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Biomedical subjects

Y Tsuji

Publications and source records attributed to Y Tsuji.

At least 145 records · Page 8Linked to original sources
PubMed1998

Shortage of glutamine (CAG) homopolymeric repeats suppresses the expression of the androgen receptor in familial cases with complete androgen insensitivity syndrome.

The androgen receptor gene of two familial cases with complete androgen insensitivity syndrome was analyzed. The shortage of glutamine homopolymeric repeats (13 repeats) in the N-terminal domain of the androgen receptor of the patients was identified by DNA sequence analysis. In vitro transfection experiments with the patients' androgen receptor gene indicated that the expression of the androgen receptor in transfected COS-7 cells was decreased by 10% as compared to that of the wild type androgen receptor gene. The thermal stability of the 5 alpha-dihydrotestosterone-androgen receptor complex was also partially impaired. The capacity of the androgen receptor to activate target gene transcription was partially disturbed in a luciferase assay. The shortened glutamine homopolymeric repeats might therefore be related to the pathogenesis of complete androgen insensitivity syndrome.

Adult↗
PubMed1998

Magnetic resonance imaging-documented extravasation as an indicator of acute hypertensive intracerebral hemorrhage.

OBJECT: The aim of this study was to determine the usefulness of magnetic resonance (MR) imaging-documented extravasation as an indicator of continued hemorrhage in patients with acute hypertensive intracerebral hemorrhage (ICH). METHODS: The authors studied 108 patients with acute hyperintensive ICH. Imaging modalities included noncontrast-enhanced computerized tomography (CT) scanning, gadolinium-enhanced MR imaging, and conventional cerebral angiography obtained within 6 hours after the onset of hemorrhage. A repeated CT scan was obtained within 48 hours to evaluate enlargement of the hematoma. Findings on MR imaging indicating extravasation, including any high-intensity signals on T1-weighted postcontrast images, were observed in 39 patients, and 17 of these also showed evidence of extravasation on cerebral angiography. The presence of extravasation on MR imaging was closely correlated with evidence of hematoma enlargement on follow-up CT scans (p < 0.001). CONCLUSIONS: Evidence of extravasation documented on MR imaging indicates persistent hemorrhage and correlates with enlargement of the hematoma.

Acute Disease↗
PubMed1998

Usefulness of the high-frequency ultrasound probe in pretherapeutic staging of superficial-type colorectal tumors.

We evaluated the usefulness of the high-frequency ultrasound probe (HFUP, 20 MHz) to determine the depth of tumor invasion in 45 patients with superficial colorectal tumors. The correct diagnostic rate was 66% (30/45) when the depth of tumor invasion was classified into the following 6 layers: mucosa (m), upper 1/3 (sm1), middle 1/3 (sm2), and lower 1/3 (sm3) areas of the submucosa, muscularis propria (mp), and the subserosa or deeper areas (s). However, when the depth of tumor invasion was evaluated in 3 layers (m-sm1, sm2-sm3, and mp-deeper layer), which is the classification used to select cases for endoscopic mucosal resection, the correct diagnostic rate was 88.9% (40/45). These results suggest that the HFUP is useful to determine the depth of invasion to select treatment for superficial colorectal tumors.

Aged↗
PubMed1998

[Vesicoureteral reflux and urinary incontinence in myelodysplastic patients: a comparison between those who had anti-reflux surgery alone and those who were treated by anti-reflux surgery combined with bladder augmentation with or without sling operation].

BACKGROUND: Vesicoureteral reflux and urinary incontinence are frequently observed among myelodysplastic patients. Since the conservative therapy is not always effective to improve these pathologies, surgical intervention is necessary for some of the patients. METHODS: Thirty-eight myelodysplastic patients were divided into 2 groups: Group A comprised 17 patients who had been operated by anti-reflux surgery (crossover method) alone and Group B 21 patients who had undergone anti-reflux surgery (Orikasa's method) and augmentation enterocystoplasty with or without sling operation. Cessation rate of reflux, bladder capacity, bladder compliance and operative complications were analyzed in the 2 groups. A questionnaire was sent to the patient asking to answer frequency of clean intermittent catheterization (CIC), severity of urinary incontinence, satisfaction rate for operation and so on. Mean followed-up periods were 11.7 (5.3-13.6) years for Group A and 3.7 (0.6-6.9) years for Group B, respectively. RESULTS: Reflux was successfully eradicated in 19 of 24 ureters (79%) of Group A and in 25 of 29 ureters (86%) of Group B, which was not significantly different. In Group A, bladder capacity and compliance slightly improved. The latter, however, remained less than 10 ml/cmH2 O. Bladder capacity and compliance of Group B increased more than twice the original value with statistical significance. Operative complication in Group A was ureteral obstruction in 1 patient, which eventually necessitated peritoneal dialysis. In Group B revision of ventriculoperitoneal shunt was necessary in 4 patients, incomplete ileus was conservatively treated in 3, and a bladder stone was formed in 1. The patients assessed that frequency of pyelonephritis was less in Group B compared to Group A. Other subjective parameters, however, such as frequency of CIC, severity of urinary incontinence, postoperative changes in the amount of urinary incontinence, and satisfaction rate for operation, were not different between the 2 groups. COMMENTS: Though operation-related complications occurred more frequently in those of Group B, these patients enjoyed significant improvement in bladder capacity and bladder compliance. We conclude when the conservative therapy fails to cure and improve vesicoureteral reflux and urinary incontinence, surgical interventions including anti-reflux surgery and augmentation cystoplasty with or without sling operation are recommended as a treatment option.

Adolescent↗
PubMed1998

Efficacy of applied cardiovascular surgery techniques for extended resection in hepato-biliary-pancreatic malignancies.

The application of extracorporeal circulation (ECC) and vascular surgery techniques provide the possibility to resect severely advanced hepato-biliary-pancreatic (HBP) malignancies that had been adjudged unresectable hitherto. In this paper, recent two successful cases are reported for the purpose of indicating the efficacy of ECC and vascular surgery techniques in HBP surgery. Two patients had a cholangiocellular carcinoma and a carcinoma of the pancreatic head, those metastatic lymph nodes invaded to the portal veins and the hepatic arteries. These tumors could be resected en bloc with these Glissonian vessels using a centrifugal pump through veno-venous bypass. Reconstruction of these portal veins was performed with autologous external iliac vein graft. Postoperative angiographies showed no anastomotic leakage or occlusion on vascular anastomotic sites in both cases, and they have gone on uneventful postoperative courses. Application of cardiovascular techniques in the field of HBP surgery might expand surgical indication for advanced malignancies.

Bile Duct Neoplasms↗
PubMed1998

Surgical results of composite graft replacement of the aortic root aneurysm.

From 1986 to 1996, 20 patients underwent aortic root replacement. All of the patients had annulo aortic ectasia (AAE); Six had DeBakey type I aortic dissection, three were acute dissections associated with Marfan's syndrome; three had previously undergone the Koster-Collins operation. During 11 years, the original Bentall procedure (1986-91), the Cabrol procedure (1991-), and the modified Bentall procedure (Carrel patch or Piehler technique) were performed. There was only 1 hospital mortality (5.0%). Four patients died during the follow-up period (mediastinitis, myocardial infarction, cerebral bleeding, and rupture of the arch aneurysm). Only 2 patients required reoperation (repair of a pseudoaneurysm of the right coronary artery and paravalvular leakage of the aortic valve replacement). The satisfactory outcomes were the result of the full-thickness anastomoses performed during coronary artery reconstruction.

Adult↗
PubMed1998

[Clinical study on poor-risk patients with non-seminomatous germ cell tumor].

Between 1988 and 1996, we treated 11 poor-risk patients with non-seminomatous germ cell tumors (NSGCT) at Nagoya University Hospital. "Poor-risk" was defined as i) advanced disease equal to or greater than class 7 of the Indiana University Classification (7 patients), ii) primary mediastinal extragonadal NSGCT (2), iii) tumor markers not normalized by the induction chemotherapy (1) or iv) primary retroperitoneal NSGCT with multiple lung metastases (1). Two patients with mediastinal tumors died during the chemotherapy. The minimal volume of fluid must be administered to patients with giant mediastinal tumors. The tumor marker normalized during the induction chemotherapy in only three patients. Three patients, whose tumor markers elevated during or one month after the induction chemotherapy, eventually died of cancer. The tumor markers in five of the seven patients which had not normalized during the induction chemotherapy, had decreased to the normal range during the salvage chemotherapy and two of the five subsequently achieved the status of "no evidence of disease" (NED). Six patients with and two without normalized tumor markers underwent retroperitoneal lymph nodes dissection and/or resection of residual tumors. Pathological examination of the resected tumors showed necrosis/fibrosis in five patients and two had elevated tumor markers immediately after the surgery and eventually died of the disease. Overall, eight (73%) of 11 poor-risk patients achieved a complete response but only five (45%) eventually achieved a NED status that was maintained (6.6 +/- 3.0 years). Our results were not satisfactory, and we believe that new strategies, such as early high-dose chemotherapy, are required for poor-risk patients, who are not likely to respond well to the induction chemotherapy.

Adolescent↗
PubMed1998

[Neoadjuvant intraarterial chemotherapy for ten cases of inflammatory breast cancer by Seldinger's methods].

The conventional methods (CM) of intraarterial (IA) chemotherapy for inflammatory breast cancer were catheterizations from superior epigastric and brachial artery under general anesthesia. Since 1997, we selected the Seldinger's methods (SM) for ten cases of the disease to control local effects and simplify the technique. Complications of the SM were slight, and side effects were equal to those with CM. The postoperative pathological findings of the SM showed the direct effects of chemotherapy to tumor cells (degenerative and necrotic changes) as compared with the embolism-like effects of CM. But the overall histological effects of chemotherapy by SM were almost equal to those for CM. The strong points of the SM were as follows: 1) More selective IA chemotherapy is available, 2) one can find the passage of the aim vessels and no trouble related to catheter, 3) general anesthesia is not necessary, and the techniques are simple, 4) the wounds are not remarkable. The disadvantages are as follows: 1) Patients must rest the day of IA chemotherapy, 2) in 20% of the procedures, one can not search the vessels, and 3) in 4 cases complications of stiffness of Mj or Mn pectral muscles were found. In future, we expect more effective results by dose escalation or combination chemotherapy.

Adenocarcinoma↗
PubMed1998

[Microwave tissue coagulation therapy with mini-laparotomy for hepatocellular carcinoma].

Recently microwave tissue coagulation therapy (MCT) has been established as a therapeutic procedure for hepatocellular carcinoma (HCC). The route of approach to penetrate the tumor is two-fold: By the percutaneous route (PMCT) or by conventional laparotomy. PMCT has the advantage of less invasive therapy, however, it is not applicable to a tumor that cannot be detected by ultrasonography. Therefore, we tried MCT with mini-laparotomy. The patient was a 57-year old man with HCC located in the S6 subsegment. The operation was performed at the semi-right side up position, and laparotomy was done by skin incision of 12 cm in the right hypochondral area. MCT was performed about 30 times, with an output of 60 watts for 45 seconds at a time. Abdominal CT image showed a low-density area of 7 x 4 cm on the 18th postoperative day. Slight damage to the liver and no obvious complications were observed. We concluded that a much wider range-coagulation than PMCT was able to be obtained by MCT with mini-laparotomy, and postoperative quality of life was better than MCT with conventional laparotomy.

Carcinoma, Hepatocellular↗
PubMed1998

[Intra-arterial preventive chemotherapy for residual liver after resection of hepatic metastasis from colorectal cancer].

We treated 18 cases with intra-hepatic arterial infusion chemotherapy after resection of hepatic metastasis from colorectal cancer (June 1991-September 1997). Eight cases were H1, 7 were H2, and 3 were H3. Hepatic lobectomy was done in 3 cases, lobectomy + partial resection in 2 cases, and partial resection in 13 cases. All cases received high-dose intermittent 5-FU infusion (WHF = 5-FU 1,000 mg/m2/5 hrs/w) on an outpatient basis. The total frequency of WHF was 4-54 times (average 29), and total 5-FU doses ranged from 6.0 to 81.0 g (average 40 g). The 1- and 5-year cumulative survival rates were 100% and 77.5% in all patients 100% and 87.5% in H1 group and 100% and 64.3% in H2 + H3 group, respectively. There was no significant difference of survival between the H1 and H1 + H3 groups. The 1- and 5-year recurrence rates in residual liver were 5.9% and 14.4%, respectively. One of 2 cases with residual liver recurrence was resected for metastasis again, and the patient is now in a disease-free state. WHF after resection of hepatic metastasis from colorectal cancer has a preventive effect for their survival, not only in H1 group but also in H2 + H3 group.

Antimetabolites, Antineoplastic↗
PubMed1998

Effect of administration of ursodeoxycholic acid at bedtime on cholesterol saturation of hepatic bile in Japanese patients with gallstone.

The administration of a single, daily 600 mg dose of ursodeoxycholic acid (UDCA) at bedtime and 3-200 mg doses per day at mealtime was conducted for 6 patients with gallstone and choledocholithiasis who were undergoing biliary drainage for the purpose of improving jaundice. Hepatic bile was collected from a drainage tube after a lapse of time in order to compare the bile acid compositions and cholesterol saturation index (SI) in bile for the 2 protocols. A significant increase in UDCA levels in hepatic bile was observed after both UDCA administration at bedtime and mealtime, but the effect of bedtime administration was significantly greater than that of mealtime administration. Whereas levels of cholic acid and chenodeoxycholic acid (CDCA) decreased for the case of bedtime administration, this was not detected for mealtime administration, although no significant differences among the mean interval values were observed. A significant in difference decreased SI was observed during UDCA bedtime administration, but not during mealtime administration, compared to the SI before administration. This suggests a decreased cholesterol excretion into the bile. Based on these findings and from the point of view of compliance, bedtime administration of UDCA appears to be an effective method.

Adult↗
PubMed1998

[Outpatient chemotherapy with weekly high-dose infusional 5-fluorouracil (weekly HD-FU) in advanced gastrointestinal cancer].

This study was designed to evaluate the efficacy, toxicity, and quality of life (QOL) of outpatient chemotherapy with weekly HD-FU in advanced gastrointestinal cancer. Treatment consisted of weekly 24-h infusion of 5-FU 2,600 mg/m2, 5-FU was administered using the Groshong catheter and the Baxter infusor LV 5 (5 ml/hr). Eight patients (pts) with advanced gastrointestinal cancer were treated 64 times (mean 8.0 times), and 21 pts were treated 168 times (mean 8.0 times) with adjuvant chemotherapy. Grade 3 or 4 toxicities were not observed. Catheter occlusions and balloon rupture were observed in 1 case each. Responses were PR 2 and NC 6. Mean times to progression were 2.0 and 3.5 months, respectively. Mean scores of QOL were: 70.5 +/- 8.2 before treatment, 78.0 +/- 13.0 after 3 weeks, 79.8 +/- 7.9 after 5 weeks, and 75.8 +/- 11.3 after treatment completion. In adjuvant cases, these scores were 80.6 +/- 11.4, 83.1 +/- 10.7, 85.1 +/- 11.5, and 91.8 +/- 6.9, respectively. In conclusion, a schedule of 5-FU is feasible for outpatient chemotherapy in advanced gastrointestinal cancer.

Adult↗
PubMed1997

A novel protease in the pupal yellow body of Sarcophaga peregrina (flesh fly). Its purification and cDNA cloning.

We purified a novel serine protease with a molecular mass of 26 kDa from Sarcophaga pupae. This protease appeared almost exclusively in the yellow body, an organ that develops temporarily in the pupae of dipteran insects and expands to form the adult midgut by engulfing the larval midgut. cDNA analysis revealed that this protease consists of 239 amino acid residues and has significant structural similarity with bovine trypsin (about 40% sequence identity). The 26-kDa protease gene was transiently activated in 1-day-old pupae. The protease was found to cross-react immunologically with antibody against sarcotoxin IA, an antibacterial protein produced by this insect. It is suggested that this protease participates in the decomposition of the larval midgut in the yellow body during metamorphosis.

Amino Acid Sequence↗
PubMed1997

Serum Soluble Interleukin-2 Receptor Levels in Patients with Breast Cancer.

Preoperative levels of serum soluble interleukin-2 receptor (1L-2R) were examined in 37 patients with breast cancer. We investigated the correlations of serum soluble IL-2R levels with various factors such as stage grouping, lymph node metastasis, distant metastasis, tumor size, histophthological type, estrogen receptor (ER), progesterone receptor (PgR) and CA 15-3. Serum soluble 1L-2R levels were measured with an enzyme-linked immunosorbent assay. Levels of serum soluble 1L-2R in the patients with stage III and IV breast cancer were significantly higher than those in the normal controls, and patients with stage I and II breast cancer. Preoperative levels of serum soluble IL-2R in patients with T3 and T4 were also significantly higher than those in patients with T1 and T2. Serum levels of IL-2R in patients with distant metastasis were also significantly higher than those in patients without distant metastasis. Moreover, serum levels of soluble IL-2R in patients with higher CA 15-3 were significantly higher than those in patients with normal CA 15-3 levels. We conclude that preoperative serum soluble IL-2R levels in patients with breast cancer may be a valuable parameter, especially in evaluating whether they have distant metastasis or not.

Journal Article↗
PubMed1997

Follow-up studies of sphincter-preserving operations for anal fistulas.

PURPOSE: This study was designed to evaluate and to compare the outcome of anal fistula surgery using techniques involving minimal sphincter damage (sphincter-preserving) and conventional laying open techniques. PATIENTS AND METHODS: From January 1987 to December 1993, 2,242 patients with anal fistulas were treated surgically, of whom 1,070 had sphincter-preserving operations. These included 530 patients with low intersphincteric fistulas (II L), 116 patients with high intersphincteric fistulas (II H), 73 patients with combined high and low intersphincteric fistulas, 239 patients with transphincteric fistulas (III), and 112 patients with supralevator fistulas (IV). The open method of fistula surgery was used in 1,172 patients. RESULTS: Of 1,070 sphincter-preserving operations, delayed healing occurred in 49 patients (4.6 percent) and recurrent fistula occurred in 32 patients (3 percent). By using the open method in 1,172 patients, delayed healing occurred in 10 patients (0.9 percent) and recurrence of fistula occurred in 23 patients (2 percent). Failure rates increased with increasing depth and complexity of the fistula. CONCLUSION: Sphincter function is better with sphincter-preserving fistula surgery than with the open method, although healing was delayed more commonly in sphincter-preserving operations that with the open methods, and fistula recurrence was similar with the two methods. Choice of operation depends on depth of fistula, outcome by manometry, and history of former operations.

Anal Canal↗