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Biomedical subjects

Y Kitagawa

Publications and source records attributed to Y Kitagawa.

At least 55 records · Page 3Linked to original sources

Primary angioplasty for isolated right ventricular infarction.

We describe a case of isolated right ventricular infarction that has rarely been diagnosed antemortem. Electrocardiogram showed ST segment elevation in left precordial chest, right precordial chest, and inferior leads, which mimicked those of anterior and inferior left ventricular infarction. Coronary angiography revealed that culprit lesion was totally occluded right coronary artery. Infarcted artery was nondominant right coronary artery with branches supplying only right ventricular wall. Restoration of coronary blood flow was obtained by primary stenting and resulted in prompt ST segment normalization in all leads. Despite extensive right ventricular wall motion abnormality, subsequent right ventricular dysfunction was not observed.

Aged↗

Induction of cytotoxic T lymphocytes specific for paraneoplastic cerebellar degeneration-associated antigen in vivo by DNA immunization.

Paraneoplastic cerebellar degeneration associated with gynecological and breast malignancies (PCD) is known to develop autoantibodies and autoreactive cytotoxic T lymphocytes (CTLs) specific for a cytoplasmic protein of Purkinje cells PCD17/cdr2, in the blood of patients. The functional roles of these antibodies and CTLs in the pathogenesis of PCD are unknown. Induction of immune response to this antigen in experimental animals should be useful to clarify the immune mechanisms in PCD patients. We immunized Balb/c mice with naked DNA, which is encoded human PCD17 neural protein in an eukaryotic expression plasmid under control of CMV promoter, and explored whether or not humoral and cell-mediated immune responses against PCD17 could be induced in vivo. We show that DNA immunization with naked pcd17 cDNA could induce autoantibodies against the cytoplasmic protein of Purkinje cells and CTLs could lyse syngenic myeloma cells pulsed with H-2K-restricted PCD17 peptide. In spite of the generation of anti-Purkinje cell antibodies and PCD17-specific CTLs in vivo, neither clinical nor pathological changes consistent with significant cerebellar degeneration have been detected.

Animals↗

Expression of bone morphogenetic proteins in colon carcinoma with heterotopic ossification.

Here we report the case of a 50-year-old woman with adenocarcinoma of the colon, showing heterotopic ossification. The patient was referred to our hospital for investigation of anemia secondary to occult gastrointestinal blood loss. By colonoscopy, an irregular polypoid mass was found in the ascending colon. A biopsy of the lesion revealed moderately to poorly differentiated adenocarcinoma with heterotopic ossification. A right hemicolectomy was done and revealed areas of heterotopic bone within the tumor, but no ossification was evident in the metastatic lesions within the mesenteric lymph nodes. The formation of heterotopic bone in gastrointestinal tumors is rare and its exact mechanism is unknown. Immunohistochemical localization of bone morphogenetic proteins (BMP), known to be primary inducers of new bone formation, was determined. BMP-5 and -6 were prominent in the cytoplasm of tumor cells, and they stained weakly in osteoblast-like cells adjacent to newly formed bone. Cytoplasmic staining for BMP-2 and -4 was weak in tumor cells, osteoblast-like cells, and stromal fibroblast cells. BMP may play an important role in heterotopic ossification in colon adenocarcinoma.

Adenocarcinoma↗

A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography.

A rare case of neurinoma in a 72 year-old Japanese woman derived from the hypoglossal nerve is reported. The tumour was composed of three interconnected nodules occurring simultaneously in the left submandibular and sublingual regions. The lesion, which presented as a neck mass, caused a slight left-sided hemiparesis of the tongue with tongue deviation to the affected side not noticed by the patient. An electromyographic (EMG) study revealed decreased muscle activity on the left side of the tongue muscle, indicating dysfunction of the hypoglossal nerve. EMG was useful for diagnosis.

Aged↗

MR imaging and thermography of facial angioedema: a case report.

Magnetic resonance imaging and thermography were performed in a 67-year-old man with idiopathic facial angioedema. Thermography suggested decreased heat emission in the region of the angioedema. Magnetic resonance imaging revealed diffuse high intensity in the subcutaneous interstitial tissue and dilated veins on T2-weighted images. Marked contrast enhancement was noted in the subcutaneous tissue on postcontrast T1-weighted images.

Aged↗

Antitumor effect of reduction of 150-kDa oxygen-regulated protein expression in human prostate cancer cells.

Heat shock proteins (HSPs)/stress proteins are molecular chaperones that are induced by various environmental and physiological stimuli. Evidence of the relations between the expression of HSPs and the regulation of cell growth or transformation has accumulated. The 150-kDa oxygen-regulated protein (ORP150), a new member of HSP family, functions as a molecular chaperone in the endoplasmic reticulum. We have examined whether transduced antisense ORP150 cDNA reduces tumorigenicity and angiogenicity. Relations between these stress proteins and cancer and possibilities for anticancer gene therapy are described.

Endothelial Growth Factors↗

Lymph node metastasis from hilar cholangiocarcinoma: audit of 110 patients who underwent regional and paraaortic node dissection.

OBJECTIVE: To assess the status of the regional and paraaortic lymph nodes in hilar cholangiocarcinoma and to clarify the efficacy of systematic extended lymphadenectomy. SUMMARY BACKGROUND DATA: There have been no studies in which regional and paraaortic lymphadenectomies for hilar cholangiocarcinoma have been routinely performed. Therefore, the metastasis rates to the regional and paraaortic nodes, the mode of lymphatic spread, and the effect of extended lymph node dissection on survival remain unknown. METHODS: This study involved 110 patients who underwent surgical resection for hilar cholangiocarcinoma with lymph node dissection including both the regional and paraaortic nodes. A total of 2,652 nodes retrieved from the surgical specimens were examined microscopically. RESULTS: Of the 110 patients, 52 (47.3%) had no involved nodes, 39 (35.5%) had regional lymph node metastases, and 19 (17.3%) had regional and paraaortic node metastases. The incidence of positive nodes was significantly higher in the patients with pT3 disease than in those with pT2 disease. The pericholedochal nodes were most commonly involved (42.7%), followed by the periportal nodes (30.9%), the common hepatic nodes (27.3%), and the posterior pancreaticoduodenal nodes (14.5%). The celiac and superior mesenteric nodes were rarely involved. The 3-year and 5-year survival rates were 55.4% and 30.5% for the 52 patients without involved nodes, 31.8% and 14.7% for the 39 patients with regional node metastases, and 12.3% and 12.3% for the 19 patients with paraaortic node metastases, respectively. Of the 19 patients with positive paraaortic nodes, 7 had no macroscopic evidence of paraaortic disease on intraoperative inspection. The survival in this group was significantly better than in the remaining 12 patients. CONCLUSION: The paraaortic nodes and the regional nodes are frequently involved in advanced hilar cholangiocarcinoma. Whether extended lymph node dissection provides a survival benefit requires further study. However, the fact that long-term survival is possible despite pN2 or pM1 disease encourages the authors to perform an aggressive surgical procedure with extended lymph node dissection in selected patients with hilar cholangiocarcinoma.

Aorta↗

Angiodysplasia of the appendix.

Angiodysplasia of the gastrointestinal tract is thought to be one of the most common causes of lower gastrointestinal bleeding in the elderly, and, in the majority of cases, lesions are located in the cecum or ascending colon. The authors report an extremely rare case of appendicular angiodysplasia. A 76-yr-old woman was hospitalized with massive recurrent red anal bleeding. Selective superior mesenteric arteriography revealed an extravasation of contrast material from the appendicular artery, and this finding proved to be bleeding from an angiodysplasia of the appendix. An appendectomy was performed, and anal bleeding did not recur postoperatively. A review of the literature revealed this to be an extremely rare case of angiodysplasia.

Aged↗

Surgical results of lumbar disc herniation in the elderly.

We investigated the surgical results of lumbar disc herniation in the elderly. Ten elderly patients underwent surgical treatment between 1990 and 1999. There were 7 males and 3 females with a mean age of 68.2 years (range: 60~85 years). Thirteen patients in their 20s and 30s were used as a control. Preoperatively, severe leg pain and gait disturbance, and higher rates of negative straight leg-raising were shown in the elderly group. Higher levels of herniation and higher graded disc degeneration were shown compared with the young. The mean total of the Japanese Orthopedic Association score in the elderly group improved from 5.1 points to 13.1 points postoperatively, and that in the young group improved from 6.9 points to 14.5 points. The recovery rate was 82.6% in the elderly group and 94.3% in the young group. Postoperatively, the recovery of gait disturbance in the elderly group tended to be poor compared with the young group. The elderly patients would not tolerate bed rest and would often do poorly if kept recumbent and in pain for long periods of time. Satisfactory results are being sought with regard to the operative management of lumbar disc herniation in the elderly.

Aged↗

Interplay of physical activity and vitamin D receptor gene polymorphism on bone mineral density.

The interplay of physical activity and vitamin D receptor (VDR) gene polymorphism in their effects on bone mineral density (BMD) was studied for 120 Japanese girls aged 18-19 years. BMD at distal radius in the group with the VDR genotype at the Apal site of Aa was significantly higher than that in the aa group, but this association disappeared in a group having the habit of physical activity. The Aa genotype gave a higher BMD than the aa genotype only in the group without the habit of physical activity. The habit of physical activity was associated with a higher BMD only in the aa genotype group. The similar interplay was observed in the VDR genotype at the TaqI site. We thus suggest that physical activity and VDR genotypes affect BMD in independent mechanism to give a saturated level of BMD. Higher dietary calcium intake tended to be associated with higher BMD only in the Aa genotype, suggesting that the calcium intake and VDR genotype affect BMD in a synergistic mechanism.

Adolescent↗

Development of endoscopic surgery for the minimally invasive treatment of digestive and other diseases.

Minimally invasive surgery has rapidly changed the performance of surgical practice in a wide range of surgical specialities in the last decade of the 20th century. The marked progress in endoscopic surgery has been conducted especially in general and digestive surgery. The Department of Surgery, School of Medicine, Keio University has contributed to the development and establishment of endoscopic surgery in every subspeciality of general and digestive surgery. Our achievements include the development of original methods for laparoscopic wedge gastrectomy and endoscopic thyroidectomy, establishment of surgical techniques in endoscopic surgery for esophageal, gastric, colorectal and hepatobiliary diseases, and the introduction of robotics and tele-communicative technologies to endoscopic surgery.

Digestive System Surgical Procedures↗

Introduction of DT40 cells into chick embryos.

AIM: To examine the transfection of exogenous genes into chick embryos, applying the characteristics of avian leukosis virus (ALV)-induced chicken B cell line DT40 to the production of chimeric birds. METHODS: The DT40 cells incorporated with exogenous gene ( lacZ constructs encoding Escherichia coli beta-galactosidase: beta-gal) were introduced into chick embryos by the injection of cells into stage X blastoderm. Manipulated eggs were incubated for 3 (trial 1) or 6 (trial 2) days, and the expression of lacZ DNA was detected by a histochemical staining method of beta-galactosidase and polymerase chain reaction (PCR) analysis. RESULTS: The survival rates of the manipulated embryos incubated for 3 days (stage 18-20: trial 1) and 6 days (stage 28, 30: trial 2) were about 42% and 38%, respectively. The expression rates of the lacZ gene in the embryos in the trials 1 and 2 were about 60% and 23%, respectively, for the survived embryos. CONCLUSION: The rate of embryonic viability and expression rate of introduced genes were not so high, but it suggested the possibility of utilizing the DT40 cells as a vector for carrying exogenous genes into chick embryos.

Animals↗

[Appropriate extent of lymphadenectomy in esophageal cancer].

Because of the high frequency and widespread distribution of lymph node metastasis in esophageal cancer, three-field dissection was introduced in the early 1980s. Although improvement in the long-term survival rate of patients who undergo three-field dissection has been reported, the clinical significance of cervical lymphadenectomy is still controversial because the effect of improved upper-mediastinal lymphadenectomy in these patients cannot be excluded. Recently, the sentinel node (SN) concept has been validated in gastrointestinal cancers including esophageal cancer using the radio-guided method. Aberrant drainage routes from the primary lesion have frequently been observed in esophageal cancer and are detectable by radio-guided SN mapping. SN navigation is useful to identify SNs as the functional first basin to evaluate the regional lymph node status and to determine the indications for extensive lymphadenectomy in patients with esophageal cancer. Individualized surgical management of patients with esophageal cancer is essential to improve the quality of life of patients and long-term results.

Esophageal Neoplasms↗

[Contrast enhancement for sentinel lymph node imaging].

The paper proposes a new contrast enhancement method for sentinel lymph node imaging. The sentinel lymph node image acquired by a conventional gamma camera system has a wide dynamic range, so that the contrast of sentinel lymph nodes relatively decreases. The proposed method, which is named an annular background subtraction (ABS) method, first found the center of the distribution of activity. Then we calculated the mean value in each annular area centered at the injection point of radiopharmaceuticals with one pixel width. The original image was subtracted by the mean value at each annular area. The performance of the proposed method was confirmed by clinical data.

Humans↗