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T Obara

Publications and source records attributed to T Obara.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Home enteral nutrition for the maintenance of remission in patients with Crohn's disease--including comparison between Elental and Enterued].

Therapeutic efficacy of Elental and Enterued as home enteral nutrition (HEN) for the maintenance of remission in 32 patients with quiescent Crohn's disease was studied retrospectively. Their cumulative rates of continuous remission and non hospitalization were statistically compared in relation to following five factors; type of disease, history of bowel resection, duration of disease, oral bile acid tolerance test (OBATT) and radiological lesion score (RLS). As to the cumulative rates of continuous remission and non hospitalization, there was no significant difference between two groups treated with Elental and Enterued. In patient with ileocolitis type, > or = 5-year history, and a high score of RLS, few cases could continuously maintain remission following a long-term HEN. Especially, patients with low absorption in OBATT had a significantly lower cumulative rate of continuous remission than those with normal absorption in OBATT. The present results suggest that above factors may be useful in the application of HEN to patients with Crohn's disease.

Adolescent↗
PubMed1995

[Multiple endocrine neoplasia type 2A, type 2B and familial medullary thyroid carcinoma syndrome].

Recently, germline mutations in the RET proto-oncogene were found to be associated with multiple endocrine neoplasia (MEN) syndromes, MEN 2A, MEN 2B and Familial medullary thyroid carcinoma (FMTC). In patients with MEN 2A and FMTC different point mutations have been identified in exons 10 and 11 of the cysteine rich regions of RET. Patients with MEN 2B have a single point mutation (ATG to ACG) at codon 918 of RET. Therefore, a direct DNA testing has been developed to provide a highly accurate technique of detecting kindred members who have inherited a specific mutation associated with MEN 2A, MEN 2B or FMTC. In USA and Europe, prophylactic thyroidectomy has been performed on the basis of positive DNA testing, and the presence of a C-cell hyperplasia or a small medullary thyroid carcinoma was confirmed in each patient operated. Through nationwide survey in Japan, 233 patients with MEN 2 syndrome have been identified. They consisted of 180 MEN 2A, 18 MEN 2B, 13 FMTC and 22 unclassified patients. At follow-up, 47% of patients had recurrent medullary thyroid carcinoma and 5.7% of patients died of the disease. Genetic analysis was performed on 15 patients of 6 unrelated families in our series, and the results revealed that germinal mutations of RET as previously reported were also responsible for MEN 2 syndrome in Japanese. DNA analysis and prophylactic thyroidectomy for kindred members at risk for MEN 2 are likely to be beneficial in Japan as well.

Carcinoma↗
PubMed1994

The effect of additive hyaluronic acid on animal joints with experimentally reduced lubricating ability.

A series of in vitro experiments demonstrated a clear effect of additive hyaluronic acid (HA) on animal joints with experimentally reduced lubricating ability. Eleven canine hip joints were utilized and the experimental conditions tested were: i) intact joints, ii) after washing the joint surfaces, and iii) after adding 1% HA to them. The frictional coefficient of every joint increased after washing and subsequently decreased after adding HA. The mean values were 0.007 (SD 0.004) on the intact joints, 0.020 (SD 0.009) after washing, and 0.013 (SD 0.005) after the addition of HA. The differences between the three values of frictional coefficients were shown to be statistically significant (p < 0.01).

Animals↗
PubMed1994

Cytotoxicity of simvastatin to pancreatic adenocarcinoma cells containing mutant ras gene.

Simvastatin (SV), a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, inhibits the synthesis of mevalonic acid. The dose-dependent (0.1-100 micrograms/ml) cytotoxicity of SV towards human (MIAPaCa-2, Panc-1, HPC-1, HPC-3, HPC-4, PK-1, PK-9) and hamster (T2) pancreatic carcinoma cell lines was determined by MTT assay. At up to 20 micrograms/ml of SV, the effect was reversible and was restored by 60 micrograms/ml mevalonic acid. Point mutation of Ki-ras at codon 12 in each cell line was detected by means of the modified polymerase chain reaction. The concentration of SV necessary to achieve 50% cytotoxicity was about 10 micrograms/ml, and at this concentration of SV, DNA synthesis assayed in terms of [3H]thymidine uptake, isoprenylation of p21ras examined by Western blotting and cell progression from G1 to S phase of the cell cycle analyzed by flow cytometry were all inhibited. Isoprenylation inhibitors of p21ras, such as SV, are expected to be useful for the treatment of pancreatic cancer.

Adenocarcinoma↗
PubMed1994

Increased activity of insulin-like growth factor-binding protein in human thyroid papillary cancer tissue.

It has been shown that both insulin-like growth factor-I (IGF-I) and IGF-binding proteins (IGFBPs) are produced by thyroid cells in culture and that the cells respond to IGF-I with increased DNA synthesis, suggesting an autocrine/paracrine role of IGF-I in the regulation of thyroid cell growth. We investigated the tissue contents of immunoreactive IGF-I (irIGF-I) and IGFBPs in human papillary carcinoma and compared them with those of normal thyroid tissue. When irIGF-I was measured after separation of the IGFBPs by gel-filtration, its content in carcinoma tissue was not different from that in adjacent normal tissue (566 +/- 58 vs. 424 +/- 75 pg/mg protein, N = 10). Nor was there any difference in the abundance of IGF-I mRNA expression determined by slot blot analysis. On the other hand, IGFBP activity measured in terms of 125I-IGF-I binding was significantly higher in cancer extracts. Western ligand blot analysis of IGFBPs revealed several species (24-42 kDa) of IGFBPs. The IGF-I-binding activity of 38-41 kDa species (corresponding to IGFBP-3) was not different between extracts of cancer tissue and those of normal tissue, whereas that of 28-32 kDa species was significantly higher in cancer tissue extracts. Since IGFBPs have been reported to modulate cellular responses to IGF-I, the present data suggest that higher IGFBP activity in cancer tissue is involved in regulating growth of thyroid papillary carcinoma cells.

Adenoma↗
PubMed1994

Test performances of three diagnostic procedures in evaluating thyroid nodules: physical examination, ultrasonography and fine needle aspiration cytology.

A retrospective study was performed to determine the reliability of physical examination (PE), ultrasonography (US) and fine-needle aspiration cytology (FNA) in the evaluation of thyroid nodules. Preoperative diagnoses of 252 euthyroid patients comprised 126 with benign lesions, 114 with papillary carcinoma and 12 with follicular carcinoma made by PE, US and FNA were reviewed. The specificity of PE, US and FNA for malignancy was 98%, 90% and 98%, respectively. The sensitivity of PE, US and FNA for malignancy was 63%, 78% and 80%. The sensitivity for papillary carcinoma of the three procedures was 68%, 83%, 88%, whereas that for follicular carcinoma was 25%, 25%, 8%, respectively. When all the test results were negative, the likelihood ratio favoring papillary carcinoma was 0.008 whereas that favoring follicular carcinoma was 0.6. The histological category of carcinoma should be considered when evaluating diagnostic procedures for thyroid nodules. No negative test result is conclusive for ruling out the possibility of follicular carcinoma.

Biopsy, Needle↗
PubMed1994

[Eight cases of thymic carcinoma].

Eight cases of thymic carcinoma (mean age 62 years, 5 males and 3 females) were treated in our hospital from Apr. 1988 to Mar. 1993, which were 21% of thymic epithelial tumors. The histologic subtypes of thymic carcinoma were 3 squamous, 4 undifferentiated, and 1 adenocarcinoma, respectively. Computed tomography showed extrathymic metastases to the mediastinal lymph nodes in 6 cases. All cases underwent thoracotomy, and postoperative radiotherapy or chemotherapy were performed. A case of squamous cell carcinoma in stage II who underwent total resection followed by irradiation is alive and disease free 5 years after surgery. However, the remaining 7 cases died of the disease within 29 months. 8 cases of thymic carcinoma and 7 of thymoma were studied immunohistologically on the formalin-fixed and paraffin-embedded tissues. Higher positivity of EMA in thymic carcinoma was noted comparing to ordinary thymoma, suggesting that EMA is a useful parameter of potential malignancy of the thymic epithelial neoplasms.

Adenocarcinoma↗
PubMed1994

[Therapeutic effectiveness of 131I-MIBG on malignant pheochromocytoma--results of long-term follow-up].

The therapeutic response of 131I-MIBG was evaluated in 4 patients with malignant pheochromocytoma who had been treated with 131I-MIBG and followed-up over 5 years. The patients were 2 men and 2 women with ages ranging from 41 to 69 years old (mean 53 years). The primary tumors in 3 of 4 patients had been resected four to eight years before 131I-MIBG treatment. One patient was diagnosed as adrenal pheochromocytoma, and two were retroperitoneal paraganglioma. And in one patient, the resection of primary mediastinal tumor was not performed due to the adhesion to pericardium but the diagnosis of paraganglioma was obtained by biopsy of bone lesion. All patients showed the clear accumulation of 131I-MIBG in tumor on scintigraphy. The number of doses of 131I-MIBG ranged from one to three times with 3.7 GBq per administration and a cumulative activity from 3.7 to 11.1 GBq. Treatment effect was obvious in one patient with lung, bone, and lymph node metastases whose cumulated absorbed dose with 11.1 GBq of 131I-MIBG exceeded over 150 Gy. At the present time, the duration of survival since the beginning of initial 131I-MIBG therapy is over 5 yrs. The other three patients, however, showed little effects, and died with the disease in 2.6 to 4.1 years after the initial 131I-MIBG therapy. 131I-MIBG will become a promising agent for therapy in patients with malignant pheochromocytoma with high degree of accumulation.

3-Iodobenzylguanidine↗
PubMed1994

[Differential diagnosis between osteoporosis and asymptomatic primary hyperparathyroidism].

Recently, patients with asymptomatic primary hyperparathyroidism (aPHPT) are on the increase. When serum Ca, P and intact PTH are determined frequently, it is not difficult to diagnose of aPHPT, even when serum alkaline phosphatase activity is increased in some postmenopausal women. However, the criteria for operation for aPHPT is difficult, because the natural course of aPHPT is unknown, particularly in terms of bone mineral density. Since bone mineral density is genetically regulated by polymorphism of vitamin D receptor (Nature 1994), the analysis of restriction fragment length polymorphism of the vitamin D receptor may be useful as one of criteria for operation in patients with aPHPT in the near future.

Alkaline Phosphatase↗
PubMed1994

Effects of high-molecular-weight sodium hyaluronate on experimental osteoarthrosis induced by the resection of rabbit anterior cruciate ligament.

Sodium hyaluronate (HA) with a molecular weight of 202 x 10(4) (HA-202) was administered into the right knees of mature rabbits for the treatment of experimental osteoarthrosis induced by resection of the anterior cruciate ligament. At six and 12 weeks after the initiation of administration, the test group was compared with a group administered physiological saline solution to determine the effects on articular cartilage and synovial tissue. In both the six- and the 12-week period, cartilage degeneration proceeded with the lapse of time in both groups; however at 12 weeks, the efficacy of HA-202 in inhibiting degeneration was clearly observed at the lateral condyle of the femur and tibia where relatively marked degeneration was observed in the saline group. A comparison was also made among three groups administered HA-95 (sodium hyaluronate with a molecular weight of 95 x 10(4)), HA-202, and saline, respectively, for 12 weeks. The saline group showed the greatest cartilage degeneration accompanied by complete disorganization of the cartilage layer and the disappearance of chondrocytes. The degeneration was less in the HA groups, and it was more significantly inhibited in the HA-202 group than in the HA-95 group.

Animals↗
PubMed1994

[Mucin-producing tumor of the pancreas: surgery or follow-up?].

Clinicopathological studies were carried out in 35 cases of mucin-producing tumor of the pancreas. In addition, natural history and serial pancreatogram changes were studied in 12 long-term follow-up cases. 83% of the main duct type and branch duct type greater than 4 cm were malignant, whereas hyperplasia cases were found in the branch duct type of 3 cm or less in size without marked dilation of the main duct and excrescent nodules. 33% of carcinoma cases were accompanied by parenchymal invasion and all those cases were of polypoid type of 2.5 cm or more in size. In long-term follow-up cases, all 3 cases of the main duct type showed progression of pancreatograms. In contrast, 8 of 9 cases of the branch duct type remained unchanged. These results suggest that surgical resection is mandatory in the main duct type and that the branch duct type where hyperplasia is highly suspected can be followed up.

Adenocarcinoma, Mucinous↗
PubMed1994

Immunohistochemical analysis of p53 expression in human pancreatic carcinomas.

Alterations in the p53 tumor suppressor gene are involved in the pathogenesis of diverse human cancers. Immunohistochemical detection of the p53 protein has been strongly correlated with mutations in the p53 gene. Fifty-four human exocrine pancreatic tumors of American, Japanese, and Senegalese origin and six xenotransplanted human pancreatic carcinoma cell lines were investigated immunohistochemically with monoclonal anti-p53 antibodies pAb 1801 and BP53-12. Positive nuclear p53 immunoreactivity was detected in 37% of paraffin-embedded primary tumors (21.8% in the Japanese group, 52.6% in the American group) and in 50% of xenotransplanted carcinoma cell lines. Since several intraductal papillary adenocarcinomas exhibited positive p53 immunostain, it seems probable that alterations in this tumor suppressor gene occur relatively early in the process of pancreatic carcinogenesis. No clear correlation was established between p53-positive immunohistochemical staining and tumor stage and histologic appearance, nor with patient age, sex, or survival time. In contrast to ductal carcinomas and intraductal papillary adenocarcinomas, none of the mucinous or adenosquamous pancreatic carcinomas exhibited positive nuclear staining for p53. The fact that more than half of the ethanol-fixed fine-needle aspirates were positive for p53 suggests that this type of immunostain may be of potential diagnostic significance. An investigation of a large series of pancreatic tumors is needed to further evaluate the relationship between p53 alterations and clinicopathologic features in human pancreatic cancer.

Adult↗
PubMed1993

[Seven patients with hyperparathyroid crisis: emphasis on prompt parathyroidectomy].

Although hyperparathyroid crisis is rare, the management of this disease remains controversial. We analyzed the clinicopathological features and treatment outcome of this disease to evaluate the significance of prompt parathyroidectomy. Seven patients with an episode of hyperparathyroid crisis who consisted of 2.3% of all surgical patients of primary hyperparathyroidism were treated from 1981 to 1992 at the Department of Endocrine Surgery, Tokyo Women's Medical College. They all showed grave hypercalcemia greater than 15mg/dl, renal dysfunction and gastrointestinal toxicity. Their ages ranged between 33 and 75 years (mean age 49.7 years); two patients were men and five were women. Six patients had an adenoma, and only one had a carcinoma. The weights of the parathyroid tumors ranged between 3.5g and 11g, and ultrasonography disclosed an enlarged parathyroid gland in all patients. All of the seven patients underwent prolonged medical treatment (mean of durations 52 days), but four of them remained with hypercalcemia greater than 15mg/dl. On the other hand, the serum calcium levels of all patients returned to normal within five days after their operations without any surgical complication. Therefore, we recommend prompt parathyroidectomy for hyperparathyroid crisis, since medical treatment requires a prolonged clinical course and sometimes fails to control grave hypercalcemia.

Adenoma↗
PubMed1993

[Characteristics and clinical course of patients with subacute thyroiditis without typical signs and symptoms].

To determine the characteristics and clinical course of patients with subacute thyroiditis (SAT) without typical signs and symptoms, clinical and pathologic records of the patients were reviewed and compared with those of patients with typical SAT. During the past 10 years, 11 of 105 patients with SAT did not have enough typical features for a diagnosis of SAT (atypical SAT). They included one male and 10 females with the average age of 50 years. The incidence of neck pain as the initial symptom in the patients with atypical SAT was low (18%) compared with that in the patients with typical SAT (69%). Of the patients with atypical SAT, 42% had elevated thyroid hormone levels and 46% had suppressed TSH levels, whereas the percentages in the patients with typical SAT were 76% and 85% respectively. Nine of 11 patients were misdiagnosed as having papillary carcinoma by physical examination, and 4 by ultrasonography. However, aspiration cytology could make a precise diagnosis of SAT in 4 patients at the time of clinical diagnosis and 3 other patients after reevaluation. Eight patients were admitted to the hospital under the diagnosis of thyroid cancer and 4 underwent surgical resection. Differential diagnosis between atypical SAT and papillary carcinoma is important, and aspiration cytology could be a conclusive diagnostic tool to avoid unnecessary treatment.

Adult↗
PubMed1993

[Relative lymphopenia in Cushing's syndrome].

The differential white blood cell (WBC) count often reveals relative lymphopenia in Cushing's syndrome and may be a clue to the discovery of the ailment. However, the incidence of this finding has rarely been reported in the literature. We conducted a study on 40 patients with Cushing's syndrome due to adrenocortical adenoma to evaluate the diagnostic implications of relative lymphopenia. Total WBC count, differential WBC count, basal level of plasma cortisol, urinary excretion of free cortisol and thyroid function were evaluated preoperatively. We also investigated the differential WBC count in 40 patients with thyroid tumors matched for age and sex with the Cushing's syndrome patients. The proportion of lymphocytes among WBCs was also compared between the two groups. The proportion of lymphocytes among WBCs was significantly lower in the patients with Cushing's syndrome (19.4 +/- 10.8%) than in those with thyroid tumors (42.3 +/- 9.5%, mean +/- SD, p < 0.05). The incidence of relative lymphopenia was high (82.5%) as well as that of increased urinary excretion of free cortisol (85.3%) in Cushing's syndrome patients. The low T3 syndrome was frequently seen (73.9%), whereas the incidences of leukocytosis and an increased level of basal plasma cortisol were relatively low (42.5% and 47.5%, respectively). Relative lymphopenia provides useful information for diagnosing Cushing's syndrome since it has high sensitivity although it should be kept in mind that its specificity is low.

Adenoma↗
PubMed1993

Immunologic significance of increased soluble CD8/CD4 molecules in patients with active systemic lupus erythematosus.

This study attempted to estimate soluble CD4(sCD4)/CD8(sCD8) molecules in active systemic lupus erythematosus (SLE) patients. Measurements were made by solid-phase enzyme-linked immunosorbent assay. sCD8 or sCD4 molecules were significantly increased in the patients as compared to control subjects. sCD8 correlated with the erythrocyte sedimentation rate. sCD4 correlated with the anti DNA antibody titer, the IgG concentration, and negatively with the complement titer. An association of these molecules with immunologic abnormalities and disease activity exists in SLE patients.

CD4 Antigens↗