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Biomedical subjects

M Ueno

Publications and source records attributed to M Ueno.

At least 163 records · Page 9Linked to original sources

[A gastrointestinal radiographic study of 18 patients with esophageal adenocarcinoma arising from Barrett's epithelium].

Gastrointestinal radiographs were reviewed with pathological correlation in 18 patients with histologically proven esophageal adenocarcinoma arising from Barrett's epithelium. Comparison was also made with postoperative radiographs of resected esophageal specimens from 3 of the patients. Esophageal carcinoma could be observed in the gastrointestinal radiographs in 17 of the 18 patients. In 14 of the 17, the classification based on the gastrointestinal radiographs was consistent with the gross classification. In 10 of the 18 patients, rough mucosa was seen on gastrointestinal radiographs in the same area in which Barrett's epithelium was observed in the histopathological specimens. Sliding esophageal hiatus hernia was present in 12 of the 18 patients, a relatively high incidence. Regular granular or reticular shadows were observed on the mucosal surface of the esophagus on the postoperative radiographs of 3 patients. It is believed that a diagnosis of Barrett's epithelium can be made from gastrointestinal radiographs if these mucosal patterns are present. Although a definitive diagnosis of Barrett's epithelium based on upper gastrointestinal radiographs is considered difficult, the presence of rough mucosa in the esophagus around the carcinoma in combination with esophageal hiatus hernia are suggestive of esophageal adenocarcinoma arising from Barrett's epithelium.

Adenocarcinoma↗

[Therapeutic strategy for adenocarcinoma in Barrett's esophagus: a study based on a comparison with squamous cell carcinoma].

The therapeutic strategy for adenocarcinoma in Barrett's esophagus is discussed based on a comparison with squamous cell carcinoma. The pattern and range of lymph node metastasis of adenocarcinoma in Barrett's esophagus is similar to that of squamous cell carcinoma, as is the pattern of recurrence. Chemotherapy is less effective, except for some reports on paclitaxel, but chemoradiation therapy is comparable in effect. The general tendency of a better prognosis for patients with carcinoma in Barrett's esophagus is the result of several factors, such as earlier detection of the disease, lower probability of lymph node metastasis, and distal location which permits less radical curative surgical procedures without cervical and superior mediastinal lymph node dissection. In principal the therapeutic strategy for adenocarcinoma in Barrett's esophagus should be determined like that for squamous cell carcinoma, taking into account the location of the lesion and the depth of invasion.

Adenocarcinoma↗

[A case of hypertensive intracerebral hemorrhage associated with ipsilateral internal carotid artery occlusion].

We report a case of intracerebral hemorrhage associated with ipsilateral internal carotid artery occlusion. The patient was a 54-year-old man, who developed a small cerebral hemorrhage in the left internal capsule. He was admitted with mild right hemiparesis to out hospital. Left carotid angiography showed an occlusion at the origin of the internal carotid artery. Right cerebral angiography revealed the slow filling of cerebral arteries of left hemisphere by the cross flow. He was treated conservatively. Two days after admission, the neurological examination revealed no notable abnormalities. The etiology of hemorrhage of this case is presumed as the arterial necrosis due to hypertension. There has been no report on the intracerebral hemorrhage associated with ipsilateral internal carotid artery occlusion. Our case suggests that the volume and enlargement of cerebral hemorrhage may be influenced by cerebral perfusion pressure.

Carotid Stenosis↗

Liver cirrhosis with marked thrombocytopenia and highly elevated serum thrombopoietin levels.

Three patients with liver cirrhosis (LC) and a bleeding tendency due to marked thrombocytopenia of less than 20 x 10(9)/l were admitted to our hospital for further examination. Bone marrow examination revealed megakaryocytic hypoplasia in all three patients. All patients exhibited amegakaryocytic thrombocytopenic purpura, myelodysplastic syndrome, or bone marrow hypoplasia. 111In-labeled platelet kinetic studies revealed decreased platelet production in all patients. Although serum thrombopoietin (sTPO) levels are usually within the normal level in patients with LC, the sTPO levels of our patients were about 10 times higher than the levels of normal subjects (1.22 +/- 0.37 fmol/ml): 13.34, 16.79, and 10.46 fmol/ml, respectively. These sTPO data supported our findings of decreased megakaryopoiesis. Our findings suggest that examination of sTPO levels is useful in determining the etiology of marked thrombocytopenia in LC patients.

Blood Platelets↗

Significance of increased oxygen extraction fraction in five-year prognosis of major cerebral arterial occlusive diseases.

UNLABELLED: In major cerebral arterial occlusive diseases, patients with increased oxygen extraction fraction (OEF), which is measured with PET, may be at increased risk for cerebral ischemia. However, the clinical significance of increased OEF remains unclear. This study investigated whether increased OEF is an independent predictor of 5-y risk of subsequent stroke. METHODS: We prospectively evaluated the relationship between the regional hemodynamic status of cerebral circulation and the subsequent risk of stroke in 40 patients with symptomatic internal carotid or middle cerebral arterial occlusive diseases who underwent PET. Patients were divided into two hemodynamic categories according to the mean hemispheric value of OEF-in the hemisphere supplied by the artery with symptomatic disease: one group with increased OEF and one with normal OEF. All patients were followed for 5 y with medical treatment until the recurrence of stroke or death. RESULTS: During 5 y, 11 total and 9 ipsilateral ischemic strokes occurred. The incidences of all ischemic strokes in patients with increased OEF and in those with normal OEF were 5 of 7 and 6 of 33 patients, respectively. There were 4 ipsilateral ischemic strokes in patients with increased OEF and 5 in those with normal OEF. Kaplan-Meier analysis revealed that the risks of all stroke and ipsilateral ischemic stroke in patients with increased OEF were significantly higher than in those with normal OEF (log-rank test; P<0.0002 and P<0.0018, respectively). Multivariate analysis with the Cox proportional hazards model showed that increased OEF significantly increased stroke recurrence: the relative risk was 7.2 (95% confidence interval [CI], 2.0-25.5; P<0.005) for all stroke and 6.4 (95% CI, 1.6-26.1; P<0.01) for ipsilateral stroke. An increase in the absolute OEF value was a better predictor of recurrent ischemic stroke than was OEF asymmetry. CONCLUSION: These findings suggest that an increased OEF is an independent predictor of 5-y risk of subsequent stroke. Identification of patients with increased OEF may have clinical significance in preventing recurrent stroke.

Adult↗

Recurrence of IgA nephropathy 17 months after renal transplantation in the allograft transmitted thin basement membrane disease (TBMD) from donor.

Recurrence of IgA nephropathy (IgAN) following renal transplantation has been described in 40-50% of such patients and it usually has a good outcome. We present the case of a 20-yr-old woman with IgAN who developed end-stage renal failure in 1995. In November 1996, she received a kidney from a living-related donor and was treated with tacrolimus, azathioprine and steroids. Zero- and one-hour biopsies were performed, which revealed minor glomerular abnormalities in light microscopy, thin basement membrane disease (TBMD) in electron microscopy. Eight months later she developed microscopic hematuria and proteinuria; however, the graft function was normal. Renal biopsy revealed an IgAN that is thought to be due to recurrence of the original disease.

Adult↗

Cologastric fistula and colonic perforation as a complication of percutaneous endoscopic gastrostomy.

Cologastric fistula has rarely been reported as a complication of percutaneous endoscopic gastrostomy (PEG). We encountered a patient in whom this problem went unrecognized for 2 years. After the initial PEG tube was changed, the second PEG tube was advanced into the colon, causing severe diarrhea. When a third PEG tube was inserted, acute peritonitis occurred because of colonic perforation. We discuss the mechanism of this complication and technical points related to its prevention.

Aged↗

Identification of a human homolog of the Drosophila neuralized gene within the 10q25.1 malignant astrocytoma deletion region.

The loss of chromosome 10 is the most frequent genetic alteration found in malignant astrocytomas. In particular, the long arm of chromosome 10 was previously reported to have two or more common deletion regions where tumor suppressor genes may be located. In this study, we performed deletion mapping of 44 malignant astrocytomas using 12 microsatellite markers on chromosome 10q and demonstrated that the minimal common region of loss of heterozygosity (LOH) was present between D10S192 and D10S566 localized at 10q25.1. Subsequently, we have identified a novel gene, termed h-neu, within the region frequently deleted and found that h-neu encodes a protein with strong homology to the Drosophila neuralized (D-neu) protein. Northern blot and RT-PCR analyses revealed that h-neu mRNA was expressed at very low levels in human malignant astrocytoma tissues and the majority of glioma cell lines examined, while normal brains expressed h-neu transcript. Furthermore, DNA sequencing analysis of the h-neu transcript revealed one of the glioma cell lines, U251MG, had a single nucleotide substitution which resulted in an amino acid change from glycine (GGC) to serine (AGC) at codon 253. The D-neu gene is known to serve a critical function in neurogenesis in Drosophila, and loss-of-function mutations produce hyperplasia of primitive neuronal cells. These observations led us to hypothesize that h-neu gene plays a role in determination of cell fate in the human central nervous system and may act as a tumor suppressor whose inactivation could be associated with malignant progression of astrocytic tumors.

Amino Acid Sequence↗

Dose-Response Effect of Dietary Docosahexaenoic Acid on Fatty Acid Profiles of Serum and Tissue Lipids in Rats.

The dose-response effects of dietary docosahexaenoic acid (22:6n-3, DHA) on the fatty acid profiles of total lipids of rat serum and tissues were investigated. Rats were fed diets containing graded levels of purified DHA at 0, 1.0, 3.4, and 8.7% of total energy in the diets for 2 weeks. It was found that each tissue had its own peculiar composition of fatty acids which differed markedly from that of circulating serum lipid. This composition was basically influenced dose-dependently by the dietary lipids with graded levels of DHA, but to different degrees in different tissues. Those of brain were most resistant and of heart most susceptible to dietary DHA.

Journal Article↗

Effects of systemic and regional chemotherapy after hepatic resection for colorectal metastases.

BACKGROUND: Although the survival benefit of hepatic resection for colorectal metastasis has been established, some controversy remains regarding the significance of adjuvant chemotherapy after hepatic resection. METHODS: One hundred thirty-two consecutive patients who had liver resection for colorectal metastasis at our hospital between 1980 and 1997 were studied. After curative hepatic resection, 37 patients underwent systemic chemotherapy, administered orally or intravenously, and 38 patients underwent regional chemotherapy, given intra-arterially or intraportally. Forty patients had no adjuvant chemotherapy. The chemotherapeutic agents used for oral administration were uracil and Tegafur or Tegafur alone. Mitomycin C (MMC) or 5-FU was used for IV chemotherapy. Combinations of 5-FU/leucovorin or MMC/5-FU (doxorubicin) were used for regional chemotherapy. Univariate and multivariate analyses were applied to test the significance of adjuvant chemotherapy for patient survival or disease-free survival. RESULTS: Overall 5-year survival was 42.2% (95% CL: 31.2%, 53.2%). Among the possible prognostic factors studied, univariate analysis showed a significant difference in survival based on the number of tumors and lymph node metastases in the hepatic hilum. There was a significant difference in disease-free survival based on adjuvant chemotherapy and lymph node metastasis. The multivariate analysis for patient survival selected four prognostic factors (P < .05), including adjuvant chemotherapy, lymph node metastasis, disease-free interval, and tumor size. The multivariate analysis for disease-free survival selected adjuvant chemotherapy, lymph node metastasis, and disease-free interval as significant factors. The most common recurrence site was remnant liver, regardless of adjuvant chemotherapy. CONCLUSIONS: Adjuvant chemotherapy significantly improved survival and disease-free survival after hepatic resection for colorectal metastases. It did not decrease recurrence rate in the remnant liver.

Administration, Oral↗

Pancreatic metastasis from a lung cancer. Preoperative diagnosis and management.

A case of a surgically resectable solitary metastasis to the pancreas from a lung cancer, confirmed by immunohistochemical staining (PE-10), is reported. ERCP revealed meniscoid interruption of the main pancreatic duct, which is uncommon in patients with primary pancreatic cancers of the pancreas in our hospital. This patient lived for 29 mo after the surgical resection of the pancreatic lesion. Therefore when metastasis limited to the pancreas is evident on clinical imaging, surgical management may be more optimal than other treatment approaches.

Adenocarcinoma↗

Protein kinase C modulates the synthesis of nitric oxide by osteoblasts.

To determine the involvement of protein kinase C (PKC) in nitric oxide (NO) synthesis of osteoblast, a combination of proinflammatory cytokines (tumor necrosis factor-alpha, interferon-gamma, bacterial lipopolysaccharide) were added on rat osteoblast-like cells. Results show that these cytokines clearly enhanced the synthesis of NO. The activation of PKC with phorbol ester also resulted in the stimulation of NO synthesis in these cells. These cytokines activated PKC and increased the levels of intracellular Ca2+. In addition, the cytokine-induced synthesis of NO was blocked by PKC inhibitors. Findings suggest the involvement of PKC in the synthesis of NO by rat osteoblasts.

Animals↗

Ultrastructural and permeability features of microvessels in the olfactory bulbs of SAM mice.

The ultrastructural features of microvessels showing increased permeability to intravenously injected horseradish peroxidase (HRP) were examined in the olfactory bulbs of senescence-accelerated prone mice (SAMP8), which showed age-related deficits in learning and memory, and senescence-accelerated resistant mice (SAMR1), which did not show the age-related deficits. HRP was visualized with tetramethyl benzidine (TMB) and diaminobenzidine (DAB) for light and electron microscopic examination, respectively. In the olfactory bulbs of 13-month-old SAMP8 mice, the staining reaction with TMB for HRP appeared in the neuropil of central area (granule cell layer and subependymal layer), in the pia mater and in the vascular wall. Some vessels located in the central area showed several changes observed at the ultrastructural level. The cytoplasm of the endothelial cells, especially in the arterioles, was segmentally thickened and contained numerous vesicles and vacuoles, some of which were HRP positive. The endothelial cell surface was occasionally undulated with microvillous protrusions. Membranous inclusions within the basal lamina, suggesting the cellular (presumably pericytal) degeneration, were frequently observed, especially in venules. The collagen deposits were occasionally observed in the subendothelial space of some vessels. Perivascular cells with vacuolated inclusions or lipid-like droplets were present around some vessels in the central area of the olfactory bulbs of aged SAMP8 mice. On the other hand, in the microvessels located in the areas negative for HRP-TMB reaction, except the vessel walls, the cytoplasm of the endothelial cells with smooth luminal surface was flattened and some vesicles located there contained HRP-DAB reaction product. Weak staining reaction with TMB for HRP appeared also in the central area of the olfactory bulbs of 3-month-old SAMP8 mice and 3- and 13-month-old SAMR1 mice. The cytoplasm of the endothelial cells in the olfactory bulbs of these mice was focally thickened and contained some cytoplasmic vesicles. Occasionally, the endothelial cell surface was moderately undulated with few microvillous protrusions. Membranous inclusions within the basal lamina were not observed in these animals. These findings indicate that the endothelial cells and pericytes in some vessels located in the central area of the olfactory bulb of aged SAMP8 mice, which show staining reaction with TMB for HRP, are ultrastructurally changed, suggesting their altered functions.

Age Factors↗

Polyethylene wear from femoral bipolar neck-cup impingement as a cause of femoral prosthetic loosening.

A 33-year-old woman underwent an uncemented bipolar hip arthroplasty for osteoarthrosis of the left hip in 1985. Because of painful aseptic loosening, the bipolar implant was revised to a total hip prosthesis in 1994. Membranous tissues around the implant histologically presented foreign-body reaction against polyethylene debris. The retrieved implant showed polyethylene wear of the rim of the bipolar cup. Three-dimensional measurement of the surface configuration of the polyethylene of the cup indicated that wear debris had been generated almost exclusively from femoral bipolar neck-cup impingement. Volumetric wear in the articulating dome portion of the polyethylene was negligible. This report clearly illustrates how impingement of a bipolar cup on the femoral neck can be a major source of polyethylene wear debris which induces femoral osteolysis and subsequent stem loosening.

Adult↗

Lymphokine-activated killer cells induced in vivo in mice showing IL-2 toxicity have cytoplasmic granules containing perforin and its hemolytic activity.

Cytoplasmic granules of LAK cells isolated from mice showing side effects of recombinant human IL-2 (rhIL-2) display BLT-serine esterase activity and calcium-dependent hemolytic activity and seem to be involved in the mechanisms of LAK cell-mediated rhIL-2 toxicity. In this report, the hemolytically active substance was partially purified from the LAK granules and shown to be mouse perforin. Mice were implanted with miniosmotic pumps filled with a dose of rhIL-2 that induced known toxicity. The LAK granules were isolated from LAK cell-rich subcutaneous tissue around the infusion sites. The hemolytically active substance in the granule preparation was solubilized by 2 M NaCl and passed through a butyl Sepharose column and then a DEAE Toyopearl column. In immunoblotting, the hemolytically active fractions reacted with an anti-mouse perforin mAb and the reaction depended on the activity. The molecular sizes of the perforin-positive bands were 66 kDa and 51 kDa under reducing and nonreducing conditions, respectively. These results confirmed the existence of mouse perforin and its hemolytic activity in the LAK granules of rhIL-2-treated mice, as has been shown for granules of cytotoxic T or NK cell clones in vitro.

Animals↗

Evaluation of tinnitus patients by peroral multi-drug treatment.

To evaluate patients complaining of subjective tinnitus, this study examined their response to peroral betahistine mesilate, vitamin B complex and diazepam in combination. Because three drugs were used together, it remains to be seen whether a single drug or a combination of drugs was effective. We issued questionnaires to 67 patients with tinnitus associated with sensorineural hearing loss of unknown etiology or tinnitus, despite normal hearing in pure tone audiometry and lack of distinct systemic disorders. Our original questionnaire contained seven items and allotted points for each item to facilitate evaluation. After prescribing the above drugs and observing patients' progress for 5 weeks, 50 of the 67 subjects were evaluated again by the same questionnaire. The present study evaluates tinnitus of patients as an example of clinical applications; this was not a controlled double blind study. It was found that, after patients took the prescribed medication, the total number of points were significantly reduced (paired t-test, P < 0.001). After medication, cases of bilateral tinnitus were significantly reduced from 27 to 14, and cases of two types of tinnitus sound, were significantly decreased from 22 to 11 (chi 2-test, P < 0.05). After 5 weeks of administration, 54% of patients felt treatment had been effective. Preliminary results suggest this peroral multi-drug treatment may provide relief for some patients with subjective tinnitus. However, long-term efficacy of the treatment was not investigated.

Administration, Oral↗

Topographical uptake of blood-borne horseradish peroxidase (HRP) in the murine testis at the light microscopic level.

Light microscopical studies on the uptake of blood-borne horseradish peroxidase (HRP) in large areas of the testis have been scarce because of the difficulty of staining HRP in testes with well-preserved morphology. However, observation of exogenous HRP in all areas of the testis enables detection of regional tissue injury induced by toxic chemicals or immunization. In the present study, the localization of blood-borne HRP in the murine testis was investigated light microscopically using plastic-embedded testes and post-embedding histochemical methods. Mice were injected intravenously with HRP, and then perfused with 2.5% glutaraldehyde and 3% paraformaldehyde in 0.1 M phosphate buffer. The fixed testes were immediately removed, dehydrated, and then embedded in plastic without cutting them into small pieces. The prepared sections treated by the diaminobenzidine method exhibited intense HRP activity with well-preserved testis morphology. It was noted that many interstitial macrophages had endocytosed HRP. In particular, HRP-endocytosing macrophages were concentrated around the tubuli recti. The testicular capsule, containing many lymphatic capillaries and vessels, was also loaded with HRP. In the subcapsular interstitium, free HRP in the lymph space accumulated, but the staining intensity was weak compared to that in testicular macrophages. No HRP infiltration into the lumen of the seminiferous tubules was observed at the light microscope level; however, HRP staining was detected in tubular walls and epithelial cells lining the rete testis and tubuli recti, indicating that these regions are permeable to HRP.

Animals↗

Carcinosarcoma of the esophagus with metastases showing osteosarcoma: a case report and review of the literature.

Carcinosarcoma of the esophagus includes both carcinomatous and sarcomatous elements. The classification and histogenesis of carcinosarcoma is controversial. In a polypoid carcinosarcoma diagnosed in a resected esophagus the sarcomatous component was composed of dense interlacing bundles of spindle-shaped cells in the submucosa. Areas with transitional features between the two components were observed. Immuno-histochemical examination showed vimentin-positive cells in the sarcomatous areas. Subsequently, obtained autopsy specimens from the lung, kidney and iliac bone showed metastatic osteosarcoma composed of an interlacing pattern of bone or osteoid components. We suspected that the sarcomatous elements in the esophagus resulted from sarcomatous transformation of carcinoma cells, and that the metastatic lesions showed differentiation of neoplastic cells to the osteosarcoma.

Carcinosarcoma↗