zoster virus infection who complained of acute severe abdominal pain preceding cutaneous manifestations. Physical examination, laboratory data and gastroscopic findings were nonspecific. In these cases, acyclovir was very effective for the symptoms. Varicella zoster virus infection should be suspected in BMT recipients who have rebellant acute abdominal pain but no characteristic skin eruptions.

Abdominal Pain↗
PubMed2001

An 80-year-old mitochondrial disease patient with A3243G tRNA(Leu(UUR)) gene presenting cardiac dysfunction as the main symptom.

MELAS is characterized by mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, but cardiac involvement also frequently occurs. An 80-year-old female patient had been suffering from insulin-dependent diabetes mellitus and neurosensory hearing loss. At the age of 79 she suffered metabolic acidosis with persistent drowsiness and was subsequently found to have severe cardiac dysfunction. Muscle biopsy disclosed the presence of abnormal mitochondria, and the MELAS gene mutation (A3243G of the tRNA(Leu(UUR))) was demonstrated. It is noteworthy that this mitochondrial disease patient has survived until a great age, which shows the wide clinical spectrum of MELAS, especially in the age of onset.

Aged↗
PubMed2001

Hypothalamic encephalitis with bradycardia.

A 74-year-old man developed fever, somnolence, hyponatremia, and life-threatening sinus bradycardia for three weeks. He showed a slight elevation of lymphocyte count and protein level in the cerebrospinal fluid. A brain CT scan revealed a diffuse low density area around the hypothalamus which was identified as a high intensity signal by flair MR imaging. Marked sinus bradycardia developed with no abnormality in the echocardiograph or cardiac enzymes. Over the next 6 weeks he became alert and normal sinus rhythm resumed. The results of endocrine tests were compatible with hypothalamic insufficiency with partial hypopituitarism and the syndrome of inappropriate secretion of ADH.

Aged↗
PubMed2001

Immortalization of human esophageal keratinocytes by E6 and E7 of human papillomavirus type 16.

Transduction of human papillomavirus type 16 (HPV16) E6/E7 into primary culture of human esophageal keratinocytes using a recombinant adenovirus prolonged the life-span, while untreated cells senesced within 14-16 population doublings (PDLs). Up-regulation of telomerase activity and acquisition of serum-resistant growth were observed in the esophageal keratinocytes with extended life-span between 50 and 100 PDLs, and drastically increased after 100 PDLs. A keratinocyte sample with a polymorphism of Pro/Pro at codon 72 of p53 showed resistance to HPV16 E6/E7-induced life-span-extension and immortalization, in contrast to others with p53 polymorphisms of Arg/Arg or Arg/Pro, which did not. The high efficiency of E6/E7-induction by adenovirus vector also revealed the M1 and M2 stages of keratinocyte immortalization first described in this report.

Adenoviridae↗
PubMed2001

[Changes over time of coping behavior and stress responses].

The purpose of this study was to investigate the relationship between coping behavior and stress response of undergraduates as they experienced over time prior to an examination. One hundred forty eight undergraduates were asked to complete a set of questionnaires on coping behavior and stress response at a month (T1), a week (T2), and immediately (T3) prior to an important examination. Cluster analysis showed that there were four clusters of coping behavior at each period of time. Regardless of their effort level, students with high distress showed higher stress score than those with low distress. In hierarchical regression analysis of stress response change, an interaction effect of effort change and distress change over T1 to T2 was significant. Stress responses lessened for students whose effort score increased but distress score decreased. The opposite was true for those whose effort score decreased but distress score increased. From T2 to T3, a main effect of distress was significant: For students whose stress response increased, distress score also increased.

Adaptation, Psychological↗
PubMed2001

[Perspectives on postgenome medicine: Gene therapy for esophageal cancer].

Despite improvements in perioperative treatment and surgical techniques, rapid recurrence led to death of many patients with advanced esophageal cancer. Since surgical resection alone rarely results in long term survival, efforts now are focused on combined multi modality treatment in an attempt to improve local control and eliminate micro metastasis present at time of surgery. We have reported that the importance of alteration of p53 gene in progression and prognosis of esophageal cancer. P53 molecule of solid tumors has been shown to play an important role in the response to DNA damage induced by chemotherapeutic agents and radiation therapy, including induction of apoptosis. Based on the research of p53 gene therapy for esophageal cancer, we applied clinical study in 1997. After intensive reference, phase study was accepted in May, 2000. Phase I/II study will start on October 2000.

Animals↗
PubMed2001

[Prognosis of endogenous fungal endophthalmitis and utility of Ishibashi's classification].

PURPOSE: Prognostic evaluations of eyes with endogenous fungal endophthalmitis were made according to the classification proposed by Ishibashi. PATIENTS AND METHODS: We surveyed endogenous fungal endophthalmitis cases at four Nihon University Hospitals and 20 branch hospitals. Sixty eyes of 34 patients were classified into five stages according to Ishibashi's proposal, and therapeutic methods and visual prognosis in each stage were then evaluated. RESULTS: Systemic antifungal drugs were efficacious in 82% of stage II and 69% of stage IIIa cases. Even among stage III b cases, antifungal drugs were efficacious in 42%. Among the unresponsive cases, only half had been given the maximum dosage of antifungal drugs. Half of the eyes in which vitrectomy was performed at stage III b achieved a postoperative visual acuity of 0.5 or better and none had a visual acuity of less than 0.03. CONCLUSION: Based on the above results, we concluded that systemic antifungal drugs should be administered at the maximum dosage in stage II and III a cases. If these eyes progress to stage III b despite the maximum dosage, vitrectomy is indicated. For stage III b eyes, the maximum dosage should be administered first. If the maximum dosage is not efficacious, vitrectomy should be carried out before progression to stage IV.

Adolescent↗
PubMed2001

[Shortening the duration of prone positioning after macular hole surgery--comparison between one week and one day].

PURPOSE: We shortened the duration of prone positioning after macular hole surgery from one week to one day and evaluated the initial hole closure rate. SUBJECT AND METHOD: The first group included 34 eyes of 33 patients who underwent surgery between April 1998 and August 1999. All 33 patients were instructed to maintain the prone position for one week after surgery (one week group). The second group included 21 eyes of 21 patients who underwent surgery between September 1999 and March 2000. These 21 patients were told to maintain the prone position for 24 hours after surgery (one day group). The indication for surgery was eyes with the reported onset of symptoms within 6 months and without long-standing macular holes. Eyes which underwent retinal pigment epithelium (RPE) or internal limiting membrane (ILM) removal were excluded from the study. Phacoemulsification and intraocular lens implantation were combined in patients with phakic eyes. In the one day group, the patients were instructed to avoid the face up position for one week. RESULTS: There were no significant differences between the two groups in terms of preoperative factors, and initial hole closure rates (i.e., 91.2% in the one week and 90.5% in the one day groups). CONCLUSION: These results suggests that the duration of prone positioning after macular hole surgery can be reduced to as little as 24 hours without RPE or ILM removal in eyes without long-standing holes.

Aged↗
PubMed2001

[Vitrectomy for diabetic cystoid macular edema].

PURPOSE: We evaluated the visual outcome of vitrectomy for diabetic cystoid macular edema. METHODS: Visual outcome and factors which may influence final visual acuity were assessed and documented retrospectively in 45 eyes of 40 patients, all of whom were followed for at least 6 months postoperatively. RESULTS: Final postoperative visual acuity was two or more lines better than preoperative visual acuity in 58%, within one line in 40%, and had decreased by two lines or more in 2%. A final postoperative visual acuity of 0.5 or better was achieved in 38%. Preoperative visual acuity and the extent of the cystoid space on fluorescein angiography were significantly related to final visual acuity. A final postoperative visual acuity of 0.5 or better was noted in 8% of eyes with a preoperative visual acuity below 0.1, in 50% of eyes with preoperative visual acuity of 0.1 or better, in 71% of eyes with a cystoid space smaller than 5 disc areas, and in 20% of eyes with a cystoid space of 5 disc areas or more. The posterior vitreous membrane condition did not influence final visual acuity. There were no complications which decreased visual acuity. CONCLUSION: Based on the above results, we conclude that diabetic cystoid macular edema is a good indication for vitrectomy regardless of the posterior vitreous membrane condition. A preoperative visual acuity of 0.1 or better and/or a cystoid space smaller than 5 disc areas may be indications for surgery aimed at achieving a final postoperative visual acuity of 0.5 or better.

Adult↗
PubMed2001

[Extracellular matrix degradation enzymes: important factors in liver metastasis of colorectal cancer and good targets for anticancer metastatic therapy].

Extracellular matrix (ECM) degradation enzymes, such as matrix metalloproteinases (MMPs) and plasminogen activators, are important factors in cancer invasion and metastasis, because invasion and metastasis of cancer cells require destruction of mesenchymal collagen or the endothelial basement membrane. Moreover, recent studies have shown that ECM degradation enzymes play important roles in cancer cell proliferation, cancer escape from the immune system, and tumor angiogenesis. ECM degradation enzymes, especially some MMPs, are good targets for anticancer metastatic therapy. Numerous anti-MMP agents have been developed and phase III clinical trials in advanced cancers ongoing. Successful control of MMPs induced by cancer cells will prevent liver metastasis of colorectal cancer.

Colorectal Neoplasms↗
PubMed2001

Inhibition of peritoneal dissemination in human gastric cancer by MMP-7-specific antisense oligonucleotide.

MMP-7 is a matrix-degrading enzyme that is mainly produced from cancer cells, and has a great role in the invasion and metastasis of cancer. We have established a highly metastatic cell line (MKN-45-P) on the peritoneum of nude mice from MKN-45 by repeated intraperitoneal inoculation of intraperitoneal free cancer cells. By the precise screening of metastasis-related genes using reverse transcriptase-polymerase chain reaction (RT-PCR), MKN-45-P characteristically expressed more MMP-7 than the original cell line of MKN-45. In this study, we studied the effects of antisense oligonucleotides complementary to exon 3 of MMP-7 mRNA on the expression of MMP-7 and metastatic potential of MKN-45-P by using in vitro and in vivo experiments. RT-PCR and western blot analysis demonstrated that 10 microM antisense oligonucleotides suppressed MMP-7 expression at both the mRNA level (84%) and protein level (56%). Antisense oligonucleotides, specific for MMP-7 suppressed invasion by MKN-45-P cells without influencing proliferation. On the other hand, scrambling sequence control oligonucleotides did not show any inhibitory effects. In addition, survival of MKN-45-P bearing mice, which had been treated for 48 hrs with antisense oligonucleotides before intraperitoneal injection, was significantly better than that of control mice. In contrast, control oligonucleotides did not influence the survival of mice with the peritoneal dissemination model. These results strongly suggest that MMP-7 may have a great role in the formation of peritoneal dissemination in gastric cancer, and the molecular control of MMP-7 using antisense oligonucleotides may be a hopeful treatment modality for peritoneal dissemination.

Animals↗
PubMed2001

Accumulation of p53 in esophageal squamous cell carcinoma.

p53 is one of the most important tumor suppressor genes. Mutation of the p53 gene can be detected immunohistochemically as over-expression of its protein in the nucleus. The p53 gene product is known to regulate cell growth and proliferation. Genetic alterations related to the carcinogenesis or progression of esophageal cancer are poorly understood. We examined accumulation of p53 protein in esophageal squamous cell carcinomas including early-stage cancers, and its clinicopathological significance. p53 immunoreactivity in the cancer tissues was found in 61 (79.2%) of 77 esophageal squamous cell carcinomas. Over-expression of p53 protein (diffusely and focally positive staining) was seen in 70.1% (54/77). p53 over-expression was detected not only in the cases of in situ or intramucosal carcinomas, but also in invasive carcinomas. No significant correlations were found between p53 over-expression and clinicopathological features such as depth of tumor invasion, lymph node metastasis or venous/lymphatic invasion. These results suggested that p53 mutations may be closely associated with the early-stage of pre-invasive esophageal carcinoma, and p53 gene mutations may play an important role in the carcinogenesis of human esophageal cancer.

Aged↗
PubMed2001

[Combination chemotherapy of doxifluridine plus mitomycin C for colorectal lung metastasis--phase II study].

PURPOSE: We conducted a multi-center study to investigate the usefulness of a combination drug therapy with doxifluridine (5'-DFUR) and mitomycin C (MMC) in colorectal cancer patients with lung metastasis. PATIENT AND METHODS: Subjects were advanced/recurrent colorectal cancer patients with lung metastasis, who underwent concomitant drug administration with 533 mg/m2/day of 5'-DFUR orally and 4 mg/m2/day of MMC every 2 weeks intravenously. RESULTS: Of 84 patients registered, 54 patients who were evaluable for tumor response showed results such as: complete response, one; partial response, 4; no change, 30; and progressive disease, 19, corresponding to a response rate of 9.3%. The median survival period of 54 patients was long at 473 days. The median administration days of 5'-DFUR was 201.5 days and the median number of MMC administrations was 14, indicating a long administration period of the combined therapy. The incidence of adverse drug reactions (ADRs) was 37.2% which included thrombocytopenia, 16.7%, and leukocytopenia, 11.5%; only a few ADRs were grade 3 or over. CONCLUSIONS: While combined therapy with 5'-DFUR and MMC resulted in a low response rate, the regimen suggested a survival effect in the patients.

Adult↗
PubMed2001

Preliminary study for sentinel lymph node identification with Tc-99m tin colloid in patients with esophageal or gastric cancer.

The purpose of this study is to determine whether a lymph node identified with high radioisotope (RI) activity is a sentinel node. We studied 26 patients with either esophageal or gastric cancer whose preoperative imaging studies showed no lymph node metastasis. Before surgery, Tc-99m tin colloid was injected via endoscopy into the submucosa. In lymph nodes dissected at surgery, RI activity was measured by a scintillation counter, and metastatic status was examined by hematoxylin-eosin staining. The number of dissected nodes was 45 +/- 15 (mean +/- SD) per patient, and the number of nodes with high RI activity was 4 +/- 1. Nodal metastasis occurred in 11 of 26 patients. In 9 of these 11 patients, metastatic foci were found in one or more nodes with high RI activity. In one of the 2 remaining patients, endoscopic clipping was applied just above the injection sites, and in the other patient, the tumor invasion was beyond the muscle layer. For further analysis, the case with clipping was excluded, and only those in which the tumor invasion was confined within the muscle layer were evaluated. Six of 18 patients in this analysis showed nodal metastasis. Each of the 6 patients had at least one node that showed high RI activity and that was positive for metastasis. We conclude that when tumor invasion remains within the muscle layer, lymph nodes with high RI activity can be regarded as sentinel nodes.

Aged↗
PubMed2001

[Indications for combined resection and reconstruction of the hepatic artery in biliary tract carcinoma].

More than 10 years have passed since hepatic artery resection was first performed for the treatment of biliary tract cancer. The safety of this procedure has been established with the introduction of the microsurgery technique. However, the benefits of and indications for this treatment have not yet been clarified. Twenty-three patients underwent vascular resection (portal vein in 7, portal vein + hepatic artery in 9, hepatic artery in 7) among 114 resected patients with biliary tract cancer in our institution. The right hepatic artery was reconstructed by end-to-end anastomosis in most cases. The curative resection rate was 88.9% in hilar bile duct cancer. However, it was less than 50% in other carcinomas. Cumulative 5-year survival rates of vascular resection patients with hilar bile duct cancer, lower bile duct cancer, gallbladder cancer, and cholangiocarcinoma were 14.8%, 25%, 0%, and 0%, respectively. On the other hand, the rates were 38.9%, 0%, 0%, and 0%, in the stage III + IV patients who did not undergo vascular resection. The longest survival period among patients with hilar bile duct cancer and lower bile duct cancer was 85 months and 65 months, respectively, whereas it was 15 months in gallbladder cancer and 20 months in cholangiocarcinoma patients. No hilar bile duct cancer patient who survived for more than 3 years had lymph node metastasis. The longest surviving cholangiocarcinoma patient has received adjuvant chemotherapy consisting of 5-fluorouracil and cisplatin. It is concluded that patients with hilar bile duct cancer are good candidates for vascular resection. Adjuvant chemotherapy should be administered to gallbladder cancer and cholangiocarcinoma patients, because vascular resection alone does not result in prolongation of life in these patients.

Aged↗
PubMed2001

[Successful donor lymphocyte infusion for Epstein-Barr virus-associated lymphoproliferative disorder after allogeneic bone marrow transplantation from an HLA 1-locus-mismatched sibling donor in a patient with acute lymphocytic leukemia].

We report a case of Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) after allogeneic bone marrow transplantation (allo-BMT) from a partially mismatched related donor for acute lymphocytic leukemia, which was treated successfully by donor lymphocyte infusion (DLI). A 54-year-old woman in first complete remission from acute lymphocytic leukemia received an unmanipulated bone marrow transplant from an HLA-A 1-locus-mismatched sibling donor after preconditioning with cyclophosphamide and total body irradiation. Prophylaxis against graft-versus-host disease (GVHD) was done with tacrolimus and short-term methotrexate. Skin GVHD (grade I) occurred on day 36, but this subsided spontaneously without treatment. On day 61, rapidly progressive cervical lymphadenopathy with fever developed. Lymph node biopsy revealed lymphoid cell proliferation, which was positive for LCA, L26 and LMP-1. A diagnosis of EBV-LPD was made. After withdrawal of the tacrolimus, DLI (1 x 10(6) CD3 cells/kg) resulted in remission. This case suggests that even in the absence of risk factors such as severe GVHD, intensive immunosuppressive therapy and ATG administration, allo-BMT from an HLA 1-locus-mismatched related donor can be complicated by EBV-LPD, and that reduction of immunosuppressive therapy and DLI can be an effective treatment for it.

Bone Marrow Transplantation↗