Biomedical subjects

K Shirouzu

Publications and source records attributed to K Shirouzu.

At least 73 records · Page 4Linked to original sources

PubMed2000

Unresectable advanced gastric cancer effectively treated by combined chemo-immunotherapy: a report of two cases.

We have experienced two cases of unresectable advanced gastric cancer effectively treated by chemo-immunotherapy. One case was of a 68-year-old male patient diagnosed as having inoperable advanced gastric cancer with liver and lung metastasis. This patient was treated by combined chemo-immunotherapy of MMC 10 mg/M, 5'-DFUR 800 mg/day and OK-432 5 KE/2W. At 6 months later, a computed tomography (CT) scan and upper gastrointestinal (GI) series revealed that the metastatic liver tumors and stomach lesion were remarkably decreased in size, and endoscopic biopsy confirmed no cancer cells in the stomach lesion. Moreover, the metastatic lung tumor had disappeared on chest X-ray. The other case was of a 68-year-old female patient with unresectable advanced gastric cancer treated by combined administration of MMC 10 mg/M, 5-FU 200 mg/day and OK-432 5 KE/2W. At 2 months after commencing the treatment, there was a reduction in the serum carcinoembryonal antigen (CEA) level. At 6 months later, the CEA had decreased to normal, the primary and metastatic sites had completely disappeared on CT, and endoscopic biopsy confirmed no cancer cells in the stomach lesion. This patient has survived to date for 5 years and 6 months after commencing the treatment. These results suggested that combined chemo-immunotherapy of MMC, antimetabolite, and OK-432 was an effective treatment for unresectable advanced gastric cancer.

Aged↗

PubMed2000

Immunohistochemical study on the expression of cyclin D1 and E in gastric cancer.

Cyclin D1 and E have been found to be deregulated and overexpressed in various types of cancers. In order to study the cell cycle regulatory mechanisms in gastric cancer, we have analyzed the protein expression of cyclin D1 and cyclin E in 76 tumor specimens from patients with primary gastric cancer, using immunohistochemistry. Overexpression of cyclin D1 was observed in 38 cases (50.0%). Overexpression of cyclin E was observed in 40 cases (52.6%). There was no significant difference between the expression of cyclin D1 and any clinicopathological factor. Cyclin E overexpression was correlated with a high incidence of lymph node metastasis, a low incidence of T1, and with Stage I. There was no significant difference in survival curves between cyclin D1 (+) and cyclin D1 (-). The survival curves of cyclin E (-) were significantly higher than those of cyclin E (+). These results suggested that in gastric carcinoma, cyclin E overexpression was useful as a prognostic indicator, but cyclin D1 was not.

Cyclin D1↗

PubMed2000

Bilateral pleural effusion following cervical abscess drainage: a case report.

Postoperative bilateral chylothorax after cervical surgery has been rarely reported, whereas unilateral chylothorax has been occasionally reported after thoracic surgery. Here, we report a rare case of bilateral pleural effusion that developed after cervical abscess drainage. On the second day after the drainage, the patient felt dyspnea, and bilateral pleural effusion was found on a chest X-ray. The effusion was thought to be chyle and was successfully treated with conservative management. Additionally here, we have suggested that non-traumatic chylothorax was caused by increasing intraluminal pressure occurring inside the thoracic duct after its ligation. Careful follow up of any respiratory symptoms and of chest X-rays is recommended after cervical intervention.

Abscess↗

PubMed2000

Two cases of cancer in the remnant stomach derived from gastritis cystica polyposa.

We have recently encountered two patients with early gastric cancer in the remnant stomach which resulted from gastritis cystica polyposa at the anastomosis site. The remnant stomach, which had been reconstructed with the Billroth II method, contained an elevated sessile lesion at the anastomosis site. One patient was a 73-year-old woman who had undergone gastrectomy for a gastric ulcer at 30 years earlier, cancer type I + IIa of the remnant stomach was diagnosed, and total remnant gastrectomy was performed. The other patient was a 59-year-old man who had undergone gastrectomy for a duodenal ulcer at 31 years earlier, cancer type I + IIa of the remnant stomach was diagnosed, and subtotal remnant gastrectomy was performed. Histological examination in each case showed that moderately differentiated adenocarcinoma had developed from gastritis cystica polyposa. These results suggested that this cancer has a close relationship with gastritis cystica polyposa.

Aged↗

PubMed2000

Thoracoscopic lung biopsy for diffuse infiltrative lung disease.

Thoracoscopic lung biopsy is becoming the procedure of first choice for the diagnosis of many localized and diffuse lung diseases. We have performed thoracoscopic lung biopsy for 17 patients with diffuse infiltrative lung disease, in Kurume University Hospital. There were 13 females and 4 males with a mean age of 48 years (range: 19-71 years). Thoracoscopic surgical biopsy was performed in the right lung in 12 and in the left lung in 5. Adequate lung tissue from each case was obtained for pathological examination. The mean surgical biopsy time was 49 min (range: 25-72 min) and bleeding was negligible. The mean duration for chest tube drainage was 2.6 days. No postoperative complication such as prolonged air leakage occurred. A specific diagnosis from the biopsy was achieved in 13 (76.4%) of the 17 cases. In only 6 (35.2%) of the 17 cases, the pathological diagnosis was the same as that from the thoracoscopic biopsy. In these 6 cases, the same diagnosis was obtained only in those with idiopathic interstitial pneumonitis or diffuse panbronchitis. Thoracoscopic lung biopsy was safe and useful for diagnosis for diffuse infiltrative lung disease.

Adolescent↗

PubMed2000

Morphological change in the MNNG-treated rat gastric mucosa.

To investigate the process of carcinogenesis in gastric cancer, we studied the histological features of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-treated rats. Samples of the gastric mucosa from both MNNG-treated and control rats were histologically examined every 2 months, for 10 months. In 40% of the MNNG-treated rats, atrophy in the gastric mucosa was observed after 2 months, and regenerative epithelium was observed after 4 months, followed by adenomatous proliferation and disappearance of the tight junction electron microscopically after 6 months. A small intestinal cancer had developed in 2 rats at 6 months. While gastric cancer had developed in 3 rats at 8 months, and in one of these 3 rats, peritoneal dissemination was observed macroscopically and histologically. These results suggested that adenomatous proliferation and disappearance of the tight junction observed electron microscopically were characteristic pathological features of precancerous lesions in the stomach in MNNG-treated rat.

Animals↗

PubMed2000

Advanced gastric cancer with liver metastasis effectively treated by intra-hepatic arterial infusion of 5-FU, MMC and peroral administration of 5-FU: a case report.

We have experienced a case of advanced gastric cancer with liver metastasis effectively treated by intra-hepatic arterial infusion of 5-fluorouracil (5-FU), mitomycin C (MMC) and peroral administration of 5-FU. The patient was a 48-year-old male diagnosed as having advanced gastric cancer with multiple liver metastasis in the bilateral lobes of the liver. This patient was treated by intra-hepatic arterial infusion of 5-FU (250 mg/2 days x 8 doses), MMC (20 mg x 1 dose, 6 mg/2 weeks x 6 doses) and peroral administration of 5-FU (200 mg/day). At 14 weeks later, a CT revealed that the metastatic liver tumors had disappeared. However, at 7 months after the therapy, the patient eventually died of liver and brain metastasis. These results suggested that intra-hepatic arterial infusion of 5-FU and MMC was an effective therapy for metastatic tumors in the liver, but we need to perform intra-hepatic arterial infusion using a new prolonged regimen to treat the liver metastasis.

Administration, Oral↗

PubMed2000

Multiple carcinoids in the stomach with hypergastrinemia and type A gastritis: a case report.

We have experienced a case of the stomach with hypergastrinemia and type A gastritis with multiple carcinoids in a 37-year-old woman. An upper gastrointestinal series revealed multiple minute polyps in the upper body of the stomach. All polyps were diagnosed as carcinoid using endoscopic biopsies. She had neither symptom or signs of typical carcinoid disease. The serum gastrin level was as high as 725 pg/ml. Total gastrectomy was performed, and the diagnosis of multiple gastric carcinoids (sm, no) with type A gastritis was histologically confirmed. After the operation, the serum gastrin level returned to normal, and the patient has been doing well and is disease-free to date at 7 years after the operation. This case suggested that multiple gastric carcinoid lesions may be precipitated by chronic atrophic gastritis accompanying hypergastrinemia. In the treatment of multiple gastric carcinoids with type A gastritis, total gastrectomy with lymph node dissection should be standard operative procedure, in order to resect the fundic gland area completely which could be the origin of carcinoids and endocrine cell micronest.

Adult↗

PubMed2000

Primary gastric lymphoma: a clinicopathological study.

A retrospective study of 25 patients treated for primary gastric lymphoma was made to investigate a number of problems related to treatments and report the factors influencing prognosis. In the 5-year-survival rate according to Working Formulation classification, either survival rate of low-grade type or intermediate-grade type was higher than that of high-grade type. Both the 5-year-survival rate of cases without lymph node metastasis and that of cases that involved perigastric lymph nodes were higher than that of cases that involved distant gastric lymph nodes. Those surviving five years after perigastric lymph node metastasis had received D3 or D4 dissection and postoperative multicombined chemotherapy. Tumors invading only to the submucosal layer had received D2 dissection and were not treated by postoperative multicombined chemotherapy, and recurrence was not recognized in these cases. Of 9 cases infiltrating into the musclaris propria or serosa without lymph node metastasis, 8 cases were treated by postoperative multicombined chemotherapy and were alive without recurrence, but one case without postoperative multicombined chemotherapy died by recurrence. Therefore, adequate therapy for gastric lymphoma with infiltrating into submucosal layer is gastrectomy with D2 lymph node dissection, and postoperative multicombined chemotherapy is not necessary. The cases with perigastric lymph node metastasis, or the cases with invading from muscularis propria to serosa require D3 or D4 lymph node dissection with postoperative multicombined chemotherapy. But the cases with distant gastric lymph node metastasis or invading adjacent structure or high-grade type histologically (WF classification) require preoperative chemotherapy.

Humans↗

PubMed2000

Changes in atrial natriuretic peptide concentration and expression of its receptors after pneumonectomy in the rat.

Atrial natriuretic peptide (ANP) is a cardiac hormone which affects endothelial cell function through a receptor-mediated process. Pneumonectomy is a common thoracic surgical procedure that can cause pulmonary oedema in the remaining lung. Few reports have investigated the aetiology of this complication. The aim of this study was to determine the changes in ANP concentration and expression of its receptors following pneumonectomy as a possible aetiology for postpneumonectomy pulmonary oedema (PPE). We compared plasma ANP concentrations, cGMP concentrations, and natriuretic peptide receptor (NPR)-A mRNA and NPR-C mRNA expression in rat lung 3 h after pneumonectomy (n=5) or a sham operation (n=5). The ANP concentrations in plasma and lung tissue in the pneumonectomy group were significantly higher than in the control group (749.5 versus 202.7 pg x ml(-1), P<0.01; 33.1 versus 6.8 ng x g(-1) wet tissue, P<0.01 respectively). The level of ANP mRNA expression in the pneumonectomy group was significantly higher than in the control group (1.44 versus 0.41 relative ANP mRNA expression, P<0.05). The concentration of cGMP and the level of NPR-A mRNA expression were not significantly different between the pneumonectomy and control groups. The level of NPR-C mRNA expression in the pneumonectomy group was significantly higher than in the control group (4.17 versus 2.19 relative NPR-C mRNA expression, P<0.01). These findings suggest that changes in pulmonary ANP and NPR-C expression may contribute to the development of PPE in the remaining lung in the acute phase following pneumonectomy.

Animals↗

PubMed2000

[New trends in neoadjuvant chemoradiotherapy for locally-advanced esophageal cancer: esophagectomy--is it necessary?].

In responders to neoadjuvant chemoradiotherapy for locally-advanced esophageal cancer, there was no significant difference in the long-term outcome between patients who underwent esophagectomy and those who did not. Esophagectomy might be unnecessary for patients who achieve a complete response with chemoradiotherapy for an esophageal cancer, in cases when salvage surgery is considered in order to treat any future recurrence.

Carcinoma, Squamous Cell↗

PubMed2000

Early tumor growth in metastatic organs influenced by the microenvironment is an important factor which provides organ specificity of colon cancer metastasis.

We have previously demonstrated that liver metastases in nude mice and lung metastases in nude rats occurred specifically, when KM12SM human colon carcinoma cells were inoculated orthotopically into the cecal wall of nude mice and rats. To clarify the relationship between the tumor growth potential in the metastatic organs and the metastatic organ preference in these two metastatic models, we have evaluated the in vitro cell growth activities affected by the organ conditioned medium (CM) from the liver and lung, and the in vivo growth activities of the ectopic implanted tumors in the liver and lung. The tumorigenicity of the ectopic implanted tumors was 100% in mouse liver, 33% in rat liver, 50% in mouse lung, and 75% in rat lung. The crude liver CM of the animals showed inhibitory activities for KM12SM cell growth in a dosage-dependent manner, and the crude lung CM stimulated KM12SM cell growth. The liver CM of nude mice inhibited the KM12SM cell growth more strongly compared with the CM of nude rats, and the lung CM of nude rats was more strongly stimulated compared with the CM of nude mice. The liver CM of nude mice had non-heparin binding factors, which stimulated or inhibited KM12SM cell growth, in a molecular weight range of 50 to 100 kDa. By contrast, the liver CM of nude rats showed no growth stimulating activity for KM12SM cells. These results suggest that the metastatic organ specificity of KM12SM cells may depend on the early tumor growth influenced by the microenvironment in metastatic organs.

Animals↗

PubMed1999

Identification of a gene coding for a protein possessing shared tumor epitopes capable of inducing HLA-A24-restricted cytotoxic T lymphocytes in cancer patients.

Genes encoding tumor epitopes that are capable of inducing CTLs against adenocarcinomas and squamous cell carcinomas, two major human cancers histologically observed in various organs, have rarely been identified. Here, we report a new gene from cDNA of esophageal cancer cells that encodes a shared tumor antigen recognized by HLA-A2402-restricted and tumor-specific CTLs. The sequence of this gene is almost identical to that of the KIAA0156 gene, which has been registered in GenBank with an unknown function. This gene encodes a Mr 140,000 protein that is expressed in the nucleus of all of the malignant tumor cell lines tested and the majority of cancer tissues with various histologies, including squamous cell carcinomas, adenocarcinomas, melanomas, and leukemia cells. However, this protein was undetectable in the nucleus of any cell lines of nonmalignant cells or normal tissues, except for the testis. Furthermore, this protein was expressed in the cytosol of all of the proliferating cells, including normal cells and malignant cells, but not in normal tissues, except for the testis and fetal liver. Two peptides of this protein were recognized by HLA-A2402-restricted CTLs and were able to induce HLA-A24-restricted and tumor-specific CTLs from peripheral blood mononuclear cells of most of HLA-A24+ cancer patients tested, but not from peripheral blood mononuclear cells of any healthy donors. These peptides may be useful in specific immunotherapy for HLA-A24+ cancer patients with various histological types.

Antigens, Neoplasm↗

PubMed1999

MDM2 interacts with MDMX through their RING finger domains.

The N-terminus of MDM2 proto-oncoprotein interacts with p53 and down modulates p53 activity by inhibiting transcriptional activity and promoting p53 degradation. MDMX is structurally related to MDM2 and also binds to p53. However, the function of MDMX has not been clarified yet. We found that MDM2 hetero-oligomerized with MDMX through their C-terminal RING finger domains. Yeast two-hybrid analysis revealed that the hetero-oligomerization between MDMX and MDM2 was more stable than the homo-oligomerization of each protein. MDM2 has been shown to be degraded by the ubiquitin-proteasome pathway, while MDMX was a stable protein. Interaction of MDMX with MDM2 through the C-terminal RING finger domains resulted in inhibiting degradation of MDM2. These data indicate that MDMX functions as a regulator of MDM2.

Binding Sites↗

PubMed1999

Effect of intracerebroventricular injection of tumor necrosis factor alpha on gut mucosal protein turnover in mice fed enterally.

OBJECTIVE: The objective of this study was to determine whether mucosal protein turnover is enhanced by intracerebroventricular (ICV) injection of tumor necrosis factor alpha (TNF-alpha) in mice fed enterally. METHODS: Male B6C3F1 mice (n = 37, 20.0-25.0 g) were catheterized in the ICV space using stereotaxic coordination, and subsequently a catheter was inserted into the stomach for enteral feeding on Day 0. The animals were fed a standard mouse diet and water ad libitum for 4 days. On Day 4, enteral feeding was begun with a standard liquid diet, and either artificial cerebrospinal fluid (control) or recombinant human (Rh) TNF-alpha (5 ng/h) was continuously given via the ICV catheter using an osmotic pump. On either Day 5 or 7, the mice were sacrificed 10 min after injection of [U-(14)C]phenylalanine (5 microCi/mouse, ip). Fractional synthetic rates (FSRs) of jejunal mucosa and muscle were measured by the pool flooding technique. Interleukin-6 (IL-6) levels in the plasma were measured by ELISA. RESULTS: Body weight was significantly reduced by ICV injection of TNF-alpha, because muscle FSR was decreased with TNF-alpha. There were no differences in IL-6 levels in the plasma between the two groups. The FSR of jejunal mucosa was elevated by infusion of TNF-alpha as compared with control mice on both Days 5 and 7 [Day 5: (control) 99.5 +/- 17. 6%/day vs (TNF) 150.5 +/- 20.5%/day, P < 0.05; Day 7: (control) 54.8 +/- 8.8%/day vs (TNF) 102.7 +/- 19.1%/day, P < 0.05). CONCLUSION: injection of TNF-alpha enhanced the mucosal protein synthesis rate without elevating IL-6 levels as compared with control mice, suggesting that the central nervous system links to the gut to regulate mucosal protein turnover through cytokine in the brain, but plasma IL-6 is not involved in this linkage.

Animals↗

PubMed1999

Total esophagectomy versus proximal esophagectomy for esophageal cancer at the cervicothoracic junction.

To investigate the adequate extent of esophagectomy and lymphadenectomy for an esophageal cancer localized at the cervicothoracic junction, the mortality and morbidity rates, survival rates, and patterns of recurrence were retrospectively analyzed in two groups-14 patients who underwent total esophagectomy with or without laryngectomy and 15 patients who underwent proximal esophagectomy with or without laryngectomy-at Kurume University Hospital from 1981 to 1996. Proximal esophagectomy with or without laryngectomy resulted in a lower hospital mortality rate and better overall survival for patients who underwent curative esophagectomy compared with total esophagectomy with or without laryngectomy. Multivariate analysis indicated that the extent of esophagectomy (total esophagectomy versus proximal esophagectomy) was not a prognostic factor. The incidence of recurrence was not different between the two groups. Lymph node metastasis or recurrence from such esophageal cancers was localized to the neck and upper mediastinum. For an esophageal cancer localized at the cervicothoracic junction, therefore, proximal esophagectomy with or without laryngectomy and with cervical and upper mediastinal lymphadenectomy could be better indicated for preselected patients.

Aged↗

PubMed1999

Phase II study of raltitrexed (Tomudex) in chemotherapy-pretreated patients with advanced colorectal cancer. Tomudex Cooperative Study Group.

Raltitrexed (Tomudex), a novel folate-based inhibitor of thymidylate synthase, has demonstrated anti-tumour efficacy comparable with 5-fluorouracil and leucovorin in patients with advanced colorectal cancer (CRC). This phase II study was conducted to evaluate the anti-timor efficacy and tolerability of raltitrexed in patients with advanced CRC who had received one previous chemotherapy regimen. Raltitrexed was administered at a dose of 3.0 mg/m2 i.v. over 15 min once every 3 weeks. Of 43 eligible patients, 53% had colon cancer and 47% rectal cancer. Objective responses were observed in 16% of patients [95% confidence interval (CI): 7-31%; seven partial responses). The median duration of response was 101 days (range: 45-239 days), the median overall duration of response was 145 days (range: 104-302 days) and the median survival was 11.6 months (95% CI: 9.4-14.7 months). Liver metastases showed a 17% (three of 18) response rate and lung metastases a 12% (three of 25) response rate. Adverse events of grade 3 or 4 reported for more than 5% of patients were neutropenia (23%), leukopenia (9%), reversible SGPT increase (7%) nausea/vomiting (19%), anorexia (14%), asthenia (9%) and hypotension (7%). Grade 3 or 4 diarrhea, stomatitis and alopecia were not observed. In summary, raltitrexed had an acceptable toxicity profile and promising anti-tumor activity against advanced CRC in patients who had received prior chemotherapy. Further clinical trials of combination chemotherapy using raltitrexed are warranted.

Adult↗

PubMed1999

Improvement of dysgeusia after thymectomy with thymoma.

We present a case of 39-year-old woman with thymoma complaining of dysgeusia. This patient had suffered from dysgeusia for the previous 6 months. Thymectomy with the thymoma was performed, and her dysgeusia was improved within 6 months after the operation. The anti-acetylcholine-receptor antibody was reduced from 0.9 nmol/l to 0.4 nmol/l (normal: below 0.6 nmol/l) by the surgical intervention. This case suggested that symptoms of dysgeusia can be associated with myasthenic status.

Adult↗