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Biomedical subjects

T Shuin

Publications and source records attributed to T Shuin.

At least 109 records · Page 6Linked to original sources

Retinoblastoma gene mutation in primary human renal cell carcinoma.

We searched for possible mutations in the E2F-binding region of retinoblastoma gene in primary human renal cell carcinomas, using polymerase chain reaction and single-strand conformational polymorphism analysis of RNA. Retinoblastoma gene mutation was detected in 1 of 21 cases (5%). DNA sequencing of the polymerase chain reaction product verified that this case had a 6-base deletion at the beginning of exon 8. Our findings suggest that mutation of the retinoblastoma gene is involved in only a subgroup of sporadic human renal cell carcinomas.

Base Sequence↗

[Combination therapy with interferon-alpha and continuous infusion of 5-fluorouracil for advanced renal cell carcinoma].

Between May 1990 and April 1994, eleven patients with metastatic renal cell carcinoma received a combination therapy with interferon-alpha (IFN alpha) and 5-fluorouracil (5FU). IFN was administered intramuscularly six or ten million units three times per week for 4 weeks and 300 mg/m2 of 5FU was administered by continuous intravenous infusion daily for 4 weeks. Of 8 evaluable patients, two had a partial response (25%) two had a minor response (25%), and two had a stable disease (25%). The common side effects of the regimen were flu-like symptoms (91%), mucositis (64%) and leukopenia (75%). Three patients refused this therapy because of severe mucositis or stomatitis. Although the combination of IFN and 5FU in patients with metastatic renal cell carcinoma had some efficacy, this regimen had severe toxicity especially for the gastrointestinal (GI) tract. None of the patients could be administered the initially scheduled dosage of 500 mg/m2 of 5FU. The dose limiting factor of this regimen is considered to be GI symptoms.

Aged↗

[Complete response of lung metastasis from bladder cancer by combination chemotherapy with methotrexate, epirubicin and cisplatin: a case report].

We report a case of lung metastasis from bladder cancer effectively responding to a combination chemotherapy using methotrexate, epirubicin and cisplatin (MEC therapy). A 78-year-old man with high grade bladder cancer underwent total cystectomy on June 5, 1991. He was pointed out to have an abnormal shadow on the plain chest X-ray on August 14, 1992. Computed tomography demonstrated multiple lung metastasis. MEC combination chemotherapy was applied for this case. After 3 courses of MEC therapy, computed tomography showed marked regression of tumor. He has been alive for 12 months with no evidence of disease after chemotherapy. Toxicity of MEC therapy were moderate myelosuppression and mild anorexia and alopecia. These toxicity was adequately tolerable by the 78-year-old patient. This case suggests that MEC therapy is effective against advanced bladder cancer.

Aged↗

Infrequent somatic mutations of the p16 and p15 genes in human bladder cancer: p16 mutations occur only in low-grade and superficial bladder cancers.

A recently identified gene, p16, located on chromosome 9p21, has been shown to be deleted and/or mutated in various types of human cancers. To investigate structural alterations of p16 and a neighboring gene, p15, we examined human bladder cancers for mutations in the entire coding region of these genes using polymerase chain reaction and single-strand conformational polymorphism analysis. Of 50 samples obtained from patients with bladder cancer, 3 (6%), all low-grade and superficial tumors, were found to have p16 gene alterations. The alterations included 1 missense mutation and 2 single-base deletions. We found no p15 gene mutations in these 50 bladder cancers. Our results suggested that p16 gene mutations, although they occurred at low frequency, are involved in some low-grade and early stage bladder cancers.

Base Sequence↗

Somatic mutations of the von Hippel-Lindau tumor suppressor gene in sporadic central nervous system hemangioblastomas.

Hemangioblastoma is one of the benign tumors in the central nervous system. It is often associated with the von Hippel-Lindau (VHL) disease, a well known hereditary tumor syndrome. It is believed that inactivation of both alleles of VHL tumor suppressor gene is essential in the tumorigenic processes in hemangioblastomas associated with VHL disease. The molecular basis for the development of sporadic hemangioblastomas is not known. Here, we analyzed 13 cases of primary sporadic hemangioblastomas for somatic mutations of VHL gene with single strand conformational polymorphism analyses of the tumor DNAs. We detected abnormal single strand conformational polymorphism pattern in 7 tumors (54%). Of these 7 possibly mutated tumors, we successfully characterized 3 tumors by direct sequencing. We were unable to sequence 4 tumors because of the poor quality of DNA obtained from paraffin blocks. Somatic mutations in the 3 tumors were 2 missense mutations and 1 microdeletion. These mutations were observed in 1 tumor in exon 1 and 2 tumors in exon 2. Our results suggest that mutations of VHL tumor suppressor gene are involved in the development of at least 20% of sporadic central nervous system hemangioblastomas.

Base Sequence↗

DNA polymerase beta gene mutation in human prostate cancer.

DNA polymerase beta is a nuclear protein essential to DNA repair in mammalian cells. A high frequency of mutations in this gene has been reported in colorectal cancers. To clarify the tumorigenesis steps of human prostate cancers in the molecular basis, we examined the entire coding region of the human DNA polymerase beta gene in human prostate cancer tissues using polymerase chain reaction, single-strand conformational polymorphism analysis of RNA, and sequencing analysis. Consequently, we detected DNA polymerase beta gene mutations in 2 of 12 cases (17%). The first case is an A to G transition at nucleotide 893, resulting in a substitution of the amino acid from tyrosine to cysteine. In the second case, we found an A to G transition at nucleotide 305, a T deletion at nucleotide 569, and an A insertion into the 6 repeats of A from nucleotide 612 to 617. This T deletion shifted the subsequent reading frame and resulted in the premature termination at codon 163 instead of 336. The two cases were advanced grade and stage. Present results suggest that polymerase beta gene mutations, although they occurred at relatively low frequency, are involved in certain cases of human prostate carcinogenesis.

Adenocarcinoma↗

Frequent somatic mutations and loss of heterozygosity of the von Hippel-Lindau tumor suppressor gene in primary human renal cell carcinomas.

We analyzed 47 primary sporadic human renal cell carcinomas (39 clear cell and 8 non-clear cell) for mutations of the von Hippel-Lindau (VHL) tumor suppressor gene using the polymerase chain reaction and single strand conformational polymorphism analysis of DNA. All of the positive cases in single strand conformational polymorphism analyses were further characterized by direct sequencing. Somatic mutations were detected in 22 (56%) of 39 clear cell renal carcinomas including 15 deletions, 3 insertions, 3 missense mutations, and 1 nonsense mutation. Nineteen of these mutations predicted to produce truncation of the VHL protein. These mutations mainly occurred in the last one-third region of exons 1, 2, and 3. In addition, loss of heterozygosity of the VHL gene was observed in 16 (84%) of 19 informative clear cell renal carcinomas. No somatic mutations were detected in 8 non-clear cell carcinomas. These results show that the VHL tumor suppressor gene is one of the major tumor suppressor genes in human renal cell carcinomas, especially in the clear cell subtype renal cell carcinoma. Clear cell carcinoma might be distinguished from other pathological types of renal cell carcinomas by molecular genetic techniques.

Base Sequence↗

Differential expression of protooncogenes in human germ cell tumors of the testis.

BACKGROUND: It has been suggested that tumorigenesis of the germ cell tumor of the testis includes abnormal and developmentlike differentiation of primordial germ cells to several mature type tumors. METHODS: To clarify roles of protooncogenes in the unique tumorigenic mechanism in the human germ cell tumor, the authors examined the expression of 15 protooncogenes in human primary germ cell tumors of the testis with Northern blot analyses. RESULTS: Fifteen (94%) of 16 seminomas and 5 (83%) of 6 embryonal carcinomas had a significant levels of N-myc expression, whereas they did not express two receptor type protooncogenes, c-erbB-1 and c-erbB-2. In contrast, some immature teratomas had a high level of c-erbB-1 expression, and an advanced case showed a significant level of c-erbB-2 expression. Immature teratomas did not show N-myc expression. Higher levels of c-mos expression were observed in several cases of seminomas and embryonal carcinomas. Expression of c-Ki-ras or N-ras was observed in all histologic subgroups and normal testes. CONCLUSION: A significant level of N-myc expression may be essential for undifferentiated tumors including seminoma and embryonal carcinoma, whereas c-erbB-1 and possibly c-erbB-2 may have important roles in the differentiated tumors such as immature teratoma. These results suggest that some of the protooncogene expression may be switched critically during the differentiation from seminomas or embryonal carcinomas to the more differentiated-type tumor.

Biomarkers, Tumor↗

A phase II study of prophylactic intravesical chemotherapy with 4'-epirubicin in recurrent superficial bladder cancer: comparison of 4'-epirubicin and adriamycin.

Since intravesical recurrence of superficial bladder cancer (Ta, T1) after transurethral resection (TUR) is frequent, adjuvant therapy to reduce the recurrence rate has been extensively investigated. Although intravesical chemotherapy has been employed for 30 years or more, neither the exact effect on the bladder epithelium nor the optimal dose and administration schedule has yet been clarified. In recent years, several derivatives of Adriamycin (ADR) have been developed, and 4'-epirubicin (FARM) is one of them. This drug has been shown to have antitumor effects almost equal to those of ADR and to produce less toxicity when given systemically as chemotherapy. In an attempt to clarify the effect of intravesical FARM in the prevention of recurrence of superficial bladder cancer, we conducted a prospective randomized trial to compare the effects of equal doses of FARM and ADR given by intravesical instillation after TUR in cases of highly recurrent superficial bladder cancer. A total of 73 patients with recurrent superficial bladder cancer were randomized to receive TUR and either 30 mg FARM or 30 mg ADR by intravesical instillation every 2-4 weeks for 1 year. The prophylactic effect on recurrence and the toxic effects of these drugs were investigated. The current results show that FARM provides efficacy almost equal to that of ADR in the prevention of recurrence in these patients. However, FARM also caused almost the same local toxic effects (bladder irritation, among others) as ADR. On the basis of these preliminary results, FARM is surmised to be one of the agents as beneficial as ADR in the prevention of recurrence of superficial bladder cancer.

Administration, Intravesical↗

Spontaneous rupture of adrenal pheochromocytoma: a case report.

We report a case of retroperitoneal hemorrhage due to spontaneous rupture of a right adrenal pheochromocytoma, presenting as an acute abdominal emergency with symptoms of peripheral vasoconstriction. An elective operation was successfully performed on day 7 after sufficient volume replacement with continuous administration of an alpha and beta-adrenergic blocking agent.

Adrenal Gland Neoplasms↗

Nucleolar organizer regions in bladder cancer: application to urinary cytology.

OBJECTIVES: We investigated the relationship between the numbers of nucleolar organizer regions (NORs) in nonmalignant reactive cells and those in transitional cell carcinomas using urinary exfoliated cell specimens. Another aim of this study was to determine whether higher numbers of NORs are correlated with tumors with higher pathologic grade. METHODS: Nucleolar organizer regions, which are important for regulating protein synthesis, were counted by means of a silver staining technique in urinary exfoliated cells from 34 patients with transitional cell carcinoma (TCC) and in 30 patients with other urologic diseases (controls). RESULTS: The number of argyrophilic proteins of the nucleolar organizer region (Ag-NORs) per cell (mean +/- SD) was 2.9 +/- 0.5 in the control group and 5.5 +/- 1.9 in patients with TCC, which was significantly higher than that in the controls (p < 0.001). It was 4.0 +/- 1.0 in patients with grade 1 TCC, 5.4 +/- 2.0 in those with grade 2 TCC, and 6.5 +/- 1.2 in those with grade 3 TCC. Although no statistically significant difference was observed between the groups, the patients with grade 2 TCCs with higher numbers of Ag-NORs showed a tendency to have more diffuse and/or invasive lesions. CONCLUSIONS: This method is simple and quick, and can identify low-grade malignancy. It could be used as a tool for further grading of grade 2 TCCs and for determining prognosis.

Adult↗

Photokilling of T-24 human bladder cancer cells with titanium dioxide.

A photoexcited titanium dioxide surface has a strong ability to decompose water into hydrogen and oxygen. We have studied this effect in order to use it to kill cancer cells in vitro and in vivo. A distinct cell killing effect was observed on cultured T-24 human bladder cancer cells treated with titanium dioxide particles and 300-400 nm UV light irradiation. Titanium dioxide plus UV light also dramatically suppressed the tumour growth of T-24 cells that were implanted in nude mice. Cells cultured on the titanium dioxide electrode were also killed under UV irradiation when the electrode was anodically polarised, suggesting that photogenerated holes are involved in the cell killing. The cell killing effect caused by titanium dioxide particles plus UV light irradiation was significantly hampered in the presence of L-cysteine and catalase, scavengers of hydroxyl radicals and hydrogen peroxide respectively. Transmission electron microscopic observations showed the titanium dioxide particles to be distributed on the cell surface and inside the cells. These results suggest that titanium dioxide particles under UV light irradiation produced photogenerated holes on the surface yielding hydroxyl radicals and hydrogen peroxide inside or outside the cells and the cells were then killed by the action of these highly oxidising molecules. The possible application of photoexcited titanium dioxide particles to cancer treatment as a new anti-cancer modality is discussed.

Catalase↗

Schedule-intensified M-VAC chemotherapy for advanced urothelial cancer with recombinant human granulocyte colony stimulating factor (rhG-CSF).

M-VAC (Methotrexate, vinblastine, adriamycin and cisplatin) combination systemic chemotherapy is useful for treating invasive or metastatic transitional cell carcinoma. Granulocytopenia is the major dose-limiting factor of this chemotherapy and it takes 4 weeks or more to complete a single course of M-VAC. We have tried to shorten the period of M-VAC chemotherapy from 4 to 3 weeks by using rhG-CSF. With this modified M-VAC regimen, the number of days on which the absolute neutrophil count was less than 1000/mm3 was significantly reduced and the period to reach the neutropenia nadir was shortened. No severe side-effects were observed. In all patients treated with 2 courses of this modified M-VAC short regimen, the period of hospitalization could be reduced by 2 weeks. We emphasize the possibility of shortening the M-VAC regimen.

Aged↗

[M-VAC chemotherapy for advanced urothelial cancer--side effects and their management].

Since the M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) regimen was reported by Sternberg in 1985, it has been widely accepted for the treatment of metastatic transitional cell carcinoma. This regimen has a significantly high response rate, but bone marrow suppression and gastrointestinal (GI) symptoms are inevitable. To complete this M-VAC regimen, preventive therapy for side effects is necessary. From November 1986 to March 1993, a total of 72 patients were admitted and received M-VAC therapy at our hospital. All of them had metastatic or invasive transitional cell carcinoma and they received a total of 163 complete courses of M-VAC therapy. We examined the side effects of this M-VAC regimen, and evaluated the effectiveness of colony-stimulating factor for prevention of granulocytopenia or granisetron for prevention of GI symptoms. Twenty-three patients (39 courses) were given recombinant colony-stimulating factor. This cytokine prevented the nadir of neutropenia and shortened the period to reach the nadir and period that the neutrophil count was below 1,000/mm3. Twelve patients (26 courses) were given granisetron, with significant reduction of the incidence of GI symptoms. These findings suggest that M-VAC therapy is effective and safe when used in combination with these drugs.

Adult↗

[A study on reservoir function of Kock pouch during a 3-year postoperative period].

Kock continent ileal reservoir has been one of the major options of urinary diversion for the patients with bladder cancer. We performed Kock pouch operation in 16 patients (male 12, female 4; from 41 to 66 years old, mean age 57 years old). Since the reservoir function of Kock pouch after a long postoperative period is not well known, we examined the volume capacity, the compliance and the length of efferent valve of Kock pouch in 8 patients during a 3-year postoperative period. Although the compliance was stable, the volume capacity and the length of the efferent valve showed a decreasing tendency. The shorter efferent valve was not always associated with the case of urinary incontinence. Most of the complications in 15 patients was trouble of efferent valve (prolapse of efferent valve in 7 cases and eversion or fistula formation that required reconstruction surgery in 3 cases). Although some complications were observed, the reservoir function of the pouch was stable. Therefore this method is reliable for permanent urinary diversion.

Adult↗

[New salvage chemotherapy (cisplatin, adriamycin, bleomycin, methotrexate, etoposide) for advanced nonseminomatous testicular cancer: experience in three cases].

Three patients with advanced non-seminomatous testicular tumor were treated with a new salvage chemotherapy. All patients were refractory to prior PVB (cisplatinum, vinblastine, bleomycin) or VAB-6 (cisplatinum, bleomycin, vinblastine, dactinomycin, cyclophosphamide) therapy. They were treated with the following combination chemotherapy: Cisplatin 30 mg/body day 1-5; adriamycin 40 mg/body day 1; bleomycin 30 mg/body/day 1: methotrexate 400 mg/body day 1; etoposide 150 mg/body day 1-5 (CABME therapy). This treatment was repeated monthly and in total four courses were given. One complete response and one partial response were obtained. Especially, we achieved 65% and 63% remission of liver metastases and residual tumors could be resected. Myelosuppression was marked, but other toxicity was tolerable. Therefore, we postulated that CABME therapy played an important role for the refractory testicular tumors.

Adult↗

Analyses of p53 gene mutations in primary human bladder cancer.

Mutations in the tumor suppressor gene p53 have been detected in many tumors. p53 gene mutations are also known to be involved in the progression of human bladder cancers. We investigated structural alterations in the entire coding region of the p53 gene in primary human bladder cancers, using polymerase chain reaction and single-strand conformational polymorphism analysis of RNA. Of 25 samples obtained from patients, 6 (24%) were found to have p53 alterations. DNA sequencing of the PCR products revealed 6 point mutations resulting in single amino-acid substitutions in the regions of exons 5, 6, 7, 8, and 10 of this gene, respectively. Five of 6 cases with p53 mutations were invasive, with metastasis or high-grade tumors. Interestingly, the one remaining case was a recurrent, low-grade, and superficial (pTa) tumor. In this early stage tumor, allelic loss of the p53 gene was also found, using a polymerase chain reaction-based restriction fragment length polymorphism assay. Our findings are in agreement with previous observations that p53 mutations occurred in a high percentage of high grade or invasive bladder cancers. Since mutation and allelic loss of the p53 gene were also detected in a low-grade and low-stage tumor in the present study, it is suggested that the p53 gene is involved in early stages of some bladder cancers as well as in their late stages.

Aged↗

[Clinical observations on bladder cancer--difference in clinical features with age].

Three hundred and ninety-four patients with transitional cell carcinoma of the bladder who initially visited Yokohama City University Hospital were reviewed according to age group. The patients were divided into four groups, group A (less than 49 years old), group B (from 50 to 64 years old), group C (from 65 to 79 years old) and group D (more than 80 years old). The clinical characteristics as follows were obtained by statistical analysis compared with these four groups. No statistical significance was obtained about frequency of macroscopic hematuria as chief complaint. However, the younger age groups (A and B) tended to visit hospital later after the first symptom of hematuria. The older age groups (C and D) had multiple and large tumor at the first cystoscopic examination. The older age groups (C and D) had high stage and high grade tumor at the first roentgenological examination and transurethral biopsy or resection. The 5-year recurrence free rate after transurethral resection of bladder tumor (TUR-BT) of the older age group (D group) was lower than that of the other groups. The 5-year survival rate of older age group was lower than that of the younger age group. However, no statistical significance between the age groups existed concerning high grade or high stage tumor and survival after total cystectomy. We clarified here that the clinical features of elderly patients who have bladder cancer were significantly different from those of younger patients. Otherwise the prognosis of patients who have high grade and/or high stage bladder cancer were demonstrated to be poor regardless of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗