[Radiographic diagnosis of benign colonic tumors excluding adenoma].
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Adult↗
Biomedical subjects
M Koga
Publications and source records attributed to M Koga.
[Surgical treatment of massive pulmonary embolism--the time of the operation and its effectiveness].
The records of 6 patients undergoing pulmonary embolectomy for massive pulmonary embolism (MPE) at Kurume University Hospital during 17 years were reviewed to determine the management of surgery. The patients consisted of 2 men and 4 women. The patients' ages ranged from 29 to 68 years (mean age, 49.3 years). The records showed that one patient died of brain death after operation and the others survived. All the patients complained of chest pain, anterior chest discomfort and dyspnea. Sudden syncope was observed in 2 patients. Artificial mechanical ventilation was performed preoperatively on 3 patients. Right ventricular load was demonstrated on electrocardiograms and ultrasonograms. Pulmonary angiograms were attempted on two patients and one of them had cardiac arrest during this examination. MPE was suspected by perfusion defect of 50% to 80% of pulmonary vasculature demonstrated on lung perfusion scintigram in 4 patients. Open pulmonary embolectomy with cardiopulmonary bypass (CPB) was performed on all patients using crystalloid cardioplegia and topical cooling. Intraoperative pulmonary angiograms were performed in 4 patients to prevent residual thromboemboli. Since most thromboemboli originate below the level of the vena cava, acute double ligation of the vena cava just below the renal vein was performed to control recurrent embolism. Oral anticoagulant, warfarin, was administered for 3 months after embolectomy as prophylaxis against postoperative recurrent embolism. It is our opinion that an aggressive attitude toward pulmonary embolectomy on CPB is necessary to save lives of MPE patients. This surgical procedure is very easy and safe.
Adult↗
[Efficacy of pancreatic scan--comparison among conventional scan, SPECT and X-CT].
We studied the efficacy of pancreas scintigraphy using 75Se-selenomethionine by conventional method and SPECT in 26 patients diagnosed as pancreatic tumor or pancreatitis. X-CT was also performed in all patients and compared its efficacy with that of scintigraphy. In order to evaluate the image quality, 4 doctors analysed the images independently without clinical information and score them according to the possible abnormality. The average score of each film was adopted as an index for sensitivity, and the standard deviation was evaluated as objectiveness of the images. As for the detection of pancreatic tumor, both the sensitivity and the objectiveness of X-CT were superior to those of scintigraphies. However, evaluation by scintigraphy combined with X-CT increased the diagnostic sensitivity of pancreatitis than that of X-CT alone in some cases. These results suggest that the scintigraphy has no indication to suspected pancreatic tumor, but it still has some value in limited cases of pancreatitis. Almost no advantage was noted in SPECT combined with conventional image. Main reason was the artifact of SPECT preventing the accurate interpretation. Only benefits of SPECT were to decrease the false positive rate and to increase the objectiveness of 75Se-selenomethionine scan. When the scan is discussed as the examination, careful considerations should be done on the point of limited advantage on diagnostic efficacy and marked disadvantage of radiation to patients and environment.
Adult↗
[Radiotherapy of uterine cervix carcinoma].
Seventy-eight patients with uterine cervix cancer were treated radically with standardized radiation therapy at Teikyo University Hospital in Tokyo from January 1979 to December 1985. The age of these patients ranged from 32 to 88 years old (average age 66.0). The pathology and the stage of them were 71 cases of squamous cell carcinoma (1 in stage I, 11 in stage II, 58 in stage III and 1 in stage IV) and 7 cases of adenocarcinoma (6 in stage III and 1 in stage IV). The cumulative survival rates for 5 years by Kaplan-Meier method were 71.5% for squamous cell carcinoma stage II, 47.4% for squamous cell carcinoma stage III and 0% for adenocarcinoma stage III. Radiation injury was studied by the grading system of Kottmeier-NIRS in Japan. The incidence of the injuries for grade 2 and 3 was 12.8% (10/78), and the items of those were rectal injury 5.1% (4/78) and sigmoidal colonic injury 7.7% (6/78). The results of survival rate were fair for the squamous cell carcinoma compared with the other reports but poor for adenocarcinoma stage III. Concerning the therapy for advanced adenocarcinoma of the uterine cervix, special consideration should be given for irradiation doses or infusion chemotherapy.
Adenocarcinoma↗
Modulation of estrogen receptor and epidermal growth factor receptor mRNAs by phorbol ester in MCF 7 breast cancer cells.
Previous studies have demonstrated an inverse relationship between estrogen receptor (ER) and epidermal growth factor receptor (EGF-R) gene expression in human breast cancer cells. This relationship was further investigated in MCF 7 cells treated with 12-O-tetradecanoylphorbol-13-acetate (TPA). Exposure to 10 nM TPA resulted in a time-dependent increase in EGF-R mRNA, first apparent at 3 h and maximal between 9 and 24 h. There was a concomitant fall in ER mRNA with a maximum decline to 15-20% of control between 12 and 24 h. Although EGF-R mRNA levels declined between 24 and 72 h, both EGF-R mRNA and EGF-R binding remained above control levels and this was accompanied by a sustained depression of ER mRNA. These data support the view that ER and EGR-R gene expression is inversely regulated in human breast cancer and describe for the first time an inhibitory effect of a phorbol ester on steroid hormone receptor gene expression.
Breast Neoplasms↗
[The effects of angiographic contrast media on the aggregation and morphology of red cells in vitro].
The effects of four angiographic contrast media on the aggregation and morphology of human red cells in vitro, using microscopic observations were studied. The media included an ionic contrast medium, sodium meglumine amidotrizoate (amidotrizoate); non-ionic low-osmolal contrast media, iopamidol and iohexol; and an ionic low-osmolal contrast medium, sodium meglumine ioxaglate (ioxaglate). Strong, large aggregates formed in the control blood, without media, where aggregation of red cells was inhibited by contrast media mixed with the blood in a ratio of 2:1. Almost no aggregates were observed for amidotrizoate, an ionic contrast medium, while there were a few rouleaux formed in the presence of ioxaglate. Nearly all of the red cells aggregated in the presence of iopamidol and iohexol; iohexol produced the greater aggregation of the two. Besides rouleaux, irregular aggregates were formed with iohexol. When the contrast media were mixed with blood in a ratio of 1:2, their inhibitory effects on aggregation declined. These results clearly indicate that contrast media inhibit the in vitro aggregation of red cells, and ionic-contrast media produced more potent inhibitory effects than non-ionic media. With added NaCl and meglumine, iohexol did not induce red cell aggregation. This suggests that ionic-contrast media have greater inhibitory effects on aggregation than non-ionic media, a result of their ionic properties. Red cells were morphologically quite normal in the presence of ioxaglate, where most red cells were crenated in the presence of iopamidol and iohexol, and shrank in the presence of amidotrizoate. In the presence of iopamidol and iohexol with the osmolality adjusted to that of a saline solution, both normal red cells and crenation were observed. This suggests that non-ionic contrast media may directly effect morphological changes in red blood cells. These results revealed that ioxaglate, an ionic contrast medium, was the best in vitro medium, to prevent aggregation of red cells and crenation deformity of erythrocytes.
Contrast Media↗
[Improved contrast enhancement with a positive pressure drip infusion method and 350 mg I/ml high concentration contrast media in routine contrast enhanced CT].
Sixty cases of routine contrast enhanced CT were analyzed about the utilities of positive pressure drip infusion method using high concentration contrast media 350 mgI/ml, 100 ml. They were divided into three groups and each twenty cases were received positive pressure drip infusion method using Iohexol 350 mg/ml, 100 ml (350PP), positive pressure drip infusion method using Iohexol 300 mgI/ml, 100 ml (300PP) or conventional drip infusion method using Iohexol 300 mgI/ml, 100 ml (300DI). Enhancement effects of the liver parenchyma, the aorta and the spleen at upper, middle and lower levels of the liver were evaluated with increased attenuation on pre- and postcontrast CT. And intrahepatic contrast was evaluated with attenuation difference between liver parenchyma and intrahepatic vessels on postcontrast CT. In result, 300PP kept better enhancement effects and obtained better intrahepatic contrast than 300DI at the each level of the liver, and 350PP was still better than 300PP. The analysis of relationship between intrahepatic contrast and body weight suggested that 300PP was the optimal choice for the cases with 40-50 kg body weight and 350PP was for the ones with 50-60 kg as the infusion method of routine contrast enhanced CT. And the dose of contrast media seemed to be more needed for the cases over 60 kg body weight. 350PP and 300PP were concluded as useful, safe and simple methods for routine contrast enhanced CT of the liver.
Body Weight↗
Modulation of the growth-inhibitory effects of progestins and the antiestrogen hydroxyclomiphene on human breast cancer cells by epidermal growth factor and insulin.
The molecular basis of the growth-inhibitory effects of progestins or antiestrogens in human breast cancer has not been fully elucidated. Both direct actions and indirect actions, where the growth inhibition results from modulation of the production of, and/or the response to, growth factors, have been proposed. In this study the ability of some growth factors to modulate progestin-induced inhibition of cell proliferation was investigated in vitro, using T-47D human breast cancer cells. When T-47D cells grown in insulin-containing medium were treated for 4 to 5 days with the synthetic progestin, ORG 2058, at a concentration of 10 nM, cell numbers were reduced to 10 to 20% of control. Simultaneous treatment with epidermal growth factor (EGF) and ORG 2058 led to a partial reversal of the growth-inhibitory effect of the progestin. The magnitude of the effect of EGF was concentration dependent, being half-maximal at 0.48 ng/ml (0.08 nM) and maximal at concentrations greater than 5 ng/ml (greater than 0.8 nM), where cell numbers were increased by 50% compared to those in the presence of ORG 2058 alone. ORG 2058 was no more potent in the absence of insulin, and, after several passages in insulin-free medium, addition of insulin failed to modulate the effect of ORG 2058. However, when maximal concentrations of insulin (5 micrograms/ml) and EGF (10 ng/ml) were administered together with ORG 2058, insulin and EGF appeared to act synergistically to reduce the ORG 2058-induced inhibition of proliferation. In similar experiments in which cells were treated with hydroxyclomiphene, a potent antiestrogen, insulin was shown to partially reverse the growth-inhibitory effects of hydroxyclomiphene. Significant increases in cell number above hydroxyclomiphene-treated controls were apparent at insulin concentrations greater than 50 ng/ml, and at 5 micrograms/ml the increase was approximately 2-fold. In contrast to the situation with progestins, simultaneous treatment with EGF and insulin had only an additive effect in reversing the growth-inhibitory effect of the antiestrogen. The results are compatible with the hypothesis that part of the growth-inhibitory effects of progestin and antiestrogen on human breast cancer cell proliferation is mediated by inhibition of autocrine growth factor production. However, they do not exclude more direct mechanisms involving modulation of progesterone and/or estrogen receptors by EGF and/or insulin.(ABSTRACT TRUNCATED AT 400 WORDS)
Breast Neoplasms↗
Serial section reconstruction using a computer graphics system: applications to intracellular structures in yeast cells and to the periodontal structure of dogs' teeth.
A computer graphics system for reconstruction from serial section micrographs was applied to intracellular details of a yeast target cell (Saccharomyces cerevisiae cell) induced by the alpha factor mating pheromone and was also applied to a periodontal structure of a dog tooth moved orthodontically. In the former, intracellular organelles and a distribution of vesicles could be clearly observed through the cell membrane using the transparent display method in which the smoothing of the reconstructed outer cell membrane surface by computer processing was applied to the transparent display. In the latter case, by cutting through a reconstructed dog tooth and its periodontal tissues, labiolingual and mesiodistal cut surfaces of the tooth and of adjacent alveolar bone could be observed with fine details (232 sections were used).
Animals↗
Early carcinoma of the extrahepatic bile duct.
This study attempts to define early carcinoma of the extrahepatic bile duct through a study of 11 patients whose carcinomatous invasion did not extend to the outer layer of the bile duct. The patients were divided into the following 3 groups, namely; a mucosa group comprised of 3 patients, a fibromuscular layer group comprised of 5 patients, and an adventitia group comprised of 3 patients. None of the patients had any lymphnode metastases. Histological characteristics were determined according to infiltrative growth (INF alpha, beta, gamma), lymphatic invasion (ly), venous invasion (v) and perineural invasion (pn). In the mucosa group, INF alpha was observed in 2 patients, while ly, v, and pn factors were all negative. In the fibromuscular layer group, INF beta was seen in 3 patients, ly was positive in 2 patients, while v, and pn factors were negative in all patients. In the adventitia group, INF gamma was found in 2 patients, and ly, v, and pn factors were positive in all patients except for 1 in whom v was negative. Death from recurrence occurred in all the adventitia group patients and in 1 other patient. Early carcinoma of the extrahepatic bile duct could therefore be defined at present, as being carcinoma confined to within the mucosa and fibromuscular layer.
Adenocarcinoma↗
Therapeutic strategy for intrahepatic lithiasis.
Among the various benign biliary tract diseases, intrahepatic lithiasis is the most refractory condition to treat surgically. Recently, endoscopic treatment (mainly cholangiofiberscopic lithotomy) has been more and more frequently employed. A nationwide survey by questionnaire was conducted in 1985 to clarify the exact status of the current therapies for intrahepatic lithiasis in Japan. A total of 143 institutions (33.4%) responded to our questionnaire, and 2614 cases over a 10-year-period were collected and analyzed. Operation alone was performed in 53.8%, operation plus endoscopic treatment in 38.6%, operation plus dissolution therapy in 5.5%, operation plus endoscopic treatment and dissolution therapy in 0.04% and endoscopic treatment alone in 2.1%. The most common treatment was surgery. This was employed in 97.9% of all the patients, but endoscopic treatment was added in 40.7% of the cases to extract stones mainly intra- and/or post-operatively. Dissolution therapy was carried out occasionally, but with poor results. Conducting both adequate surgical biliary drainage and cholangiofiberscopic lithotomy may result in a marked improvement in the treatment of this intractable disease.
Cholelithiasis↗
Follistatin gene expression in the ovary and extragonadal tissues.
Follistatin is a glycosylated single-chain protein originally isolated from porcine follicular fluid. It specifically inhibits the secretion of FSH from the pituitary. We have now isolated and characterized a cDNA for rat follistatin from the PMSG-stimulated ovarian library. The deduced amino acid sequence of the rat follistatin precursor is highly homologous (greater than 98%) to porcine and human follistatins including potential Asn-glycosylation sites. The genomic clone encoding rat follistatin was also isolated and revealed that the exon and intron organization of the follistatin gene structure is conserved among rat, porcine, and human. Northern analyses in rat tissues demonstrated that the follistatin gene is expressed not only in the ovary but also in the kidney and brain. In the immature rat ovary, the follistatin mRNA level is stimulated by PMSG injection (20 IU/rat), but is not affected by human CG (10 IU/rat) after PMSG administration. In situ hybridization studies revealed that the mRNA level in the ovary was low in primordial follicles, but dramatically increased in the granulosa cells of the growing secondary and tertiary follicles and then decreased in the mature preovulatory follicles. A strong follistatin mRNA signal was observed over the collecting tubules of the outer medulla of the kidney, and a weak to moderate signal was detected in brain. The broad tissue distribution of follistatin mRNA strongly suggests other physiological roles for follistatin besides the inhibition of pituitary FSH release.
Amino Acid Sequence↗
Enzyme-immunoassay for estrogen receptors in human pituitary adenomas.
We have performed an enzyme-immunoassay for estrogen receptor on 56 human pituitary adenomas and compared the results with a single point estradiol binding assay. There was a significant positive correlation between the two assays of cytoplasmic estrogen receptor (r = 0.960). Normal human pituitaries (N = 2) had an estrogen receptor concentration of 17 fmol/mg protein by enzyme-immunoassay. Of 14 prolactinomas, 6 (43%) contained estrogen receptor with a concentration of 33.5 +/- 7.4 (mean +/- SEM) fmol/mg protein. Six of 11 (55%) macroprolactinomas were estrogen receptor-positive, whereas all 3 microprolactinomas were estrogen receptor-negative. Only one (13%) of 8 GH- and PRL-secreting adenomas, and 3 of 6 (50%) gonadotropin-secreting adenomas were estrogen receptor-positive; the latter had a concentration of 13.5 +/- 1.6 fmol/mg protein. Estrogen receptor was not detected in 21 pure GH-secreting adenomas and 7 nonsecreting adenomas. These results demonstrate the precise frequency of estrogen receptor in various human pituitary adenomas, since enzyme-immunoassay as well as single point estradiol binding assay could detect estrogen receptor even in small specimens. Enzyme-immunoassay is suitable for evaluation of estrogen receptor status in human pituitary adenomas.
Adenoma↗
1,25-Dihydroxyvitamin D3 and the regulation of human cancer cell replication.
Several human and animal cancer cell lines have been shown to possess specific high affinity receptors for 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3). The replication of several of these cell types has also been shown to be regulated by this hormone, both in vitro and in vivo. To further understand the mechanisms of these actions, we have examined cancer cells in vitro and in vivo. The in vitro studies extend our previous reports on the treatment of human breast cancer cells (T 47D) with 10(-9) to 10(-6) M 1,25-(OH)2D3, which resulted in a dose- and time-dependent decrease in cell numbers over 6 days. Treatment with 10(-8) M 1,25-(OH)2D3, which reduced cell numbers to approximately one half of those found in control cultures at 6 days, was associated with a doubling of the proportion of cells in the G2 + M phase of the cell cycle and was accompanied by a significant decline in the proportion of G0/G1 cells. At higher concentrations there was a significant decline in S phase cells with accumulation of cells in both G0/G1 and G2 + M phases. The antiestrogen, tamoxifen, at a concentration which caused similar effects on cell number, resulted in proportional decreases in both S and G2 + M phase cells and accumulation of G0/G1 cells. The effects of 1,25-(OH)2D3 on T 47D cell proliferation were associated with time- and concentration-dependent reductions in epidermal growth factor receptor levels to a minimum level of about half that seen in control cultures. The in vivo experiments extend our previous studies, which demonstrated marked inhibition of the growth of human cancer xenografts in immunosuppressed mice by 1,25-(OH)2D3. Xenograft growth was inhibited with 1,25-(OH)2D3 (0.1 microgram ip three times per week) but growth was rapidly restored when the 1,25-(OH)2D3 was withdrawn. Thus, there are clear-cut time- and dose-dependent, yet reversible, effects of 1,25-(OH)2D3 on the replication of human cancer cells in vitro and in vivo, which are possibly mediated through changes in growth factor receptor levels. Further study of these effects may advance understanding of the hormonal control of cellular replication in human cancers.
Calcitriol↗
[Prophylactic use of cefpiramide (CPM) in open heart surgery].
The concentration of cefpiramide (CPM) in serum and myocardial tissues was measured in 24 patients with open heart surgery. The regimen was given in bolus of 2 g intravenously before the commencement of cardiopulmonary bypass. Blood and tissues of the right atrial appendage and pericardium were surveyed for samples at an estimated interval after the administration of CPM. The concentration of CPM in the blood and the myocardial tissues were consistently efficacious for both gram positive and negative bacterium. The duration and dosage of CPM, selected in the study, were both satisfactory for prevention of infection in open heart surgery.
Adolescent↗
[Diagnosis of colon cancer (depth of invasion) by barium enema examination; present condition].
Accuracy of the barium enema examinations in diagnosis of the depth of invasion of the small carcinomas of the colon was reviewed. The materials included 101 sessile carcinomas and 12 small advanced carcinomas that were 20 mm or less in diameter. The carcinomas with stalks and the depressed type early carcinomas (Type IIc) were excluded from the study, because the former were impossible to the nature by X-ray examinations and the latter were extremely rare. Presence of the depressed portions on the surface of the elevated lesions observed in the frontal views and the degree of the deformity observed in the profile views of the lesions were correlated with the pathological specimen and the accuracy of the radiological diagnosis of the depth of invasion was estimated. The cases with gross malignant cell invasion into the submucosal or the deeper layers were diagnosed correctly with present radiological diagnostic criteria. But, those with a small amount of malignant cell invasion into the submucosal layer or the cases with malignant cell invasion limited to the mucosal layer (intramural cancer) were not always correctly diagnosed and there was a variety in diagnosis of the depth of invasion in this group. With the current radiological techniques, proper profile views of the lesions were not obtained in quite a few cases, nor the surface characteristics of the small elevated lesions were well documented. It would probably be possible to improve these techniques and to improve diagnostic accuracy to some extent, but with certain limitations.
Barium Sulfate↗
[A human infection of the cestode, Diphyllobothrium nihonkaiense Yamane et al., 1986].
A mature cestode, obtained from a 49-year-old man in Fukuoka, southern Japan, was examined. The worm was about 70 cm in length without scolex. The largest segment was 1.8 x 0.8 cm. Cirrus sac lay at an obtuse angle (about 150 degrees) to seminal vesicle. The eggs were 62.06 +/- 9.40 x 43.33 +/- 6.43 microns and the shell thickness 1.0-1.5 microns, with round, shallow and sparsely distributed surface pits ranging 0.8-2.0 microns in diameter. The above features suggested that this worm was identified as the cestode, Diphyllobothrium nihonkaiense.
Animals↗
Genetic instability and the development of steroid hormone insensitivity in cultured T 47D human breast cancer cells.
The estrogen receptor (ER)-positive human breast cancer cell line T 47D exhibited genetic instability under cell culture conditions which maintained almost continuous exponential growth. This resulted in the spontaneous generation of three ER-positive sublines with a range of DNA ploidies and distinctive phenotypes. One of these sublines, T 47D-5, exhibited resistance to the growth-inhibitory effects of the synthetic nonsteroidal antiestrogen tamoxifen and the synthetic progestin ORG 2058, in marked contrast to "wild type" T 47D cells (designated T 47D-7 in this study). T 47D-5 cells were cloned by limiting dilution and 11 clonal cell lines were tested for sensitivity to tamoxifen. Although all clones of T 47D-5 were significantly less sensitive than T 47D-7 cells, a spectrum of sensitivities was observed. Three clones, T 47D-5-13, T 47D-5-21, and T 47D-5-23, were further characterized by measuring the concentrations of receptors for estrogen, progesterone, growth hormone, and epidermal growth factor and responses to estradiol, tamoxifen, and progestin, in terms of both induction of specific proteins and effects on cellular proliferation. Although the T 47D-5 subline and clone T 47D-5-23 were insensitive to both the growth-stimulatory effects of estradiol and the inhibitory effects of tamoxifen, this was not related to the concentration of ER or its ability to induce progesterone receptor. Estrogen receptor levels were similar in resistant and sensitive clones of T 47D-5 [70,000-81,000 sites/cell] and were 2.5-fold greater than in the sensitive T 47D-7 line [32,600 +/- 5,000 (SEM) sites/cell]. Northern blots showed no difference in the size of ER mRNA transcripts between sensitive and resistant clones. Estradiol treatment increased progesterone receptor (PR) levels in all cell lines but the magnitude and sensitivity of this response were unrelated to growth responses indicating a divergence in estrogenic control of cellular proliferation and specific protein synthesis within these clones. T 47D-5, T 47D-5-13, T 47D-5-21, and T 47D-5-23 were all insensitive to the growth-inhibitory effects of ORG 2058. The progestin was also unable to increase lactogenic and epidermal growth factor receptor concentrations in these four lines in contrast to the response in T 47D-7 cells. The insensitivity to progestin in the T 47D-5 subline and its three clonal cell lines could be accounted for, in part, by a 75-80% reduction in PR levels when compared with T 47D-7 cells.(ABSTRACT TRUNCATED AT 400 WORDS)
Breast Neoplasms↗