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Biomedical subjects

T Kaku

Publications and source records attributed to T Kaku.

At least 91 records · Page 5Linked to original sources
PubMed1994

Adenoma malignum of the uterine cervix detected by imaging methods in a patient with Peutz-Jeghers syndrome.

Adenoma malignum of the uterine cervix in a 25-year-old Japanese woman with Peutz-Jeghers syndrome (PJS) is described. A cervical multicystic mass was detected by CT scan, sonography, and MR imaging. These imaging findings strongly suggested the presence of adenoma malignum in spite of normal Pap smear, colposcopy, and cervical biopsy reports. Radical hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and para-aortic lymph node biopsy were performed after confirmation of adenoma malignum by conization. Both ovaries showed multicentric sex cord tumor with annular tubules. She is alive and well with no evidence of disease 23 months after surgery. Imaging methods including sonography, CT scan, and MR imaging may be useful aids in detecting the presence of adenoma malignum, especially in patients with PJS.

Adenoma↗
PubMed1994

Reassessment of myometrial invasion in endometrial carcinoma.

OBJECTIVE: To assess different methods of measuring the depth of myometrial invasion in endometrial carcinoma as a prognostic factor. METHODS: Eighty-eight cases of stage I or II endometrial carcinoma treated initially by hysterectomy between 1979-1989 were reviewed histologically. Three methods of measuring myometrial invasion were evaluated: 1) percentage of invaded tumor thickness to whole thickness of myometrium, 2) percentage of whole tumor thickness to total thickness of tumor and myometrium, and 3) distance from the tumor-myometrial junction to the uterine serosa. We evaluated the effect of several factors on prognosis by multivariate analysis using Cox regression models. RESULTS: Myometrial invasion determined by these three measurement methods was associated significantly with survival in a univariate analysis. When myometrial invasion assessed by each method and other prognostic factors were entered into a multivariate model, the distance from the tumor-myometrial junction to the uterine serosa, lymph-vascular space invasion, and cervical stromal involvement were identified as independently significant prognostic factors. CONCLUSION: This method of evaluating myometrial invasion by measuring the distance from the tumor-myometrial junction to the uterine serosa was most useful as a correlate with survival.

Carcinoma↗
PubMed1994

Laminin localization and gelatinolytic activity of epithelial rest of Malassez grown on titanium.

The purpose of this study was to examine laminin localization in epithelial rests of Malassez grown on titanium and their gelatinase activity. Laminin localization was confirmed by immunocytochemistry in all epithelial cells grown on titanium. The conditioned medium from the epithelial cells grown on titanium exhibited 72kD- and 92 kD-gelatinase activities by gelatin zymography. Those results suggest that laminin contributes to the epithelial cell attachment to titanium and that gelatinases may be mobilized for epithelial cell movement on titanium.

Animals↗
PubMed1994

Effect of sustained release diltiazem (Diltiazem-R) in patients with stable effort angina.

Ca++-antagonist is effective not only for variant angina but also for effort angina. The effects of sustained release diltiazem (diltiazem-R) and beta 1-blocker (atenolol) on exercise tolerance were studied in seven patients with stable effort angina in a cross over trial. Diltiazem-R (100mg) or atenolol (50mg) was given once a day, each treatment period lasting for two weeks after a two-week control period. The treadmill exercise test was performed on the last day of each protocol. Both diltiazem-R and atenolol decreased heart rate at rest and the decrease with atenolol was greater than that with diltiazem-R. The systolic blood pressure was unchanged at rest by both drugs. At maximal work levels, atenolol decreased the heart rate and pressure rate product significantly but diltiazem-R did not. Both diltiazem-R and atenolol significantly prolonged the exercise time (average 137 and 165 seconds respectively), time to onset of 1mm ST depression (240 and 288 seconds respectively). There was no significant difference in exercise tolerance between diltiazem-R and atenolol. These findings suggest that diltiazem-R, a sustained release Ca++-antagonist, provides beneficial effects in patients with stable effort angina.

Angina Pectoris↗
PubMed1993

Expression of alpha-smooth muscle actin in benign or malignant ovarian tumors.

We compared the expression of alpha-smooth muscle actin (alpha-SMA) between benign and malignant human ovarian tissues by immunohistochemical staining and Western blot analysis using the monoclonal antibody specific to alpha-SMA. In normal human ovaries, alpha-SMA was found in the blood vessel walls, muscle fibers, and stromal cells surrounding the follicles. The main source of alpha-SMA in the benign ovarian tumors was the blood vessel walls which highly expressed the alpha-SMA throughout the tumor. In malignant tumor tissues, however, the vessels located in or close to the cluster of cancer cells did not express alpha-SMA. It corresponded to the results of the Western blot analysis, showing that the amount of alpha-SMA in malignant ovarian tumor tissues was much smaller than that in benign tumor tissues. Thus, the alteration in alpha-SMA expression seems to reflect the qualitative difference in vessels between benign and malignant ovarian tissues, and therefore alpha-SMA is considered to potentially be a histopathologically useful marker for indicating the malignant potential of ovarian tumors.

Actins↗
PubMed1993

Relationship between paraaortic lymph node involvement and intraperitoneal spread in patients with ovarian cancer--a multivariate analysis.

In 125 patients with epithelial ovarian cancer (FIGO stages I-IV), 32 (26%) had paraaortic lymph node (PAN) metastases. The estimated 5-year survival rate of PAN-negative patients was 71%, while that of PAN-positive patients was 17% (P < 0.0001). Positive rates of PAN metastasis at each stage level, based only on intraperitoneal spread of the disease, were 2% for stage I, 9% for stage II, 43% for stage III, and 87% for stage IV. According to univariate analysis, histological grade, and all disease site parameters examined, such as subdiaphragmatic surface, liver and spleen capsule, intestines and mesentery, omentum, pelvic peritoneum, sigmoid colon and rectum, uterus and tubes, and peritoneal cytology, showed a statistically significant correlation to the presence of PAN metastasis. Multivariate analysis using the logistic regression model revealed that the omental involvement, uterine and tubal involvement, and histological grade were independently correlated with PAN metastasis. The relative risk of PAN metastasis in the patients with these three factors is 18.5 times higher than that in patients without these factors. The present data suggested that, for the disease with omental and/or uterine and tubal involvement, surgical evaluation of PAN is mandatory in order to perform correct FIGO staging.

Abdominal Neoplasms↗
PubMed1993

Ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma.

An ovarian mucinous cystadenocarcinoma with sarcoma-appearing solid mural nodules in an 18-year-old Japanese woman is reported. Right ovarian cyst had two poorly circumscribed, solid nodules and several tiny studs. Microscopically, the epithelial elements consisted of benign, low malignant potential and malignant mucinous tumors. The mural nodules were made up of highly malignant anaplastic cells simulating sarcoma. In one of the mural nodules, continuity between the malignant mucinous cells and sarcoma-appearing cells was identified. Immunohistochemically, the sarcoma-appearing nodule was uniformly positive for vimentin and focally positive for epithelial markers such as EMA, CAM5.2, and AE1/AE3. This case demonstrated an orderly transformation and dedifferentiation of epithelial cells to undifferentiated mesenchymal cells. Although she had stage IIb disease, she lived disease free for 3 years and 5 months after surgery followed by 10 courses of chemotherapy containing cisplatin and Adriamycin.

Adolescent↗
PubMed1993

Pharmacokinetics of flosequinan in elderly patients with chronic congestive heart failure.

We have investigated the pharmacokinetics of the direct vasodilator flosequinan in elderly patients with congestive heart failure. Eight patients received a single dose of 50 mg, and 8 patients received once-daily treatment with 25 mg for two weeks. In the single dose study, the tmax of flosequinan was 2.5 h, Cmax was 1.17 microgram.ml-1 and t1/2 was 5.63 h. The tmax of the metabolite BTS 53554 was 20.3 h, Cmax was 1.44 microgram.ml-1 and t1/2 was 62.0 h. BTS 53554 accumulated gradually in the 14-day repeated dose study and steady-state was reached after approximately 2 weeks. Flosequinan was not found to accumulate. Adverse reactions were not observed in either the single or repeated dose study. It is advisable to consider renal function and body weight when flosequinan is to be administered to elderly patients with congestive heart failure. The initial dose should be 25 mg.

Aged↗
PubMed1993

Association of endometrial epithelial metaplasias with endometrial carcinoma and hyperplasia in Japanese and American women.

We reviewed endometrial tissue from 166 cases of endometrial adenocarcinoma and hyperplasia--91 seen at Kyushu University, Fukuoka, Japan, and 75 at George Washington University, Washington, D.C., U.S.A.--to compare the prevalence of epithelial metaplastic changes in the two populations. Metaplasias were more common in the benign endometrium associated with carcinoma at George Washington University (78%) than at Kyushu University (54%). They were associated with carcinomas of lower grade and accompanied by hyperplasia at both institutions. These results indicate that endometrial metaplasias, like endometrial hyperplasias, tend to be associated with less virulent endometrial carcinomas and to be more common in American women (who represent a high-risk population for endometrial carcinoma) than in Japanese women (in whom the risk is low but rising.

Endometrial Hyperplasia↗
PubMed1993

[Alterations of hemostatic markers in elderly patient with atrial fibrillation without a history of stroke].

To evaluate whether hemostatic abnormalities contribute to the increased risk of stroke, the authors prospectively studied the hemostatic markers (HM) (beta-TG, PF4, FPA, TAT, PIC, D-dimer) in 34 elderly patients with atrial fibrillation (Af) without a history of stroke (mean age 79.2) and 14 age-matched controls. In the Af group FPA was significantly higher than in the control group (p < 0.05). Among them, 8 patients showed a similar abnormal HM pattern as in cardioembolic is chemic stroke and in these, 4/8 patients had valvular disease (VD), 2/8 had hypertension (HT), 2/8 had congestive heart failure (CHF), 1/8 had diabetes mellitus (DM) and 1/8 had hyperlipidemia (HL). Eight patients showed the same abnormal HM pattern as atherothrombotic is chemic stroke and of these, 2/8 had HT as complications. Five patients showed combination of a HM abnormal pattern, that was observed in cardioembolic and atherothromboic ischemic stroke. The other 13 patients showed a normal HM pattern, were in these patients, 4/13 had HT, 1/13 had DM, 1/13 had VD, and 1/13 had CHF. The patients with VD complication tended to have embolic HM abnormality. Contrary to previous reports, nonvalvular Af patients do not necessarily tend to have high risk of cardioembolic stroke. Our data suggest difficulties in clinical diagnosis among Af patients with ischemic stroke whether it is cardio embolic or atherothrombotic.

Aged↗
PubMed1993

[Long-term follow-up study after permanent pacemaker implantation in patients aged 60 years or over with sick sinus syndrome].

Ninety-five patients aged 60 years or over with a permanent pacemaker implanted for sick sinus syndrome were divided into two groups: 32 patients with physiological pacing (group P) and 63 patients with ventricular pacing (group V). The mean follow-up period was 45.0 +/- 36.6 months in group P and 50.3 +/- 37.8 months in group V. Paroxysmal atrial fibrillation (Af) occurred in 28% of group P and 71% of group V (p < 0.05). The incidence of stable Af was also lower in group P than in group V (9% vs. 30%, p < 0.05). None of group P with only bradyarrhythmia had stable Af. However, 6 of 21 patients (29%) in group V with bradyarrhythmia showed stable Af. There was no significant difference in stable Af between group P with bradycardia-tachycardia syndrome (BTS) and group V with BTS (19% vs. 31%). A lower incidence of embolic events was also observed in group P (3% vs. 25%, p < 0.05). Nine of 16 patients with embolic events in group V died of complications following embolism (8 patients; cerebral embolism, one patients: renal and superior mesenteric arterial embolism). The survival rates at 5 and 10 years were 80% and 69%, respectively, for group P and 56% and 33% for group V (p < 0.01). Thus, with regard to permanent pacing for patients with sick sinus syndrome, physiological pacing should be selected for control of morbidity and total mortality.

Aged↗
PubMed1993

Large cyst formation in pleomorphic adenoma.

The aim of this study was to examine about the etiology of large cyst formation in pleomorphic adenoma from the histopathological standpoint by examining four cases of our own as well as previously reported ones. In the first of our cases, a large cyst wall lined with keratinized squamous epithelium was observed. In the second, a large cyst containing mucinous material was lined with a single cell layer of squamous epithelium-like cells. The third case was a carcinoma in pleomorphic adenoma with some large cysts lined with multiple layers of atypical epithelial cells. In the fourth case, a hemorrhagic portion were seen on a large cyst wall without a lining of epithelial cells. From these histopathological observations and the suggestions of previous authors, we surmised that the large cyst formation in pleomorphic adenoma might originate from the squamous metaplasia of tumor cells and the enlargement of duct-like structures by outstanding secretion from tumor cells or salivary gland tissues, hemorrhagic portions, or necrosis in the malignant tumor.

Adenoma, Pleomorphic↗
PubMed1992

Mutual recognition between polymerized liposomes. IV. Polysaccharide-lectin system.

As a model of cell-cell recognition processes, the association processes of a polysaccharide (mannan)-carrying liposome with a lectin (Concanavalin A, Con A)-carrying polymerized liposome were followed by turbidimetry. The association process was strongly inhibited by the addition of a low molecular weight sugar, methyl-alpha-D-mannopyranoside, which shows that the association between the liposomes is due to the specific interaction between Con A and mannan. The association rate constant obtained was much smaller than the theoretical value for a diffusion-controlled binary association process. This implies that the association rate of liposomes is limited by the recognition between complementary ligands bound on the liposome surfaces. Another reason for the smaller association rate constant in the liposome-liposome system is the repulsive hydration effect. The effect of the surface density of the lectin immobilized on the liposome on the recognition was also examined.

Concanavalin A↗
PubMed1992

Microcarcinoma of the endometrium: a mapping study with special reference to cytologic atypia in the endometrium.

In order to elucidate the basis for the development of an endometrial carcinoma, we looked for microcarcinomas measuring < 5 mm in greatest diameter, and studied their histologic characteristics and those of the neighboring endometrium. Using serial step section methods, two microcarcinomas were detected. A microcarcinoma was found in one of 14 uteri resected for atypical hyperplasia and the other was found in one of 114 uteri resected for endometrial carcinoma. The neighboring endometrium of the former was adenomatous and had atypical hyperplasia and that of the latter was atrophic and contained atypical glands characterized by cytologic atypia and not by architectural changes. The findings may suggest endometrial carcinomas to have two pathogenetic forms: a carcinoma associated with hyperplasia and occurring in premenopausal women, a second carcinoma associated with atrophic endometrium and occurring in postmenopausal women. Atypical glands in atrophic endometria may indicate that endometrial specimens from postmenopausal women should be carefully screened for cytologic atypia.

Adenocarcinoma↗
PubMed1992

Adenosarcoma of the uterus: a Gynecologic Oncology Group clinicopathologic study of 31 cases.

We report on the clinical and pathologic findings in 31 cases of adenosarcoma of the uterus subjected to hysterectomy and staging laparotomy. Nine of 30 patients (30%) have had recurrent tumor and six of 30 (20%) have already died of tumor in a relatively short follow-up period (mean, 38.3 months). Seventeen of 31 cases were diagnosed as adenosarcoma with sarcomatous overgrowth (SO). Ten of these 17 with SO contained focal or extensive rhabdomyosarcoma. In six cases, extrauterine spread was identified as follows (two patients had two sites each): vaginal involvement (two cases), pelvic lymph node metastases (two), positive peritoneal cytologic findings (two), parametrial invasion (one), and ovarian metastasis (one). Extrauterine spread (stage III) (p less than 0.001) and myometrial invasion (p = 0.04) were associated with higher rates of recurrence. The presence of lymphatic and/or vascular invasion, SO, and rhabdomyosarcomatous differentiation also indicated poor prognosis but did not attain statistical significance. Based on this experience, staging laparotomy including peritoneal cytology is suggested in cases of clinical stages I and II adenosarcoma. The differential diagnosis of these tumors is also discussed.

Adult↗
PubMed1992

[Visuo-postural control of schizophrenics--variations of sway area during horizontal eye movement].

In the present study, we investigated the neurological mechanism of commonly known specific or unnatural postures in schizophrenic patients. Using a gravimeter, body sway studied in 26 chronic schizophrenic patients, 10 schizoaffective disorder patients and 21 normal subjects. During eye fixation at a target while keeping an upright posture, schizophrenic patients presented a larger gravimetric area than the normal subjects and the patients with schizoaffective disorder. There was a negative correlation (r = -0.509) between the standard deviation of the sway gravimetric area during fixation and the dose of neuroleptics in schizophrenic patients, but no correlation was found in patients with schizoaffective disorder (r = -0.01), although they took neuroleptics in a similar regimen to that for the schizophrenics. There was no correlation between the standard deviation of the sway gravimetric area during fixation and the duration of illness. There was also no correlation between the former and the amplitude ratio of saccades during smooth pursuit eye movements. When horizontal eye movements pursuing the target were loaded in this experiment, both the normal subjects and the patients with schizoaffective disorder showed a decrease in a loaded gravimetric area and a tendency towards postural stabilization. However, schizophrenic patients having higher SANS scores (Andreasen) presented an increase in gravimetric area. This suggests that schizophrenic patients with higher SANS score may have organic cerebellar changes related to impairment of the mechanism of visual and postural coordinations.

Adult↗