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Biomedical subjects

H Niikura

Publications and source records attributed to H Niikura.

At least 19 recordsLinked to original sources
PubMed2005

Intraoperative electrical stimulation of the pelvic splanchnic nerves during nerve-sparing radical hysterectomy.

OBJECTIVES: This study sought to determine whether intraoperative electrical stimulation (IES) of pelvic splanchnic nerves (PSNs) while monitoring bladder contraction was useful to predict postoperative bladder function during conventional nerve-sparing radical hysterectomy. METHODS: Seventeen patients with stage Ib or IIa cervical cancer underwent conventional radical hysterectomy. IES was performed in all cases, stimulating the roots of PSN, the posterior sheath of the vesicouterine ligament (PVL) and the dorsal area of the ligament. After resection of the uterus, the PSN roots were stimulated again. Bladder function was evaluated by urodynamic study (UDS) preoperatively and 3 months after surgery. RESULTS: The results of IES were consistent with bladder function evaluated by postoperative UDS. In 13 of 17 cases, an increased intravesical pressure was observed with IES of the PSN roots after uterus resection. Nine of 13 cases showed marked detrusor contraction with UDS 3 months after surgery and were able to void without using abdominal pressure except in one case. In the remaining 4 of 17 cases, no response could be detected to IES on either side. Three cases voided using abdominal pressure and one used clean intermittent self-catheterization without spontaneous voiding. CONCLUSIONS: IES while monitoring intravesical pressure during radical hysterectomy represents a technically simple and useful procedure for the prediction of postoperative bladder function.

Adenocarcinoma↗
PubMed2004

Expression of EBAG9/RCAS1 is associated with advanced disease in human epithelial ovarian cancer.

Oestrogen receptor-binding fragment associated gene 9, EBAG9, is an oestrogen-responsive gene that was identified in MCF-7 human breast carcinoma cell line. It is identical to RCAS 1, a cancer cell surface antigen possibly involved in immune escape. In the present study, we examined the expression of EBAG9/RCAS1 in human epithelial ovarian cancer using immunohistochemistry, immunoblotting and reverse transcription-polymerase chain reaction (RT-PCR). A total of 90 epithelial ovarian cancer cases were examined immunohistochemically by means of the antibodies for EBAG9 and ERalpha. The correlation between EBAG9 immunoreactivity and clinicopathological parameters was examined. mRNA expression of EBAG9 and ERalpha were evaluated by RT-PCR in 22 cases. The expression for EBAG9 and ERalpha was examined by immunoblotting in 12 ovarian cancer cell lines. EBAG9 immunoreactivity was detected in the surface and cytoplasm of carcinoma cells in 46 out of 90 cases (51.1%). EBAG9 expression was significantly higher in serous histology (P=0.0402) and advanced disease (P=0.0206). No significant relationship was detected between EBAG9 immunoreactivity and overall survival (P=0.689). There was a highly significant correlation between EBAG9 and ER immunoreactivity (P<0.0001). The EBAG9 mRNA was detected in 20 out of 22 cases. In all of the cases that were positive for ERalpha mRNA, they were also positive for EBAG9 mRNA. Immunoreactive band corresponding to EBAG9 was detected in 11 out of 12 of ovarian cancer cell lines, and was consistent with ERalpha expression. In conclusion, the wide distribution of EBAG9 and its relation to advanced disease suggest that this protein may play important roles in epithelial ovarian cancer.

Antigens, Neoplasm↗
PubMed2001

[Autoimmune hemolytic anemia].

Autoimmune hemolytic anemia (AIHA) is subclassified according to the character of the autoantibodies, however, its clinical pictures are highly heterogenous even in a given subclass. In this article, we reviewed pathogenesis, clinical and laboratory characteristics of AIHA, exemplifying data of 26 patients with autoimmune hemolysis with warm-type autoantibodies (13 AIHA, 10 Evans' syndrome, 3 systemic lupus erythematosus), and recent advances in this field. White blood cell and platelet counts varied among patients at presentation. Six of 13 AIHA patients had low reticulocyte production index (RPI) indicative of inappropriate reticulocyte response with considerable erythroblasts in the bone marrow, suggesting that ineffective erythropoiesis contributes the pathogenesis of warm-type AIHA. Ten patients were judged to require red cell transfusion. Their RPI did not differ from that of patients who did not require transfusion, indicating that the degree of hemolysis is the major determinant of the severity of the disease. No significant side effects of transfusion were observed.

Anemia, Hemolytic, Autoimmune↗
PubMed1999

Transition of polycythemia vera to chronic neutrophilic leukemia.

Two cases of polycythemia vera (PV) had transition to a hematological condition compatible with chronic neutrophilic leukemia (CNL) 17 and 8 years after diagnosis, respectively. One patient was treated with carboquone followed by hydroxyurea (HU) and the other with HU during PV phase. On transition, both had neutrophilia with white blood cell count above 40,000/microl, elevated neutrophil alkaline phosphatase activity, splenomegaly, normal karyotype without bcr-abl rearrangement. Busulfan was temporally effective in controlling the neutrophil count. However, one patient progressed to the so-called spent phase and the other subsequently had multiple transitions between PV and CNL. These cases may represent a form of uncommon evolution of PV and support the contention that CNL is a type of myeloproliferative disorder and that at least some CNL cases have derangement at the hematopoietic stem cell level.

Busulfan↗
PubMed1998

Laser-induced fluorescence excitation spectroscopy of N(2)(+) produced by VUV photoionization of N(2) and N(2)O.

Synchrotron radiation emitted from the UVSOR storage ring is monochromated by a grazing-incidence monochromator and introduced coaxially with the second harmonic of a mode-locked Ti:sapphire laser. Sample gases, N(2) and N(2)O, are photoionized into vibronically ground N(2)(+) with the fundamental light of the undulator radiation at 18.0 and 18.6 eV, respectively. Laser-induced fluorescence (LIF) excitation spectra of N(2)(+) from N(2) and N(2)O are measured in the laser wavelength region of the (B (2)Sigma(u)(+), v' = 0) <-- (X (2)Sigma(g)(+), v" = 0) transition at 389-392 nm. The LIF excitation spectra of N(2)(+) exhibit two maxima due to the P and R branches in which rotational bands are heavily overlapped. The rotational temperature is determined by simulating an LIF excitation spectrum by using the theoretical intensity distribution of rotation bands convoluted with the spectral width of the laser.

Journal Article↗
PubMed1998

Disseminated intravascular coagulation in acute lymphoblastic leukemia at presentation and in early phase of remission induction therapy.

A high frequency of disseminated intravascular coagulation (DIC) in adult acute lymphoblastic leukemia (ALL) has been reported; however, its clinical relevance and characteristics have not been fully determined. We studied 67 adults with newly diagnosed ALL between 1982 and 1996 to clarify these questions. DIC was diagnosed in ten of 64 patients (16%) who underwent coagulation study at presentation and in 14 of 40 patients (35%) screened for DIC within 7 days after starting remission induction therapy. Overall, 24 of 67 patients (36%) had DIC during this period. Hemorrhagic symptoms were generally mild, while two patients required red blood cell transfusions. Patients who developed DIC had higher white blood cell counts and more frequently a palpable spleen than those who did not. There was no difference in age, French-American-British subtype, karyotype, immunophenotype, lactate dehydrogenase level, percentage of blasts in bone marrow, or frequency of lymphadenopathy or hepatomegaly between patients who had DIC and those who did not. Fibrinolysis tended to be milder in DIC complicating ALL than in that complicating acute promyelocytic leukemia; however, there was no difference in other coagulation parameters between these two subtypes. An etiological link between CD34 expression in common ALL patients and DIC was suggested.

Adolescent↗
PubMed1998

Immunoblastic lymphadenopathy-like T cell lymphoma evolving into a massive plasma cell proliferation with biclonal paraproteinemia.

We present a case of immunoblastic lymphadenopathy-like T cell lymphoma (IBL-T) who subsequently developed a massive proliferation of plasma cells. At diagnosis of IBL-T, the patient had polyclonal hypergammaglobulinemia and subsequently, while on chemotherapy, developed paraproteinemia with biclonal peaks and the IBL-T lesion was replaced with a massive proliferation of CD38-positive plasma cells. The evolution was not likely to be attributed to a new neoplastic proliferation of B cells. It appeared that two B cell clones possibly had a growth advantage among the polyclonal B cells due to a depletion of suppressor T cells or to a disturbance in the immune system.

ADP-ribosyl Cyclase↗
PubMed1997

Coagulation patterns of disseminated intravascular coagulation in acute promyelocytic leukemia.

Coagulation patterns of 19 newly-diagnosed acute promyelocytic leukemia (APL) patients with disseminated intravascular coagulation (DIC) at presentation were studied. Seventeen patients had hemorrhagic complications, of which four were fatal. Fatal hemorrhages were related with lower fibrinogen level and lower platelet count. DIC of the APL patients without infection was characterized by low fibrinogen and normal antithrombin III (ATIII) level. Thrombin-ATIII complex level was elevated in all patients examined. Patients with infection had higher fibrinogen levels than those without infection and some patients had reduced ATIII level. Ten remission inductions were tried with multidrug chemotherapy and seven with all-trans retinoic acid (ATRA). Complete remission was achieved in seven of ten inductions with chemotherapy and in all seven inductions with ATRA. Two patients treated with chemotherapy had fatal hemorrhage after starting therapy but none treated with ATRA.

Adolescent↗
PubMed1997

Expression of epidermal growth factor-related proteins and epidermal growth factor receptor in common epithelial ovarian tumors.

The biologic significance of epidermal growth factor (EGF)-related proteins and EGF receptor (EGFR) in the development and progression of human ovarian carcinoma was studied in 7 ovarian cystadenomas, 6 mucinous tumors of low malignant potential (LMP), and 25 invasive adenocarcinomas by immunohistochemistry. Results were correlated with clinicopathologic features. We also examined immunoreactivity in five serous adenocarcinomas both before and after cisplatin chemotherapy. Amphiregulin (AR) expression was observed only in mucinous tumors (4 of 8 cystadenomas, 2 of 6 tumors of LMP, and 6 of 10 cystadenocarcinomas), but was not detected in the serous tumors or clear cell adenocarcinomas. EGF, cripto, and EGFR expression was significantly higher in mucinous cystadenocarcinomas than in mucinous cystadenomas or mucinous tumors of LMP. Three of five specimens obtained at a second operation after chemotherapy had more intense or diffuse immunostaining for transforming growth factor alpha (TGF-alpha) than the initial specimens did. Coexpression of more than two of the EGF-related proteins or EGFR significantly correlated with increased surgical stage in serous and clear cell carcinoma. AR expression seems to correlate with mucinous differentiation rather than with advanced stages of ovarian tumors. Our results indicate that expression of some EGF-related proteins is greater in certain subtypes of ovarian carcinomas than in their benign counterparts and that coexpression of these proteins is associated with advanced stage in serous and clear cell carcinoma. Increased TGF-alpha expression may also be related to ovarian tumor resistance to cisplatin chemotherapy.

Adenocarcinoma↗
PubMed1997

Case report: primary hepatic lymphoma associated with chronic liver disease.

We report on a case of primary hepatic lymphoma that developed in a patient with chronic hepatitis C. Given that Japan is an area endemic for both hepatitis B and C viruses, we reviewed 51 Japanese cases of primary hepatic lymphoma, addressing the question as to whether the Japanese cases have unique characteristics and whether there is a causal relationship to the presence of chronic liver disease. Primary hepatic lymphoma most commonly affected middle-aged males. Presenting symptoms and physical findings were non-specific. Aminotransferases tended to stay in the low range compared with marked increases in lactate dehydrogenase. Sixteen patients (31%) had chronic liver disease, eight had liver cirrhosis and eight had chronic hepatitis, suggesting that there is a possible aetiological link between chronic liver disease and primary hepatic lymphoma.

Adult↗
PubMed1997

[All-trans retinoic acid-induced myelomonocytoid differentiation in acute promyelocytic leukemia].

A 30-year-old man with a diagnosis of acute promyelocytic leukemia (APL) was admitted. Laboratory findings were as follows: WBC 32,900/microliter with 88% promyelocytes, Hb 10.4 g/dl, platelets 2.6 x 10(4)/microliter. Coagulation tests revealed DIC. Bone marrow was hypercellular with 91.8% promyelocytes which were strongly positive for peroxidase and positive for alpha-naphthyl butyrate esterase. Cytogenetic study revealed 46, XY, t(15;17) (q22:q11). He was treated with all-trans retinoic acid (ATRA) along with hydroxyurea (HU) and low-molecular weight heparin (LMH). Because his WBC increased to 93,700/microliter on day 6 of ATRA therapy, DCMP chemotherapy was given, while ATRA was withheld. He developed enterocolitis due to myelosuppression. ATRA was restarted along with granulocyte-colony stimulating factor (G-CSF). His WBC rose to 10,400/microliter with a marked, but temporary predominance of myelomonocytes both in peripheral blood and in bone marrow. These myelomonocytoid cells were positive for specific and nonspecific esterase double stainings. Then he entered complete remission. It was of interest that myelomonocytoid differentiation of APL cells was induced by ATRA. The etiology was discussed.

Adult↗
PubMed1997

[Blast crisis accompanied by severe DIC of Ph negative chronic myeloid leukemia showing t(9;16) and positive M-BCR/ABL rearrangement].

A 66-year-old woman complained of chest discomfort in January 1995. In March the accelerated phase of chronic myeloid leukemia (CML) was diagnosed. Chromosomal analysis demonstrated negative Ph and positive t(9;16) (q34;p11) with positive major BCR/ABL chimeric mRNA. Administration of hydroxycarbamide was initiated, but in May she developed high fever and severe left hypochondralgia. Her WBC was 62,100/microliter (blast 64%), and LDH was 3,590 IU/l. Bone marrow examination showed 78.6% blasts, with a nucleated cell count of 74 x 10(3)/microliter. Blasts were negative for esterase stain and partially positive for both peroxidase stain and PAS reaction. Surface marker analysis revealed that blasts were positive for CD13, CD19, CD33, CD34, and HLA-DR. A diagnosis of blast crisis was made and she was treated with the VDS-CP regimen with heparin for DIC. After temporary improvement her disease recurred rapidly with severe DIC. Treatment with low molecular weight heparin and fresh frozen plasma failed to control DIC and she died of subarachnoid hemorrhage on the 48th hospital day. This is the first veprted of case Ph-negative, M-BCR/ABL-positive CML with t(9;16) accompanied by severe DIC.

Aged↗
PubMed1996

Expression of epidermal growth factor family proteins and epidermal growth factor receptor in human endometrium.

The biological significance of epidermal growth factor (EGF)-related proteins in the development and progression of endometrioid endometrial carcinoma was studied. Expression of EGF-related proteins including EGF, transforming growth factor-alpha (TGF-alpha), cripto (CR), amphiregulin (AR), and EGF receptor (EGFR) were immunohistochemically examined. Results were then correlated with clinicopathologic findings and steroid receptor status in 12 specimens with normal endometrium, 13 with endometrial hyperplasia, and 40 with endometrioid endometrial carcinoma. EGFR, EGF, TGF-alpha, and CR immunoreactivities were observed in 58.3%, 66.7%, 91.6%, and 66.7% of normal endometrial specimens; 100%, 15.4%, 100%, and 30.8% of endometrial hyperplasia specimens; and 67.5%, 32.5%, 65.0%, and 65.0% of endometrial carcinoma specimens, respectively. AR immunoreactivity was not observed in any of the normal, hyperplastic, or neoplastic endometrium. The presence or absence of EGFR or TGF-alpha in endometrial carcinoma correlated with surgical stage, depth of myometrial invasion, and findings from peritoneal washing cytology. EGF expression significantly correlated with the age of the patients and that of CR with surgical stage and peritoneal washing cytological findings. There was a significant correlation between EGFR and TGF-alpha expression, and between EGF and TGF-alpha. Co-expression of EGFR and TGF-alpha, EGFR and CR, and TGF-alpha and CR in carcinoma specimens significantly correlated with advanced surgical stage, deeper myometrial invasion, and positive peritoneal washing cytology. In normal as well as hyperplastic endometrium, endometrial glands immunohistochemically positive for TGF-alpha were generally positive for ER, but in poorly differentiated endometrial carcinoma, cells positive for TGF-alpha tended to be negative for ER. The results of the present study show that among EGF-related proteins, expression of TGF-alpha and CR seem to be associated with the progression of human endometrioid endometrial carcinoma. Additionally, expression of TGF-alpha became increasingly estrogen independent with increasing histological carcinoma grades.

Adult↗
PubMed1996

Hypocomplementemia and hematological abnormalities in immunoblastic lymphadenopathy and immunoblastic lymphadenopathy-like T cell lymphoma.

Serum complement levels and hematological data were evaluated in five patients with immunoblastic lymphadenopathy (IBL) and four with IBL-like T cell lymphoma (IBL-T). Anemia with Hb values below 10.0 g/dl was seen in four patients. A direct Coombs test was positive in five patients and the bone marrow of two of these showed features of pure red cell aplasia. Seven patients were thrombocytopenic with platelet counts below 100 x 10(9)/l. Six of the seven patients had splenomegaly. Platelet-associated IgG was elevated in all three thrombocytopenic patients examined. Whole complement activity (CH50) was reduced in eight patients (89%) at presentation and subsequently normalized in five who were treated either with prednisolone (two patients with IBL) or with multidrug combination chemotherapy (three with IBL-T). One patient achieved complete remission and four partial remission. Remission was accompanied by normalization of hematological abnormalities and elevation of complement activity to the normal range in all cases. These results suggested that complement-mediated mechanisms are responsible, at least in part, for some of the hematological abnormalities observed in IBL and IBL-T and that hypocomplementemia is a common abnormality with significance as a laboratory marker for the disease activity.

Aged↗
PubMed1996

Prognostic implications in myelodysplastic syndromes: A review of 62 cases.

We retrospectively reviewed 62 MDS patients (15 RA, 3 RARS, 10 CMML, 20 RAEB, 14 RAEBT) to clarify the current problems in their management. Median survival of RA and RARS patients was 67.9 months and significantly longer than that of CMML, RAEB, or RAEB-T patients with median survivals of 16.1, 16.8, and 9.5 months, respectively. Karyotypic abnormalities were observed in 58% of the patients examined. Forty-two patients died, 16 (38%) of leukemic transformation and 21(50%) of bone marrow failure. While most of the RAEB-T patients of all ages and all the RAEB patients diagnosed below 60 years of age died of transformation, 70% of the older RAEB patients died of infection. Prognosis after transformation was poor and 12 patients died within two months. These results indicate that management after transformation and treatment against infection in RAEB patients with advanced age are crucial to improve the prognosis in MDS.

Adult↗
PubMed1996

17 beta-hydroxysteroid dehydrogenase in common epithelial ovarian tumors.

Type 1 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) is an estrogen-metabolizing enzyme that catalyzes the conversion of estrone to the more biologically potent estradiol. We examined the immunolocalization of 17 beta-HSD in five specimens of normal human ovary and in 51 specimens of common epithelial tumors of the ovary to study the expression of 17 beta-HSD in these ovarian neoplasms. 17 beta-HSD immunoreactivity was detected in granulosa cells of dominant preantral follicles but not in the surface epithelium of the normal cycling human ovary. In 12 patients, the enzyme was not expressed in tumor cells of benign cystadenoma. 17 beta-HSD was immunolocalized in the cytoplasm of four specimens (50%) of eight of tumors of low malignant potential and in 20 specimens (67%) of 30 of invasive carcinoma. 17 beta-HSD immunoreactivity was also observed in nonluteinized stromal cells of mucinous tumors (two adenomas of six, three tumors of five with low malignant potential, and two of 10 invasive carcinomas) but not in other histologic types. Type 1 17 beta-HSD expression, therefore, correlated with malignant transformation of the surface epithelium of the human ovary, supporting a possible role in its progression by increasing in situ estradiol concentration.

17-Hydroxysteroid Dehydrogenases↗