Biomedical subjects

K Togashi

Publications and source records attributed to K Togashi.

At least 73 records · Page 4Linked to original sources

PubMed1999

Prospective observation of small "flat" tumors in the colon through colonoscopy.

PURPOSE: No prospective observations of "flat" tumors of the colon have yet been reported. The purpose of this study was to investigate the progression of small flat tumors by prospective observations using colonoscopy. METHODS: The shapes of flat tumors were classified into three types, including slightly elevated lesions with a flat top (flat-top type), slightly elevated lesions with a wide depression in the center (wide-depressed type), and slightly elevated lesions with a slit-like depression in the center (slit-depressed type). A total of 14 flat tumors of the colon in 13 patients (2 women; median age, 58; range, 46-72 years) were examined in this project. All cases were followed up prospectively using colonoscopy, and all underwent a resection using the submucosal saline injection and snaring technique. RESULTS: Because two patients were eventually dropped from the follow-up, only 12 lesions were studied. The observation period ranged from 11 to 26 (median, 19) months. At the time the observations started, the diameter of the tumors varied from 2 to 6 (median, 4) mm, and the shapes were flat-top type in five lesions, wide-depressed type in three lesions, and slit-depressed type in four lesions. Of the 12 flat tumors, 8 showed various changes in their shape. However, only two lesions demonstrated an increase in diameter of the tumor from 2 to 4 mm. In the other ten tumors any change in size was less than 2 mm. No lesions were carcinomas according to the final histologic diagnosis, but all were adenomas. CONCLUSIONS: Flat tumors of the colon did not rapidly progress when they measured approximately 5 mm in diameter. Such flat tumors did tend to change their shapes; however, such changes did not indicate invasion to the submucosal layer.

Adenoma↗

PubMed1999

Efficacy of magnifying endoscopy in the differential diagnosis of neoplastic and non-neoplastic polyps of the large bowel.

PURPOSE: We have introduced magnifying colonoscopy into clinical practice and analyzed its diagnostic efficacy, especially regarding the ability to distinguish neoplastic from non-neoplastic polyps. METHODS: The materials consisted of 923 polyps. After identifying the lesions during normal colonoscopy, a dye was sprayed, and then the zoom apparatus of the colonoscope was used to make a magnified observation at a maximum 100 times magnification. We classified the crypt orifices into six categories and labeled them A to F as follows: A, a medium round appearance; B, an asteroid appearance; C, an elliptic appearance; D, a small, round appearance; E, a cerebriform appearance; F, no apparent structural appearance. RESULTS: Forty-two of 923 polyps did not reveal any clear images of crypt patterns. The percentage of histologically neoplastic change in the lesions classified as A, B, C, D, E, and F were 10, 15.9, 93.7, 100, 94.8, and 87.5 percent, respectively. When we considered types A and B to represent a crypt pattern of non-neoplastic lesions, and types C, D, E, and F to represent neoplastic lesions, and when the lesions that did not show any clear images were classified as a misjudgment, the diagnostic accuracy of neoplastic lesions (sensitivity) was 92 percent and that of non-neoplastic lesions (specificity) was 73.3 percent. Overall, the diagnostic accuracy in differentiating neoplastic from non-neoplastic lesions was 88.4 percent. Twenty-three neoplastic lesions that were misjudged to be non-neoplastic were histologically adenoma with mild atypia in 22 and adenoma with moderate atypia in 1. CONCLUSION: Magnifying colonoscopy was considered to be useful in determining the indications for colonoscopic removal.

Adenomatous Polyps↗

PubMed1999

Evaluation of ectopic pregnancy by magnetic resonance imaging.

Patients (n = 37) suspected of ectopic pregnancy were prospectively evaluated with magnetic resonance (MR) imaging to assess the capability of MR imaging in the diagnosis of ectopic pregnancy. Five levels of confidence were defined: diagnostic, suspicious, equivocal, questionable, and negative. Tubal wall enhancement and presence of tubal haematoma or gestational sac-like structure were considered diagnostic findings. There were 21 diagnostic, two suspicious, eight equivocal, and six negative findings. MR findings were compared with the surgical findings in 18 patients. Surgical confirmation was obtained in 12 diagnostic, two suspicious, and four equivocal studies. Using the MR diagnostic criteria for tubal pregnancy, MR had 12 true positive, three true negative, three false negative, and no false positive results for the diagnosis of tubal pregnancy. Retrospective analysis of the signal intensity of haematoma and ascites was performed for these 18 surgically confirmed cases. The predominant signal intensity of tubal haematoma was an intermediate signal on T1-weighted image (WI) and a low signal on T2WI. Ascites showed signal intensity higher than that of urine on T1WI in 100% of 13 cases. In conclusion, MR imaging with use of intravenous contrast material allows a specific diagnosis of tubal pregnancy, recognizing tubal wall enhancement and fresh tubal haematoma.

Adult↗

PubMed1999

Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds.

Typical appearances of uterine leiomyoma at magnetic resonance (MR) imaging are well established, and diagnosis is usually easy. However, cases that, are extremely difficult to differentiate from other conditions are occasionally encountered. To understand the wide spectrum of MR imaging findings, such unusual appearances can be classified into three categories: degeneration and other histopathologic findings, specific types of unusual leiomyomas, and unusual growth patterns. The common types of degeneration are hyaline (>60% of cases), cystic (approximately 4%), myxoid, and red. Edema is not a phenomenon of degeneration but is a common histopathologic finding (approximately 50% of cases). Hemorrhage, necrosis, and calcification (approximately 4% of cases) may also be observed. Specific types of unusual leiomyomas include lipoleiomyoma and myxoid leiomyoma, which may have MR imaging features characteristic enough to allow differentiation from other gynecologic and nongynecologic diseases. Intravenous leiomyomatosis, metastasizing leiomyoma, diffuse leiomyomatosis, and peritoneal disseminated leiomyomatosis represent unusual growth patterns; other unusual growth patterns are retroperitoneal growth, parasitic growth, and the pattern that may occur in cervical leiomyoma. Because leiomyomas are the most common gynecologic tumors and are exclusively benign, it is important to be familiar with the variety of MR imaging appearances of uterine leiomyomas to distinguish them from other significant diseases.

Female↗

PubMed1999

Detection of porcine circovirus from lesions of a pig with wasting disease in Japan.

A wasting disease characterized by progressive weight loss and dyspnea has been observed in weaning pigs on a farm in Yamagata Prefecture in 1998. Histopathologic findings in an affected pig were bronchointerstitial pneumonia and intracytoplasmic clusters of basophilic inclusions in macrophages of lymph nodes, which were similar to those in pigs with postweaning multisystemic wasting syndrome (PMWS) recently reported in North America and Europe. Porcine circovirus (PCV)-like particles were observed in bronchial lymph node of the pig by electron microscopy, and PCV antigens were detected in the lesions by immunohistochemical staining. PCV DNA was also detected in the lung and tonsil by PCR, and restriction fragment length polymorphism analysis of the PCR products with HinfI showed the same type of the PCV associated with PMWS (pmws PCV). Homology of nucleotide sequences between the PCR product and corresponding regions of published pmws PCV genomes was very high. These results indicated that virus detected in this study was pmws PCV. To our knowledge, this is the first report on the presence of pmws PCV in Japan.

Amino Acid Sequence↗

PubMed1999

Dermoid cysts of the ovary with malignant transformation: MR appearance.

OBJECTIVE: This study presents the MR appearances of five women with a total of six proven dermoid cysts of the ovary with malignant transformation. To our knowledge, the MR findings of this entity have not been reported. CONCLUSION: The lesions appeared to be fat-containing tumors with a solid component (4/6) that extended transmurally (4/6) and extensively invaded neighboring pelvic organs (3/6). The supervening malignancy was squamous cell carcinoma in four tumors, melanoma in one, and transitional cell carcinoma in one. The mode of spread differed from that of common ovarian tumors in that it included transmural extension and local invasion, reflecting squamous cell carcinoma.

Carcinoma, Squamous Cell↗

PubMed1999

MR imaging of endometrial stromal sarcoma: correlation with pathologic findings.

OBJECTIVE: This study describes MR imaging of eight patients with endometrial stromal sarcoma and correlates the imaging findings with histopathologic findings. To our knowledge, the radiologic findings of this entity have not been reported in the literature. CONCLUSION: Endometrial stromal sarcoma typically presents with extensive myometrial involvement, which is either sharply demarcated or diffusely infiltrative. Bands of low signal intensity are observed within the areas of myometrial involvement on T2-weighted images. These bands correspond to the preserved bundles of myometrium on pathologic examination. Tumor extension along the vessels or ligaments is another characteristic of MR imaging of endometrial stromal sarcoma.

Adult↗

PubMed1999

[Two cases of descending necrotizing mediastinitis].

Descending necrotizing mediastinitis (DNM) is relatively rare inflammatory lesion with high mortality unless an appropriate surgical treatment is undertaken. Recently we successfully treated two surgical cases of DNM. In both cases, the disease started with pharyngeal abscess, and the mediastinal swelling followed. The surgery consisted with neck drainage and the mediastinal drainage through thoracotomy at the same time. A continuous mediastinal irrigation was performed postoperatively, and both patients recovered well. Immediate drainage of the primary lesion and the mediastinum is important once the diagnosis of DNM is established.

Aged↗

PubMed1999

[Effect of preoperative chemotherapy for bulky N2 non-small-cell lung cancer].

The effect of chemotherapy as the adjuvant therapy to bulky N2 disease (stage IIIA) non-small-cell lung cancer was examined. From January 1992 to December 1996, 464 patients with non-small-cell lung cancer underwent surgery. Seven patients (1.5%) with N2 disease (stage IIIA) received two cycles of preresectional cisplatin and vindesin chemotherapy, followed by standardized surgical resection (Group A). 46 patients (9.9%) had pathological N2 disease (T1-3, M0) after surgery (Group B). In Group A a complete resection was accomplished in two patients (28.6%), and five patients had incomplete resection with a deseased margin, followed thoracic irradiation 60 to 75 Gy. In three patients in Group A the N2 disease was pathologically downstaged to N1 or N0 disease. Overall survival at five years in Group A and in Group B was 48% and 39%, and median survival time was 49 months and 38 months. Although complete resection rate was lower in Group A (28.6%) than in Group B (78.2%), there was no significant difference between five year survival and median survival time in Group A and Group B. These data may be thought to suggest that induction chemotherapy in Group A was effective on occult micrometastatic disease.

Aged↗

PubMed1999

[Assessment of induction therapy and resection in stage IIIb non-small cell lung cancer].

Twelve patients with stage IIIb non-small cell lung cancer underwent induction therapy and resection from January 1990 to July 1998. They were divided into two groups; group A (n = 5) received two (to four) preresectional cisplatin and videsine chemotherapy, group B (n = 7) received chemoradiotherapy (radiation with concurrent low-dose-daily cisplatin). All patients in both groups had clinically down-stage and had no major side effects preventing surgery. 3 patients underwent radical pneumonectomy and 9 patients had radical lobectomy with no operative mortality. In 9 patients the disease was pathologically downstaged. Overall five-year survival was 27%, while in group A it was 50%. In group B 2-year survival was 18% and the longest survivor had pulmonary recurrence four years after surgery. Our data show better prognosis in group A than in group B. This results suggest that chemotherapy may be superior pre-resectional therapy to chemoradiotherapy.

Adult↗

PubMed1998

Role of reducing co-factor in cerulenin-insensitivity of 6-hydroxymellein synthase in carrot cell extract.

The activity of 6-hydroxymellein synthase, a multifunctional polyketide biosynthetic enzyme of carrot, was not inhibited by cerulenin in the presence of NADPH. However, cerulenin showed a marked inhibitory activity to the synthase if the reducing co-factor was omitted from the assay mixture. The synthase was also sensitive to the antibiotic even in the presence of NADPH when the acyl condensation site and the reducing domain at the reaction center of the enzyme were dissociated under the high ionic strength condition. In addition, the synthase activity was appreciably inhibited when NADH was employed instead of NADPH. These observations strongly suggest that a phosphate group attached to 2'-position of adenosyl moiety of NADPH molecule plays an important role in the apparent insensitivity of 6-hydroxymellein synthase toward cerulenin.

Acyltransferases↗

PubMed1998

Asymptomatic hyponatremia due to inappropriate secretion of antidiuretic hormone as the first sign of a small cell lung cancer in an elderly man.

A 72-year-old man was hospitalized with asymptomatic hyponatremia. Despite hyponatremia, urinary sodium excretion with urine osmolality exceeding plasma osmolality persisted. Plasma vasopressin levels were high and independent of plasma osmolality during hypertonic saline infusion. Computed tomography of the chest showed enlarged mediastinal and right hilar lymph nodes. Microscopically, a specimen of lymph nodes obtained by biopsy represented vasopressin-producing small cell lung carcinoma. Chemotherapy plus irradiation improved the hyponatremia. Thus, careful evaluation is necessary to determine the cause of hyponatremia disorders in elderly patients.

Aged↗

PubMed1998

Inhibition of human telomerase activity by alterperylenol.

Human telomerase is a ribonucleoprotein that maintains telomeres by adding TTAGGG tandem repeat sequences using RNA template of the enzyme. Telomerase activity is highly expressed in immortalized cells but not in most somatic cells, except for some renewal tissues, such as hematopoietic stem cells. Therefore, telomerase can be a target for anticancer drugs. Here we show that a fungus metabolite, alterperylenol, inhibits human telomerase activity. Alterperylenol inhibited telomerase activity (IC50 = 30 microM), but altertoxin I, a structurally related compound, did not affect it at 1 mM. Moreover, alterperylenol did not affect the activity of viral reverse transcriptase at 1 mM.

Benz(a)Anthracenes↗

PubMed1998

[A role of limited operation for non-small cell lung cancer at present].

Our indication of limited operation is passive. Twenty-three patients with stage I non-small-cell lung cancer underwent a limited resection from 1983 to 1995. They were divided into two groups: group A (n = 12) included the elderly patients with the smaller nodule (< or = 2 cm), group B (n = 11) included the patients with decreased pulmonary function or important heart disease. Overall four-year survival was 67%, while the survival in group A was better than that in group B. The rate of local recurrence was 30.4% in both groups and second primary lung cancer occurred in two cases. We conclude that the limited operation played an important role in surgical treatment of patients with non-small cell lung cancer, especially with the smaller nodule (< or = 2 cm).

Aged↗

PubMed1998

[Nodular bronchioloalveolar carcinoma with multiple small air spaces caused by bronchiolectasis].

A 67-year-old man was admitted to our hospital with a faint abnormal shadow in the right S2 on January 1995. Chest CT showed a faint abnormal shadow about 3 cm in diameter with multiple small air spaces. He was admitted again 18 months later for surgical treatment because the shadow on chest X-ray had grown. Right upper lobectomy was performed in June 1996 and pathohistological examination revealed bronchioloalveolar carcinoma. Tumor cells along the walls of the alveolus were recognized only in the periphery of the lesion. The center of the lesion was fibrotic and multiple small air spaces ranging from 0.5 mm to 10 mm in diameter were present. One cause of these air spaces was considered to be the "check valve" mechanism, but the majority of the air spaces were derived from ectatic bronchioli. These results suggested that bronchiolectasis had developed with central fibrosis only in the tumor. Central fibrosis in this case had played a significant role in determining the radiographic appearance of the lesion.

Adenocarcinoma, Bronchiolo-Alveolar↗

PubMed1997

Characterization of a series of vacuolar type H(+)-ATPase inhibitors on CTL-mediated cytotoxicity.

Four vacuolar type H(+)-ATPase (V-ATPase) inhibitors, i.e. concanamycin A (CMA), bafilomycin A1 (BMA), destruxin E (DRE) and prodigiosin 25-C (PRG) profoundly blocked the perforin-dependent cytotoxicity mediated by CD8+ CTL clone. Cytoplasmic acidic compartments were not detected under fluorescent microscopy after treatment of the cells with these V-ATPase inhibitors. In the lytic granule fractions, BMA, CMA, DRE and PRG completely abrogated the perforin activity, although these drugs slightly decreased the granzyme A activity. Under the same conditions, BMA and CMA markedly reduced the perforin content, while DRE and PRG had no significant effects as assayed by immunoblotting using anti-perforin antibody. These data suggest that perforin is predominantly inactivated even without proteolysis in DRE- or PRG-treated cells. We propose that acidic pH is essential to maintain not only quantity but also quality of perform in the lytic granules.

Animals↗

PubMed1997

Inactivation and proteolytic degradation of perforin within lytic granules upon neutralization of acidic pH.

In our recent studies, an inhibitor of vacuolar-type H(+)-ATPase, concanamycin A (CMA) has been shown to neutralize acidic pH in vacuolar organelles, including lytic granules, and to decrease the perforin content markedly. In the present paper, we have further investigated the role of acidification in perforin storage by using CMA. In CD8+ cytotoxic T-lymphocyte (CTL) clones, the amount of perforin decreased rapidly at 30-90 min but no more decrease occurred at 90-120 min after the addition of CMA. Since exposure to actinomycin D, cycloheximide, or brefeldin A failed to reduce the perforin content, the perforin decrease in CMA-treated cells seems to be largely due to a reduction in the perforin already stored in lytic granules, rather than to the inhibition of the de novo synthesis or the intracellular glycoprotein transport of perforin. Diisopropylfluorophosphoridate (DFP) markedly antagonized the decrease in the perforin content in CMA-treated cells, while other protease inhibitors, i.e. antipain, E-64, leupeptin, pepstatin A and phenylmethylsulphonyl fluoride, did not. Nevertheless, DFP hardly reversed the abrogation of the killing activity by CMA. Indeed, the lytic granules prepared from DFP plus CMA-treated cells showed only a marginal level of haemolytic activity. In cell-free experiments using perforin-enriched granule fractions, acidic pH completely blocked the perforin activity. Under the acidic conditions, perforin was more resistant to an inactivation by calcium when exposed to calcium prior to the haemolysis test. Thus, these data suggest that perforin is primarily inactivated, possibly in a calcium-dependent manner, and is subsequently hydrolysed by DFP-sensitive proteases in the lytic granules at neutral pH. We conclude that acidic pH plays an essential role to maintain the integrity of perforin within the lytic granules.

Animals↗

PubMed1997

Spontaneous resolution of a postcesarean arteriovenous fistula of the uterine cervix: the usefulness of transvaginal color Doppler scanning.

We encountered in a woman at the 28th day after cesarean delivery the transient appearance of a uterine cervical mass with a prominent blood flow, that was revealed to be an acquired arteriovenous fistula. The size and blood flow of the mass were monitored using transvaginal color Doppler scanning and magnetic resonance imaging (MRI). Based on these findings, the arteriovenous fistula was managed conservatively without any adverse complications.

Adult↗