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Biomedical subjects

J Kinoshita

Publications and source records attributed to J Kinoshita.

At least 37 records · Page 2Linked to original sources
PubMed1999

Maximum Density of Tumor Staining Obtained by Preoperative IV-DSA as a Prognostic Indicator for Node-Negative Breast Cancer.

BACKGROUND: We previously demonstrated that the density of tumor enhancement by intravenous digital subtraction angiography (IV-DSA) is correlated with the number of tumor microvessels and that the incidence of distant metastasis is highin patients with breast cancer who show a high maximum density of tumor enhancement (MAX) on IV-DSA. In the present study, we evaluated the prognostic value ofMAX for node-negative breast cancer patients. Patients and METHODS: A total of 128 node-negative breast cancer patients underwent preoperative IV-DSA, and the region of interest (ROI) was set in the areas enhanced by IV-DSA of the breast. MAX was calculated by the time-density curve. Patients were divided into two subgroups: those with MAX >/= 9 (n=35) and those with MAX < 9 (n=93). RESULTS: Patients with recurrence had a significantly higher MAX value than those without recurrence (11.8 +/- 3.8 vs 7.1 +/- 3.0, p<0.01). The disease-free survival rate was significantly worse in patients with higher MAX values than in those with lower MAX values (p <0.001). Multivariate analysis showed that MAX was the strongest predictor of disease-free survival (p =0.026). CONCLUSIONS: These results suggest that the maximum density obtained by IV-DSA is a strong, independent prognostic indicator for node-negative breast cancer patients.

Journal Article↗
PubMed1999

The expression of variant exon v7-v8 CD44 antigen in relation to lymphatic metastasis of human breast cancer.

The purpose of this prospective study was to evaluate the expression of CD44 splice variant epitopes in human breast cancer and their potential as prognostic indicators. Invasive breast cancer tissues obtained from 91 patients were examined for expression of the standard CD44 antigen and variant CD44 antigens (v5, v6, v7, v7-v8, and v8-v10) by immunohistochemical staining to investigate the relations of these antigens to clinicopathological factors and prognosis. The expression of standard CD44 antigen was detected in 54.9% of 91 patients with primary human breast cancer. The variant epitopes of CD44 examined, i.e., v5, v6, v7, v7-v8, and v8-v10, were expressed in 54.9%, 54.9%, 0%, 34.1%, and 0%, respectively. There was a significant difference in tumor size, lymph nodal status, and degree of lymphatic permeation between patients who were positive for exon v7-v8 and those negative for this variant (p < 0.01). Prognosis was also significantly worse in patients positive for CD44 v7-v8 than in those negative for this variant. However, multivariate analysis with the three prognostic indicators tumor size, lymph nodal status, and the degree of lymphatic invasion, has shown that the expression of CD44 v7-v8 antigen in breast carcinoma was not a significant independent prognostic factor and was closely dependent on lymphatic invasion and nodal status. Fourteen of 31 patients who were positive for CD44 v7-v8 experienced recurrences. The mode of recurrence was lymphatic metastasis in 10 out of these 14 patients. Breast cancer cells expressing v7-v8 CD44 antigen have an extremely high affinity for lymph nodes and lymphatic vessels, and are likely to metastasize to distant lymph nodes even at a very early stage in the progression of this disease. This suggests that not only the anatomical factors but also organ affinity plays an important role in the establishment of lymph nodal metastasis of breast cancer.

Adult↗
PubMed1999

Major organ function under mechanical support: comparative studies of pulsatile and nonpulsatile circulation.

We examined a major organ function during 3 h biventricular assisted circulation after acute myocardial infarction model in the pig. In left ventricular circulation, the outflow cannula was placed in the ascending aorta and an inflow cannula through the mitral valve in the left ventricle. A pump (pulsatile group, Zeon Medical, Inc., Tokyo, Japan and nonpulsatile group, Nikkiso HPM-15, Nikkiso, Inc., Tokyo, Japan) was connected to each cannula. In right ventricular circulation, the outflow cannula was placed in the pulmonary artery and an inflow cannula in the right ventricle. The right ventricular circulation was supported by a nonpulsatile pump (Nikkiso HPM-15). The items measured were the regional blood flows of the cortex and medulla in the kidney, white matter and gray mater in brain, and liver; renal arterial flow; carotid arterial flow; portal vein flow; common hepatic arterial flow; arterial ketone body ratio (AKBR); and lactate/pyrubic acid (L/P). In the pulsatile group, the renal cortical blood flow increased, and the medulla blood flow decreased. On the other hand, in the nonpulsatile group, both regional blood flows decreased. That means that in the pulsatile assisted group intrarenal redistribution improved rather than in the nonpulsatile assisted group. In addition the liver regional blood flow, AKBR, and L/P showed significant differences between the pulsatile and nonpulsatile groups. On the other hand, the white matter and gray matter regional blood flows and carotid arterial flow did not show significant differences between the groups. The results of our study indicated that pulsatile circulation produced superior circulation in the kidney and liver, and microcirculation on the cell level was superior as well in early treatment of acute heart failure.

Animals↗
PubMed1998

Acinic Cell Adenocarcinoma Arising in the Breast of a Young Male: A Clinicopathological, Immunohistochemical and Ultrastructural Study.

A 23-year-old man with acinic cell adenocarcinoma of the breast is reported. He presented with a 4.8 x 4.2 cm mass in his left breast, and excisional biopsy was performed. Under the light microscope, tumor cells had abundant periodic acid-Schiff-positive secretory granules and eosinophlic cytoplasms. Electron microscopy revealed the granules to have various electron densities, a finding characteristic of acinic cell adenocarcinoma. Immunohistochemically, the tumor cells were stained with salivary-type amylase. Electron microscpic and immunohistochemical investigation greatly facilitated the diagnosis of this acinic cell adenocarcinoma, which was in an unusual location. We believe this is the first case report of acinic cell adenocarcinoma of the mammary gland studied utilizing light microscopic, ultrastructural and immunohistochemical techniques.

Journal Article↗
PubMed1998

Sex hormone-receptor-negative tumors have a higher proliferative activity than sex hormone-receptor-positive tumors in human adenocarcinomas of the gastrointestinal tract.

To determine whether a correlation exists between hormone receptors and their proliferative activities, the levels of estrogen receptors (ER) and progesterone receptors (PgR) in surgical specimens from 23 patients with gastric cancer and from 32 patients with colorectal cancer were investigated using an enzyme immunoassay. These values were examined in relation to the parameters of cell kinetics determined by DNA flow cytometry. When the cutoff value was determined as 2.0 fmol/mg of cytosolic protein, ER and PgR were found in 13 (56%) and 6 (26%) of the 23 patients with gastric cancer, respectively, and in 10 (31%) and 10 (31%) of the 32 patients with colorectal cancer, respectively. There was a significant correlation in the expressions of ER between the cancer tissues and normal mucosa (P = 0.040). Although the expressions of ER or PgR were apparently not related to pathological status, better correlations of hormone receptor-negative tumors with increased hyperaneuploid levels were evident. According to a multiple regression analysis, ER levels significantly correlated with changes in the DNA index (P = 0.041) and in the heterogeneity index score (HIS) (P = 0.034). Thus, sex hormone receptors proved to be relevant factors associated with the proliferative activity of adenocarcinoma of the gastrointestinal tract. These findings indicate that the expression of hormone receptors provides pertinent biological information required to determine adequate therapeutic regimens in patients with gastrointestinal cancer.

Adenocarcinoma↗
PubMed1998

Decreased activity of arachidonate 12-lipoxygenase in platelets of Japanese patients with non-insulin-dependent diabetes mellitus.

To study the metabolism of the platelet 12-lipoxygenase pathway in diabetes, we evaluated the correlation between the activity and amount of arachidonate 12-lipoxygenase in the platelets of patients with non-insulin-dependent-diabetes mellitus (NIDDM). There were four parts in this investigation: (1) examination of abnormalities in platelet 12-lipoxygenase in patients with NIDDM recruited from the Hospital of Juntendo University School of Medicine; (2) comparison of 12-lipoxygenase in the platelets of non-obese NIDDM patients without angiopathy versus normal subjects matched for age, sex, and body mass index (BMI); (3) evaluation of gender differences; and (4) assessment of the potential influence of glycemic control. The activity of 12-lipoxygenase was assayed by incubation of [1-14C]arachidonic acid with the platelet cytosol. The reaction mixture was extracted and separated by thin-layer chromatography, and the radioactive end products were detected. The activity of 12-lipoxygenase in the platelets of patients with NIDDM was significantly less than in normal subjects (P < .003), whereas the amount of 12-lipoxygenase protein did not differ between the two groups. Thus, the specific activity of 12-lipoxygenase in diabetic patients was significantly less than that of normal subjects (P < .001). The enzyme activity and the specific enzyme activity of 12-lipoxygenase in non-obese NIDDM patients without angiopathy were significantly lower than the values in normal subjects matched for gender, age, and BMI (P < .006 and P < .0007, respectively). No significant difference in the activity or amount of platelet 12-lipoxygenase was observed between males and females matched for age, BMI, and disease. In addition, no relationship was observed between 12-lipoxygenase activity and blood glucose levels measured at the time of specimen collection. However, slight negative correlations were noted between 12-lipoxygenase activity and 1,5-anhydroglucitol, hemoglobin A1c (HbA1c), and fructosamine (r = .369, -.354, and -.279, respectively). When recombinant 12-lipoxygenase was incubated with varying concentrations of glucose or fructose, enzyme inactivation was related to the length of incubation, and was unaffected by glucose or fructose. These observations suggest that the activity of 12-lipoxygenase in the platelets of patients with NIDDM is decreased by prolonged hyperglycemia. The mechanism involved requires further investigation.

Adult↗
PubMed1998

Pioglitazone enhances splanchnic glucose uptake as well as peripheral glucose uptake in non-insulin-dependent diabetes mellitus. AD-4833 Clamp-OGL Study Group.

To evaluate the effect of pioglitazone on insulin resistance in non-insulin-dependent diabetes mellitus (NIDDM) patients, a double-blind placebo-controlled trial was carried out with 30 NIDDM patients. Twenty-one subjects, three on diet alone and 18 on sulfonylurea (SU), orally received 30 mg pioglitazone once daily for 12 weeks. Nine subjects, one on diet alone and eight on SU, received a matching placebo once daily for 12 weeks. Euglycemic (5.2 mmol/l) hyperinsulinemic (1200 pmol/l) clamp combined with an oral glucose load (OGL) was performed before and after 3-month treatment with pioglitazone or placebo to determine insulin-stimulated glucose disposal and splanchnic glucose uptake (SGU). No significant differences existed in the patients' characteristics, including age and body mass index, between the two study groups. The pioglitazone treatment increased the mean glucose infusion rate (GIR) prior to OGL from 8.2 +/- 2.2 to 9.2 +/- 2.0 mg/kg.min (mean +/- SD, P = 0.003) and increased the SGU rate from 28.5 +/- 19.4 to 59.4 +/- 27.1% (P = 0.010). The placebo treatment produced no significant changes in either GIR or SGU after treatment. A significant difference (P = 0.042) was observed in change of SGU between the pioglitazone and placebo treatment groups. In conclusion, the results indicate that pioglitazone is effective for ameliorating insulin resistance in NIDDM by enhancing SGU as well as peripheral glucose uptake.

Blood Glucose↗
PubMed1998

Treatment of maxillary molars with vertical fractures.

To date, there has been no reliable method for treating bucco-palatal fractured maxillary molar teeth. We have developed a simple repositioning method to fix teeth fractured in this way using wire. The effectiveness of this new approach was evaluated in both in vitro experimental research and clinical studies.

Calcium Hydroxide↗
PubMed1998

Usefulness of revised fasting plasma glucose criterion and characteristics of the insulin response to an oral glucose load in newly diagnosed Japanese diabetic subjects.

OBJECTIVE: To examine the usefulness of the revised criterion for fasting plasma glucose (FPG) in the diagnosis of diabetes recommended by the American Diabetic Association (ADA) (126 mg/dl, 7 mmol/l), and to characterize insulin response during the 75-g oral glucose tolerance test (OGTT) in newly diagnosed Japanese diabetic subjects. RESEARCH DESIGN AND METHODS: A series of 2,121 Japanese subjects underwent a 75-g OGTT (0-3 h) and were divided into three groups (normal glucose tolerance [NGT], impaired glucose tolerance [IGT], and diabetes mellitus [DM] according to the current World Health Organization criteria. After the cutoff values of FPG that distinguish NGT and IGT from diabetes were analyzed, the usefulness of the ADA criterion for FPG was examined by comparing diagnostic parameters (sensitivity, specificity, and accuracy) with those for the cutoff value of 140 mg/dl. To assess insulin response, both the insulinogenic index (IsIx), a marker of early secretion, and the area under the insulin response curve (AUCins), a marker of total secretion, were compared between the DM, NGT, and IGT groups. RESULTS: First, the FPG cutoff value distinguishing NGT from diabetes was 109 mg/dl. An FPG of 126 mg/dl showed a higher sensitivity (0.52 vs. 0.31), the same specificity (1.00), and a higher accuracy (0.82 vs. 0.74) than an FPG of 140 mg/dl, and it had a higher specificity (1.00 vs. 0.86) with a slightly lower accuracy (0.82 vs. 0.85) than an FPG of 109 mg/dl. Second, the FPG cutoff value differentiating IGT from diabetes was 113 mg/dl. An FPG of 126 mg/dl showed a higher sensitivity (0.52 vs. 0.31) and accuracy (0.80 vs. 0.74) and a similar specificity (0.97 vs. 1.00) compared with an FPG of 140 mg/dl, and it had a higher specificity (0.97 vs. 0.82) with the same accuracy (0.80) as an FPG of 113 mg/dl. Third, the DM group showed the lowest IsIx among the three groups at all FPG values. The AUCIns in the DM group increased along with FPG, reached the maximum level at an FPG of 110 mg/dl, and declined thereafter. AUCIns was higher in the DM group than in the NGT group at FPG values > or = 100 mg/dl. CONCLUSIONS: The revised ADA criterion for FPG of 126 mg/dl may improve diagnostic sensitivity without loss of specificity in Japanese diabetic subjects when compared with an FPG criterion of 140 mg/dl. Although early insulin secretion was impaired, total insulin secretion did not seem to be reduced in newly diagnosed Japanese diabetic subjects.

Adult↗
PubMed1997

Analysis of the tumor staining obtained by preoperative IV-DSA for breast cancer patients: density and metastasis correlation.

We examined the density of tumor enhancement on intravenous digital subtraction angiography (IV-DSA) in patients with breast cancer in relation to disease-free survival. The subjects of the present study consisted of 103 patients with invasive ductal carcinoma measuring 5 cm or less treated from July 1988 to September 1993. In the 103 patients, 15 had distant metastasis. The region of interest was set in the areas enhanced by IV-DSA of the breast. The maximum density (MAX) was calculated by the time-density curve. When the patients were divided according to three classes of MAX, i.e., 0-5.0 pixels (group A, n = 23), 5.1-9.0 pixels (group B, n = 50), 9.1 pixels or more (group C, n = 30), disease-free survival was highest in group A followed by group B and C, respectively. The disease-free survival rate in group C was significantly lower than that of group A or B (p < 0.05). Thus, high values of MAX were associated with low rates of disease-free survival. Since the value of MAX was found to be independent from other prognostic factors by multivariate analysis, these results indicate that MAX has a close correlation with metastasis or recurrence of breast cancer, making IV-DSA a promising prognostic factor.

Adult↗
PubMed1997

A newly developed silicone-coated membrane oxygenator for long-term cardiopulmonary bypass and cardiac support.

The surface of polypropylene hollow fiber was successfully coated with a very thin (0.2 micron) silicone layer. Experimental studies were performed in long-term (6 h) normothermic cardiopulmonary bypass (CPB) using 10 goats. A conventional membrane oxygenator (Mera Excelung HPO-15H, MERA, Tokyo, Japan) was used for 5 goats as a control (Group C) and a new silicone-coated membrane oxygenator, which is of the same construction as that of the one used for Group C, for 5 (Group S). The O2 transfer and CO2 removal functions showed the same ranges. In the other parameters, there were no differences between the 2 groups. As for hemolysis, however, the plasma free hemoglobin of Group S was lower than that of Group C. Currently, 3 chronic percutaneous cardiopulmonary support (PCPS) experimental models have been conducted, and there has been no evidence of thromboembolism or deterioration of the oxygenator. In conclusion, this new oxygenator is suitable not only for CPB, but also for long-term cardiac support.

Animals↗
PubMed1996

In situ topology of cytochrome b5 in the endoplasmic reticulum membrane.

Cytochrome b5 is tail-anchored in the ER membrane and is composed of three functionally different portions; amino-terminal heme-containing catalytic, central hydrophobic membrane-anchoring, and carboxy-terminal ER-targeting portions [Mitoma, J. and Ito, A. (1992) EMBO J. 11, 4197-4203]. In situ topology of cytochrome b5 in the ER-membrane was studied using immunofluorescence microscopy. Antibodies were raised against the hydrophilic portion (anti-b5) and the carboxy-terminal seven amino acid residues (anti-peptide) of cytochrome b5 and used for detection of the cytochrome in COS cells which expressed the rat cytochrome. Anti-b5 antibody detected the cytochrome in a reticular staining pattern characteristic of the ER, even when the cell plasma membrane was permeabilized with Streptolysin O. The anti-peptide displayed a fluorescence signal only with Triton-permeabilized cells in which the antibody was able to penetrate into the ER lumen. In a double immuno-staining of the cell using the antipeptide antibody and the antibody against protein disulfide isomerase, both antibodies showed the same staining pattern in the presence of either Triton X-100 or Streptolysin O. The results indicate that the carboxy-terminal hydrophilic stretch is exposed to the luminal side. Cytochrome b5 was tagged with c-myc peptide at the carboxy-terminal end and the topology of the c-myc peptide was analyzed by the same method. Anti c-myc monoclonal IgG detected the tagged cytochrome b5 only after Triton treatment of the fixed cells, suggesting that the addition of c-myc peptide to the carboxy-terminal end does not affect insertion or orientation of the cytochrome in the ER membrane.

Animals↗
PubMed1995

Slipped capital femoral epiphysis associated with hyperparathyroidism. A case report.

A case of slipped capital femoral epiphyses is reported which occurred in association with primary hyperparathyroidism. Only two similar cases have been found in the English literature. The patient was a man, 16 years of age, who presented with bilateral slipped epiphyses. Investigation showed that he had primary hyperparathyroidism due to a parathyroid adenoma. At a single operation, the epiphyses were pinned in situ, and the adenoma removed. The result was satisfactory.

Adenoma↗
PubMed1995

Relationship between staining by digital subtraction angiography and vascularity in breast cancer: analysis of the time-density curve and the results of staining for factor VIII-related antigen/von Willebrand factor.

We performed intravenous digital subtraction angiography (IV-DSA) in 31 patients with primary invasive breast cancer, and calculated the maximum density of tumor staining from the time-density curve obtained. Specimens resected from the same patients were stained for factor VIII-related antigen/von Willebrand factor (vWF), and the amount of microvessels was calculated by image processing. A significant correlation (correlation coefficient: 0.85) was found between the maximum density of tumor staining and the vascularity determined by staining for vWF, indicating that the maximum density indirectly reflects the vascularity in the tumor.

Angiography, Digital Subtraction↗
PubMed1994

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Chromosome Mapping↗