Biomedical subjects

S Kikuchi

Publications and source records attributed to S Kikuchi.

At least 649 records · Page 36Linked to original sources

PubMedDate not supplied

Amygdaloid kindling elicits persistent changes in pertussis toxin-catalyzed ADP-ribosylation.

We examined the changes in pertussis toxin (PTX)-catalyzed ADP-ribosylation in amygdaloid-kindled rats to clarify the role of G proteins in the basic mechanisms of epilepsies. Autoradiographic analysis showed a remarkable increase in PTX-catalyzed ADP-ribosylation in 39-41-kDa proteins in hippocampus and cerebral cortex of kindled animals. The 39- to 41-kDa proteins were shown to be alpha-subunits of Gi and Go by immunoblotting with specific anti-Gi alpha and anti-Go alpha. The increase in ADP-ribosylation of these proteins was observed on stimulated and unstimulated sides of brains 24 h after the last generalized seizure and persisted for at least 3-4 weeks. These results suggest that persistent alterations in signal transduction through Gi and Go might be related to acquisition of long-lasting epileptogenesis.

Adenosine Triphosphate↗

PubMedDate not supplied

Congenital cholesteatoma of the petrous pyramid.

A congenital cholesteatoma arising from the petrous pyramid is rarely encountered, and we report a case of such a cholesteatoma in a 23-year-old male. This cholesteatoma was successfully removed by a middle cranial fossa approach. The cholesteatoma showed a unique mode of spread, that is, it originated from the pyramidal apex and extended in two directions: through the facial canal to the tympanic sinus, and along the tympanic tegmen to the mastoid antrum. We discuss the importance of CT and MRI for achieving a diagnosis, as well as the merits of using a middle cranial fossa approach for the surgical excision of this cholesteatoma.

Adult↗

PubMedDate not supplied

Occult follicular carcinoma metastasizing to the sinonasal tract.

We report a 34-year-old woman with a clinically occult primary carcinoma of the thyroid metastasizing to the sinonasal tract. The metastasis showed intensive vascularization and involved the nose, the maxillary, ethmoid and sphenoid sinuses, extending to the intracranial cavity. After embolization, the lesion was removed and histopathologically diagnosed as follicular carcinoma of the thyroid. A subsequent total thyroidectomy revealed an 8-mm primary lesion within the left lobe. Thyroid metastases, although rare, need to be considered in the differential diagnosis of hypervascular tumors in the sinonasal tract.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Immobilization of E. coli cell as an antigen by radiation polymerization method.

E. coli NIJ cells were immobilized by radiation polymerization of 2-hydroxyethyl methacrylate at low temperatures. The immobilized E. coli cells as an antigen were reacted with peroxidase labeled anti-E. coli in competition with the free E. coli cells. It was found that E. coli cells can be assayed quantitatively with the immobilized E. coli cells in disc form. Microorganisms such as gram negative bacteria had no specific affinity to anti-E. coli. Cross reactivity of the immobilized E. coli cells with the E. coli cells from various strains was examined.

Antibodies, Bacterial↗

PubMedDate not supplied

Lymph node metastasis in early gastric cancer: how can surgeons perform limited surgery?

BACKGROUND: In Japan, the standard treatment policy for all potentially curable patients with gastric cancer is radical resection, including extensive lymph node dissection. The extent of lymph node dissection remains a controversial issue in the management of early gastric cancer. A recent trend in the surgical treatment of early gastric carcinoma has been to limit surgery such that a complete cure is achieved and the patient's quality of life is improved. However, approximately 10% of early gastric cancers are reported to be node positive and little is known about the protocol of surgical treatment most appropriate for the treatment of early gastric cancer. In this study, we examined the clinicopathological features that could distinguish node-positive cancer from node-negative cancer. PATIENTS AND METHODS: The clinicopathological features of 26 patients with node-positive early gastric cancer were reviewed from the database of gastric cancer at the Department of Surgery, Sendai National Hospital. They were compared with those of 239 patients with node-negative cancer. RESULTS: Tumor size, macroscopic appearance, depth of cancer invasion, histological growth pattern and lymphatic invasion were associated with lymph node metastasis. Node-positive patients with early gastric cancer had a poorer survival rate than node-negative patients (P<0.05). CONCLUSION: Limited surgery, such as local resection without lymphadenectomy, can be performed for elevated or flat type cancer, or tumor <2 cm in diameter. Lymphadenectomy is recommended to achieve higher possible cure rates for other early gastric cancers.

Female↗

PubMedDate not supplied

Does gastrojejunostomy for unresectable cancer of the gastric antrum offer satisfactory palliation?

BACKGROUND/AIMS: Gastrojejunostomy is the procedure of choice for patients with obstruction or stenosis of the gastric outlet or duodenum. However, the palliative benefits of this procedure in gastric cancer remain uncertain. Thus, the present study was performed to address this problem. METHODOLOGY: In the present study, 52 patients who had undergone gastrojejunostomy for unresectable cancer of the gastric antrum at Kitasato University Hospital and Kitasato University East Hospital in Japan between 1972 and 1994 were examined. RESULTS: The median survival time in these 52 patients was 5.0 months. The duration of palliation ranged from 0-13 months, with an average of 2.8 months. No significant difference between clinicopathologic factors and duration of palliation was found and location of tumor was the only independent prognostic factor (coefficient: 0.890; hazard ratio: 2.435). CONCLUSIONS: Although gastrojejunostomy for unresectable cancer of the gastric antrum is the procedure most often chosen at laparotomy, the palliative benefits of gastrojejunostomy do not sufficiently compensate for the patients' limited post-operative survival and quality of life.

Adult↗

PubMedDate not supplied

Gastric cancer with invasion limited to the muscularis propria.

The clinicopathological features of 84 muscularis propria (mp) gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach, were reviewed retrospectively, and compared with 267 early gastric cancers (m/sm cancer) and 333 gastric cancers invading beyond the subserosal layer (ss-si cancer). There were statistical differences in tumor size, histological growth pattern, cancer-stromal relationship, lymph node metastasis, lymphatic invasion, vascular permeation and operative procedure between mp gastric cancer and early gastric cancer or ss-si gastric cancer. The mp tumors were significantly larger than the early cancer tumors but significantly smaller than the ss-si tumors (P < 0.0001), and mp cancer had more frequent lymph node metastasis (50%) than did early gastric cancer (10%) but less frequent lymph node metastasis than did ss-si cancer (84%; P < 0.0001). Histologically, infiltrative and scirrhous types were more common in the mp cancer group than in the early cancer group. The frequency of vascular permeation in the mp cancer group was almost the same as that in the early cancer group. Univariate analysis revealed that the significant prognostic factors were nodal involvement (P = 0.0213) and lymphatic invasion (P = 0.0364). Multivariate analysis of the mp-invaded cancer cases, however, revealed that lymph node metastasis was not a significant prognostic factor, although it was more important than was lymphatic invasion. Multivariate analysis also revealed that the prognosis of our mp gastric cancer patients was affected most by vascular permeation, followed by tumor size.

Analysis of Variance↗

PubMedDate not supplied

c-erbB-2, p53 protein expression and steroid hormone receptors in breast carcinomas: an immunohistochemical study.

p53, c-erbB-2 protein, steroid hormone receptors, and their correlation with clinicopathologic features were investigated in 70 primary breast carcinomas. All markers were measured immunohistochemically on paraffin sections. Altered p53 expression was found in 27.1% of cases and was associated with negative estrogen receptor status. p53 immunostaining was correlated weakly with histologically lymphatic vessel invasion of carcinoma. c-erbB-2 protein overexpression was seen in 48.6% of cases. A trend was observed in the correlation between c-erbB-2 immunostaining and regional lymph node metastases. Estrogen receptor status was not associated with any histologic or clinical parameters, whereas progesterone receptor status was associated with lymph node metastasis and histologically lymphatic vessel invasion of cancer. PgR status, p53 and c-erbB-2 immunostaining may prove to be an additional criterion in histologic diagnosis of breast cancer.

Adult↗

PubMedDate not supplied

Significant prognostic factors in patients with node-negative gastric cancer.

BACKGROUND: We evaluated the influence of several clinicopathological variables on 5 year survival of patients with node-negative gastric cancer. PATIENTS AND METHODS: Clinical characteristics were retrieved from the records of all patients who underwent gastric resection between 1985 and 1995 at the Department of General Surgery, Sendai National Hospital, and follow-up data were obtained from our tumor registry. Pathological characteristics were determined from a detailed review of all available histopathological slides. The results of a retrospective analysis of clinicopathological data of 339 patients having no lymph node metastasis were compared with those of 358 patients with lymph node metastasis. Univariate and multivariate analyses of patients with node-negative gastric cancer were performed to evaluate the prognostic significance of clinicopathological features (age, gender, gross type, histological type, depth of invasion and location). RESULTS: The 5 year survival rate for patients with node-negative gastric cancer was 92.5%. Node-negative gastric cancers were characterized by a smaller tumor, expansive and medullary histological type, and less frequency of lymphatic invasion and vascular permeation. In multivariate analysis, the statistical significant prognostic factors were tumor size (P = 0.0185), vascular permeation (P = 0.0011) and cancer-stromal relationship (P = 0.0291). CONCLUSION: Tumor size, vascular microinvasion and cancer-stromal relationship are the most reliable predictors of 5 year survival for patients with node-negative gastric cancer.

Adenocarcinoma↗

PubMedDate not supplied

Is extended lymphadenectomy valuable in palliatively gastrectomized patients with gastric cancer and simultaneous peritoneal metastasis?

BACKGROUND/AIMS: The optimal extent of lymphadenectomy in patients with gastric cancer and simultaneous peritoneal metastasis upon non-curative resection remains unclear. The aim of the present study was to evaluate the efficacy of extended lymphadenectomy in palliatively gastrectomized patients with gastric cancer and simultaneous peritoneal metastasis. METHODOLOGY: The significance and limit of extended lymphadenectomy according to the extent of peritoneal metastasis was analyzed retrospectively in 110 patients with gastric cancer and simultaneous peritoneal metastasis who had undergone palliative gastrectomy. RESULTS: Of the 47 patients with P1 metastasis, the median survival period of the 23 patients who underwent extended lymphadenectomy and the 24 patients who underwent limited lymphadenectomy was 21.7 months and 17.2 months, respectively. Of the 63 patients with P2 or P3 metastasis, the median survival period of the 16 patients who underwent extended lymphadenectomy and the 47 patients who underwent limited lymphadenectomy was 10.4 months and 12.8 months, respectively. No significant differences in survival time based on extent of lymphadenectomy were observed either in the patients with P2 or P3 metastasis (P = 0.262) or in those with P1 metastasis (P = 0.277). CONCLUSIONS: The results of the present study demonstrate that extended lymphadenectomy in gastric cancer yields no positive impact on survival upon non-curative resection either in patients with gastric cancer and simultaneous metastases to the adjacent peritoneum (P1) or to the distant peritoneum (P2 or P3).

Female↗

PubMedDate not supplied

Three-dimensional reconstruction of colorectal tumors from serial tissue sections by computer graphics: a preliminary study.

BACKGROUND/AIMS: We present herein the three-dimensional reconstruction of colorectal tumors, with particular reference to growth pattern into each layer of the colorectal wall, and measurement of tumor volume and surface area. METHODOLOGY: Conventional tissue section images of colorectal tumors were analyzed using a computer graphics analysis program. The two-dimensional extent of invasion by each tumor into each layer of intestinal wall were determined from the images of each section. Based on data from multiple sections, tumor and surrounding normal tissue layers were reconstructed three-dimensionally, and volume and surface area of the tumors were determined. RESULTS: Using this technique, three-dimensional morphology of tumor and tumor progression into colorectal wall could be determined. Volume and surface area of the colon tumor were 4871 mm3 and 1741 mm2, respectively. Volume and surface area of the rectal tumor were 1090 mm3 and 877 mm2, respectively. CONCLUSIONS: This technique may provide a new approach for pathological analysis of colorectal carcinoma.

Colonic Neoplasms↗

PubMedDate not supplied

Surgical outcome of curative resection in patients with Borrmann type IV gastric carcinoma with particular reference to the extent of lymph node metastasis.

BACKGROUND/AIMS: The prognosis after curative resection for Borrmann type IV carcinoma, according to the extent of lymph node metastasis, is poorly understood. METHODOLOGY: The surgical outcome of curative resection was examined in 78 patients with T2-T3 Borrmann type IV gastric carcinomas, with particular reference to the extent of lymph node metastasis. RESULTS: The 5-year survival rate was 35.7% for the n0 patients, 27.8% for the n1 patients, 18.2% for the n2 patients and 0% for the n3 or n4 patients. The survival curve for the n3 or n4 patients differed significantly from those of the n0 (P < 0.0001), n1 (P = 0.0009) and n2 (P = 0.0203) patients. However, no other statistically significant differences between the curves were found. CONCLUSIONS: The results of the present study indicate that patients with Borrmann type IV carcinoma of the stomach may indeed be cured by curative surgery, and that the surgical outcome of this disease does not depend on the extent of lymph node metastasis under curative resection if lymph node metastasis is restricted to the n2 lymph nodes.

Female↗

PubMedDate not supplied

An in-vitro model of scirrhous carcinoma of the stomach using stomach fibroblasts derived from gastric cancer patients.

BACKGROUND/AIMS: The mechanisms of the particular stromal changes that occur upon cancer invasion by scirrhous carcinoma of the stomach, in particular, the relationships among cancer cells, stomach fibroblasts and collagen, a major constituent of the stroma of the invasive tumor, have yet to be clarified. METHODOLOGY: Three different human fibroblast cell lines (TIG-101, MF-2, MKF-1) and a cancer cell line derived from scirrhous carcinoma of the stomach (KATO III) were cultured three-dimensionally in collagen gels to investigate collagen gel contraction by these cells as a model of scirrhous carcinoma of the stomach. RESULTS: The gels contracted and gradually decreased in size in all of the fibroblast (TIG-101, MF-2 and MKF-1) cultures, but not in the KATO III culture, and the extent of gel contraction was not uniform among the fibroblast cell lines. The extent of gel contraction when fibroblasts derived from stomach (MF-2, MKF-1) were co-cultured with KATO III cells in collagen gel was almost similar to that of fibroblasts alone. Moreover, microscopic examination following Masson's trichrome staining revealed condensation and remodeling of collagen fibrils only around the fibroblast cells. CONCLUSIONS: The extent of collagen gel contraction by fibroblasts may depend on their in vivo origin. This property appears to be characteristic of fibroblasts, but not of malignant epithelial cells, under this culture system. Furthermore, the results of the present study demonstrate that stomach fibroblasts may play an important role in the stromal changes associated with scirrhous gastric cancer.

Adenocarcinoma, Scirrhous↗

PubMedDate not supplied

Marginal ulcer on the jejunum after proximal gastrectomy by jejunal interposition.

Marginal ulcer after proximal gastrectomy has never been previously reported, despite that this procedure preserves the fundic gland area of the stomach, which secretes gastric acid. In this report, we describe a patient who developed a marginal ulcer on the oral side of the gastrojejunal anastomosis after proximal gastrectomy by jejunal interposition. This case serves as a reminder that gastric acid secretion of the remnant stomach must be carefully monitored after proximal gastrectomy in gastric cancer surgery.

Anastomosis, Surgical↗

PubMedDate not supplied

Tumor volumetry: proposal of a new concept to predict lymph node metastasis in early gastric cancer.

BACKGROUND: The present study was conducted to evaluate the significance of tumor volumetry in early gastric cancer for predicting lymph node metastasis. MATERIALS AND METHODS: [corrected] Computer-generated three-dimensional images of tumors from 147 patients with early gastric cancer, who underwent curative gastrectomy with lymphadenectomy, were reconstructed from continuous tissue sections and the volume (mm3) of each tumor was measured by the surface rendering method. Logarithmic tumor volume and conventional pathological factors were then studied with respect to the prevalence of metastasis to regional lymph nodes. RESULTS: The results of univariate analysis showed that lymph node metastasis was associated with a larger tumor diameter, larger logarithmic tumor volume, a higher rate of blood and lymphatic vessel invasion and a higher incidence of submucosal invasion. However, the results of logistic regression analysis showed that only two factors, logarithmic tumor volume and blood vessel invasion, were independent variables that correlated with lymph node metastasis. Moreover, logarithmic tumor volume was the most important variable correlated with lymph node metastasis in early gastric cancer (p = 0.004, odds ratio: 23.831). CONCLUSIONS: Based on the present results, tumor volumetry appears to represent a novel method of predicting the likelihood of lymph node metastasis in early gastric cancer.

Adult↗

PubMedDate not supplied

Surgical outcome of node-positive early gastric cancer with particular reference to nodal status.

BACKGROUND: The risk of recurrence according to nodal status in patients with node-positive early gastric cancer (EGC) remains unclear and no appropriate treatment approaches have yet been established for such patients. MATERIALS AND METHODS: The surgical outcome of gastrectomy in combination with lymphadenectomy was examined in a total of 100 patients (54 males and 46 females, ranging in age from 25 to 84 years; average 56.6 years) with EGC and metastasis to lymph nodes. The outcome was assessed with particular reference to the extent of lymph node metastasis. RESULTS: The 5 and 10-year overall survival rates were 93.5 and 89.8%, respectively. Significant differences in survival were detected when anatomical distribution of lymph node metastasis (p < 0.0001), number of positive nodes (p = 0.0004) and tumor size (p = 0.0085) were examined. In particular, in 73 patients for whom the metastasis was limited to a perigastric node, prognosis was excellent and no recurrence was observed during the follow-up period. On the other hand, 27 patients with metastasis to a lymph node beyond the perigastric region were defined as comprising a high risk group for recurrence among node-positive EGC patients due to their poor prognosis (10-year survival rate, 58.5%). CONCLUSION: The results of the present study have suggested that radical gastrectomy combined with lymphadenectomy is essential to achieve complete remission in patients with lymph node metastasis restricted to perigastric nodes. For patients with a high risk of recurrence in EGC, whose condition is complicated by lymph node metastasis beyond the perigastric region, care should be taken to prevent recurrence by conducting long-term follow-up even after radical surgery. In order to improve survival, an appropriate protocol for post-operative adjuvant therapy may be needed for patients such as those with advanced gastric cancer.

Adult↗

PubMedDate not supplied

Limited effectiveness of extended lymph-node dissection for node-negative patients with proximal gastric cancer.

BACKGROUND: The optimal surgical treatment with respect to the extent of lymph-node dissection for node-negative patients with gastric cancer remains to be established. MATERIALS AND METHODS: A total of 101 node-negative patients with proximal gastric cancer (62 males and 39 females; age range 33 to 79 years; mean 58.0 years), who had undergone curative total gastrectomy, were retrospectively evaluated to determine whether any correlation existed between survival and the extent of lymph-node dissection (D1, limited; D2, extended lymph-node dissection). RESULTS: The 10-year survival rates of patients with T1 (n = 59), T2 (n = 31) or T3 tumors (n = 11) were 100%, 90.0% and 46.7%, respectively. Significant differences in survival were found between patients with T1 and T2 tumors (p = 0.018), T2 and T3 tumors (p = 0.003), and T1 and T3 tumors (p < 0.0001). Despite the fact that only 9 patients with a T1 tumor underwent a D2 lymph-node dissection, all other patients had an excellent prognosis. On the other hand, the 10-year survival rates of patients with T2 or T3 tumors who underwent a D1 or D2 lymph-node dissection were 83.3% and 76.8%, respectively, representing no significant difference between the two procedures for advanced stage cases (p = 0.590). Multivariate analysis showed that depth of invasion was the only statistically significant prognostic factor (p < 0.0001; relative risk, 19.018). CONCLUSIONS: Conventional radical prophylactic D2 lymph-node dissection does not improve the survival of node-negative patients with proximal gastric cancer when compared to limited D1 dissection.

Adult↗

PubMedDate not supplied

Significant prognostic factors in patients with early gastric cancer.

BACKGROUND: Early gastric cancer is defined as a gastric carcinoma confined to the mucosa or submucosa regardless of lymph node status, and it has an excellent prognosis with a 5-year survival rate of more than 90%. From 1985 to 1995, we encountered 266 cases of early gastric cancer in our hospital. METHODS: A retrospective analysis of the 266 cases of early gastric cancer was performed to evaluate the prognostic significance of clinicopathological features (age, gender, tumor size, tumor location, depth of invasion, lymph node metastasis, histological type, lymphatic invasion, vascular invasion, histological growth pattern, cancer-stromal relationship and type of operation). RESULTS: The overall survival rate of all the patients with early gastric cancer was 95.7%. In univariate analysis, the statistical significant prognostic factors were regional lymph node metastasis (P = 0.0004), lymphatic invasion (P = 0.0053) and cancer-stromal relationship (P = 0.0016). Absence of lymph node metastasis and lymphatic invasion, and a medullary-type histopathology were associated with improved survival. In multivariate analysis, the statistically significant prognostic factors were lymph node metastasis and cancer-stromal relationship. CONCLUSIONS: Presence of lymph node involvement and a scirrhous type of gastric cancer are associated with poor prognosis. Lymph node dissection with gastric resection is necessary for patients with early gastric cancer who have a high risk of lymph node metastasis. Postoperative chemotherapy is recommended for a scirrhous type of early gastric cancer.

Adenocarcinoma↗