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Biomedical subjects

Kazuo Shirouzu

Publications and source records attributed to Kazuo Shirouzu.

At least 73 records · Page 4Linked to original sources
PubMed2004

A case of argon plasma coagulation therapy for hemorrhagic rectal tumor in a highly aged patient.

A 95-year-old woman admitted to our hospital for senile dementia showed hemorrhage from rectum, and colonoscopy was performed. Circumferential hemorrhagic concomitant nodular aggregated tumor was found spreading from just above denticulate line to the lower rectum. She has a past history of rectal tumor, for which endoscopic mucosal resection was performed in 1998. Based on the biopsy finding, the tumor was diagnosed as a highly differentiated adenocarcinoma, and the hemorrhage was speculated to be induced by local recurrence. Considering patient's very high age and poor risks, argon plasma coagulation (APC) therapy succeeded in controlling the hemorrhage. After the therapy, the tumor itself showed no tendency to grow, and clinical course remained favorable for 10 months up to now. APC therapy is considered useful for the hemorrhagic tumors in the gastrointestinal tract in the highly aged patients with high risk.

Aged↗
PubMed2004

A case of hilar bile duct cancer with intestinal Behçet's disease.

We encountered a hilar bile duct cancer patient with intestinal Behçet's disease who manifested various symptoms during a short period in the acute stage after liver resection. Under a diagnosis of hilar bile duct cancer, a 52-year-old Japanese male was referred and admitted to our hospital. Hepatectomy and resection of the extrahepatic bile duct were performed. During the postoperative course, a large number of painful aphthous ulcers developed in the oral mucosa, along with a genital ulcer. A deep excavation-type ulcer was confirmed by colonoscopy in the ileum on the orifice side. We administered colchicine and mesalazine. Thereafter, the patient was treated at the outpatient clinic. Recurrent localized hilar bile duct cancer developed, and the patient died about 8 months after surgery. We present the clinical details of this rare case of hilar bile duct cancer with intestinal Behçet's disease.

Behcet Syndrome↗
PubMed2004

Transforming growth factor-beta1 expression and the role of angiotensin-converting enzyme inhibitor on perianastomotic intimal hyperplasia in polytetrafluoroethylene graft implanted in rabbit carotid artery.

The purpose of this study was to evaluate the relationship between intimal hyperplasia and transforming growth factor-beta1 (TGF-beta1) mRNA expression in synthetic arterial grafts and also to clarify the effect of angiotensin-converting enzyme inhibitor (ACEI) on perianastomotic intimal hyperplasia and TGF-beta1 mRNA expression. Thirty New Zealand White rabbits were randomly divided into two groups (15 each); one group was administered Captopril 10 mg/kg/day per os as an ACE inhibitor, and the other group received on saline as a vehicle from 7 days prior to operation until the graft was harvest (1, 8, or 14 weeks). A 10-mm segment of an expanded polytetrafluoroethylene graft (3 mm in diameter) was implanted in the right common carotid artery of the rabbits; 15 rabbits had by-pass grafting alone (Graft Alone group) and the other 15 rabbits had by-pass graft along with the ACEI (Graft plus ACEI group). The artery grafts were harvested. The intima to media height ratio (IMHR) and the TGF-beta1 mRNA expression level in perianastomotic graft tissue by reverse transcription-polymerase chain reaction (RT-PCR). The IMHRs gradually increased from 1 to 14 weeks in both groups (vs. 1 wk in each group, p<0.05). The IMHRs of the Graft plus ACEI group were comparable to those of Graft Alone group at 1 week, but significantly lower at 8 and 14 weeks (vs. Graft Alone group, p<0.05). The TGF-beta1 mRNA expression levels of the Graft plus ACEI group were clearly lower than those of the Graft Alone group at 1 and 8 weeks (vs. Graft Alone group, p<0.05), but similar at 14 weeks. TGF-beta1 in the synthetic artery graft of the Graft Alone group was up-regulated as early as 1 week after the operation, when no definitive development of a quantifiable neointima was observed. The TGF-beta1 mRNA expression of the Graft Alone group was highest at 8 weeks and lowest at 14 weeks (vs. 1 week, *p<0.05), but such time-dependent changes were not observed in the Graft plus ACEI group. The results indicated that ACEI reduced intimal hyperplasia in the grafts of the Graft plus ACEI group and also suppressed TGF-beta1 mRNA expression in perianastomotic intimal hyperplasia tissues to the normal artery level. Perianastomotic intimal hyperplasia in synthetic arterial graft is considered to be related to TGF-beta1, the expression of which is locally mediated by angiotensin II and, therefore, suppressed by ACEI.

Anastomosis, Surgical↗
PubMed2004

Graciloplasty for internal and external sphincteric resection of lower rectal cancer.

Anal sphincteric resection for rectal cancer is most commonly followed by colostomy in the lower abdominal wall, which enforces quite a poor quality of life due to a permanent stoma. For surgeons treating lower rectal cancer, the goal is to achieve defecation via the anus without placing a stoma. Internal sphincteric resection, partial external sphincteric resection and coloanal anastomosis have been reported for the treatment of lower rectal cancer with avoiding a colostoma. Extended resection of the external sphincter, however, limits patient's daily activities because of poor functional results and necessitates reconstruction of damaged anal function. This paper describes a case of graciloplasty for postoperative anal dysfunction that yielded a good clinical outcome in a 65-year-old female who had undergone very low anterior resection with complete internal and partial external sphincteric resection for lower rectal cancer.

Aged↗
PubMed2004

A case of pulmonary embolism after abdominal angiography.

The patient was a 72-year-old woman who had been diagnosed with cholecystolithiasis and had undergone laparoscopic cholecystectomy. Since the postoperative pathologic diagnosis was a gallbladder cancer with a depth of wall penetration of subserosa, she was admitted to Kurume University Hospital for a second-look operation. After admission, abdominal angiography was performed with a right femoral arterial puncture. After the release of inguinal compression with a belt, chest pain and difficulty in breathing appeared. Despite her normal blood pressure, arterial blood gas analysis showed a PO2 of 74.7 mmHg and a PCO2 of 41.5 mmHg, representing a slight decrease in PO2. Chest X-rays showed an increased cardiothoracic ratio and decreased lucency in the left upper lung field. The electrocardiogram revealed atrial premature contraction. Cardiac ultrasound did not show expansion of the right heart and blood vessels or abnormal structures in the main pulmonary artery. Since lung perfusion scintigraphy revealed perfusion defects in the left upper to middle and right upper lung fields, acute pulmonary embolism was diagnosed, and oxygen inhalation, thrombolytic, and anticoagulant therapy were instituted immediately. The symptoms improved the following day, but 240,000 u/day of urokinase was administered for 5 days, and 1,500 u/day of heparin for 10 days. On lung perfusion scintigrams 6 days later, the defects had disappeared. Moreover, no definite abnormal shadows were noted on chest X-rays. Radical surgery for gallbladder cancer was performed 3 weeks later. Considering the possible development of pulmonary embolism, we felt the need for careful management if the patient is released from bed rest after abdominal angiography.

Aged↗
PubMed2004

Experimental gene therapy using p21Waf1 gene for esophageal squamous cell carcinoma by gene gun technology.

In our previous study, the proliferation rate of esophageal squamous cell carcinoma cell lines, which poorly expressed p21Waf1, was found to be regulated by p21Waf1 gene transfection using adenovirus vector. In the present study, in order to examine the effect of p21Waf1 gene therapy in esophageal cancer, we used gene gun technology, which proved to be a powerful method to introduce the p21Waf1 gene into esophageal cancer cells. p21Waf1 transfection to KE3 and YES2 cells (weakly expressed p21Waf1 protein cells) showed a high expression of p21Waf1 protein after applying this gene gun technique. In KE3 and YES2 cells, statistical significant growth inhibition was observed after p21Waf1 transfection compared with LacZ transfection (KE3, p=0.0009; YES2, p<0.0001). In in vivo transfection experiments, on day 14, the estimated volume of KE3 tumors subjected to p21Waf1 gene transfection was 95% in comparison with the pretreatment volume on day 0, while the volume of KE3 tumors subjected to LacZ gene therapy increased to 268%. On day 14, the estimated volume of YES2 tumors subjected to either p21Waf1 or LacZ gene therapy increased to 474 and 686%, respectively. In KE3 and YES2 cells, significant growth inhibition was observed after combination therapy using p21Waf1 transfection and anticancer drug 5-fluorouracil (5Fu) compared with 5Fu alone (KE3, p<0.0001; YES2, p<0.0001). In conclusion, p21Waf1 gene therapy using the gene gun technique significantly inhibited the low basal p21Waf1 expressed esophageal cancer cell growth in vitro and in vivo. Furthermore, p21Waf1 transfection strongly enhanced the effect of 5Fu suggesting that p21Waf1 may prove beneficial in chemotherapy combined with gene therapy using gene gun technology in patients with esophageal cancer who have a low level of p21Waf1 expressed tumor.

Animals↗
PubMed2004

[The repetitive immune cell transfer therapy combining non-myelosuppressive chemotherapy for patients with advanced and refractory cancer].

Autologous tumor cells stimulated with T lymphocytes (AuTL) were generated ex vivo from peripheral blood lymphocytes over a two-week co-culturing process with autologous tumor cells. These AuTLs were capable of lysing established tumor cell lines and may have a potential for efficacy as an adoptive immunotherapy (IT) in advanced and metastatic refractory cancer patients (pts). We investigated the feasibility of a combination of AuTL transfer and chemotherapy (ChT) based on the conventional conditioning regimen in order to take advantage by both the anticancer effects and reconstruction of antitumor immunity. Nineteen patients were enrolled in a pilot clinical trial. The two administrations of AuTL were given prior to chemotherapy (ChT) for one treatment cycle. The treatment was repeated at least for three cycles over a one-week interval. The conventional ChT regimen was based on the standard dosage. The pts consisted of 3 of gastric cancer, colon cancer, lung adenocarcinoma, respectively, 6 of esophageal cancer, and 2 of breast and pancreas carcinoma, respectively. AuTLs were administered 1x/2 weeks using direct injection or intraarterial infusion. The median duration of the treatment was over 11.5 months, and the median survival time was 14.8 months. Adverse events related to both the ChT and AuTL transfers at all dosages were minimal. Four of the 13 pts achieved major tumor responses (2 CR: complete regression and 2 PR: partial regression) in this study. Three pts showed progressive disease, and 6 pts had stable disease for over 90 days. PBMC were evaluated for cytokine production prior to the treatment and after 3 treatments. Two and one of 4 CR/PR pts had increased IFN-gamma and TNF-alpha production with no TGF-beta1 responses by their PBMC after 3 treatments, respectively. Two out of 6 pts who experienced stable disease after the treatment had high IFN-gamma and TNF-alpha responses and no TGF-beta1 or IL-4 response. TGF-beta1 and IL-4 secretion increased in parallel in 3 out of 3 pts that experienced progressive disease after the treatment. These data show that combination therapy of AuTL transfer and non-myeloablative ChT is a feasible option for patients with refractory advanced cancers without serious adverse events and without reducing Th1 cytokine responses in peripheral blood for most of the pts that responded to the treatment. According to each mechanism of IT and ChT, a more stringent evaluation of AuTL transfer combined with non-myeloablative ChT for various kinds of cancers should be performed to manage the immunodeficiency in the pts with advanced cancer and to improve the effect of antitumor AuTLs.

Adoptive Transfer↗
PubMed2004

[Gastric cancer with liver metastasis effectively treated by intra-hepatic arterial infusion].

The prognosis of gastric cancer with liver metastasis is very poor. Because many gastric cancers with liver metastasis have multiple metastatic tumors in the liver, and the indication for surgical resection is rare. Moreover, the non-curative factors of many cases are not only liver metastasis but also are lymph node metastasis and peritoneal dissemination. However, some authors have reported gastric cancer with liver metastasis was treated effectively by intra-hepatic infusion of an anti-cancer drug. In this article, we report three cases of gastric cancer with liver metastasis that are treated effectively by intra-hepatic arterial infusion of an anti-cancer drug. There were no non-curative factors except liver metastasis. The first was a H3 case treated effectively by intra-hepatic arterial infusion of 5-fluorouracil (5-FU), mitomycin C (MMC) and peroral administration of 5-FU. The metastatic liver tumors had disappeared in 14 weeks. However, the patient eventually died of liver and brain metastases in 7 months after the therapy. The second was a H2 case treated effectively by intra-hepatic arterial infusion of CDDP and peroral administration of 5'-DFUR and PSK. The metastatic liver tumors had disappeared in 4 months, and the patient is still alive without recurrence in 35 months after surgery. The third was a H2 case treated effectively by intra-hepatic arterial infusion of cisplatin (CDDP) and peroral administration of TS-1 and PSK. The size of metastatic nodules had increased, and Virchow lymph node metastasis had appeared in 28 months after surgery. The patient eventually died in 32 months after surgery. These results suggested that intra-hepatic arterial infusion of CDDP with peroral administration of TS-1 or 5'-DFUR was an effective therapy for gastric cancer with liver metastasis.

Administration, Oral↗
PubMed2004

[Intra-arterial cellular immunochemotherapy for unresectable pancreatic cancer with liver metastasis].

PURPOSE: To date, no treatment has had a significant impact on pancreatic cancer with liver metastasis. We performed locoregional cellular immunochemotherapy for unresectable pancreatic cancer with liver metastasis. SUBJECTS AND METHODS: A 71-year-old man was diagnosed for unresectable stage IVb pancreatic cancer. This patient was given intra-arterial infusion of gemcitabine (GEM) 400 mg/body and intravenous infusion GEM 600 mg/body, simultaneously. The day after GEM infusion, he was given intra-arterial autologous tumor cell activated T lymphocytes (AuTL). RESULTS: Tumor markers, such as CEA and CA19-9, had decreased a little. Primary tumor and metastatic liver tumor were reduced, but he died due to intra-abdominal dissemination within 5 months after diagnosis of unresectable pancreatic cancer. CONCLUSIONS: Reduced primary pancreatic tumor and metastatic liver tumor was obtained by locoregional cellular immunochemotherapy. But we could not control intra-abdominal dissemination. In conclusion, we suggest that intra-abdominal AuLT infusion in combination with intra-arterial AuLT infusion may be advisable to patients for unresectable pancreatic carcinoma with intra-abdominal dissemination.

Aged↗
PubMed2004

[A case of radiofrequency ablation therapy for recurrent hepatomas with tumor fever--efficacy of hepatic arterial infusion therapy with antibiotics and anticancer drugs].

Efficacy of hepatic arterial infusion therapy (HAI) using antibiotics for hepatic abscess has been reported. However, we effectively performed RFA therapy after HAI with antibiotics and anticancer drugs for recurrent hepatomas with tumor fever. A 67-year-old female of recurrent hepatomas with fever is presented here. She was diagnosed with a 6 cm recurrent hepatoma, both in the right and IM lobes. Her liver function was child A with hepatitis C. On her CT scan, we found an enhanced 60 mm mass at an early phase and it was washed out at a delayed phase. Initially, we gave systemic medication of antibiotics, but could not decrease the fever. Therefore, we performed HAI with antibiotics and anticancer drugs. The patient's temperature went down after 14 days, and we were able to cut down her tumor size. After HAI, we were able to completely perform RFA for recurrent hepatomas.

Aged↗
PubMed2003

Expression of vascular endothelial growth factor as a prognostic factor in node-positive squamous cell carcinoma in the thoracic esophagus: long-term follow-up study.

To clarify the clinical significance of the expression of vascular endothelial growth factor (VEGF) in squamous cell carcinoma in the thoracic esophagus, particularly as a prognostic factor, we have investigated the correlation between VEGF expression in tumor cells and microvessel density (MVD), pathologic factors, and survival. A total of 92 specimens, each from a thoracic esophageal squamous cell cancer patient who underwent transthoracic curative R0 esophagectomy between 1991 and 1994, were examined immunohistochemically using anti-human VEGF and anti-human von Willebrand factor antibodies. The incidence of VEGF expression in the tumor cells was relatively low, at 23.9% of all specimens. There was no significant correlation between VEGF expression and histopathologic factors. The MVD at the tumor margin in patients with VEGF-positive tumor cells was significantly greater than that in VEGF-negative cases (35.2 +/- 8.9 vs. 22.7 +/- 8.2). The survival rate for patients with VEGF expression was significantly lower than that of those without VEGF expression; the same situation was found in node-positive patients but not in node-negative patients. In addition, multivariate analysis revealed that VEGF expression was an independent prognostic factor in node-positive patients. VEGF may be implicated in the definition of the malignant phenotype of squamous cell esophageal cancer via tumor angiogenesis. Accordingly, VEGF expression in the tumor cells could be a useful prognostic factor for esophageal cancer, particularly in node-positive patients.

Carcinoma, Squamous Cell↗
PubMed2003

Optimal lymphadenectomy for squamous cell carcinoma in the thoracic esophagus: comparing the short- and long-term outcome among the four types of lymphadenectomy.

Controversy continues over the optimal extent of lymphadenectomy (regional versus three-field) for a potentially resectable squamous cell carcinoma in the thoracic esophagus. In the Consensus Conference of the International Society for Diseases of the Esophagus (ISDE), held in Munich in 1994, the types of lymphadenectomy were classified as standard, extended, total, or three-field lymphadenectomy. The objective of the present study was to determine the optimal procedure among these four types of lymphadenectomy. The mortality and morbidity rates, postoperative course, and survival rates were compared among 302 patients who underwent curative (R0) transthoracic esophagectomy with one of these four types of lymphadenectomy at Kurume University Hospital, Fukuoka, Japan, from 1986 to 1998. Three-field lymphadenectomy resulted in better survival than any other type of lymphadenectomy for patients with positive lymph node metastasis from a cancer in the upper or middle thoracic esophagus. A postoperative complication, such as recurrent laryngeal nerve paralysis, anastomotic leakage, and tracheal ischemic lesion, was significantly more common after three-field lymphadenectomy. However, the mortality rate was the same among the four procedures. Three-field lymphadenectomy was optimal for an upper or middle thoracic esophageal cancer with metastasis in the lymph node(s) based on improved long-term survival, whereas there was not a large difference in short-term and long-term outcomes after the four types of lymphadenectomy for a lower thoracic esophageal cancer.

Aged↗
PubMed2003

Cell growth inhibition by all-trans retinoic acid in SKBR-3 breast cancer cells: involvement of protein kinase Calpha and extracellular signal-regulated kinase mitogen-activated protein kinase.

All-trans retinoic acid (ATRA), a synthetic derivative of vitamin A, inhibits the growth of breast cancer cells. To elucidate the mechanism by which ATRA causes cell growth inhibition, we examined changes in cell cycle and intracellular signaling pathways, focusing on protein kinase C (PKC) and mitogen-activated protein kinase (MAPK). Using the estrogen receptor-negative, retinoid receptor-positive breast cancer cell line SKRB-3, we found that treatment with ATRA significantly decreased the expression of PKCalpha, as well as reducing ERK MAPK phosphorylation. ATRA treatment leads to dephosphorylation of Rb, and consequently to G(1) arrest. Marked changes in the expression of cyclins (particularly cyclins A and E) were observed in SKBR-3 cells treated with ATRA. Using a series of pharmacological and molecular approaches, we found evidence that ATRA-induced SKBR-3 cell growth inhibition involves the deregulation of the PKCalpha-MAPK pathway. These data suggest that retinoids interfered with signal transduction pathways that are crucial for cell cycle progression, and highlight the complexities of the biological effects of retinoid derivatives.

Antineoplastic Agents↗
PubMed2003

Relationship between microvessel density and thermographic hot areas in breast cancer.

PURPOSE: This study was conducted to evaluate the validity of thermography in breast examination. METHODS: We performed contact thermography and measured the direct temperature by inserting a needle-type thermometer into the tissue. The core temperature of the tumor (dTt) and the temperature of the tissue surrounding the tumor (dTs) were compared with normal tissue. The microvessel density (MVD) and the MIB-1 labeling index (MIB-1 LI) of the tumor were examined immunohistochemically. The subjects were 48 women with primary invasive ductal carcinoma. The area of the tumor was diagnosed pathologically, and the hot area was measured using thermography. RESULTS: The dTt was significantly higher than the dTs. Both the dTt and dTs were significantly higher when the thermographical hot area was positive, or when more than four lymph node metastases were found. The dTs was correlated with MVD. A correlation between MVD and tumor temperature measured directly was also confirmed. A higher dTs was related to the dissociated wide area of the thermogram. CONCLUSION: These findings suggested a relationship between dTs and the high-risk group of breast cancer. We also found that abnormalities in temperature were reflected in thermography and that a higher dTs was related to the dissociated wide area of the thermogram.

Breast Neoplasms↗
PubMed2003

Long-term survival following treatment with antineoplastons for colon cancer with unresectable multiple liver metastases: report of a case.

We report a case of survival for nearly 8 years after treatment of unresectable multiple liver metastases from colon cancer, using microwave ablation and the nontoxic antitumor agent, the antineoplastons. A 72-year-old man diagnosed with adenocarcinoma of the ascending colon and 14 bilateral liver metastases underwent a right hemicolectomy combined with microwave ablation of six metastatic liver tumors. We also decided to give antineoplastons to inhibit metastatic tumor growth and recurrence. Antineoplaston A10 was given intravenously, followed by oral antineoplaston AS2-1. Computed tomography scans done 1 and 4 years after the initial diagnosis showed recurrent tumors in S(4) and S(7), respectively. The patient underwent a second and a third microwave ablation of the recurrent tumors, and has survived for nearly 8 years without suffering any serious adverse effects. He is currently free from cancer. This case report demonstrates the potential effectiveness of the nontoxic antitumor agent, the antineoplastons, for controlling liver metastases from colon cancer.

Adenocarcinoma↗
PubMed2003

Spontaneous regression in small cell esophageal carcinoma.

Spontaneous regression or remission of cancers has been defined as the disappearance of the malignancies without any treatment or with obviously inadequate treatment. Spontaneous regression is rare, while any case with a small cell carcinoma in the esophagus was not found in the literature. We experienced a 73-year-old man with small-cell carcinoma in the thoracic esophagus whom underwent esophagectomy with lymphadenectomy. A pathological examination of the resected specimens found metastasis from the small cell carcinoma in the mediastinal lymph nodes, but no malignant cells in the esophageal lesion--an ulcer scar from which the biopsy specimen was taken to be a small-cell carcinoma. This may be the first case report that spontaneous regression in a small-cell carcinoma in the esophagus was found by esophagectomy and pathological examination.

Aged↗
PubMed2003

An optimal therapeutic expression level is crucial for suicide gene therapy for hepatic metastatic cancer in mice.

The most serious problem in current gene therapy is discrepancies between experimental data and actual clinical outcomes, which may be due to insufficient analyses and/or inappropriate animal models. We have explored suicide gene therapy by using various clinically relevant animal models and doubt the clinical use of maximal suicide gene expression, which has been generally recommended. To explore this subject further, we studied what expression level of suicide gene and what promoter led to the maximal clinical benefit in the case of hepatic metastatic cancer in mice. Therapeutic and adverse side effects of 4 adenoviral vectors that express herpes simplex virus thymidine kinase (HSV-tk) under different promoters were scrupulously investigated in 2 mouse models of hepatic metastasis of gastric cancer that possess clinical characteristics. Surprisingly, increases in HSV-tk expression beyond a certain point, achieved by the Rous sarcoma virus long terminal repeat promoter, not only enhanced the adverse side effects of lethal hepatotoxicity and ganciclovir-independent cytotoxicity but also failed to further increase therapeutic potential. Moreover, the carcinoembryonic antigen (CEA) tumor-specific promoter, the therapeutic potential of which had been underestimated, was much more useful-even in the case of low CEA-producing cancer-than had been previously reported. In conclusion, the optimal therapeutic expression level of a suicide gene is a novel concept and a crucial factor for successful cancer gene therapy. The present results, which contradict those of previous studies, alert researchers about possible problems with ongoing and future clinical trials that lack this concept.

Adenoviridae↗