Cytokeratin-positive non-Hodgkin's lymphoma.
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Humans↗
Biomedical subjects
K Kodama
Publications and source records attributed to K Kodama.
Toxigenicity of Helicobacter pylori isolates possessing cagA gene and vacuolating cytotoxin.
Inflammatory cells in the gastric epithelium and direct cell damage are important effects of H. pylori infection in causing gastroduodenal diseases. The aim of this study was to determine whether H. Pylori possessing the cagA gene and vacuolating cytotoxin activity (cagA+/tox+) has these toxigenicities. The detection of cagA was performed by the polymerase chain reaction method. Culture supernatants of H. pylori were tested on rabbit gastric epithelial cell culture for intracellular vacuolation. H. pylori isolates were divided into two major types, cagA+/tox+ and cagA-/tox- strains. Ten Japanese monkeys were allocated to two groups, with six animals inoculated with the cagA+/tox+ strain and four animals inoculated with the cagA-/tox- strain. Five other Japanese monkeys served as controls. They were observed endoscopically every week and the severity of gastritis was evaluated in biopsy specimens obtained from the antral mucosa. Histopathological examination of the gastric mucosa revealed a more severe neutrophil infiltration caused by the cagA+/tox+ strain than that caused by the cagA-/tox- strain for 3 months after inoculation. These findings indicate that cagA and vacuolating cytotoxin may be important factors in causing the severe damage of the human gastric mucosa produced by H. pylori.
Animals↗
Class Ia antiarrhythmic drug cibenzoline: a new approach to the medical treatment of hypertrophic obstructive cardiomyopathy.
BACKGROUND: The class Ia antiarrhythmic drug disopyramide relieves the outflow tract obstruction of hypertrophic obstructive cardiomyopathy (HOCM). Disopyramide, however, has several adverse effects, such as dysuria and thirst, resulting from its anticholinergic activity. A new class Ia antiarrhythmic drug, cibenzoline, has little anticholinergic activity. The aim of this study is to elucidate whether cibenzoline attenuates left ventricular pressure gradient (LVPG) in patients with HOCM. METHODS AND RESULTS: Ten patients with HOCM (mean age, 59+/-12 years) participated in this study. LVPG and left ventricular functions were measured before and 2 hours after administration of a single oral dose of 150 or 200 mg cibenzoline. LVPG decreased from 123+/-60 to 39+/-33 mm Hg (P=.0026). The E/A ratio in transmitral Doppler flow increased from 1.20+/-0.84 to 2.00+/-1.72 (P=.029). Isovolumic relaxation time increased from 73+/-16 to 101+/-23 ms (P=.0026). Left ventricular diastolic dimension remained unchanged, but left ventricular systolic dimension enlarged significantly, from 21.6+/-2.4 to 26.2+/-3.3 mm (P=.0004). Fractional shortening decreased from 47.6+/-6.1% to 34.6+/-8.8% (P=.0007). Left ventricular ejection time index decreased significantly, and preejection period index increased in all the patients. Decreased LVPG remained maintained even in the long-term treatment with cibenzoline. Conclusions These results indicate that cibenzoline can markedly attenuate LVPG in patients with HOCM. A decrease in myocardial contractility seems to be closely related to a marked decrease in LVPG.
Aged↗
Glutamate dehydrogenase mRNA is immediately induced after phencyclidine treatment in the rat brain.
To clarify the molecular mechanism of phencyclidine (PCP)-induced schizophreniform psychosis in humans and of behavioral abnormalities in experimental animals, we used differential screening of a cDNA library from the cerebral cortex of rats treated with PCP. We identified a PCP-induced cDNA clone as the gene encoding glutamate dehydrogenase (GDH), an enzyme central to glutamate metabolism. GDH mRNA levels significantly increased as early as 15 min following PCP administration in both the cerebral cortex and the cerebellum. This effect was observed even in the presence of a protein synthesis inhibitor, cycloheximide. In contrast to a transient increase in c-fos expression, the elevation of GDH mRNA levels lasted up to 8 days after a single PCP injection. These results suggest that GDH mRNA induction may be involved in the pathology of PCP-induced psychosis, and that GDH may be one of the candidate genes that are vulnerable in subjects with schizophrenia.
Animals↗
Transient leftward QRS axis shift during treadmill exercise testing or percutaneous transluminal coronary angioplasty is a highly specific marker of proximal left anterior descending coronary artery disease.
The efficacy of transient QRS axis shift to the left as a predictor of proximal left anterior descending coronary artery (LAD) disease was assessed. By using receiver operating characteristic curve analysis, we indicated that the difference in modal QRS axis between before and after exercise was useful in detecting proximal LAD disease.
Aged↗
Comparison of myocardial contrast echocardiography and coronary angiography for assessing the acute protective effects of collateral recruitment during occlusion of the left anterior descending coronary artery at the time of elective angioplasty.
To assess the immediate change in collateral flow distribution within the occluded myocardium and the acute protective effects on myocardial ischemia after coronary occlusion, myocardial contrast echocardiography (MCE) was performed in 15 patients with normal left ventricular function undergoing elective coronary angioplasty of the left anterior descending artery, and the results were compared with those obtained from coronary angiography (CA). The sonicated or nonsonicated contrast material was injected into the right coronary artery before and during coronary occlusion and collaterals were graded on a 4-point scale (none = 0 to good = 3). Development of subjective anginal symptoms, ST-segment shift and wall motion abnormality during coronary occlusion were graded on a 4-point scale (none = 0 to severe = 3). Both MCE and CA detected a significant development in collateral flow during coronary occlusion. There was no significant correlation between MCE and CA collateral grades before or during coronary occlusion. The collateral flow assessed with MCE was inversely but significantly correlated with development of subjective anginal symptoms (r(s) = -0.70, p <0.01), ST-segment shift (r(s) = -0.78, p < 0.005) or wall motion abnormality (r(s) = -0.91, p < 0.001) during coronary occlusion. In contrast, the angiographic collateral flow was not correlated with development of anginal symptoms (r(s) = -0.46, p = 0.10), ST-segment shift (r(s) = -0.41, p = 0.14), or wall motion abnormality (r(s) = -0.26, p = 0.35). The present study suggested that the acute protective effects of coronary collaterals during coronary occlusion were closely associated with myocardial perfusion rather than the angiographic epicardial collateral vessel filling, and thus MCE was useful in assessing the acute protective effects of coronary collaterals during coronary occlusion.
Aged↗
Immunohistochemically detected expression of motility-related protein-1 (MRP-1/CD9) in lung adenocarcinoma and its relation to prognosis.
Motility-related protein-1 (MRP-1)/CD9 is a trans-membrane glycoprotein closely associated with suppression of cell motility and reduced metastatic potential of some tumor cells. We currently report that, according to the RT-PCR method for MRP-1/CD9 gene expression, patients with low expression of MRP-1/CD9 in non-small-cell lung cancer, especially the adenocarcinoma type, showed short overall survival. Then, to determine accurately the prognostic value of MRP-1/CD9 product levels in lung-adenocarcinoma cells, we immunohistochemically investigated its expression in 132 lung-adenocarcinoma patients undergoing potentially curative surgery. Of these patients, 44 (33%) showed reduced expression of MRP-1/CD9 in cancer cells, and an inverse association was observed between its expression and factors associated with tumor progression, such as nodal involvement (p = 0.029) or stage (p = 0.028). Patients with reduced expression of MRP-1/CD9 showed a significantly worse prognosis in overall survival (p = 0.005) and disease-free survival (DFS; p < 0.0001) than those with stronger expression; and even among patients with stage-I disease, similar results were obtained (overall survival, p = 0.038; DFS, p = 0.012). In a multivariate analysis, immunohistochemical MRP-1/CD9-expression level was an independent prognostic factor for DFS (p = 0.021), but not for overall survival (p = 0.572). Thus, immunohistochemical MRP-1/CD9-expression level solely in lung-adenocarcinoma cells within the tumor tissue appears to be a prognostic factor for DFS, and may be useful for detecting a high-risk sub-group of recurrence during the post-operative clinical course of the disease.
Adult↗
bcl-2 oncoprotein in surgically resected non-small cell lung cancer: possibly favorable prognostic factor in association with low incidence of distant metastasis.
BACKGROUND: The bcl-2 oncoprotein serves a regulatory function in permitting several cell types to die in an apoptotic process. Its overexpression probably plays a role in tumorigenesis and tumor development. The aim of this study was to determine the clinicopathological and prognostic significance of the bcl-2 oncoprotein in patients with nonsmall cell lung cancer (NSCLC). METHODS: Immunostaining for bcl-2 oncoprotein was performed on 182 operable NSCLCs. RESULTS: Thirty-six patients (19.8%) showed a positive immunostaining for bcl-2 oncoprotein. Histologically, its incidence was higher in squamous cell carcinomas (29.6%). Its expression status was inversely correlated with tumor development-associated parameters such as tumor stage in NSCLCs, especially in squamous cell carcinomas, bcl-2 positive patients with NSCLCs, especially squamous cell carcinomas, showed better overall survival and disease-free survival (DFS). In a multivariate analysis, this oncoprotein status had prognostic value in DFS for NSCLCs and in overall survival for squamous cell carcinomas. The recurrence of bcl-2 positive NSCLCs was significantly uncommon in distant extrathoracic organs. CONCLUSIONS: The expression of bcl-2 oncoprotein in NSCLCs may be an early event of tumor development, especially in squamous cell carcinomas, and may be of importance in determining tumor progression and prognosis.
Adult↗
Influence of cathepsin D expression in lung adenocarcinoma on prognosis: possible importance of its expression in tumor cells and stromal cells, and its intracellular polarization in tumor cells.
BACKGROUND: Cathepsin D, an aspartic lysosomal proteinase, has been described to be closely associated with tumor progression and prognosis in some human malignancies. The purpose of this study was to determine clinicopathological and prognostic significance of cathepsin D expression in lung adenocarcinoma. METHODS: Expression of cathepsin D in 152 lung adenocarcinoma patients was immunohistochemically studied using the antihuman cathepsin D antibody. RESULTS: Eighty patients (53%) showed negative immunoreactivities in tumor cells. The cathepsin D-positive patients (72 patients, 47%) were divided into two subgroups; granular type expression (48 patients, 31%) with its polarized expression mainly in the luminal side of the cytoplasm of tumor cells and basal type expression (24 patients, 16%) with its polarized expression mainly in the basal or infranuclear side of the cytoplasm. Patients with basal type expression showed significantly more marked scar formation (P = 0.042), and especially among the patients with stage I disease, those with basal type tended to show poorer prognosis (P = 0.071) than the others. Cathepsin D was also expressed in stromal cells within the tumor tissues, and 86 patients (57%) with moderate to massively infiltrating cathepsin D-positive stromal cells showed a lower grade of differentiation (P = 0.005) and higher scar grade (P = 0.0003) than those with few cathepsin D-positive stromal cells. Cathepsin D status in stromal cells was significantly associated with prognosis (P = 0.014), and in a multivariate analysis, its expression status in stomal cells was marginally an independent prognostic factor only among the stage I patients. CONCLUSIONS: In determining significance of cathepsin D expression in this disease, it is important to consider separately its expression cell type and its polarization pattern in tumor cells within the tumor tissue. How ever, only cathepsin D status in stromal cells within the tumor tissue is a marginal marker influencing prognosis among stage I patients.
Adenocarcinoma↗
The spread of methicillin-resistant Staphylococcus aureus in a rural community: will it become a common microorganism colonizing among the general population?
At Fujiwara Memorial Hospital (FMH), a community hospital with 140 beds located near a large agricultural area in Akita prefecture, the annual number of patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) has been increasing in recent years. To elucidate the current status of MRSA spread, the frequency of its isolation among a total of 10598 bacteriological specimens obtained from patients treated at FMH between July 1989 and December 1994 was evaluated. The frequency increased from 3.8% in 1990 to 9.6% in 1994, and of all the patients colonized with MRSA, outpatients accounted for 4.5% in 1990 and 34.9% in 1994. These outpatients included patients from long-term care facilities, those cared for at home with chronic diseases, and those who had been hospitalized in tertiary general hospitals. This remarkable increase in the percentage of outpatients colonized with MRSA may suggest the spread of MRSA in our community.
Ambulatory Care↗
Evaluation of ability to defecate using saline evacuation from the rectum.
PURPOSE: The purpose of this study is to establish a simple technique to evaluate anorectal motility and the dynamics of defecation. METHODS: Pressure fluctuations in the rectum and anal canal during 500 ml of saline infusion in the rectum and then a saline evacuation curve were recorded using manometer and uroflowmeter. RESULTS: This study consisted of 37 patients with a mean age of 49.6 years. All patients without problems with defecation showed periodic relaxation of the anal canal, which was synchronized with rectal contractions during saline infusion. The saline evacuation curves of these patients were characterized by short evacuation time and high-peak flow. Of the 13 patients with constipation, 9 showed no rectoanal synchronization and had segmental evacuation curves. The patients with incontinence tended to have poor ability for holding saline in the rectum, resulting in low-peaked evacuation curves. CONCLUSIONS: This simple and noninvasive technique for recording anorectal pressure fluctuations and dynamics of saline evacuation from the rectum enables quantitative and qualitative evaluation of the ability to defecate.
Anal Canal↗
Surgery for multiple lung metastases from alveolar soft-part sarcoma.
Between 1985 and 1993, six patients were surgically treated for alveolar soft-part sarcoma (ASPS) arising from the thighs or buttocks, four of whom underwent aggressive excision of multiple metastases using a neodymium:yttrium-aluminum garnet (Nd:YAG) laser. In total, 333 tumors were removed from these four patients during eight pulmonary operations. In patients 1, 3, and 4, uncontrollable extrapulmonary involvement and/or local recurrence at the primary site were noted during their treatment course, and they died of tumor progression 40, 68, and 46 months after excision of the primary lesion, respectively. In patient 1, a 37-year-old woman, prolonged survival with adequate lung function was achieved after the excision of metastases, including one bulky metastatic tumor located adjacent to the mediastinum, which might have led to a lethal complication. Patient 3, a 25-year-old woman who underwent aggressive metastasectomies for both pulmonary and extrapulmonary metastases combined with intermittent chemotherapy, died of widespread metastases to multiple organs. On the other hand, patient 2, a 23-year-old woman who underwent excision of 130 pulmonary and three brain metastases during four thoracotomies and two craniotomies, is still alive without any symptoms 98 months after excision of the primary lesion. These data suggest that repeated excisions of lung metastases from ASPS may influence long-term survival or maintenance of good performance status in patients in whom extrapulmonary metastasis and recurrence are either absent or controlled.
Adult↗
Salutary effect of adjunctive intracoronary nicorandil administration on restoration of myocardial blood flow and functional improvement in patients with acute myocardial infarction.
Salutary effect of nicorandil, a K+ adenosine triphosphate channel opener, on restoration of myocardial blood flow and functional improvement after coronary revascularization was investigated in 20 patients with first anterior acute myocardial infarction. Ten patients received intracoronary administration of nicorandil (2 mg) after coronary revascularization; the other 10 patients received coronary revascularization only and served as control subjects. Myocardial contrast echocardiography and two-dimensional echocardiography were performed to assess microvascular integrity and regional function in the infarcted area. Nicorandil improved peak contrast intensity ratio (p < 0.001), calculated as the ratio of peak contrast intensity in the infarcted and noninfarcted areas, indicating the restoration of myocardial blood flow to the infarcted myocardium. Regional wall motion improved more significantly in 1 month in patients who received nicorandil (p < 0.01). Thus our results suggested the usefulness of intracoronary nicorandil administration after coronary revascularization for restoring blood flow and functional improvement in patients with acute myocardial infarction.
Angioplasty, Balloon, Coronary↗
Dramatic response of postthymomectomy myasthenia gravis with multiple lung nodules to corticosteroids.
A 36-year-old woman underwent thymomectomy and left pneumonectomy with total pleurectomy for stage IVa invasive thymoma without myasthenia gravis. Six years later, a crisis of myasthenia gravis developed associated with multiple lung nodules. Steroid therapy induced remarkable regression of the lung nodules that has persisted for more than 11 months. Concurrently, the clinical severity of her myasthenia gravis markedly decreased and recovered to the extent of permitting her to return to normal life.
Adult↗
Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: a single-institution study.
OBJECTIVES: To comparatively evaluate lobectomy and limited resection for T1 N0 M0 non-small-cell lung cancer, we reviewed case series with concurrent nonrandomized controls. METHODS: Limited resection with curative intent was performed for 63 patients with T1 N0 M0 non-small-cell lung cancer over a 10-year period. These 63 patients included 46 patients who underwent a segmentectomy as an intentional limited resection. These patients had good pulmonary function and could tolerate a lobectomy in the management of their disease. The other 17 patients underwent wedge resection or segmentectomy as a compromised limited resection because they had poor pulmonary reserve or other limiting factors and could withstand a thoracotomy but could not tolerate a lobectomy in the management of their disease. RESULTS: The 5-year survival was 93% in the intentional resection group. The survival curve for this group was not different from that for 77 patients who underwent the standard operation (lobectomy plus complete mediastinal lymph node dissection) for T1 N0 M0 non-small-cell lung cancer during the same period. The frequency of local/regional recurrence in the intentional resection group was 8.7% (4/46); the recurrence in three patients was situated in the mediastinum. According to multivariate analysis, limited resection was not associated with poor survival. CONCLUSION: Segmentectomy with regional lymph node dissection, including the mediastinum, should be considered as an acceptable alternative treatment for selected patients with T1 N0 M0 disease.
Aged↗
Intraoperative real-time visualization of coronary arteries by means of power Doppler echocardiography: preliminary experience.
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Cardioplegic Solutions↗
Isolated 3-methylcrotonyl-CoA carboxylase deficiency in a 15-year-old girl.
A 15-year-old girl with a former clinical diagnosis of cerebral palsy was found to have isolated deficiency of 3-methylcrotonyl-CoA carboxylase (MCC) on gas chromatography-mass spectrometry (GC/MS) analysis and enzyme determination. Her symptoms included marked growth retardation from birth, profound mental retardation, tonic seizures, rigospastic quadriplegia with opisthotonic dystonia, gastroesophageal reflux with poor esophageal peristalsis, and recurrent episodes of aspiration pneumonia. Brain MRI revealed marked brain atrophy, involving both the gray and white matter. Although she did not exhibit acute metabolic decompensation or acute encephalopathy, her neurological symptoms continuously worsened. This patient is the oldest among reported cases of MCC deficiency who had symptoms at birth, and this case may have the severest sequelae of the longest known natural course of this inborn error of metabolism.
Adolescent↗
A prospective, randomized, double-blind multicenter trial of a single bolus injection of the novel modified t-PA E6010 in the treatment of acute myocardial infarction: comparison with native t-PA. E6010 Study Group.
OBJECTIVES: This prospective, randomized, double-blind multicenter trial evaluated the efficacy and safety of a single bolus injection of the novel modified tissue-type plasminogen activator (t-PA) E6010 in the treatment of acute myocardial infarction compared with that of native t-PA. BACKGROUND: E6010 is a novel modified t-PA with a prolonged half-life (t1/2 alpha > or = 23 min) compared with native t-PA (t1/2 alpha = 4 min). E6010 can be administered in patients as a single intravenous bolus injection, and early recanalization can be expected. METHODS: The efficacy of E6010 was compared with that of native t-PA in 199 patients with acute myocardial infarction who were treated within 6 h of onset in a prospective, randomized, double-blind multicenter trial. Patients were given either 0.22 mg/kg body weight of E6010 intravenously over 2 min or native t-PA (tisokinase) 28.8 mg or 14.4 million IU (10% of the total dose over 1 to 2 min, the remainder infused over 60 min). RESULTS: The primary end point was the recanalization rate of the infarct-related coronary artery at 60 min after the start of treatment. Time to reperfusion was shorter in the E6010 group than in the native t-PA group. Thrombolysis in Myocardial Infarction flow grade 2 or 3 recanalization at 15, 30, 45 and 60 min after administration was observed in 37%, 62%, 74% and 79% (95% confidence interval [CI] 70% to 87%) of the E6010-treated patients and in 14%, 32%, 50% and 65% (95% CI 55% to 74%) of native t-PA-treated patients, respectively (p = 0.032 at 60 min). CONCLUSIONS: The present study indicates that, compared with native t-PA, a single bolus injection of E6010 over 2 min produces a higher rate of early recanalization of the infarct-related coronary artery without fatal bleeding complications.
Aged↗