Biomedical subjects

Y Moriya

Publications and source records attributed to Y Moriya.

At least 55 records · Page 3Linked to original sources

PubMed1999

A case of metastatic extramammary Paget's disease that responded to combination chemotherapy.

Extramammary Paget's disease is considered to be a malignant tumor originating from the sweat glands. Some cases of extramammary Paget's disease infiltrate the dermis and metastasize to the regional lymph nodes. No standard treatment has been established for advanced cases. Few previous studies of the treatment for metastatic Paget's disease have revealed an effective regimen. The prognosis of metastasized cases is very poor. We encountered a patient in whom extramammary Paget's disease had metastasized to the lymph nodes beyond the regional lymph nodes and systemic chemotherapy was partially effective. Combination chemotherapy consisted of mitomycin C 3.5 mg/m2 and epirubicin 50 mg/m2 on day 1, vincristine 0.6 mg/m2 on days 1 and 7, cisplatin 30 mg/m2 from days 1 to 3, and 5-fluorouracil 350 mg/m2 from days 3 to 7. After two courses of chemotherapy, the metastatic lymph nodes decreased in size by more than 90% compared to that before chemotherapy. We defined the treatment effect of this regimen as a partial response (PR). Microscopic examination of the resected lymph nodes revealed replacement of metastatic lesions by fibrous tissue, suggesting a therapeutic effect. Anorexia, alopecia, and leukopenia (neutropenia) have been reported as toxicities, but all were tolerated. Our results may provide useful indications for the management of this tumor. This particular combination chemotherapy is recommended for extramammary Paget's disease patients with systemic nodal metastases.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1999

Clinical implications of lymph node micrometastases in patients with colorectal cancers. A case control study.

There is no unanimity about the prognostic significance of lymph node micrometastases from colorectal cancer. A case-control study of patients with recurrent and nonrecurrent colorectal cancer who were closely matched for the Dukes stage, extent of lymph node dissection, tumor size, tumor location, number of resected lymph nodes, age and gender was performed. The presence of micrometastases in a total of 1,633 lymph nodes from 44 patients (22 with and 22 without recurrence) were examined by immunohistochemistry using antibodies for cytokeratin (KL-1) and p53 (RSP53). Immunostaining with KL-1 revealed micrometastases in 15/22 patients [68%; 82/820 lymph nodes (10%)] and 15/22 patients [68%; 45/813 lymph nodes (6%)] in the recurrent and nonrecurrent groups, respectively. Immunohistochemical analysis, using RSP53, of 18 paired patients with p53-positive primary tumor revealed micrometastases in 4/9 patients [44%; (7/265 lymph nodes (2.6%)] and 4/9 patients [44%; 6/257 lymph nodes (2.3%)] with and without recurrence, respectively. Neither the micrometastatic frequencies of the patients nor the resected lymph nodes of the recurrent and nonrecurrent groups differed significantly. Micrometastases in regional lymph nodes are an interesting phenomenon, but do not influence patients' prognoses if the involved lymph nodes are removed.

Adult↗

PubMed1999

The influence of craniofacial form on bite force and EMG activity of masticatory muscles. VIII-1. Bite force of complete denture wearers.

Today, Japan as a society is aging. The average life expectancy of Japanese people is approximately 80 years. One result of this is that preservation of masticatory functions in elderly people has become increasingly important from the viewpoint of quality of life. In the future, the use of dentures in facilitating masticatory functions as a substitute for teeth that are lost during the aging process will assume greater significance. Accordingly, appropriate evaluation and judgment of complete dentures for edentate jaws is crucial. This study was designed to elucidate the effects of the craniofacial form in complete denture wearers on the mode of activity of gnathic functions. First, subjects wearing complete dentures in both the upper and lower jaws were instructed to carry out vertical clenching, and bite force direction was determined. These data were then related to the subject's craniofacial morphology. These results suggest that the bite force direction in complete denture wearers is not affected by gender differences, but is closely associated with lateral craniofacial morphology, and that appropriate setting of occlusal plane and the occluded vertical dimension is extremely important in the preparation of complete dentures.

Aged↗

PubMed1999

Macroscopic intrabiliary growth of liver metastases from colorectal cancer.

BACKGROUND: The clinicopathologic features of colorectal liver metastases that invade the bile duct were evaluated. METHODS: From 1992 to 1996, 149 patients who underwent a first hepatic resection were studied for a total of 377 colorectal liver metastases. Twenty-one second hepatic resections in these patients were also analyzed. RESULTS: Bile duct invasion was histologically observed in 62 (42%) of 149 patients with first colorectal liver metastasis. Eighteen patients (12%) had gross extension of the tumor in the bile duct ranging from 4 mm to 42 mm (median 17.0 mm). Histologically, two thirds (12 of 18) of the tumors with macroscopic bile duct invasion were well-differentiated adenocarcinomas with a tendency for less vascular involvement. The actuarial 3- and 5-year survivals were 62% and 57% for patients with no bile duct invasion, 56% and 48% for patients with microscopic bile duct invasion, and 94% and 80% for patients with macroscopic bile duct invasion. The 5-year survival rate was better for patients with macroscopic bile duct invasion than for those with only microscopic (P = .02) or no bile duct invasion (P = .03). In a multivariate analysis, macroscopic bile duct invasion was an independent prognostic variable for favorable outcome after hepatic resection. CONCLUSIONS: Macroscopic bile duct invasion of colorectal liver metastases may reflect an indolent biologic behavior, warrants an aggressive surgical approach, and confers a better prognosis.

Adenocarcinoma↗

PubMed1998

Resection of both hepatic and pulmonary metastases in patients with colorectal carcinoma.

BACKGROUND: More than 40% of patients who undergo curative resection of advanced colorectal carcinoma can be expected to have recurrence of the disease. The most frequent sites of recurrence are the liver (33% of patients) and lung (22%). Interest has therefore focused on treating hepatic or pulmonary metastases, or both, to improve the outcomes of these patients. Although surgical resection has become an increasingly accepted treatment for resectable localized hepatic or localized pulmonary metastases from colorectal carcinoma, the value of aggressive surgery for the removal of both hepatic and pulmonary metastases from patients with primary colorectal carcinoma remains to be clarified. METHODS: Data on 30 patients who had undergone resection of both hepatic and pulmonary metastases from colorectal carcinoma were included in the study. RESULTS: Independent, significant prognostic features were found to be the time that hepatic or pulmonary metastases occurred and the distribution of pulmonary metastases. Median survival times were 30 months (range, 7-108 months) after resection of both hepatic and pulmonary metastases and 48.5 months (range, 11-149 months) after excision of the primary colorectal tumor. Actuarial 1-, 3-, and 5-year survival after resection of both hepatic and pulmonary metastases was 86.7%, 49.3%, and 43.8%, respectively. No perioperative mortality occurred. There were three cases of minor morbidity, which the authors considered acceptable. CONCLUSIONS: Resection of both hepatic and pulmonary metastases from colorectal carcinoma may help to prolong the survival of a small group of patients with these metastases.

Adult↗

PubMed1998

Blockage of interleukin-6 receptor ameliorates joint disease in murine collagen-induced arthritis.

OBJECTIVE: To clarify the role of interleukin-6 (IL-6) in the pathogenesis of collagen-induced arthritis (CIA). METHODS: CIA was induced by immunizing twice at a 3-week interval with bovine type II collagen (CII) emulsified with complete adjuvant. Rat anti-mouse IL-6 receptor (anti-IL-6R) monoclonal antibody MR16-1 or isotype-matched control antibody KH-5 was then injected once intraperitoneally. Symptoms of arthritis were evaluated with a visual scoring system, and serum anti-CII antibody and IL-6 levels were measured by enzyme-linked immunosorbent assay. In addition, the CII responsiveness of splenic lymphocytes from mice with CIA was examined. RESULTS: In mice with CIA, excess production of IL-6 in sera was observed within 24 hours after the first CII immunization, and then rapidly decreased. Serum IL-6 increased again beginning 14 days after immunization, in conjunction with the onset of arthritis. When MR16-1 was injected immediately after immunization with CII, it inhibited the development of arthritis in a dose-dependent manner. Furthermore, MR16-1-treated mice exhibited lower serum levels of IgG anti-CII antibody and reduced responsiveness of lymphocytes to CII. This suppressive effect was observed when MR16-1 was injected on day 0 or 3, but not when injected on day 7 or 14. CONCLUSION: IL-6 produced after CII immunization appears to play an essential role in the immunity to CII, and anti-IL-6R antibody reduces the development of CIA by suppressing IL-6 signal transduction.

Animals↗

PubMed1998

Propionic acid stimulates superoxide generation in human neutrophils.

Short-chain carboxylic acids are the metabolic by-products of pathogenic anaerobic bacteria and are found at sites of infection in millimolar quantities. We previously reported that propionic acid, one of the short-chain carboxylic acids, induces an increase in intracellular Ca2+ ([Ca2+]i) in human neutrophils. Here we investigate the effect of propionic acid on superoxide generation in human neutrophils. Propionic acid (10 mm) induced inositol 1,4, 5-trisphosphate (IP3) formation and a rapidly transient increase in [Ca2+]i, but not superoxide generation, whereas 1 microm formylmethionyl-leucyl-phenylalanine (fMLP), a widely used neutrophil-stimulating bacterial peptide, stimulated not only IP3 formation and Ca2+ mobilization but also superoxide generation. The IP3 level induced by propionic acid was slightly lower than that induced by fMLP. The transient increase in [Ca2+]i induced by propionic acid immediately returned to the basal level, whereas a sustained increase in [Ca2+]i, which was higher than the basal level, following a transient increase in [Ca2+]i was induced by fMLP. The peak level induced by propionic acid was lower than that with fMLP. In the absence of extracellular Ca2+, thapsigargin, a potent inhibitor of endoplasmic reticulum Ca2+-ATPase, induced an increase in [Ca2+]i even after propionic acid stimulation, but not after fMLP. The Ca2+ ionophore A23187 and thapsigargin induced superoxide generation by themselves. Propionic acid enhanced the superoxide generating effect of A23187 and thapsigargin. These results suggest that Ca2+ mobilization induced by propionic acid is much weaker than that with fMLP, and propionic acid is able to generate superoxide in the presence of a Ca2+ ionophore and a Ca2+ influx activator.

Adult↗

PubMed1998

Abnormal expression of CD44 variants in the exfoliated cells in the feces of patients with colorectal cancer.

BACKGROUND & AIMS: Recent investigations have shown that CD44 variant exons are frequently overexpressed in human colorectal adenocarcinoma. The aim of this study was to investigate abnormal expression of the CD44 gene in exfoliated cells from patients with colorectal cancer. METHODS: Exfoliated cells in feces from 25 patients with colorectal cancer before and after surgery and from 15 healthy volunteers were analyzed. CD44 standard, variant 6, and variant 10 messenger RNA (mRNA) expressions were examined in the exfoliated cells in feces by using reverse-transcription polymerase chain reaction followed by Southern hybridization with exon-specific probes. RESULTS: CD44 standard mRNA was detected in all samples before and after surgery and in all healthy volunteers. CD44 variant 6 and variant 10 mRNA were detected in 17 of 25 patients (68%) and 15 of 25 patients (60%), respectively, in individual feces obtained before surgery. CD44 variant 6 mRNA and variant 10 mRNA were detected in postoperative samples in 3 of 25 patients (12%) and 7 of 25 patients (28%), respectively. Fifteen of 17 patients who were positive for CD44v6 based on preoperative fecal samples became negative after surgery (88.2%). Similarly, 12 of 15 patients who were CD44v10 positive in preoperative fecal samples were negative postoperatively (80%). CONCLUSIONS: These results suggest that analysis of CD44 variant expression in the exfoliated cells in feces can provide a noninvasive diagnostic test for colorectal cancer.

Adult↗

PubMed1998

Radical and nerve-preserving surgery for rectal cancer in The Netherlands: a prospective study on morbidity and functional outcome.

BACKGROUND: Operative procedures for primary rectal cancer from Japan combine pelvic nerve-preserving techniques with radical tumour resection to ensure optimal local tumour control with minimal bladder and sexual dysfunction. A prospective study was undertaken to evaluate morbidity and functional outcome of such a technique in Dutch patients. METHODS: Forty-seven patients were operated on by a Japanese surgeon. Postoperative course was monitored. Voiding and sexual function were analysed using questionnaires completed by patients. RESULTS: After operation, only prolonged paralytic ileus (five of 47 patients) and perineal wound dehiscence (five of 18) occurred more frequently than reported in literature. There were no deaths. No patient developed urinary incontinence. Three of 11 women and 19 of 30 men were sexually active. Two men were impotent after operation. Impotence was related to sacrifice of the inferior hypogastric plexus (P = 0.037). Preservation of the superior hypogastric plexus was crucial for ejaculation (P = 0.003). CONCLUSION: A relationship between sacrifice of specific nerve structures and accompanying dysfunction was established. The nerve-preserving technique yields good results in terms of morbidity and functional outcome, and should be considered for adoption as a standard surgical procedure for primary rectal cancer.

Adenocarcinoma↗

PubMed1998

Dedifferentiated chordoma: a case report.

Dedifferentiated chordoma, i.e. chordoma with a sarcomatous component, is a rare bone tumor. This case report is of a dedifferentiated chordoma in the sacrococcygeal region in a 50-year-old male. The patient was initially diagnosed as having a leiomyosarcoma at the first medical consultation, but after the tumor recurred it was proven to be a dedifferentiated chordoma. The primary tumor, which measured 7 x 5 cm, was located in front of the sacrum so as to compress the rectum forward. The resected specimen showed histological features of chordoma, but the presence in some parts of the tumor of spindle-shaped epithelial cells led to a misdiagnosis of leiomyosarcoma. Thirty-six months later, a local recurrent tumor measuring 24 x 17 cm was identified and promptly resected. The recurrent tumor showed features of pleomorphic cell sarcoma mimicking malignant fibrous histiocytoma. In the pleomorphic sarcomatous area, many mitotic figures were seen, and the MIB-1 labeling index was greater than 40%, which was higher than that of the conventional chordoma area. From histological and immunohistochemical examination, the resected tumor was proven to be a dedifferentiated chordoma. This case highlights the importance of careful study of suspected chordoma to allow early identification of sarcomatous components. When we encounter a chordoma with a spindled epithelial component, we need to distinguish this tumor from a dedifferentiated chordoma and other spindle cell sarcomas such as leiomyosarcoma.

Bone Neoplasms↗

PubMed1998

Macroscopic features at the deepest site of tumor penetration predicting liver metastases of colorectal cancer.

Liver metastasis is the gravest prognostic factor in colorectal cancer. To identify a reliable indicator for liver metastasis, we evaluated macroscopic features and seven established histopathological findings at the cut section containing the deepest penetration using univariate and multivariate analyses in 417 colorectal cancers. Macroscopic features were divided into two types, streak type and non-streak type, according to the presence or absence of white streak(s) at the advancing margin of tumor invasion. Streak type was observed in 109 patients (26%). The frequency of liver metastasis in streak type tumors (56%) was significantly higher than that in non-streak type tumors (13%) (p < 0.001). The white streak corresponded histologically with cancer cells showing focal dedifferentiation with marked stromal and perivascular fibrosis extending towards the serosa or adventitia. In 343 curatively treated patients, univariate analysis showed that recurrent liver metastasis was significantly associated with macroscopic features, venous invasion, focal dedifferentiation and lymph node metastasis. Multivariate analysis disclosed that macroscopic features and lymph node metastasis were independent indicators of liver metastasis. These macroscopic features, corresponding histologically to stromal behavior against invading cancer cells, are a simple and useful indicator of liver metastasis of colorectal cancer.

Colonic Neoplasms↗

PubMed1998

Anastomotic recurrence after curative resection of a transverse colon carcinoma: a case report.

We report a case of anastomotic recurrence after curative surgery for transverse colon cancer in a 53-year-old man. The recurrence was first detected as a submucosal tumor 1.3 cm in diameter, located on the suture line, during an annual follow-up barium enema and colonoscopy. A repeat examination 3 months later showed the lesion to be a typical colon cancer, 2.5 cm in size, with a large ulcerated area. Right hemicolectomy was performed with curative intent. Anastomotic recurrence is much rarer after colonic resection than after anterior resection. This was the first time that we had detected a recurrent lesion as a submucosal tumor during annual follow-up examination.

Adenocarcinoma↗

PubMed1998

Perianal Paget's disease associated with rectal carcinoma: a case report.

A 58-year-old man was referred to us because of anal bleeding. Digital rectal examination revealed a 1.2 x 0.8 cm-sessile villous tumor located in the anal canal and lower rectum. Pruritus was lacking and there were no erythematous lesions or any skin lesion in the perianal region. Histologic examination of the excised lesion revealed the presence of an adenocarcinoma within a villous adenoma. The malignancy exhibited well, moderately and poorly differentiated areas with signet-ring cell elements. Because the carcinoma had massively invaded into the submucosa, additional abdominoperineal resection was performed. Microscopic examination of the obtained specimens showed incidental Paget's disease of the anal skin. Although perianal Paget's disease associated with rectal cancer is rare, cautious pathologic examination of the anal and perianal skin in cases with anorectal carcinoma is necessary, even if there are no suggestive clinical findings. If there is perianal Paget's disease, surgical resection with sufficient apparently normal skin and close follow-up are necessary.

Adenocarcinoma↗

PubMed1998

A case of giant peritoneal loose bodies mimicking calcified leiomyoma originating from the rectum.

Two giant peritoneal loose bodies were found in the pelvis in a 79-year-old man. These bodies were demonstrated by computed tomography and magnetic resonance imaging to be well circumscribed masses and to have marked calcification in their central portion. Preoperatively, these bodies had been diagnosed as a calcified leiomyoma originating from the rectum; however, surgery revealed these lesions to be detached appendices epiploica. Histological examination showed that these peritoneal loose bodies consisted of thin layers of eosinophilic substance and had no cellular component. Small peritoneal loose bodies are occasionally found during laparotomy, but such large ones measuring 6 cm are very rare. In our case, accurate diagnosis could not be obtained preoperatively, because these loose bodies mimicked calcified leiomyoma of the rectum.

Aged↗

PubMed1998

Effects of experimental osteoporosis on alveolar bone loss in rats.

A study was conducted to investigate the relationship between osteoporosis and alveolar bone loss. Alveolar bone loss was evaluated by radiographic and visual inspection of rats with experimental osteoporosis. Twenty 4-week-old female Sprague-Dawley rats were divided into the following groups: Group A-ovariectomized and given a standard solid diet; Group B-ovariectomized and given a calcium-deficient diet; Group C-sham-ovariectomized and given a standard solid diet; and Group D-sham-ovariectomized and given a calcium-deficient diet. After 4 weeks, the rat were euthanatized. The maxillae, mandibles, femurs, and tibias were removed carefully and fixed in 10% neutral buffered formalin. The bone mineral density of each bone and the alveolar bone loss were measured. The bone mineral densities of the maxillae, mandibles, femurs and tibias in Group C were significantly higher than those in Groups B and D, but not higher than those in Group A. However, there were no significant differences between any of the groups with regard to alveolar bone loss from the cemento-enamel junction to the molar bone crest. Therefore, it was concluded that osteoporosis itself may not be capable of causing periodontal destruction, and thus may not be a major factor in periodontal disease.

Alveolar Bone Loss↗

PubMed1998

Immunocytochemical localization and biochemical characterization of large proteoglycans in developing rat bone.

This study used biochemical and light and electron microscopic immunohistochemical methods to localize and characterize large hyaluronate-binding proteoglycans in the developing mandible of fetal rats at embryonic day 15 (Day 15) to Day 18 using a monoclonal antibody (MAb) 5D5. This antibody is derived from bovine sclera and specifically recognizes the core protein of large proteoglycan such as versican, neurocan and brevican, but not that of aggrecan. At the light microscopic level, MAb 5D5 moderately stained the extracellular matrices among osteoblasts at the centers of ossification in Day 15 mandible specimens. Weaker staining was observed in osteoblasts, whereas Meckel's cartilage lacked staining. Ultrastructural immunocytochemistry showed the presence of immunogold particles over unmineralized matrices among osteoblasts and their intracellular organelles. In Day 16 to 18 specimens, bone nodules were recognized in LR gold sections before immunostaining, but, after immunostaining, consistently appeared devoid of mineral crystals and were seen as a demineralized structure that had an electron dense periphery within which fine filamentous and granular material were present. The appearance of these structures was created by the demineralization of thin sections on grids during immunostaining. Specific immunogold staining was clearly seen over the demineralized structures corresponding to bone nodules. The majority of immunogold particles tended to localize inside of the structures. Bone proteins were extracted from fresh, Day 18 specimens with a three-step technique: 4 M guanidine HCl (GdnCl,-extract), aqueous EDTA without GdnCl (E-extract), followed by GdnCl. Western blot analysis of SDS-polyacrylamide gel electrophoresis after chondroitinase ABC digestion, showed that G1-extract gave a 5D5 reactive band greater than 400 kDa, whereas E-extract produced two major reactive populations of small molecular size with core proteins approximately 63 and 74 kDa. These results indicate that the large proteoglycan having smaller molecular weight is preferentially localized to bone nodules and may correlate with bone matrix mineralization.

Animals↗

PubMed1997

Characterization of a mutant of Vibrio vulnificus for heme utilization.

Vibrio vulnificus, an opportunistic human pathogen, can obtain iron from a variety of heme proteins. This process involves the digestion of heme proteins by an exoprotease to liberate protoheme (iron-protoporphyrin IX). In the present study, we isolated and characterized a mutant for protoheme utilization. One mutant isolated by treatment with a chemical mutagen was shown to be unable to use either protoheme or heme proteins, but multiplied in a medium supplemented with an iron siderophore, such as iron-vulnibactin. Like a wild-type strain, the mutant sensed iron depletion, so that the 74- and 79-kDa outer membrane proteins were expressed under iron-regulated conditions. Both the parent and mutant strains secreted hemolysin independent of the iron concentration of the medium. Whole cells of either of the strains were equally capable of binding of hematin. Taken together, the data suggest that the mutant may have a mutation in a gene encoding an inner membrane or a periplasmic protein which transports protoheme or iron dissociated from protoporphyrin IX into the cell.

DNA, Bacterial↗

PubMed1997

Triple-stapled low colorectal anastomosis for the narrow pelvis.

Standard linear staplers for transverse occlusion of the rectum is sometimes too large to be applied in a narrow pelvis. A proximate TL 30 (Ethicon, Inc., Somerville, NJ) is easily introduced and applied twice for occlusion of the rectum, followed by anastomosis with a circular stapler. This triple-stapling technique is a safe and easy procedure for low colorectal anastomosis in a narrow pelvis.

Anastomosis, Surgical↗