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Biomedical subjects

O Ishikawa

Publications and source records attributed to O Ishikawa.

At least 19 recordsLinked to original sources
PubMed2002

Preliminary thermographic evaluation of new nitroglycerine tape on the peripheral circulatory disturbance in systemic sclerosis.

OBJECTIVE: To evaluate the effects of newly developed nitroglycerine (NTG) tape on the peripheral circulatory disturbance in systemic sclerosis (SSc). METHODS: The finger temperature (FT) of 25 patients with SSc was monitored by thermography before the application of NTG tape to the wrist and one hour afterwards. To check the placebo effect, the change of FT with placebo tape in six patients who had shown a distinct rise in FT (>2 degrees C) with NTG tape was monitored. RESULTS: Twenty one patients with SSc had a low FT before the application of NTG tape (colder than mean-2SD of normal controls). FT was significantly raised in patients with SSc after the application of NTG tape (p<0.01). Patients with low FT showed a distinct rise in FT more often than patients with a normal FT (71% v 0%, p<0.01). FT was raised with NTG tape more than with placebo tape (4.2 (SD 1.9) degrees C v 2.2 (2.8) degrees C, p<0.05). CONCLUSION: The application of NTG tape increases peripheral circulation in patients with SSc who have distinct circulatory disturbance. The application of NTG tape may improve peripheral circulatory disturbance in SSc.

Administration, Cutaneous↗
PubMed2001

Quantitative analysis of estrogen receptor-alpha and -beta messenger RNA expression in human pancreatic cancers by real-time polymerase chain reaction.

Recent studies have disclosed the presence of a second estrogen receptor (ER; ER-beta) in addition to a classical ER-alpha. ER-beta mRNA expression has yet to be studied in pancreatic cancers. Thus, we studied the expression of ER-alpha and ER-beta mRNA in pancreatic cancers (n=29) by real-time quantitative reverse transcriptase-polymerase chain reaction, and compared the expression levels in pancreatic cancers with those in breast cancers (n=116) which are typical estrogen-dependent tumors. Breast cancers were divided into two groups, ER-positive and ER-negative, according to the ER status determined by enzyme immunoassay. ER-alpha mRNA levels were significantly (P<0.01) higher in ER-positive (679.4+/-74.7 fmol/microg RNA) than ER-negative (159.7+/-33.4) breast cancers, and pancreatic cancers showed significantly (P<0.01) lower ER-alpha mRNA levels (17.5+/-10.0) than ER-negative breast cancers. On the other hand, ER-beta mRNA levels were significantly (P<0.01) higher in ER-negative (14.1+/-1.6) than ER-positive breast cancers (7.9+/-1.0), and pancreatic cancers showed significantly (P<0.01) higher ER-beta mRNA levels (28.1+/-5.1) than ER-negative breast cancers. Accordingly, ER-alpha/ER-beta mRNA ratios were significantly (P<0.01) lower in pancreatic cancers (0.94+/-053) than in ER-positive (203.9+/-34.5) and ER-negative (21.9+/-5.2) breast cancers. ER-beta2 mRNA variant expression was significantly (P<0.05) higher in pancreatic cancers than in ER-positive and ER-negative breast cancers, and, on the contrary, ER-beta1 mRNA variant expression was significantly (P<0.01) lower in pancreatic cancers than in ER-positive and ER-negative breast cancers. These results suggest a possibility that ER-beta (ER-beta2) plays a more important role than ER-alpha in pancreatic cancers.

Adult↗
PubMed2001

Lack of effectiveness of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma.

BACKGROUND: Cisplatin has been reported to enhance the cell-killing effect of radiation. The current study was conducted to evaluate the efficacy and toxicity of radiotherapy combined with cisplatin in patients with locally advanced pancreatic carcinoma. METHODS: Forty-one patients with pancreatic carcinoma that was unresectable but confined to the pancreatic region were treated with external beam radiation (50.4 grays [Gy] in 28 fractions over 5.5 weeks) and daily cisplatin (5 mg/m(2)/day as a 30-minute infusion just before each radiation fraction). Maintenance 5-fluorouracil (5-FU) (500 mg/m(2)) given once weekly was initiated 1 week after the completion of the chemoradiotherapy and continued until disease progression or unacceptable toxicity. RESULTS: Of the 41 patients, 31 (76%) completed the scheduled course of chemoradiotherapy. The median survival time was 7.7 months, and the 1-year survival rate was 36%. The median progression free survival time was 5.8 months. The first site of failure was distant metastases in 25 patients, locoregional recurrence in 6 patients, and both sites in 1 patient. The major toxicity was leukocytopenia and nausea/emesis. CONCLUSIONS: Radiotherapy with daily cisplatin appears to be inferior to conventional chemoradiotherapy using 5-FU in patients with locally advanced pancreatic carcinoma.

Adenocarcinoma↗
PubMed2001

An increase of mature type skin collagen cross-link, histidinohydroxylysinonorleucine, in the sclerotic skin of morphea.

Histidinohydroxylysinonorleucine (HHL) is a trivalent cross-link of type I collagen that is stable and has physiologic properties. In this study, we conducted a biochemical quantification of HHL in five patients with morphea. We compared the quantity of HHL contained in the lesional skin and the adjacent normal skin. The molar ratio of HHL to collagen in the sclerotic lesion was significantly higher than that of the adjacent normal skin (0.36 +/- 0.09 vs. 0.28 +/- 0.10, P<0.01). We could find no relationship between an increase of HHL content and the duration of the disease. The results indicate that an increased amount of HHL may play a certain role to inducing the sclerotic skin change characteristic of morphea.

Adult↗
PubMed2001

Primary cutaneous nocardiosis due to Nocardia nova in a healthy woman.

We describe a 68-year-old healthy woman with an unusual skin manifestation of mycetoma. A dark reddish erythematous plaque was present on the dorsum of the left hand for over 10 years. A skin biopsy revealed sulphur granules in the abscess, and Nocardia nova was identified from the specimen. Treatment with dapsone resulted in significant improvement. We review the clinical features of cutaneous N. nova infections.

Aged↗
PubMed2001

Application of sentinel node biopsy to gastric cancer surgery.

BACKGROUND: Sentinel node (SN) biopsy has been tried in the management of a variety of cancers with the hope that it would eliminate many unnecessary lymph node dissections, resulting in less morbidity. This important technique, however, has not been tried in gastric cancer surgery. The feasibility of SN biopsy and its accuracy in predicting the lymph node status in patients with gastric cancer were examined in the current study. PATIENTS AND METHODS: SN biopsy was performed in patients with T1 (n = 44) or T2 (n = 30) gastric cancers (ie, immediately after laparotomy, indocyanine green was injected around the primary tumor, and the green-stained nodes [SNs: 2.6 +/- 1.7 nodes per patient] were removed). Then, gastrectomy with extended lymphadenectomy was performed. The unstained nodes (non-SNs: 39 +/- 18 nodes per patient) were obtained from the resected specimens. Both SNs and non-SNs were subjected to histologic examination with hematoxylin-eosin. RESULTS: SNs could be identified in 73 of 74 patients (success rate, 99%). Of these 73 patients, 10 had lymph node metastases in SNs or non-SNs, or both; 6 in both SNs and non-SNs; 3 in SNs alone; and 1 in non-SNs alone. The sensitivity of the SN status in the diagnosis of the lymph node status of the patient was 90% (9/10) and specificity was 100% (63/63). Sensitivity was 100% in the T1 group (n = 44) and 88% in the T2 group (n = 29). CONCLUSIONS: SN biopsy using indocyanine green can be performed with a high success rate, and the SN status can predict the lymph node status with a high degree of accuracy, especially in patients with T1 gastric cancer.

Coloring Agents↗
PubMed2001

Does pleural lavage cytology before thoracic closure predict both patient's prognosis and site of cancer recurrence after resection of esophageal cancer?

BACKGROUND: Operative manipulation occasionally exfoliates and spreads cancer cells in the surgical field, and it is a matter of concern whether the exfoliated cancer cells actually affect the patient's prognosis and sites of cancer recurrence. METHODS: In 240 patients with esophageal cancers, lavage cytology (LC) of the right pleural cavity was performed before and after esophageal resection combined with regional lymphadenectomy. The cytologic results were compared with the pathologic factors associated with cancer extension, postoperative survival, and cause of surgical failure. RESULTS: Only 3 patients (1.3%) were LC positive before resection. Of the 237 LC-negative patients, LC was also negative after resection in 215 patients (90.7%) (LC-/-), but LC became positive after resection in 22 patients (9.3%) (LC-/+). The 3-year survival rate was 0% in the LC-/+ group versus 65% in the LC-/- group, and the median survival rates were 10.9 months and 25.0 months, respectively (P <.0001). Multivariate analysis revealed that LC-/+ was an independent prognostic factor (P =.0331), along with nodal involvement and depth of cancer invasion. However, there were no significant differences in the sites of cancer recurrence between the 2 groups. Only 1 patient was found to develop the first recurrence in the pleural cavity. The LC-/+ group had a higher incidence of bulky lymph-node metastasis (P =.0009). CONCLUSIONS: Pleural LC after resection of esophageal cancer seems to be a prognostic indicator of overall recurrence, but not necessarily in the pleural cavity. Patients with a positive LC after resection may benefit most by effective systemic adjuvant chemotherapy.

Adult↗
PubMed2001

Effects of soy protein on levels of remnant-like particles cholesterol and vitamin E in healthy men.

We determined the effects of soy protein isolate (SPI) intake on remnant-like particles (RLP), lipolytic enzymes, lipid transfer protein, transaminases, sex hormones, iron, calcium, and vitamin E in healthy men. In the first randomized, crossover experiment, 14 men were given either 20 g per day of SPI or nothing (control) for each 4-week segment. After 3 weeks of SPI intake, TG and RLP cholesterol levels were significantly lower than the baseline by 13.4% (p<0.05) and 9.8% (p<0.05), respectively. However, no significant change was found in total and low-density lipoprotein (LDL) cholesterol levels or the activities of lipoprotein lipase, hepatic lipase, cholesteryl ester transfer protein, and lecithin cholesterol acyltransferase. Although the levels of transaminases. testosterone, iron, and calcium did not change, the vitamin E level was reduced from the baseline by 9.7%, a significant decrease (p<0.01). In the second study, we attempted to determine the effect of vitamin E supplement taken with SPI. For each 3-week segment, 12 men were given 20 g per day of SPI, either with or without 200 mg per day of vitamin E, in a randomized crossover design. The vitamin E level was reduced by 9.2%, a significant decrease (p<0.05), after SPI intake for 3 weeks, and vitamin E supplement increased vitamin E level significantly (p<0.05). These results demonstrate that SPI intake reduces remnant lipoproteins, TG, and the plasma level of vitamin E, although vitamin E supplementation compensates for the reduction of vitamin E. Therefore the supplementation of vitamin E may be required in subjects with long-term and abundant intake of soy protein.

Adult↗
PubMed2001

[Reconstruction of the cervical esophagus using cutaneous or musculocutaneous flaps].

Reconstruction of the cervical esophagus using cutaneous or musculocutaneous flaps is described. The delto-pectoral cutaneous flap, latissimus dorsi or pectoris major musculocutaneous flap, free forearm cutaneous flap, and free rectus abdominis musculocutaneous flap are generally used for reconstruction of the cervical esophagus. Although free jejunal transfer with microsurgery is now common for reconstruction of the cervical esophagus, cutaneous or musculocutaneous flaps remain useful in high-risk patients or patients in whom free jejunal transfer or gastrointestinal reconstruction would prove incompetency due to a history of abdominal surgery or other reasons. Cutaneous or musculocutaneous flaps are also used in patients with failure of free jejunal transfer or incurable fistula after reconstruction using the stomach or colon for thoracic esophageal cancer.

Esophageal Neoplasms↗
PubMed2000

Association of functional microsatellites in the human type I collagen alpha2 chain (COL1A2) gene with systemic sclerosis.

Systemic sclerosis (SSc) or scleroderma is a generalized disorder of connective tissue. The etiology is poorly understood; however, both genetic and environmental factors have been implicated. To investigate the disease-susceptible gene for SSc, we examined the association of the disease with a gene (COL1A2) for type I collagen, which accumulates excessively in the affected organs. The COL1A2 gene containing a specific combination of the two dinucleotide repeats, repeat-haplotype, is involved in the regulation of gene expression. Homozygotes for a 5'-(CA)13CGCACA(CG)6(CA)8 -(GT)12 -3' were found with significantly higher frequency (P = 0.029, relative risk, RR > 6.93) in SSc patients than in controls, and association was prominent (P = 0.0042, RR > 32.0) in the male patients positive for SSc-specific antinuclear antibodies (ANAs). This repeat-haplotype showed the highest stimulative activity for the transcription of the COL1A2 promoter among the reporter gene constructs tested. The results indicate that a portion of the patients having a specific dinucleotide repeat-haplotype homozygously and expressing the ANAs have a significantly higher risk for SSc than those individuals with other combinations of the repeat-haplotypes.

Base Sequence↗
PubMed2000

K-ras point mutation in the nerve plexuses around the superior mesenteric artery in resectable adenocarcinoma of the pancreatic head: distribution pattern and related factors.

BACKGROUND: Adenocarcinoma of the pancreas is likely to spread into the nerve plexuses around the superior mesenteric artery (SMA) at a microscopic level. Since there has been no detailed report on how minute cancer invasion is distributed among the peri-SMA plexuses or which cases are more vulnerable to such an event, it has long been controversial how to treat this area when resecting the pancreatic head cancer. HYPOTHESIS: The K-ras mutation assay is more sensitive than the conventional histologic diagnosis in detecting minute cancer invasion around the SMA. DESIGN: Prospective consecutive series. SETTING: Cancer center hospital. PATIENTS AND METHODS: The entire circle of the peri-SMA tissues was obtained from 24 patients who had received an extended pancreatectomy for adenocarcinoma of the pancreatic head. They were divided into right and left hemicircular samples (48 samples), and each sample was used for both histologic and genetic diagnoses. Since all patients' primary tumors were positive for point mutation at codon 12 of the K-ras gene, the presence or absence of the mutation was determined for the peri-SMA plexuses using the mutant allele specific amplification method. RESULTS: Compared with results of the histologic examination, the K-ras mutation assay was more sensitive in detecting positive findings in the peri-SMA plexuses (12 samples from 9 patients). According to the distribution of the K-ras mutation into the right- and left-half samples, 24 patients were classified into the following 4 patterns (right/left): negative/negative in 15 patients; positive/negative in 6 patients; positive/positive in 3 patients; and negative/positive in 0 patients. In 3 patients who showed a positive/positive pattern in the genetic diagnosis, their right-half samples included more cancer cells that were detectable by routine microscopy. There was no relation between K-ras mutation and lymphatic invasion, while K-ras mutation was particularly related with the invasion of portal vein (P =.04) and posterior peripancreatic tissues (P =.002). All 3 patients with K-ras mutation in bilateral plexuses were classified by the TNM staging system as T4 using Union Internationale Contre le Cancer classification. CONCLUSIONS: The K-ras mutation (at codon 12) assay indicated a simple and regular pattern of cancer extension into the nerve plexuses around the SMA from adenocarcinoma of the pancreatic head: (1) The left half of the plexus was unlikely to be involved by cancer in cases in which the right half was intact. (2) Cancer extension into the peri-SMA plexuses occurred after the posterior confine of the pancreas had been involved by direct invasion from the primary pancreatic tumor. (3) The left half was not involved in cancerous tumors classified as T1 to T3 but was occasionally involved in those classified as T4 tumors. These data seem to provide a useful indicator of some additional treatments (resection, irradiation, etc) for the peri-SMA region when a locally advanced pancreatic head cancer is treated with a curative intent.

Adenocarcinoma↗
PubMed2000

Total gastrectomy with dissection of lymph nodes along the splenic artery: a pancreas-preserving method.

BACKGROUND: In Japan, the tail and body of the pancreas are generally removed for dissection of lymph nodes along the splenic artery. A new pancreas-preserving method was developed to decrease the postoperative complications due to pancreatic resection. PATIENTS AND METHODS: Between 1981 and 1989, 110 patients were registered in a randomized controlled trial, which included total gastrectomy plus dissection of lymph node along the splenic artery, either with (55 patients: Group A) or without (55: Group B) pancreas tail resection. In Group B, the splenic artery and spleen were removed and the pancreas was preserved. There were no significant differences between the two groups in terms of sex, age, location, microscopic classification, or disease stage. The postoperative complications and survival rates were compared between the two groups. RESULTS: The average number of dissected nodes along the splenic artery was 4.6 and 4.1 for Groups A and B, respectively. The amounts of blood loss during the operation were 994 ml and 904 ml for groups A and B, respectively. Anastomosis failure and/or pancreatic fistula occurred in nine patients in Group A (16%) and seven in Group B (13%). One year after the operation, a glucose tolerance test showed diabetes in 6% and impaired glucose tolerance in 33% of patients in group A, while these findings were normal in group B. The 5-year survival rates were 80% and 76.7% for groups A and B, respectively. CONCLUSIONS: The pancreas-preserving method described here was superior to the more common pancreas resecting method with regard to surgical risk and postoperative glucose tolerance.

Adult↗
PubMed2000

Stem cell factor and IL-6 do not promote complete maturation of human cultured mast cells from umbilical cord blood cells: an ultrastructural study.

Human mast cells are classified into two phenotypes based on their neutral protease compositions. One type is a tryptase-positive and chymase-positive MCTC cell that is predominant in the skin, another is a tryptase-positive and chymase-negative MCT cell that is predominant in the lung. Cord blood-derived human mast cells cultured in the presence of stem cell factor and interleukin-6 are a mixture of MCTC and MCT at various ratios, as revealed by immunocytochemical staining. We performed an electron microscopic analysis of cord blood-derived human cultured mast cells and found that they were so immature that we could not distinguish MCT and MCTC from their ultrastructural morphology. The response to secretagogues was not the response of MCTC but rather of MCT. Although human cultured mast cells are the most useful cells for use in in vitro experiments, the present culture condition supplemented with stem cell factor and interleukin-6 does not develop fully mature mast cells in vitro.

Cell Differentiation↗