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Biomedical subjects

T Mitomi

Publications and source records attributed to T Mitomi.

At least 127 records · Page 7Linked to original sources

[Hematopoietic recovery after autologous bone marrow transplantation in high-dose chemotherapy of cancer patients].

In order to evaluate the possible utility of autologous bone marrow transplantation (ABMT), eighteen cancer patients were treated with high-dose combination chemotherapy supported by ABMT. We investigated CFU-GM/kg infused as well as bone marrow nucleated cells/kg to predict for hematopoietic recovery. Although hematopoietic recovery was not related to the nucleated cell number of the transfused bone marrow, CFU-GM infused related significantly to neutrophil recovery to 500/mm3 (correlation coefficient, r = -0.73, p less than 0.001) and platelet recovery to 50,000/mm3 (r = -0.69, p less than 0.001). Furthermore, a significant relationship of CFU-GM infused to the period of neutropenia below 500/mm3 was observed (r = -0.67, p less than 0.001). Taken together, CFU-GM dose can predict for neutrophil and platelet recovery, suggesting that ABMT can shorten the period of bone marrow suppression following high-dose chemotherapy.

Adult↗

A new high-yield continuous cell-culture system for lymphokine-activated killer cells.

We performed basic studies on a new high-yield culture system (concentrate rotary tissue-culture system) for application to adoptive immunotherapy with lymphokine-activated killer (LAK) cells. Using this system, we demonstrated that up to 2 x 10(7) peripheral blood mononuclear cells/ml could be cultured in interleukin-2 with a sufficient recovery rate and cytotoxicity in short-term cultures (6 days). This system can also be used to proliferate LAK cells to four times the initial cell number with sufficient cytotoxicity for 14 days of culture. Thus, this system allows activation of sufficient numbers of cells to conduct clinical trials on humans.

Culture Techniques↗

A study of the extracellular matrix protein as the migration pathway of neural crest cells in the gut: analysis in human embryos with special reference to the pathogenesis of Hirschsprung's disease.

Immunocytochemical studies on the human embryo were made using antineuronal cell antibody and a panel of anti-extracellular matrix protein antibodies such as fibronectin, laminine, collagen type IV, and hyaluronic acid. All the enteric ganglia are shown to be from a single, vagal neural crest source, although the recent dual gradient migration theory of neural-crest-derived cells in the gut can be challenged. Neural-crest-derived cells first appear in the mesenchyme of the developing esophagus at 4 weeks, and then migrate down along the gut in a craniocaudal direction. The observed distribution of fibronectin and hyaluronic acid indicates the presence of these matrices providing a migration pathway for neural-crest-derived cells in the developing gut. The appearance of neural-crest-derived cells in the gut is always preceded by the appearance of these matrices. On the other hand, substrate or laminine and collagen type IV appears to promote outgrowth of neurites from settled neural-crest-derived cells and their maturation. The distribution of these matrices within the pathway seems consistent with their role in navigating the neural-crest-derived cells toward their final destination. Enteric neurogenesis is dependent on these matrices, and their alteration in early embryonal stage may be a significant factor in the pathogenesis of Hirschsprung's disease.

Cell Movement↗

Congenital absence of the portal vein.

A 14-year-old girl presented at the hospital after discovering an abdominal tumor. CT scan and ultrasonography indicated a hepatic tumor and also revealed the absence of the portal vein. The patient was admitted to excise the hepatic tumor. It was found that the venous blood from the small intestines flowed into the left renal vein and then emptied directly into the inferior vena cava. A tumor extending from the right lobe through the middle portion of the liver was excised. The postoperative course was satisfactory and marked regeneration of the residual hepatic tissue was observed. Also the blood level of ammonia in the superior mesenteric vein was low, approximately 120 micrograms/dl, compared to the normal value of 350 micrograms/dl in the portal vein. This low blood level may indicate the presence of some homeostatic control mechanism.

Adolescent↗

[Randomized controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum].

To evaluate of adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer, randomized controlled study by 35 institutions in Kanagawa prefecture was conducted. From March 1985 till February 1987, 462 patients were assigned one of two different regimens. 448 patients (97.0%) of them satisfied the eligibility criteria. Control group received mitomycin C intravenously on the day and the day after the operations respectively followed by 5-FU orally over for 6 months. PSK group received in addition to mitomycin C and 5-FU as in control group, PSK orally for over 3 years. By February 1989, follow up studies of the patients after their operations had been carried out for two years to four years. The disease free curve and the survival curve of PSK group were higher than those of control group, differences between the two groups were statistically significant (Disease free curve: P = 0.0096, survival curve: p = 0.0391). From these results, adjuvant immunochemotherapy with PSK was considered beneficial for curatively resected colorectal cancer.

Adjuvants, Immunologic↗

[Gastric acid secretion and cellular immunity in patients with gastric cancer].

Three hundred and one gastric cancer patients have been examined preoperatively to investigate their gastric acid secretions after stimulation by tetragastrin, and serum gastrin stimulation by a test meal, as well as for skin reactions and an evaluation of their serum glycoproteins. The results have indicated that their gastric secretions and serum gastrin response were found to be reduced, according to the advancement of their cancer, and that the gastric acid secretion of patients with signet ring cell carcinoma was higher than that of patients with other histological carcinomas. Gastric acid secretions of patients with an ulcerated type of cancer, that is, type IIc and type III in an early cancer stage and type IIc of an advanced Borrmann V type, was higher than in patients with other types, and there were significant correlationships between gastric secretions and PHA skin test and gastric secretions and the IAP and the sialic acid.

Adenocarcinoma, Mucinous↗

[Gastric acid secretions and serum gastrin levels in patients with mucosal and submucosal gastric cancers].

Gastric acid secretions and serum gastrin levels have been examined in 128 patients with early gastric cancer and in 98 gastric ulcer patients. Gastric cancer patients were found to have lower acid secretions than did gastric ulcer patients, and those with elevated types of a differentiated adenocarcinoma had lower acid secretions than did those with depressed types of an undifferentiated adenocarcinoma. Gastric acid secretions in patients with both a gastric ulcer and cancer were found to decrease with aging. However, the serum gastrin levels were found to be decreased in patients with a gastric ulcer and to be increased in patients with a gastric cancer. Incidences of a differentiated adenocarcinoma increased with aging. From these observations, it has been speculated that the carcinogenesis of a differentiated adenocarcinoma may be related to increasing endogenous gastrin levels and decreasing gastric acid secretions. These results suggest that a continuous check of the serum gastrin levels might be a good marker for cancer detection and that gastrin antibodies might be useful for treatment.

Adenocarcinoma↗

[Clinical effects of PSK on esophageal and gastric cancer patients and usefulness of serum levels of glycoproteins and HLA antigens as prognostic indicators].

This study was carried out to evaluate whether the preoperative levels of serum glycoproteins (CEA, SCC, TPA, IAP, ACT, ASP and sialic acid) and HLA antigens (class I and II) could be potential aids in the selection of suitable gastric and esophageal cancer patients for postoperative adjuvant immunotherapy of PSK. Gastric cancer patients underwent gastrectomy and received postoperative adjuvant chemotherapy (MMC, FT and ADR) with or without PSK. One hundred and forty esophageal cancer patients in cooperative study groups (organizing chairman; Dr. Hiroshi Satoh) underwent esophagectomy and received postoperative adjuvant radiotherapy and chemotherapy (FT, BLM) with or without PSK. The efficacy of PSK was recognized in the patients with normal levels of all glycoproteins in gastric cancer, and with normal levels of CEA or SCC or TPA and abnormal levels of one or more APRs in both gastric and esophageal cancer, and with positive HLA-B40 antigen. The combination of tumor-associated factors, such as CEA, SCC and TPA and various non-specific reactants such as APRs was useful as a prognostic indicator. In addition, some of HLA antigens were also valuable. The pretreatment levels of glycoproteins and HLA antigens have potential aids in the selection of patients with gastric and esophageal cancer for PSK treatment.

Adjuvants, Immunologic↗

[Gastrointestinal bleeding in children].

The site and nature of lesions producing gastrointestinal bleeding was evaluated in pediatric patients admitted to Tokai University Hospital. The differential diagnosis was possible based upon the character of the bleeding and the age of the patient. Upper endoscopy is the diagnostic maneuver of choice in evaluating the upper gastrointestinal bleeders. Sigmoidoscopy, colonoscopy, technetium scans, tagged red cell scans and intraoperative angiography were helpful in locating bleeding sites of lower bleeders. Common causes of bleeding were as follows: Hemorrhagic disease, necrotizing enterocolitis, and midgut volvulus in neonates; intussusception and internal hernia in infants; juvenile polyp and infectious diarrhea in children; duodenal ulcer and ulcerative colitis in adolescents. Gastro-duodenal ulcers were found in all age groups. One neonate died of indomethacin induced bleeding, however, bleeding from acute ulcer was usually controlled by conservative treatments. Increasing frequency of variceal bleeding due to portal hypertension after successful Kasai procedure for congenital biliary atresia was emphasized.

Adolescent↗

[A new high-yield continuous cell culture system and its clinical application in adoptive immunotherapy with LAK cells].

We developed a high-yield culture system, consisting of a culture bag on a rotator. The culture bag has two compartments, an inner compartment separated from an outer compartment by a semipermeable membrane. Cells in an appropriate culture medium are placed in the inner compartment, and medium without serum is placed in the outer compartment. The bag is rotated at an angle of 45 degrees between 0.5 and 5 rpm in a 37 degrees C incubator. The medium is changed in the outer compartment at intervals when needed. The outer compartment acts as the feeder as well as allows catabolites to diffuse through the culture. In addition, since the system is a closed-system, sterile conditions can easily be maintained. Using this system, we demonstrated that up to 20 X 10(6) cells/ml of PBMC could be cultured in IL-2 with sufficient recovery rate and cytotoxicity.

Cytological Techniques↗

[Dopamine infusion test as a gastric secretion test].

The secretion of gastric acid in the peptic ulcer patients were examined by the dopamine infusion test (DIT). Production of gastric acid was investigated when the patients were treated by 30-minute dopamine infusion of 2 micrograms/kg/min. According to the difference of production of gastric acid, 132 patients were categorized into three groups: 59 Cata-responders, 28 Ana-responders and 45 Non-responders. Cata-responders were the patients whose production was less than 0.2mEq/30 min, Ana-responders, greater than 0.2mEq/30 min and Non-responder less than or equal to 0.2mEq/30 min. Cata- and Ana-responders showed higher gastric acid secretion preoperatively, and higher gastric acid reduction rate after selective proximal vagotomy (SPV) than Non-responder. Cata-responder showed decreased acid output preoperatively and unchanged after SPV with DIT. Ana-responder showed increased acid output preoperatively and decreased after SPV with DIT. Non-responder showed unchanged acid output preoperatively and decreased after SPV. Cata-responder may be depending more on vagus-mediated factor and parietal cell mass. Ana-responder may be depending more on vagus-mediated factor, parietal cell mass and dopaminergic factor. Non-responder may be depending more on gastrin cell mass and less cholinergic influence. From these findings dopamine receptor may exist in the stomach, and DIT seems to be useful in studying pathogenesis of the peptic ulcer and determining treatment for patients with peptic ulcer.

Adolescent↗

[Tracheoesophageal anastomosis for intractable aspiration pneumonia].

Permanent tracheostomy and tracheoesophageal anastomosis were performed as a means of surgical intervention for the treatment of intractable aspiration pneumonia. Conventional method of tracheoesophageal anastomosis has entailed various problems. The improved technique by the authors utilized the special histological features of the situation and makes possible safe and reliable anastomosis. This technique retains the tracheal perichondrium to strengthen the anastomosed portion of the trachea, and can thus prevent suture insufficiency due to tension upon the anastomotic site.

Aged↗

In vitro estimation and imaging of attenuation coefficients and instantaneous frequency for breast tissue characterization.

For breast tissue characterization, three acoustic parameters, integrated attenuation coefficient(IAC), frequency-dependent attenuation coefficient(FDAC) and instantaneous frequency(IF), were estimated in vitro and processed to make images of these parameters for resected human breast specimens. Experimental system with a 5 MHz center frequency was used and the same estimating and imaging system was connected with a clinical diagnostic device with a 7.5 MHz annular array probe (Aloca SSD 270) for in vivo type studies. To estimate these parameters, fast Fourier transform and spectral difference method were adopted for IAC and FDAC and the Hilbert transform for IF. Large statistical variances were found in the estimated values of these parameters. These dispersions of data may be due to insufficient size and tissue heterogeneity of the breast specimens. Additional miscellaneous problems may be involved. However, all of these can be, in part, overcome by averaging procedures. The significance of estimating and imaging these parameters for breast tissue characterization was discussed.

Acoustics↗

Paget's extension of esophageal carcinoma. Immunohistochemical and mucin histochemical evidence of Paget's cells in the esophageal mucosa.

A 68-year-old male with Paget's disease of the esophagus is reported. The underlying primary esophageal carcinoma was diagnosed as adenosquamous cell carcinoma on the basis of the presence of both adenocarcinoma and epidermoid carcinoma components. There was invasive growth of clear Paget's cells in the esophageal epithelium. Mucin histochemistry disclosed common characteristics of mucin between Paget's cells and adenosquamous cell carcinoma. It was histochemically confirmed that the existence of mucin was a general feature of extramammary Paget's disease. In 13 control esophageal carcinomas including three with adenocarcinomatous elements, Paget's cells were not found in the epithelium. To date only one case of Paget's disease of the esophagus has been described in the literature.

Aged↗

Concentrations of alpha-1-antichymotrypsin and other acute phase reactants in patients with gastric cancer.

The serum levels of alpha-1-antichymotrypsin, immunosuppressive acidic glycoprotein, acid soluble glycoproteins, and sialic acid as acute phase reactants (APRs) and carcinoembryonic antigen (CEA) as a cancer-producing glycoprotein were measured preoperatively in 245 patients with gastric cancer who underwent gastrectomy and were treated with postoperative adjuvant chemotherapy or immunochemotherapy. The patients were classified into four groups: group A had normal leverl of serum CEA and APRs; group B had abnormal CEA levels; group C had normal levels of CEA and one or more abnormal levels of APRs; and group D showed abnormal levels of CEA and one or more abnormal levels of APRs. Groups A and B showed good survival rates, but groups C and D had poor rates. The patients in groups A and C who received immunochemotherapy exhibited significantly better survival rates than those treated with chemotherapy. The pretreatment of levels of CEA and APRs have potential as aids in prognosis and in the selection of suitable immunopotentiators and anticancer drugs for cancer patients.

Acute-Phase Proteins↗

[Role of autologous bone marrow transplantation in cancer chemotherapy].

Over the past 9 years, total number of 147 patients with various types of malignant solid tumors were treated 220 times with high-dose chemotherapy supported by autologous bone marrow transplantation. Two most frequently used chemotherapeutic protocols were: cyclophosphamide 1,600 mg/m2 + adriamycin 80 mg/m2 + ACNU 3 mg/kg and cyclophosphamide 1,600-2,400 mg/m2 + adriamycin 80 mg/m2 + CDDP 100-120 mg/m2. There were 89 patients with advanced and/or recurrent diseases. The overall response (CR + PR) rate was 44.1% with the complete response (CR) rate, being 11.8% among 68 evaluable patients in this group. The most favorable response was obtained in breast cancer patients with 77.3% response rate and 13.6% CR rate. Nearly 50% of patients with gastric, lung, gynecological and pediatric malignancies responded, whereas poor responses were observed in the cases of pancreato-biliary, colorectal, esophageal cancers and melanoma. In 8 complete responders, three are alive and well without any evidence of disease 5 years after the treatment. There were 58 patients who underwent this treatment in adjuvant settings. There are 5 patients with breast cancer who have been followed over 5 years after treatment. All of them are alive and well without any demonstrable diseases. Four of them were in stage IIIa and histologically examined axillary nodes were positive in 14/15, 11/17, 37/44, 22/25. Autologous bone marrow transplantation seems to be instrumental in shortening the period of myelosuppression, thus allowing safe dose escalation in chemotherapy. Adequacy of cryopreserved marrow as marrow inoculum was ascertained with mononuclear cell count, cellular viability, CFU-GM, CFU-E, BFU-E and CFU-Mk.

Antineoplastic Combined Chemotherapy Protocols↗

Use of Broviac/Hickman catheter for long-term venous access in pediatric cancer patients.

Forty-two indwelling central venous catheters were inserted in 29 pediatric patients with malignant solid tumors. Indications included pre- and postoperative parenteral nutrition, intensive chemo-radiotherapy and bone marrow transplantation. Fifteen of the central venous catheters (15 patients) were Broviac/Hickman and remaining 27 catheters (14 patients) were traditional Silastic. Accidental displacements occurred in seven of the 27 Silastics (26%), whereas no Broviac catheter was inadvertently pulled out. Overall complication rates, including infection, accidental removal, and occlusion of the catheter, were 9.6 per 1,000 Silastic use days and 0.35 per 1,000 Broviac use days. No deaths were related to catheter complications. For long-term angioaccess in pediatric cancer patient the Broviac catheter was demonstrated to have a lower complication rate than the traditional Silastic catheter.

Adolescent↗