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Biomedical subjects

M Wakabayashi

Publications and source records attributed to M Wakabayashi.

At least 37 records · Page 2Linked to original sources
PubMed2000

Relationship between p53 overexpression and the proliferative activity in hepatocellular carcinoma.

Relationship between p53 protein overexpression and clinicopathological findings and the proliferative activity was studied in 50 cases of hepatocellular carcinoma (34 biopsy and 16 surgically resected cases) using immunohistochemistry. Overexpression of p53 was observed in 26.5% of biopsy cases and 31. 3% of surgically resected cases. Investigation of the relationship between the p53-positive rate and the clinical stage of HCC showed that it was significantly higher in Stage IV (the most advanced cancer; 54.5%) than in Stage I/II/III (13.0%) (p<0.05). Examination of the relationship between the p53-positive rate and tumor differentiation in the biopsy cases showed that p53 was positive in 9.1% of well differentiated carcinomas, 21.4% of moderately differentiated carcinomas, and 55.6% of poorly differentiated carcinomas, indicating that p53 positivity increased as tumors became less differentiated. The p53-positive rate of poorly differentiated carcinoma (55.6%) was significantly higher than that of well and moderately differentiated carcinoma (16.0%) (p<0.05). In the surgically resected cases, p53 overexpression tended to be more frequent in the less differentiated parts of each tumor nodule. In cases with nodule in nodule pattern of HCC, the p53-positive rate was different among nodules with the same level of differentiation. Examination of tumor cell proliferative activity using the proliferating cell nuclear antigen L.I. showed that this indicator was significantly higher in the p53-positive tumors than in the p53-negative tumors (52.7+/-32.4% vs. 32.4+/-15.3%: p<0.05). These results suggest that p53 overexpression may be involved in determining the dedifferentiation and the proliferative activity of HCC. Examination of the surgically resected cases confirmed that p53 overexpression became heterogeneous during the multistep carcinogenesis and growth process of HCC, which is considered to develop from a single cell. This finding suggests that p53 overexpression may be involved in tumor progression.

Aged↗
PubMed2000

[Day surgery for treatment of varicose veins in the leg].

We had surgically treated varicose veins in 554 legs of 386 patients as of June 30, 2000. Varicose veins of the stem or segment type without skin changes were treated with sclerotherapy combined with high ligation, while a part of secondary varicose veins and the reticular or web type were treated with sclerotherapy alone. This paper describes our methods for day surgery for this condition. The most important therapeutic consideration in the surgical procedure is achieving sufficient venous collapse to prevent the occurrence of intravenous thrombus. In our 386 patients, a massive intravenous thrombus that was resected occurred in one limb (0.1%). Postoperative bleeding also occurred in one limb (0.1%) of a patient with severe liver cirrhosis.

Ambulatory Surgical Procedures↗
PubMed2000

[Evaluation of fluorine-18-fluorodeoxyglucose whole body positron emission tomography imaging in the clinical diagnosis of lung cancer].

In recent years the use of positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (FDG) has become a valuable tool in the detection of a variety of tumors including lung cancer. To determine its role in the diagnosis of patients with suspected lung cancer, we compared the results of FDG-PET with those of the other scintigraphic imaging techniques (67Ga-planar image, 201Tl-SPECT and 99mTc-bone scintigraphy) used worldwide in patients with lung cancer. The analysis group consists of 178 patients, 159 malignant pulmonary diseases and 19 benign pulmonary diseases. FDG-PET was performed in 65 patients (51 malignant pulmonary diseases, 14 benign pulmonary diseases). FDG-PET had a sensitivity, specificity and accuracy of 98.0%, 78.6% and 93.8%, respectively, in detecting malignant pulmonary nodules. In N staging, sensitivity, specificity and accuracy were 66.7%, 81.3% and 76.0%, respectively. In M staging, the accuracy was 100%. Thus, FDG-PET imaging was more accurate than the other types of scintigraphic imaging. In our observations, whole-body 18FDG-PET images improved diagnostic accuracy in the evaluation of lung lesions and the staging of lung cancer.

Bone and Bones↗
PubMed1999

Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma: comparison with percutaneous ethanol injection therapy.

BACKGROUND: The authors compared the efficacy of percutaneous microwave coagulation therapy (PMCT) and percutaneous ethanol injection therapy (PEIT) in the treatment of patients with cirrhosis and a solitary nodular hepatocellular carcinoma (HCC) < or = 2 cm in greatest dimension. METHODS: Of 43 patients with well-differentiated HCC, 23 were treated with PMCT and 20 with PEIT. Of the 47 patients with moderately or poorly differentiated HCC, 25 were treated with PMCT and 22 with PEIT. In a retrospective, nonrandomized study, the prognoses of 90 patients during the 12-72 months preceding the study were analyzed according to histologic tumor grade. RESULTS: The overall 5-year survival rates for patients with well-differentiated HCC treated with PMCT (70%) and PEIT (78%) were not significantly different. No difference between the patterns of recurrence was observed. Among the patients with moderately or poorly differentiated HCC, overall survival with PMCT (5-year survival rate: 78%) was significantly better than with PEIT (5-year survival rate: 35%) (P = 0.03). Nine of 22 patients with moderately or poorly differentiated HCC treated with PEIT experienced recurrence in the original target subsegment. Only 2 of 25 patients treated with PMCT had a recurrence in the same subsegment as the initial tumor. CONCLUSIONS: PMCT may be superior to PEIT for the local control of moderately or poorly differentiated small HCC.

Aged↗
PubMed1999

Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study.

OBJECTIVE: Percutaneous microwave coagulation therapy (PMCT) was performed for metachronous small solitary liver tumors measuring < or = 3.0 cm in diameter that had metastasized from colorectal cancer. PMCT was used for local control of the lesions, and the efficacy of this treatment was assessed. METHODS: In 15 patients, a microwave electrode (specially designed for this purpose, 25 cm long and 2.0 mm thick) was inserted percutaneously into the tumor area under ultrasonic guidance. Microwaves at 80 watts were used to irradiate the tumor and the surrounding area. RESULTS: Thirteen of the 15 metastatic tumors were radically ablated by 3-10 applications of microwave irradiation. Although the follow-up period was short (9-37 months), 10 patients survived. No recurrence has been detected in the treated area (except two foci where PMCT was insufficient), and no serious side effects or complications were encountered during or after the PMCT. In four of the five nonsurviving patients, death was due to metastases to the bone, brain, lung, or other areas of the liver despite complete local tumor control by PMCT. CONCLUSION: PMCT is a safe and effective treatment for metachronous small liver tumors that have metastasized from colorectal cancer.

Aged↗
PubMed1999

Clinicopathologic significance of protein induced vitamin K absence or antagonist II and alpha-fetoprotein in hepatocellular carcinoma.

Protein induced vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) have been considered useful serum markers of hepatocellular carcinoma (HCC). In this study, we examined the clinicopathologic significance of these tumour markers in patients with HCCs by measuring their serum levels and performing immunohistochemistry. We studied 349 Japanese patients with HCCs. Their serum PIVKA-II and AFP levels were determined by enzyme immunoassay before treatment. We examined the correlations between serum PIVKA-II and AFP levels and tumour size, presence of satellite nodules, histologic HCC grade, and concomitant liver diseases and subjected tumour tissues to immunohistochemical staining to detect PIVKA-II and AFP expression. The serum PIVKA-II levels of patients with poorly differentiated HCCs were significantly higher than those of patients with well and moderately differentiated HCCs (p<0.05) and they were higher in HCC patients with than without satellite nodules. The serum AFP levels were influenced significantly by concomitant liver diseases, but not by the other factors. Immunohistochemical staining revealed the PIVKA-II expression levels of poorly differentiated HCCs were higher than those of well and moderately differentiated HCCs (p<0.05). Some HCC cells were PIVKA-II-positive, others were AFP-positive, and some expressed both. The serum PIVKA-II concentration was a better indicator of HCC than AFP, as it was not influenced by concomitant liver diseases. The presence of PIVKA-II in serum correlated with the presence of satellite nodules and the histologic HCC grade, a result concordant with the immunohistochemical findings.

Aged↗
PubMed1998

Intravaginal misoprostol for medical evacuation of first trimester missed abortion.

Objective: To evaluate the safety and efficacy of intravaginal misoprostol for medical evacuation of first trimester missed abortions.Methods: Seven women with a transvaginal ultrasound diagnosis of a first trimester missed abortion were treated with 800 µg of misoprostol. Four 200 µg misoprostol tablets were placed intravaginally, and a repeat dose of 800 µg was repeated if products of conception were not expelled in 12 hours.Results: Five of seven of the medical evacuations were successful. The average gestational age for the patients was 9 weeks with a range of 8 3/7 to 9 3/7 weeks. The average time from insertion to complete passage of products of conception was 18 hours with a range from 5 hours 10 minutes to 50 hours. Only one patient in the successful group required the second dose of misoprostol. One patient completely passed products of conception 2 weeks after the 2 doses of misoprostol and was considered a treatment failure. Another patient passed products of conception within 12 hours following insertion of the misoprostol but required a dilatation and curettage 3 days later and was also considered a treatment failure. Side effects included cramping in all patients, which was noted to be moderate in six and mild in one. One patient also had mild nausea, mild headache, and one episode of diarrhea. The average blood loss was estimated at 434 mL with a range from 171 to 871 mL.Conclusion: Intravaginal misoprostol for medical evacuation of first trimester missed abortions appears to be safe and effective and may be an alternative to dilatation and curettage.

Journal Article↗
PubMed1998

Characterization of cytochrome P450 (CYP3A12) induction by rifampicin in dog liver.

1. Effects of rifampicin (Rif) on the contents of cytochrome P450 (P450) enzymes (CYP1A1/2, 2B11, 2C21 and 3A12) assessed by enzyme-linked immunosorbent assay and catalytic activities (ethoxyresorufin O-deethylase, and testosterone 6 beta-, 16 alpha- and 16 beta-hydroxylase; 6 beta-, 16 alpha- and 16 beta-OHT) in dog liver microsomes were compared between liver lobes of both the male and female dogs. 2. In the control dogs, the contents of individual P450 enzymes and their activities showed no significant differences between individual liver lobes and between the sexes. 3. Rif treatment (10 mg/kg/day, p.o. for 7 days) induced substantial increases in the content of CYP3A12 and 6 beta- and 16 beta-OHT activities, and slight increases in the content of CYP2B11 and 16 alpha-OHT activity, and their elevated levels were virtually the same between liver lobes. The magnitudes of the elevation of the CYP3A12 level and 6 beta- and 16 beta-OHT activities compared with control levels appeared to be greater in the female dogs. However, the ratios of their magnitudes (CYP3A content/6 beta-OHT activity and CYP3A content/16 beta-OHT activity) showed no differences between the sexes. 4. In both the control and Rif-treated dogs, the activities of 6 beta- and 16 beta-OHT were specifically inhibited by anti-CYP3A12 antiserum, and 16 alpha-OHT activity was specifically inhibited by anti-CYP2B11 and anti-CYP2C21 antiserum. 5. These results indicate that Rif treatment induces the expression of CYP3A12 protein, and correlates well with the elevation of its catalytic activity (6 beta- and 16 beta-OHT), and that the female dog is more responsive to Rif treatment as compared with the male.

Animals↗
PubMed1998

Postoperative chemotherapy may improve prognosis in unresectable gastric cancer.

We have retrospectively evaluated to prognosis of patients with unresectable gastric cancer (UGC) and the effect of postoperative chemotherapy on that prognosis. One hundred patients who died of UGC included 37 patients who received postoperative chemotherapy (chemotherapy group) and 63 patients who did not receive postoperative chemotherapy (control group). Chemotherapy regimens were as follows: intravenous mitomycin (MMC) plus 5-fluorouracil (5-FU) (n=15), oral 5-FU alone (n=10), intravenous methotrexate (MTX) plus 5-FU (n=8), intravenous cisplatin plus 5-FU (n=2), and hepatic arterial infusion of 5-FU plus oral 5-FU (n=2). No prior chemotherapy or radiation therapy was given. All patients' cancers were stage IV. Median survival of the chemotherapy group (238 days) was significantly longer than the control group (137 days). The 1-year survival rate in the treated group was 19.0% but only 2.4% in the control group (p < 0.01). Patients with palliative gastrojejunostomy did not survive significantly longer than those having laparotomy alone or ileal tube insertion. We conclude that the prognosis for patients with UGC remains very poor, but postoperative chemotherapy may contribute to prolonged survival in patients with UGC.

Adenocarcinoma↗
PubMed1998

Hepatic infarction following percutaneous ethanol injection therapy for hepatocellular carcinoma.

We report on two patients who developed hepatic infarction after undergoing percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC). In both cases, liver function parameters deteriorated immediately after the ethanol injection, and enhanced computed tomography images showed a wedge-shaped avascular low-density area due to hepatic infarction. In one patient, PEIT was performed for a nodule treated with transcatheter arterial infusion (TAI) using a suspension of styrene maleic acid neocarzinostatin (SMANCS) 4 weeks before. In the other patient, TAI with SMANCS had been carried out 14 months previously for a different nodule in the same segment where the nodule treated with PEIT was located. When PEIT is used for patients with HCC who have previously undergone TAI, especially with SMANCS, PEIT may induce hepatic infarction.

Antineoplastic Agents↗
PubMed1998

Detection of circulating tumor cells in a patient with intravascular lymphomatosis: a case study examined by the cytology method.

Detection of circulating tumor cells in a patient with intravascular lymphomatosis (IVL) of the lung is reported. Peripheral blood cells were suspended in an isotonic sodium chloride solution, and red blood cells were lysed. The suspension was smeared on glass slides, fixed in 95% ethanol solution and stained using the Papanicolaou method. At the diagnosis of IVL, approximately 65 tumor cells were detected in one smear preparation, which contained about 8 x 10(5) nucleated cells. However, tumor cells disappeared from peripheral blood when those in the lung were eliminated by multiagent chemotherapy. Cytology examination of peripheral blood cells may be of assistance in the early diagnosis of IVL and in the assessment of therapeutic intervention.

Adult↗
PubMed1998

Cloning and characterization of the promoter region of monkey thymidylate synthase gene.

Thymidylate synthase (TS) catalyzes the conversion of deoxyuridylate to thymidylate. Promoter regions of the TS gene from three vertebrates, human, mouse and rat, have been analyzed so far. A unique inverted repeat was present in the promoter region of the human, but not in the mouse and rat, TS genes, and the feature of the promoter region is considerably different between the human TS gene and the two rodent TS genes. To examine whether the characteristics of the human TS gene promoter is intrinsic to human or primate, we cloned a DNA fragment containing the promoter region of the monkey TS gene and determined the nucleotide sequence in this region. The nucleotide sequence in the promoter region of the monkey TS gene was revealed to have 88% homology with that in the corresponding region of the human TS gene. The unique repeated structure mentioned above was also found in the monkey TS gene. Furthermore, the Sp1-binding motif and the CACCC box were found to be conserved in the monkey TS gene. The result of chloramphenicol acetyltransferase assay suggested that the Sp1-binding motif and the CACCC box are essential for the promoter activity of the monkey TS gene, as in the case of the human TS gene.

Animals↗
PubMed1998

[Renal function monitoring using an ambulatory renal monitor].

BACKGROUND AND PURPOSE: Diethylenetriamine penta acetic acid (99mTc-DTPA), a substance which indicates glomerular filtration, is distributed equally in blood and tissue after a bolus intravenously injection. Ambulatory Renal Monitor (ARM) is a portable and non invasive device which monitors extracorporeally the clearance of intravenously injected 99mTc-DTPA. We examined correlation between half-time of clearance estimated by ARM and glomerular filtration rare, and clinical usefulness of ARM for a renal function monitoring. MATERIALS AND METHODS: The purposes of this paper are to describe the results obtained through basic analysis experiments and reproducibility in normal control, and its clinical application for 9 renal transplant patients, three drug-induced renal damage, one acute renal failure, one hemolytic uremic syndrome (HUS), two chronic nephritis, one donor of renal transplantation, one ureteral tumor, three renal tumors, two ureteral stones, one bilateral hydronephrosis and two normal controls. The half time of clearance of the tracer measured by an ARM. (ARM-HTC) is compared with the half time of clearance of the tracer measured by repeated blood sampling (Sampling-HTC) as a golden standard, serum creatinine and creatinine clearance. RESULTS: A significant correlation (linear) was detected when ARM-HTC was compared with Sampling-HTC (r = 0.91), 1/serum creatinine (r = 0.85) or creatinine clearance (r = 0.82), although ARM-HTC showed a delay compared with Sampling-HTC. CONCLUSIONS: The reason of this delay may be due to a difference in half-time when the tracer distributed in the blood and tissue. The results indicate that the estimation of 99mTc-DTPA clearance by ARM is valuable for renal function evaluation in wide ranges of renal function and in different origins of renal dysfunction such as in renal transplantation.

Adult↗
PubMed1997

Neuropathology of sporadic amyotrophic lateral sclerosis of long duration.

We performed post-mortem examinations of three patients with progressive neurogenic amyotrophy of long duration. One patient had been clinically diagnosed as having sporadic amyotrophic lateral sclerosis (ALS) and two had been diagnosed with progressive spinal muscular atrophy (PSMA). The disease durations were 10, 17 and 20 years, respectively, and all of the patients died of respiratory failure with no artificial respiratory support. In all of the patients, both the upper and lower motor neuron systems were affected; degeneration of the former was definite, but was milder than that usually encountered in sporadic ALS patients, and the histopathology of the latter was identical to that of sporadic ALS. Light microscopy revealed Bunina bodies, which are characteristic of sporadic ALS, in the remaining anterior horn cells of each patient. In addition, ubiquitin-positive skein-like inclusions were also identified, immunohistochemically, in the remaining anterior horn cells of each patient. Neuron counts indicated that the number of neurons was preserved in Clarke's column in these patients, but was significantly reduced in the intermediolateral nucleus, compared with control subjects. Based on these findings, we think that these three patients, with long disease durations, were affected by essentially the same underlying disease process as that of sporadic, classical ALS. Moreover, we question the neuropathological occurrence of sporadic ALS without involvement of the upper motor neuron system, namely, pure PSMA or lower motor neuron disease.

Aged↗
PubMed1997

Hemorrhage into a simple liver cyst: diagnostic implications of a recent case.

Hemorrhage complicating simple liver cyst is rare. On imaging studies, the differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is unreliable, and hepatectomy has been performed for benign liver cyst in this situation. We describe the characteristics of hemorrhage into a liver cyst in a patient who underwent dome resection of the cyst. In our patient, important diagnostic findings included benign cytologic features in a cyst fluid specimen aspirated with ultrasonographic guidance and a fall in hemoglobin and hematocrit, suggestive of hemorrhage. Other informative features were absence of communication between the intrahepatic bile ducts and the cystic liver lesion upon endoscopic retrograde cholangiopancreatography, as well as benign intraoperative frozen-section histology.

Aged↗
PubMed1997

Endoscopic nasobiliary drainage for bile duct injury after laparoscopic cholecystectomy.

Bile duct injuries are a potential complication of laparoscopic cholecystectomy (LC). A patient who underwent successful endoscopic nasobiliary drainage (ENBD) for a bile duct injury sustained during LC is presented. Of particular note, the patient also had Chilaiditi's syndrome. A 59-year-old woman was admitted with symptomatic cholecystolithiasis and Chilaiditi's syndrome. LC was performed. Postoperatively, the patient complained of abdominal discomfort. Laboratory examination revealed cholestasis. Bilious material began spilling from an intraabdominal drain. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) showed bile leakage. ENBD was performed. Repeat ERCP 10 days later failed to show a bile leak or stenosis of the common bile duct. The patient improved rapidly and had no complaints after the procedure. ENBD is a useful endoscopic technique to prevent peritonitis from bile leakage after LC. Chilaiditi's syndrome is not a contraindication for LC.

Bile Ducts↗
PubMed1997

Clinicopathologic features of submucosal carcinoma of the stomach.

A retrospective study of 155 patients with submucosal gastric carcinoma compared the clinicopathologic features with mucosal and muscularis proprial gastric carcinoma. Fifty-seven percent of the patients presented with gastrointestinal symptoms, whereas 36.1% had been detected by mass screening. The incidence of curative resection, lymph node metastasis, and complications were 96.1, 20.6, and 14.8%, respectively. Two patients died of sepsis and pulmonary infarction 30 days post-operatively. Five patients died of recurrent gastric cancer 1-5 years postresection. The overall 5-year survival rate was 90.2%. Recurrence patterns, histologic type, lymph node metastasis, lymphatic and venous infiltration, and growth pattern were similar to those of muscularis proprial carcinoma rather than mucosal carcinoma. Therefore, curative gastrectomy with extended lymphadenectomy (D2) may be feasible for submucosal carcinoma of the stomach.

Adenocarcinoma↗