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Biomedical subjects

E Shin

Publications and source records attributed to E Shin.

At least 19 recordsLinked to original sources

Optimizing typhoid fever case definitions by combining serological tests in a large population study in Hechi City, China.

Blood culture-based diagnosis can only detect a fraction of the total burden of Salmonella enterica subsp. enterica serovar Typhi. The objective of the study was to detect additional typhoid fever cases through serological tests. A total of 1732 prolonged fever episodes were evaluated using three serological tests, Widal, Tubex and Typhidot-M in a typhoid fever endemic area of southern China. A case definition which included a positive Widal test (TO>or=80 & TH>A), a positive Tubex test (>or=4) and a positive Typhidot-M test, increased the detection of cases by more than twofold from 13 to 28 cases. The case definition has a specificity of 100% and a sensitivity of 39%. Case definitions based on combinations of serological tests can detect additional typhoid fever cases with higher specificity than a single serological test. Improved case detection is essential to understand the true disease burden and can help to boost the power of intervention trials.

Adolescent↗

Cox-2 expression on tissue microarray of breast cancer.

AIM: To measure cyclooxygenase-2 (Cox-2) expression in a series of breast cancers and evaluate its potential as a predictive marker for doxorubicin chemotherapy. PATIENTS AND METHODS: Cox-2 expression was analyzed in 178 node-positive patients treated with doxorubicin-based adjuvant chemotherapy by immunohistochemistry on tissue microarray (TMA). RESULTS: Cox-2 was over-expressed in 70 out of the 178 invasive breast cancers. Cox-2 expression was significantly increased in undifferentiated tumors. There was no significant association between Cox-2 over-expression and tumor size, histologic grade, and estrogen receptor expression. Disease-free survival and overall survival of the patients having Cox-2 expressing tumor were significantly decreased when compared with the patients having Cox-2 negative tumor (p=0.009 for DFS, p=0.011 for OS). CONCLUSION: Cox-2 expression may represent an aggressive phenotype of breast cancer which is resistant to doxorubicin.

Antibiotics, Antineoplastic↗

HER2 status in pure ductal carcinoma in situ and in the intraductal and invasive components of invasive ductal carcinoma determined by fluorescence in situ hybridization and immunohistochemistry.

AIM: To determine the HER2 status of ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) of the breast. The increased prevalence of HER2 amplification and overexpression in DCIS is considered to be maintained in the intraductal component of IDC; however, HER2 amplification and overexpression are detected much less in IDC. METHODS AND RESULTS: Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) were performed to detect HER2 in 270 IDCs with an intraductal component and in 50 pure DCIS samples; IHC was also performed in 116 metastatic nodes. HER2 was found to be amplified in 77 cases (28.5%) and overexpressed in 79 (29.3%) of the 270 IDCs. HER2 amplification was similar between intraductal and invasive components of the same tumour. The concordance for HER2 status between invasive and intraductal components of individual tumours was 98.5% and 99.3% by FISH and IHC, respectively. HER2 was amplified in 25 (50%) of the 50 pure DCIS samples. HER2 overexpression in metastatic nodes resembled the HER2 status in the primary tumour for 108 (93.1%) of 116 cases (kappa =0.831). CONCLUSION: Our study indicates that the intraductal component of IDC may differ biologically when compared with pure DCIS. HER2 appears to lack a critical role in the progression from DCIS to IDC and HER2 status is maintained in metastatic lesions.

Adult↗

Secreted factors from ventral telencephalon induce the differentiation of GABAergic neurons in cortical cultures.

It is widely believed that the pyramidal cells and interneurons of the cerebral cortex are distinct in their origin, lineage and genetic make up. In view of these findings, the current thesis is that the phenotype determination of cortical neurons is primarily directed by genetic mechanisms. Using in vitro assays, the present study demonstrates that secreted factors from ganglionic eminence (GE) of the ventral telencephalon have the potency to induce the differentiation of a subset of cortical neurons towards gamma-aminobutyric acid (GABA)ergic lineage. Characterization of cortical cultures that were exposed to medium derived from GE illustrated a significant increase in the number of GABA-, calretinin- and calbindin-positive neurons. Calcium imaging together with pharmacological studies showed that the application of exogenous medium significantly elevated the intracellular calcium transients in cortical neurons through the activation of ionotropic glutamate receptors. The increase in GABA+ neurons appeared to be associated with the elevated calcium activity; treatment with blockers specific for glutamate receptors abolished both the synchronized transients and reduced the differentiation of GABAergic neurons. Such studies demonstrate that although intrinsic mechanisms determine the fate of cortical interneurons, extrinsic factors have the potency to influence their neurochemical differentiation and contribute towards their molecular diversity.

Animals↗

Update results of FEC followed by docetaxel neoadjuvant trials for primary breast cancer.

This study has been initiated to evaluate the safety, clinical and pathologic response as well as the relation of response (pCR or non-pCR) and survival (overall and relapse-free) of fluorouracil, epirubicin and cyclophosphamide (FEC) followed by docetaxel (DOC) as preoperative chemotherapy in patients with operable breast cancer. Japanese patients with primary breast cancer, Tlc-3N0M0 or T1-3NIM0, age 20-60, PS 0-1 were included in this study. Preoperative chemotherapy consisted of 4 cycles of FEC (500 mg/m(2), 100 mg/m(2), 500 mg/m(2)) every 3 weeks followed by 4 cycles of DOC (75 mg/m(2)) every 3 weeks. Since June 2002, 200 patients were enrolled in this study, and the time of this interim analysis, 80 patients were evaluable for safety and clinical efficacy. The overall clinical response rate was 71.4% (14% CR, 44% PR, 42% SD/PD), and the only G3,4 toxicities, neutropenia and febrile neutropenia were observed in 54% and 14% of patients, respectively. Eighty nine patients were evaluable for pathologic response by central review. Pathologic response was evaluated among invasive tumors on multiple cross-section specimens based on a modified version of the Japanese grading system for Japanese Breast Cancer Society. The pathologic response rate was 17%. In this ongoing trial, FEC followed by DOC was active and well tolerated.

Antineoplastic Agents, Phytogenic↗

Interpreting the multifocal visual evoked potential: the effects of refractive errors, cataracts, and fixation errors.

AIM: To understand how refractive errors, cataracts, and fixation errors affect multifocal visual evoked potential (mfVEP) responses. METHODS: Monocular mfVEP responses were obtained using a pattern reversal dartboard display. For the control condition, visual acuity was corrected to > or =20/20 and foveal fixation was maintained. The right eye was tested under the following conditions: simulated refractive error, simulated cataract, steady eccentric fixation, and unsteady fixation. RESULTS: No subject demonstrated significant abnormalities under control conditions. For the simulated refractive error condition, significant centrally located abnormalities were seen for all subjects. For the simulated cataract condition, significant abnormalities were found for three subjects. The steady eccentric fixation condition yielded abnormalities in both eyes for all subjects while the unsteady fixation condition yielded significant central abnormalities in the tested eye. With eccentric and unsteady fixation conditions, all subjects had at least one sector with a waveform polarity reversal. CONCLUSIONS: While the mfVEP is a useful tool for identifying local optic nerve damage or ruling out non-organic aetiology of visual field defects, factors such as uncorrected refractive errors, cataract, eccentric fixation, and unsteady fixation can produce apparent field defects on the mfVEP. With care, these problems can be correctly identified.

Adult↗

Proteolytic enzyme conjugated to SC-glucan as an enzymatic transdermal drug penetration enhancer.

The objective of this study was to investigate the effect of papain, a proteolytic enzyme, on the percutaneous absorption of drugs. To guarantee the enzyme stability during the skin penetration, papain was modified by the conjugation to SC-glucan. The enhancing activity of drug penetration was evaluated using antipyrine and indomethacin as hydrophilic and hydrophobic model drugs, respectively. The SC-glucan-papain conjugate was found to be very effective for facilitating the percutaneous absorption of antipyrine. Microscopic observations showed that the thickness of stratum corneum and viable epidermis was increased by the treatment of the SC-glucan-papain conjugate. Moreover, it induced phase separation, lacuna formation, and lamellar disruption within the stratum corneum interstices. These structural changes by the SC-glucan-papain conjugate are likely to be induced from hydrolysis of extensive crosslinking of corneocyte envelopes and intracellular proteins. However, the SC-glucan-papain conjugate showed no skin irritation according to the Draize test, which may be due to the difficulty of the SC-glucan-papain conjugate in penetrating into the skin.

Administration, Cutaneous↗

Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves.

STUDY DESIGN: The mechanical properties of multilevel human cervical spines were investigated by applying pure rotational moments to each specimen and measuring multidirectional intervertebral motions. OBJECTIVES: To document intervertebral main and coupled motions of the cervical spine in the form of load-displacement curves. SUMMARY OF BACKGROUND DATA: Although a number of in vivo and in vitro studies have attempted to delineate normal movement patterns of the cervical spine, none has explored the complexity of the whole cervical spine as a three-dimensional structure. METHODS: Sixteen human cadaveric specimens (C0-C7) were used for this study. Pure rotational moments of flexion-extension, bilateral axial torque, and bilateral lateral bending were applied using a specially designed loading fixture. The resulting intervertebral motions were recorded using stereophotogrammetry and depicted as a series of load-displacement curves. RESULTS: The resulting load-displacement curves were found to be nonlinear, and both rotation and translation motions were coupled with main motions. With flexion-extension moment loading, the greatest degree of flexion occurred at C1-C2 (12.3 degrees), whereas the greatest degree of extension was observed at C0-C1 (20.2 degrees). With axial moment loading, rotation at C1-C2 was the largest recorded (56.7 degrees). With lateral bending moments, the average range of motion for all vertebral levels was 7.9 degrees. CONCLUSIONS: The findings of the present study are relevant to the clinical practice of examining motions of the cervical spine in three dimensions and to the understanding of spinal trauma and degenerative diseases.

Analysis of Variance↗

Metastatic breast cancer with resistance to both anthracycline and docetaxel successfully treated with weekly paclitaxel.

We report the case of a 38-year-old woman who underwent surgery for stage III-b breast cancer, and whose liver metastasis failed to respond to both docetaxel (administered at 30-40 mg/m2 every 2 weeks as a 1-h intravenous infusion) and epirubicin (administered as a 40-60 mg/m2 bolus hepatic arterial infusion). For subsequent treatment, this patient was managed with weekly paclitaxel. The regimen showed some usefulness for the treatment of the liver metastasis, as indicated by an improvement in performance status and tolerable toxicity. This case demonstrates that weekly paclitaxel may be well tolerated and useful for patients with extensive metastatic breast cancer that was resistant to treatment. Our findings also suggest that paclitaxel could be used as a salvage therapy in patients with anthracycline- and docetaxel-resistant breast cancer.

Adult↗

New technique of laparoscopic-assisted excision of a cholecystocolic fistula: report of a case.

Cholecystocolic fistula is a rare complication of gallstone disease that is most commonly diagnosed at the time of surgery. It is generally considered to be a contraindication to laparoscopic cholecystectomy because of the difficulties involved in its management intraoperatively. Laparoscopic stapling or suturing techniques have been reported as feasible and safe methods for repairing such fistulas; however, these procedures are not always able to be performed due to technical difficulties. We exteriorized a cholecystocolic fistula through an umbilical incision, whereby it was repaired safely and easily. This report describes our new technique for managing a cholecystocolic fistula found incidentally during a laparoscopic cholecystectomy.

Cholecystectomy, Laparoscopic↗

Influence of stent expansion states on platelet deposition in an extracorporeal porcine arteriovenous shunt model using a multichannel perfusion chamber.

Limited data are available about incomplete stent expansion (SE) on platelet deposition (PD). We examined PD following different SE using an extracorporeal porcine arteriovenous shunt model to which a perfusion chamber with four parallel silastic tubes were connected. Blood flow was set at a 20 and 100 mL/min in 1.8 and 3.1 mm diameter tubes, respectively. P154 stents were deployed completely (Group A, n=15) or incompletely (Group B, n=15) in 1.8 mm (n=13) and 3.1 mm (n=17) tubes. 51Cr-labelled platelet autologous blood was injected 1 hr before the perfusion. After 15 min-perfusion, the testing tubes were assessed for radioactivity counts. In-stent cross sectional area was measured by intravascular ultrasound. There was a significant difference in PD between group A and B regardless of channel size (118+/-18.4 vs 261.4+/-52.1 pits x 10(6)/cm2, p<0.05). With adjusted shear rate and similar stenosis, PD was similar in both tubes. In smaller 1.8 mm tubes, a stenosis as subtle as 10% was associated with a significant PD difference (226.1+/-20 vs 112.9+/-20.5 plts x 10(6)/cm2, p<0.005). This model enabled a repetitive, simultaneous comparison of PD following different SE states. It seems that the quality of SE remains crucial in smaller channels.

Animals↗

Selenium deficiency potentiates methamphetamine-induced nigral neuronal loss; comparison with MPTP model.

The present study was designed to understand the role of an antioxidant, selenium (Se) on methamphetamine (MA)-induced dopaminergic cell damage in the substantia nigra (SN). Male C57BL/6J mice were fed either selenium-deficient (<0.01 ppm Se) or selenium-replete (0.2 ppm Se) diet for 90 days. Se-deficiency potentiates MA-induced reductions of tyrosine hydroxylase-like immunoreactivity (TH-IR), dopamine (DA) and its metabolites, 3, 4-dihydroxyphenylacetic acid (DOPAC) and homovanilic acid (HVA) in the SN. These dopaminergic toxicities were comparable to that induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). By contrast, Se-repletion significantly blocked dopaminergic toxicity after MA treatments. These results suggest that Se-deficient MA-treated mouse is a relevant model of Parkinsonism, and that optimal level of Se plays a crucial role in preventing nigral dopaminergic toxicity induced by MA. However, different mechanisms in the thermoregulation mediated by MA or MPTP remain to be further determined.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

Optimal management of the axilla in patients with breast cancer.

BACKGROUND: Although most surgeons perform some form of axillary lymph node dissection (ALND) as part of locoregional management of operable breast cancer, the extent of dissection remains controversial. PATIENTS AND METHODS: Observation of the axilla trial (protocol I) and partial dissection trial (protocol I) began in January 1996. Between January 1996 and May 2000, 45 post-menopausal and 207 women with clinically node-negative breast cancer were enrolled into protocol I and protocol II respectively. RESULTS: The 4-year cumulative incidence rate of axillary recurrence was 7% in patients with untreated the axilla. The 4-year overall survival rate was 98% in patients with untreated the axilla. The 4-year disease-free and overall survival rates were 96% and 98% respectively in patients treated with partial dissection. CONCLUSION: Total axillary dissection seems to be unnecessary in Japanese breast cancer patients with relatively small tumors.

Adult↗

A proposal for the histopathological diagnosis of ductal carcinoma in situ of the breast.

BACKGROUND: As the incidence of ductal carcinoma in situ (DCIS) is increasing, it is necessary to make a guideline for the pathological examination and diagnosis of DCIS, by creating criteria based on clinical and biological aspects of the disease. METHOD: We collected biopsy specimens originally diagnosed as benign lesions, from patients who subsequently developed invasive carcinoma in the ipsilateral breast. The histology of the biopsy specimens was re-evaluated principally according to the 1995 Philadelphia Consensus on DCIS. Histopathological agreement on each biopsy specimen was made by the JBCS Study Group members under a multiviewer microscope. In the course of making conclusive agreements among the pathologists, we developed a consensus for the histopathological diagnosis of DCIS, especially non-comedo types. RESULTS: DCIS is defined as a carcinoma of ductal epithelial origin, without any evidence of stromal invasion. It is necessary to note the methods of pathologic examination required to diagnose DCIS. Stromal invasion is an important prognostic factor, and should be diagnosed with caution. Classification of proliferative ductal lesions as benign or malignant (DCIS), the subtype of DCIS (nuclear grade, architecture, and necrosis), and the histological grading of DCIS are proposed and recommended. CONCLUSION: Although we have made a new proposal according to current concepts, there are still several unresolved problems. Thus further examination and modification will be necessary in the future.

Breast Neoplasms↗

[Combination chemotherapy with vinorelbine and other cytotoxic agents for advanced breast cancer patients--a protocol of vinorelbine plus AC regimens used by the Japan Vinorelbin Study Group].

A new generation type of vinca alkaloid, vinorelbine (VNR), is a promising agent for the treatment of breast cancer patients. As a first line treatment for metastatic breast cancer, combination chemotherapy including anthracyclines plus VNR has demonstrated a high response rate and tolerability. In addition, other VNR containing regimens, such as 5-fluorouracil plus VNR, produced a 64% response rate. This evidence suggests VNR-containing combination chemotherapy may be a promising first-line treatment for breast cancer patients. In Japan, VNR is not registered, but a late phase II study has been completed. An approximately 30% response rate was obtained with its use as a monotherapy. In addition, a phase I/II study of combination VNR plus AC (adriamycin + cyclophosphamide) has been conducted. At the present time, the results are being analyzed.

Antineoplastic Agents, Phytogenic↗

[Male breast cancer].

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Antineoplastic Agents, Hormonal↗

[Efficacy of combination therapy for multiple liver metastases of colorectal cancer].

In our hospital, combination therapy, mainly intra-arterial infusion, is performed for multiple liver metastases of colorectal cancer. The median survival time of the combination group (n = 18), the hepatectomy only group (n = 3) and the best supportive care group (n = 7) were 21.7, 12.5 and 6.1 months, respectively. The prognosis of the combination group was significantly better than that in the other groups (p < 0.0001). Univariate analysis against the combination group revealed that serum CEA was a significant prognostic factor (p = 0.0196). Moreover, we divided the combination group into two groups on the basis of serum CEA either below or above 50 ng/ml. The prognosis of the low CEA group (n = 11), whose median survival time was 25.9 months, was significantly better than the high CEA group (n = 7), whose median survival time was 17.8 months (p = 0.0031). It therefore appears that combination therapy may be of no benefit when serum CEA is above 50 ng/ml.

Antimetabolites, Antineoplastic↗

A Retrospective Study of Breast Cancer Patients Treated with Quadrantectomy without Radiation Therapy.

BACKGROUND: Radiation therapy after breast-conserving surgery (BCS) reduces the risk of local recurrence. However, whether radiation therapy is necessary forall patients undergoing BCS remains unclear. METHODS: In order to determine the selection criteria for patients who can safely omit radiation therapy and to confirm the survival benefit of quadrantectomy without radiation therapy, we reviewed 107 patients who underwent quadrantectomy without radiation therapy between February 1988 and July 1995. RESULTS: The 5-year overall survival, disease-free survival and cumulative local recurrence rates were 93.7%, 80.7% and 12.1% respectively. There were no significant differences of 5-year overall survival (94.0% vs 94.1%) and disease-free survival rates (83.1% vs 70.0%) between patients with or without tamoxifen. The 5-year cumulative local recurrence rate of patients with tamoxifen, however, tended to be lower (p = 0.0810) than that of patients without tamoxifen. The 5-year cumulative local recurrence rate of the patients aged 45 or less was significantly higher than that of patients aged from 45 to 55 years and those over 55 (p= 0.0090 and 0.0089, respectively). In ER positive patients, the 5-year cumulative local recurrence rate of patients with tamoxifen tended to be lower (p= 0.0791) than that of patients without tamoxifen. CONCLUSION: The survival rate of quadrantectomy without radiation therapy wasacceptable. While the risk of local recurrence following quadrantectomy withoutradiation therapy is substantial, radiation therapy following quadrantectomy might not be necessary in elderly ER positive women receiving adjuvant tamoxifen therapy.

Journal Article↗