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Biomedical subjects

Hidenori Tanaka

Publications and source records attributed to Hidenori Tanaka.

At least 19 recordsLinked to original sources
PubMed2025

KRAS Mutations in Duodenal Lavage Fluid After Secretin Stimulation for Detection of Pancreatic Cancer.

OBJECTIVE: Although pancreatic ductal adenocarcinoma (PDAC) is still a devastating disease, the survival rate for surgically removed PDACs has significantly improved in recent years. Early detection is essential in managing PDAC. BACKGROUND: The presence of KRAS mutations in PDAC leads to the initial genetic abnormality and offers a significant timeframe for identifying resectable PDACs. A minimally invasive and highly specific PDAC screening test is necessary to prevent the need for invasive follow-up tests. METHODS: Between July 2021 and March 2023, 169 cases were enrolled in 7 institutions. By administering secretin before esophagogastroduodenoscopy (EGD), the excretion of pancreatic juice into the papillary fluid can be stimulated, creating a resource for testing. Washing fluid was collected using a specialized catheter from control individuals (n=75) and patients with resectable PDAC (n=89) at the initial diagnosis. A highly sensitive technique was employed to study KRAS gene mutations. RESULTS: This study obtained an AUC of 0.934 (95% CI: 0.904, 0.964) when using KRAS mutations in duodenal lavage fluid to differentiate between patients with resectable PDAC and healthy controls. The estimated sensitivities were calculated with specificity set at 100%, resulting in a sensitivity of 83.1% (95% CI: 71.7%, 91.2%). The McNemer test showed a significantly higher sensitivity for KRAS mutations than serum CEA and CA19-9 ( P <0.0001). CONCLUSIONS: We created a method to identify resectable PDACs by analyzing KRAS mutation levels in duodenal fluid collected during EGD with secretin stimulation of pancreatic juice secretion.

Humans↗
PubMed2007

Arias-Stella reaction in an adenomyomatous polyp of the uterus.

We describe a rare case of an Arias-Stella reaction in an adenomyomatous polyp of the endometrium found in the first trimester of pregnancy. A 33-year-old Japanese woman, gravida 1, para 1, presented for an initial prenatal examination at 6-week gestation; ultrasound revealed a myoma-like solid mass in the cervical canal. An abnormal Papanicolaou's smear (highly suspicious of adenocarcinoma) prompted the resection of this pedunculated polyp. Histologically, the musculature located in the center of the polyp was covered by the endometrium; numerous glands within both the endometrium and the musculature exhibited an Arias-Stella reaction. This explains the result of Papanicolaou's smear, because subsequent smears - both intrapartum and postpartum - were negative. To our knowledge, this is the first reported incident of an Arias-Stella reaction in an adenomyomatous polyp. This could be one of the diagnostic pitfalls in Papanicolaou's smears taken during pregnancy.

Adenocarcinoma↗
PubMed2006

Can we omit para-aorta lymph node dissection in endometrial cancer?

BACKGROUND: Patients with endometrial cancer can present with various complicating illnesses, including obesity, diabetes mellitus, hypertension and advanced aging. These patients are at high risk of severe post-operative complications. Thus, the question of whether or not to perform systemic pelvic and para-aortic lymphadenectomy remains controversial for all patients. It is reported that external iliac lymph nodes are the most commonly involved lymph nodes in endometrial cancer, and para-aortic lymph node (PAN) metastases spread via a route shared by the common iliac lymph nodes. The aim of this study was to evaluate the potential efficacy of omitting PAN dissection when metastasis of the common iliac and external iliac lymph nodes is negative. METHODS: Between January 1994 and June 2004, a total of 101 patients at Akita University Hospital who had undergone total hysterectomy and bilateral salpingo-oophorectomy, total pelvic lymphadenectomy and para-aortic lymphadenectomy to the level of the renal vein for endometrial cancer were enrolled in this study. RESULTS: Eleven patients in all were found to have metastasis for PANs. Among 13 patients with common and/or external iliac positive lymph nodes, 10 showed PAN metastasis. Of the 88 patients with negative lymph nodes, 87 showed no PAN metastasis. Based on these data, common and/or external iliac lymph nodes had 90.9% sensitivity (10/11) and 96.7% specificity (87/90) for detecting PAN metastasis. CONCLUSION: Para-aortic lymphadenectomy might be avoided by the negativity of such lymph nodes, thereby minimizing post-operative complications.

Adenocarcinoma, Clear Cell↗
PubMed2006

Single case of renal cell carcinoma and endocrine pancreatic head cancer occurring with von Hippel-Lindau disease.

Von Hippel-Lindau (VHL) disease is an autosomal dominant genetic disease in which various neoplastic lesions occur in multiple organs. Reported here is a case of VHL disease with concurrent renal cell carcinoma and endocrine pancreatic cancer. The patient was a 43-year old woman. On this occasion, the patient had sought treatment from her local physician, complaining chiefly of yellowing of the skin and bulbar conjunctiva. Abdominal ultrasound and computed tomography scans revealed a mass in the right kidney and a mass in the pancreatic head. Peripheral blood genetic analysis revealed an Arg/stop heteroconjugative mutation in codon 113 in exon 1 of the VHL gene on the short arm of chromosome 3 (p25-26). After various tests were performed, the patient was diagnosed with right renal cell carcinoma, malignant tumor of the pancreatic head, and multiple pancreatic cysts accompanying von Hippel-Lindau disease. Right nephrectomy and pancreatoduodenectomy were performed. Based on the histopathological results, the patient was diagnosed with right renal cell carcinoma and highly differentiated endocrine pancreatic cancer. Immunohistologically, a large number of atypical cells were found to be positive for both anti-chromogranin and anti-synaptophysin antibodies in the endocrine tumor. Immunostaining for each type of gut hormone was also performed, but all results were negative. Based on the above findings, nonfunctioning, highly differentiating endocrine cancer was diagnosed. This is the first confirmed case of renal cell carcinoma and endocrine pancreatic cancer occurring concurrently with VHL. This is an important case, so it is presented here along with a short discussion of the literature.

Adult↗
PubMed2006

Questionnaire on perioperative antibiotic therapy in 2003: postoperative prophylaxis.

We distributed a questionnaire to institutions accredited by the Japan Surgical Society asking about the use of antibiotics in digestive tract surgery in Japan in 2003, and compared the results with those of a similar questionnaire distributed in 1993. The period of antibiotic administration for esophageal resection was at least 6 days in 64.9% of the 1993 questionnaire responses, but less than 4 days in 60.4% of the present questionnaire responses. For distal gastrectomy, antibiotics were given for 5 days postoperatively at 53.0% of the responding institutions in the 1993 survey, but for only 3 days, at 72.4%, in the present survey. An oral antibiotic was given as part of antibacterial colon preparation before colon resection at 70% or more of the institutions in the 1993 survey, while no antibiotic colon preparation was given at 80% of the institutions in the present survey. The period of antibiotic administration for laparoscopic cholecystectomy was at least 4 days in 72% of the institutions in the 1993 survey, but this decreased remarkably to fewer than 2 days at 80.8% of the institutions in the current survey. There were no differences in the selection of antibiotics between the two surveys. The period of antibiotic administration has decreased remarkably in the last decade.

Anti-Bacterial Agents↗
PubMed2006

Creating a manual for proper hand hygiene and its clinical effects.

PURPOSE: To prevent cross-infections, we created a manual for the treatment of infectious wounds that clarifies when to wash one's hands and when to wear gloves. METHODS: Six patients with widespread infectious wounds caused by methicillin-resistant Staphylococcus aureus (MRSA) were treated. The bacterial count on the hands of the staff was calculated. We then compared the number of patients with MRSA isolated, and typed the MRSA isolates using pulsed-field gel electrophoresis (PFGE). RESULTS: The pathogenic bacterial count among hospital staff before treatment/before hand hygiene was 8.2 x 10 colony-forming units (cfu)/hand, which were not detected before treatment/after hand hygiene. The pathogenic bacterial count on the hands before hand hygiene/after treatment climbed to 9.1 x 10(5) cfu/hand, and after treatment/after hand hygiene decreased to 0.38 cfu/hand. The number of patients with MRSA isolates before this protocol was 15/402 (3.7%), but that level significantly decreased to 5/411 (1.2%) after implementation of the manual. There were 13 strains of type F by PFGE before the manual was adopted, but five strains of MRSA isolated after the present manual was enforced were all observed to have different migration patterns. CONCLUSION: A hand hygiene manual is effective for decreasing the rate of cross-infection.

Anti-Infective Agents, Local↗
PubMed2006

Adenofibroma of the endometrium protruding into the vaginal cavity: findings on transvaginal ultrasonography, MRI and CT.

Adenofibroma is a rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. We report the case of a 42-year-old woman with adenofibroma of the endometrium protruding into the vagina. Transvaginal ultrasonography revealed the tumor as an intravaginal mass containing multiple cystic components. Magnetic resonance imaging (MRI) showed a heterogeneous high-intensity mass filling the vaginal cavity on T2-weighted imaging, with a low-contrast enhanced septum identified within the mass on gadolinium-enhanced, T1-weighted imaging. Contrast-enhanced computed tomography (CT) showed a heterogeneous low-attenuating multicystic mass filling the vaginal cavity. Although preoperative diagnosis of this rare tumor is very difficult, the combination of MRI, CT, and ultrasonography offers a useful diagnostic tool.

Adenofibroma↗
PubMed2005

Real-time quantitative RT-PCR detection of disseminated endometrial tumor cells in peripheral blood and lymph nodes using the LightCycler System.

OBJECTIVE: Some endometrial cancer patients without clinical evidence of extrauterine spread die as a result of recurrence even after curative operation. These recurrences may arise from occult tumor cells that are not detected by conventional methods. The goal of this study was to develop a quantitative method for the detection of disseminated tumor cells (DTCs) in the peripheral blood (PB) and lymph nodes (LNs) of patients with endometrial cancer. METHODS: Ninety-eight PB samples from 30 patients and 218 LNs from 14 patients were studied. Real-time quantitative analysis was performed using a LightCycler instrument and a TaqMan probe for cytokeratin 19 (CK19) as a marker gene. RESULTS: This method resulted in the reproducible quantitation of 10 to 10(6) MCF-7 cells (CK19-expressing breast cancer cell line) per 10(6) peripheral blood nucleated cells. CK19 mRNA expression was detected in 28 PB samples and in 62 LNs. Only three preoperative PB samples and one postoperative PB sample (from four patients) and 33 LNs (from six patients) were PCR-positive. The PCR-positive rate of LNs was higher in patients with pathologically metastatic (path-positive) LNs than in patients with path-negative but PCR-positive LNs. Furthermore, the CK19 mRNA background expression rate was higher in the LNs of path-negative but PCR-positive patients than in LNs of path-negative and PCR-negative patients. CONCLUSIONS: Real-time qRT-PCR with TaqMan probes is a sensitive, specific and rapid method for the detection of DTCs in PB and LNs. Additional studies with larger numbers of patients and adequate follow-up would be of benefit.

Aged↗
PubMed2005

Conformational transition of the core chain in radiation-modified polysilane micelles formed in selective solvents.

Poly(methyl acrylate)-grafted poly(methyl-n-propylsilane) (PMPrS-g-PMA) and poly(acrylic acid)-grafted PMPrS (PMPrS-g-PAA) were synthesized by gamma-ray-induced graft polymerization, and the association behavior of these graft copolymers was investigated in selective solvents composed of good and poor solvents for the PMPrS main chain. Fluorescence spectroscopy with perylene as a fluorescent probe revealed that PMPrS-g-PAA in a water/THF mixed solvent self-assembles into micelles with a swollen core of PMPrS chains in the water content range of 50-95%. UV spectroscopy demonstrated that a further increase of the water content gives rise to the conformational transition of the PMPrS chains in the micelle core from the random conformation to the conformation that corresponds to that in the solid state at a water content of ca. 95%, independent of the grafting yield. Similar behavior was also observed in DMSO/THF solutions of PMPrS-g-PMA, for which the conformational transition occurred at the constant DMSO content of ca. 95%. These results indicate that solvatochromic behavior of polysilane, which is a characteristic feature of polysilane, proved to provide information on the inner structure of those micelles: PMPrS chains in the core undergo conformational transition as the content of the poor solvents for PMPrS increases, while maintaining the micelle structure.

Journal Article↗
PubMed2005

Purification and properties of a family-10 xylanase from Aureobasidium pullulans ATCC 20524 and characterization of the encoding gene.

An extracellular endo-1,4-beta-xylanase was purified from the culture supernatant of the ascomycete Aureobasidium pullulans ATCC 20524 grown on xylan. The purified enzyme was homogeneous as judged by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and isoelectric focusing, which showed an apparent M (r) of 39 kDa and a pI of 8.9, respectively. Xylanase activity was optimal at pH 6.0 and 70 degrees C. The genomic DNA and cDNAs encoding this protein were cloned and sequenced. The xylanase gene (xynII) encoded a 26 amino acid signal peptide and a 335 amino acid mature protein. DNA regions encoding the signal sequence and the mature protein were interrupted by introns of 56 and 73 bp, respectively. The xynII 5'-noncoding region had two consensus binding sites (5'-GCCARG-3') for the transcription factor PacC mediating pH regulation. Quantitative real-time polymerase chain reaction analysis revealed that the transcription levels at pH 6.0 and 8.0 were 8-fold and 22-fold higher than that at pH 2.7, respectively. A cloned xynII cDNA was expressed and secreted in the yeast Pichia pastoris. Sequence alignment and phylogenetic analysis suggested that the XynII belongs to glycosyl hydrolase family 10 and that it is evolutionarily distant from two clusters formed by other family-10 xylanases.

Amino Acid Sequence↗
PubMed2005

Drug susceptibility of isolates from severe postoperative intraperitoneal infections causing multiple organ failure.

PURPOSE: To select the most appropriate antibiotic regimens for life-threatening postoperative infections, we obtained isolates from patients with severe postoperative infections over a 12-year-period, and examined their drug susceptibility. METHODS: The subjects of this study were 55 patients with multiple organ failure (MOF) caused by postoperative infection. RESULTS: All strains of Methicillin-resistant Staphylococcus aureus (MRSA) were susceptible to Vancomycin (VCM) and Teicoplanin (TEIC). Only 0.3% of all the Pseudomonas aeruginosa strains were resistant to Imipenem (IPM), but 53.6% of the strains from the severe infections were resistant to IPM. On the other hand, there were few P. aeruginosa strains resistant to Meropenem (MEPM), Ceftazidime (CAZ), Ciprofloxacin (CPFX), and Pazufloxacin (PZFX), even among strains isolated from severe infections. The resistant rate of Bacteroides fragilis to Clindamycin (CLDM) was 35.9%, but there were strains resistant to IPM and Panipenem. CONCLUSION: These findings suggest that VCM or TEIC are most appropriate for severe abdominal abscess caused by MRSA, whereas MEPM, CAZ, CPFX, and PZFX are more effective against P. aeruginosa infections. The only antibiotic effective against B. fragilis infections in this study was IPM.

Abdominal Abscess↗
PubMed2005

Endometrial adenocarcinoma after liver transplantation.

In June 1999, a 50-year-old Japanese woman underwent a liver transplant and was started on tacrolimus hydrate. A routine gynecologic examination at that time was unremarkable. In December 2001, the patient was found to suffer from endometrial adenocarcinoma and total abdominal hysterectomy with adnexa was carried out. No significant changes in liver function were observed. However, because fever in the patient of up to 38.5 degrees C continued, the volume of the tacrolimus hydrate was reduced, and then stopped completely. The patient's fever decreased to approximately 36.5 degrees C and she was discharged on the 18th postoperative day. The present case is the first report of endometrial adenocarcinoma in a patient after liver transplantation.

Adenocarcinoma↗
PubMed2005

Surgical indications for combined partial rectosigmoidectomy in ovarian cancer.

AIM: To evaluate surgical indications for combined partial rectosigmoidectomy in ovarian cancer with direct invasion of the rectum and sigmoid colon or dissemination into the pouch of Douglas. METHODS: Subjects comprised 25 patients with ovarian cancer who underwent primary surgery and rectosigmoidectomy between 1990 and 2002 at our hospital. Federation of Obstetrics and Gynecology staging of tumors was II (n = 6), III (n = 17) or IV (n = 2). The histologic type was serous adenocarcinoma (n = 18), clear cell adenocarcinoma (n = 4), and others (n = 3). Bowel resection was performed during primary surgery in 18 patients, and after neoadjuvant chemotherapy (NAC) in seven patients. Cumulative survival rate was compared between NAC and non-NAC groups. Patients were divided into three groups based on extent of surgical resection to compare survival rates: no residual tumor (n = 19); maximum residual tumor diameter <1 cm (n = 5); and maximum residual tumor diameter > or =1 cm (n = 1). RESULTS: Cumulative 5-year survival was 41.3% for all patients. Cumulative 5-year survival in the 18 patients who underwent bowel resection during primary surgery was 62.2%, compared to 13.9% in the seven patients who underwent bowel resection after NAC. Cumulative 5-year survival based on extent of surgical resection was: no residual tumor, 60.8%; residual <1 cm, 0%; and residual > or =1 cm, 0%. Cumulative 5-year survival for patients with complete tumor resection (no residual tumor), excluding clear cell adenocarcinoma, was 79.5%. CONCLUSION: In ovarian cancer with direct invasion of the rectum or sigmoid colon or dissemination into the pouch of Douglas, complete tumor resection with rectosigmoidectomy during primary surgery is associated with good clinical outcomes.

Adult↗
PubMed2005

Purification and properties of an extracellular endo-1,4-beta-xylanase from Penicillium citrinum and characterization of the encoding gene.

An extracellular endo-1,4-beta-xylanase was purified from the culture filtrate of a filamentous fungus Penicillium citrinum FERM P-15944 grown on birch-wood xylan. The purified enzyme showed a single band on SDS-PAGE with an apparent M(r) of 20,000 and had an isoelectric point below 3.5. Xylanase activity was optimal at pH 5.0 and 55 degrees C. The genomic DNA and cDNAs encoding this protein were cloned and sequenced. Southern blot analysis indicated that the xylanase gene (xynA) was present as a single copy in the genome. An open reading frame of 657 bp was interrupted by two introns of 65 and 55 bp, and encoded a presumed prepropeptide of 27 amino acids and a mature protein of 190 amino acids. Three distinct transcription start points were observed at positions -20 (A), -31 (A), and -36 (A) from the start codon. The 5'-noncoding region had a putative TATA box at nt -66 (TATAAA). The xynA cDNA was functionally expressed under the control of the alcohol oxidase I gene promoter in the methylotrophic yeast Pichia pastoris. A neighbor-joining tree showed that the P. citrinum enzyme is closely related to several other fungal xylanases belonging to the glycoside hydrolase family 11: Trichoderma reesei XYN2, Aspergillus niger xynNB, Penicillium funiculosum xynC, Penicillium sp. strain 40 xynA, Chaetomium gracile cgxB, and Aspergillus nidulans xlnA and xlnB.

Amino Acid Sequence↗
PubMed2005

[A case of resectable solitary liver metastasis from breast cancer].

We report a case of resectable solitary liver metastasis from breast cancer. A 53-year-old woman underwent a pectoral muscle-preserving mastectomy for T1 N0M0 (Stage I) left breast cancer in May 2000. Histopathologic diagnosis was medullary carcinoma. Thereafter, the patient was followed up with adjuvant chemotherapy. A solitary tumor in the right lobe of the liver at S6 was found 10 months after mastectomy by ultrasonography. With a diagnosis of liver metastasis from breast cancer, right hepatectomy was performed in May 2001. At present, she remains disease free for 4 years after hepatectomy. We think that a surgical procedure for liver metastasis from breast cancer, if possible, is beneficial in prolonged survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Evidence for the involvement of double-strand breaks in heat-induced cell killing.

To identify critical events associated with heat-induced cell killing, we examined foci formation of gammaH2AX (histone H2AX phosphorylated at serine 139) in heat-treated cells. This assay is known to be quite sensitive and a specific indicator for the presence of double-strand breaks. We found that the number of gammaH2AX foci increased rapidly and reached a maximum 30 minutes after heat treatment, as well as after X-ray irradiation. When cells were heated at 41.5 degrees C to 45.5 degrees C, we observed a linear increase with time in the number of gammaH2AX foci. An inflection point at 42.5 degrees C and the thermal activation energies above and below the inflection point were almost the same for cell killing and foci formation according to Arrhenius plot analysis. From these results, it is suggested that the number of gammaH2AX foci is correlated with the temperature dependence of cell killing. During periods when cells were exposed to heat, the cell cycle-dependent pattern of cell killing was the same as the cell cycle pattern of gammaH2AX foci formation. We also found that thermotolerance was due to a depression in the number of gammaH2AX foci formed after heating when the cells were pre-treated by heat. These findings suggest that cell killing might be associated with double-strand break formation via protein denaturation.

Carcinoma, Non-Small-Cell Lung↗