Biomedical subjects

A Kosaka

Publications and source records attributed to A Kosaka.

At least 37 records · Page 2Linked to original sources

PubMed1997

Implication of Video Assisted Thoracoscopic Surgery in the Diagnosis of Pulmonary Metastasis of Breast Cancer.

PURPOSE: To determine pulmonary metastasis, video assisted thoracoscopic surgery (VATS) was performed on the patients who had undergone breast cancer aurgery. PATIENTS AND METHODS: Nineteen patients with a history of breast cancer underwentVATS, because of subsequent abnormal pulmonary shadows on chest computed tomograms (CT). All patients were suspected to have pulmonary metastasis from breast cancer. RESULTS: The VATS procedure showed 10(52%) patiens to have pulmonary metastasis, but, 9(48%) had primary lung cancers or benign lesions. In the patients of pulmonary metastasis, 7 had nodular lesions (5 had a single nodule and 2 had two nodules with a median diameter of 8.5 mm), and 3 patients had pleural dissemination. The follow-up period of the patients with pulmonary metastasis ranged from 3 to 28 months. Three patients died of brain metastasis and respiratory failure, 3 suffered recurrence and 4 were free from disease after VATS. CONCLUSION: VATS was useful for distinguishing small metastatic lesions from other diseases and a minimally invasive surgical approach in the follow-up of breast cancer patients suspected of pulmonary metastasis.

Journal Article↗

PubMed1997

Idiopathic perforation of the gallbladder: report of a case and a review of the Japanese literature.

A 79-year-old man was admitted to our hospital because of severe epigastric pain. Ultrasonography and computed tomography revealed a slightly distended gallbladder with a small amount of free intraabdominal fluid. At emergency laparotomy, perforation of the gallbladder was recognized and thus a cholecystectomy was performed. Histopathologically, localized necrosis was seen at the site of perforation: however, the inflammation of the surrounding tissue was mild and no thrombus was detected within the intramural vessels. In addition, the gallbladder contained no stones and a bile culture was negative. Postoperatively, the diagnosis of idiopathic perforation of the gallbladder was established. The findings of this case help to emphasize the importance of considering this disorder in elderly patients presenting with peritonitis of unknown origin.

Aged↗

PubMed1997

Primary adenosquamous carcinoma of liver resected by right trisegmentectomy: report of a case and review of the literature.

A case of primary adenosquamous carcinoma of the liver in a patient with an elevated level of serum squamous cell carcinoma-related antigen is reported. A 68-year-old man was admitted to our hospital with a 10-day history of fever and jaundice. From the results of laboratory and imaging studies before surgery, a diagnosis of cholangiocellular carcinoma was made, and the patient underwent right trisegmentectomy with regional lymph node dissection. Histopathological examination of the resected specimen revealed adenocarcinoma, squamous cell carcinoma, and a transitional area containing both types of cancer cells. The number of argyrophilic nucleolar organizer regions and the labeling index of proliferating cell nuclear antigen were markedly elevated and the deoxyribonucleic acid ploidy pattern was aneuploid in the squamous component. The patient died due to liver metastases 3 months after the operation. We reviewed the 31 cases of adenosquamous carcinoma of the liver reported in the Japanese and English language literature, including the present case.

Aged↗

PubMed1997

Cloning, expression and pharmacology of a truncated splice variant of the human 5-HT7 receptor (h5-HT7b).

1. The rat 5-hydroxytryptamine (5-HT)7 receptor displays two splice variations, a long form, and a truncated splice isoform, arising from the introduction of a stop codon near the carboxy-terminus. The human-5HT7 receptor gene contains at least two introns and encodes a 445 amino acid 5-HT receptor. 2. A truncated splice variation in the human 5-HT7 receptor was isolated from a human placental cDNA library. In accordance with current NC-IUPHAR nomenclature guidelines, it is suggested that this receptor be donated as the h5-HT7b receptor and the long form of the receptor as h5-HT7a. 3. The h5-HT7b receptor was stably expressed in HEK 293 cells and ligand affinities were determined by displacement of [3H]-5-carboxyamidotryptamine (5-CT; Kd = 0.28 +/- 0.6 nM, Bmax = 7.3 +/- 17 pmol mg-1 protein). The rank order of affinities (pKi) for a series of ligands was: 5-carboxamidotryptamine (5-CT, 9.65) > 5-hydroxytryptamine (5-HT, 9.41) > methiothepin (8.87) > mesulergine (7.87) > 8-hydroxy-2 (di-n-propylamino)tetralin (8-OH-DPAT, 6.85) > ketanserin (6.44). 4. The h5-HT7b receptor coupled positively to adenylyl cyclase in HEK 293 cells. This response was elicited by a number of agonists with the following order of potency (pEC50): 5-CT (8.7 +/- 0.11) > 5-MeOT (5-methoxytryptamine; 8.1 +/- 0.20) > 5-HT (7.5 +/- 0.13) tryptamine (5.6 +/- 0.36) > 8-OH-DPAT (5.3 +/- 0.28) > 5-methoxytryptamine (5.0 +/- 0.06). This rank order was comparable to that observed in the radioligand binding studies. 5. In a similar fashion to that described for the 5-HT7a receptor, PCR studies suggested that the 5-HT7b receptor mRNA is found in great abundance throughout the brain, in the small intestine and aorta. 6. It is concluded that the h5-HT7 receptor, like the rat receptor, exists as splice variants exhibiting similar pharmacology, signal transduction and distribution. It is thus likely that there exists a complex physiological role for alternate splicing products of the 5-HT7 receptor gene.

Alternative Splicing↗

PubMed1997

[A case of liver metastases from leiomyosarcoma in the chest wall which was made resectable by chemoembolization].

We here report a recently experienced case in which TAE and intra-arterial infusion chemotherapy for treatment of liver metastases of leiomyosarcoma in the chest wall caused a shrinking of the metastasized focus, thus facilitating liver resection. Patient; a 38-year-old man Present History and Courses; Resection of leiomyosarcoma in his chest wall was done in May, 1994. However, a local recurrence was noted in September, 1995, and the tumor was removed. Then, he received systemic chemotherapy with CDDP (100 mg) and ADM (45 mg). Abdominal CT and ultrasonic examinations made in February, 1996 revealed liver metastases at S2,5,8. Angiography detected densely stained images of tumors at a number of sites along with S2,5,8. Since these were thought unresectable, TAE therapy with EPIR (30 mg) and lipiodol (4 ml) was attempted 3 times. Then, a reservoir for intra-hepatic arterial infusion was implanted in April, 1996 and EPIR at a dose of 30 mg (150 mg in total) was given through arterial infusion, resulting in tumor disappearance at S5,8 but further growth of the tumor metastasizes at S2. Therefore, a resection of the left lateral segment of liver was done August 23. Though he was discharged in October, metastasis was found in the thoracic spine in December. Thus, he underwent resection of the vertebral arch including the tumor.

Adult↗

PubMed1997

[A case of unresectable advanced cancer of the gall bladder successfully treated by arterial infusion therapy with cisplatin].

A 70-year-old male was admitted for obstructive jaundice. He was diagnosed as an unresectable advanced cancer of the gall bladder that was stage IV associated with direct extension of the liver (Hinf3) and the bile duct (Binf3), and with enlargement of paraaortic lymph node (N4(+)) by image analyses. Intraarterial infusion therapy with cisplatin (CDDP, 50 mg) was started through the common hepatic artery. Since the primary tumor and the enlarged paraaortic lymph node shrank markedly and the bile duct was completely obstructed, additional arterial infusion with CDDP (50 mg) was made. CT examination thereafter revealed that the paraaortic lymph node enlargement disappeared although thickening of the gall bladder wall still remained. Therefore this case was considered as a complete response (CR). Then, a reservoir for hepatic arterial infusion was implanted and CDDP (a total of 230 mg) was repeatedly infused 5 times. CT scanning images taken 7 months after the start of the treatment showed neither primary tumor nor enlargement of paraaortic lymph node. An extensive cholecystectomy was performed. Histopathological examination revealed signet-ring cell carcinoma located in all layers of the gall bladder. Factors indicating clinicopathological stage were se, hinf1, vs0, bw1, hw0 and ew2 (according to the General Rules for Surgical and Pathological Studies on Cancer of Bile duct).

Aged↗

PubMed1996

Hepatocellular carcinoma associated with anabolic steroid therapy: report of a case and review of the Japanese literature.

We report herein the case of a 35-year-old woman with aplastic anemia who developed hepatocellular carcinoma after long-term therapy with oxymetholone. She was treated with 60 mg/day of oxymetholone for 3 years (total dose 64.8 g). Alpha-fetoprotein, hepatitis B surface antigen, and hepatitis C antibody were all negative, but serum titers of carcinoembryonic antigen and carbohydrate antigen were elevated. Lateral segmentectomy of the liver was performed. The histopathological findings were compatible with those of multiple hepatocellular carcinoma without liver cirrhosis. Three years since the operation, the patient is doing well and no signs of tumor recurrence have been detected. According to our review of Japanese cases of hepatocellular carcinoma associated with anabolic steroid therapy, in all instances the tumors developed after long-term administration of anabolic steroids for hematologic diseases. In patients under long-term anabolic steroid therapy, routine screening of the liver by ultrasonography and computed tomography should be performed to detect liver tumors in the early stages.

Adult↗

PubMed1996

[Clinical evaluation of hepatic arterial infusion chemotherapy in patients with liver metastases from colorectal cancer].

Seventy-four cases of hepatic metastasis of colorectal cancer experienced in our hospital from January 1988 to February 1996 were examined for hepatic arterial infusion chemotherapy induced macrobiotic effect. A group (21 cases of hepatectomy and hepatic arterial infusion chemotherapy), B group (31 cases of hepatic arterial infusion chemotherapy only) and C group (22 cases of iv and po systemic chemotherapy) were comparatively examined for survival rate using Kaplan-Meier method. Single administration of adriamycin, epirubicin, cisplatin (CDDP) and 5-FU, along with CDDP-5-FU combined therapy and 5-FU 1,000 mg/5 hr intermittent continuous infusion therapy, were used. Mean survival period was 719 +/- 369, 426 +/- 417, 158 +/- 125 days for groups A, B and C, respectively. One-year survival rate by degrees of H factor was comparatively examined because of different H factor rates for these 3 groups. As a result, it proved to be 83 and 40% for groups A and B, respectively, in H1,2 cases and 32 and 11% for groups B and C, respectively, in H3 cases, with their respective significant differences (p < 0.05). Positive treatment, including hepatectomy, hepatic arterial infusion chemotherapy and the like, was suggested to contribute to patient macrobiosis.

Aged↗

PubMed1996

[An unusual case of pyogenic hepatic abscess rupturing into the pericardial cavity].

A rare case of pyogenic hepatic abscess that ruptured into the pericardial cavity is reported. A 50-year-old female who had been admitted for cholangitis associated with bi-lateral stricture of bile duct and intrahepatic stones, presented a pyogenic hepatic abscess in the left lobe on an abdominal computed tomography (CT). Percutaneous transhepatic abscess drainage (PTAD) was performed. But during PTAD-graphy five days later, cardiac tamponade developed secondarily to rapid accumulation of contrast medium in the pericardial cavity flowing from liver abscess. An emergency subxiphoid pericardectomy was performed and she made a good recovery. Unfortunately seven months later, she died of septicemia caused by a newly developed abscess in the right lobe of the liver.

Drainage↗

PubMed1995

Comparison of axonemal proteins from two kinds of Tetrahymena. I. Different characteristics of dyneins in heat stability.

Tetrahymena thermophila could still swim after incubation of the cell body at 40 degrees C for 30 min, whereas Tetrahymena pyriformis did not show any motility after the treatment. Turbidity measurements revealed that axonemes of T. pyriformis lost ATP-dependent sliding activity by the heat treatment, whereas those of T. thermophilia still had the activity under the same conditions. In connection with this difference in susceptibility to high temperature, the biochemical characteristics of dyneins were compared between the two species of Tetrahymena. Axonemal dyneins from the two species had significant vanadate-sensitive ATPase activity even after the heat treatment. Native gel electrophoresis and the following two-dimensional electrophoresis showed that the outer arm dynein of T. thermophilia is more stable in maintaining native configuration than that of T. pyriformis against the heat treatment, although both treated dyneins keep three (alpha, beta and gamma) subunits. Analysis by peptide mapping demonstrated that beta- and gamma-subunits of the outer arm dynein are considerably different in amino acid sequences between the two species. These results imply that dynein of T. thermophilia changed their amino acid sequences and biochemical characteristics to adapt to high temperature.

Amino Acid Sequence↗

PubMed1995

[Outcomes of effective treatment of cases of metastatic liver tumors by intra-arterial infusion chemotherapy].

We studied the prognoses of unresectable liver tumors, including 31 colorectal cancers and 10 gastric cancers treated by intra-arterial infusion chemotherapy using an implantable reservoir. Adriamycin, epirubicin, or cisplatin were administered intermittently early on. Cisplatin and 5-FU combined therapy were given later. In nine with colorectal metastases and six with gastric metastases, metastatic lesions decreased, and in 4 patients with metastatic lesions could be resected. But in many patients, hepatic and other organ recurrences were observed. We need to try many other treatments.

Adenocarcinoma↗

PubMed1994

Cloning and expression of a 5-hydroxytryptamine7 receptor positively coupled to adenylyl cyclase.

A cDNA clone (designated as GP2-7) encoding a novel 5-hydroxytryptamine (5-HT) receptor was isolated from a guinea pig hippocampal library. The receptor shares amino acid homology within the hydrophobic domains with other cloned 5-HT receptor subtypes (34-48%). The sequence of GP2-7 is homologous to that described for a novel receptor previously cloned from a rat brain cDNA library and provisionally designated as 5-HT7. mRNA for GP2-7 was detected in cortical and limbic brain regions. Transiently expressed GP2-7 showed high-affinity binding to [3H]5-HT (pKi = 9.0) with the following rank order of affinities: 5-carboxyamidotryptamine (5-CT) > 5-HT = 5-methoxytryptamine (5-MeOT) > methiothepin > 8-hydroxy-2-(dipropylamino)tetralin (8-OH-DPAT) > spiperone >> sumatriptan. Adenylyl cyclase activity in CHO-K1 cells transiently transfected with GP2-7 was stimulated by several analogues of 5-HT with the following order of potency: 5-CT > 5-HT = 5-MeOT > dipropyl-5-CT > 8-OH-DPAT. Methiothepin and spiperone were potent antagonists. Preliminary analysis suggests that GP2-7 closely resembles a receptor in the guinea pig hippocampus that exhibits a high affinity toward 5-CT.

Adenylyl Cyclases↗

PubMed1994

[Evaluation of cases of metastatic liver tumors resected following intra-arterial infusion chemotherapy].

We encountered four cases whose unresectable metastatic liver tumors could be resected by operation after intra-arterial infusion chemotherapy using an implantable reservoir. Metastatic lesions were thus markedly reduced and localized. Three cases were metastases of colorectal cancer and one of gastric cancer. All cases of liver metastases were synchronous and more than H2 stage. In these cases, metastatic lesions were reduced at an early stage of this chemotherapy after resection of the primary lesions. Resection of metastases was carried out from 4 to 14 months after the first operation. Effects of this chemotherapy were also observed histologically; necrosis and fibrosis were found in the cancer nest, which paralleled the reduction in tumor size. Our results indicate that this chemotherapy could be a neoadjuvant chemotherapy for unresectable metastatic liver tumors which may become resectable after this chemotherapy as seen in our cases. However, lung metastases and peritoneal dissemination influenced the prognosis of our cases. Treatment of extra-hepatic recurrence seemed important to improve the prognosis of these patients.

Aged↗

PubMed1993

[Reservoir system implantation technique via the inferior epigastric artery for local recurrence of rectal cancer].

A reservoir system was implanted via the inferior epigastric artery into the internal iliac artery for local recurrence of rectal cancer under lumbar anesthesia. At the same time, the internal iliac artery on the opposite side of the tumor and the superior and inferior gluteal artery on the tumor side were embolized by gelform and coil. Five-hour continuous intraarterial infusion of 1,000 mg/m2 of 5-FU with intravenous drip infusion of 20 mg/m2 of leucovorin and one shot intraarterial infusion of 50 mg/m2 of cisplatin were performed as the treatment. This technique allows easier insertion of the catheter than by the conventional method, elevates the anticancer drug levels in the pelvic cavity and prevents ulcer of the buttocks and perineum. The technique is considered an effective form of treatment for local recurrence of rectal cancer.

Aged↗

PubMed1993

[Study of intra-arterial infusion chemotherapy for hepatocellular carcinoma using an implantable reservoir].

Twenty-two patients with unresectable hepatocellular carcinoma were treated by intra-arterial infusion chemotherapy using an implantable reservoir. The catheter was placed in the hepatic artery via the left subclavian artery. Adriamycin or epirubicin were administered intermittently. From the result, the response rate in all cases was 22.7%, and no difference in the response rate by Stage was observed. However, the less the hepatic disturbance, the greater the effect was: 75% in clinical stage I, 18.2% in II and 0% in III. Significant differences of ICG R15, doses and frequency of intra-arterial infusion were observed between PR, NC and PD cases. The usefulness of this chemotherapy was suggested in highly advanced hepatocellular carcinoma, especially in Vp3.

Aged↗

PubMed1993

[A case of liver metastasis from retroperitoneal leiomyosarcoma successfully treated by intra-arterial infusion chemotherapy of adriamycin or epirubicin using an implantable reservoir].

A 59-year-old woman was diagnosed as having liver metastasis (H3) 38 months after undergoing resection for retroperitoneal leiomyosarcoma. A catheter was placed in the hepatic artery and intra-arterial infusion chemotherapy using an implantable reservoir was performed with 30 mg of adriamycin or epirubicin at each treatment every 2-4 weeks. Imaging revealed that the tumor had been markedly reduced, and a partial response was obtained for 18 months. The patient has survived for 33 months since liver metastasis was detected. Although effective chemotherapy for metastatic leiomyosarcoma in the liver has been poorly documented, intra-arterial infusion chemotherapy proved highly effective in this case, suggesting that it effectively improved the prognosis.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1993

[A case of breast cancer with thrombosis during treatment of lung metastasis].

A 74-year-old female with lung metastasis of breast cancer was treated with chemo-endocrine therapy (intravenous administration of epirubicin at 30 mg/2w, oral administration of UFT at 400 mg/day, alternate oral administration of medroxyprogesterone acetate at 800 mg/day and tamoxifen at 40 mg/day) and immuno-therapy (intravenous administration of lentinan at 2 mg/w). Lung tumors decreased in size and number. At the same time, deep vein thrombosis of the lower extremities occurred, which caused multiple pulmonary embolization. In this case, several factors were suggested to cause thrombosis in the advanced or recurrent breast cancer patient.

Administration, Oral↗

PubMed1992

Extension incision for renal carcinoma including invaded vena cava and right lobe of liver.

We report on a thirty-five-year-old woman with renal cell carcinoma who successfully underwent right radical nephrectomy and extended right hepatic lobectomy with resection and reconstruction of inferior vena cava (IVC). A temporary bypass was placed between the infrarenal IVC and right atrium using a heparin-coated synthetic tube. The tumor was resected en bloc including right kidney, adrenal gland, hepatic lobe, and IVC. The IVC was reconstructed using an expanded polytetrafluoroethylene (EPTFE) graft. Her postoperative course was uneventful with no signs of recurrence four years after surgery.

Adult↗