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Biomedical subjects

H Shinya

Publications and source records attributed to H Shinya.

At least 19 recordsLinked to original sources
PubMed2001

Decreased expression of DNA-dependent protein kinase, a DNA repair protein, during human colon carcinogenesis.

DNA-dependent protein kinase (DNA-PK), consisting of a catalytic subunit (DNA-PKcs) and the Ku70 and Ku86 proteins, participates in the repair of DNA double-strand breaks (DSBs). We assessed its expression immunohistochemically in normal human colon tissue, colon adenomas, colon carcinomas, and normal tissue distant from carcinomas. Normal colonocytes expressed all DNA-PK proteins. Compared with the expression in normal tissue [176.62 +/- 18.56 (the intensity of expression x the percentage of cells expressing this protein), mean + SE], the expression of Ku70 was significantly reduced in adenomas (36.62 +/- 11.09; P < 0.001) and carcinomas (85.68 +/- 15.76; P < 0.01), as was the expression of Ku86 [(113.10 +/- 10.22 versus 41.66 +/- 14.71 in adenomas (P < 0.01) or versus 85.68 +/- 15.76 in carcinomas (P < 0.05)]. The expression of DNA-PKcs was not significantly changed. The marked underexpression of Ku70 and Ku86 starting at the adenoma stage may be crucial to the development of colon cancer.

Adenoma↗
PubMed2000

Management of nodular goiters and their operative indications.

It remains controversial whether or not nodular goiters should be treated surgically or conservatively. This report reviews our 9-year experience of treating nodular goiters in 334 patients, 44 of whom underwent surgery, and compares the methods of treatment employed from 1990 to 1999 with those employed from 1971 to 1989 when 171 operations were carried out. In accordance with diagnoses made using fine-needle aspiration biopsy (FNAB) and ultrasonography, patients were treated as follows. Those with cysts were given percutaneous ethanol injection therapy (PEIT), and those with solid tumors underwent surgery if cancer of >class 3 was suspected or if the tumors were >3 cm. Consequently, 44 patients with solid tumors underwent surgery and 72 with cysts were treated by PEIT. The number of operations performed annually decreased to half of the pre-1990 figure. During the follow-up of those patients who did not undergo surgery, four with solid tumors and two with cysts later required surgery due to suspected carcinoma of >class 3 in 3 patients or as a result of personal choice in 3 patients. The growth of solid tumors was not able to be measured in most cases. These results indicate that the number of operations performed for nodular goiters can be reduced by PEIT. An accurate cytological diagnosis supports this therapeutic strategy.

Biopsy, Needle↗
PubMed1998

[Evaluation of transition zone biopsy in systematic prostate biopsy].

We evaluated the systematic biopsies performed on 83 patients suspected of having prostate cancer. In the systematic biopsy, 6 cores were from the peripheral zone and 2 cores from the transition zone. Cancer was detected in 25 patients (30.1%). The percentage of patients who had abnormal digital rectal examination and transrectal echo findings, average PSA and PSA density, and the number of examinations which suggested cancer were higher in the cancer group than in the non-cancer group, although the mean prostate volume was smaller. Cancer was more frequently detected in the peripheral zone than in the transition zone. Cancer was detected only in the transition zone in only 1 of the 25 cancer patients. We conclude that biopsy of the transition zone to all the patients is not always needed in systematic biopsy.

Aged↗
PubMed1996

Hyperammonemia inhibits platelet aggregation in rats.

The effect of hyperammonemia on ex vivo platelet function and in vivo nitric oxide synthesis was evaluated in rats. In addition, mitochondrial energy production was assessed from the fluorescence intensity of tetramethylrhodamine ethyl ester (TMRE). Continuous ammonium acetate infusion significantly reduced ex vivo platelet aggregation concomitant with a decrease of the platelet cytoplasmic ATP level. The serum level of L-arginine, as well as the levels of nitrite and nitrate (oxidative by-products of nitric oxide), increased with ammonium infusion. Prior administration of N omega-nitro-L-arginine methyl ester, a competitive inhibitor of nitric oxide synthase, did not affect the ammonia-induced rise in L-arginine, but substantially attenuated the associated decrease of platelet ATP and TMRE fluorescence as well as diminishing the anti-aggregatory effect of ammonia infusion. These findings suggest that the synthesis of nitric oxide from L-arginine is accelerated by continuous ammonium infusion and inhibits ex vivo platelet aggregation in the rat, probably by reducing mitochondrial energy production.

Acetates↗
PubMed1993

[Measurement of serum PSA by DELFIA PSA kit and its application for mass screening. The Gunma Urological Oncology Study Group].

The significance of prostate specific antigen (PSA) measured by DELFIA PSA kit in the 1,177 serum samples examined by mass screening for prostate cancer was evaluated. All subjects were examined by questionnaire, digital rectal examination (DRE) and prostatic acid phosphatase (PAP) and the subjects in whom prostate cancer was suspected from abnormal DRE and/or elevated PAP were recommended to receive the secondary screening for the presence of prostate cancer. All serum specimens used for this study were kept in our serum bank. The cut-off value was investigated between non-cancer subjects (diagnosed as normal, voiding disturbance or BPH) and prostate cancer patients. When the cut-off value was 2.89 ng/ml, the sensitivity, specificity and accuracy as prostate marker was 80.6%, 90.0% and 89.4%, respectively. Therefore, the cut-off value was determined as 3.0 ng/ml. The significance of PSA was retrospectively evaluated compared to PAP in the subjects examined by our mass screening. Twenty eight of the 39 palpable prostate cancers which could not be detected from the PAP level were detected from the PSA level, namely the sensitivity of the detection using the PSA level is more excellent than that using PAP. However, the false negative rate obtained using PSA was high (30.3%) in the patients with stage B disease. The relationship among serum PSA concentration, prostate size estimated by DRE and age was investigated. PSA was increased with age and prostate size. This estimation should be confirmed by using an ultrasonography because the prostate size obtained by DRE is inaccurate as compared with that obtained by ultrasonography.

Adult↗
PubMed1993

Endoscopic placement of long intestinal tubes.

Partial intestinal obstruction has been successfully managed by the use of long intestinal tubes. For proper decompression, the long tube must pass beyond the pylorus; however, failure of the tube to progress by gravity alone has been reported to be as high as 46 per cent. A simple method of endoscopic placement of the long tube into the duodenum is described. If one is familiar with performing upper endoscopy, this technique can be learned easily.

Endoscopy, Digestive System↗
PubMed1990

Cancerous colonic polyps. "Hands on" or "hands off?".

Management of the malignant colonic polyp remains a subject for debate even after almost two decades of experience. Some researchers believe all patients should have a colonic resection; others argue that only certain cases call for laparotomy, while still others hold for a selective approach but with varying criteria. Therefore, a survey has been made of current practice and opinion from the time colonoscopic polypectomy was introduced in 1969 to the present. The authors have reviewed a sizable segment of their experience, dividing cases of malignant polyps into two broad categories: those in which complete polypectomy was followed by bowel resection; and those undergoing polypectomy alone. The determinants leading to one course or the other were analyzed, as were the results.

Colectomy↗
PubMed1989

Possible role of cholecystokinin in the development of acute pancreatitis in rats.

The aim of this study was to elucidate whether cholecystokinin (CCK) had a role in the occurrence and/or in the development of experimental acute pancreatitis in rats, and furthermore to find the possibility for the treatment of acute pancreatitis with a CCK antagonist, proglumide. The administration of CCK-8 significantly increased serum levels of amylase, lipase and pancreatic wet weight. The administration of proglumide significantly reduced the blood levels of trypsin, pancreatic wet weight, water content and improved survival rate. These findings were supported by microscopic examination. The results of this study demonstrate that CCK has an important role in the development of acute pancreatitis and that proglumide might have prophylactic and therapeutic effects in acute pancreatitis.

Acute Disease↗
PubMed1984

Contribution of endoscopy to diagnosis and treatment of gastric cancer.

The contribution of fiberoptic endoscopy to the diagnosis and treatment of gastric cancer was evaluated in 174 patients. For the purpose of staging, they were compared with 99 patients admitted to the same institution in the pre-endoscopy era. The frequency of minimal gastric cancer (stages I and II) was 16.5 percent in the patients who had esophagogastroduodenoscopy in contrast with only 4 percent in the patients without endoscopy. Fiberoptic endoscopy was superior to barium gastrography in the diagnosis of minimal gastric cancer. The effect of early diagnosis on survival was such that at 3 year follow-up, the cumulative proportion of stage I and II patients still alive was 85 percent compared with only 17.5 percent of stage III patients and none of the stage IV patients.

Adult↗
PubMed1984

Endoscopic gastroduodenal polypectomy.

During a 6-year period from 1976 to 1982, 7346 gastrointestinal endoscopy procedures were performed in the Surgical Endoscopy Unit of Beth Israel Medical Center. This report summarizes our experience with 443 gastroduodenal polyps excised in 257 patients. Of these, 123 were male and 134 female, ranging in age from 19 to 92. The vast majority were between the ages of 60 and 80. With one exception, polyps varied from 0.3 cm to 6 cm in diameter (one patient had a 12-cm hyperplastic polyp). There were 399 gastric polyps in 238 patients and 44 duodenal polyps in 19 patients. Of the polyps excised, 282 (63.1%) were sessile and 161 (36.9%) were pedunculated. The majority of the patients (185) had a single polyp and 72 patients had two or more polyps. Seven patients with multiple polyps had Peutz-Jeghers Syndrome and two patients had Gardner's Syndrome. Hyperplastic polyps constituted the majority (62%) of the polyps. These polyps have minimal, if any, tendency to degenerate into carcinoma. In contrast, adenomatous gastroduodenal polyps (21%) have a definite propensity to degenerate into carcinoma. This occurred in 9.6% of the patients in this series. There were no deaths and only two complications (bleeding) in this series.

Adenoma↗
PubMed1983

Primary linitis plastica of the colon and rectum. Report of two cases.

Primary linitis plastica of the colon and rectum is an uncommon entity. Sixty-six cases have been reported in the English literature. Two new cases are reported, one of the transverse colon with widespread metastases and the other of the right colon extending from the appendix to the distal resection margin of the transverse colon. Some clinical and pathologic characteristics of the tumor are discussed, based on a review of the literature.

Adenocarcinoma, Scirrhous↗
PubMed1982

A rationale for the endoscopic management of colonic polyps.

The incidence of invasive cancer in colonic polyps is related to the size of the lesion and the histologic type of the adenoma. It is greatest for villous adenomas and least for tubular adenomas. The malignant potential increases with the size of the polyp, and in lesions 3 cm and larger malignant disease is present in at least 12 per cent. In general, polyps with invasive malignant disease require colon resection, but for pedunculated adenomas, colonoscopic polypectomy is adequate treatment. Even when invasive cancer is close to the line of endoscopic resection but does not invade the stalk or does not display lymphatic or vascular invasion, a case may be made for conservative, endoscopic treatment alone because the occurrence of local or distal metastasis is very unusual.

Adenoma↗
PubMed1982

Technique of colonoscopic polypectomy.

Most colonic polyps can be removed colonoscopically from all reaches of the colon, provided that one is experienced with endoscopic morphology and snare electrosurgical techniques. Virtually all pedunculated polyps and the majority of benign sessile polyps can be excised colonoscopically, certain of the larger benign sessile polyps and all malignant sessile lesions still require partial colectomy, if the patient's general condition will permit. Preparation for colonoscopic polypectomy includes thorough mental as well as physical preparation of the patient and the availability of properly functioning endoscopic and snare-cautery equipment. An experienced colonoscopist is one who is not only prepared for the diagnostic possibilities but experienced enough to manage certain of the larger polyps so that laparotomy is limited to those few lesions that are not amenable to safe and total colonoscopic polypectomy.

Colonic Neoplasms↗
PubMed1982

Colonoscopic diagnosis and management of rectal bleeding.

The use of the colonoscope to evaluate the cause of rectal bleeding in a series of 2200 patients has been reviewed. The most common cause of bleeding in this series was found to be neoplastic polyps, which were present in 723 patients (32 per cent). Colonic carcinoma was detected as the source of the bleeding in 425 cases (19 per cent). Although a large number of barium enema films were false negatives, the patients reviewed are a highly select group. It is still believed that barium enema studies and colonoscopy are complementary rather than competitive procedures. Their continued combined use greatly enhances diagnostic accuracy. Various other causes of colonic bleeding, including inflammatory bowel disease, arteriovenous malformations, endometriosis, ovarian carcinoma, ischemic colitis, and radiation colitis, have been discussed and their endoscopic appearance described. Of particular significance is the coexistence of internal hemorrhoids or diverticular disease and neoplastic colonic lesions. Barium enema films and sigmoidoscopy have been frequently described as the twin pillars of diagnosis in the detection of colonic pathology. Colonoscopy, as the third pillar of diagnosis, should be an integral part of the evaluation of patients with rectal bleeding.

Colitis↗