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Biomedical subjects

T Morimoto

Publications and source records attributed to T Morimoto.

At least 397 records · Page 22Linked to original sources

Transition of T cell receptor gamma/delta expressing double negative (CD4-/CD8-) lymphocytes after allogeneic bone marrow transplantation.

We studied peripheral blood CD4-CD8- gamma/delta T cells in recipients of allogeneic marrow grafts, using three-color immunofluorescence and flow cytometry, and investigated changes in their numbers in relation to the administration of hematopoietic growth factors or chronic graft-versus-host disease (GVHD). In the early post-bone marrow transplantation (BMT) period, the relative and absolute numbers of peripheral CD4-CD8- gamma/delta T cells in 22 allogeneic marrow graft recipients in relation to the use of hematopoietic growth factors were studied. During the first 4 weeks, increased numbers of CD4-CD8- gamma/delta T cells were observed in recipients of either recombinant human granulocyte colony-stimulating factor (rhG-CSF) or granulocyte macrophage colony-stimulating factor (GM-CSF). However, 4-8 weeks after BMT, the number of these cells was similar in both groups whether or not growth factors had been administered. At a later stage after BMT (3-12 months), peripheral CD4-CD8- gamma/delta T cells from 43 allogeneic BMT recipients were studied. These cells were markedly decreased in patients with chronic GVHD, and this decrease correlated closely with the clinical signs of chronic GVHD. These results suggest that CD4-CD8- gamma/delta T cells may play an important role in the recovery of neutrophils associated with growth factors during the very early post-BMT period, and in the immunodeficient state of chronic GVHD at a later stage after BMT.

Adolescent↗

[Two cases of aorto-coronary bypass grafting for two different types of single coronary artery].

Single coronary artery is a rare congenital anomaly and its prognosis is good. This entity can be diagnosed only by coronary angiography in lift. Atherosclerotic obstruction of a single coronary artery causes a high incidence of sudden death, so this anomaly does not take a good course. We present two cases of CABG which have two different types of single coronary artery with some significant stenoses of the coronary arteries.

Aged↗

Classification and surgical treatment of hepatocellular carcinoma (HCC) with bile duct thrombi.

Nine (1.66%) out of 542 cases of HCC treated surgically in our hospital between 1985 and 1992, had macroscopic bile duct thrombi. Three cases presented preoperatively with obstructive jaundice. Two of these received thrombectomy in the hilar bile duct and died of hepatic insufficiency on postoperative days 10 and 66, the other case underwent extended left lobectomy, but also died of renal failure and sepsis 3 months after the operation. In addition, we also treated 6 cases diagnosed at earlier stages than those presenting with obstructive jaundice with both hepatectomy and thrombectomy. In these patients the outcome was as follows: 2 died of recurrent HCC 3 months and 16 months, respectively, after operation, 1 died of apoplexy with no recurrence after 19 months, 1 had a recurrence 5 months after the operation, but is still alive after 7 months, and 2 are still alive 24 months and 60 months after surgery with no recurrence. The outcome is still poor in our series with obstructive jaundice. But in this report, we propose radical surgical treatment for HCC with bile duct thrombi in accordance with our classification, especially for those cases without obstructive jaundice.

Adult↗

[The causes and timing of reoperation for coronary artery disease].

In eight hundred and sixteen consecutive patients undergoing coronary artery bypass grafting (CABG) within the past 19 years (1974 to 1993), repeated CABG were performed on 12 patients (1.47%). The main reasons for repeated CABG were graft failure (GF), progression of native disease (NP) and incomplete revascularization (IR). The incidence of GF only and GF combined NP were high either within a half year or around 5 years after CABG. When the recurrence of angina is noted after CABG, the catheter intervention should be chosen at first but the reoperation should be done not so late. Although all patients survived from reoperation, three patients continued to have mild angina pectories. If a reoperation is inevitable, maximum utilization of arterial graft and accomplishment of complete revascularization are emphasized.

Aged↗

[Improvement of clinical symptoms by UFT and TAM and a case of bone metastasis from breast carcinoma during pregnancy].

At age 35, the patient was diagnosed with left breast carcinoma (T4bN0M0, Stage IIIb) during her first pregnancy, and underwent mastectomy of the left breast and bilateral oophorectomy. Although CPA was administered as adjuvant chemotherapy after the operation, left pelvic pain developed about a year after the operation, and bone metastasis was detected from the imaging diagnosis. Then, the therapy was switched to UFT (600 mg/day) and tamoxifen (20 mg/day), which markedly relieved the pain along with bone scintiscan (NC) and simple X-P (NC). Five years have passed since the operation, and the progress is excellent. There is neither increase of pain nor adverse reactions to drugs. Furthermore, the patient received breast reconstruction operation at her strong insistence in the third year after operation, and has achieved a high quality of life (QOL).

Adult↗

[Early detection of breast cancer by mass screening using mammography].

A mass screening trial for breast cancer using mammography was carried out in Tokushima Prefecture, either itinerant screening in the communities or center screening at the workplace. Craniocaudal and lateral oblique imagings of the breast using two-view film mammography were performed at the first stage of screening. In addition, physical examination of the breast was also performed on subjects independently. A total of 8 cases with breast cancer were found in these trials by mammography alone, and no cases with breast cancer were detected by physical examination. The detection rates were 0.19% in itinerant screening, and 0.92% in center screening, respectively. This was much higher than the level (0.10%) obtained by mass screening using physical examination alone in Japan. Moreover, in elderly patients (age over 50 years), the detection rates were higher (0.54%, 1.21%). The number of clinical stage for cases with breast cancer detected by these screening were 5 cases in TIS and 3 in stage I. Thus, all cases were patients with early-stage breast cancer. From these results, mass screening using mammography should be mandatory for elderly women (over 50 years) with asymptomatic breasts.

Adult↗

[A randomized clinical trial of adjuvant endocrine therapy after breast conserving surgery for early breast cancer. Cooperative Study Group for Breast Conserving Therapy].

To evaluate the clinical efficacy of adjuvant endocrine therapy after breast conserving surgery for early breast cancer, we have conducted a randomized controlled study since 1989. One hundred twelve-patients having a small breast tumor, less than 2 cm in diameter, and no palpable axillary lymph node, were the subjects of this study. All these patients underwent partial mastectomy with axillary lymph node dissection and were randomly divided into two groups according to the type of postoperative adjuvant endocrine therapy: Group I, tamoxifen (20 mg/day) for 2 years; Group II, no tamoxifen administration. The median follow-up period was 32.2 months. The incidence of local recurrence in the ipsilateral breast was 1.9% in Group I, which was lower than in Group II (6.8%). Three-year disease-free survival rates were also more favorable in Group I (94.2%) than in Group II (88.9%). This difference in prognosis was evident in patients with ER-positive tumors but not related to the menopausal status. These results suggest that adjuvant endocrine therapy with tamoxifen may be recommended for patients who underwent breast conserving surgery for early breast cancer, especially in those with ER-positive tumors.

Adult↗

[Malignant parasagittal meningioma appearing as a large subcutaneous mass].

We present a rare case of malignant meningioma appearing as an extracranial soft-tissue mass. A 34-year-old male was admitted with left parietal subcutaneous soft-tissue mass. Neurological examination on admission revealed right leg monoparesis and papilledema. Skull X rays showed hyperostosis of the left parietal bone. There was no evidence of bony destruction. CT and MRI showed a tumor with a large intracranial component, which was homogeneously enhanced. The tumor was totally removed by left ostoplastic craniotomy. The light-microscopic examination showed a meningothelial meningioma accompanied by malignant components with necrotic foci and mitotic figures. Tumor cells had invaded all the layers of the skull via the Haversian canals. We propose that hyperostosis with tumor invasion through all three layers of the skull should be considered as a malignant feature.

Adult↗

[A case of Hangman's fracture associated with vertebral arteriovenous fistula treated with trapping].

A case of a traumatic vertebral arteriovenous fistula associated with a hangman's fracture is reported. A 45-year-old male fell down about 2 meters and struck his parietooccipital region against the ground. Profuse nasal bleeding developed. He was transferred to a local hospital, where his respiration was ataxic and blood pressure was low. After intubation, he was transferred to our emergency department. Cervical x-p revealed fracture of C1, C2 and subluxation of C2 body. Because of uncontrollable nasal bleeding, the bilateral maxillary arteries were embolized with spongel. At this time, right vertebral angiograms demonstrated a vertebral arteriovenous fistula with an pseudoaneurysm located at C2 level. On the 13th hospital day, direct balloon occlusion of the fistula was attempted; this could not be achieved because the subclavian and vertebral arteries were tortuous and the balloon catheter could not be introduced to the level of the fistula in the vertebral artery. The patient was only observed until follow-up angiogram on the 24th hospital day revealed enlargement of the pseudoaneurysm. We performed trapping of both the proximal and distal ends of the involved vertebral artery; from C5 to C1. Postoperative course was uneventful, hangman's fracture was fixed with a Halo vest. Four months after operation, fistula and pseudoaneurysm were not opacified on angiogram. We believe that transvascular techniques are the treatment of choice for vertebral arteriovenous fistulas. However, as the next best thing, we can use trapping for the patient whose vessels are too tortuous to introduce the balloon catheter to the involved vessel.

Arteriovenous Fistula↗

Cancerous residue in breast-conserving surgery.

Local tumor extension was studied using a continuous series of multiple blocks of mastectomy specimens to assess malignancy remaining after breast-conserving surgery for early-stage breast cancer. In this study, 183 cases were chosen, consisting of 6 noninvasive ductal carcinoma cases and 177 invasive ductal carcinoma cases. The histopathology in 59 (32%) of the 183 cases corresponded to that showing extensions of more than 2.6 cm from the tumor margin. These wide extensions were also seen in 17% of breast cancers with a tumor size of less than 2 cm. The incidence of wide extension was higher in younger patients with cases of noninvasive ductal carcinoma. Extension to the nipple-areola was seen in 14% of cases with a tumor size of less than 2 cm. Breast cancers with multicentric development accounted for 3% of those with a tumor size under 2 cm. These findings suggest that if lumpectomy is performed with a margin of 2 cm for tumors with a size of 2 cm or less, a cancerous residue would be found in the surgical margin of 15-20% of the cases. The actual incidence was 23% of cases after breast-conserving treatment in our study. On the basis of the data, breast-conserving treatment with only local resection of the primary lesion showed cancerous residue such as intraductal cancerous extension in about 20% of cases. Therefore, it was concluded that, as part of breast-conserving therapy of early-stage breast cancer, radiation therapy of the whole breast should be performed after surgery with clear margins to control local recurrence.

Adult↗

Distribution of adenosine deaminase binding protein in normal and malignant tissues of the gastrointestinal tract studied by monoclonal antibodies.

A mouse monoclonal antibody V-715 was raised against fresh colon cancer tissues. Biochemical analysis elucidated that the antigen defined was adenosine deaminase binding protein (ADBP). In colon cancer cell lines, V-715 was positive in 8 out of 16 differentiated cancers and in 2 out of 8 poorly differentiated cancers. In frozen sections, ADBP was expressed in 17 out of 33 differentiated colon cancers, but none of 4 poorly differentiated colon cancers. In normal colon, the expression was observed in epithelium. In gastric cancers, ADBP was expressed in 10 out of 15 differentiated cancers, but weakly or only heterogenously expressed in 2 out of 8 poorly differentiated cancers. In normal gastric mucosa, ADBP was mainly detected in the foveolar epithelium, but was weakly or not expressed in the deep gastric glands. Carcinoid tumors and malignant lymphoma of the stomach did not express ADBP. These results suggest that ADBP may act as a marker of enterocytic differentiation in normal and neoplastic gastrointestinal cells, and might be exploitable in clinical and pathological diagnosis of gastrointestinal cancers.

Adenocarcinoma↗

Immunohistochemical study of estrogen receptor and estradiol on papillary thyroid carcinoma in young patients.

We have immunohistochemically examined estrogen receptors (ER) and estradiol (E2) on papillary thyroid carcinoma in young females under the age of 25 years. The 10 young females in this study were compared with 64 females 30 years of age or older who underwent surgery for treatment of papillary thyroid carcinoma. We did not find any significant difference in the incidences of positive staining for E2 between the two groups. Of the specimens obtained from the young patients, 80% (8/10) showed positive staining for ER; this was significantly higher (P < 0.01) than that observed in patients 30 years of age or older (25%). We think that, especially in youth, estrogen may play an important role as a promoting factor. This indication needs further study.

Adolescent↗

Tumor progression accompanied by increase in proliferation rate in breast cancer: a preliminary report.

Forty consecutive cases with invasive ductal carcinoma of the breast (samples of both the primary invasive area and the involved node were available for 19 cases, multiple sections of breast tissue including both the primary invasive area and forefront intraductal cancerous area were available for 15 cases; and multiple sections of breast cancerous tissue and the involved node were available for six cases) were examined by immunohistochemical analysis for evaluation of their proliferation rate. In this study, we selected the PCNA index as a marker of the proliferation rate of the tumor cells. We demonstrated that the PCNA index of the primary invasive area was significantly higher than that of the forefront intraductal area (P = 0.0017), and the PCNA index of the involved nodes was significantly higher than that of the primary invasive area (P = 0.0004). These preliminary findings suggest that the progression from the tumor cells of the intraductal cancerous area to the metastatic tumor cells must be accompanied by two phases of increase in the proliferation rate.

Breast Neoplasms↗

The quality of mass screening for breast cancer by physical examination.

Mass screening for breast cancer using physical examination alone has been carried out since 1983 in Zentsuji, Kagawa Prefecture, Japan. Over a 7-year period, breast cancer was detected in 11 of a total 8,271 examinees, the detection rate being high at 0.13%. The detected cases included a few early-staged breast cancers, suggesting that mass screenings are of slight efficacy. Seven cases of interval cancer were found by breast self-examination after the mass screenings, supporting the value of breast self-examination. A relatively large number of interval breast cancers was detected in 1985 and 1986, when the rates of required further examination remained under 1%. The sensitivity and specificity of this screening were 61.1% and 94.5%, respectively, indicating a low sensitivity. These results suggest that the qualitative diagnoses made from the first screening by physical examination alone were often revealed to be false negatives. Therefore, the existing diagnosis should be employed in the first screenings. It is recommended that mammography be introduced to detect breast tumors which are nonpalpable or undetectable by physical examination alone.

Adult↗