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Biomedical subjects

T Sano

Publications and source records attributed to T Sano.

At least 127 records · Page 7Linked to original sources
PubMed2001

[Problems of international standardization of gastric cancer surgery].

Treatment results of gastric cancer patients differ considerably between Japan and the West, even at the same stage of disease. This may be partly explained by the varying extent of local control and the "stage-migration" theory. There is an important conceptual difference concerning lymphadenopathy and lymphadenectomy: Japanese surgeons believe that lymph nodes are the governors of metastatic disease and thus that lymphadenectomy will result in cure, while in the West lymph nodes are seen merely as the indicators of systemic metastasis and thus lymphadenectomy serves only for staging. The UICC TNM system has recently abandoned the anatomical N-classification and adopted the numeric N-classification. Although this is a good prognostic indicator, it does not provide surgeons with any information for surgical decision-making. Japanese surgeons will continue to use the Japanese classification that has served as a guideline for standard D2 lymphadenectomy. To establish an international standard for gastric cancer treatment, both sides should make efforts to understand each other and discuss most practical and beneficial treatment modalities for patients in the respective medical environments.

Gastrectomy↗
PubMed2001

[Pulmonary mucormycosis caused by Cunninghamella bertholletiae in a non-immunocompromised woman].

A 74-year-old woman was admitted for further examination because of an abnormal nodular shadow and thickening of the bronchovascular bundle in the left upper lobe on chest radiography and CT. The findings from a transbronchial biopsy specimen were not conclusive. A thoracoscopic lung biopsy specimen revealed a fungal infection, and partial resection of S1 + 2 of the left upper lobe was carried out. In the dilated bronchus, mucus of high viscosity was seen. Lymphocytes and plasma cells had infiltrated into the bronchioles and alveoli. Fungus was cultured from the mucus, and the morphological characteristics showed Cunninghamella bertholletiae. Pulmonary mucormycosis caused by C. bertholletiae in a non-immunocompromised person is very rare. Furthermore, this patient also had a wheeze, eosinophilia, elevation of the serum IgE level, and was positive for specific IgE to Mucor. We therefore consider that this case was an incomplete type of allergic bronchopulmonary fungusis (ABPF).

Aged↗
PubMed2001

[Chylothorax as the initial manifestation of malignant pleural mesothelioma--a case report].

A case of chylothorax associated with diffuse malignant pleural mesothelioma in a 53-year-old woman was reported. Chest radiography in a mass examination revealed right pleural effusion. A thoracentesis yielded fluid with characteristics consistent with chyle. In spite of our suggestion that thoracoscopy for further examination was necessary, the patient and her husband had refused the operation for months. Chest CT scanning revealed a nodule behind the xiphoid process. Lymphoscintigraphy suggested an obstruction of the right parasternal lymphatic vessel. Repeated thoracentesis did not yield a diagnosis. As bilateral pleural effusion and chylous ascites appeared, dyspnea worsened. About 2 years after the mass examination thoracoscopy was performed. On thoracoscopic exploration, a nodule was found in the anterior mediastinum and a biopsy was performed. Histological analysis revealed that the patient had the epithelial subtype of malignant pleural mesothelioma. Thoracoscopic pleural biopsy is a useful means of establishing the nature of a chylous effusion. In adult patients with chylothorax, thoracoscopic exploration should be performed as soon as possible to rule out malignancy.

Chylothorax↗
PubMed2000

3-Amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) induces apoptosis in rat splenocytes and thymocytes by different mechanisms.

3-Amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) is a potent carcinogen present in cooked meat. Although the target of this carcinogen is mainly in the liver, Trp-P-1 is distributed in the thymus and spleen as well as in the liver after administration. However, the cytotoxic effect of Trp-P-1 on lymphocytes has not been examined in detail. In the present study, we investigated the cytotoxicity of Trp-P-1 against rat splenocytes and thymocytes. Trp-P-1 reduced viability of both types of cells in the same manner, the LD(50) at 6h in culture was 15 microM, and the time for the 50% decrease in cell viability (t(1/2)) at 20 microM was 3h. In both types of cells, Trp-P-1 caused the activation of caspase-3-like proteases and the cleavage of poly(ADP-ribose) polymerase, both of which are biochemical markers of apoptosis. On the other hand, DNA fragmentation occurred in splenocytes, but not in thymocytes although Trp-P-1 activated 32-34kDa nucleases that may not be able to degrade DNA into nucleosomal units. These results indicated that Trp-P-1 induces apoptosis in both splenocytes and thymocytes by different mechanisms in which distinct apoptotic pathways may exist downstream of the caspase cascade.

Animals↗
PubMed2000

Sphingosine 1-phosphate as a major bioactive lysophospholipid that is released from platelets and interacts with endothelial cells.

The serum-borne lysophospholipid mediators sphingosine 1-phosphate (Sph-1-P) and lysophosphatidic acid (LPA) have been shown to be released from activated platelets and to act on endothelial cells. In this study, we employed the repeated lipid extraction (under alkaline and acidic conditions), capable of detecting Sph-1-P, LPA, and possibly structurally similar lysophospholipids, whereby a marked formation of [(32)P]Sph-1-P, but not [(32)P]LPA, was observed in [(32)P]orthophosphate-labeled platelets. Platelet Sph-1-P release, possibly mediated by protein kinase C, was greatly enhanced in the presence of albumin, which formed a complex with Sph-1-P. This finding suggests that platelet Sph-1-P may become accessible to depletion by albumin when its transbilayer movement (flipping) across the plasma membrane is enhanced by protein kinase C. Although human umbilical vein endothelial cells expressed receptors for both Sph-1-P and LPA, Sph-1-P acted much more potently than LPA on the cells in terms of intracellular Ca(++) mobilization, cytoskeletal reorganization, and migration. The results suggest that Sph-1-P, rather than LPA, is a major bioactive lysophospholipid that is released from platelets and interacts with endothelial cells, under the conditions in which critical platelet-endothelial interactions (including thrombosis, angiogenesis, and atherosclerosis) occur. Furthermore, albumin-bound Sph-1-P may account for at least some of the serum biological activities on endothelial cells, which have been ascribed to the effects of albumin-bound LPA, based on the similarities between LPA and serum effects.

Biological Transport↗
PubMed2000

Evaluation of the New International Union Against Cancer TNM staging for gastric carcinoma.

BACKGROUND: The lymph node (N) classification in the International Union Against Cancer (UICC) TNM staging system for gastric adenocarcinoma has been revised. The new classification is based on the number of positive regional lymph nodes instead of the anatomic location of the regional lymph node metastasis. Both classification systems were compared for prognostic significance. METHODS: A total of 4362 gastric carcinoma patients who underwent resection between 1969 and 1990 were analyzed. RESULTS: Thirteen percent of patients could not be staged according to the new system. Based on the previous classification, 647 patients were classified as pN1 and 711 patients as pN2. When reclassified, 587 patients remained pN1, 54 patients became pN2, and 6 patients became pN3. Of the 711 pN2 patients, 333 became pN1, 267 remained pN2, and 111 patients became pN3. Both lymph node classification methods defined groups with widely differing prognoses. The prognoses of patients classified as new pN2 were more homogeneous than those of the group classified as old pN2. Survival of new pT4/pN1 patients was significantly better than that of other subgroups in Stage IV. Nine potential prognostic factors, including lymph node metastasis, were studied in multivariate analysis. The hazard ratios were 1.38 (1.16-1.64) for pN1 and 2.55 (2.16-3.01) for pN2, based on the old classification. They were 1.51 (1.29-78) for pN1, 3.11 (2.56-3.78) for pN2, and 3.88 (2.98-5.05) for pN3, based on the new classification. CONCLUSIONS: The new N classification is superior as a prognostic factor to the old N classification, although there is inadequacy in stage grouping. [See editorial on pages 1763-5, this issue.]

Humans↗
PubMed2000

A simple preparation of half N-acetylated chitosan highly soluble in water and aqueous organic solvents.

A simple and improved method of preparing highly soluble chitosan (half N-acetylated chitosan) was developed using a series of chitosan samples of low molecular weights, and the solubility of the half N-acetylated chitosan in water and organic solvents was investigated in detail. To reduce the molecular weight, chitosan was treated with NaBO3 under the condition that chitosan was homogeneously dissolved in aqueous acetic acid. Weight-average molecular weights of the obtained chitosan samples were determined using a size-exclusion chromatography system equipped with a low-angle laser light-scattering photometer. Each chitosan sample was then N-acetylated with acetic anhydride under the condition that chitosan was homogeneously dissolved in aqueous acetic acid again. The water solubility of the half N-acetylated chitosan thus prepared increased with decreasing molecular weight. From 1H NMR spectroscopy, it was suggested that the sequence of N-acetylglucosamine and glucosamine residues was random. The solubility of the half N-acetylated chitosan of low molecular weight was rather high even in aqueous dimethylacetamide and dimethylsulfoxide.

Acetylation↗
PubMed2000

Hypersegmentation of inflammatory cells in Langerhans cell granulomatosis.

Langerhans cell granulomatosis (LCG) is characterized by a mixture of Langerhans cells and eosinophils in varying proportions. The characteristic morphology of Langerhans cells have already been described in many articles, but little attention has been paid to inflammatory cells. We examined six cases of Langerhans cell granulomatosis, which had originally been diagnosed as eosinophilic granuloma. Inflammatory cells present in LCG showed hypersegmentation. Twenty percent to 70% of eosinophils had three or more segmented nuclei, and 10-25% of neutrophils had five or more segmented nuclei. Such findings have never been described, and we believe hypersegmentation to be a feature of LCG. Furthermore, we emphasize that eosinophils in LCG mimic neutrophils in ethanol-fixed preparations, and thus may be a pitfall in making a diagnosis in cytology and intraoperative consultation.

Adult↗
PubMed2000

Gastrointestinal stromal tumor with skeinoid fibers of the ileum.

Gastrointestinal stromal tumor (GIST) is not uncommon among gastrointestinal nonepithelial tumors, but there are few reports describing the cytologic findings. We report a case of GIST with skeinoid fibers in scrape cytology preparation. The patient was a 53-year-old man with a tumor in the small intestine. Scrape preparations from the cut surface of the resected tumor revealed cellular material composed of spindle cells showing loose clusters or single cells. The nuclei were spindled, elongated or cigar-shaped, and relatively uniform. The cytoplasm was fragile and demonstrated a finely fibrillar material. Dense hyaline materials with irregular outline were observed within the loose clusters composed of the tumor cells. The hyaline materials were also observed in the background. Histologic preparation showed spindle cells arranged in a fascicular or storiform pattern. Most eosinophilic globules were distributed between the tumor cells. The globules were positive in periodic acid-Schiff reaction, and were stained blue with Masson's trichrome stain. Immunohistochemically, the tumor cells were strongly and diffusely positive for c-kit, focally and weakly positive for alpha-smooth muscle actin, and negative for CD34 and S-100 protein. We emphasize that skeinoid fibers are characteristic of GIST arising in the small intestine, and their presence predicts a good prognosis, even in malignant GIST.

Gastrointestinal Neoplasms↗
PubMed2000

Dilated rough endoplasmic reticulum corresponding to septate cytoplasmic vacuoles in papillary thyroid carcinoma.

Septate cytoplasmic vacuoles, which are one of the cytologic findings characteristic of papillary thyroid carcinoma, are small, uniform, and well-defined vacuoles, with defined strands of cytoplasm separating them. We report on a case with histologic and ultrastructural findings corresponding to septate cytoplasmic vacuoles, which have not been previously described. The patient was a 51-yr-old man with a mass in the left anterior of the neck, measuring 4.0 x 3.5 cm in diameter. Aspiration cytology smears revealed findings typical of papillary thyroid carcinoma, including papillary tissue fragments, intranuclear inclusions, nuclear grooves, powdery chromatin, and psammoma bodies. The tumor cells which were located at the periphery of small three-dimensional clusters, and others which showed a sheet-like arrangement, demonstrated uniform, small vacuoles in relatively abundant, dense cytoplasm. Histologically, a small number of papillary thyroid carcinoma cells with multiple vacuoles were observed, which were limited to the hobnail-shaped cells located at papillary configurations or floating tumor cells within the papillary lumen. Ultrastructurally, the hobnail-shaped tumor cells demonstrated various-sized dilated rough endoplasmic reticulum and rich heterochromatin. We emphasize that septate cytoplasmic vacuoles correspond to dilated rough endoplasmic vacuoles and are probably related to degenerative changes.

Carcinoma, Papillary↗
PubMed2000

Treatment of primary gastric lymphoma: experience in the National Cancer Center Hospital, Tokyo.

The single institutional experience of the treatment of primary gastric lymphoma is presented in chronological order. Between 1963 and 1986, 74 patients were treated with various uncontrolled methods and resection line involvement was seen in seven cases. Between 1987 and 1995, a prospective study was conducted employing total gastrectomy with systematic lymphadenectomy, followed by chemotherapy for cases with lymph node metastasis. Fifty patients were enrolled and the 5-year survival rate was 86%. Thorough histological examinations of the resected specimens revealed multiple foci in the stomach and nodal involvement in 36% and 50% of cases, respectively. Since 1995, the effects of eradication of Helicobactor pylori have been examined in association with the introduction of the histological diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma. Special attention should be paid to the elevated type tumors because they could metastasize to lymph nodes preserving the features of "low-grade" MALT lymphoma.

Combined Modality Therapy↗
PubMed2000

Gastric lymphography and detection of sentinel nodes.

The lymphatic drainage system of the stomach was studied using lymphography with various dyes, and several major routes have been shown. Gastric lymph channels are multidirectional and form complex networks. We conducted a retrospective study to know the first site of metastasis from small gastric cancers by examining 89 cases with only one lymph node metastasis. The perigastric nodal area close to the primary tumor was the first site of metastasis in only 62% of the cases. N2 metastasis without N1 involvement was seen in 13%. In order to identify sentinel nodes for local resection of gastric cancer, a novel method needs to be developed.

Carbon↗
PubMed2000

Phenotypic modulation of smooth muscle cells in human cerebral aneurysmal walls.

We used immunohistochemical methods to analyze the phenotypes of smooth muscle cells (SMCs) in human cerebral arteries and aneurysmal walls. Thirty-two aneurysmal walls were studied; 31 aneurysmal walls were resected at operation and 1 aneurysm was obtained at autopsy. Seven control arteries were obtained at autopsy. Semiserial sections were subjected to immunohistochemical staining with antibodies to alpha-smooth muscle actin (alpha-SMA), desmin and smooth muscle myosin heavy chain isoforms: SM1, SM2 and SMemb. In control cerebral arteries, SMCs in the media were strongly immunostained for alpha-SMA, desmin, SM1 and SM2; immunoreactivity for SMemb was faint or weakly positive. SMCs in both non-ruptured and ruptured aneurysmal walls showed no staining for desmin; the expression of alpha-SMA was well preserved. Compared with control cerebral arteries, in 4 of 11 non-ruptured aneurysmal walls, the staining intensity of SMCs for SMemb was clearly increased. In ruptured aneurysmal walls, the expression of SM2 was lower than in control cerebral arteries and non-ruptured aneurysmal walls. Our study suggests that the phenotype of SMCs in aneurysmal walls is different from the contractile type in the media of normal cerebral arteries, at least partially changing to the synthetic type in some non-ruptured aneurysms. SMCs in ruptured aneurysmal walls may have lost both phenotypes before rupture. Phenotypic modulation of SMCs in the aneurysmal walls appears to be related to a remodeling of the aneurysmal wall and to a rupture mechanism.

Actins↗
PubMed2000

Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoya experience.

From 1977 to 1997, surgical resection was possible in 142 (80%) of 177 patients with hilar cholangiocarcinoma after relieving jaundice by single or multiple percutaneous transhepatic biliary drainage followed by percutaneous transhepatic cholangioscopy and/or percutaneous trans-hepatic portal vein embolization. Curative resection was possible in 108 (61%) of the 142 patients, and 100 of these patients underwent various types of hepatectomy with caudate lobectomy for a 30-day operative mortality rate of 6% and 9% hospital mortality. Combined portal vein resection was carried out in 43 cases including 41 hepatectomies and 2 bile duct resections. Hepatopancreatoduodenectomy was performed in 16 patients. Cancer recurrence was observed in 58 of the 108 patients undergoing curative resection. The 3-, 5-, and 10-year survival rates for 100 patients undergoing curative hepatectomy and 8 with curative bile duct resection were 43%, 26%, and 19%; and 31%, 16%, and 0%, respectively; those for 40 patients with positive lymph node metastasis, 84 with perineural invasion, and 43 with combined portal vein resection were 27%, 14%, and 7%; 34%, 21%, and 13%; and 18%, 6%, and 0%, respectively. These survival rates are significantly better than those for 35 patients with unresectable cancer. Curative resection after aggressive preoperative management is recommended as a reasonable surgical approach to hilar cholangiocarcinoma.

Adult↗
PubMed2000

Pancreatoduodenectomy after hepato-biliary resection for recurrent metastatic rectal carcinoma.

Intrapancreatic bile duct metastasis from rectal carcinoma is rare. A 48-year-old man underwent extended left hepatic lobectomy and caudate lobectomy with extrahepatic bile duct resection for liver metastasis from a rectal carcinoma presenting with intrabiliary growth. A second recurrent tumor was successfully resected by pancreatoduodenectomy without injury to the jejunal loop for biliary reconstruction. Preservation of the previous bilio-enteric anastomosis was critical. Placing the jejunal limb of the hepaticojejunostomy through the retrogastric route was superior to placement through the common retrocolic and anteduodenal route, because the mesentery of the Roux-en Y jejunal limb did not obscure the pancreatic head. Histologic examination revealed a recurrent tumor growing into the remnant intrapancreatic bile duct. This suggested two possibilities: spontaneous shedding of cancer cells from the proximal metastasis, and implantation as a complication of percutaneous transhepatic biliary drainage. In both these circumstances, the metastatic lesion is not systemic, but is a local disease. An aggressive surgical approach for localized recurrence of this type may improve survival.

Bile Ducts, Extrahepatic↗
PubMed2000

Molecular characterization of Hop latent virus and phylogenetic relationships among viruses closely related to carlaviruses.

The complete nucleotide sequence of the hop latent virus (HpLV) genome was determined. The viral RNA genome is 8,612 nucleotides long, excluding the poly(A) tail, and contains six open reading frames (ORFs), which encode putative proteins of 224-kDa (ORF 1), 25-kDa (ORF 2), 11-kDa (ORF 3), 7-kDa (ORF 4), 34-kDa (ORF 5), and 12-kDa (ORF 6). ORF 5 encodes the coat protein as demonstrated by N-terminal sequencing of three proteolytic peptides derived from the virus particle. The genome organization of HpLV is similar to that of other species in the genus Carlavirus, and the overall sequence of HpLV is more similar to that of Potato virus M than to sequences of other carlaviruses reported to date. The amino acid sequences of the putative methyltransferase, RNA helicase, and RNA-dependent RNA polymerase encoded in ORF 1 and an 'accessory' helicase encoded in ORF 2 of the HpLV genome were compared with those of viruses in the 'tymo' lineage: the genera Carlavirus, Potexvirus, Allexivirus, Foveavirus, Trichovirus, Capillovirus, Vitivirus, and Tymovirus. The phylogenetic relationships among the viruses in these genera are discussed. This is the first molecular characterization of a carlavirus infecting hop plants.

Amino Acid Sequence↗