Biomedical subjects

K Komaki

Publications and source records attributed to K Komaki.

At least 37 records · Page 2Linked to original sources

PubMed1999

[Evaluation of coronary flow velocity and coronary flow reserve before and after coronary angioplasty using transthoracic Doppler echocardiography and Doppler guide wire].

Evaluation of left anterior descending coronary (LAD) blood flow before and after coronary angioplasty was carried out non-invasively by ultrasonic Doppler echocardiography with a newly developed digital, high-frequency, high-resolution transthoracic ultrasonic Doppler flowmeter and a 7.5 MHz probe. The results were compared with those obtained using an intracoronary Doppler guide wire. Sixteen patients, 12 males and 4 females (mean age 57 +/- 14 years) with old myocardial infarction (8 patients) and angina pectoris (8 patients) were studied. Coronary flow reserve was compared following intravenous administration of adenosine triphosphate in 12 patients. The LAD blood flow was detected in 15 of 16 patients. There was a significant increase in the diastolic peak velocity from 22.2 +/- 10.6 to 29.4 +/- 14.6 cm/sec (mean +/- SD) and the coronary flow reserve from 1.8 +/- 0.3 to 2.8 +/- 0.6 (mean +/- SD). There was a good correlation between the data obtained using transthoracic flow measurement and intracoronary flow measurement (r = 0.61, p < 0.05). LAD blood flow can be easily detected parasternally using a digital, high frequency, high-resolution ultrasonic Doppler flowmeter. This method may be applicable for judging the efficacy of coronary angioplasty by measuring coronary flow reserve and for observing the clinical course of the patient non-invasively.

Adenosine Triphosphate↗

PubMed1999

Late recurrence of acinic cell carcinoma of the parotid gland.

Acinic cell carcinoma of the salivary glands is a rare cancer representing a low grade malignancy. The recurrence of a tumor is sometimes encountered, usually within 5 years of initial operation. We describe an unusual recurrence after a long interval following primary surgery. In 1987, a 60-year-old woman underwent excision of a mass in the superficial lobe of the right parotid gland under the preoperative diagnosis of a benign tumor. A histologic diagnosis of acinic cell carcinoma was made by examining sections from the resected mass. The patient noted several small nodules in the right parotid region in 1995, but she did not visit our clinic until 1998 when tenderness developed. A locally recurrent tumor and cervical lymph nodes containing metastases were resected and postoperative radiotherapy was given 11 years after the first operation. At least 10 years of follow-up may be necessary for patients with acinic cell carcinoma because of slow-tumor growth.

Carcinoma, Acinar Cell↗

PubMed1998

Prognostic Factors for Node-negative Breast Cancers: Results of a Study Program by the Japanese Breast Cancer Society.

BACKGROUND: Prognostic factors for predicting the recurrence of node-negativebreast cancers have been controversial. The present study was performed to elucidate practically useful prognostic factors using formalin-fixed paraffin sections. METHODS: This was a case-controlled multi-institutional study that composed 40 patients with recurrent node-negative breast cancer and 80 patients with node-negative breast cancer but without recurrence after radical surgery. Tumors weresmaller than 3 cm in diameter and were treated surgically between January 1, 1985 and December 31, 1990. The recurrent and non-recurrent cases were matched with regard to their age, adjuvant chemotherapy and the year in which surgery was performed. Fourteen immunohistochemical factors and 8 histological factors of theprimary tumor were studied on formalin-fixed, paraffin-embedded sections by immunohistochemical and histochemical analyses. RESULTS: According to univariate analysis, factors such as progesterone receptor (PgR), MIB-1, CD44v6, CD44v9 and platelet-derived endothelial cell growth factor (PDECGF) were significantly different between the recurrent and non-recurrent groups (p &ly; 0.1; Wilcoxon-Mann-Whitney analysis). Chi-squared test showed significant differences in MIB-1, cdc2 and stromal plasminogen activator receptor (suPAR). Histologically, mitotic count was also significantly different between the two groups (p < 0.005). Multivariate analysis revealed that positivity for cdc2 (p=0.01), high mitotic count (p=0.04) and negativity for CD44v9 (p=0.02)were independent prognostic factors among variables selected by univariate analysis, and that positivity for MIB-1 (p=0.03) and cdc2 (p =0.01), and negativity for CD44v9 (p =0.03) were independent prognostic factors among the immunohistochemical markers examined. CONCLUSION: Our results indicated that positivity for MIB-1 and cdc2, high mitotic count and negativity for CD44v9 could serve as independent factors for predicting the recurrence of node-negative breast cancer.

Journal Article↗

PubMed1998

Value of mass screening for thyroid cancer.

This study aims to clarify the presently uncertain value of mass screening for thyroid cancer, which has been performed by physical examination along with mass screening for breast cancer in Zentsuji, Japan since 1983. Among 18,619 subjects, 36 individuals with thyroid cancer (0.19%) were found. The detection rate was 0.40% at the initial screening and 0.10% during subsequent periodic screening. All thyroid cancers were confirmed histologically as well differentiated carcinoma. The tumor size in the mass-screening group (14 +/- 6 mm) was significantly smaller than in patients presenting at an outpatient clinic during the same period (19 +/- 13 mm) (p < 0.05). The incidence of nodal metastases in the mass-screening group (38%) was significantly lower than in the outpatient group (68%) (p < 0.05). Thus mass screening seemed to find thyroid cancers in a relatively early stage. Mass screening for thyroid cancer was economic in this instance because it was performed together with screening for other cancers, such as breast cancer. Thyroid cancer screening required less than one additional minute per subject. The ultimate aim of mass screening is to reduce mortality. No improvement in prognosis from enforced mass screening for thyroid cancer was detected in this study. It cannot be demonstrated that there is sufficient value of mass screening for thyroid cancer to perform it independently despite early cancer detection.

Adult↗

PubMed1998

Effects of interferon-alpha and gamma on development of LAK activity from mononuclear cells in breast cancer patients.

We examined the effect of recombinant IFN-alpha and IFN-gamma on induction of LAK cells from peripheral blood mononuclear cells (PBMNCs) in 7 pre-operative breast cancer patients and 4 healthy volunteers. Significant LAK activity was developed from PBMNCs of pre-operative breast cancer patients and healthy volunteers after incubation for 4 days with IL-2 (presence of IL-2 vs. absence of IL-2). Incubation of PBMNCs of pre-operative breast cancer patients with 1000 U/ml of IFN-alpha for 4 days suppressed the LAK activity significantly (P < 0.05). By contrast, incubation of PBMNCs of pre-operative patients with 1000 U/ml of IFN-gamma for 4 days increased the LAK activity significantly (P < 0.05). Significant cytotoxicity against MCF-7 cells (estrogen receptor positive human breast cancer cell line) was developed from PBMNCs of pre-operative breast cancer patients at 20:1 and 40:1 E/T ratios after incubation for 4 days with IL-2 (absence of IL-2 vs. 20:1 or 40:1, P < 0.05, P < 0.05), whereas PBMNCs of healthy volunteers did not. Stimulation of LAK cells with IFN-gamma produced a significant augmentation of cytotoxic activity against MCF-7 (P < 0.05), while IFN-alpha suppressed the cytotoxicity significantly (P < 0.05). These findings suggested that combined stimulation by IFN-gamma and IL-2 might be a reasonable treatment for breast cancer patients.

Breast Neoplasms↗

PubMed1997

Relationship between prognostic score and thyrotropin receptor (TSH-R) in papillary thyroid carcinoma: immunohistochemical detection of TSH-R.

We have demonstrated the expression of thyrotropin receptor (TSH-R) in thyroid neoplasms (13 adenomas, 21 papillary carcinomas, two follicular carcinomas) and adjacent normal thyroid using the monoclonal antibody against human TSH-R and have also demonstrated a relationship between prognostic scores and the expression of TSH-R. Among the adenomas, eight showed an intensity similar to that of normal thyroid and five showed a higher intensity than normal. Two tumours exhibited heterogeneous distribution of TSH-R. Among the papillary carcinomas, seven showed similar intensity to normal tissue and four showed higher intensity and ten showed weaker intensity. Eight tumours showed heterogeneous distribution of the stain. Among the follicular carcinomas, one showed similar intensity to normal tissue and the other exhibited weaker intensity. Both cases showed homogeneous distribution of TSH-R. The adenomas never showed a weaker intensity than normal thyroid, but various intensities of TSH-R occurred in differentiated carcinomas. There was no significant relationship between the clinical data and the signal intensity in the adenomas. Among the papillary carcinomas, however, the group with weaker intensity had significantly poorer prognostic scores than the other two groups. Thus, we assume that low TSH-R may be expressed by the clinically high-risk group of patients with papillary thyroid carcinoma.

Adenocarcinoma, Follicular↗

PubMed1997

Estimation of free calcium levels after thyroidectomy.

Total calcium is routinely measured after thyroidectomy in a clinical setting, while the measurement or calculation of the free calcium level is not generally performed. We reviewed total and free calcium levels in patients who underwent lobectomy (n = 15), subtotal thyroidectomy (n = 15) and total thyroidectomy (n = 15). Postoperative total calcium levels decreased significantly in comparison to preoperative levels in all thyroidectomies (p < 0.01), and this fall was significantly related to the extent of surgery (p < 0.01). In contrast, there was no significant difference between preoperative and postoperative free calcium levels in patients undergoing lobectomy, although we found a decrease in free calcium levels after both subtotal and total thyroidectomy. Total protein levels decreased regardless of the type of operation. Serum total calcium levels were thought to be altered by serum protein levels through the change of protein-bound calcium levels. When examined for free calcium levels, some patients were administered unnecessary calcium supplementation because hypocalcemia had been judged from the total calcium level. Since the wrong diagnosis may be given with regard to hypoparathyroidism by measurement of total calcium levels alone, we propose that free calcium levels should be routinely measured or calculated after thyroidectomy.

Biomarkers↗

PubMed1997

Assessment of plaque rupture by intravascular ultrasound.

To investigate the mechanism of plaque rupture, we carried out morphologic and quantitative assessments of ruptured plaque with a 30-MHz intravascular ultrasound catheter before coronary intervention. Plaque rupture, defined as an echolucent intraplaque area communicating with arterial lumen, was noted in all of 22 patients with coronary artery disease examined in the study. The plaque was eccentric in 16 patients (73%) and in 10 of these 16 patients there was a tear at the margin of the plaque (63%). Calcification was noted in only 6 patients (22%). Plaque area ranged from 8.7 to 44.1 mm2. The ruptured area ranged widely, from 1.0 to 14.0 mm2, and the percent ruptured area also ranged widely, from 3.9% to 50.9%. Fibrous cap was recognized in 20 patients. The thickness of the fibrous cap ranged from 0.1 to 0.6 mm (mean, 0.36 mm) and thinning of the fibrous cap was noted in 16 patients (80%). From these results, we conclude that intravascular ultrasound can provide detailed observations of plaque rupture consistent with pathologic studies. Accordingly, it is a suitable method for evaluation of plaque rupture in vivo. Plaque weakness, due to the presence of atheromatous core, thin fibrous cap, and no calcification, seems to be the major determinant of plaque rupture. In addition, the great variation in cap thickness and ruptured area suggests the role of other triggers, such as mechanical and hemodynamic stress, in plaque rupture.

Coronary Artery Disease↗

PubMed1996

Molecular epidemiology of breast cancers in northern and southern Japan: the frequency, clustering, and patterns of p53 gene mutations differ among these two low-risk populations.

Comparison of acquired mutations in the p53 tumor suppressor gene can illuminate factors contributing to carcinogenesis among cancer cohorts. Japan has an ethnically homogeneous population with a low incidence of breast cancer. Previously we reported an unusual frequency, allelic status, and clustering of mutations in breast cancers from the northern part of the main Japanese island. To extend these findings, exons 2-11 and adjacent intronic sequences were analysed in tumors of women from northern (Hokkaido) and southern (Tokushima) Japan. The frequency of breast cancers with p53 gene mutations in the Hokkaido group is the highest reported (81%) while that in Tokushima (28%) is similar to most other populations. Thirteen of the 19 mutations (68.4%) in the Hokkaido cohort were heterozygous, an unusually high frequency for p53 mutations in any tumor type. There were three missense mutations at codon 175, a known hotspot for alterations in the p53 gene, and three missense mutations at codon 179, a rare site for p53 changes. In addition, the patterns of p53 gene mutation differed between the two Japanese cohorts (P=0.04). The multiple differences in acquired p53 mutations suggest unsuspected biological differences among breast cancers in northern and southern Japan. In addition, the high frequency of p53 mutations in breast cancers from Hokkaido predicted a poorer prognosis for this population which was confirmed on examination of mortality data.

Adult↗

PubMed1996

A new method for evaluating right ventricular dimensions and volume by cineangiography.

The aim of the present study was to establish a new method to evaluate the right ventricular dimensions and volume. Biplane right ventriculography of steep left anterior oblique view (LAO) and right anterior oblique view perpendicular to LAO were performed in 32 patients. The right ventricular volume and ejection fraction calculated from the three axial dimensions of the right ventricular cavity (the septum-free wall dimension, the anterior-posterior dimension, and either the long axis dimension or the tricuspid valve-apex dimension at end-diastole and end-systole) were well correlated to those from Simpson's method. In conclusion, we developed a new method for estimating right ventricular dimensions and volume.

Adolescent↗

PubMed1996

A characteristic difference among GroEL homologs from intracellular symbionts of closely-interrelated species of aphid.

Nucleotide sequences encoding GroEL homologs of intracellular symbionts in three closely interrelated aphids were compared with one another and that for GroEL. It was suggested that in these proteins a particular position is highly susceptible to amino acid substitution, through which the GroEL homologs of symbionts seemed to have acquired a unique function on top of the activity as molecular chaperone. This may represent a rare example of non-neutral evolution of molecule under the positive selection pressure.

Amino Acid Sequence↗

PubMed1996

Heterogeneous distribution of thyrotrophin receptor messenger ribonucleic acid (TSH-R mRNA) in papillary thyroid carcinomas detected by in situ hybridization.

OBJECTIVE: TSH suppression therapy has been reported to be effective in some cases of papillary carcinoma of the thyroid. However, there has been little information regarding the status of expression of TSH-R mRNA in papillary carcinomas. Therefore, we examined the expression of TSH receptor (TSH-R) mRNA in thyroid tumours by in situ hybridization. DESIGN: Surgically resected thyroid tumour specimens were used. The expression level of TSH-R mRNA was detected by in situ hybridization, and the difference between tumours and their adjacent normal thyroid tissues was assessed. PATIENTS: Tumours and adjacent normal thyroid tissues were obtained from nine patients with differentiated papillary carcinomas and eight with adenomas. MEASUREMENTS: We performed in situ hybridization on frozen sections of thyroid tissues. Digoxigenin-labelled oligonucleotide was used to hybridize and to detect TSH-R mRNA. We counted positively stained cells and non-stained cells in each section, calculated the positivity of stained cells and assessed the distribution of positively stained cells. RESULTS: In normal thyroid tissue, the positivity was 95.3 +/- 2.3% (mean +/- SD) and the distribution of TSH-R mRNA was homogeneous. In adenoma, positivity was 93.5 +/- 4.4%. In most cases of adenoma, the distribution was homogeneous. In papillary carcinoma, the expression level of TSH-R mRNA was significantly lower and the positivity was 81.9 +/- 12.6%. Furthermore, in five cases of papillary carcinoma, the distribution was heterogeneous; four of these cases were stage 3, while the remaining case was stage 1. Three of the four cases with a homogeneous distribution were stage 1, while one case was stage 3. CONCLUSIONS: The heterogeneity of TSH-R mRNA distribution suggests the effect of TSH on carcinoma cells may be variable. Furthermore, papillary carcinomas of advanced clinical stage showed a tendency to low expression and heterogeneous distribution of TSH-R mRNA.

Adenoma↗

PubMed1995

A Malignant Phyllodes Tumor of the Breast in a 6-Year Old Girl.

We recently encountered a 6-year-old girl with a malignant phyllodes tumor of the breast. The patient's mother noticed a tumor on the right breast of her first doughter at 8 months after from her birth. The baby was brought to the Second Depertment of Surgery, University of Tokushima, at age 20 months. We recommended removal of the 3.5 x 2.9 cm tumor in the right breast, but it was not done. Next, she visited our department at 6 years of age because the tumor had gradually enlarged, reaching a size of 4.3 &timus; 4.0 cm. She underwent excisional resection of the tumor, and the tumor was diagnosed as a malignant phyllodes tumor of the breast coexisting with a borderline phyllodes tumor. To our knowledge, this is the youngest reported case of a malignant phyllodes tumor of the breast. Moreover, the malignant lesion was positive for estrogen receptor (ER) and showed strong proliferating cell nuclear antigen (PCNA) staining. On the other hand, the borderline part was negative for ER and showed weak PCNA staining. Thus, in the present case, the expression of ER, the exposure to estrogen (for example, the mother's estrogen during gestation) and increase in the proliferation rate may have played important roles in the mechanism of the transformation of the phyllodes tumor.

Journal Article↗

PubMed1995

Difference in thymidylate synthetase activity in involved nodes compared with primary tumor in breast cancer patients.

Thymidylate synthetase (TS) is a key enzyme as a methyl donor in the methylation reaction from dUMP to dTMP. TS activity was assessed in various tissue of mammary disorders. The descending order of TS activity was as follows: cancer-positive nodes, primary cancers, cancer-negative nodes, benign lesions, and normal parenchyma. Significant differences in TS activity were found between the positive nodes and each of the other tissues (p < 0.01). In node-positive cases, a significant correlation in TS activity was found between the primary cancers and positive nodes (r = 0.616, p = 0.033). There was no correlation between the nodal status and the TS activity in primary cancers. In 11 of 12 cases, the TS activity of positive nodes was higher than the 'calculated' TS activity of the primary cancer, which was defined as the TS activity per unit weight of cancer cells. A significant correlation was found between the calculated TS activity and the mitotic frequency in primary cancers (r = 0.697, p = 0.0001). On the other hand, a significant correlation could not be found between the TS activity and the mitotic frequency in positive nodes (r = 0.364, p = 0.244).

Breast↗

PubMed1995

Intra-QRS high-frequency ECG changes with ischemia. Is it possible to evaluate these changes using the signal-averaged Holter ECG in dogs?

The purpose of this experiment is to study the possibility of intra-QRS high-frequency electrocardiographic (HFECG) changes for the evaluation of and recovery from myocardial ischemia in both the time-domain and spectral-turbulence analyses on the signal-averaged ECG using the Holter ECG monitoring (Holter SAECG) system. A balloon catheter was inserted into the left anterior descending coronary artery (LAD of 8 mongrel dogs and was maintained inflated for 2 hours to occlude the LAD and then was deflated to allow for reperfusion. The cardiac signal from the three orthogonal leads of the surface ECG (X, Y, and Z) was recorded and analyzed with a Del Mar Avionics (model 459, Irvine, CA) recorder and analyzer (model 563). The Holter SAECG was assessed before the LAD occlusion phase (control), during the coronary occlusion phase (ischemia), after the reperfusion phase (recovery). To evaluate intra-QRS ECG changes in the time-domain analysis, root-mean-square (RMS) voltage of the entire QRS in 40-250 HZ (40 RMS), 100-250 Hz (100 RMS), and 150-250 Hz (150 RMS) were studied and the vector magnitude of the QRS was depicted. In the spectral-turbulence analysis and spectrocardiogram to study the discordance of the ECG wave front velocity by fast Fourier transformation analysis, the interslice correlation mean (IC mean) and interslice correlation standard deviation (IC SD), which were calculated as the mean and standard deviation of the Pearson correlation coefficient of each time slice with its neighbor, were investigated. In the time-domain analysis, the LAD occlusion by balloon catheter at ischemia produced a reduction in 40 RMS, 100 RMS, and 150 RMS, while a restoration was seen at recovery in 40 RMS and 100 RMS. In the spectral-turbulence analysis, LAD occlusion at ischemia caused a decrease in IC mean and an increase in IC SD. The waveform of the vector magnitude and the spectrocardiogram seen at control showed changes with ischemia and was restored at recovery with the coronary reperfusion. It was thought possible to capture the intra-QRS HFECG changes that occur during myocardial ischemia and recovery from it in the time-domain analysis and spectral-turbulence analysis on the Holter SAECG system in spite of the limitation of this methodology. To evaluate myocardial ischemia and recovery, this method should be useful clinically.

Animals↗

PubMed1995

[Evaluation for micropotential analysis by signal-averaged ECG using Holter monitoring].

The development of signal-averaged electrocardiogram (SAECG) has made possible the examination of ventricular late potentials (LP). Recently, the Holter SAECG system, which uses the tape of Holter monitoring, was produced. In the filtered QRS duration (FQRS), a correlation of R = 0.81 was seen between real time SAE and Holter SAE. Correlation of root mean square voltage of the signals in the last 40 mS of QRS (RMS40) and the duration of low amplitude signals (< 40 microV) in the latter part of the QRS (LAS40) were 0.79 and 0.70, respectively between these two systems. As good correlation was seen among the various indicators on the Holter SAECG and real time SAECG, a comparative study in the evaluation for ventricular tachycardia (VT) was performed on these two SAECG systems. With the Holter SAECG, positive LP were as follows: in myocardial disease with VT, 83.3% were positive LP; in myocardial disease without VT, 7.5% were positive LP; and in the healthy subjects, 0% were positive LP. For assessing VT, either real time SAECG or the Holter SACGE may be considered equally suitable for clinical use. During the treadmill exercise test, myocardial ischemia was investigated by the Holter SAECG system. After exercise, healthy subjects revealed longer FQRS, larger root mean square voltage of the signals in the QRS (RMS Total). While in ischemic heart disease, that had ST depression on the Holter ECG after exercise, decrease in RMS Total was found. For assessing myocardial ischemia, it is believed that Holter SAECG had the possibility of evaluating high frequency component in the entire QRS.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocardiography, Ambulatory↗

PubMed1994

Significant Correlation between the Presence of Type W Collagen in the Duct Wall and the Development of Wide Intraductal Cancerous Extension in Breast Cancer.

To identify the characteristics of cases with an wide intraductal cancerous extension (WICE), we examined the relationship between WICE and type IV collagen distribution, and the relationship between WICE and the content of the proliferation-associated proteins in human breast cancer. The immunohistochemical distribution of type IV collagen and proliferating cell nuclear antigen (PCNA) were investigated in formalin-fixed tissue sections from 21 breast cancer cases. We demonstrated a significant correlation (p=0.014) between the presence of WICE and immunostaining of type IV collagen in the cancerous ducts (ducts occupied by cancer cells) in the central invasive area of breast cancer. However, no correlation was found between the presence of WICE and the PCNA index (percentage of positive cells per 1000 tumor cells). These findings suggest that the lack of the process of the loss of type IV collagen in the duct wall is more important than the nature of the tumor cells in the development of WICE.

Journal Article↗

PubMed1994

p53 alteration correlates with negative ER, negative PgR, and high histologic grade in breast cancer.

Seventy tumors of invasive ductal carcinoma of the breast were examined for p53 alteration by the RT-PCR-SSCP method. Sixty-five samples (92.9%) were investigated in the regions of codons 101-200 and 201-300. In total, 16 samples (24.6%) showed p53 gene alteration. We found that p53 gene alteration showed a correlation with (1) a negative ER status, (2) a negative PgR status, and (3) a high histologic grade (especially numerous mitotic figures) of the tumor. However, we found no correlation between p53 gene alteration and the lymph node status or clinical stage. Thus, p53 gene alteration in breast cancer may occur in highly malignant breast cancer other than advanced clinical stage cancer or node-positive cancer.

Adult↗