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Biomedical subjects

M Kaji

Publications and source records attributed to M Kaji.

At least 19 recordsLinked to original sources

Analysis of donor-type chimerism in lineage-specific cell populations after allogeneic myeloablative and non-myeloablative stem cell transplantation.

We analyzed donor-type chimerism in CD3+, CD14.15+ and CD56+ cells from 36 patients who had undergone conventional-intensity allogeneic stem cell transplantation (CST) and 34 patients who had undergone non-myeloablative allogeneic stem cell transplantation (NST) for hematological malignancies. On day 28 after transplantation, all fractions in NST patients and CD3+ cells in CST patients who received a non-total body irradiation (TBI) regimen showed more frequent mixed chimerism (<90% donor cells) than those in patients who had received TBI. NST patients with acute graft-versus-host disease (grade II-IV) frequently showed more than 50% donor-type chimerism in CD3+ cells on day 14 (P=0.029). NST patients with <50% donor-type chimerism on day 14 and with <90% donor-type chimerism on day 28 in CD56+ cells had significantly poor 1-year overall survival (0 vs 91%, P<0.001 and 20 vs 74%, P=0.002, respectively). Both NST and CST patients with <90% donor-type chimerism in CD14.15+ cells on day 28 had significantly poor 1-year overall survival (14 vs 70%, P=0.005 and 0 vs 66%, P=0.002, respectively). Our data show that the extent of donor-type chimerism in lineage-specific cells appears to have an impact on outcome after allogeneic stem cell transplantation.

Adolescent↗

A novel diagnostic method for evaluation of vascular lesions in the digestive tract using infrared fluorescence endoscopy.

BACKGROUND AND STUDY AIMS: We have developed an infrared fluorescence endoscope to evaluate gastrointestinal vascular lesions. Infrared endoscopy (IRE) after intravenous administration of indocyanine green (ICG) is used at present to examine vascular lesions such as esophageal varices. However, no previous study has compared the sensitivity of infrared fluorescence endoscopy (IRFE) with that of IRE. In this study, we compared the usefulness of IRFE and IRE. PATIENTS AND METHODS: For IRFE we used an infrared endoscope equipped with excitation and barrier filters and an intensified charge-coupled device camera. In preliminary experiments, the observable tissue depth was assessed by wrapping increasing numbers of layers of commercially available pork around a syringe containing a uniform concentration of ICG or by changing the concentration of ICG in a syringe covered by a piece of pork of uniform thickness. In the clinical part of the study, ICG was administered intravenously at different concentrations to patients with esophageal varices and the resulting infrared fluorescent images were evaluated. RESULTS: The preliminary experiments revealed that the depth of tissue that could be visualized was significantly greater in IRFE than it was in IRE (11.2 mm in IRFE vs. approximately 3.2 mm in IRE). Clear infrared fluorescence was obtained by IRFE at lower concentrations of ICG than the concentrations required to obtain clear images using IRE. In the clinical part of the study, clear infrared fluorescence was observed in a region where esophageal varices had been detected by conventional endoscopy when ICG was administered in doses of 0.005 mg/kg to 0.01 mg/kg, which was lower than the doses used in IRE. CONCLUSIONS: Compared with conventional IRE, IRFE facilitated the observation of deeper layers, and esophageal varices were observed by IRFE following the intravenous administration of a markedly reduced dose of ICG. IRFE, in combining the characteristics of reflected infrared light and fluorescence, may be a useful novel procedure in the diagnosis of vascular lesions in the gastrointestinal tract.

Aged↗

[Aortic valve replacement presence of anti-Jr(a) antibody].

A 65-year-old female with a heart murmur developed progressive symptom of chest oppression. She was diagnosed severe aortic valve stenosis with echocardiogram. Antibody screening revealed anti-Jr(a) antibody. Preoperatively, erythropoietin was administered. Over 14 days, a total 1,000 ml of her blood was drawn and stored for autologous transfusion. The aortic valve was replaced with ATS mechanical valve [18 mm advanced performance (AP)]. Following surgery, her stored blood was administered to him. But her HCT was 17% on the 1st postoperative day. Frozen thawed red cells were transferred 7th postoperative day.

Aged↗

[Carney triad; report of a case].

We report a case of Carney triad which is very rare disease composed of gastrointestinal stromal tumor (GIST), pulmonary chondroma and paraganglioma. A 15-year-old girl was reffered for treatment with multiple tumors in the left lung. At the age of 13, she underwent total gastrestomy for GIST. At that time multiple pulmonary tumors have already developed and made a diagnosis of chondroma. Progressive enlargement of their size and persistent bloody sputum made her received operation. Finally she underwent left pneumonectomy. In general all 3 tumors have manifested for a long time. Gastric tumors and paragangliomas are often lethal. This shows the necessity of intensive and long-term follow-up.

Adolescent↗

Assessment of synthetic peptides of severe acute respiratory syndrome coronavirus recognized by long-lasting immunity.

In order to determine highly immunogenic severe acute respiratory syndrome coronavirus (SARS-CoV) epitope peptides capable of inducing long-lasting immunity, we first screened immunoglobulin-G (IgG) antibodies reactive to 197 different overlapping 15-mers from the SARS-CoV proteins in the sera of three infected patients. Forty-two peptides among them were reactive to the sera from all three patients. Consequently, we tested for the reactivity of these 42 peptides to patients' sera (n = 45) at 6-month post-infection. The significantly higher levels of IgG antibodies specific to three (S791, M207 and N161) of 42 peptides were detectable in the post-infection sera from 23 (51%), 27 (60%) and 19 (42%) of 45 patients, respectively. These three peptides, recognized by their long-lasting immunity, may provide a better understanding of the immunogenicity of SARS-CoV.

Enzyme-Linked Immunosorbent Assay↗

Does compensatory hyperparathyroidism predispose to ischemic stroke?

BACKGROUND: Parathyroid hormone (PTH) is vasoactive, and the endothelium is one of the target tissues of this hormone. Hyperparathyroidism is frequently associated with hypertension. OBJECTIVE: To determine if hyperparathyroidism, which develops particularly in elderly women as a compensatory mechanism to osteoporosis, may be a risk factor for ischemic stroke. METHODS: Serum PTH levels and bone mineral density (BMD) in 107 elderly patients with ischemic stroke (>or=65 years old) were assessed on the day of onset. The control group consisted of 107 healthy volunteers matched for age and sex. RESULTS: BMD was significantly lower and serum PTH higher in female stroke patients than in control subjects; there was a negative correlation between these two measurements. One-third of the female stroke patients had a serum PTH level higher than the mean + 2 SD of the control subjects (high PTH group), and the interval between menopause and the stroke was significantly longer in the high PTH group than in the normal PTH group. Multiple logistic analyses revealed hypertension and ischemic heart disease were more prevalent in the high PTH group. BMD and PTH were normal in male stroke patients. CONCLUSION: High serum PTH level may be associated with high incidence of ischemic stroke in women, possibly through the increased incidence of hypertension.

Absorptiometry, Photon↗

Video-assisted anatomic mediobasal segmentectomy of lung.

Although video-assisted thoracic surgery (VATS) is now widely accepted, pulmonary segmentectomy is rarely performed. We present a case series of patients undergoing this procedure. The first patient had multiple arteriovenous malformations of the right mediobasal segment and a leiomyoma in the bronchus of the mediobasal segment. The second patient had multiple pulmonary metastases from colon cancer, including one in the right mediobasal segment. The third patient had metastases in the right ventrobasal and mediobasal segments from a solitary fibrous tumor that originated in the contralateral diaphragm. In the first two patients, a solitary mediobasal segmentectomy was done. In the third patient, a combined ventrobasal and mediobasal bisegmentectomy was performed. There were no complications, and visualization was excellent. Because VATS provides such excellent exposure, mediobasal segmentectomy of the lung is feasible, even though this operation is not done as an open procedure.

Aged↗

An extrapleural approach to the anterior mediastinum using video-assisted thoracic surgery (VATS).

A lateral extrapleural approach via video-assisted thoracic surgery (VATS) was used in a patient suspected of having a benign tumor of right lobe of the thymus. The patient previously had undergone lung resection for pulmonary tuberculosis, and the ipsilateral thorax had contracted and dense pleural adhesions were likely to exist. Lateral extrapleural approach by VATS was performed successfully and is an alternative to open surgery in highly selected patients with anterior mediastinal lesions.

Aged↗

Clinical significance of tissue inhibitor of metalloproteinase and matrix metalloproteinase mRNA expression in thymoma.

BACKGROUND: Matrix metalloproteinases (MMPs) are proteolytic enzymes which degrade extracellular matrix and basement membrane. There is much evidence that their increased expression is correlated with tumor aggressiveness in various carcinomas. Tissue inhibitor of metalloproteinases (TIMPs) are the specific inhibitors of MMPs. MMPs and TIMPs are considered to play an important role in carcinoma invasion and metastasis. We hypothesized that MMPs and TIMPs also play an important role in thymoma. MATERIALS AND METHODS: This study included 34 thymoma cases. The mRNA levels of MMP-1, -7, and -9, TIMP-1 and -2, and GAPDH were quantified by real-time polymerase chain reaction using LightCycler. We also performed immunohistochemistry for TIMP-1. RESULTS: The TIMP-1/GAPDH mRNA expression level was significantly higher in invasive (stage II-IV) thymomas (means +/- SE, 81.4 +/- 28.1) than in noninvasive (stage I) thymomas (30.9 +/- 8.3, P = 0.026). The MMP-1/GAPDH mRNA expression level was also higher in invasive thymomas (19.7 +/- 7.5) than in non invasive thymomas (2.26 +/- 1.72, P = 0.020). Immunopositivity of TIMP-1 was localized in stromal cells adjacent to the advancing margin of the tumor. CONCLUSIONS: These findings suggest that TIMPs and MMPs play an important role in the invasion of thymoma.

Gene Expression↗

Angioarrestin mRNA expression in early-stage lung cancers.

AIMS: Angioarrestin is a recently isolated gene, which has a novel function as an angiogenesis inhibitor. Angiogenesis plays an important role in tumorigenesis. It has been reported that the angioarrestin expression was decreased in lung cancer. We attempted to determine the influence of angioarrestin expression on clinicopathological features in patients with lung cancer who had undergone surgery. METHODS: Expression of angioarrestin messenger RNA was evaluated by a quantitative reverse transcription-polymerase chain reaction (RT-PCR) in 93 lung carcinomas and adjacent histological normal lung samples using LightCycler. RESULTS: Angioarrestin/GAPDH mRNA expression was significantly decreased in the tumor of lung cancer tissue (86.676+/-123.505) than in the normal lung tissue (1154.218+/-2003.508, p<0.0001), although only four lung cancer tissues had more than one tumor/normal ratio of angioarrestin/GAPDH mRNA expression. There was no relationship between angioarrestin gene expression and age, gender or T-status. However, decreased angioarrestin/GAPDH expression was especially seen at stage I lung cancer (54.156+/-62.783) when compared to stage II-IV lung cancer (110.315+/-151.359, p=0.0316). Decreased angioarrestin/GAPDH expression was especially seen at N0 lung cancer (56.396+/-69.941) when compared to N2 lung cancer (137.522+/-180.489, p=0.0362). CONCLUSIONS: The decreased expression of angioarrestin mRNA was the early phase phenomena for tumor progression from lung cancer. Alternatively, loss of antianiogenesis might play a role in oncogenesis for lung cancer.

Angiopoietin-Like Protein 1↗

Excited state processes in a four-component photosensitive system based on a bisimidazole derivative.

The four component system consisting of bis[2-(o-chlorophenyl)-4,5-diphenylimidazole] (Cl-HABI), N,N'-bis(diethylamino)benzophenone (EAB), N-phenylglycine (NPG) and an iodonium salt (BIP-T) can be used for the photoinitiation of radical polymerization reactions. The excited state processes involved are reported and all the transient species, including the triplet state and ketyl radical of EAB as well as the lophyl radical, are characterized. Rate constants of interaction between the different partners in the four component system are determined. Redox potentials of the different compounds are evaluated enabling the free energies for electron transfer reactions to be calculated. An overall scheme for the evolution of the excited states and a general discussion on the role played by the different components in photoinitiating polymerization are then provided.

Journal Article↗

[Prosthetic valve endocarditis after aortic valve replacement with freestyle stentless xenograft].

A 52-year-old man underwent aortic valve replacement with freestyle stentless xenograft, using subcoronary technique for active infective endocarditis in June, 2001. Eighteen month later he had late prosthetic valve endocarditis associated with aortic annular abscess due to Staphylococcus epidermidis infection. The abscess was debrided and gelatin-resorcin-formalin glue (GRF glue) was injected into the abscess cavity. Abscess cavity was closed with continuous running suture of 3-0 polypropylene stitches. Finally the aortic valve was replaced with ATS mechanical valve (20 mmAP). After administration of vancomycin and gentamicin for 4 weeks, he discharged on 57th postoperative day in good condition. We strongly suggest that GRF glue is essential to close the aortic annular abscess of combined with aortic regurgitation due to active infective endocarditis.

Aortic Valve↗

[Surgical treatment for left ventricular false aneurysm caused by infective endocarditis; report of a case].

A 24-year-old man who had left ventricular (LV) false aneurysm, which is caused by mitral valve infective endocarditis, underwent aneurysmectomy, direct closure of aneurysmal mouth and concomitant mitral valve replacement. Post-operative course was uneventful. It has been reported that the etiology of this false aneurysm was due to the vegetations' friction, which could have caused an initial endocardial ulceration that progressively expanded into the myocardium. The false aneurysmal wall should be completely removed in order to eliminate the possibility of recurrence of the infective endocarditis. We believe that the surgical treatment should be carried out as soon as possible after completion of diagnosis because the aneurysmal wall is usually quite thin and could rupture easily.

Adult↗

Amelioration of osteoporosis by menatetrenone in elderly female Parkinson's disease patients with vitamin D deficiency.

Significant reduction in bone mineral density (BMD) occurs in patients with Parkinson's disease (PD), correlating with immobilization and with vitamin D deficiency, and increasing the risk of hip fracture, especially in elderly women. As a biological indicator of compromised vitamin K status, an increased serum concentration of undercarboxylated osteocalcin (Oc) has been associated with reduced BMD in the hip and an increased risk of fracture in otherwise healthy elderly women. We evaluated treatment with vitamin K(2) (menatetrenone; MK-4) in maintaining BMD and reducing the incidence of nonvertebral fractures in elderly female patients with PD. In a random and prospective study of PD patients, 60 received 45 mg of MK-4 daily for 12 months, and the remaining 60 (untreated group) did not. At baseline, patients of both groups showed vitamin D and K(1) deficiencies, high serum levels of ionized calcium, and glutaminic residue (Glu) Oc, and low levels of parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D [1,25-(OH)(2)D], indicating that immobilization-induced hypercalcemia inhibits renal synthesis of 1,25-(OH)(2)D and compensatory PTH secretion. BMD in the second metacarpals increased by 0.9% in the treated group and decreased by 4.3% in the untreated group (p < 0.0001). Vitamin K(2) level increased by 259.8% in the treated group. Correspondingly, significant decreases in Glu Oc and calcium were observed in the treated group, in association with an increase in both PTH and 1,25-(OH)(2)D. Ten patients sustained fractures (eight at the hip and two at other sites) in the untreated group, and one hip fracture occurred among treated patients (p = 0.0082; odds ratio = 11.5). The treatment with MK-4 can increase the BMD of vitamin D- and K-deficient bone by increasing vitamin K concentration, and it can also decrease calcium levels through inhibition of bone resorption, resulting in an increase in 1,25-(OH)(2)D concentration.

Aged↗

[Surgery for multiple primary lung cancers].

Thirty-eight patients (3.4%) of multiple primary lung cancers were treated among 1,106 patients of lung cancer at Nagoya City University Hospital. Twenty-eight patients had multiple lung lesions at the same time. Ten had the second primary lung cancer from 5 to 12 years after the first operation. Thirty-six patients had the second operation, and two had adjuvant therapy for lung cancer. Their 5 year survival rate was 36%. Especially of the patients with stage I lung cancer, 5 year survival rate was 65%. Radical but less invasive operation like VATS should be chosen for their treatment.

Adenocarcinoma↗

[Therapeutic options which potentially cure patients with thymoma].

This study reports clinicopathologic features, treatment, and outcome of 107 thymomas, especially focusing on a combined modality program using hemithorax irradiation (HI) and restaging surgery using corticosteroid for advanced thymoma showing disseminative lesions. The use of HI after presumably total resection of the dissemination under posterolateral thoracotomy had no effect on reducing the incidence of relapsing. On the other hand, our own experience revealed that corticosteroid caused degenerative changes in the epithelial cells and lymphocytes of thymomas. The fact led us administer corticosteroid not only in preoperative setting but during postoperative HI. A better prognosis may be anticipated, although the follow up period is short and the number of patients involved is small.

Adrenal Cortex Hormones↗

Expression of the MTA1 mRNA in thymoma patients.

The MTA1 gene is a recently identified metastasis-associated gene which has been implicated in the signal transduction or regulation of gene expression. We examined the mRNA expression levels of the MTA1, the human homologue of the rat mta1 gene in thymoma. Expression of MTA1 mRNA was evaluated by reverse transcription polymerase chain reaction (RT-PCR) in 30 thymoma samples using LightCycler. The data was analyzed in reference to clinicopathological data. There was no relationship between MTA1 gene expression and age and gender. MTA1/GAPDH mRNA level in stage IV thymoma (6.431+/-3.404) was significantly higher than the level in stage I thymoma (2.592+/-1.902, P=0.0081). There was a tendency towards higher MTA1/GAPDH mRNA level in stage IV thymoma when compared to stage II thymoma (3.746+/-3.292, P=0.072). Thus our results show that the expression of the MTA1 gene is closely related to invasiveness in thymoma. The gene MTA1 could potentially provide information on the mechanism of tumor invasion and metastasis.

Adult↗