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Biomedical subjects

Y Motoo

Publications and source records attributed to Y Motoo.

At least 55 records · Page 3Linked to original sources
PubMed1997

Undifferentiated (anaplastic) carcinoma of the pancreas showing sarcomatous change and neoplastic cyst formation.

CONCLUSION: Pancreatic undifferentiated (anaplastic) carcinoma contained two components: sarcomatous change of spindle-cell type and a neoplastic cyst. Immunohistochemical analysis suggested that both the sarcomatous and the cystic portions were of epithelial origin. This case showed a "dual" differentiation both into the sarcomatous change and into the cystic lesion. BACKGROUND: Pancreatic sarcoma or sarcomatous change is very rare. The origin of sarcomatous change is unknown. On the other hand, pancreatic adenocarcinoma sometimes shows necrosis and forms a cystic lesion during its growth, but a neoplastic cyst formation is very rare except for cystadenomas. METHODS: We report a case of pancreatic undifferentiated (anaplastic) carcinoma associated with sarcomatous change and neoplastic cyst formation. Clinicopathological and immunohistochemical analyses were performed. RESULTS: A 75-yr-old male was admitted because of low back pain and body weight loss. He died 7 d after admission presenting obstructive jaundice. Autopsy disclosed that the large mass was a poorly differentiated ductal adenocarcinoma, which mostly consisted of sarcomatous components of spindle-cell type. The cystic lesion was a neoplastic cysts with the wall composed of epithelial tumor cells. There was no necrosis or hemorrhage in the cystic cavity. Immunohistochemical analyses suggested that both the tumor and the cystic lesion were of epithelial origin. Sarcomatous changes were recognized also in the metastatic lesions in the liver and lymph nodes. The tumor is considered to be labeled undifferentiated (anaplastic) carcinoma of the pancreas.

Aged↗
PubMed1997

Prolonged intrahepatic cholestasis in acute-onset, severe autoimmune hepatitis.

A 72-year-old woman was admitted because of jaundice and hepatocellular dysfunction. She was diagnosed with autoimmune hepatitis from laboratory test results showing high titers of antinuclear antibodies and negativity for hepatitis viral markers. Steroid i.v. pulse therapy and oral administration of prednisolone were effective in improving the liver function test results, except for hyperbilirubinemia. Elevated serum bilirubin levels, of approximately 20 mg/dl persisted for more than 6 months, despite the administration of ursodeoxycholic acid. Insulin-glucagon therapy was given for normalization of transaminases and then withdrawn 3 weeks after admission, but it was resumed at 3 months, resulting in a dramatic decrease in serum bilirubin levels, which then normalized in 2.5 months. Liver biopsy 6 months after onset showed chronic active hepatitis with bile plugs. Insulin-glucagon therapy, because of its choleretic effect, may be worth continuing even after recovery of acute hepatic failure.

Acute Disease↗
PubMed1997

Effect of niuche-shen-qi-wan on painful muscle cramps in patients with liver cirrhosis: a preliminary report.

Twelve patients with liver cirrhosis complaining of painful muscle cramps were treated with Niuche-Shen-Qi-Wan (TJ-107). Three patients were at the decompensated state. Muscle cramps disappeared in 4 weeks on the average after oral administration of TJ-107 in all 12 patients. During the period of TJ-107 administration, there was no significant improvement of hepatic function. One patient complained of mild epigastric discomfort after taking TJ-107, but there were no other adverse effects. Our results indicate that TJ-107 is useful for treatment of painful muscle cramps in cirrhotic patients.

Administration, Oral↗
PubMed1997

Effect of gegen-tang on painful gynecomastia in patients with liver cirrhosis: a brief report.

Four patients with liver cirrhosis and complaining of painful gynecomastia were treated with oral administration of Gegen-Tang (TJ-1). Pain disappeared in 3 patients in one week, and in one patient in 4 weeks. The size of gynecomastia did not change significantly on mammography, but palpable induration diminished or disappeared. The patients had been treated with Chaihu (saiko) group drugs for liver diseases, and TJ-1 was used in combination with these drugs. Serum levels of estrogen, progesterone, testosterone, and other sex hormones did not change significantly after TJ-1 treatment. These results suggest that TJ-1 could be used for the painful gynecomastia that is occasionally seen in cirrhotic patients.

Administration, Oral↗
PubMed1996

Cruveilhier-Baumgarten syndrome in which venous hum disappeared following endoscopic variceal sclerotherapy.

We report a case of Cruveihier-Baumgarten syndrome associated with portal vein thrombosis that developed, slowly during a 2-year period after endoscopic variceal sclerotherapy. The thrombosis led to the disappearance of the venous hum and the dilated abdominal wall veins characteristic of this syndrome. A 73-year-old woman was hospitalized for treatment of esophageal varices in April 1988. Her spleen was markedly enlarged, and the histologic findings of her liver were not consistent with hepatic cirrhosis, but with idiopathic portal hypertension. A venous hum was audible in the upper abdomen. Superior mesenteric angiography revealed a porto-systemic shunt vessel under the abdominal wall, originating from the umbilical vein. She was injected four times with a sclerosant, and this brought about disappearance of the esophageal varices. Two years after the first admission, the venous hum was no longer audible, but there was a recurrence of the esophageal varices. More than 2 years later (4 years after the first admission), ultasonographic study, computed tomography, and angiography showed a large thrombus, which completely obstructed the portal vein at the origin of the umbilical vein, and the development of collateral vessels, seen as a "cavernous transformation."

Aged↗
PubMed1996

Detection of K-ras point mutations at codon 12 in pure pancreatic juice for the diagnosis of pancreatic cancer by PCR-RFLP analysis.

The present study was undertaken to detect K-ras point mutations at codon 12 in pure pancreatic juice (PPJ) for the diagnosis of pancreatic cancer (PC) using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. PPJ was collected through a cannula under a duodenal fiberscope from 26 patients with PC and 32 patients with chronic pancreatitis (CP). DNA was extracted from PPJ and was used as the template for PCR. Analysis of PPJ by PCR-RFLP with BstNI revealed that the incidence of K-ras point mutations at codon 12 was 81% (21/26) in patients with PC and 6% (2/32) in those with CP. With reference to the location of PC, the incidence of K-ras mutations was 79% (11/14) in the head, 86% (6/7) in the body, and 80% (4/5) in the tail of the pancreas. The incidence of K-ras mutants was 50% (1/2) in tumor size 1 (TS1; < or = 2.0 cm in size), 71% (5/7) in TS2 (2.1 to < or = 4.0 cm), 89% (8/9) in TS3 (4.1 to < or = 6.0 cm), and 88% (7/8) in TS4 (> 6.1 cm). These results suggested that analysis of K-ras point mutations at codon 12 in PPJ using the PCR-RFLP method is a promising new genetic test for the diagnosis of PC.

Adult↗
PubMed1996

Detection of K-ras point mutations at codon 12 in pancreatic juice for the diagnosis of pancreatic cancer by hybridization protection assay: a simple method for the determination of the types of point mutation.

The present study was undertaken to detect K-ras oncogene point mutations at codon 12 in pure pancreatic juice (PPJ) by the hybridization protection assay (HPA) method for the diagnosis of pancreatic cancer (PC). This assay can be carried out within 30 min and can determine not only the presence of a mutation, but also the mutational type of K-ras at codon 12. The minimal ratio of mutant DNA detectable by the HPA was 5-10% of the total DNA. PPJ was collected through a cannula under duodenal fiberscope control from 20 patients with PC and 20 patients with chronic pancreatitis (CP). Analysis of PPJ by the HPA revealed that the incidence of K-ras point mutations at codon 12 was 55% (11/20) in patients with PC and 0% (0/20) in those with CP. Mutational types of K-ras at codon 12 in PC were aspartic acid (Asp) in nine cases, both Asp and cysteine in one case, and arginine in one case. Analysis of K-ras point mutations at codon 12 in PPJ using the HPA method seems promising as a new genetic test for the diagnosis of PC, because the HPA method is simple, and can easily determine the mutational type.

Base Sequence↗
PubMed1996

[Sensitivity and specificity of tumor markers in cancer diagnosis].

Each serum tumor marker has its own sensitivity and specificity. The sensitivity is the true positive rate in malignant cases, and the specificity is the true negative rate in benign cases. We should ascertain various benign diseases or triggers which tend to show false-positivity, especially in the measuring of CA19-9, CA125, and acute phase reactants, such as, IAP and TPA. Cancer-specificity is high in sialyl-stage-specific embryonic antigen-I, sialyl-Tn antigen, and NCC-ST-439, etc. Organ-specificity is considerably high in the case of some markers, such as, alpha-fetoprotein, elastase-I, and neuron-specific enolase, etc. On the other hand, the organ-specificity of carcinoembryonic antigen is low. Therefore, the combination of different categories of tumor markers is of great importance. Recently, molecular diagnosis of cancer is being developed. However, even K-ras oncogene mutations at codon 12 are not absolutely specific to pancreatic cancer from genetic analysis of pancreatic juice endoscopically aspirated from patients with pancreatic diseases. Improvement of sensitivity and specificity is still one of the most important issues in the research and development of tumor markers.

Biomarkers, Tumor↗
PubMed1996

Preoperative diagnosis of mucinous gastric adenocarcinoma by endoscopic ultrasonography.

OBJECTIVES: The aims of this study were to investigate the characteristic features of mucinous gastric carcinoma on endoscopic ultrasonography (EUS) and to demonstrate the usefulness of EUS in the preoperative diagnosis of this disease. METHODS: Twelve patients with mucinous gastric carcinoma who underwent EUS examination between April 1984 and April 1995 were enrolled in this study. All patients subsequently underwent surgery. Histopathologically, tumors were classified according to the mucin content (high or moderate) and the glandular formation of the tumor cells (well or poorly differentiated). Finally, the histological and endosonographic features were compared. RESULTS: In all patients, the infiltrated wall appeared echogenic because of diffusely distributed, reticular, highly echoic speckles in the submucosa and muscularis propria. The presence of mucinous lakes surrounded by reactive fibrous tissue correlated well with reticular, highly echoic speckles on EUS. There was an increase in echogenicity and thickness of the muscularis propria, depending on the invasion of the mucin. Although the boundary between submucosa and muscularis propria was distinct and the five-layered gastric wall structure was generally preserved, the mucosal layer was not discriminated in patients with poorly differentiated mucinous carcinoma with high mucin content. CONCLUSIONS: As a preoperative diagnostic procedure, EUS may be useful in recognizing the mucinous component of gastric tumors and may facilitate the differentiation of mucinous carcinoma from other gastric epithelial tumors.

Adenocarcinoma, Mucinous↗
PubMed1995

The human pancreatitis-associated protein (PAP)-encoding gene generates multiple transcripts through alternative use of 5' exons.

The nucleotide (nt) sequence of the human cDNA encoding PAP, a pancreatic secretory protein induced during acute pancreatitis, was found to be identical with that of a gene activated in human primary hepatocellular cancer, designated HIP. To obtain insight into the expression of PAP/HIP, we characterized the gene organization, especially focusing on the 5'-flanking region, and found that it spans about 3 kb and is composed of six exon. Exon 1 encodes the 5'-noncoding sequence and exon 2 consists of three miniexons, 2a, 2b and 2c; the common exon 2c encodes the sequence including the start codon. Analysis by RT-PCR revealed the presence of at least three different types 5'-ends of human PAP/HIP transcripts which were derived from alternative use of 5'-exons. Although all three types of transcripts were expressed in both normal small intestine and pancreas, their gene expression was increased ectopically in gastric cancer, hepatocellular cancer and pancreatic acinar cell carcinoma. Furthermore, significant differences among the transcript types were detected between normal and tumor tissues, and especially between gastric and hepatocellular cancers, suggesting that PAP/HIP expression may vary with differences in 5'-alternative splicing.

Alternative Splicing↗
PubMed1995

Measurement of serum PSP/reg-protein concentration in various diseases with a newly developed enzyme-linked immunosorbent assay.

An enzyme-linked immunosorbent assay, based on two monoclonal antibodies (Hreg1-1 and Hreg101-1) specific for pancreatic stone protein (PSP)/reg-protein, was developed to determine the concentration of this protein in serum from individuals with various diseases. The serum concentration of PSP/reg-protein was significantly higher in patients with various pancreatic diseases than in normal controls, and was also significantly higher in patients with acute pancreatitis or chronic relapsing pancreatitis than in patients with chronic pancreatitis. Furthermore, the serum PSP/reg-protein concentration was also significantly increased in liver cirrhosis, choledocholithiasis, and various cancers of the digestive system, and was extremely high in all patients tested with chronic renal failure. A significant correlation was apparent between the serum concentration of PSP/reg-protein and elastase-I in 68 patients with chronic pancreatitis or pancreatic cancer. Whereas only 7 of these patients showed a normal serum PSP/reg-protein concentration and a significantly increased elastase-I concentration, 15 of these patients showed a significantly increased serum PSP/reg-protein concentration and a normal serum elastase-I concentration. These results indicate that the serum PSP/reg-protein concentration may reflect pancreatic damage, especially in acute pancreatitis, and may be a sensitive a marker for such damage as elastase-1, although false positivity was apparent in renal failure and in some patients with hepatic dysfunction or digestive system malignancies.

Antibodies, Monoclonal↗
PubMed1995

Endosonographic evaluation of giant gastric folds.

Giant gastric folds develop in several benign and malignant diseases. We used endoscopic ultrasonography to evaluate giant gastric folds in 15 patients with Borrmann type IV scirrhous carcinoma, 8 patients with gastric lymphoma, 5 patients with anisakiasis, 1 patient with Menetrier's disease, and 6 normal subjects with simple gastric hyperrugosity. With a 7.5 MHz transducer, a five-layered gastric wall structure was imaged. The thickness of the gastric wall and each layer was measured and compared with the endosonographic findings of 16 healthy subjects. Endoscopic ultrasonography findings revealed that the second layer alone was thickened in Menetrier's disease, and the third layer alone enlarged in anisakiasis. Most of the patients with scirrhous carcinoma showed an abnormally enlarged third and fourth layer. The second layer together with the third layer was thickened in healthy subjects with simple hyperrugosity and also in patients with gastric lymphoma. However, the fourth ultrasound layer corresponding to the muscularis propria was significantly thickened only in malignant conditions. It is concluded that endoscopic ultrasonography can visualize the structure of giant gastric folds and may facilitate the differentiation of benign from malignant etiologies.

Adenocarcinoma, Scirrhous↗
PubMed1995

Endosonography of a submucosal tumor-like gastric lesion caused by fibrotic ulcer healing.

A 61-year-old woman with a gastric antral ulcer scar had a lesion that showed a submucosal tumor-like appearance on endosonography, which proved at resection to represent dense submucosal fibrous tissue. The reason for this marked reaction has not yet been established. Although we felt that the endosonographic pattern most likely showed submucosal fibrosis, in view of her past medical history, malignant lymphoma or aberrant pancreas could not be ruled out with certainty.

Endoscopy, Gastrointestinal↗
PubMed1995

Comparison of lansoprazole and famotidine for gastric ulcer by endoscopic ultrasonography: a preliminary trial.

To compare the efficacy of lansoprazole and famotidine in the treatment of gastric ulcer, 24 patients with gastric ulcer were treated for 8 weeks. They were assessed by endoscopic ultrasonography (EUS), which provides cross-sectional images of the gastric wall as well as endoscopic images. Patients were randomly assigned to receive either lansoprazole 30 mg once daily (n = 12), or famotidine 20 mg twice daily (n = 12). The healing rate after 4 weeks of treatment was 80% in the lansoprazole group and 40% in the famotidine group. After 8 weeks of treatment, the respective healing rates were 100 and 72.7%. Healing to Sakita's S2 stage of scarring occurred significantly more often in the lansoprazole group than in the famotidine group after 4 weeks (50% vs. 0%; p < 0.05). After 4 weeks of treatment, the submucosal fibrous tissues detected by EUS were significantly less extensive in the lansoprazole-treated patients with deep ulcers (reaching the muscle layer or serosa) than in the famotidine-treated patients with deep ulcers (p < 0.01). These results suggest that lansoprazole may be more effective in ulcer healing than famotidine, particularly in patients with deep gastric ulcers.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1995

Effect of liu-junzi-tang on the symptom of bitter taste in patients with chronic gastritis.

A symptom of bitter taste was found in 15 out of 82 patients with chronic gastritis that was diagnosed from symptoms and endoscopic findings. Liu-junzi-tang was very effective in 12 (80%) of the 15 patients. The symptom of bitter taste completely disappeared in 24.7 days on average after oral administration of Liu-junzi-tang in these 12 patients. In the remaining 3 patients, the symptom of bitter taste did not completely disappear, but was improved. Other symptoms associated with chronic gastritis and endoscopic findings were also improved in these patients. These findings indicate that Liu-junzi-tang may be a good remedy for the symptom of bitter taste in patients with chronic gastritis.

Adult↗