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Biomedical subjects

M Sasaki

Publications and source records attributed to M Sasaki.

At least 199 records · Page 11Linked to original sources
PubMed2001

[Bladder carcinoma producing granulocyte colony-stimulating factor (G-CSF): a case report].

An 84-year-old male was admitted to our hospital with complaints of leg edema and general fatigue. He had undergone transurethral resection of transitional cell bladder cancer, grade 3, pT1b, one year previously. The computed tomographic scan revealed a hypoattenuating bladder tumor, protruding extravesically. Laboratory examination showed remarkable leukocytosis of 46,900/mm3 in the peripheral blood and high value of granulocyte colony-stimulating factor (G-CSF) 226 pg/ml (normal: less than 30 pg/ml). The resection of the tumor (partial cystectomy) was performed. The histological diagnosis was transitional cell carcinoma, grade 3. The production of G-CSF was confirmed by immunohistochemical examination in the recurrent tumor and the surgical sample from the transurethral resection. The leukocyte count in the peripheral blood decreased to the normal range after surgery. But leukocytosis recurred one month postoperatively and the computed tomographic scan revealed intrapelvic tumor recurrence. He died due to drastic progression of recurrent tumor at three months postoperatively.

Aged↗
PubMed2001

[Clinical usefulness of FDG-PET in oncology].

The clinical diagnosis of tumors is mainly performed using conventional radiography, CT, MRI, and ultrasonography, which provide anatomic and morphologic information. On the other hand, nuclear medicine imaging, which exploits the biochemical aspects of tissue, is considered to be useful for the characterization of tumors but is still clinically underutilized. Positron emission tomography (PET) with 2-deoxy-2-[18F] fluoro-D-glucose(FDG), an in-vivo imaging method that measures glucose metabolism, has been used to detect tumors with increased glucose metabolism. Over the past 20 years, numerous reports have demonstrated the usefulness of FDG-PET in diagnosing tumors, although FDG-PET has only been performed at a small number of institutions. Since FDG-PET has been shown to be superior to other morphologic imaging modalities in diagnosing tumors, FDG-PET has now become widespread at many institutions and has also been incorporated into the clinical pathways for disease management. FDG-PET is a safe and cost-effective method with several advantages over morphologic imaging and is already covered by many insurance companies in a variety of countries. This article discusses the current application of FDG-PET in oncology, especially regarding lung cancer, malignant lymphoma, and thyroid cancer. In addition, practical approaches for the clinical use of FDG-PET are discussed.

Fluorodeoxyglucose F18↗
PubMed2001

[A case of bronchioloalveolar cell carcinoma with bilateral diffuse interstitial infiltrative shadow during the treatment of Takatsuki's disease].

A 54-year old man treated with Takatsuki's disease was referred to us complaining of cough and excessive sputum. A chest roentgenogram showed bilateral diffuse interstitial infiltrative shadow. Chest CT showed banding shadows around the bronchioles and lobule-septum thickening in the right middle and both lower lung fields, and many small nodules in both lower lung fields. The histological diagnosis was adenocarcinoma replaced with one layer of bronchiolar epithelium, and partly bronchiolo-alveolar carcinoma. The patient received 3 courses of combination chemotherapy with docetaxel and cisplatin. After chemotherapy, the chest CT showed no change. The clinicopathological characteristics of this rare case included adenocarcinoma mixed with bronchioloalveolar carcinoma, in which radiography showed bilateral diffuse interstitial infiltrative shadow.

Adenocarcinoma↗
PubMed2001

[A child case of subarachnoid hemorrhage triggered by head injury: a case report].

We report a case of basal subarachnoid hemorrhage in a child. The etiology of this lesion was difficult to diagnose. The patient was a 9-year-old boy. He sustained minor head injury followed by loss of consciousness and cardiopulmonary arrest. He was brought to our emergency room by ambulance. On arrival, he presented with cardiopulmonary arrest and deep comatose state. Basal subarachnoid hemorrhage was revealed on CAT scan. 3D-CTA documented two bulging portions: one was at the junction between the left vertebral artery and the left posterior inferior cerebellar artery. The other one was shown at the basilar artery. He died on the 7th hospital day. The autopsy revealed a laceration of the left vertebral artery. Microscopically, the wall around the laceration showed a defect in the internal elastic membrane and a decrease of smooth muscle cells with moderate fibrosis in the tunica media. These findings were compatible with the structure of a congenital aneurysm. Hence, the patient was strongly suspected to have had a congenital aneurysm whose rupture was triggered by minor head injury.

Aneurysm, Ruptured↗
PubMed2001

[Three cases of Costello syndrome presenting with intractable epilepsy and profound psychomotor retardation/regression].

We report three cases of Costello syndrome (CS) presenting with intractable epilepsy and profound psychomotor retardation/regression. Previous reports on CS described mild to moderate psychomotor retardation, and epilepsy in only 8% of the cases. The details of these neurological complications have not been reported so far. All the present cases had intractable epilepsies and profound psychomotor retardation/regression. Two of them had symptomatic localization-related epilepsies and the other had Lennox-Gastaut syndrome following West syndrome. Unusual complication of profound psychomotor retardation/regression in our cases seems to be caused by intractable epilepsy. It should be noted that CS patients with epilepsy may have more severe central nervous symptoms than those previously reported.

Abnormalities, Multiple↗
PubMed2001

Paroxysmal discharges on EEG in young autistic patients are frequent in frontal regions.

EEGs were recorded in 86 autistic patients during sleep. Epileptic discharges were observed in 37 cases (43%). Twenty-seven (73%) of these 37 cases had localized spikes, 8 had multiple spike foci, one had generalized spikes, and one had both multiple spike foci and generalized spikes. Forty-seven epileptic discharge foci were registered in 36 cases, the exception being one with generalized spikes. Thirty-six (76.6%) of the registered 47 epileptic discharge foci were in the frontal region, one (2.1%) in the temporal region, 7 (14.1%) in the centro-parietal region, and 3 (6.4%) in the occipital region. Twenty (55.6%) of the 36 frontal spikes were at midline (11 at Fz and 9 at Cz), 8 on the left side, and 8 on the right side. The dipole of midline spikes was in the deep midline frontal region. These results suggest that frontal dysfunctions are important in the mechanism of symptoms in autism.

Adolescent↗
PubMed2001

[Hepatic resection for synchronous liver metastases of gastric cancer].

Since 1970, we have treated 125 patients with synchronous liver metastases from gastric cancer. We analyzed 4 of these 125 patients who underwent hepatic resection, and studied the indications for hepatic resection. There were 3 H1 patients and 1 H2 patient. Lateral segmentectomy was performed for 2 patients and partial segmentectomy was performed for 2 patients. Hepatic arterial infusion (HAI) chemotherapy followed by surgery was performed for patients, one of whom died of recurrence in the residual liver at 49 months. The other patient has survived without recurrence for 30 months. Two patients without HAI died after 11.3 months and 1.9 months, respectively. The survival time of 3 H1 patients who underwent hepatectomy was 30.2 months, while that of the other H1 patients without hepatectomy was 8.3 months. In conclusion, when local control is obtained during surgery and the liver metastasis is H1 in a patient with synchronous liver metastasis of gastric cancer, aggressive hepatectomy supported by HAI should be performed to improve the prognosis.

Aged↗
PubMed2001

[Multiple focal cortical dysplasias presenting with intractable epilepsy: case report].

A 14-year-old female, who had intractable epilepsy associated with multiple focal cortical dysplasias (FCD), was reported. She developed intractable epilepsy at the age of 7 and was diagnosed as having frontal lobe epilepsy based on the seizure semiology and interictal EEG. MRI revealed multiple lesions in the right frontal, bilateral occipital and left parietal lobes. EEG demonstrated that ictal discharge was preceded by spike on the right frontal region and FDG-PET showed hypometabolic area in the right frontal lobe. Chronic subdural electrode recordings from the right frontal lobe indicated that ictal onset zone was located around the right frontal lesion, especially frontal tip and base, and these areas including the lesion were resected. Postoperatively, residual seizure was noted although seizure frequency was decreased. It is well known that, postoperatively, satisfactory seizure outcome can be obtained in patients with FCD. However, further investigation in terms of surgical indication and strategies for multiple FCD should be needed.

Adolescent↗
PubMed2001

Flk-1 specific kinase inhibitor (SU5416) inhibited the growth of GS-9L glioma in rat brain and prolonged the survival.

BACKGROUND: Accumulating evidences suggest that tumor growth and metastasis depend on angiogenesis. At present, plenty of efforts are made to discover a chemical compound that specifically inhibits tumor angiogenesis either by reducing pro-angiogenic factor or increasing anti-angiogenic factors. OBJECT: SU5416, a novel, synthetic, potential inhibitor of angiogenesis specifically blocks the Flk-1/KDR tyrosine kinase activity. In vivo effect of SU5416 in the treatment of intracranial tumors has not been previously described. METHODS: We transplanted GS-9L cells into the right caudate nucleus of male Fisher 344 rats and administrated SU5416 intraperitoneally (i.p.) to investigate the impact of SU5416 on tumor angiogenesis and growth in vivo. Starting on Day 1 or Day 8, forty-two animals were treated with SU5416 at three different doses (e.g. 12.5, 25.0 and 50.0 mg/kg body weight) via i.p. injection every day until the end-point. As a control, seven animals received no treatment and after implant fourteen animals were treated with vehicle (DMSO) only. RESULTS: SU5416 prolonged the survival in the treated groups without any significant systemic adverse effect. Median survival in the treated group started on Day.1 was statistically longer compared to that in the control groups (p<0.01). Histological analysis of the treated tumors showed an increase in necroses and reduced in vascularity compared to the control tumors. Furthermore, the number of apoptotic cells increased in the treated tumors on a TUNEL stain. CONCLUSION: Small molecular compounds, such as SU5416 may be useful therapeutics that specifically inhibits the enzymatic activity of Flk-1 kinase and downstream events of tumor angiogenesis.

Animals↗
PubMed2001

[How to support the death at home].

Forty-three patients who were taken care of at home were divided into three groups according to the place of their death to examine the cause of death at home and to improve the home care service, especially for supporting the death at home. Group A included 15 patients who died at home, group B included 22 patients who died at the hospital and group C included 6 patients who were transferred to our hospital by ambulance to confirm they were dead. In group A, 8 patients died from cancer, 5 from old age, 1 from chronic heart failure and 1 from Wernicke's encephalopathy. In group B, 8 patients died from pneumonia, 3 from other acute diseases, 4 from cancer, 4 from other chronic diseases. In group C, 5 patients died from old age and 1 from cancer. After the home care service was changed to 24-hour support, the number of patients who died at home increased from 1 to 14, and the emergency transfer by ambulance decreased from 5 to 1. The patients with chronic and gradually deteriorating conditions, such as cancer and aging itself, tend to die at home and this is effectively supported by the 24-hour home medical care service.

Aged↗
PubMed2001

[The care insurance and the patients of at home care].

Thirty-one patients used the at-home nursing care service provided by our hospital. However, they were also taken care of by old family members, mostly 60 years old or more, thus only 23.8% of the maximum Care Insurance was used. The average insurance, for the service is 6,312 yen, which does not increase according to the level of care the patient required. Especially, the expenses regarding the home bathing service, which is the most used, have doubled since the Care Insurance started. The family of most patients may not be able to pay more than 10,000 yen every month for the care of old and handicapped people. The increased expenses can become an obstacle regarding the promotion of at-home care.

Home Care Services↗
PubMed2000

Molecular cloning and functional characterization of a novel nuclear receptor similar to an embryonic benzoate receptor BXR.

Benzoate X receptor (BXR) is a member of the nuclear hormone receptor superfamily and is activated by alkyl esters of amino benzoic acids and expressed during early development stages. We report here a second BXR, which was cloned by screening Xenopus laevis embryonic cDNA libraries. This new BXR, termed BXRbeta, exhibits 97% identity in the DNA-binding domain and 79% identity in the ligand-binding domain in amino acid sequence to previously reported Xenopus BXR. The BXRbeta strongly binds as a heterodimer with retinoid X receptor (RXR) to direct repeats of an AGGTCA motif spaced 4 or 5 base pairs apart and activates transcription by addition of methyprednisolone and dexamethasone as well as amino- and hydroxybenzoates.

Amino Acid Sequence↗
PubMed2000

Kdap, a novel gene associated with the stratification of the epithelium.

The skin develops and differentiates during embryogenesis, which is concertedly regulated by a variety of genes. The present study isolated from the rat embryonic skin a novel differentiation-associated gene named Kdap (keratinocyte differentiation-associated protein) by suppression subtractive hybridization between the skin of 14day postcoitus (dpc) embryo (the prehair-germ stage) and that of 17dpc embryo (the hair-germ stage). Its mRNA contained four spliced forms in these tissues. The gene encoded a protein of total 98 amino acids with a calculated molecular mass of 11kDa and an isoelectric point of 6.1 as an unspliced form. The two splicing zones were well conserved among rat, mouse, and human. This protein had a high hydrophobic N-terminal region, a possible signal sequence, and contained two putative N-myristoylation sites and two casein kinase II phosphorylation sites. In situ hybridization experiments detected Kdap transcripts exclusively in the suprabasal cell layers of the embryonic epidermis. Intense expression was also seen in suprabasal cells in regions of infundibulum of the hair follicle. These results indicated that Kdap provides a new insight into the mechanism of differentiation and the maintenance of stratified epithelia.

Amino Acid Sequence↗
PubMed2000

Dynamic regulation of neuronal NO synthase transcription by calcium influx through a CREB family transcription factor-dependent mechanism.

Neuronal nitric oxide (NO) synthase (nNOS) is dynamically regulated in response to a variety of physiologic and pathologic stimuli. Although the dynamic regulation of nNOS is well established, the molecular mechanisms by which such diverse stimuli regulate nNOS expression have not yet been identified. We describe experiments demonstrating that Ca(2+) entry through voltage-sensitive Ca(2+) channels regulates nNOS expression through alternate promoter usage in cortical neurons and that nNOS exon 2 contains the regulatory sequences that respond to Ca(2+). Deletion and mutational analysis of the nNOS exon 2 promoter reveals two critical cAMP/Ca(2+) response elements (CREs) that are immediately upstream of the transcription start site. CREB binds to the CREs within the nNOS gene. Mutation of the nNOS CREs as well as blockade of CREB function results in a dramatic loss of nNOS transcription. These findings suggest that nNOS is a Ca(2+)-regulated gene through the interactions of CREB on the CREs within the nNOS exon 2 promoter and that these interactions are likely to be centrally involved in the regulation of nNOS in response to neuronal injury and activity-dependent plasticity.

Animals↗
PubMed2000

Warm ischemia and reperfusion injury in diet-induced canine fatty livers.

BACKGROUND: Fatty liver is associated with primary nonfunction after liver transplantation, contributing a shortage of suitable liver grafts. Because extensive investigation of mechanisms underlying such nonfunction has been limited largely to rodents, we made a new fatty liver model in dogs and studied primary nonfunction after warm ischemia. METHODS: We developed a diet rich in fat but deficient in choline to induce fatty change in canine liver and investigated effects of 60 min of warm ischemia and reperfusion in dogs with such fatty livers. RESULTS: Microscopically evident steatosis increased with duration of dietary manipulation (up to 12 weeks), as did hepatic total lipid and triglyceride levels. No dog with >30% of steatotic hepatocytes, >445 mg/g hepatic total lipid or >145 mg/g hepatic triglyceride survived after 60 min of warm ischemia. Arterial ketone body ratios decreased and blood endotoxin increased after reperfusion in nonsurvivors. The main histologic finding in livers of nonsurvivors was marked sinusoidal congestion. CONCLUSIONS: Damage to hepatocytes and nonparenchymal cells after warm ischemia and reperfusion was thought to be closely related to sinusoidal microcirculatory disturbances in fatty livers. The canine fatty liver model reported here may be useful in studying the pathology of primary nonfunction and in establishing criteria for allowable degrees of fatty change in potential liver grafts.

Alanine Transaminase↗
PubMed2000

Rapid immunologic diagnosis of classic late infantile neuronal ceroid lipofuscinosis.

OBJECTIVE: To establish a new method for rapid diagnosis of late infantile neuronal ceroid lipofuscinosis (LINCL, CLN2) using specific polyclonal antibodies against the CLN2 gene product. METHODS: Cells and tissues were obtained from five patients with LINCL, two with variant type NCL, three with other lysosomal storage diseases, and eight control subjects. Two antibodies were raised against N- and C-terminal peptide fragments of the normal product of the CLN2 gene. The authors examined the possibility of diagnosis of LINCL with immunostaining and immunoblotting using specific antibodies made of the recently identified defective gene in LINCL. RESULTS: Immunoreactivity with these antibodies showed the absence or marked reduction of CLN2 immunoreactivity in the lymphocytes, lymphoblasts, and fibroblasts of all five patients with LINCL examined. CONCLUSIONS: These results indicate the usefulness of this diagnostic method based on the changes in CLN2 immunoreactivity. This relatively simple, specific, and cost-effective method is a promising diagnostic tool for this disease, although additional studies are necessary.

Aminopeptidases↗
PubMed2000

Prognosis of primary testicular seminoma: a report on 57 new cases.

Most urologists perform adjuvant radiation therapy for stage 1 (TxN0M0) testicular seminoma after orchiectomy, although the majority of patients with clinical stage 1 seminoma do not have occult metastases and therefore do not require elective nodal irradiation. However, there are currently no clinical or histological parameters that can be used to distinguish patients who need radiation therapy from those who do not. We reported previously that estimates of volume-weighted mean nuclear volume (MNV) were a better predictor of the prognosis of prostate cancer and renal cell carcinoma than subjective histological grading. Here, we examined the usefulness of estimation of MNV for predicting the prognosis of primary testicular seminoma. A retrospective study of 57 patients with testicular seminoma diagnosed between April 1981 and March 1997 at Kobe City General Hospital was performed. Unbiased estimates of MNV data were compared for prognostic value with the level of beta-human chorionic gonadotropin (beta-HCG), alpha-fetoprotein (AFP), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH). Fifty patients were stage 1 (TxNoMo), and 7 patients were stage 2 (TxN1-2M0). All patients received orchiectomy, followed by radiation therapy. Estimates of MNV of stage 2 patients were significantly larger than that of stage 1 patients (P = 0.0142). Although the LDH level was also significantly higher in stage 2 (P = 0.001), there were no significant differences between stages 1 and 2 with respect to beta-HCG (P = 0.997), ALP (P = 0.226), and AFP (P = 0.467). Multivariate logistic regression analysis revealed that the estimate of MNV was the only variable predicting lymph node metastasis (P = 0.0315). In stage 1 patients, only the estimate of MNV was significantly correlated with progression-free survival (P = 0.0118). These findings indicate that the estimate of MNV may be an important prognostic indicator for testicular seminoma. Estimates of MNV may also be useful for excluding patients from surveillance protocols.

Alkaline Phosphatase↗