Search PubMed⌕ Search

Biomedical subjects

N Tanigawa

Publications and source records attributed to N Tanigawa.

At least 55 records · Page 3Linked to original sources

Advanced gallbladder carcinoma with liver metastasis showing a favorable response after intra-arterial infusion chemotherapy: report of a case.

A 66-year-old woman visited a local clinic due to general fatigue. After undergoing examinations at our hospital, the patient was diagnosed to have advanced gallbladder carcinoma with metastasis to the liver and cholecystolithiasis, After receiving a cholecystectomy, we performed chemotherapy by the intra-arterial infusion of low-dose cisplatin and 5-fluorouracil via hepatic artery, and observed its marked effect on the tumors by computed tomography. The level of carcinoembryonic antigen decreased from 114.5 ng/ml to 0.8 ng/mg, and carbohydrate antigen 125 decreased from 1 094 U/ml to 75 U/ml. The present result suggests that this therapy may be useful for some selected patients with an advanced gallbladder carcinoma.

Adenocarcinoma↗

Overexpression of rck/p54, a DEAD box protein, in human colorectal tumours.

The RCK gene is a target of the t(11;14)(q23;q32) chromosomal translocation observed in human B-cell lymphoma, and the overexpression of its protein (rck/p54) by the translocation was shown to cause malignant transformation. The rck/p54 protein belongs to the DEAD box protein/RNA helicase family, which has a variety of functions such as translation initiation, pre-mRNA splicing and ribosome assembly. The expression of rck p54 in colorectal adenocarcinoma cells was examined by immunohistochemistry and Western blot analysis. The rck/p54 protein was found to be overexpressed in tumour tissues resected from 13 (50%) out of 26 cases of colorectal adenocarcinomas and two out of two (100%) cases of colonic severe dysplastic adenomas. In view of activities of rck/p54 determined in other tissue types, we suggest that rck/p54 may contribute to the cell proliferation and carcinogenesis at the translational level in the development of colorectal tumours.

Adenocarcinoma↗

Clinical evaluation of lymph node metastasis in gastric cancer defined by the fifth edition of the TNM classification in comparison with the Japanese system.

BACKGROUND: This study compared the classification of lymph node metastasis according to the number of involved nodes based on the new tumour node metastasis (TNM) system (fifth edition) with the classification by the Japanese Research Society for Gastric Cancer from an anatomical perspective. METHODS: The two classifications were related to long-term results in 1489 patients with gastric cancer who underwent gastrectomy with systematic extended lymphadenectomy. RESULTS: Both classifications performed well as prognostic indicators (5-year survival rates: pathological (p) N0, 89 per cent; pN1, 66 per cent; pN2, 34 per cent; pN3, nil; and M1, 10 per cent by the TNM classification; n0, 89 per cent; n1, 63 per cent; n2, 46 per cent; n3, 20 per cent; and n4, 8 per cent by the Japanese classification). For regional lymph nodes, the TNM classification was a better index of the prognosis. Significant survival differences were observed among patients with M1 disease according to the number of involved lymph nodes (between one and six nodes, 48 per cent; seven to 15 nodes, 12 per cent; more than 15 nodes, 2 per cent), indicating that patients with distant metastatic lymph nodes (M1) should also be classified by the number of involved nodes. On the other hand, the Japanese classification has the added benefit of being a good indicator of the anatomical extent of lymphadenectomy. CONCLUSION: The new TNM classification provided a better index of the prognosis of patients who underwent systematic lymph node dissection. However, both classifications have specific benefits in the surgical treatment of gastric cancer.

Female↗

Detection of apoptotic cells in human colorectal cancer by two different in situ methods: antibody against single-stranded DNA and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) methods.

We comparatively investigated the extent of apoptotic cell loss in human colorectal cancers evaluated by two methods, namely the conventional terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP)-biotin nick end-labeling (TUNEL) method and immunohistochemistry for single-stranded (ss) DNA. The apoptotic index (AI) obtained with the TUNEL method was higher than that shown by the immunohistochemistry for ssDNA. However, a significant correlation in AIs evaluated by these methods was found. The AIs obtained by both methods were significantly higher in the advanced cancers than in the early cancers. Cellular proliferation activity was assessed in terms of positivity rate (PR) for expression of proliferating cell nuclear antigen (PCNA). The PR of advanced cancers was significantly higher than that of early cancers. The present results indicate that immunohistochemistry for ssDNA is useful (as is the TUNEL method) for evaluation of apoptotic tumor cells in colorectal carcinomas. In addition, it was confirmed that there is a remarkable increase of not only proliferation activity, but also tumor cell apoptosis in the process of progression of colon cancer from early to advanced stages of the disease.

Adult↗

Should use of the internal thoracic artery be avoided under conditions of low free flow? Postoperative hemodynamic assessment using pulsed Doppler echocardiography.

There are cases in which it is thought advisable to avoid the use of the left internal thoracic artery (LITA) in coronary artery bypass grafting (CABG) due to its low free flow (FF). However, even though the LITA flow is very low, anastomosis without any further maneuvers intraluminally is recommended. The present study investigated the clinical results of CABG, using a LITA with low FF. The 60 cases of CABG were divided into 2 groups: (i) Group L (n = 23), in which LITA FF was less than 20 ml/min; and (ii) Group H (n = 37) in which it was more than 20 ml/min. A comparative study on the basis of coronary angiography and pulsed Doppler echocardiography was performed. In both groups, no LITA graft occlusion was identified, and the 'string sign' was also absent. In the LITA blood waveform, all cases exhibited a biphasic pattern with a higher mid-diastolic and a lower end-systolic component. There were no significant differences in the LITA flow diastolic peak velocity, velocity time integrals and the diastolic/systolic peak velocity ratios. These results suggest that the LITA can be used for CABG even when the free flow is less than 20 ml/min.

Aged↗

[Evaluation of coronary flow velocity and coronary flow reserve before and after coronary angioplasty using transthoracic Doppler echocardiography and Doppler guide wire].

Evaluation of left anterior descending coronary (LAD) blood flow before and after coronary angioplasty was carried out non-invasively by ultrasonic Doppler echocardiography with a newly developed digital, high-frequency, high-resolution transthoracic ultrasonic Doppler flowmeter and a 7.5 MHz probe. The results were compared with those obtained using an intracoronary Doppler guide wire. Sixteen patients, 12 males and 4 females (mean age 57 +/- 14 years) with old myocardial infarction (8 patients) and angina pectoris (8 patients) were studied. Coronary flow reserve was compared following intravenous administration of adenosine triphosphate in 12 patients. The LAD blood flow was detected in 15 of 16 patients. There was a significant increase in the diastolic peak velocity from 22.2 +/- 10.6 to 29.4 +/- 14.6 cm/sec (mean +/- SD) and the coronary flow reserve from 1.8 +/- 0.3 to 2.8 +/- 0.6 (mean +/- SD). There was a good correlation between the data obtained using transthoracic flow measurement and intracoronary flow measurement (r = 0.61, p < 0.05). LAD blood flow can be easily detected parasternally using a digital, high frequency, high-resolution ultrasonic Doppler flowmeter. This method may be applicable for judging the efficacy of coronary angioplasty by measuring coronary flow reserve and for observing the clinical course of the patient non-invasively.

Adenosine Triphosphate↗

Changes of angiogenesis and tumor cell apoptosis during colorectal carcinogenesis.

Activation of the angiogenic process occurs during tumorigenesis, as does disturbance of cell proliferation and apoptosis. Seeking a potential correlation, we investigated tumor cell apoptosis, proliferation, and angiogenesis in the adenoma-carcinoma sequence of colorectal carcinogenesis using an in situ apoptosis detection kit and MIB-1 and anti-CD34 antibodies in 27 adenomas with low dysplasia, 17 adenomas with high dysplasia, and 26 carcinomas in adenoma, as well as assessed p53 and bcl-2 expressions. The results showed that the potential for apoptosis was augmented, paralleling the increment of proliferation, in adenomas with low dysplasia but diminished when adenomas progressed from low dysplasia to high dysplasia and cancer. A gradual increment of microvessel density was observed during the progression with an increase during transition from low dysplasia to high dysplasia and cancer. Correlation coefficient test showed an inverse correlation between apoptotic index and microvessel density when all of the lesions were taken into account. No apparent impact of aberrant p53 on angiogenesis or bcl-2 on apoptosis was observed in this study. These results suggest that the angiogenesis initiates during transition from low dysplasia to high dysplasia and cancer, which may, in turn, contribute to the reduction of tumor cell apoptosis during colorectal carcinogenesis.

Adenocarcinoma↗

Inhibition of apoptosis by survivin predicts shorter survival rates in colorectal cancer.

Deregulated inhibition of apoptosis (programmed cell death) may facilitate the insurgence of neoplasia, but whether it also influences the outcome of common cancers has remained controversial. In this study, we investigated the expression of a novel inhibitor of apoptosis, survivin, in colorectal cancer and its relationship with tumor cell apoptosis and overall prognosis. By immunohistochemistry, survivin was expressed in 91 of 171 (53.2%) cases of colorectal carcinomas of histological stages 0 to IV. In contrast, normal colon epithelium did not express survivin. Although survivin expression did not correlate with p53 abnormalities (46.5% versus 58.0%; P = 0.18), survivin-positive cases were strongly associated with bcl-2 expression (72.5% versus 27.4%; P < 0.0001) and reduced apoptotic index (0.76% +/- 0.39% versus 1.17% +/- 0.62%; P < 0.0001). Expression of survivin alone in bcl-2-negative (discordant) cases also resulted in reduced apoptotic index (0.82% +/- 0.57% versus 1.16% +/- 0.66%; P = 0.0046). When analyzed for prognostic significance, patients with low apoptotic index (< 0.97%) had worse survival rates than the group with high apoptosis (P < 0.001), and a multivariate Cox proportional hazard model identified reduced apoptosis as an independent predictive factor for overall survival (P < 0.0001). These data demonstrate that apoptosis inhibition by survivin, alone or in cooperation with bcl-2, is an important predictive/prognostic parameter of poor outcome in colorectal carcinoma and identify survivin as a new diagnostic/therapeutic target in cancer.

Adult↗

Platelet-derived endothelial cell growth factor/thymidine phosphorylase expression correlated with tumor angiogenesis and macrophage infiltration in colorectal cancer.

To clarify whether platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) expression in both tumor cells and stromal cells has independent or synergistic effects on tumor angiogenesis and progression and to explore a possible regulator for PD-ECGF/TP expression, immunohistochemical staining was conducted on 148 specimens of colorectal cancer. The microvessel count was significantly correlated with the extent of PD-ECGF/TP expression. Macrophage infiltration in tumors with positive TP was significantly higher than in tumors with negative TP (P < 0.001). The Cox model showed that PD-ECGF/TP expression was an independent prognostic factor, although the microvessel count had a stronger value in determining the patient prognosis.

Adenocarcinoma↗

Expression of a novel antiapoptosis gene, survivin, correlated with tumor cell apoptosis and p53 accumulation in gastric carcinomas.

A novel inhibitor of apoptosis designated survivin has recently been found in many common human cancers but not in normal tissues. A potential distribution of survivin in gastric cancer and its implication for apoptosis inhibition have been investigated. Recombinant survivin expressed in Escherichia coli as a glutathione S-transferase fusion protein was used to raise a novel panel of mouse monoclonal antibodies. In an immunohistochemical analysis of 174 cases of gastric carcinomas (stages I-III), anti-survivin monoclonal antibody 8E2 (IgG1) reacted with 34.5% of cases (60 of 174 cases) with a variable number of tumor cells stained (20-100%). In contrast, no expression of survivin in neighboring normal tissues was observed. When stratified for p53 and bcl-2 expression and apoptotic index, the expression of survivin significantly segregated with p53- and bcl-2-positive cases [56.1 versus 15.2% (P = 0.001) and 69.2 versus 31.6% (P = 0.006), respectively] and with a decreased apoptotic index as compared with that of survivin-negative tumors (0.97 +/- 0.64 versus 0.62 +/- 0.39%, P < 0.001). These data identify a role for survivin in promoting aberrantly increased cell viability in gastric cancer and suggest a potential correlation between accumulated p53 and survivin expression in neoplasia.

Adult↗

Combined hepatocellular and cholangiocellular carcinoma in a non-cirrhotic liver.

Combined hepatocellular (HCC) and cholangiocellular carcinoma (CCC) (mixed carcinoma) is a rare subtype of primary hepatic carcinoma. We report a case of mixed carcinoma that developed in a non-cirrhotic liver, in a patient who was serologically negative for both hepatitis B and C viruses. A 65-year-old Japanese woman with a 25-year history of chronic rheumatoid arthritis had been treated with steroids and anti-inflammatory drugs, and was diagnosed by ultrasonography with an asymptomatic solitary tumor in the right lobe of the liver. On computed tomography scan and hepatic arteriography, the tumor was well enhanced by contrast medium in the early phase. Based on the findings of elevated serum alpha-feto protein (AFP, 245 ng/ml) and normal carcino-embryonic antigen (CEA, 2.6 ng/ml) levels, a preoperative diagnosis of hepatocellular carcinoma was made. Right lobectomy of the liver was performed on January 7, 1997. Histological examination showed that the resected tumor consisted of combined CCC cells and HCC cells in an intermingled form, with CCC being far more dominant than HCC. The tumor was therefore determined to be a combined carcinoma, subclassified as intermingled type. This case appears to indicate that mixed type carcinoma developed in a non-cirrhotic liver, with CCC being dominant; such a finding is extremely unusual, based on previously published reports.

Aged↗

Tumor angiogenesis as a prognostic marker in operable non-small cell lung cancer.

BACKGROUND: Recent evidence suggests that tumor angiogenesis is associated with patient outcome in a number of malignancies. However, little is known about the significance of tumor microvessel density as evaluated by an anti-CD34 antibody in patients with lung cancer. METHODS: Tumor tissues were obtained from 101 patients with operable non-small cell lung cancers. Immunohistochemical detection of tumor-associated microvessels was performed using anti-CD34 antibodies directed against endothelial markers. Average counts of the three most vascular areas on a X200 field were recorded. RESULTS: Staining for CD34 was easy to interpret because of specific and minimal background staining. The Kaplan-Meier method showed a statistically significant difference between the microvessel count and overall survival. The microvessel count was identified as the only significant and independent prognostic marker. In both univariate and multivariate analyses, the microvessel count was significantly related to the development of hematogenous metastasis but failed to associate with the development of nodal metastasis. CONCLUSIONS: Tumor vascularity is an independent prognostic factor and important for the development of hematogenous metastasis.

Adult↗

Increasing incidence of streptococcal impetigo in atopic dermatitis.

Streptococcal impetigo associated with atopic dermatitis has dramatically increased from 1989 to 1994 in outpatients visiting our hospital, totalling 174 cases. The most frequent causative agents were group A streptococci (Streptococcus pyogenes, 70.7%) followed by group G (19.5%) and group B (9.8%). Streptococcus was isolated singly in 28.2% of cases and in concomitant with Staphylococcus aureus (S. aureus) in 71.8%. Major clinical features of streptococcal impetigo, especially caused by group A streptococci, were non-bullous pustules with thick crusted ceiling. Impetigo caused by group G or B streptococci generally formed smaller sized pustules of fewer numbers. Impetigo was usually present, associated with severe eczematous lesions. Various degrees of fever were noticed in 32.8% (group A, 39.8%; group G, 17.6%; group B, 11.8%) during active stages. The lesions on the face often resembled Kaposi's varicelliform eruption in any group. Systemic antimicrobial agents were administered in 71.3% of cases and the remainder were treated with topical antibiotics (oxytetracycline hydrochloride) or disinfectants (povidone-iodine). Recurrence occurred within a month in 38.0% of cases treated with topical agents only and in 17.7% treated with systemic antimicrobial agents. Antimicrobial susceptibility tests and the results of treatment seem to indicate that cephems, as well as penicillins, are the first choice of treatment for streptococcal impetigo.

Adolescent↗

Clinical outcome of stenting in superior vena cava syndrome associated with malignant tumors. Comparison with conventional treatment.

PURPOSE: We analyzed the clinical outcome of treatment with the expandable metallic stent (EMS) for the superior vena cava (SVC) syndrome associated with malignant tumors, and the results were compared with those of radiotherapy. MATERIAL AND METHODS: Of 33 patients with the SVC syndrome, 23 were treated by Gianturco EMS placement and 10 were treated by radiotherapy and/or chemotherapy alone. Of the 23 EMS patients, 11 had treatment before EMS placement and 12 had no treatment before EMS placement. RESULTS: After stenting, the clinical symptoms disappeared in 78% (18/23) of the patients, i.e. in 50% of the patients with intraluminal tumors, and in 93% of those with extrinsic compression. The clinical symptoms improved in 80% of patients who received radiotherapy. The mean duration of survival was 145 days in patients who underwent stenting, and 146 days in those receiving radiotherapy. However, the survival period differed significantly between patients with intraluminal tumors (44.9 days) and those with extrinsic compression (198.6 days). Between patients with previous treatment and those with no previous treatment, there was no significant difference in response rate or in survival period which were 82% versus 75%, and 127 days versus 162 days, respectively. CONCLUSION: The clinical symptoms showed similar improvement in patients receiving EMS placement or radiotherapy. EMS placement was effective in relieving clinical symptoms in patients who had failed to respond to radiotherapy.

Adult↗

Prognostic value of tumor cell proliferation and intratumor microvessel density in advanced gastric cancer treated with curative surgery.

To clarify the prognostic value of tumor cell proliferation [proliferating cell nuclear antigen (PCNA)-positive rate assessed by anti-PCNA immunostaining] and intratumor microvessel density (/0.74 mm2, assessed by anti-CD34 immunostaining) in gastric cancer, 192 advanced gastric cancer patients who underwent curative surgery were investigated. Multivariate analysis showed that the following variables were significantly related to prognosis: age (P=0.029), depth of invasion (P=0.005), lymph node metastasis (P=0.006), lymphatic invasion (P=0.038), venous invasion (P=0.0005), PCNA-positive rate (P=0.049) and intratumor microvessel density (P=0. 011). In conclusion, tumor cell proliferation and intratumor microvessel density were independent prognostic factors in patients with advanced gastric cancer undergoing curative surgery.

Adult↗

Efficacious diagnosis of primary and metastatic human carcinomas with a combination of p53 mutation analysis and clonality analysis of androgen receptor gene.

It is occasionally difficult to differentiate between multiple primary and metastatic tumors in case of multiple carcinomas. p53 gene mutation pattern by PCR-SSCP and a clonality analysis on the human androgen receptor gene (HUMARA) in multiple tumors were used to distinguish whether carcinomas were multiple primary tumors or a metastasis. Three female patients with multiple carcinomas, who had undergone surgical resection, were selected for these analyses as typical candidates from 11 cases tested. In the first case with bilateral breast cancer the combined analyses were performed on DNA extracted from tumor portions in paraffin sections of each tumor sample and the results indicated that the carcinomas consisted of a primary carcinoma and metastatic tumors. The carcinomas in the second patient consisted of multiple primary carcinomas and the tumors in the third patient consisted of two independent primary carcinomas with different clonal origins. Thus a combination of p53 gene mutation analysis and clonality analysis on HUMARA provided useful, reliable evidence which can help in discriminating multiple primary tumors from metastatic tumors.

Aged↗

[Assessment of function preserving gastrectomy for early gastric cancer].

To assess function preserving gastrectomy for early gastric cancer, the effectiveness of a reduction of the extent of gastrectomy, preservation of pylorus, and preservation of vagus nerve was evaluated. Postoperative physical results after pylorus-preserving gastrectomy with preservation of vagus nerve (group I, 32 cases), 2/3 distal gastrectomy with preservation of vagus nerve (group II, 12 cases), 2/3 distal gastrectomy without preservation of vagus nerve (group III, 21 cases) and 4/5 distal gastrectomy without preservation of vagus nerve (group IV, 81 cases), were investigated. Postoperative/ preoperative body-weight ratio in groups I (96.6%) and II (97.4%) was significantly higher than in groups III (92.2%) or IV (89.5%). The patients in groups I and II had fewer abdominal symptoms than in group IV. The gastric emptying pattern of patients in group I was slower than in the other groups. Contraction of the gallbladder in groups I and II was better than in group IV. The serum concentration of cholecystokinin after meals was low in group I, but increased rapidly in the other, groups. Reducing the extent of gastrectomy, preserving the pylorus, and preserving the vagus nerve, resulted in preservation of physical status after gastrectomy.

Body Weight↗