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Biomedical subjects

T Nishida

Publications and source records attributed to T Nishida.

At least 307 records · Page 17Linked to original sources

Comparison of CA 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitoring of ovarian cancer.

OBJECTIVE: To compare serum CA 125 assays with computed tomography (CT) and transvaginal ultrasound (TVUS) for early detection of disease recurrence in patients with ovarian cancer. METHODS: Sixty-two patients with non-mucinous epithelial ovarian cancer who had positive CA 125 levels (> 35 U/ml) were studied. We performed a retrospective review to determine the usefulness of serum CA 125 measurements. Setting the cut-off limit at either 35 U/ml or 16 U/ml, the accuracy of CA 125 measurements was compared with that of CT scanning, TVUS and operative findings at second-look laparotomy (SLL) in the early detection of recurrent tumors. RESULTS: Compared with SLL, both the specificity and the positive predictive value of CA 125 measurements were 100% at 16 and 35 U/ml. The sensitivity and the negative predictive value were 30.8 and 71.9%, respectively, below 35 U/ml and 53.8 and 79.3%, respectively, below 16 U/ml. The false-negative rate of CT was 36.1%. When the cut-off limit was reduced from 35 to 16 U/ml, 57.1% of patients considered to be in remission were reclassified as having persistent disease. A complete response confirmed by CT did not represent remission: CA 125 levels were 7.5-fold higher at the time of re-evaluation by CT. TVUS also lagged behind CA 125 assays in detecting disease recurrence. The sensitivity of ultrasound appeared to be lower than that of CT because it failed to detect extrapelvic lesions. CONCLUSION: A screening threshold (cut-off level) of 16 U/ml for CA 125 should be used to detect recurrent serous ovarian adenocarcinoma. Although ultrasound is a convenient method of detecting intrapelvic lesions, and has cost benefit, CT is necessary to detect extrapelvic recurrence. Neither CT nor ultrasound are more accurate than serial CA 125 assays in detecting disease recurrence.

Biomarkers, Tumor↗

Leiomyosarcoma of the small intestine presenting as a pelvic mass.

We present a challenging case of differential diagnosis of leiomyosarcoma of the small intestine in a patient presented with a pelvic mass. This 43-year-old Japanese woman complained of hypermenorrhea and was diagnosed as myoma uteri. She underwent partial resection of the ileum with a primary end-to-end anastomosis, omentectomy, and appendectomy, as well as a simple hysterectomy and bilateral salpingo-oophorectomy. CT and MRI indicated an intestinal tumor at the gaseous site. The histological diagnosis was leiomyosarcoma of the small intestine and leiomyoma of the uterus. Although such leiomyosarcomas are rare, they can appear as pelvic masses and must be differentiated from gynecologic disease. Preoperative CT and MRI of the abdomen were useful in obtaining the diagnosis.

Adult↗

Gonadotropin-releasing hormone agonist therapy induces apoptosis in uterine leiomyoma.

OBJECTIVE: We examined uterine tissue samples obtained from premenopausal women with uterine leiomyoma treated with gonadotropin-releasing hormone agonist (GnRHa) to investigate the mechanism of the effects of GnRHa. STUDY DESIGN: Surgically resected myoma tissue obtained from 26 premenopausal patients with uterine leiomyoma treated with GnRHa, 20 premenopausal patients with uterine leiomyoma who did not receive GnRHa treatment, and 15 postmenopausal women with uterine leiomyoma were examined histologically. RESULTS: GnRHa treatment reduced the size of uterine leiomyomata and induced significant hyaline degeneration in tumor tissue. Le(Y)-antigen expression was detected in 18 (69.3%) of 26 GnRHa-treated patients (P < 0.02) and in 12 (80.0%) of 15 postmenopausal women (P < 0.05), but in only eight (40.0%) of the 20 premenopausal patients who did not receive GnRHa. Apoptotic cells, detected by the nick-end labeling method were observed in 14 patients (53.8%) in the GnRHa-treated group, 10 patients (50.0%) in the non-treated group, and 12 postmenopausal women (80.0%). CONCLUSION: Our findings suggest that induction of apoptosis may be a mechanism of the effect of GnRHa in leiomyoma.

Adult↗

Improvement of rat liver graft function by insulin administration to donor.

BACKGROUND & AIMS: The nutritional status of a donor is considered to be an important factor affecting organ viability. The purpose of the present study was to examine hepatic energy status in connection with posttransplantation liver function. METHODS: The following five groups of donor rat livers were prepared and stored in University of Wisconsin solution at 4 degrees C: fasted group, rats fasted for 24 hours; fed group, rats provided standard laboratory chow; fed plus insulin group, fed rats treated with insulin before harvest; fasted plus insulin group, fasted rats treated with insulin before harvest; and fed plus glucagon group, fed rats pretreated with glucagon. RESULTS: Hepatic levels of adenosine triphosphate and total adenine nucleotides were maintained in the decreasing order of the fed plus insulin, fed, fasted plus insulin, fasted, and fed plus glucagon groups during preservation. Lactate production rate and fructose 2,6-bisphosphate level increased in the order of the fed plus insulin, fed, fed plus glucagon, fasted, and fasted plus insulin groups. Liver function after transplantation evaluated by the bile flow rate and enzyme leakage was well restored in the fed plus insulin group. CONCLUSIONS: Insulin administration to nutritionally well-supported livers before harvest improved energy metabolism during preservation and liver function after transplantation.

Adenosine Triphosphate↗

Insulin pretreatment protects the liver from ischemic damage during Pringle's maneuver.

BACKGROUND: Although maintenance of adenosine triphosphate (ATP) levels is important to restore liver functions during anoxia, ATP production by oxidative phosphorylation is inhibited during Pringle's maneuver, and only a little ATP can be supplied by glycolysis. The glycolytic activity of the liver is controlled by the nutritional condition and hormones. Enhancement of glycolytic activity by insulin may increase ATP production and thus may protect the liver from ischemia. METHODS: Rats were divided into three groups: fasted group, food was withheld for 24 hours; fed group, food was provided ad libitum; and insulin group, fed rats were administered insulin (12 units/kg during a 30-minute period) before portal triad clamping (PTC) was performed. After laparotomy was performed, PTC was performed for 30 minutes. The fructose 2,6-bisphosphate (F-2,6-BP) level, the hepatic levels of lactate and ATP, the bile flow rate, the plasma levels of aspartate transaminase and lactate dehydrogenase, and the indocyanine green clearance were measured at appropriate times. RESULTS: The hepatic F-2,6-BP levels before PTC in the fasted, fed, and insulin groups were 6.2 +/- 3.8, 55.6 +/- 10.6, and 122.2 +/- 31.3 nmol/gm dry weight liver, respectively. The glycolytic activity of the insulin group before PTC was significantly enhanced compared with that of the other groups. Lactate was more rapidly accumulated in livers of the insulin group during PTC than in those of the other groups. The ATP level and energy charge during PTC of the insulin group were higher than those of the other groups. The bile flow rate and indocyanine green clearance after PTC were restored in the order of the insulin, fed, and fasted groups. CONCLUSIONS: Insulin administration before PTC increased the hepatic F-2,6-BP content and enhanced glycolytic activity. Insulin pretreatment combined with feeding improved the hepatic energy metabolism during PTC and restored the liver functions after PTC. Insulin has protective effects on the liver during PTC.

Adenine Nucleotides↗

Overexpression of p53 protein and DNA content are important biologic prognostic factors for thyroid cancer.

BACKGROUND: Many factors gave been reported to be of prognostic importance for thyroid cancer. Biologic aggressiveness may influence postoperative recurrences and the prognosis of thyroid cancer. Immunohistochemical staining for the p53 protein and DNA content are novel factors that suggest biologic aggressiveness. METHODS: Retrospective study of the survival rate after operation of differentiated thyroid cancer was undertaken at Osaka Police Hospital. Age, gender operative method, extent of lymph node dissection, use of radioiodine, primary or recurrent tumor, tumor size and invasion, lymph node involvement, presence of distant metastases, DNA ploidy, percentage of S phase and G2M phase fractions, positive staining for the p53 protein, and histologic type and subtype were evaluated as possible prognostic factors by univariate and multivariate analyses of survival. RESULTS: Positive staining for the p53 protein was related to postoperative local recurrence, and DNA ploidy was related to distant metastatic recurrence. Univariate analysis suggested that age, tumor size and invasion, lymph node involvement, presence of distant metastases, percentage of S phase fraction, histologic subtype, DNA ploidy, and positive staining for the p53 protein were significant prognostic factors. Multivariate analysis suggested that positive staining of the protein and DNA ploidy were independent prognostic factors for overall survival. CONCLUSIONS: Both positive staining for the p53 protein and DNA ploidy, which suggest biologic aggressiveness, are independent prognostic factors for overall survival of patients with thyroid cancer, Examination of these biologic factors may provide new information regarding postoperative recurrences and the prognosis of thyroid cancer.

Aged↗

Superficial spreading type of early gastric cancer.

To determine the clinicopathological features of the superficial spreading type of early gastric cancer, which is defined as early gastric cancer in which the product of the longest diameter of the tumour and the diameter perpendicular to it is greater than 25 cm2, they were compared retrospectively with those of small-sized early gastric cancers, which are defined as tumours smaller than 2 x 2 cm2. The superficial spreading type accounted for 5.46% of all early gastric cancers. The distinguishing histopathological features of superficial spreading lesions were: a diffuse type of cancer, submucosal invasion and advanced lymph node involvement. Of the 32 patients with superficial spreading lesions, eight underwent an additional resection as a continuance of the first gastrectomy, because of an indistinct tumour margin. More extensive lymph node dissection was also performed on the group with superficial spreading lesions. There was no difference in 5 year survival rate between the two groups (superficial spreading type, 96.0% vs small-sized type, 95.1%). The most appropriate treatment for superficial spreading lesions is a wide surgical resection with extensive lymph node dissection.

Female↗

Granulocyte colony-stimulating factor for gastrointestinal perforation in patients with leukopenia.

OBJECTIVE: Leukopenia in the setting of widespread infection may predispose to sepsis, which is associated with a poor prognosis. Granulocyte colony-stimulating factor (G-CSF), which restores polymorphonuclear leukocyte function and count, has been shown to have protective effects in animal models of sepsis and burns. The aim of this retrospective study was to determine whether G-CSF can reduce the morbidity and mortality gastrointestinal perforation with leukopenia. PATIENTS AND METHODS: The studied subjects were 31 patients who had reduced leukocyte and neutrophil counts before undergoing surgery for gastrointestinal perforation, including six gastroduodenal, nine small intestinal, and 16 colonic perforations from 1986 to 1994. The patients were divided into two groups: a G-CSF(+) group (n = 8) that received G-CSF subcutaneously (150 microgram/day) during the perioperative period, and a G-CSF(-) group which did not. MAIN RESULTS: No significant difference was found in the preoperative and operative factors of the two groups. The postoperative increase in the leukocyte and polymorphonuclear cell counts of the G-CSF(+) group was significantly higher than that of the G-CSF(-) group (p <0.01). Renal, hepatic, and gastrointestinal insufficiency was significantly less common in the G-CSF(+) group than in the G-CSF(-) group. The mean number of organs that failed was reduced from 4.00 +/- 2.50 in the G-CSF(-) group to 1.88 +/- 2.03 in the G-CSF(+) group. One of the eight patients who received G-CSF died of sepsis because of panperitonitis. In contrast, in the G-CSF(-) group, 15 of 23 patients died of sepsis because of panperitonitis. The cause-specific survival rate of the G-CSF(+) group was better than that of the G-CSF(-) group (p <0.05). CONCLUSION: These results suggested that G-CSF reduced the morbidity and mortality of gastrointestinal perforation in patients with leukopenia and encouraged a prospective randomized study in future.

Aged↗

Extracellular matrix and growth factors in corneal wound healing.

The crystal clear cornea has been challenged by refractive surgeries. The surgical outcome depends on the healing responses of the cornea. The factors responsible for the corneal wound healing have been characterized. The orchestrated action of extracellular matrix proteins, growth factors, cytokines, and their receptors have been investigated extensively over the past decade. The clinical results with refractive surgeries provide us various important information with regard to the physiology and pathology of the cornea. The role of basement membrane or Bowman's membrane is now challenged for the maintenance and repair of the epithelium. Furthermore, the interactions between epithelium and stroma is another field to be investigated. The regulatory mechanisms of the maintenance of stromal collagen by keratocytes is also studied. This review discusses the current advancement in the healing responses of the cornea to various injuries and refractive surgeries.

Animals↗

Improvement of intraperitoneal chemotherapy for rat ovarian cancer using cisplatin-containing microspheres.

Microspheres consisting of L-lactic acid and glycolic acid copolymer containing cisplatin (CDDP-PLGA) were developed to improve the delivery of cisplatin. We evaluated the effects of intraperitoneal administration of cisplatin prepared as CDDP-PLGA in rats with ovarian cancer. The toxicity, platinum distribution, and therapeutic effects of CDDP-PLGA were evaluated as compared with those in the case of cisplatin aqueous solution. The LD50 of CDDP-PLGA was almost four-fold higher than that of cisplatin aqueous solution. CDDP-PLGA released cisplatin slowly and achieved a higher concentration in the peritoneal cavity and in peritoneal tumors for prolonged periods, while the tissue concentration of cisplatin was reduced elsewhere in the body, as compared with the case of cisplatin aqueous solution. The survival of rats with peritoneal carcinomatosis was increased by this delivery system relative to cisplatin aqueous solution. CDDP-PLGA thus allows a higher dose to be given without increasing systemic toxicity, enhancing the therapeutic effect of cisplatin.

Animals↗

Ovarian mucinous cystadenocarcinoma with sarcoma-like mural nodules.

We present a rare case of a 31-year-old woman with a mucinous ovarian tumor with sarcoma-like mural nodules. The epithelial elements consisted of a mixture of benign, borderline-malignant, and mucinous adenocarcinoma; the sarcoma-like mural nodules consisted of pleomorphic and epulis-like cells. The lesion was resected for an ovarian tumor. In an immunohistochemical study, these cells stained for lysozyme and vimentin. The patient received 2 courses of cisplatin (100 mg/m2). There was no evidence of disease at a second-look laparotomy after 1 year, and none upon examination 6 years after the initial operation. The mural nodules might be of non-epithelial origin. The prognosis of patients with this rare lesion appears favorable, according to this and previous reports.

Adult↗

Inhibitory effects of acid water prepared by an electrolysis apparatus on early plaque formation on specimens of dentine.

The aim of this study was to compare the effects of acid water prepared by an electrolysis apparatus with placebo treatment on the ultrastructure of early plaque formed on dentine specimens attached to retainers in the oral cavity. Dentine specimens were taken from 12 healthy extracted human 3rd molars. 4 dentine specimens were placed in the both the right and left buccal flanges of retainers fabricated from self-setting acrylic resin. The retainers were placed on both maxillary buccal sites in 6 subjects. The test solution was acid water (AW) prepared by an electrolysis apparatus with a pH of 2.7 and an oxidation-reduction potential of more than 1100 mV. As a positive control, 0.2% chlorhexidine digluconate (CHX) solution was used and normal saline solution as a negative control. 4 specimens placed in the right and left retainers were randomly allocated to 4 treatments as follows: treatment A, washing with AW; treatment B, washing with CHX solution; treatment C, washing with normal saline; treatment D, no washing. Washing was carried out in a plastic beaker containing 30 ml of each solution for 30s 2X daily over a 7-day period. The specimens were then carefully removed from the retainers, the morphology and thickness of the plaque formed examined by SEM, and the developmental condition of the plaque analyzed statistically. The plaque on the specimens in treatments A and B consisted mainly of coccoid forms. Mature plaque formation with complex flora was seen on the specimens in treatments C and D. The mean thickness of the plaque deposits on the dentin specimens as measured on SEM photographs magnified 2000 times was 8.80 mm for treatment. A, while in treatment B it was 3.90 mm. Plaque thickness for treatment C was 24.97 mm, and for treatment D 25.67 mm. The thickness of plaque formed on the sectioned specimens was significantly less for treatments A and B than for treatments C and D. However, there was no statistically significant difference between treatments A and B, and between treatments C and D (p < 0.0001). The results of this short-term study indicate that AW washing has almost the same potential for inhibition of plaque formation as CHX washing, and is more effective for inhibiting plaque formation than washing with sterile saline. It is therefore concluded that AW may be useful as an anti-plaque agent.

Acids↗

Classification of the cycle of the seminiferous epithelium in the common tree shrew (Tupaia glis).

The classification of the cycle of the seminiferous epithelium was carried out in the common tree shrew (Tupaia glis). The tree shrew captured in Thailand were fixed with Bouin's fixative, embedded in paraffin wax, and stained with PAS-hematoxylin. The cycle was classified into twelve stages on the basis of the acrosomal changes of spermatids. Relative frequencies of stages form I to XII were 11.9, 7.2, 8.9, 22.5, 12.9, 9.7, 8.0, 5.9, 4.0, 3.2, 2.9, and 3.6%, respectively. Different stages did no appear in a cross-sectioned tubule as did in primates. The head of matured spermatid was discoidal in shape and different from that of primates and rodents. Spermatogenesis of the common tree shrew is different from that of primates and rodents according to its morphological features.

Animals↗

Magnetic resonance imaging of the internal structure of the mouse fetus.

Magnetic resonance imaging (MRI) has potential as an imaging technique in fetal anatomy. In this article are presented images obtained from mouse fetuses at 16 days of pregnancy by means of the ultraconductive MRI system (JEOL AIM270). When fetuses removed from the uterus were fixed with 10% neutral formalin, various organs including heart, liver, lungs and bones were clearly seen, and a clear outline was obtained of the fetal skin and subcutaneous tissue by varying the setting. The same specimens were able to be used for histological evaluation. This MRI system will allow wider application in fetal anatomy and provide additional information about the developing mouse fetus.

Abdomen↗

Reassessment of second look operation for epithelial ovarian cancer.

We retrospectively reviewed 91 patients with epithelial ovarian cancer who underwent second-look operation (SLO). SLO identified a persistent tumor in 18 (19.8%) of 91 patients. Of these 18 patients, 13 (72.2%) showed disease progression after SLO. Patients with a positive SLO in which the identification of the persistent disease was only possible by washing cytological study showed better prognosis than patients with macroscopic lesions. Of the 73 patients with a negative SLO, 12 (16.4%) developed recurrence after cessation of treatment. These 12 patients were from stage 1c to 3 with Grade 2 and 3 tumors. The SLO findings were more sensitive than the serum tumor marker in identifying persistent disease. Also we reviewed 55 patients having no SLO. Among 57 cases in stage 1 and 2 with Grade 1 tumor, there were no cases of recurrence, regardless of whether they had SLO or not. Our results suggest that SLO findings correlate well with the patient's prognosis. SLO may not be needed for patients in stage 1 and 2 with Grade 1 tumor. Patients with advanced stage disease with Grade 2 and 3 tumors have high-risk for recurrence after negative SLO. While SLO is still of benefit in management of ovarian cancer, refinements are needed to determine its indication and scheduling.

Adult↗

Experimental intraperitoneal administration of cisplatin-activated carbon for rat ovarian adenocarcinomas.

Selective delivery of a high level of cisplatin (CDDP) to the omentum, intraperitoneal disseminated tumors and lymph nodes was studied using a dosage form of CDDP-activated carbon. Although intraperitoneal CDDP-activated carbon delivered much higher levels of CDDP to the omentum, tumors and lymph nodes, a primary burst phenomenon of CDDP occurred just after administration. This indicates that activated carbon is an unsuitable particle to provide a slow steady release of CDDP.

Adenocarcinoma↗

[Prognostic factors in ovarian epithelial cancer].

To data much has been reported concerning the prognostic factors in ovarian cancer. The factors may be summarized in accordance with their predictability and feasibility. The emphases are the most valuable clinical, histopathological, molecular biological and immunological factors.

Antineoplastic Combined Chemotherapy Protocols↗