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Biomedical subjects

O Ishikawa

Publications and source records attributed to O Ishikawa.

At least 91 records · Page 5Linked to original sources
PubMed1998

Linear cutaneous lupus erythematosus following the lines of Blaschko.

We describe two Japanese girls with discoid lupus erythematosus (DLE) in whom the condition showed a linear configuration following the lines of Blaschko. The clinical appearance was unusual but histological examination established the diagnosis. After reviewing the previous reports, we found that in six of eight patients with linear 'discoid' lesions, the age at onset was under 14 years; no patient has progressed to systemic lupus erythematosus. Patients with 'linear' DLE may compose a certain clinical subset. We propose the term 'linear cutaneous lupus erythematosus' which may be more suitable for the linear lesions of DLE.

Adolescent↗
PubMed1998

Creeping eruption caused by a larva of the suborder Spirurina type X.

We report a 40-year-old Japanese man with a creeping eruption caused by a larva of the nematode suborder Spirurina type X. He had eaten raw small squid (hotaruika) 4 weeks before the serpiginous erythematous eruption appeared on his abdomen. Routine laboratory tests revealed only slight eosinophilia in his peripheral blood. Although we could not find the larva in an excised skin specimen, an indirect immunofluorescence test confirmed the presence of antibodies against larvae of the suborder Spirurina type X. We review 28 reported cases in Japan which showed that creeping eruption caused by larvae of the suborder Spirurina type X has the following clinical characteristics: an incubation time of 1-4 weeks; a migratory, well-defined, narrow, serpiginous erythematous eruption; and only slight peripheral blood eosinophilia. Excision of the advancing end of the track was curative in our patient.

Adult↗
PubMed1998

Perianal hidradenitis suppurativa: early surgical treatment gives good results in chronic or recurrent cases.

Hidradenitis suppurativa (HS) represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses followed by the formation of sinus tracts and scarring. It is an uncommon disorder frequently involving the perianal region. We review the clinical and pathological features of 12 patients (10 men and two women) with perianal HS (PHS). The mean age at presentation was 43 years (range 24-65), and the mean duration of illness was 14 years (range 2-30). Two patients exhibited multiple areas of involvement, including the axilla and the nape of the neck, in addition to the perianal region. Histological examinations showed epidermis-lined sinuses surrounded by dense plasma cell infiltration in four of nine specimens. The complications related with PHS included anal fistula (seven patients), diabetes mellitus (four), malignant tumour (two) and sepsis (one). Three patients died of the complications. Eight patients underwent wide local excision. The defects were managed with a meshed split-thickness skin graft in five patients, and open treatment in the remainder. New lesions developed in untreated skin of two patients. However, no patient relapsed in the surgically treated sites. PHS is frequently complicated with anal fistula and is occasionally life-threatening as a result of the occurrence of malignant tumours or sepsis. Early surgical excision followed by meshed split-thickness skin graft can successfully cure the lesion without functional disturbance.

Adult↗
PubMed1998

Mast cell tryptase stimulates both human dermal fibroblast proliferation and type I collagen production.

BACKGROUND: Mast cell tryptase has been shown to be mitogenic for fibroblasts, however, it still remains unknown whether mast cell tryptase stimulates collagen production by human derrmal fibroblasts. OBJECTIVE: We have investigated the effect of mast cell tryptase on type I collagen production by human dermal fibroblasts as well as the proliferation of the fibroblasts. METHODS: Tryptase isolated from human lung tissue was added to the culture of fibroblasts from normal dermis, and the fibroblast proliferation and the activity of type I collagen synthesis in the supernatants were assayed, respectively. RESULTS: Fibroblast proliferation was increased with tryptase in a concentration-dependent manner, and a significant increase was observed in the presence of tryptase at concentrations from 0.01 to 10 microg/mL. The increase of fibroblast proliferation with 3 microg/mL tryptase was significantly reduced by 15 microg/mL antitryptase IgG antibody, which was demonstrated to inhibit fibrinogenolysis of tryptase. On the other hand, the production of type I collagen by the fibroblasts was significantly increased with tryptase at a concentration of 10 microg/mL. The collagen production in the presence of 10 microg/mL tryptase was significantly inhibited by 50 microg/mL antitryptase IgG antibody. CONCLUSION: Tryptase increases not only the proliferation of human dermal fibroblasts but also type I collagen production.

Cell Division↗
PubMed1998

Spiral CT during pharmacoangiography with angiotensin II in patients with pancreatic disease. Technique and diagnostic efficacy.

PURPOSE: To compare the diagnostic efficacy of pancreatic pharmacoangiographic CT using angiotensin II with conventional angiographic CT. MATERIAL AND METHODS: Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was performed with a 1-3 micrograms/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT. RESULTS: In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma was significantly increased at pharmacoangiographic CT (p = 0.0010). Although the attenuation value of tumors was also increased on images obtained after the injection of angiotensin II, the tumor-to-pancreas contrast was significantly greater at pharmacoangiographic CT (p = 0.0479). The mean differences in attenuation between tumor and pancreas at angiographic CT with and without angiotensin II were respectively 182 HU and 115 HU. CONCLUSION: Pharmacoangiographic CT with angiotensin II proved superior to conventional angiographic CT in the diagnosis of pancreatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor.

Adult↗
PubMed1998

Dermal connective tissue metabolism in photoageing.

The term photoageing describes the clinical and histological cutaneous changes that are the consequence of repeated chronic sun exposures and are qualitatively different from those observed in chronological ageing. The connective tissue of the skin is composed mainly of collagen, glycosaminoglycans and elastin and, thus, alterations of these components in photoageing are briefly reviewed in the present article. Collagen changes in photoageing are partly explained by cross-links as well as the unbalanced regulation of collagen production and breakdown. Some visible skin changes can be induced by the consequence of dermal glycosaminoglycans, because the total amount, as well as the composition of the main disaccharide units, is significantly altered in the exposed sites of both aged people and photoaged mice. As for the mechanism of solar elastosis, increased elastin mRNA levels resulting from transcriptional up-regulation of the gene have been reported. Taken together, all components of the dermal connective tissue are affected by chronic actinic damage; however, further in vitro investigation is required to unmask the exact events in photoageing. With regard to this, our novel three-dimensional culture system should be of great help because it mimics the in vivo condition by self producing the extracellular matrices.

Collagen↗
PubMed1998

Immunological features of patients with primary biliary cirrhosis (PBC) overlapping systemic sclerosis: a comparison with patients with PBC alone.

To characterize the immunological features of patients with primary biliary cirrhosis (PBC) overlapping systemic sclerosis (SSc), 26 patients with PBC were classified according to the presence of scleroderma-related features (Raynaud's phenomenon, sclerodactyly etc.). The patients were classified into 10 patients with PBC overlapping SSc (PBC-SSc), four patients with some scleroderma-related features although not meeting the criteria of SSc (PBC-SSc spectrum) and 12 patients with PBC alone. Sera from PBC-SSc showed a significantly higher positivity to anti-centromere antibody (P< 0.01) and to E1beta of pyruvate dehydrogenase complex (P< 0.005) than those from patients with PBC alone. The same tendency was observed in PBC-SSc spectrum patients. Patients with PBC exhibiting scleroderma-related features, in both the PBC-SSc and PBC-SSc spectrum, may comprise a subset in PBC, not only clinically, but also immunologically.

Adult↗
PubMed1998

Isolation and characterization of a novel human pancreas-specific gene, pancpin, that is down-regulated in pancreatic cancer cells.

By means of the differential display method, we isolated a novel human gene that is expressed specifically in pancreas. The cDNA, designated "pancpin," contained an open reading frame of 1,215 nucleotides encoding a 405 amino acid protein, showing a high degree of similarity to serine protease inhibitors belonging to the serpin superfamily. To investigate its possible role in pancreatic carcinogenesis, we looked for genetic alterations of this gene in pancreatic cancer cell lines and primary pancreatic cancer tissues. Expression of pancpin was barely detectable in any of the four pancreatic cancer cell lines examined, and very weak also in 10 of 13 pancreatic cancer tissues. A somatic missense mutation at codon 221 was found in two of 16 primary pancreatic cancers. These findings indicate that down-regulation of pancpin expression may play a significant role in development or progression of pancreatic cancer.

Amino Acid Sequence↗
PubMed1998

[A measure to continue intra-arterial infusion chemotherapy long-term for locally advanced pancreatic cancer].

For locally advanced non-resectable cancer of the pancreas, we have routinely performed intra-arterial chemotherapy: Each catheter is placed in the splenic artery and gastroduodenal artery during laparotomy, and a mixture of Methotrexate and Angiotensin-II is infused within 30 minutes. This treatment is repeated weekly at our outpatient clinic as long as possible. However, obstruction of the catheter or corresponding artery is the major cause of interruption of treatment. The present paper reports a case in which intra-arterial chemotherapy was possible by repeated catheterization for the catheter obstruction. A 54-year-old woman with non-resectable pancreatic cancer underwent catheter placement during laparotomy, but they became occluded one month later. Another catheter was placed into the common hepatic artery by the Seldinger method. After this catheter was occluded again, another catheter was placed into the inferior pancreaticoduodenal artery via the superior mesenteric artery by the Seldinger method. By repeating this catheter placement, we succeeded in continuing the intra-arterial chemotherapy, and the patient has remained alive (30 postoperative months) without losing her quality of life.

Angiotensin II↗
PubMed1998

[Adjuvant intra-arterial chemotherapy with gastrin receptor antagonist after hepatic resection in colorectal cancer metastasis].

The aim of this study was to determine whether chemo-endocrine therapy after the resection of liver metastasis from colorectal cancer would prevent recurrence in the remnant liver and prolong survival. Eleven colorectal cancer patients underwent hepatic resection for liver metastasis. Subsequently, they were administered Proglumide gastrin antagonist 1,200 mg/day + 5'-DFUR 800 mg/day for 2 years. In seven of them, MMC 6-10 mg and ADM 20 mg were infused intra-arterially every two weeks alternately for one year. In four of them, 5-FU 250 mg/day was infused for seven days continuously intra-arterially every two weeks for one year. Recurrence in the remnant liver occurred in four of 11 patients. All of these patients underwent repeated hepatectomy. The mean disease-free survival in the remnant liver was 37 months and the five-year survival rate was 91%. These results indicate that intra-arterial chemotherapy with gastrin receptor antagonist might be effective for adjuvant therapy in patients with resectable liver metastasis from colorectal cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

[Report of case who survived more than five years after repeated intraperitoneal chemotherapy with cisplatin and 5-fluorouracil for treatment of macroscopically negative but microscopically positive peritoneal dissemination of gastric cancer].

UNLABELLED: Prognosis of patients with macroscopically negative but microscopically positive peritoneal dissemination is so poor that the two-year survival rate after the surgery was 0% during 1975-1981. It improved to 38% during 1982-1988 but the five year survival rate was 0%. CASE REPORT: A 57-year-old male underwent distal gastrectomy and lymph node dissection on November 10, 1992 due to Borrmann type 3 gastric cancer measuring 5.4 cm in diameter and locating in the gastric antrum (H0 P0 t3 n3 stage IV a). Peritoneal lavage cytology revealed cancer cells, and, thus, this patient was treated with intraperitoneal chemotherapy using an intraperitoneal infuser port. Through the infuser port, cisplatin and 5-FU were given at a dose of 70 mg/m2 and 700 mg/m2, respectively. Because fluorouracil infusion caused abdominal pain after the second infusion, it was administered i.v. for 24 hours thereafter. The infuser port was removed after the four infusions because the patient developed appendicitis. Fluorouracil was given p.o. at a dose of 300 mg/day from one month after surgery (total dose of fluorouracil 54.6 g). Cytological examination of the ascites revealed no cancer cells after the second intraperitoneal chemotherapy, and the patient fared well five years and four months after the surgery. Therefore, it is suggested that intraperitoneal chemotherapy with cisplatin and fluorouracil is an effective treatment for microscopical peritoneal dissemination, though it may have an adverse effect such as chemical peritonitis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Photosensitive drug eruption induced by flutamide.

We describe a 68-year-old man who showed a photosensitive drug eruption induced by flutamide. The minimal erythema dose with ultraviolet A light was reduced to 2 J/cm2 under administration of flutamide, which recovered to over 16 J/cm2 after cessation of the medication, without changing the reactivity to ultraviolet B. The absorption spectrum of flutamide was not altered after ultraviolet A irradiation, suggesting that flutamide is photostable with regard to ultraviolet A. In addition, bovine serum albumin was not covalently photocoupled with flutamide under ultraviolet A. Thus, flutamide seems to have low potency to act as a photohapten, and it is likely that a non-photohaptenic mechanism operates in this photosensitivity or its active metabolite may work as a photosensitizer.

Aged↗
PubMed1998

Pancreatic invasion as the prognostic indicator of duodenal adenocarcinoma treated by pancreatoduodenectomy plus extended lymphadenectomy.

UNLABELLED: Pancreatoduodenectomy has become the standard procedure in resection of the duodenal adenocarcinoma, and some adjuvant therapies can be added to obtain further improvement in postoperative outcome. However, for patient selection, it is necessary to have a predictive indicator showing, if possible before laparotomy, which instances are noncurable by surgery alone or need adjuvant therapies. METHODS: A retrospective analysis was made for 24 consecutive patients whose duodenal adenocarcinoma were treated by pancreatoduodenectomy plus a wide range of lymphadenectomies without any adjuvant therapies at Osaka Medical Center for Cancer and Cardiovascular Diseases. Patient survival rates were related to macroscopic and microscopic findings and to findings obtained by preoperative imaging techniques. RESULTS: The overall survival rate was 69% at 3 years and 57% at 5 years; locoregional recurrence was the primary cause of death. Although the 5-year survival rate was 44% in patients with nodal involvement and 76% in those without, this difference did not reach statistical significance (P = .079). Instead, invasion into the pancreatic parenchyma at a macroscopic level was the most significant prognostic factor; the 5-year survival rate was 78% in the 16 patients without and 16% in the 8 patients with pancreatic invasion (P = .0047). Invasion into the pancreas correlated well with the angiographic findings; the 5-year survival rate was 25% in patients whose angiograms delineated the pancreatic invasion and 83% in patients whose angiograms did not (P = .0084). CONCLUSION: When duodenal adenocarcinoma was treated by pancreatoduodenectomy plus a wide range of lymphadenectomy, pancreatic invasion at a macroscopic level was most associated with patient survival. Pancreatic invasion was well delineated by the preoperative angiogram, which would be helpful in patient selection.

Adenocarcinoma↗
PubMed1997

Measurement of histidinohydroxylysinonorleucine and hydroxyproline in skin collagen by reversed-phase high-performance liquid chromatography after 9-fluorenylmethyl chloroformate labeling.

A novel, highly sensitive method to quantify histidinohydroxylysinonorleucine (HHL), a trifunctional type of cross-link in skin collagen, was developed. HHL in skin hydrolysates labeled with 9-fluorenylmethyl chloroformate (FMOC-Cl) was separated by reversed-phase high-performance liquid chromatography. Mass spectrometric analysis revealed that two FMOCs were bound to two primary amino acid residues, histidine and hydroxylysine, but not to lysine residue in one HHL molecule. Hydroxyproline was simultaneously measured to express the molar ratio of HHL to collagen. The detection range of HHL was from 1 to 10 pmol and that of hydroxyproline from 1 to 50 pmol. A 6-mm punch-biopsied human skin sample contained 0.40 to 0.69 mol of HHL per one molecule of collagen. This sensitive method is useful as it is rapid and can be used to examine the aging process or the change of HHL content in skin collagens of various pathologic states.

Chromatography, High Pressure Liquid↗
PubMed1997

Detection of pancreatic and gastric cancer cells in peripheral and portal blood by amplification of keratin 19 mRNA with reverse transcriptase-polymerase chain reaction.

Reverse transcriptase-polymerase chain reaction (RT-PCR) targeted at keratin 19 mRNA was applied to detect circulating cancer cells in the peripheral and portal blood of pancreatic and gastric cancer patients. Keratin 19 mRNA expression was studied by RT-PCR in cancer tissues (12 pancreatic and 15 gastric cancers) and in peripheral and/or portal blood samples from patients with pancreatic cancer (stage I, n = 5; stage II, n = 1; stage III, n = 15; stage IV, n = 19), gastric cancer (stage la,b, n = 28; stage II, n = 9; stage IIIa,b, n = 5; stage IVa,b, n = 7) and benign pancreatic diseases (n = 7). Peripheral blood samples from 50 healthy volunteers served as controls. RT-PCR was conducted in duplicate in each sample, and only samples showing keratin 19 transcript in both determinations were considered as being positive. All the pancreatic and gastric cancers, but none of the control blood samples, were found to be positive. Dilution study using pancreatic cancer cells serially mixed against peripheral blood showed that detection sensitivity was more than one cancer cell in 10(6) peripheral blood mononuclear cells. In pancreatic cancer patients, RT-PCR analysis of the portal blood samples gave positive results in one stage III and one stage IV patient, and that of peripheral blood samples gave positive results in 2 stage IV patients. No positive results were obtained in any of the blood samples from gastric cancer patients. Our results indicate that incidence of circulating cancer cells is unexpectedly very low even in advanced pancreatic and gastric cancer patients.

Humans↗
PubMed1997

Diagnosis of carcinoma in situ of the pancreas by peroral pancreatoscopy and pancreatoscopic cytology.

BACKGROUND: Most pancreatic carcinomas are unresectable at the time of diagnosis, but recently the diagnosis of carcinoma in situ of the pancreas has become possible. This diagnosis can be made by the detection of cancer cells in pancreatic juice and the radiographically demonstrated lack of a mass lesion. It has greatly improved the effectiveness of surgery. Carcinoma in situ remains within the pancreatic ductal epithelium and has not yet invaded the parenchyma. However, it has often been difficult to locate carcinoma in situ by conventional diagnostic methods, such as ultrasonography, endoscopic ultrasonography, computed tomography, and endoscopic retrograde pancreatography. METHODS: Peroral pancreatoscopy and a new method of cytodiagnosis, pancreatoscopic cytology, were used to analyze 11 patients with carcinoma in situ of the pancreas, 10 with disease in the main duct of the pancreas and 1 with disease in the branch ducts. The results of pancreatoscopic cytology were compared with those of conventional pancreatic juice cytology. RESULTS: Under peroral pancreatoscopy, carcinoma in situ of the pancreas in the main duct appeared as papillary mucosa, irregular mucosa, or nodular mucosa. Using pancreatoscopic cytology, cancer cells were obtained from all the lesions, allowing a more thorough analysis than pancreatic juice cytology. CONCLUSIONS: Peroral pancreatoscopy and pancreatoscopic cytology are useful for locating and diagnosing carcinoma in situ of the pancreas.

Aged↗
PubMed1997

Involvement of carbohydrate antigen sialyl Lewis(x) in colorectal cancer metastasis.

PURPOSE: Recognition of metastatic tumor cells with distinct biochemical phenotypes predominant in the primary tumors should be useful not only for establishment of new therapeutic approaches but also for identification of high-risk or low-risk patients for relapse. We examined whether carbohydrate antigens, sialyl Lewis(x) (sLe(x)) and sialyl Lewis(a) (sLe(a)) are involved in colorectal cancer metastasis. METHODS: Metastatic abilities of human colon cancer cell variants that were selected for their high or low cell surface levels of sLe(x) (KM12-HX and KM12-LX, respectively) were analyzed. Also, immunohistochemical expressions of sLe(x) and sLe(a) in 159 primary colorectal cancers were examined to determine the clinical significance of increased expression of these antigens. RESULTS: KM12-HX cells adhered more readily to tumor necrosis factor-alpha activated endothelial cells than did KM12-LX cells. Increased adhesion of KM12-HX cells to activated endothelial cells was inhibited by antibodies against E-selectin and sLe(x) and by modification of cell surface carbohydrates. KM12-HX cells showed more invasive ability in vitro and more metastatic potential in the liver of nude mice than KM12-LX cells. Although no difference was seen in the expression of six messenger ribonucleic acids corresponding to progression or metastasis of colorectal cancer, expression of fucosyltransferase was found to be responsible for the higher expression of sLe(x) in KM12-HX cells. Clinical records of patients showed that disease-free survival rate of patients with sLe(x)-positive tumors was significantly poorer than that of those with sLe(x)-negative tumors. Cox's multivariate analysis revealed that the sLe(x) status was an independent predictive factor for disease recurrence (P = 0.004), depth of invasion (P = 0.0005), and histologic type (P = 0.037), but sLe(a) status, age, gender, tumor location, N stage, and vessel invasion were not. CONCLUSION: Increased expression of sLe(x) could be involved in establishment of colorectal cancer metastasis. It appears that examining sLe(x) expression may serve as a potent marker of the recurrence in patients with colorectal cancer.

Adult↗