Biomedical subjects
H Andoh
Publications and source records attributed to H Andoh.
Palliative treatment with metallic stents for unresectable gallbladder carcinoma involving the portal vein and bile duct.
We report a case of gallbladder carcinoma associated with biliary obstruction and portal vein stenosis caused by massive lymph node metastases. The patient, a 59-year-old woman, was treated with self-expandable metallic stents--a spiral Z-stent in the portal vein, and a Wallstent in the bile duct--and intra-arterial infusion chemotherapy. She returned to work immediately after leaving the hospital, and has been treated with intra-arterial infusion chemotherapy once a week at our outpatient department. At present, she has good quality of life, with patency of both endoprostheses, 8 months after the placement of the metallic stents in the portal vein and the common bile duct. This case shows that portal vein and biliary stenting, together with intra-arterial infusion chemotherapy, can be an effective modality for the palliative treatment of advanced gallbladder carcinoma involving the portal vein and bile duct, to improve quality of life.
Laparoscopy-assisted Ruge procedure for the creation of a neovagina in a patient with Mayer-Rokitansky-Küster-Hauser syndrome.
OBJECTIVE: To describe the successful use of a laparoscopy-assisted Ruge procedure for the reconstruction of a vagina in a patient with Mayer-Rokitansky-Küster-Hauser syndrome. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 19-year-old Japanese woman with Mayer-Rokitansky-Küster-Hauser syndrome. INTERVENTION(S): Creation of a neovagina by a laparoscopy-assisted Ruge technique. MAIN OUTCOME MEASURE(S): Clinical examinations were performed during the follow-up period. The depth and diameter of the neovagina were measured by vaginography. Patient satisfaction also was determined. RESULT(S): The neovagina was 12 cm in length and 4 cm in diameter. The mucosa of the neovagina was pinkish and had a moist surface. No intraoperative or postoperative complications were observed. CONCLUSION(S): The use of an isolated segment of the sigmoid colon for vaginal construction has the advantages of providing a sufficient length of neovagina and not requiring immediate postoperative self-dilatation. We believe that our procedure has various advantages in addition to those of the original Ruge method, including its minimally invasive nature and excellent cosmetic results. Further, a laparoscopy-assisted operation allows for the diagnosis of uterine defects and the creation of a neovagina at the same time.
Diagnostic utility of CSF soluble CD27 for primary central nervous system lymphoma in immunocompetent patients.
The aim of this study is to determine the diagnostic utility of cerebrospinal fluid (CSF) soluble CD27 (sCD27) as a tumor marker for primary central nervous system lymphoma (PCNSL) in immunocompetent patients. A total of 93 CSF samples were collected from the following four patient groups: the PCNSL group, 13 patients (26 samples) with PCNSL, 12 samples obtained at initial diagnosis, 10 during therapy, four at complete remission; the other brain tumors (OBT) group, 30 patients (30 samples) with other brain tumors; the other neurological diseases (OND) group, 25 (25 samples) with other neurological diseases; the inflammatory neurological diseases (IND) group, 12 patients (12 samples) with inflammatory neurological diseases. sCD27 levels were determined by sandwich enzyme-linked immunosorbent assay. The optimal cut-off value was found to be 15 U ml-1. The CSF sCD27 levels were over 15 U ml-1 in 23 of the 26 PCNSL samples and were significantly higher than those in the OBT and OND groups in which all samples were below 15 U ml-1. Elevated CSF sCD27 levels were also observed in 11 of 12 IND samples. In the two PCNSL patients whose CSF sCD27 levels were studied longitudinally, the sCD27 levels correlated very well with remission and relapse of the disease. CSF sCD27 is useful as a tumor marker for PCNSL in immunocompetent patients, and is also useful to evaluate the effect of various types of treatment. Although there was a large cross-reactivity in the CSF sCD27 levels between PCNSL and IND group, white blood cell count in the CSF is helpful to distinguish these two diseases.
A case of extrahepatic portosystemic shunt without portal hypertension treated by laparoscopically assisted embolization.
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Permissible arterial occlusion time in aneurysm surgery: postoperative hyperperfusion caused by temporary clipping.
The relationship between hyperperfusion and temporary clipping was evaluated to determine the safe limit for the duration of temporary clipping in aneurysm surgery. Twenty-one patients surgically treated for a ruptured aneurysm were examined using xenon-enhanced computed tomography on postoperative days 4 to 13. Eight of the 16 patients undergoing temporary clipping had focal hyperperfusion; whereas the five patients without temporary clipping had no hyperperfusion. Mean total temporary clipping time in patients with hyperperfusion was significantly longer than that in patients without (31.9 vs. 13.9 minutes, p = 0.0157) and mean maximum single temporary clipping time in patients with hyperperfusion was also significantly longer than in patients without (18.4 vs. 8.6 minutes, p = 0.0313). Moreover, cerebral infarction was related to hyperperfusion (p = 0.0027). These results support the hypothesis that temporary clipping during aneurysm surgery causes postoperative hyperperfusion and cerebral infarction. Temporary clipping may be harmful when performed for more than 20 minutes of total duration, since postoperative hyperperfusion was seen under this condition.
Minimally invasive needlescopic cholecystectomy.
We utilized a mini-sized grasper and retractor measuring 2.5 mm in diameter and a new mini-sized laparoscope measuring 3 mm in diameter to perform a laparoscopic cholecystectomy. A 10/12-mm trocar was inserted as the first trocar for the laparoscope and specimen extraction. Under a direct laparoscopic view, the mini-sized grasper and retractor were inserted and the laparoscopic procedures were performed mainly through the 5-mm trocar placed on the left upper quadrant as the working port. These procedures were successfully performed on five patients with a comparable operation time to that of a conventional laparoscopic cholecystectomy, but appeared to be more minimally invasive.
p53 tumor suppressor gene in acoustic neuromas.
Alterations of the p53 tumor suppressor gene in 21 cases with acoustic neuroma were investigated by polymerase chain reaction-restriction fragment polymorphism (PCR-RFLP) and single strand conformation polymorphism (PCR-SSCP). Neither mutation nor deletion was found. In 13 informative cases, no loss of heterozygosity (LOH) was confirmed. Thus our results further substantiate the scant contribution of p53 gene tumorigenesis and cell proliferation to acoustic neuromas.
[A survey on research ethics committee in Japanese baccalaureate programs in nursing].
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[Ethical problems in nursing: recognition and professional conduct, as a nurse, regarding HIV infection of patients due to blood products].
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Detection of circulating anti-p53 antibodies in patients with colorectal carcinoma and the antibody's relation to clinical factors.
PURPOSE: Mutation of the p53 tumor suppressor gene is the most common genetic alternation in colorectal carcinoma and is assessed mainly by molecular analysis of the gene sequence or by immunohistochemical analysis of p53 protein accumulation. Purpose of this study was to detect circulating antibody against p53 proteins in serum of patients with colorectal carcinoma and to evaluate its clinical significance. METHODS: We used immunoblotting techniques to detect circulating anti-p53 antibodies. Relationship among staging, immunohistochemical expression of p53 in the primary tumor, and serum carcinoembryonic antigen level was investigated. RESULTS: Circulating anti-p53 antibodies were detected in 32 (68 percent) of 47 patients. Antibody was found in patients at all clinical stages of disease. In 33 patients whose sera and primary tumor tissues were available for testing, 16 (48 percent) were positive for both circulating anti-p53 antibody and p53 expression in the tumor. The anti-p53 antibody test was positive in 78 and 56 percent of patients with high and normal serum carcinoembryonic antigen levels, respectively. CONCLUSION: Detection of anti-p53 antibodies may become a new diagnostic indicator of colorectal carcinomas.
Mammalian 60-kDa stress protein (chaperonin homolog). Identification, biochemical properties, and localization.
Mammalian chaperonin homolog (HSP60) was purified from porcine livers cytosol using a tandem ATP-Sepharose column and Mono Q column chromatography. A partial amino acid sequence (96 amino acid residues) of this protein was determined and coincided with those of human HSP60 with 96.9% homology, which was deduced from the nucleotide sequence of the cDNA. The sequence of the NH2 termini of the purified protein (5 amino acid residues) coincided with the signal sequence of HSP60. These facts led to the identification of the 60-kDa liver protein with the chaperonin homolog. Dihydrofolate reductase was able to form a stable complex with the liver chaperonin homolog. The liver chaperonin homolog was detected by at least five spots around pI = 5.6 on two-dimensional gel electrophoresis. Immunoblotting studies using an antibody against chaperonin homolog showed that the chaperonin homolog was localized in the cytosol, mitochondrial, and nuclear fractions of porcine liver. The chaperonin homolog was localized both in the mitochondria and cytoplasm of rat kidneys at the electron microscopic level. The chaperonin homolog in the cytosol, but not in the other subcellular fractions, was cross-reacted with an antibody against the synthetic peptide corresponding to the signal peptide of HSP60 as well as the purified chaperonin homolog on immunoblotting. These results suggested that the functional chaperonin homolog in the cytosol may be transported into the mitochondria and the protein may be processed to mitochondrial HSP60 in the organella.
Heterotransplantation of human parathyroid glands into nude mice.
Heterotransplantation of human parathyroid tissues into nude mice was performed to investigate the characteristics of grafted tissues. Grafts prepared from hyperplasia, adenoma and normal glands which were resected at operation were implanted in the gluteus muscle of the recipient mice (female, KSNnu/nu strain). Graft function was evaluated by measuring human intact PTH concentrations in sera of the mice. Serum PTH concentrations 12 weeks after transplantation were correlated with the tissue volume in the mice which received one, two, four or eight pieces of 1 mm3 hyperplastic tissues. Changes in graft function were examined in the mice which received four grafts prepared from hyperplasia, adenoma or normal glands. Transplantation of parathyroid tissues resulted in an increase in PTH concentrations for 4 weeks, reaching a plateau thereafter. The level remained unchanged for 8 weeks. Serum PTH levels in the mice with grafts prepared from hyperplasia or adenoma were significantly higher than in those with grafts from normal glands, though without a significant difference between the mice with grafts from adenoma and from hyperplasia. Serum calcium levels were similar in all three groups. We also observed the response of grafted parathyroid tissue to a low calcium level in sera: there was higher PTH secretion four weeks after the administration of the low calcium diet. The success of heterotransplantation was histologically proven by the presence of grafts which were not atrophic in the muscle 12 weeks after transplantation. Nucleoli were found more frequently, and nuclear pleomorphism was observed in the cells of heterografts.
Effect of the combination of hyperthermia and irradiation on human colon cancer cells.
The combination of hyperthermia and radiation is considered to have a synergistic effect on mammalian cells, which depends on temperature and duration of time of the hyperthermia and on the sequence in which the modalities are given. The response of cultured colon cancer cells to hyperthermia and ionizing radiation was evaluated using the flow cytometry method by measuring DNA damage. The enhanced DNA damage after combined treatment with hyperthermia and irradiation was recognized after both sequences: heat followed by radiation as well as radiation followed by heat. The results demonstrated that the sequence of radiation plus heat produced more DNA damage on colon cancer cells than did the reverse order. The clinical application of these results is discussed.
Diffuse cerebral air embolism following trauma: striking postmortem CT findings.
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Heat shock protein 70 in rat liver with necrosis and regeneration induced by thioacetamide.
Heat shock protein (hsp), which changes both its concentration and localization in reaction to stresses such as heating, ischemia, etc., is thought to protect protein structure and act as a chaperone in intracellular transportation. We examined one of the hsps, hsp 70, in rat liver with necrosis and regeneration produced by thioacetamide (TAA). Hsp 70 was determined by immunoblotting and detected histologically by immunostaining, using a specific antibody. Generally, hsp 70 moves from the cytosol to the nucleus, where it concentrates 15 min after TAA injection. After 15 min, hsp 70 was not detected in the nuclei of hepatocytes around the central vein, where the hepatocytes later became necrotic. However, hsp 70 immunostaining was increasingly strong in the nuclei of hepatocytes around the portal area, which did not become necrotic. These findings show that, in acute necrosis, hsp 70 seems to correlate with nuclear protection or with the transportation of some protein from the cytosol to the nucleus. Hepatocytes probably neither survive nor regenerate without hsp 70 in their nuclei.
Our technique of parathyroid autotransplantation in operation for papillary thyroid carcinoma.
BACKGROUND: For papillary thyroid carcinoma, we have used our standard operative method consisting of total thyroidectomy, bilateral lymph node dissection, and parathyroid autotransplantation. Our special parathyroid transplantation method involves transplantation of the minced glands into the pectoralis major muscle. We investigated whether this method is useful for preserving parathyroid function. METHODS: In 17 patients who underwent our standard operation for papillary thyroid carcinoma, the intact parathyroid hormone (PTH) and serum calcium levels were determined for 4 weeks after the operation. RESULTS: In all cases the intact PTH levels fell below detectable limits immediately after operation and then recovered to the preoperative level about 2 weeks after the operation. The same recovery patterns were observed in two groups undergoing transplantation of two glands and three or four glands. CONCLUSIONS: These recovery patterns of intact PTH levels seem to indicate that the glands were grafted successfully and recovered their function. Our method is thought to be useful for preserving parathyroid function after surgery.
Preparative high-yield electroelution of proteins after separation by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and its application to analysis of amino acid sequences and to raise antibodies.
A method for the preparative high-yield electroelution of proteins from sodium dodecyl sulphate (SDS) polyacrylamide gel strips was established. The method consisted of SDS-polyacrylamide gel electrophoresis, detection of proteins with sodium acetate and electrophoretic elution at 200 V for 3 h by utilizing a horizontal flat-bed gel electrophoresis apparatus. Standard proteins with molecular masses of 14-66 kilodalton (cytochrome c, aldolase, ovalbumin and bovine serum albumin) were recovered with an average yield of 73.6 +/- 2.3%. A membrane-bound protein, rat skeletal muscle Ca(2+)-ATPase (100 kilodalton) was also well recovered (over 60%). This method was applicable to the purification of proteins required for N-terminal amino acid sequencing and to raise antibodies.