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Biomedical subjects

K Endo

Publications and source records attributed to K Endo.

At least 1,045 records · Page 58Linked to original sources

Hand-Schüller-Christian disease with occult diabetes insipidus, cardiac failure and renal dysfunction.

A 60-year-old man was diagnosed as Hand-Schüller-Christian disease due to the triad of exophthalmus, decalcification of the bone, and diabetes insipidus. He had xanthogranuloma on the face and a nuchal region, and unusual complications of ADH-resistant diabetes insipidus due to renal dysfunction, and chronic cardiac failure. Urine osmolality was hypotonic, but urine volume was within the normal limit, despite the presence of central diabetes insipidus. Hypophyseal, adrenal and thyroid function were not remarkable. The skin biopsy showed the infiltration of eosinophilic granuloma cells. Treatment with vincristine was effective to regress the xanthogranuloma. Diabetes insipidus was not treated because of the absence of polyuria and polydipsia.

Acute Kidney Injury↗

Autoimmune hemolytic anemia and myasthenia gravis.

A case of autoimmune hemolytic anemia associated with myasthenia gravis in a 33-year-old female is presented. The association of autoimmune hemolytic anemia and myasthenia gravis is a very rare event, with only eight cases reported. The known association of these two diseases is reviewed. To our knowledge, this is the first reported case in which autoimmune hemolytic anemia preceded systemic myasthenia gravis.

Adult↗

Wild-type p53 gene transfection in human cultured sarcomas: effect of CDDP.

We examined the susceptibility of five human bone and soft tissue sarcoma cell lines to transfection with recombinant p53 adenovirus vector (AxCA-p53). Transfection efficiency was more than 90% at 72 h with AxCA-lacZ at a multiplicity of infection (MOI) of 50 in all the cell lines, except for MG-63 (p53 gene mutated) cells. Western blot analysis showed overexpression of both P21/Waf1 and Bax protein in all the cell lines, implying sufficient and successful p53 gene transfection. AxCA-p53 transfection at MOI of 50 resulted in a significant decline of viable cells at 72 h, due to apoptosis, in NY (mutated) and Saos-2 (deletion), but not in the other three lines. The two apoptosis-induced cell lines showed a gradual increase in Bax expression up to 72 h and non-detectable expression of Bcl-XL from 48 h, suggesting the involvement of an apoptosis-inducing mechanism. Pre-treatment with cis-diamminedichloroplatinum (II) (CDDP) at 0.1 microg/ml significantly suppressed tumor cell viability in NY and HuO-3N1 (mutated), but not in the other three lines including HT-1080 carrying the wild-type p53 gene, implying the existence of different mechanisms for the tumor suppressive effect of p53 gene transfection and CDDP. These results indicate that wild-type p53 gene transfection with CDDP is a promising therapy for some, but not all, non-resectable bone-and soft tissue sarcomas, regardless of intrinsic p53 gene status.

Adenoviruses, Human↗

Diagnostic capability and rational resectional surgery for early gallbladder cancer.

Gallbladder carcinoma limited to the mucosa (pT1a) or muscularis proper (pT1b) with no lymph node metastasis (stage I) is defined as early carcinoma of the gallbladder. Eleven patients with early carcinoma of the gallbladder, treated by either simple or extended cholecystectomy (cholecystectomy plus wedge resection of the gallbladder bed of the liver and lymphadenectomy), were reviewed to determine the diagnostic capability and to clarify the rational resectional procedure for this stage of the disease. A definitive pre-operative diagnosis was made in only 2 patients with pT1b tumors. Most of the remaining 9 patients were diagnosed incidentally after cholecystectomy for polyps or stones. Among 7 patients with pT1a tumors, 5 underwent simple cholecystectomy and 2 underwent extended cholecystectomy. All 7 patients survived with a recurrence-free condition for 5 years or more following the operation. Two patients with pT1b tumors, however, died of a local recurrence or bile duct carcinoma following simple cholecystectomy. Two patients with pT1b tumors who were correctly diagnosed before the operation and underwent extended cholecystectomy survived without recurrence. It is concluded that patients with pT1a tumors can be successfully treated by simple cholecystectomy, while patients with pT1b tumors require extended cholecystectomy.

Adult↗

In vivo nuclear uptake of a vitamin D analog (OCT) in different tumor cell populations of FA-6 cancer xenograft in nude mice by receptor autoradiography.

1 alpha, 25-dihydroxyvitamin D3 [1 alpha, 25(OH)2D3] and its analogs have been shown to repress the production of parathyroid hormone-related peptide (PTHrP) in tumors, which is a major factor causing humoral hypercalcemia associated with various cancers. Since vitamin D analogs may be applicable to the treatment of cancer patients, the present study was undertaken to examine whether OCT, an analog with little calcemic activity, is incorporated into tumor tissues, and to identify cellular and subcellular sites of its specific uptake and retention. [26-3H]OCT was injected i.v. into nude mice inoculated with a human pancreatic carcinoma cell line (FA-6). At 1 hour after the injection, intracellular concentration of radioactivity was visualized by receptor (thaw-mount) autoradiography. The results indicate a heterogeneous distribution of radioactivity in nuclei of certain large cancer cells as well as in single or clustered small and elongated cells within the tumor, while connective tissue cells outside of the tumor remained free of nuclear labeling. The data suggest that OCT acts selectively at the genome of cancer cells during a certain maturational stage and also of a second population of small fibroblast-like cells that may have been transplanted with the tumor or are host-derived.

Animals↗

Detection of perfusion areas of the gallbladder vein on computed tomography during arterial portography (CTAP)--the background for dual S4a.S5 hepatic subsegmentectomy in advanced gallbladder carcinoma.

BACKGROUND/AIMS: It has been speculated that the veins of the gallbladder join the intrahepatic portal veins supplying the Couinaud's S4a-S5. This has been the theoretical ground for the resection of these 2 hepatic subsegments in advanced gallbladder carcinoma. However, no consensus has been reached on this concept. METHODOLOGY: The current study describes the non-neoplastic perfusion defects in connection with the gallbladder bed in 100 consecutive hepatic CTAP (computed tomographies during arterial portography). The suitability of S4a and S5 subsegmentectomies of the liver for advanced gallbladder carcinoma was also investigated by examining CTAP images of the branches of the portal vein involved in the perfusion defect. RESULTS: Two types of gallbladder venous perfusion were observed: 1) sphenoid distribution from the gallbladder bed into the P4a (37%), P5 (52%) and P6 (3%), and 2) perfusion into the P4 (9%) or directly into the middle hepatic vein (9%) after communicating with the hepatic hilum at the dorsal side of S4. CONCLUSIONS: These results support liver resection at S4a and S5 as the surgical approach for cases of advanced gallbladder carcinoma.

Gallbladder↗

Surgical treatment and postoperative outcomes for middle and lower bile duct carcinoma in Japan--experience of a single institute.

BACKGROUND/AIMS: Recently, the Japanese Classification on Cancer of the Biliary Tract was revised and adopted the new comprehensive staging that is similar to UICC's TNM classification. We should be paying close attention to the significance of newly defined extensive factors of carcinomas on the long-term prognosis. METHODOLOGY: The surgical outcome for 99 patients who underwent resected middle (Bm) and lower (Bi) bile duct carcinomas was reviewed in order to evaluate the suitability of the surgical procedures employed for their treatment, namely, standard pancreatoduodenectomy for Bi carcinoma and bile duct resection with D2 lymph node dissection for Bm carcinoma. RESULTS: The overall 5-year cumulative survival rate (operative death excluded) of Bm and Bi carcinoma patients was 37.4% and the 5-year survival rate of the patients in whom surgical curability (curA) was accomplished was 51.6%. Recently, a new prognostic factor, "t-category", which indicates the degree of pericholedochal neoplastic invasion was proposed in the 4th edition of the Japanese General Rules for Surgical and Pathological Studies on Cancer of the Biliary Tract. The 10-year survival rates by t-category were 49.1% (t1), 19.7% (t2), and 0% (t3 and t4) respectively. For Bm carcinoma, the patients undergoing bile duct resection under the condition of curA showed excellent prognoses. For Bi carcinoma, the patients fulfilling particular histological criteria, i.e., those concerning the histological depth of neoplastic invasion (m, fm, panc1a), duodenal involvement (du0, du1), vascular invasion (pv0), pericholedochal neoplastic invasion (t1), lymph node metastasis (n0), and comprehensive stage I, had good postoperative outcomes. Taking into account the fact that the metastatic rate of paragastric lymph nodes was 1.3%, the cases of panc0,1 should be operated by pylorus-preserving pancreatoduodenectomy. The overall 5-year survival rates including far-advanced cases were 39.9% in Bm carcinoma patients and 36.9% in Bi carcinoma patients. However, these postoperative outcomes are far from satisfactory. CONCLUSIONS: Therefore, we concluded that pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy with extended D3 lymphadenectomy combined with systematic multimodal therapy are indicated in each and every case of Bm and Bi carcinoma.

Bile Duct Neoplasms↗

Preliminary study of proton magnetic resonance spectroscopy in bone and soft tissue tumors: an unassigned signal at 2.0-2.1 ppm may be a possible indicator of malignant neuroectodermal tumor.

PURPOSE: To evaluate the utility of proton magnetic resonance spectroscopy in bone and soft tissue tumors, especially whether or not the N-acetyl aspartate signal (NAA) could be recognized in neurogenic tumors. MATERIALS AND METHODS: Forty-nine proton magnetic resonance spectroscopy studies were performed in 60 bone and soft tissue tumors. The patients were 28 males and 30 females. Eleven studies were incomplete, and were excluded from analysis. A point-resolved spectroscopy sequence (TR=1500 or 2000 ms, and TE=30, 60, 136, or 272 ms) was used on a 1.5-Tesla clinical MR scanner. RESULTS: An unassigned signal at about 2.0-2.1 ppm was recognized in six of 47 lesions: clear cell sarcoma (2/2), Ewing sarcoma (1/1), malignant fibrous histiocytoma (1/3), malignant schwannoma (1/1), and mucoepidermoid carcinoma (1/1). Neuroblastoma (1/1), primitive neuroectodermal tumor (1/1), and malignant melanoma (1/1) after chemotherapy or radiotherapy did not show this signal. This signal was not detected in neurofibroma (9/9), schwannoma (6/6), pheochromocytoma (2/2), or other mesenchymal tumors of non-neuroectodermal origin. CONCLUSIONS: The assigned signal at about 2.0-2.1 ppm was detected in a small percentage of bone and soft tissue tumors and could be suggestive of an untreated malignant tumor of neuroectodermal origin.

Adolescent↗

Dynamic contrast-enhanced MR imaging of the water fraction of normal bone marrow and diffuse bone marrow disease.

PURPOSE: To clarify the contrast-enhancement pattern of the normal hematopoietic element by isolating the signal of the water fraction in vertebral bone marrow and to investigate whether this approach can be used to characterize bone marrow pathology in several diffuse bone marrow diseases. METHODS: Two groups were examined: 30 normal healthy volunteers and 19 patients with primary diffuse bone marrow disease (aplastic anemia [n=8], myelodysplastic syndrome (MDS) [n=5], chronic myelogenic leukemia (CML) [n=4], polycythemia vera [n=2]). Isolation of the signal of hematopoietic tissue was done by the chemical-shift misregistration effect. Twenty consecutive T1-weighted midsagittal lumbar vertebral images were obtained immediately after the intravenous administration of Gd-DTPA of 0.1 mmol/kg body weight, and the pattern of the time-intensity curve, the peak contrast-enhancement (CE) ratio, and the washout rate (%/min) of bone marrow in normal volunteers were compared with those in patients suffering from primary diffuse bone marrow disease. RESULTS: The pattern of the time-intensity curve of patients with aplastic anemia showed a low peak value followed by a slow washout. However, the pattern of time-intensity curves in patients with MDS, CML, and polycythemia vera was similar to that of normal volunteers. The peak CE ratio of the water fraction in normal marrow ranged from 0.45 to 1.26 (mean +/- S.D.: 0.87 +/- 0.18). Patients with aplastic anemia showed an abnormally lower peak CE ratio of the water fraction (mean +/- S.D.: 0.34 +/- 0.19, p<0.0001). On the other hand, the peak CE ratio of the water fraction in patients with MDS was significantly higher than that of normal volunteers (mean +/- S.D. 1.35 +/- 0.39, p<0.05). In contrast, the peak CE ratio of patients with CML or polycythemia vera did not differ significantly from that of normal volunteers. The mean washout rate of patients with aplastic anemia was significantly lower than that of normal volunteers (mean +/- S.D.: 3.50 +/- 2.51%/min vs. 7.13 +/- 1.74%/min, p<0.01). However, there was no significant difference in the washout rate among patients with MDS, CML, polycythemia vera, and normal volunteers. CONCLUSION: Dynamic contrast-enhanced MR imaging of the water fraction provides additional valuable qualitative information about structural changes of the hematopoietic element.

Adolescent↗

Heparanase gene expression and metastatic potential in human gastric cancer.

BACKGROUND: Heparanase has been reported to play an important role in tumor progression and metastasis. We examined the relationship between heparanase mRNA expression and biological factors regarding invasion and metastasis of human gastric cancer. MATERIALS AND METHODS: In 63 human gastric carcinomas, 42 adjacent normal gastric tissues and four gastric cancer cell lines, heparanase mRNA expression was evaluated using reverse transcription PCR (RT-PCR). Total RNA obtained from human peripheral blood (PB) leucocyte and placenta were used as positive controls. The relationship between heparanase mRNA expression and various clinicopathological factors were analyzed. RESULTS: The heparanase mRNA expression evaluated with RT-PCR revealed that 31 out of 63 gastric cancer tissues (49%), 11 out of 42 normal gastric tissues (26%) and 4 gastric cancer cell lines were positive. The positive rate in cancer tissues was significantly higher than that in normal tissues (p<0.05). In the heparanase mRNA-positive cancer tissues, venous invasion was frequent (p<0.05) and the histological differential grade was significantly poorer than in negative cases (p<0.01). CONCLUSION: We propose that heparanase mRNA expression is involved in invasion and development of human gastric cancer and detection of this expression may be a factor related to metastasis and prognosis of such patients.

Female↗

Antitumor effects of three platinum complexes, (-)-(R)-2-aminomethylpyrrolidine(1,1-cyclobutanedicarboxylato)-platinum (II) monohydrate (DWA2114R), cis-diammine-(1,1-cyclobutanedicarboxylato)platinum(II) (CBDCA) and cis-diamminedichloroplatinum(II) (CDDP), in mice.

(-)-(R)-2-Aminomethylpyrrolidine(1,1-cyclobutanedicarboxylato++ +)platinum(II) monohydrate (DWA2114R), cis-diammine(1,1-cyclobutanedicarboxylato)platinum(II) (CBDCA) and cis-diamminedichloroplatinum(II) (CDDP) were compared for their antitumor effects and nephrotoxicity-inducing activities at the same dosage (1/8, 1/4, 1/3, 1/2, 2/3 or 3/4 of the LD10 or LD10) on the basis of their intravenous lethal doses in mice. DWA2114R was effective against murine tumor lines, Colon 26 and Colon 38 carcinomas, M5076 ovarian sarcoma and P388 L1210 leukemias, implanted subcutaneously (s.c.). Triple injection every other day of DWA2114R was more effective than a single injection at each sublethal dose. The antitumor effects of DWA2114R against these tumors were more effective than or were similar to those of CBDCA and CDDP. The antitumor effect against CDDP-resistant L1210 leukemia implanted s.c. was only observed in the treatment of DWA2114R, but not in CBDCA and CDDP. No excellent antitumor effects of three platinum complexes were observed against Lewis lung carcinoma and B16 melanoma implanted s.c. even at triple injection every other day, and no effect was obtained against Meth-A fibrosarcoma under similar conditions. While the treatment of CDDP showed marked increases in levels of blood urea nitrogen and of urinary protein and sugar at effective doses in the antitumor evaluations, the treatment of DWA2114R as well as CBDCA showed no increase in these parameters. These results indicate that DWA2114R represents a desirable second generation antitumor platinum complex.

Animals↗

In vitro antitumor mechanism of a new platinum complex, (-)-(R)-2-aminomethylpyrrolidine(1,1-cyclobutanedicarboxylato+ ++) platinum(II).

The antitumor mechanism of (-)-(R)-2- aminomethylpyrrolidine (1.1-cyclobutanedicarboxylato)platinum(II) (DWA2114R) was examined using cultured murine L1210 leukemia cells by estimating its effects on parameters such as proliferation, macromolecular synthesis, morphology and cell cycle progression. Each parameter was estimated in cells concomitantly exposed to the drug for 24-48 hr. More than 0.1 microM of DWA2114R markedly inhibited cell proliferation as well as DNA synthesis, and it decreased in mitotic index in a concentration-dependent manner. One microM of DWA2114R decreased DNA synthesis by 80% in the cells treated for 24 hr, while the inhibition of RNA synthesis was less than 40%. A significant inhibition of protein synthesis was caused only by treatment with a high concentration (100 microM) of the drug. Under complete cytostatic conditions (10 microM of DWA2114R), cell volume markedly increased and about 40% of the total cells were polynucleate. In addition, flow cytometrical analysis revealed that most of these cells were accumulated in the G2/M phase of the cell cycle, and a new peak located in the G2/M phase of tetraploid cells emerged. On the other hand, the cells treated with 100 microM of the drug did not increase in volume and their progress in the cell cycle was almost completely blocked.

Animals↗

Immunoscintigraphy using 99mTc-labeled anti-CEA monoclonal antibody for patients with colorectal cancer.

Immunoscintigraphy by 99mTc labeled mouse CEA antibody, BW 431/26, was done for 14 patients with colorectal cancer. All patients underwent body scan 6 and 24 hours after administration of 99mTc antibody, 30 mCi/1mg. In 13 out of 14 cases (92.9%) with colorectal cancer, the specific accumulation of 99mTc was shown. The count ratio between the lesion and normal tissue indicating the accumulation of labeled antibody was calculated as 2.6 to 12.8. The hepatic metastasis could be demonstrated as cold spots in one case and as hot spots in the other case. No adverse reaction was noticed in any of patients examined. These results indicate that immunoscintigraphy by 99mTc-CEA antibody detects carcinoma of the colon excellently, and is quite useful clinically. With SPECT, it is possible to localize the site of the lesion more distinctly and to predict the accumulation of the antibody in the tumor as a treatment application.

Adult↗

Early recurrence of gastric cancer in a patient with chronic renal failure.

We report here a rare, rapid peritoneal recurrence after curative gastrectomy for gastric cancer occurred in a 51 year old woman who had been treated with hemodialysis due to chronic renal failure for 8 years. Preoperatively, her immune status was very low, as indicated by decreased natural killer cell activity and photohemagglutinin reaction and by increased immunosuppressive acidic protein. The density of S-100 positive intratumoral dendritic cells in the resected stomach was low, which also suggested a lower level of loco-regional immunity. Rapid progress of the recurrent disease and the poor prognosis might be related to the suppressed immune activity induced by a long-term chronic renal failure and hemodialysis. Thus, for patients with chronic renal failure who require resection of a gastric cancer, close follow-up is important.

Adenocarcinoma↗