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Biomedical subjects

Hiroyuki Kuwano

Publications and source records attributed to Hiroyuki Kuwano.

At least 163 records · Page 9Linked to original sources
PubMed2002

Risk factors for esophageal cancer and the multiple occurrence of carcinoma in the upper aerodigestive tract.

The multiple occurrence of squamous cell carcinoma is frequent in the upper aerodigestive tract (UADT). Risk factors not only for esophageal cancer, but also for multiple cancer in the UADT, were reviewed. Both cigarettes smoking and alcohol drinking are will known risk factors for esophageal cancer. The joint effect of these 2 factors on the occurrence of esophageal cancer is considered to be synergetic, but familial aggregation of esophageal cancer is also reported. Regarding the multiple occurrence of cancer of the UADT, both heavy smoking and heavy drinking play an important role. In addition, our studies revealed that a family history of UADT cancer might also be a risk factor for multiple cancer. Recent improvement of molecular biology techniques have helped to show that tumor-suppressor genes, such as p53 and FHIT, may be candidates for target genes of these risk factors.

Alcohol Drinking↗
PubMed2002

The subepithelial extension of esophageal carcinoma for determining the resection margin during esophagectomy: a serial histopathologic investigation.

BACKGROUND: An evaluation of the safe resection margin in esophagectomy or esophageal endoscopic mucosal resection for carcinoma, based on serial histologic investigations by measuring the length of subepithelial extension of the lesion beneath the noncancerous epithelium, has not been reported. METHODS: Forty-eight patients with esophageal carcinoma restricted to within the esophageal wall including 67 lesions (27 mucosal, 27 submucosal cancer, and 13 lesions of cancer invading to proper muscular layer) were histopathologically examined. The length of subepithelial extension (SEE) beneath the noncancerous epithelium of each lesion was measured and the clinicopathologic significance of SEE was discussed. RESULTS: Among these 67 lesions in 48 cases, there were 17 (25.4%) lesions with SEE. The rates of coexistence of SEE were 3.7, 37.0, and 46.2% in mucosal and submucosal cancer, and cancer invading the proper muscular layer, respectively. When the positive rate was more than 50% for the factors of SEE--lymphatic permeation, blood vessel permeation, and intramural metastasis--the prognosis was significantly poorer in the patients with esophageal cancer. CONCLUSIONS: When the lesion was restricted to within the mucosal layer, SEE was almost negligible at resection. The coexistence of SEE was thus found to be one of the prognostic factors predicting a poor prognosis.

Aged↗
PubMed2002

Thoracoscopic treatment of Bochdalek hernia in the adult: report of a case.

Bochdalek hernia is a type of congenital diaphragmatic hernia that mainly occurs in childhood, but is extremely rare in adults. A case report of Bochdalek hernia in a 17-year-old woman, complaining of left lateral upper abdominal pain is herein reported with a brief review of the literature. The herniated organs into the thoracic cavity in this case were the as stomach, large intestine, spleen and greater omentum which was diagnosed using computed tomography, an upper gastrointestinal double contrast study and irrigography. The patient was successfully treated by video-assisted thorachoscopic surgery (VATS) with a pushback method. The post-operating course was uneventful with minimal pain of the surgical wound. This case demonstrated the efficacy of the VATS repair for Bochdalek hernia.

Adolescent↗
PubMed2001

c-myc is a downstream target of the Smad pathway.

c-Myc is one of the most potent regulators of cell cycle progression in higher eukaryotes. Down-regulation of c-Myc is a critical event for growth inhibition induced by transforming growth factor-beta (TGF-beta) and is frequently impaired in cancer cells. We determined a Smad-responsive element in the c-myc promoter. This element is a complex of the TGF-beta1 inhibitory element (TIE) originally identified in the transin/stromelysin promoter and an E2F site responsible for transcriptional activation of the c-myc promoter. Smad3 and E2F-4 directly bound to the element (TIE/E2F), and substitution of two nucleotides in TIE/E2F impaired binding of both Smad3 and E2F-4 as well as serum-induced activation and TGF-beta-induced suppression of the c-myc promoter activity. Smads bound TIE/E2F within 1 h after stimulation with TGF-beta, before the suppression of c-myc transcription, whereas binding of p130 to TIE/E2F became augmented later than 12 h. TGF-beta signaling did not compete with E2F-4 for binding to TIE/E2F, but reduced p300 co-immunoprecipitating with E2F-4. Therefore, TGF-beta signaling may suppress c-myc promoter activity by dissociating p300 from E2F-4.

Animals↗
PubMedDate not supplied

MCLA-dependent chemiluminescence suggests that singlet oxygen plays a pivotal role in myeloperoxidase-catalysed bactericidal action in neutrophil phagosomes.

Bacteria ingested by a neutrophil are located in phagosomes in which H(2)O(2) is produced through the NADPH oxidase-dependent respiratory burst. Myeloperoxidase (MPO) plays important role in the bactericidal action of phagosomes. MPO catalyses the reaction of H(2)O(2) and Cl(-) to produce HClO. The chemical mechanism behind the bactericidal action of the MPO-H(2)O(2)-Cl(-) system is unclear. Bactericidal action may result from (a) the direct reactions of HOCl with biological components (through amine chlorination) or (b) (1)O(2), formed non-enzymatically from HOCl and H(2)O(2), that mainly works to kill microorganisms through bacterial respiratory chain injury. To answer this question, we developed a Cypridina luciferin analogue (MCLA)-dependent chemiluminescence method to determine the rate of formation of (1)O(2) from a (1)O(2) source at pH 4.5-9.0. Using the MCLA-dependent chemiluminescence method, we found that the rate of formation of (1)O(2) from the MPO-H(2)O(2)-Cl(-) system peaked at pH 7.0. Segal et al. (28) reported that almost all Staphylococcus aureus is killed 2 min after phagocytosis by neutrophils where the phagosomal pH is 7.4-7.75. However, amine chlorination by HOCl did not proceed at pH > 7.0. Moreover, the bactericidal activities of the MPO-H(2)O(2)-Cl(-) system with Escherichia coli at pH 4.5 and 8.0 were paralleled by the rate of formation of (1)O(2). Combining these observations and the results reported by Segal et al., we concluded that (1)O(2) is a major chemical species in the killing of bacteria in neutrophil phagosomes.

Bacteria↗
PubMedDate not supplied

Malignant transformation of the mouse anorectal epithelium induced by an inoculated human cancer cell line.

Four kinds of human cancer cell lines and one mouse cancer cell line were inoculated into the subepithelial area of the anorectum of female nude mice. Among the cell lines, two cell lines (KATO III and Lu 135) showed the potential enforcement of atypical changes in the adjacent mouse anorectal epithelium. Moreover, the submucosal invasion of the malignant transformed cells of the mouse epithelium was demonstrated in specimens obtained from three KATO III-inoculated mice. This exciting and novel phenomenon clearly demonstrates the need to change the present general concept of a single-cell origin of cancer tissue. This valuable and novel discovery may change the basis of oncology research while also providing new ideas for projects to investigate the mechanisms of carcinogenesis from several aspects such as molecular biology, cell biology, and pathology. Moreover, the novel experimental design itself is also extremely useful as a simple model for investigating the mechanisms of oncogenesis.

Anal Canal↗
PubMedDate not supplied

Should patients over 85 years old be operated on for colorectal cancer?

BACKGROUND: The aim of this study is to evaluate risk factors for mortality, morbidity, and long-term survival in very old patients with colorectal cancer compared with old patients. METHODS: Patients operated on with colorectal cancer aged 75 years old or older were divided into 2 groups: Group A (75-84 years, n = 93) and Group B (>or=85, n = 21). RESULTS: The serum albumin level, oxygen pressure in arterial blood gases, and forced expiratory volume in 1 second in Group B were significantly lower than in Group A, respectively (P = 0.0094, 0.0264, 0.0363). Pulmonary complications were developed significantly more frequently in Group B than in Group A (P = 0.0019). Group B had a significantly higher mortality rate than Group A (P = 0.0477). There was no significant difference between the 2 groups in the 2- and 5-year survival rates. CONCLUSIONS: Very old patients with colorectal cancer should not be denied surgery on account of chronological age alone, although the perioperative risks for the very old are very high.

Aged↗
PubMedDate not supplied

Left hepatectomy for the choledochal cyst (type IV-A) with intrahepatic stenosis: report of a case.

The case of a 16-year-old male with expansion of the gallbladder and dilatation of the common bile duct is reported. Ultrasonography and computed tomography imaging showed expansion of the gallbladder and eminent cystic dilatation in the common bile duct and the left intrahepatic bile duct. Endoscopic retrograde cholangiopancreatography indicated expansion-like beads of the bilateral hepatic ductus and the left intrahepatic bile duct, including anomalies of the pancreaticobiliary ductal junction. Because relative stenosis of the membranous diaphragm was revealed in the porta hepatis, we diagnosed this case as a type IV-A choledochal cyst, using Todani's classification. Intraoperative cholangiography and cholangiofiberscopy showed a pinhole stricture and re-expansion of the tip of the left intrahepatic bile duct. As the narrow segment could not be expanded though we put proper pressure there, left hepatectomy was performed as a preventive measure in addition to extended biliary tract excision and cholangiojejunostomy. Hepatectomy seems to be an appropriate choice in a case of intrahepatic stenosis to help increase the patient's postoperative quality of life.

Adolescent↗
PubMedDate not supplied

A comparison of right-lobe and left-lobe graft for living-donor liver transplantation.

BACKGROUND/AIMS: The practice of living-donor liver transplantation has been widely established. However, in adult cases, the issue of graft liver volume has been raised. Recently, liver transplantation using the right lobe has been done in cases requiring a larger graft volume. We compared right lobectomy with left lobectomy for hepatocellular carcinoma not accompanied by liver cirrhosis and examined the safety of hepatic right lobectomy for donation. METHODOLOGY: In total, 124 hepatocellular carcinoma patients without liver cirrhosis, 89 who had undergone right hepatectomy and 35 who had undergone left hepatectomy, were studied. For each group, we statistically examined the patients' profiles. RESULTS: The resected right lobe was significantly heavier than the left lobe. There were significant differences between the two groups in terms of the number of blood transfusions needed. Moreover, delayed recoveries in terms of hemoglobin, total bilirubin, and clotting disorder on postoperative day 7, as well as the frequency of any complications, were more prevalent in the right-lobe group. CONCLUSIONS: It was confirmed that right lobectomy is more invasive than left lobectomy. It is necessary to prioritize the donor's safety and quality of life in living-donor liver transplantation, and adequate medical and ethical consideration is demanded.

Adolescent↗
PubMedDate not supplied

A case of intraductal papillary-mucinous carcinoma of the pancreas with the onset of acute pancreatitis.

Intraductal papillary-mucinous carcinoma of the pancreas has been reported with increasing frequency. We report a case with intraductal papillary-mucinous carcinoma of the pancreas and discuss surgical treatment and current imaging modalities. A case with intraductal papillary-mucinous carcinoma was analyzed by radiological findings and clinical course. A 47-year-old man developed abdominal pain and nausea. Computed tomography showed a diffusely dilated main pancreatic duct. Duodenoscopy showed a patulous orifice of the pancreas with massive mucus secretion, but the pancreatic juice was not positive for malignant cells. Endoscopic retrograde cholangiopancreatography revealed a markedly dilated pancreatic duct extending from the body to the tail of the pancreas. Distal pancreatectomy was performed with splenectomy and lymph nodes dissection. Histopathological diagnosis was intraductal papillary-mucinous carcinoma. Endoscopic retrograde cholangiopancreatography is useful for diagnosing intraductal papillary mucin-producing tumors. To avoid unnecessary total pancreatectomy and preserve pancreatic function, intraoperative frozen section examination is widely available for the surgical treatment of intraductal papillary mucin-producing tumors.

Acute Disease↗
PubMedDate not supplied

Paraesophageal hiatus hernia, which has progressed for 8 years: report of a case.

We report a case of a paraesophageal hernia, which was successfully treated with laparoscopic surgery after a natural history of eight years. Eight years before surgery only the fundus of the stomach was included in the hernia sac. At surgery, although the gastroesophageal junction and fundus were found in their normal positions, the distal half of the stomach and the omentum were pulled into the thorax, which demonstrated an organoaxial gastric volvulus. As the omentum tightly adhered to the top of the hernia sac and there was no tight adhesion between the stomach and hernia sac, the omentum could serve as the lead point for the gastric volvulus. This patient was successfully treated with laparoscopic surgery and is presently in good condition without any recurrence of the hernia.

Aged↗
PubMedDate not supplied

Laparoscopic resection of splenic artery aneurysm; a case report.

We report a case of a patient who underwent three-dimensional arterial computed tomography, color Doppler sonography and laparoscopic splenectomy for splenic artery aneurysm. Helical computed tomography revealed a splenic artery aneurysm, 3.0 x 1.8 cm in diameter. Color Doppler sonography reveals a weak pulsatile flow from the aneurysm. Surgical treatment is indicated for such cases since approximately 10% of these aneurysms tend to rupture which thus results in fatal hemorrhaging. As a result, a laparoscopic splenectomy was performed. According to our experience, three-dimensional computed tomography and color Doppler sonography can be performed for the arterial and venous information with less invasion than angiography and a laparoscopic splenectomy for splenic aneurysm can be performed which is safer and less invasive than conventional open procedure.

Aneurysm↗
PubMedDate not supplied

Glut-1 glucose transporter expression in esophageal squamous cell carcinoma is associated with tumor aggressiveness.

BACKGROUND: Glucose transporter (Glut) proteins, which are membrane proteins responsible for the transport of glucose across cellular membranes, have six forms. To further elucidate the role of Glut-1 expression in esophageal squamous cell carcinoma, we examined the expression of Glut-1 protein immunohistochemically. MATERIALS AND METHODS: Immunohistochemical expression of Glut-1 was examined in surgically resected tissues from 95 patients with esophageal squamous cell carcinoma. RESULTS: Of the 95 esophageal carcinomas, 91 (95.8%) had some Glut-1 immunostaining in the membranes of the cancer cells. Positive staining (> 30% of cancer cells showing Glut-1 expression) was observed in 49 (51.6%) of the cases. Comparison of Glut-1 expression and clinicopathological characteristics in the 95 patients with esophageal cancer revealed significant associations between Glut-1 expression and tumor status (p < 0.001), lymph node status (p < 0.05), metastatic status (p < 0.01), and pathological stage (p < 0.001). The survival rates of patients with Glut-1-positive tumors were significantly lower than those of patients with Glut-1-negative tumors (log-rank p < 0.05). CONCLUSION: In conclusion, the level of Glut-1 expression may be a useful marker that can provide information on tumor aggressiveness and prognosis in patients with esophageal squamous cell carcinoma.

Adult↗
PubMedDate not supplied

Expression of vascular endothelial growth factor (VEGF) and its receptors (Flt-1 and Flk-1) in esophageal squamous cell carcinoma.

BACKGROUND: To clarify the clinical significance of vascular endothelial growth factor (VEGF) and its receptors, VEGFR-1 (Flt-1) and VEGFR-2 (Flk-1), in esophageal cancers, we evaluated the relationships between the expression of VEGF and its receptors, tumor microvessel density (MVD), clinicopathological factors and prognosis. MATERIALS AND METHODS: Thoracic esophageal squamous cell carcinoma (SCC) specimens were obtained during surgery from 64 previously untreated patients. Expression levels of VEGF and its receptors were determined immunohistochemically, and tumor MVD was assessed. RESULTS: Twenty-four (37.5%) of the tumors showed diffuse VEGF immunoreactivity. VEGF expression was significantly correlated with tumor status (p < 0.05) and poor prognosis (log-rank; p < 0.05). VEGFR-1 immunoreactivity was detected in the cytoplasm of the cancer cells in 27 patients (42.2%). VEGFR-1-positive cancers tended to be associated with poorer nodal status (p = 0.1513), but VEGFR-1 expression did not correlate with prognosis in the univariate survival analysis (p = 0.2964). VEGFR-2 immunoreactivity was detected in the cancer cell cytoplasm in 26 patients (40.6%), but VEGFR-2 expression did not correlate with clinicopathological factors or prognosis. Comparison of the MVD and clinicopathological characteristics revealed significant associations between high MVD and poorer tumor status (p < 0.05), blood vessel invasion (p < 0.05) and poor prognosis (p < 0.01). In the multivariate analysis, MVD was identified as an independent prognostic factor as well as depth of tumor invasion and lymph node metastasis. Although VEGF expression correlated significantly with the MVD (p < 0.05), the correlations between VEGFR-1 and VEGFR-2 expression and the MVD were not significant. There were, however, significant intercorrelations in expression between VEGF, VEGFR-1 and VEGFR-2. CONCLUSION: Vascular endothelial growth factor (VEGF) may play a role in the control of angiogenesis in esophageal squamous cell carcinoma. However, although VEGF expression correlates significantly with coexpression of its receptors, VEGFR-1 and VEGFR-2, these receptors do not appear to contribute directly to tumor progression. Nevertheless, VEGF and its receptors represent a logical target for antiangiogenic therapy for esophageal SCC.

Adult↗
PubMedDate not supplied

Utility of serosal stamp cytology as an indicator for high-risk peritoneal metastasis in colorectal cancer surgery.

BACKGROUND/AIMS: Although peritoneal lavage cytology is widely performed during surgery for gastric cancer and the results have been reported to provide an accurate prognostic factor, its value has not been well established in colorectal cancer. In this study, we demonstrated the utility of serosal stamp cytology from the viewpoint of cell adhesion molecules. METHODOLOGY: Between 1997 and 1999, peritoneal lavage cytology and serosal stamp cytology were performed in 34 patients with resectable colorectal cancer. Epithelial cadherin (E-cadherin) was examined as an index of the progress degree of peritoneal metastasis. RESULTS: Although peritoneal lavage cytology was positive in one case, serosal stamp cytology was positive in 10 cases. E-cadherin expression was lost in all peritoneal lavage cytology and/or serosal stamp cytology positive patients. CONCLUSIONS: Our data indicate that serosal stamp cytology is more sensitive and simple than peritoneal lavage cytology. Serosal stamp cytology may be useful in identifying patients at high risk for peritoneal recurrence.

Adult↗