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Biomedical subjects

M Abe

Publications and source records attributed to M Abe.

At least 649 records · Page 36Linked to original sources

Clinical results of breast-conservation therapy using a CT simulator.

The CT simulator is a real-time, CT-linked, 3-D treatment planning system which consists of a CT scanner, a multi-image display, a treatment planning device with real-time visual optimization, and a laser beam projector. The clinical benefit of this system was evaluated in breast cancer patients undergoing breast-conserving therapy. Between December 1987 and March 1993, 244 breasts in 243 patients underwent breast-conserving therapy at Kyoto University Hospital. Clinically, there were 159 stage I and 85 stage II tumors. Pathological staging showed 216 stage I, 24 stage II, and 4 stage III tumors. All except 10 tumors were invasive ductal carcinomas. Eleven tumors were margin-positive by histopathological examinations. As surgical treatment, quadrantectomy or wide excision with complete axillary dissection was performed. Radiation therapy consisted of 50 Gy delivered to the whole breast by opposed tangential fields over 5 weeks using 60Co gamma rays. For patients with a positive margin, boost electron irradiation was given to a total of 10 Gy. We used the CT simulator for individualized optimization of the tangential fields. Prompt and accurate determination of the tangential portals was possible by using the simulator to determine various parameters, including the beam angle and head rotation angle. During follow-up for 2-66 months (median: 20 months), unrelated death occurred in 2 patients and distant metastases developed in 5 (bone 4, lung 1). However, neither local recurrence nor symptomatic radiation pneumonitis has since occurred. The cumulative survival rate and the disease-free survival rate at five years were 95.2% and 91.8%, respectively. The CT simulator appears to be a useful tool for individualized optimization of tangential irradiation fields in breast-conserving therapy.

Adult↗

[Advances in biology and pathogenesis of multiple myeloma].

Plasma cell malignancy, multiple myeloma, is the prototype of monoclonal terminal-differentiated B cell proliferation that reveals a monoclonal Ig in the serum and/or urine of the majority of patients. New insights into the biology and pathogenesis of this entity are based on careful research to a complex cytokine network including TNF beta, IL-1 beta, and IL-6, many oncogene products such as bc1-2 protein, H-ras p-21 protein, and RB-1 product, and cell surface antigens associated with myeloma cells. The recent understanding on the mechanism for acquisition of IgV region diversity during B cell development has clarified the origin of the clonogenic cell in multiple myeloma. Further identification of new prognostic parameters as well as new therapeutic agents is necessary for the rational therapy of this refractory malignancy.

Aged↗

[Comparison of complement activation between tuberculous and malignant pleuritis].

Complement activation products in pleural effusions were studied to clarify the causes of tuberculous and malignant pleuritis. Pleural SC5b-9, an activation product of complement common pathway, was significantly higher in tuberculous effusions than in malignant ones. In the tuberculous effusions, the levels of SC5b-9 and LDH (a marker of tissue damage) were significantly correlated, but in the malignant effusions these two values were not correlated. In the tuberculous effusions, SC5b-9 and Bb values were significantly correlated, but SC5b-9 and C4d were not, and nor were SC5b-9 and immune complex. In the malignant effusions, SC5b-9 and Bb values were low and were not significantly correlated. These results suggest that complement activation plays a significant role in tuberculous pleuritis, but not in malignant pleuritis.

Antigen-Antibody Complex↗

[Application of large curved forceps for taping in cardiovascular surgery].

A new large curved forceps was manufactured for trial with the object of taping in cardiovascular surgery. Widely used and commercially available forceps could be utilized on the taping of large vessel less than 5 to 5.8 cm in diameter. With this new forceps, aneurysmally dilate great vessels (less than 8 cm in diameter) could be safely taped without compression of aortic wall. This forceps has already applied not only for the major vascular surgery, but also for the wearing of cardiac net in coronary artery bypass grafting.

Aortic Aneurysm↗

[A case of Evans's syndrome in which thrombocytopenia and hemolysis was improved by Sairei-to].

A 51-year-old male diagnosed as having Evans's syndrome in 1991 was treated with 25 mg of prednisolone, but his anemia and thrombocytopenia progressed. Thus, in November 1993, treatment was begun with Sairei-to, a Chinese herbal medicine consisting of several water-soluble plant extracts. Following administration of 9.0 g/day of Sairei-to granules along with prednisolone, the platelet count increased from 6.1 x 10(4)/microliters to 12.3 x 10(4)/microliters after one week, while hemoglobin levels rose from 9.5 g/dl to 12.0 g/dl after three weeks. The patient maintained a good physical condition after the prednisolone dose was reduced, although Coomb's test and PAIgG levels remained positive. Sairei-to-seems to be a promising therapeutic agent for steroid-resistant ITP and AIHA, and seems to have no side effects.

Anemia, Hemolytic, Autoimmune↗

[A case of supravalvular pulmonary stenosis with atrial septal defect].

We reported a case of supravalvular pulmonary stenosis with atrial septal defect (ASD) in 37-year-old man. Extended pulmonary arterioplasty with the technique of Doty's operation for supravalvular aortic stenosis was carried out with bovine pericardial patch. Pressure gradient between the right ventricle and the pulmonary artery reduced from 90 to 20 mmHg after this operation. Doty's technique could be modified and successfully applicable to supravalvular pulmonary stenosis.

Adult↗

[Development of infection with Aspergillus flavus in woman being treated for allergic pulmonary Aspergillosis caused by Aspergillus fumigatus].

A 36-year-old woman who raised plants in a large greenhouse came to our hospital because of a cough and purulent sputum. A chest X-ray film showed infiltrative shadows in the left middle lung field. Aspergillus fumigatus was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left B5. Biopsy specimens revealed hyphae elements of aspergillus species and eosinophils in a plug of viscous material. Also, eosinophils and lymphocytes had infiltrated through bronchial epithelium without aspergillus species. She was given a diagnosis of allergic aspergillosis caused by Aspergillus fumigatus. Fluconazole was given and her symptoms and infiltrative shadows improved. Seventy days after treatment with fluconazole began, her symptoms recurred along with an abnormal shadow in the left upper lung field on a chest x-ray film. Aspergillus flavus, but not Aspergillus fumigatus, was isolated from samples of sputum and bronchoalveolar lavage fluid obtained from the left lung (S1+2). Biopsy specimens of the lung showed eosinophilic pneumonia. She was treated with itraconazole and her symptoms and abnormal radiographic shadows disappeared. She had no asthmatic attack or central bronchiectasis du ring the illness. This was a case of allergic pulmonary aspergillosis without asthmatic symptoms. It is interesting that one species of aspergillus was replaced by another during treatment.

Adult↗

Human T-cell leukemia virus type I tax transactivates the interleukin-6 gene in human rheumatoid synovial cells.

OBJECTIVE: To determine the effect of the human T cell leukemia virus type I (HTLV-I) tax gene on interleukin-6 (IL-6) production and gene transcription in synovial cells, we established the synovial cell line, E-11, from a patient with rheumatoid arthritis. METHODS: E-11 cells were transfected with tax expression vector using the calcium phosphate coprecipitation method. IL-6 production and gene expression were investigated by ELISA and Northern blot analysis, respectively. To clarify how tax induces IL-6 gene expression, we used deletion analysis and chloramphenicol acetyltransferase (CAT) assay, and electrophoretic mobility shift assay (EMSA). RESULTS: Transfection of the tax gene induced markedly high levels of IL-6 mRNA. Furthermore, the tax gene strongly transactivated IL-6 gene promoter activity assayed by CAT assay. By using deletion and site specific mutations, we have identified a nuclear factor (NF)-kappa B sequence (positions -73 to -63) which is essential for tax transaction. EMSA demonstrated the induction of specific binding of nuclear extracts to the NF-kappa B sequence by HTLV-I tax. CONCLUSION: The HTLV-1 tax gene may transactivate IL-6 gene in the synovial cells through NF-kappa B and may contribute in the pathophysiology of HTLV-I associated arthritis.

Arthritis, Rheumatoid↗

Oxidative changes in the liver, brain and lens of lipopolysaccharide-treated rats.

Oxidative damage in various tissues of LPS-treated rats was studied using the following parameters: changes in reduced (GSH) and oxidized glutathione (GSSG) levels in liver, brain and lens; the activity of glutathione peroxidase (GSH-PX) in both liver and brain; the content of cytochrome P450 reductase in liver. Bacterial LPS was injected i.p. (at a dose of 4 mg/kg BW) 6 h before the animals were killed. One group of rats received N omega-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase (NOS) (given for 4 days in the drinking water at a concentration of 50 mM); another group received both L-NAME and LPS. In brain and lens no changes in GSH were observed after either LPS, L-NAME or both. In contrast, GSSG and the GSSG/GSH ratio was significantly higher after LPS. This effect was abolished in the brain by L-NAME treatment. The level of the activity of the antioxidative enzyme GSH-PX in brain was significantly higher after L-NAME in LPS-treated animals. Hepatic GSH-PX activity was enhanced after either LPS, L-NAME or treatment with both substances. Additionally, LPS diminished the level of cytochrome P450 reductase with this effect being largely prevented by L-NAME. The results suggest that GSH, as an endogenous antioxidant, may play a major role in combating toxicity of LPS.

Animals↗

Reciprocal changes in left ventricular collagen alpha 1 chain gene expression between types I and IV in spontaneously diabetic rats.

The characteristic features of diabetic cardiomyopathy have been reported to be increased collagen formation associated with impairment of ventricular performance, based on experimental models of diabetes. The present study was therefore designed to clarify collagen gene expression in hearts obtained from female spontaneously diabetic BioBreeding Worcester Tokyo (BB/W@Tky) rats. Cardiac hypertrophy was observed as early as 14 weeks in diabetic BB/W@Tky rats, i.e. 4 weeks after the onset of diabetes. Left ventricular gene expression of collagen alpha 1 (I) was decreased to 10.6% of the control level. In 24-week-old diabetic rats, which had more marked cardiac hypertrophy, the level of alpha 1 Type I collagen mRNA was further decreased to 5.7% of the control level, whereas collagen alpha 1 (IV) mRNA demonstrated a 3-fold increase. As a result, a ratio of collagen alpha 1 (IV) to actin mRNA was positively correlated with plasma glucose concentration. These results suggest that hyperglycemia may alter the gene expression of extracellular matrix proteins, resulting in the morphological and functional changes seen in diabetic cardiomyopathy.

Actins↗

Preliminary Results of Quadrantectomy and Radiation Therapy for Breast Cancer.

Between November 1987 and December 1992, a total of 200 breast carcinomas in 199 patients were treated by definitive radiation therapy following quadrantectomy and level III axillary dissection. One patient with sumultaneous bilateral breast cancers was excluded and 198 patients with breast cancer were enrolled in this study. There were 9 Stage 0, 117 Stage I and 72 Stage II tumors by the UICC tumor classification system (1987). Histological examination revealed that 9 tumors were non-invasive carcinomas and 189 were invasive carcinomas. For radiation therapy, a total of 50 Gy was delivered to the ipsilateral breast using &sup60;Co gamma rays. In three cases with level III lymph node involvement, the ipsilateral supraclavicular and parasternal regions were also irradiated. Boost irradiation was given to 8 of 12 margin-positive patients, and 2 of 24 patients in whom tumor cells were present within 5 mm from the margin. We used a CT simulator for the treatment planning of radiation therapy in 196 tumors. During follow-up for 16-77 months (median: 35 months), 2 patients died of unrelated causes and 6 developed distant metastasis (4 to bone and 2 to lung). Local recurrence was noted in 1 patient. Acute reactions to radiation therapy included moist desquamation involving the tip of the breast and the axilla in 14 and 5 patients, respectively, as well as bright erythema in 7 patients. Late reactions included arm edema in 12 patients, patchy depigmentation at the tip of the breast in 5 patients, moderate telangiectasia in 1 patient, and symptomatic radiationpneumonitis in 1 patient. The actuarial overall survival, cause-specific survival, disease-free survival, and relapse-free survival rates at 5 years were 97.2%, 100%, 93.5%, and 93.0%, respectively. This excellent locoregional control, together with a highly acceptable toxicity strongly suggests the usefulness of quadrantectomy and radiation therapy for Japanese women with breast cancer. The possible indications include clinical Stage 0 and, I breast cancer, and clinical Stage II cancer in patients with relatively large breasts and with the primary tumor not located close to the nipple.

Journal Article↗

Molecular genotyping for N-acetylation polymorphism in Japanese patients with colorectal cancer.

BACKGROUND: N-acetylation polymorphism has been documented as a representative pharmacogenetic trait, and also has been implicated ecogenetically in an individual's susceptibility to cancer. However, there still remains controversy concerning the association between colorectal cancer and N-acetylation polymorphism. METHODS: A newly established molecular genotyping method using polymerase chain reaction-based restriction fragment length polymorphism to analyze the distribution of polymorphism in a large group of Japanese patients with colorectal cancer was used. RESULTS: Based on an analysis of 234 Japanese patient with colorectal cancer and 329 healthy control subjects, no significant difference was observed in either the distribution of acetylator phenotypes or of allele frequencies between the two groups. In addition, no significant difference in their distribution was found based on the age at which cancer was first detected, the location of tumors, or the histopathologic features. CONCLUSIONS: N-acetylation polymorphism does not appear to be implicated crucially as a genetic trait affecting an individual's susceptibility to colorectal cancer.

Acetylation↗

Immunohistochemical evidence for amyloid beta in rat soleus muscle in chloroquine-induced myopathy.

Deposition of amyloid beta (A beta) is one of the pathological hallmarks of brains affected with Alzheimer's disease (AD). The accumulation of A beta have been observed in human myopathies with rimmed vacuoles (RVs) which might involve lysosomal function. Chloroquine, a potent lysosomotropic agent, induces muscle pathology in experimental animals similar to myopathy with RV. In this study, we demonstrate, for the first time, immunohistochemical evidence that A beta and cathepsin D, a lysosomal enzyme, accumulate in vacuolated rat soleus muscle due to chloroquine-induced myopathy. These data indicate that lysosomes are important in the metabolism of amyloid precursor protein to generate A beta. This experimental system seems to be useful not only to study basic mechanisms underlying RV myopathy but also to understand processing of amyloid precursor protein to A beta in AD.

Amyloid beta-Peptides↗

Esophageal cancer treated with radiotherapy: impact of total treatment time and fractionation.

PURPOSE: Local control rate and survival rate of esophageal cancer treated with radical radiation therapy (RT) were analyzed with special respect to total treatment time and fractionation. METHODS AND MATERIALS: Between 1979 and 1992, 88 patients with Stages I-III esophageal cancer were treated radically with RT at Kyoto University Hospital and Wakayama Red Cross Hospital. Of the 88 patients, 52 patients were treated with conventional fractionation (1.7-2.0 Gy/day, five times/week), and the remaining 36 patients were treated with accelerated hyperfractionation (AHF). In 1989, we started AHF regimen for esophageal cancer. Daily fractionations were 2.0 Gy and 1.2 Gy (field-in-field), or 1.5 Gy and 1.5 Gy at 5- to 6-h interval. Most of the patients treated with AHF received the total radiation dose of 64-68 Gy. Twenty-seven patients were treated with intraluminal brachytherapy (IBT) as boost therapy following external RT. Fourteen patients were treated with IBT following AHF. RESULTS: The median of treatment time of AHF was approximately 2 weeks shorter than that of conventional fractionation. Local control rate at 1 year were 47% for AHF, which was significantly higher than that for conventional fractionation (22%, p < 0.05). The improvement of local control by AHF was responsible for a trend to an improved cause-specific survival (p = 0.07). Local control rates at 1 year were plotted as a function of total treatment time. The slope of the linear regression line was -2.3 +/- 0.5% per day (p < 0.025) for patients treated with external RT alone, indicating a 2.3% per day loss in local control. Pretreatment and treatment parameters were evaluated in a multivariate analysis for the end point of local control. T stage (T1, 2 vs. T3, 4; p = 0.003) and fractionation schedule (p = 0.03) were independent of prognostic significance. Patients could tolerate the AHF well, although esophageal stenosis was noted frequently as a late toxicity. CONCLUSION: Accelerated hyperfractionation was the most important treatment-related variable in this patient population. Total treatment time may have a significant impact on the treatment outcome for esophageal cancer.

Adenocarcinoma↗

The effects of intraoperative radiotherapy on bone-healing ability in relation to different doses and postradiotherapy intervals.

PURPOSE: Alterations in bone-healing ability after intraoperative radiotherapy were investigated in relation to different doses and postradiotherapy intervals in an experimental model. METHODS AND MATERIALS: Bilateral osteotomy of the fibulae of 56 rabbits was carried out either immediately, 13 weeks or 39 weeks after unilateral intraoperative radiotherapy with 10-MV X ray using one of three doses, 25, 50, or 100 Gy. The healing of the fibulae was evaluated radiographically and histologically 13 weeks after the osteotomy. RESULTS: Bone-healing ability was irreversibly reduced in all irradiated fibulae and these damages occurred in a dose-dependent manner. The severity of the damage also tended to increase with the time interval between irradiation and osteotomy. This interval-related aggravation was characterized by augmented bone loss at the osteotomy ends and atrophy of the neighboring areas. CONCLUSION: These results serve as useful information concerning the surgical intervention of irradiated bone during and after intraoperative radiotherapy, and also after conventional radiotherapy.

Animals↗

Combined cytokinesis-block micronucleus and chromosomal aberration assay for the evaluation of radiosensitizers at low radiation doses.

PURPOSE: Several methods have been tried for evaluating the efficacy of hypoxic cell radiosensitizers at clinically relevant low radiation doses (1-4 Gy). The cytokinesis-block micronucleus assay is known to be useful for both the in vitro and in vivo evaluation of radiosensitizers, while the chromosomal aberration assay has been commonly used to assess the mutagenicity of various agents. In the present study, the chromosomal aberration assay and the cytokinesis-block micronucleus assay were performed simultaneously to assess the radiosensitizing effect of etanidazole and KU-2285 at low radiation doses. The correlation between the two assays was also evaluated. METHODS AND MATERIALS: In vitro study: EMT-6 cells were irradiated at a dose of 1-3 Gy under hypoxic conditions with or without the drugs at 1 mM. In vivo-in vitro study: EMT-6 tumor-bearing BALB/c mice received 2-4 Gy of radiation with or without administration of the drugs at 200 mg/kg. Single-cell suspensions were then obtained in both studies and were used for the cytokinesis-block micronucleus assay and the chromosomal aberration assay. The micronucleus frequency in binucleate cells was evaluated in the former assay, and the frequency of chromosomal aberrations in metaphase cells was evaluated in the latter assay. RESULTS: In vitro study: the sensitizer enhancement ratios of etanidazole and KU-2285 were 1.73 and 2.21, respectively, in the micronucleus assay, and 1.41 and 1.79 in the chromosomal aberration assay. In vivo-in vitro study: the sensitizer enhancement ratios of etanidazole and KU-2285 were 1.18 and 1.31, respectively, in the micronucleus assay, and 1.16 and 1.42 in the chromosomal aberration assay. In both studies, a linear correlation was observed between the micronucleus frequency and the chromosomal aberration frequency. The background (i.e., the frequency at 0 Gy) of the latter assay was considerably lower than that of the former assay, especially in the vivo study. CONCLUSIONS: The chromosomal aberration assay has not yet been established as a method for evaluating the effect of radiosensitizers. However, a combination of the cytokinesis-block micronucleus assay and the chromosomal aberration assay seems to be useful for assessing radiosensitizers at low radiation doses for the following reasons: a) the chromosomal aberration assay is as sensitive as the micronucleus assay and possibly more specific, because chromosomal aberrations can be observed before cells pass through the first metaphase after irradiation and, thus, reflect quite acute damage, even though they reflect only a part of the total damage; b) the combined assay provides relatively more information for the time and labor required.

Aerobiosis↗