Biomedical subjects

K Akazawa

Publications and source records attributed to K Akazawa.

At least 19 recordsLinked to original sources

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

Quality of life after laparoscopy-assisted Billroth I gastrectomy.

OBJECTIVE: To evaluate the quality of life of patients who had undergone laparoscopy-assisted Billroth I gastrectomy (LAG) for cure of cancer. SUMMARY BACKGROUND DATA: In 1994, the authors reported the first case of LAG for early gastric cancer, and this approach quickly has been adopted by Japanese surgeons. However, little is known about the subjective clinical results of this less invasive surgery. METHODS: Quality of life was estimated using the 24-item questionnaire with a scoring system of 1, 2, and 3 and was compared between 41 consecutive patients with LAG and 35 with conventional open gastrectomy. All patients underwent Billroth I gastrectomy for early gastric cancer from January 1993 to July 1997 and were alive without recurrence. RESULTS: Patients who had undergone LAG were taking a normal diet (100%) with >66% of volume at each meal (90%), showed no decreased performance status (90%), and were satisfied with their surgical results (88%). Patients with LAG, when compared with open gastrectomy, showed significantly better results with regard to weight loss, difficulty in swallowing, heartburn and belch, early dumping syndrome, and total score. LAG was better accepted by the patients. CONCLUSIONS: Quality of life after Billroth I gastrectomy was significantly better in patients in whom a laparoscopic technique was used than in those who underwent a conventional method. LAG is less invasive and better accepted by patients and is the procedure of choice for the treatment of early gastric cancer.

Aged↗

PubMed1999

Role of transforming growth factor-beta 1 in invasion and metastasis in gastric carcinoma.

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) is a major modulator of cellular proliferation and extracellular matrix formation. We determined the role of TGF-beta1 in invasion and metastasis in gastric cancer. MATERIALS AND METHODS: We detected TGF-beta1 expression in primary and lymph node metastatic lesions of gastric cancer, using an antibody and in situ hybridization. The plasma TGF-beta1 levels in the peripheral vein and in the tumor drainage vein were assayed. RESULTS: In the cytoplasm of cancer cells, TGF- beta1 was immunostained in 35.9% (78 of 217) of primary gastric carcinomas, and this expression was confirmed by in situ hybridization. Of 59 gastric carcinomas with a TGF-beta1-negative primary tumor, metastatic lymph nodes were positive for TGF-beta1 staining in 32 cases (54.2%). Positive staining of TGF-beta1 in gastric cancer tissues was closely related to serosal invasion, infiltrative growth, and lymph node metastasis. Multivariate analysis showed that the expression of TGF-beta1 was an independent risk factor for serosal invasion and infiltrative growth of the tumor. The plasma level of TGF-beta1 did not differ between TGF-beta1-negative and -positive groups. There were also no differences in plasma TGF-beta1 levels among each tumor stage, between the peripheral and the tumor drainage veins, and between preoperative and postoperative testings. CONCLUSION: Transforming growth factor-beta1 is closely related to the invasion and metastasis of gastric cancer, and production of TGF-beta1 in the tumor does not contribute to the total amount of TGF-beta1 in the blood circulation. We interpret our observations to mean that in a tumor microenvironment, TGF-beta1 alters the biologic behavior of the tumor.

Aged↗

PubMed1998

Decrease in p53 protein in cultured cardinal ligament fibroblasts from patients with prolapsus uteri.

The authors examined the growth response of cardinal ligamental fibroblasts derived from patients with prolapsus uteri (HPLiF) and compared it with the response of those from control subjects (HCLiF). The growth rate during the logarithmic growth phase was not different between HPLiF and HCLiF, while the cell density at confluence (saturation density) was significantly higher in HPLiF than in HCLiF. When added alone, platelet-derived growth factor (PDGF), insulin-like growth factor-I (IGF-I), and epidermal growth factor (EGF) produced minimal effects on DNA synthesis in HCLiF. The simultaneous addition of PDGF, IGF-I and EGF synergistically stimulated the DNA synthesis. In contrast, PDGF alone was able to initiate DNA synthesis in HPLiF. The combination of PDGF, IGF-I, and EGF significantly stimulated the DNA synthesis of HPLiF compared with HCLiF. p53 protein and p53 gene transcripts decreased by 50% in HPLiF. The anti-WAF1 antibody reacted intensely with a 21-kDa protein in the homogenates of control fibroblasts, while the immunoreactive band in prolapsus fibroblasts was clearly reduced. These results indicate that the higher proliferative activity at near confluency in prolapsus fibroblasts may result from the decreased expression of p53 protein and p53 mRNA followed by the decrease in p21 protein. Furthermore, the failure of cells to enter quiescence may lead to a decrease in the synthesis and deposition of elastin and thus may contribute to the loss of supportive function in uterine connective tissues.

Aged↗

PubMed1998

Static torque-angle relation of human elbow joint estimated with artificial neural network technique.

Static relations between elbow joint angle and torque at constant muscle activity in normal volunteers were investigated with the aid of an artificial neural network technique. A subject sat on a chair and moved his upper- and forearm in a horizontal plane at the height of his shoulder. The subject was instructed to maintain the elbow joint at a pre-determined angle. The wrist was then pulled to extend the elbow joint by the gravitational force of a weight hanging from a pulley. Integrated electromyograms (IEMGs), elbow and shoulder joint angles and elbow joint torque were measured. Then the relation among IEMGs, joint angles and torque was modeled with the aid of the artificial neural network, where IEMGs and joint angles were the inputs and torque was the output. After back propagation learning, we presented various combinations of IEMGs, shoulder and elbow joint angles to the model and estimated the elbow joint torque to obtain the torque-angle relation for constant muscle activation. The elbow joint torque increased and then decreased with extension of the elbow joint. This suggests that if the forearm is displaced from an equilibrium point, the torque angle relation would not act like a simple spring. In a view of the musculoskeletal structure of the elbow joint, the relation between the elbow joint angle and the moment arm of the elbow flexor muscles seems to have a dominant effect on the torque-angle relation.

Adult↗

PubMed1998

Mass screening for neuroblastoma at 6 months of age: difficult to justify.

BACKGROUND/PURPOSE: A statistical analysis of the mass screening for neuroblastoma in Japan based on a population study rarely has been reported. This study aims to evaluate retrospectively the effectiveness of mass screening at 6 months of age using the available population data. METHODS: The data on the neuroblastoma cases registered by the Committee for Pediatric Solid Malignant Tumors in the Kyushu area were analyzed based on both screened and unscreened populations in the Kyushu area. RESULTS: From 1988 to 1992, the cumulative incidence of neuroblastoma in children less than 5 years of age was 82 in 484,599 for screened children, and 11 in 92,966 for unscreened children, respectively. Fourteen of the 82 screened patients had negative findings at 6 months of age (MS-negative cases). No significant difference was observed in the cumulative mortality rates from neuroblastoma in children younger than 5 years of age between the screened children and the unscreened children. Six of seven patients who died among the screened children were MS-negative cases with stage III or IV disease. In addition, no significant difference was found in the cumulative mortality rates from the neuroblastoma cases in patients less than 5 years of age between the children screened from 1988 to 1992 (7 of 484,599) and all children from 1980 to 1984 (14 of 668,084). CONCLUSIONS: These findings suggests that the majority of the patients detected by mass screening had a favorable prognosis, and, mass screening in Japan for children less than 6 months of age was not observed to reduce the incidence and mortality from neuroblastoma. Therefore, mass screening at 6 months of age was not found to improve substantially the prognosis of patients with unfavorable neuroblastoma identified over 1 year of age, which is the primary purpose of such mass screening for neuroblastoma.

Evaluation Studies as Topic↗

PubMed1998

Action of interleukin-3 on the proliferation of leukaemic progenitor cells from patients with acute myeloblastic leukaemia.

In the present study, we examined the effects of interleukin-3 (IL-3) on the proliferation of leukaemic progenitor cells from 11 Japanese patients with acute myeloblastic leukaemia (AML), including the effect of its combination with granulocyte/macrophage colony-stimulating factor (GM-CSF) or granulocyte colony-stimulating factor (G-CSF). The results showed that IL-3 sufficiently stimulated the proliferation of AML progenitor cells in almost all the cases examined, and that the stimulation pattern of IL-3 was similar to that of GM-CSF, although different from that of G-CSF. Furthermore, IL-3 worked synergistically with G-CSF, whereas IL-3 and GM-CSF together were less actively synergistic (P < 0.05). These findings suggest the possibility of IL-3/G-CSF/cytosine arabinoside (Ara-C) combination therapy, which may be able to enhance the cytotoxic effect of Ara-C on AML progenitor cells powerfully in a wider range of patients including cases refractory for IL-3/Ara-C combination therapy.

Adolescent↗

PubMed1998

Risk factors for low birthweight in Japanese infants.

The purpose of our study was to identify risk factors for low birthweight (LBW; birthweight < 2500 g) in Japanese infants. The data was collected from questionnaires completed by the parents of 23132 infants who underwent a standardized well baby check-up for 1-month-old infants, conducted by the Fukuoka City Medical Association from 1987 to 1995. The following eight factors and their second-order interaction terms were examined as potential risk factors for LBW: maternal age at delivery, history of live-born LBW infant, history of abortion in previous pregnancies, maternal smoking, coffee and alcohol consumption during pregnancy, prenatal training and live birth order. The results of multiple logistic regression analysis showed that the following three factors and one interaction term significantly contributed to LBW: history of live born LBW infant, maternal smoking, live birth order and the interaction between maternal smoking and live birth order. The smoker-related risk for LBW was quite different in each of the three groups stratified by live birth order. Efforts should be made, for example, to increase the accessibility of early, high-quality prenatal care for the high-risk groups with previous LBW babies and to implement smoking intervention, ranging from specific medical procedures to broad-scale public health and health-related educational programs in schools.

Alcohol Drinking↗

PubMed1998

Reduced chlamydial infection and gonorrhea among commercial sex workers in Fukuoka City, Japan.

BACKGROUND: Until recently, epidemiologic studies of sexually transmitted diseases (STDs), including human immunodeficiency virus type-1 (HIV-1) infection, among Japanese female commercial sex workers and their patterns of condom use have been rare. We investigated trends in STDs among female commercial sex workers and their condom use patterns in Fukuoka, Japan, from 1990 through 1995. METHODS: The study group consisted of 1218 female commercial sex workers who attended an STD clinic to undergo screening for major STDs including chlamydial infection, gonorrhea and HIV-1 infection from 1990 through 1995. Endocervical smear specimens were taken from the women to detect Chlamydia trachomatis and Neisseria gonorrhoeae, and blood samples were obtained for the serologic diagnosis of HIV-1. Also, the commercial sex workers were interviewed concerning their condom use patterns. RESULTS: The annual infection and detection rates of C. trachomatis declined significantly from 58.1% in 1990 to 46.2% in 1995 and from 16.3% in 1990 to 10.0% in 1995, respectively, while the annual infection and detection rates of N. gonorrhoeae also declined significantly from 13.2% in 1990 to 3.5% in 1995 and from 1.5% in 1990 to 0.4% in 1995, respectively. None were found to be seropositive for HIV-1 during the 6-year period. The proportion of commercial sex workers using condoms significantly increased during 1992-1993 and 1994-1995 periods, as compared with the 1990-1991 period. CONCLUSION: Reductions in the prevalence of major STDs among female commercial sex workers may be related to an increase in the frequency of condom use.

Adolescent↗

PubMed1998

[A clinical study of decreased bone density in the patients treated with long-term luteinizing hormone releasing hormone analogue (LHRH-a)--the risk of iatrogenic osteoporosis due to treatment of carcinoma of prostate].

BACKGROUND: It is well known that androgens play an important role in bone metabolism and male hypogonadism induce osteoporosis. Luteinizing hormone-releasing hormone analogue (LHRH-a) which is essential for conservative therapy of prostatic carcinoma (CaP) ultimately reduces circulating testosterone to castration levels. The purpose of this study was to determine the risk of decrease of bone mineral density in men receiving LHRH-a for CaP. PATIENTS AND METHODS: Fifty-three man with CaP aged 63 to 95 years (mean 75.5 years) were included in this study. Seven patients received LHRH-a with estrogen drug, forty-six patients received LHRH-a with or without anti androgen drug. To estimate patient's bone density we use the second metacarpal bone density using a microdensitometry method. RESULTS: Blood level of sex hormone of the forty-six patients who were received LHRH-a without estrogen, was the same as that of castration. Patients who were treated more than twelve months had less bone density than patients who were treated less than eleven months. As the duration of medical castration period was prolonged, patients bone density were reduced. Whereas seven patients who received estrogen drug did not find a decrease of bone density regardless of duration of treatment period. CONCLUSIONS: Hypogonadism induced LHRH-a also reduce bone density, so there is a risk of iatrogenic osteoporosis caused by therapy for CaP with LHRH-a. Patients with osteoporosis easily suffer from a much complicated and pernicious bone fracture, so we should measure bone density of male patients same as female treated with LHRH-a for a long-term.

Aged↗

PubMed1998

Attachment of hepatitis C virus to cultured cells: a novel predictive factor for successful interferon therapy.

In order to identify reliable predictive factors for the response to interferon (IFN) therapy, we examined 52 patients with chronic hepatitis C virus (HCV) infection who underwent IFN therapy. Titers of free virions that were not complexed with antibodies were determined by immunoprecipitation of the pretreatment sera with antihuman immunoglobulin. Cell attachment titers were determined by inoculating HPB-Ma cells, a human T-cell line, with the patients' pretreatment sera. A sustained remission was achieved in 9 out of 28 patients with genotype 1b infection and in 18 out of 24 patients with genotype 2 infection. The free virion titers and the cell attachment titers correlated well with the serum HCV RNA levels in patients with genotype 1b infection (r = 0.817, P < 0.001; r = 0.802, P < 0.001, respectively), but not in those with genotype 2 infection. They exhibited a high correlation with the responsiveness to IFN in all patients combined (P < 0.001). A multiple logistic regression analysis was performed to identify the factor most significantly associated with the response to IFN among all confounding factors. The analysis indicated that the cell attachment is the most reliable predictive factor regarding a favorable response to IFN therapy in patients with chronic HCV infection.

Adult↗

PubMed1998

[Good response in case of hepatocellular carcinoma; a case report of interdisciplinary local therapy].

A 47-year-old male patient with chronic hepatitis had a high AFP level during the follow-up period. Abdominal CT revealed at S5, which led to a diagnosis of hepatocellular carcinoma. In August 1992, partial resection of S5 was performed, and ethanol was injected into the tumor at S2. In July 1993, recurrent tumors were observed at S5 and S3. PEIT was performed for each lesion. In December 1994, multiple recurrence was observed and 4 mg SMANCS was injected through the proper hepatic artery. In July 1995, another 4 mg of SMANCS was injected into the tumors. In June 1996, only a 20 mm lesion at S5 remained while the other lesions disappeared. Under general anesthesia, the patient underwent percutaneous microwave tumor coagulation. In December 1997, the AFP level was normal, and imaging revealed disappearance of the recurrent tumor. Selection of local therapy for hepatocellular carcinoma achieved long survival in our case considering the QOL and frequent therapy administration.

Antineoplastic Agents↗

PubMed1998

N-myc gene amplification in rhabdomyosarcoma detected by fluorescence in situ hybridization: its correlation with histologic features.

Fluorescence in situ hybridization (FISH) was applied to 15 alveolar rhabdomyosarcomas (A-RMSs) and 14 embryonal RMSs (E-RMSs) to detect N-myc (also called MYCN) oncogene amplification. The results were compared with histologic characteristics and clinical factors. The number of surviving patients in each subtype was 5 of 15 with A-RMS and 5 of 14 with E-RMS. N-myc amplification was detected in 9 of the 15 A-RMSs but in none of the 14 E-RMSs. Tumor cells exhibiting N-myc amplification were identified only in the alveolar area in two A-RMSs, and they demonstrated a histologic mixture of alveolar and embryonal patterns. The remaining seven cases with an amplified N-myc showed a conventional alveolar pattern. Among the 15 A-RMSs, the survival rate of patients with tumors showing nonamplified N-myc and amplified N-myc oncogene was 4 (66%) of 6 and 1(11%) of 9, respectively (P < .05). No significant difference was observed between the other clinical findings (age, primary sites, clinical stages) of the N-myc-amplified and nonamplified tumors. Therefore, we concluded that the N-myc gene amplification, which is characteristic of a particular subtype of A-RMS, might be useful as a prognostic factor for an unfavorable outcome.

Adolescent↗

PubMed1997

Lymph node metastasis and relation to tumor growth potential and local immune response in advanced gastric cancer.

To evaluate the relation between the degree of lymph node metastasis and the growth potential of tumour cells and the local immune function in gastric cancer, we analyzed data on 444 patients with advanced serosally invasive gastric cancer who underwent curative gastrectomy. Tumour growth potential was evaluated based on the value proliferating cell nuclear antigen (PCNA) in the primary tumour, and dendritic cell infiltration into the tumour was determined as an indicator of local immune function. The values of PCNA labeling in the primary tumour increased and the infiltration of dendritic cells into the tumour decreased in relation to the extent of lymph node metastasis. High growth potential and low immune function were seen in cases with n3 lymph node metastasis. There was a reverse relation between the PCNA labeling index and dendritic cell infiltration. A variety of forms of recurrence was noted in patients with lymph node metastasis while the prognosis was less favorable, in relation to the degree of lymph node metastasis. Thus, the potential for nodal spread appears to be associated with the growth potential of tumour cells and with the local immune status of the tumour.

Cell Count↗

PubMed1997

Power of logrank test and Cox regression model in clinical trials with heterogeneous samples.

This paper evaluates the loss of power of the simple and stratified logrank tests due to heterogeneity of patients in clinical trials and proposes a flexible and efficient method of estimating treatment effects adjusting for prognostic factors. The results of the paper are based on the analyses of survival data from a large clinical trial which includes more than 6000 cancer patients. Major findings from the simulation study on power are: (i) for a heterogeneous sample, such as advanced cancer patients, a simple logrank test can yield misleading results and should not be used; (ii) the stratified logrank test may suffer some power loss when many prognostic factors need to be considered and the number of patients within stratum is small. To address the problems due to heterogeneity, the Cox regression method with a special hazard model is recommended. We illustrate the method using data from a gastric cancer clinical trial.

Bias↗

PubMed1997

Decrease in elastin gene expression and protein synthesis in fibroblasts derived from cardinal ligaments of patients with prolapsus uteri.

Abnormal connective tissues may be a key factor in the development of pelvic supportive disorders. Elastin gene transcripts and elastin synthesis in cultured fibroblasts derived from cardinal ligaments of patients with prolapsus uteri and compared them with those in fibroblasts from age-matched control patients were examined. Elastin mRNA steady-state levels and elastin synthesis were significantly down-regulated in quiescent fibroblasts from prolapsus uteri patients compared with quiescent control fibroblasts. Although transforming growth factor beta 1 (TGF-beta 1) promoted elastin mRNA and protein levels in fibroblasts from both prolapsus uteri and control patients, the maximum levels of elastin gene transcripts and elastin synthesis in response to exogenous TGF-beta 1 were significantly lower in prolapsus uteri fibroblasts than control fibroblasts. These results suggest that the marked reduction in elastin gene transcripts and elastin production in fibroblasts cultured from elderly women with prolapsus uteri could lead to a paucity of ligament elastic fibres and thus may contribute to the loss of supportive function in uterine connective tissues.

Cells, Cultured↗

PubMed1997

Evaluation of abdominal lymphadenopathy in children by ultrasonography.

BACKGROUND: There may be uncertainty as to whether enlarged abdominal lymph nodes (LNs) in children are normal or abnormal. OBJECTIVE: To compare, by ultrasonography (US), enlarged abdominal LNs in healthy children with those in children with acute abdominal pain or acute gastroenteritis. MATERIALS AND METHODS: One hundred and twenty-two asymptomatic children were selected by questionnaire and compared with 44 children with acute abdominal pain of unknown origin and 27 children with acute gastroenteritis. The number of LNs, their location, their shape and the presence of tenderness as detected by finger compression of each LN were evaluated. The children were divided into four groups according to age: 0-2, 3-6, 7-10, and 11-15 years. RESULTS: LNs were detected in the ileo-caecal and/or para-aortic areas in almost all of the asymptomatic children. The number of large LNs ( > 10 mm) in the para-aortic areas was higher in the older children (>/= 7 years of age) than in the younger children ( </= 6 years of age) (P < 0.05). The number of spindle-shaped LNs (ratio of long- to short-axis diameter >/= 2.0) was increased in the older children. The number of LNs was not increased in the children with acute abdominal pain. The size of the LNs was largest in the children with acute gastroenteritis, followed by the children with acute abdominal pain and the asymptomatic children (P < 0.001). Although the shape of the LNs was no different among the three groups of children, the frequency of round-shaped LNs (ratio of long- to short-axis diameter < 2.0) was greater in the older children with acute abdominal pain or acute gastroenteritis than in the asymptomatic children (P < 0.01). The number of LNs with tenderness detected by finger compression was significantly greater in the children with acute abdominal pain and acute gastroenteritis than in the asymptomatic children (P < 0.0001). CONCLUSION: The number of large and round-shaped LNs with tenderness tended to be increased in the children with acute gastroenteritis and acute abdominal pain. There is no clear specificity of LN enlargement in the children with acute abdominal pain, and the main challenge is to diagnose or estimate the organic pathology by US, regardless of the presence of lymphadenopathy.

Abdomen↗

PubMed1997

Surgical treatment and outcome for node-negative gastric cancer.

BACKGROUND: The clinicopathologic characteristics and prognosis for patients with node-negative gastric cancer have heretofore remained to be determined. METHODS: We analyzed data on 730 of our patients with node-negative gastric cancer who underwent curative gastric resection in the Department of Surgery II, Kyushu University Hospital, between 1965 and 1990, with reference to prognostic factors. The presence of lymph node metastasis was determined by means of routine hematoxylin-eosin staining of excised tissues. RESULTS: The 5-year survival rate was 91.7% and the 10-year rate was 88.5%; thus the prognosis was good for patients with node-negative gastric cancer. When the prognosis was analyzed by stratification of each clinicopathologic factor, the survival time was shorter for older patients when the size of the tumor was larger, when the tumor involved the entire stomach, and when-tissues revealed infiltrative growth, serosal invasion, and lymphatic invasion. Extensive lymph node dissection was performed for 86.6% of the patients, and for these patients the prognosis was better, with a statistical difference. In a multivariate analysis, tumor size, serosal invasion, and extensive lymph node dissection proved to be independent prognostic factors for patients with node-negative gastric cancer. CONCLUSIONS: Prophylactic lymph node dissection for patients with gastric cancer will prolong the survival time.

Adult↗