[A case of perforated diverticulum of the transverse colon].
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Biomedical subjects
Publications and source records attributed to K Hirabayashi.
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We reviewed the histopathological features for the diagnosis of reflux esophagitis and gastroesophageal reflux disease(GERD) including carcinogenesis of the esophagus. Histologically, the presence of capillary dilatation, elongation of papillary, hyperplasia of basal layer, inflammatory cells-infiltration, balloon cells in the epithelium, and ulceration were evaluated in GERD cases. Although, histopathological changes were not clear in endoscopic-negative GERD cases, immunohistochemical examination with cell cycle protein(PCNA, p21, and p27) revealed the same abnormalities with GERD cases. In Japan, the majority cases of GERD are evaluated in grade according to Los Angeles system, therefore the prevalence of Barrett's esophagus and cancer is very low. We hypothesize that esophageal squamous cell carcinoma arising from GERD different from Barrett's cancer sequence, and clinicopathological long-term follow up will be required to assess the carcinogenesis including gene analysis.
A complex of polyinosinic-polycytidylic acid [poly(I) x poly(C)] and cationic liposome (LIC) inhibited the growth of many tumor cell lines at low concentration in vitro, but poly(I) x poly(C) alone had no such antiproliferative effect. The IC50 values of LIC against the tumor cells ranged from 0.1 to 1000 ng/ml. LIC had strong cytotoxic effects on malignant cells of epithelial and fibroblastic origin from various tissues and was also effective against Adriamycin-resistant tumor cells. LIC did not significantly affect the growth of lymphoma cells, leukemia cells, normal diploid fibroblasts, or primary liver cells at concentrations up to 10 microg/ml. The mechanism of the antiproliferative effect of LIC against malignant cells was the induction of apoptosis. LIC induced the fragmentation of nuclear DNA and the degradation of rRNA in tumor cells. The DNA fragmentation occurred within 1-5 h after the addition of LIC, and both the fragmentation and the inhibition of cancer-cell growth were suppressed by a nuclease inhibitor. In contrast, caspase inhibitors did not affect the antiproliferative activity of LIC. These results suggest that LIC induced apoptosis in malignant cells through the direct activation of nucleases and not through the activation of caspases. LIC reduced the incidence and the size of metastatic liver-cancer tumors in two different mouse metastatic liver-cancer models using human colon carcinoma cells. Histochemical analysis revealed that the KM12-HX cells in the tumor nodules were undergoing apoptosis; therefore, LIC also induced the apoptosis of tumor cells in vivo. In these animal models, LIC caused no observed changes in normal hepatocytes.
The aim of this study was to identify two homologous serine proteinase inhibitor (serpin) molecules, squamous cell carcinoma (SCC) antigen-1 and -2, by two-dimensional electrophoresis (2-DE), combined with immunoblotting, and examine their expression in tumor tissue. The recombinant SCC (rSCC) antigen-1 showed four spots with p/ 6.5, 6.4, 6.3 and 6.0, whereas rSCC antigen-2 showed a more acidic spot with p/5.95. SCC antigen in tumor tissue appeared in three new acidic spots (p/5.7-5.5, M(r) 44 500), numbered 5, 6 and 7, besides the previously reported four spots numbered 1 to 4. These new acidic spots of SCC antigen apparently increased in SCC tissue. Treatment of tissue extract by carboxymethyl (CM)-papain agarose matrix extinguished spots 1 to 4 encoded on the SCCA1 gene, but not 5 to 7 on the SCCA2 gene. Overexpression of the SCCA2 gene may play an important role in the malignant behavior of tumor cells.
The tumor-suppressive effects of nonsteroidal antiinflammatory drugs (NSAIDs) have been suggested to be due to a reduction in cyclooxygenase (COX)-2 activity, although the effects of COX-2 in the colonic mucosa and in colorectal cancer have not been determined. Ki-67 immunoreactivity in cancers is also attracting attention, as Ki-67 reflects cell proliferation, while p53 immunoreactivity is also of interest, as it reflects the malignancy of colorectal lesions. Accordingly, to determine these correlation, we investigated the distribution and intensity of COX-2, p53 and Ki-67 expression in both cancerous and non-cancerous tissues from patients with sporadic and ulcerative colitis (UC)-associated colorectal cancer. We selected 21 colorectal cancer specimens, obtained by surgical resection or colonoscopic biopsy, from 21 patients, including 3 with UC (13 men and 8 women; aged 42-78 years). Histological examination of hematoxylin and eosin-stained specimens revealed that 9 were well differentiated; 11. moderately differentiated: and 1 was a poorly differentiated adenocarcinoma. We used anti-COX-2, p53, and Ki-67 antisera to perform immunohistochemical staining by the labelled streptavidin biotin method and then assessed and graded the staining intensity and distribution. COX-2 staining was more intense in cancer tissue than in non-cancerous areas. Colorectal cancers associated with UC were not stained intensely. COX-2, p53, and Ki-67 positivity rates in were 38.1%, 38.1%, and 47.6%, respectively. There were no relationships among the distributions or intensities of COX-2, p53, and Ki-67 expression. Our results indicate that colorectal cancer tissues overexpress COX-2, but that there are no relationships between COX-2, p53, and Ki-67 expression, suggesting that COX-2 expression may not be related to cell proliferation or to the grade of malignancy. However, it is necessary to determine whether COX-2 in cancer tissue is involved in carcinogenesis or whether it is simply a product of cancer.
Laminectomy, which had long been used for treatment of cervical spondylotic myelopathy, including ossification of the longitudinal ligament in the cervical spine, had numerous complications such as postoperative malalignment of the cervical spine and vulnerability of the spinal cord caused by total removal of the posterior structures. In 1977 Hirabayashi devised an open door expansive laminoplasty, which is a relatively easier and safer procedure than laminectomy, that eliminated such problems by preserving the posterior elements. The decompression effect of the expansive laminoplasty against a compressed spinal cord is comparable with that of laminectomy and anterior decompression followed by fusion, whereas the expansive laminoplasty has no structural problems and adverse effects on adjacent disc levels that often are associated with anterior decompression followed by fusion. Average recovery rate of expansive laminoplasty for cervical spondylotic myelopathy has been reported to be approximately 60% (Japanese Orthopaedic Association score) and with long term stability. At present, authors consider all patients with cervical spondylotic myelopathy candidates for expansive laminoplasty except for those having preoperative kyphosis and single level lesion without canal stenosis. Two remaining problems of expansive laminoplasty to be solved are prevention of C5,C6 radicular pain and/or paresis, the most frequent complication that occurs in approximately 5% to 10% of the patients, although most complications resolve spontaneously within 2 years, and correction of nonlordotic alignment to lordosis which are essential for posterior decompression effect of expansive laminoplasty by allowing the spinal cord to shift dorsally.
We used Image Analysis Processor to clarify the relation ship between cell proliferation, apoptosis and inflammation before and after eradication in H. pylori gastritis. Fifty-two patients with H. pylori gastritis were diagnosed using the Rapid Urease Test under endoscopical and histological examination. The grading of gastritis was determined by the Updated Sydney System. While the effects of Ki-67 on epithelial cell proliferation were examined by immunohistochemistry using Image Analysis Processor, and apoptosis in epithelial cells was counted after staining by in situ TDT. H. pylori density, the number of neutrophils, mononuclear cell, and number of lymphoid follicles had significantly decreased after eradication. Ki-67 labeling index significantly decreased from 11.74 percent to 0.98 percent after eradication (p < 0.0001). The apoptotic index had also decreased after eradication, but with a lack of significant difference (p < 0.06). These data suggest that H. pylori gastritis was remarkably ameliorated by eradication, have led to being capable of improving epithelial cell damage, and activity of proliferative cells and apoptotic cells were becoming normalization.
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The complex of poly(I):poly(C) and a new cationic liposome (LIC) has a potent antitumor activity against many tumor cell lines in vitro, whereas poly(I):poly(C) itself has no such activity. In the present study we tested the sensitivity of 21 human colon and pancreatic cancer cell lines to LIC or Adriamycin in vitro. The growth of most of the cell lines was strongly inhibited by both LIC and Adriamycin in vitro, although a few insensitive cell lines were different. We also studied the in vivo antitumor activity of LIC or Adriamycin in three experimental liver metastasis models in nude mice using a human pancreatic cancer cell line (AsPC-1) and two human colon cancer cell lines (Ls174T and HCC-M1544). The administration of LIC or Adriamycin was started 3 days after the injection of tumor cells. Animals received 0.1 mg/kg LIC IV twice weekly or 5 mg/kg Adriamycin IV every 5 days during the experiments. LIC showed potent antitumor activity in all three liver cancer models. Although Adriamycin had potent antitumor activity in the HCC-M1544 model, it had only a moderate effect in the AsPC-1 model and at most a weak effect in the Ls174T model. At the effective doses LIC did not cause detectable pathological changes in the liver and did not elicit toxicity to mice in these models, whereas Adriamycin did exhibit toxic effects. These results suggest that LIC is a promising candidate drug to treat hepatic metastasis.
We conducted a multiple regression analysis on the surgical results (minimum follow-up of 5 years) of 55 patients who underwent expansive open-door laminoplasty (open-door ELAP) for cervical myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in order to determine statistically the impact of factors influencing the results. Duration of myelopathy was found to be a significant factor indicating poor results, while progression of ossification and age at the time of surgery were significant factors indicating deterioration. Three other factors (preoperative severity of myelopathy, degree of spinal canal expansion and changes of the curve indices before and after surgery) did not have a significant influence on the results. To improve the surgical results, it is thus essential to operate on patients as soon as they develop symptoms of myelopathy. There exists a certain limitation in posterior decompression for OPLL including open-door ELAP until prevention of the progression of ossification becomes possible.
BACKGROUND: There is a significant interest in combination therapy using endoscopic epinephrine injection and thermal coagulation for nonvariceal hemostasis. The purpose of the study was to compare the relative effectiveness, ease of use, and safety of new Injection Gold Probes to other hemostasis techniques in three randomized, controlled laboratory studies of bleeding canine gastric ulcers. METHODS: Fifteen dogs with prehepatic portal hypertension were heparinized and bleeding gastric ulcers were induced with jumbo biopsy forceps. Three different prototypes of Injection Gold Probes were compared with monotherapy (thermal, electrocoagulation, or epinephrine injection alone), control, or combination therapy with separate injector and thermal probes. The treatment times, total number of pulses or injections, volume of epinephrine injected, and ease of applications were recorded. Gastric ulcer size, ulcer healing, and complications were evaluated at 1 and 4 weeks. RESULTS: All endoscopic treatments were effective for acute hemostasis compared with control. Thermal coagulation alone was the fastest treatment to perform. The performance of the first Injection Gold Probe prototype was restricted by its small-gauge needle. The second and third Injection Gold Probe prototypes had a larger-gauge needle and irrigation channel which made them faster and easier to use than separate injection catheters and thermal probes. CONCLUSIONS: The advantages of Injection Gold Probes were the ability to irrigate, inject, and coagulate without probe removal. Combination therapy did not increase treatment-related complications compared with monotherapies.
The process of metastasis involves a series of sequential steps in which malignant cells are released from the primary tumor and metastasize to distant sites. Syndecan-1 is a cell surface proteoglycan that mediates cell adhesion and undergoes changes upon cell transformation of some cells that may contribute to the process of metastasis. To investigate the possible role of syndecan-1 in cell proliferation and metastatic potential, we employed a highly metastatic cell line (KLN 205) derived from mouse lung squamous cell carcinoma that expressed moderate amounts of syndecan-1. At first, endogenous syndecan-1 production was inhibited by an antisense oligodeoxynucleotides (ODNs). Since antisense ODNs of syndecan-1 inhibited cell growth, we established stable transfectants of syndecan-1 in this cell line to examine a proliferative advantage with the level of syndecan-1 expression. Overexpresser cells grew at a significantly faster rate than the vector-transfected control and showed greater incidence of tumor formation when injected subcutaneously into nude mice. Surprisingly, overexpresser cells enhanced pulmonary metastasis when injected intravenously. These results indicate that syndecan-1 expression plays a role in the control of cell proliferation and suggest that syndecan-1 expression may be involved in facilitating distant metastasis of tumor cells once they managed to enter the bloodstream (after intravasation steps).
A case of aqueductal stenosis (AS) associated with marked parkinsonism is described. A ventriculoperitoneal (V-P) shunt was performed in an 18-year-old female because of hydrocephalus associated with non-neoplastic aqueductal stenosis. The patient developed acute parkinsonism with Parinaud's sign after the shunt revision. She had a marked response to levodopa and the parkinsonism improved. Subsequently, levodopa therapy was gradually discontinued without any manifestation of parkinsonism. The pathophysiology of this type of parkinsonism probably involved presynaptic dopaminergic dysfunction. However, the etiology of this complication has not been confirmed.
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BACKGROUND: Our purpose was to compare the efficacy, complications, failure rates, and crossovers of heater and bipolar probe treatments of chronically bleeding internal hemorrhoids. METHODS: Eighty-one patients (31 female, 50 male) with mean age of 53 years had large (grade 2 to 3) internal hemorrhoids with bleeding for a mean of 12 years, had failed medical management, and were randomized in a prospective study of anoscopic treatments to heater versus bipolar probes. Failure was defined as a major complication or failure to reduce the size of all internal hemorrhoids with three or more treatments. RESULTS: With similar background variables and no difference in treatment times, rectal bleeding and other symptoms were controlled in a shorter time with the heater probe than with the bipolar probe (77 versus 121 days). Five complications (fissures, bleeding, or rectal spasm) occurred with the bipolar probe, and two occurred with the heater probe. The heater probe caused more pain during treatments but had significantly fewer failures and crossovers. CONCLUSIONS: For patients who had failed medical management of chronically bleeding internal hemorrhoids, the techniques and complications of heater and bipolar probes were similar, but pain was more common, failures and crossovers were less frequent, and the time to symptom relief was shorter with the heater probe than with the bipolar probe.
There have been few reports on hypersensitivity to chironomid midges in bronchial asthmatic patients around the area of hypereutrophic natural lakes, which have been notorious as an environmental hazard due to the massive occurrence of adult chironomids during several periods of the year. Our study investigated IgE antibodies to chironomid midges in bronchial asthmatic patients around the Lake Suwa area in comparison with those of the Matsumoto area (control area). A total of 123 adult patients with bronchial asthma were investigated by measurement of IgE antibodies with extracts of three chironomid midges (Chironomus yoshimatsui, C. plumosus, and Tokunagayusurika akamusi), mite, and silkworm. In addition, in the allergy testing, 12 common inhalant antigens were used. Of 123 adult patients with bronchial asthma, 65 (52.8%) produced positive allergy tests. Thirty-three (50.8%) were positive to mite, 28 (43.1%) to silkworm, 11 (16.9%) to C. yoshimatsui, eight (12.3%) to C. plumosus, and three (4.6%) to T. akamusi. We compared our results with the previous reports. The number of positive tests to silkworm in the Lake Suwa area was higher than in other areas. However, C. plumosus and T. akamusi showed a lower number of positive reactions. We considered the lower positive number of C. plumosus and T. akamusi tests in the Lake Suwa area to be related to the advanced age of patients in this area. The chironomids are an important cause of asthma, together with mite and silkworm, in the Lake Suwa area, but affect old asthmatic patients less than asthmatic children.
There is no definite classification of brainstem encephalitis, its etiology is not clear. Bickerstaff's brainstem encephalitis (BBE) was established by clinical diagnosis without etiology. Recently there are great progression to identify a virus by using immunological methods and PCR (polymerase chain reaction) methods. Sometimes the progression of MRI revealed subdiagnostic images of brainstem lesion. Nowadays we can investigate anti-ganglioside antibodies in some BBE patients but not all. High IgG anti-GQ1b antibody titers were present in some BBE sera samples but decreased with the clinical course of illness. A girl was suffered from BBE whose Cytomegarovirus-DNA was detected in the CSF by PCR. Serum anti-GQ1b antibody was positive. The neurological symptoms disappeared with decreasing of anti-GQ1b antibody. Immuno adsorption therapy is effective for BBE with anti-GQ1b antibody positive patients.