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Biomedical subjects

Y Komoike

Publications and source records attributed to Y Komoike.

At least 37 records · Page 2Linked to original sources
PubMed1998

Transaxillary endoscopic partial mastectomy for comparatively early-stage breast cancer. An early experience.

For optimal cosmetic results in breast cancer surgery, we developed an alternative operation using endoscopy to remove tumors through a small single incision remote from the breast itself. The tumor is endoscopically resected with electrocautery and low constant suction through a short incision in the axilla, 5 cm long, after which axillary dissection is performed through the same wound in the usual manner, under visualization by the naked eye. Primary reconstruction of the breast is performed with the remaining mammary gland and a subcutaneous fat flap on the serratus muscle. Seven patients underwent this surgery. The postoperative shape of the breasts was judged to be cosmetically satisfactory, and the surgical wounds were not visible from the front in all cases. This operation has the same therapeutic oncological effect as a standard lumpectomy and, in addition, offers a greater cosmetic advantage in cases of early breast cancer.

Adult↗
PubMed1997

Prognostic factors in patients with recurrent differentiated thyroid carcinoma.

BACKGROUND: Approximately 20% of patients with thyroid carcinoma have relapse. To evaluate the factors affecting their disease-free survival and prognosis, we studied 68 patients with recurrent differentiated thyroid carcinoma, ranging in age from 5 to 73 years (mean: 47.6 years). Three-fourths of patients were followed for >10 years. Thirty-nine patients were treated with total or subtotal thyroidectomy at first operation; the remainder underwent lesser operations. Fifty-six patients had local recurrence, mostly lymph node infiltration. Twenty-six patients died. METHODS: Survival curves were constructed using the Kaplan-Meier method. Factors affecting relapse and survival were tested by univariate or multivariate analysis. RESULTS: Univariate analysis identified age at diagnosis, local tumor extension, and surgical method as significant factors for disease-free survival. These three factors and histology were significant prognostic factors. Multivariate analysis showed age, histology, and disease-free interval as significant and independent variables. CONCLUSIONS: In high-risk patients, complete resection of thyroid tissue and cervical lymph nodes is critical.

Adolescent↗
PubMed1997

A patient with Graves' disease, myasthenia gravis, and polymyositis.

Graves' disease (GD), myasthenia gravis (MG), and polymyositis (PM) are organ-specific autoimmune diseases. The association between GD and MG is well known, and an association between MG and PM has been reported. However, only one patient with all three diseases has been reported. We describe a patient with GD and PM developing 6 and 29 years, respectively after the onset of MG. This case suggests that the expression of autoimmunity occurred over a prolonged period of time and these organ-specific autoimmune diseases may be induced by a similar mechanism.

Adolescent↗
PubMed1997

p21(Waf1/Cip1) and p53 protein expression in breast cancer.

p21/Cip1/Waf1 (wild-type p53 activated fragment 1/cyclin-dependent kinase [Cdk]-interacting protein 1) is a prominent Cdk inhibitor and has been shown to be a downstream mediator of p53. In this study, we sought to clarify the clinical significance of Waf1 and the relationship between Waf1 and p53 in breast cancer. For this purpose, the expressions of Waf1 and p53 were evaluated immunohistochemically in a series of 104 patients. Waf1 was expressed in 51 (49%) of 104 tumors tested, and p53 in 33 tumors (32%). Inverse expression of these two proteins was seen in 76 cases (73%); 47 were Waf1-positive and p53-negative, and 29 were Waf1-negative and p53-positive. A comparison with clinicopathologic parameters showed that Waf1 expression correlated with negative lymph nodes (P<.01), a low histologic grade (P<.0001), and positive estrogen receptor status (P<.01). Recurrence-free survival was lower for patients with Waf1-negative tumors than for those with Waf1-positive tumors (P<.0001). In multivariate analysis, Waf1 expression and low histologic grade (1 or 2) tumors had an independent prognostic significance for recurrence-free survival. These results suggest that Waf1 is induced mainly by a p53-dependent pathway and could be a reliable indicator of recurrence in breast cancer.

Adult↗
PubMed1997

Analysis of phosphorylation of pRB and its regulatory proteins in breast cancer.

AIM: In order to study the role of retinoblastoma protein (pRB) in breast cancer, the phosphorylation of pRB and the expression of its related proteins-such as cyclin E, cyclin dependent kinase 2 (Cdk2), and p21/Cdk interacting protein 1 (Cip1)-were examined in 30 breast cancers in which pRB overexpression was confirmed immunohistochemically. METHODS: The phosphorylation of pRB for 30 tumours was investigated with western blotting. The expression of pRB, Cdk2/Cdc2, cyclin E, and p21/Cip1 was identified by immunohistochemistry and western blotting. RESULTS: The expression of pRB was confirmed in 52 of 70 tumours (74%) by immunostaining. Western blotting for pRB showed that 25 of 30 representative cancers (83%) were underphosphorylated, while only five tumours showed the hyperphosphorylated form of pRB. However, cyclin E and Cdk2-which promote phosphorylation of pRB-were expressed in all tumours. On the other hand p21/Cip1, a Cdk2 inhibitor, was expressed in 18 of 25 tumours with underphosphorylated pRB, while four of the five tumours with hyperphosphorylated pRB showed no expression of p21/Cip1. Examination of the relation between pRB phosphorylation and clinicopathological variables showed that the underphosphorylated group was characterised by low risk of lymph node metastasis (p < 0.01). CONCLUSIONS: The phosphorylation of pRB appears to be regulated mainly by p21/Cip1 through the suppression of cyclin E and Cdk2 in breast cancer. The underphosphorylated form of pRB may be useful as a prognostic factor.

Adult↗
PubMed1997

Clinical and genetic analysis of an inherited case of thyroid adenoma/cancer.

We studied a family in which thyroid neoplasms appeared to occur through genetic inheritance. Six blood relations, including the two probands, had thyroid carcinoma, and six others had benign thyroid tumors. When both parents had a thyroid neoplasm, their children frequently had thyroid neoplasms; this was confirmed through two generations of this family. To clarify the mechanism of inheritance, we performed chromosomal analysis, Southern blot analysis of three variable number of tandem repeats markers and HLA typing on two probands, and examined their RET proto-oncogenes, and p53 and RB tumor suppressor genes. We could not find any positive data on genetic analysis, although our data were limited. In conclusion, we studied a family in which thyroid neoplasms have occurred partly through genetic inheritance, although environmental factors may have influenced the occurrence of thyroid diseases. A search for a predisposing gene, using the microsatellite technique, is required to clarify the gentic factors involved.

Adenoma↗
PubMed1996

Immunohistochemical study of Cell Cycle Modulators in G(1)-S Transition in Clinical Breast Cancer Tissue.

In the present study, we investigated immunolocalization of the modulators of G(1)-S transition by using monoclonal or polyclonal antibodies for each of the modulators in 65 cases of clinical breast cancer. Two prominent cyclin dependent kinase(cdk)-cyclin complexes, cdk4-cyclin D and cdk2-cyclin E, were proved to have different modes of mutual expression. cdk4-positive lesions were found to equal cyclin D-expressing lesions in 55 cases, while the former were more extensive than the latter in 9 cases. On the other hand, cyclin E expression was detected in all the cases examined and was more dominant than that of cdk2/cdc2 in as many as 40 cases whereas the reverse was seen in only 1 case. Interestingly, cdk4(P<0.01)and cyclin E(P<0.05)expressions showed an inverse relationship with the tumor size and the cancer stage. A similar tendency was also detected for two other positive modulators of G(1)-S transition, indicating that cell cycle progression must be regulated by the cancer itself once it has grown to a certain extent. p21, which has been regarded as a universal inhibitor of the cell cycle, was expressed in 43.1% of the cases examined and its immunoreactivity showed an inverse relationship with lymph node metastasis(P<0.05). It also tended to be absent more frequently in T3 or larger cancers and stage III cases. Moreover, two patients who died as a result of cancer and three patients with recurrence were all p21 negative, suggesting that p21 is prognosticably the most significant of all these modulators.

Journal Article↗
PubMed1996

Expression of p21 (WAF1/CIP1) protein in clinical thyroid tissues.

p21 (WAF1/CIP1) protein expression in various thyroid tissues, including thyroid carcinoma, was studied by means of immunohistochemistry using anti-p21 monoclonal antibody. Normal follicles and hyperplasias rarely expressed p21, whereas immunohistochemically positive cells were also too rarely found in follicular adenomas to justify these cases being classified as positive. Twenty eight of the 93 carcinomas examined (30.1%), however, were positive for p21. Of the p21-positive cases, 80% of the undifferentiated and 28.6% of the poorly differentiated carcinomas showed lesions co-expressing p21 and p53. If diffuse immunoreactivity of p53 reflects the p53 mutation, our results indicate that p21 in these carcinomas can be induced by p53-independent as well as by p53-dependent pathways. On the other hand, well-differentiated carcinomas did not co-express these two proteins and it therefore remains unclear whether p53-independent or p53-dependent pathways are predominant in this type of carcinoma. The incidence of expression of p21 was very similar in undifferentiated (26.3%), poorly (28.0%) and well-differentiated carcinomas (32.7%), even though they are characterised by different degree of malignancy. Furthermore, no correlation between p21 expression and either clinical parameters or patient's prognosis could be established. These results suggest that p21 is only marginally related to the characteristics of thyroid carcinoma and can play only an adjuvant role in regulating the progression of this carcinoma.

Antibodies, Monoclonal↗
PubMed1996

Establishment of anaplastic thyroid carcinoma cell lines useful for analysis of chemosensitivity and carcinogenesis.

Anaplastic thyroid carcinoma (ATC) is usually associated with a poor prognosis, with most patients dying within a few months. The mechanism of its carcinogenesis is unclear, and its rapid growth and spread often prevent effective surgical therapy. Thus, chemotherapy is necessary. However, ATC is often resistant to anticancer drugs. Therefore, prediction of chemosensitivity is important in selecting appropriate treatment. In this study, after the establishment of three cell lines (K119, KOA2, and IAA) from patients with ATC, we analyzed them for abnormalities in certain oncogenes (myc, ras, ret, and c-erbB2) and the p53 tumor suppressor gene. Only one of three cell lines (KOA2) had a N-ras mutation [codon 61 CAA(Gln)-->CGA(Arg)] and a p53 gene mutation [exon 6 codon 192 Caa(Gln)-->TAG(stop)]. We also investigated their in vitro drug sensitivity and compared it with clinical chemosensitivity, retrospectively. In vitro drug sensitivity was determined using an adhesive tumor cell culture system. Only the K119 cells were sensitive to adriamycin and cisplatin in vitro. The other two were resistant to them in vitro. These results paralleled the clinical responses. We also evaluated the in vitro drug sensitivity of a poorly differentiated thyroid carcinoma cell line (SMP) and papillary thyroid carcinoma cell lines (NPA). None of the five cell lines expressed the multidrug resistance gene (mdr-1). In conclusion, we established ATC cell lines that are suitable models for characterizing the nature of multidrug resistance and carcinogenesis.

Aged↗
PubMedDate not supplied

Inhibition of both COX-1 and COX-2 is required for development of gastric damage in response to nonsteroidal antiinflammatory drugs.

We examined the gastric ulcerogenic property of selective COX-1 and/or COX-2 inhibitors in rats, and investigated whether COX-1 inhibition is by itself sufficient for induction of gastric damage. Animals fasted for 18 h were given various COX inhibitors p.o., either alone or in combination, and they were killed 8 h later. The nonselective COX inhibitors such as indomethacin, naproxen and dicrofenac inhibited PG production, increased gastric motility, and provoked severe gastric lesions. In contrast, the selective COX-2 inhibitor rofecoxib did not induce any damage in the stomach, with no effect on the mucosal PGE(2) contents and gastric motility. Likewise, the selective COX-1 inhibitor SC-560 also did not cause gastric damage, despite causing a significant decrease in PGE(2) contents. The combined administration of SC-560 and rofecoxib, however, provoked gross damage in the gastric mucosa, in a dose-dependent manner. SC-560 also caused a marked gastric hypermotility, whereas rofecoxib had no effect on basal gastric motor activity. On the other hand, the COX-2 mRNA was expressed in the stomach after administration of SC-560, while the normal gastric mucosa expressed only COX-1 mRNA but not COX-2 mRNA. These results suggest that the gastric ulcerogenic property of conventional NSAIDs is not accounted for solely by COX-1 inhibition and requires the inhibition of both COX-1 and COX-2. The inhibition of COX-1 up-regulates the COX-2 expression, and this may counteract the deleterious influences, such as gastric hypermotility and the subsequent events, due to a PG deficiency caused by COX-1 inhibition.

Animals↗
PubMedDate not supplied

Protection by aspirin of indomethacin-induced small intestinal damage in rats: mediation by salicylic acid.

Most of non-steroidal anti-inflammatory drugs (NSAIDs) except aspirin (ASA) produce intestinal damage in rats. In the present study, we re-examined the intestinal toxic effect of ASA in rats, in comparison with various NSAIDs, and investigated why ASA does not cause damage in the small intestine, in relation to its metabolite salicylic acid (SA). Various NSAIDs (indomethacin; 10 mg/kg; flurbiprofen; 20 mg/kg; naproxen; 40 mg/kg; dicrofenac; 40 mg/kg; ASA; 20-200 mg/kg) were administered s.c., and the small intestinal mucosa was examined macroscopically 24 h later. All NSAIDs tested, except ASA, caused hemorrhagic lesions in the small intestine, with a decrease of mucosal PGE(2) contents. ASA did not provoke any damage, despite inhibiting (prostaglandin) PG production, and prevented the occurrence of intestinal lesions induced by indomethacin, in a dose-related manner. This protective action of ASA was mimicked by the equimolar doses of SA (17.8-178 mg/kg). Indomethacin caused intestinal hypermotility, in preceding to the occurrence of lesion, and this event was followed by increases of enterobacterial translocation in the mucosa. Both ASA and SA prevented both the intestinal hypermotility and the bacterial translocation seen after indomethacin treatment. In addition, the protective effect of SA was not significantly influenced by either the adenosine deaminase or the adenosine receptor antagonists. Following administration of ASA, the blood SA levels reached a peak within 30 min and remained elevated for more than 7 h. These results suggest that SA has a cytoprotective action against indomethacin-induced small intestinal lesions, and this action may be associated with inhibition of the intestinal hypermotility and the bacterial translocation, but not mediated by endogenous adenosine. Failure of ASA to induce intestinal damage may be explained, at least partly, by a protective action of SA, the metabolite of ASA.

Adenosine Deaminase↗
PubMedDate not supplied

Expression of p16 and cyclin-dependent kinase 4 proteins in primary breast carcinomas.

The immunolocalization of the p16 and cdk4 proteins was investigated in 65 retinoblastoma gene product (pRB)-positive and 20 pRB-negative breast carcinomas. These proteins were expressed in similar lesions in 84.6% of the pRB-positive and 100% of the pRB-negative carcinomas. Diffuse expression of p16 was observed in 73.8 and 70.0% of the pRB-positive and -negative cases, respectively. cdk4 and p16 expression was significantly more heterogeneous in tumors of larger sizes and/or at higher stages. These findings suggest that p16 can be induced regardless of pRB status and Rb gene function in primary breast carcinoma and that it modulates the cell cycle progression in association with cdk4.

Blotting, Western↗
PubMedDate not supplied

Identification of a 7-cM region of frequent allelic loss on chromosome band 16p13.3 that is specifically associated with anaplastic thyroid carcinoma.

A total of 17 primary thyroid cancer specimens including seven anaplastic cancers, two papillary cancers adjacent to the anaplastic cancers, and eight papillary cancers were analyzed for loss of heterozygosity (LOH) on chromosome arm 16p. All tumors of anaplastic cancer showed LOHs at one or more loci, and a 7-cM region of the smallest deleted region was found on 16p13.3 between D16S423 and D16S406. This LOH was specifically found in the anaplastic cancer and not in the papillary thyroid cancer. Our present results suggest localization of the putative tumor suppressor gene on 16p13.3, which is likely to play an important role in the anaplastic transformation of thyroid cancer.

Adult↗
PubMedDate not supplied

Permissive role of neutrophils in pathogenesis of indomethacin-induced gastric lesions in rats.

INTRODUCTION: We examined the possible role of neutrophils in the pathogenesis of indomethacin-induced gastric lesions, in comparison with prostaglandin (PG) deficiency. MATERIAL AND METHODS: Rats were given indomethacin (35 mg/kg, s.c.) and killed 4 hr later. Gastric motility, mucosal PGE2 levels, and myeloperoxidase (MPO) activity were measured following indomethacin. Atropine was given s.c. 30 min before administration of indomethacin, while 16, 16-dimethyl PGE2 (dmPGE2) or anti-rat neutrophil antiserum (ANS) was given i.v. 10 min or 1 hr, respectively, before indomethacin treatment. RESULTS: Indomethacin reduced PGE2 contents in the stomach and produced hemorrhagic lesions in the stomach, with an increase of gastric motility and MPO activity. Indomethacin-induced gastric lesions were significantly prevented by dmPGE2 as well as atropine, at any time points during a 4 hr-test period. By contrast, the pretreatment of ANS did not prevent the development of gastric lesions when examined at either 1, 2 or 3 hr following indomethacin, but significantly reduced the severity of these lesions at 4 hr after indomethacin treatment. Both dmPGE2 and atropine inhibited the increase of gastric motility and MPO activity in response to indomethacin, whereas ANS prevented the increase of MPO activity, without any effect on the gastric hypermotility. CONCLUSION: These results confirmed that indomethacin-induced gastric lesions occurred in association with gastric hypermotility, in both atropine and PG-sensitive manners, and further suggest that the neutrophil activation/migration is not sufficient by itself to induce damage in the stomach and may be implicated in the process of later extension of damage.

16,16-Dimethylprostaglandin E2↗
PubMedDate not supplied

Nonpalpable breast cancer with nipple discharge: how should it be treated?

In this study, 26 cases of nonpalpable breast cancer with nipple discharge treated at our department were reviewed. Their discharge was either bloody or serous with a positive hematest, but all except for one were negative for cytology, while CEA value of the discharge was high in 72.7%. Mammograms were found to be unreliable for diagnosis, while abnormal findings were observed in 84.6% by ductography. However, final diagnosis was determined histopathologically from surgical specimens, showing 14 intraductal and 12 invasive ductal cancers, none with components of comedo carcinomas. Seventeen patients underwent mastectomy following duct-lobular segmentectomy and a small remnant of intraductal carcinoma was found microscopically in only one patient. All patients except for one have survived for 98 months on average with no symptoms of metastasis. These findings suggest that duct-lobular segmentectomy with an adequate surgical margin should be adopted as the final operation for selected patients with nonpalpable breast cancer involving nipple discharge.

Adult↗