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Biomedical subjects

Junji Tanaka

Publications and source records attributed to Junji Tanaka.

At least 73 records · Page 4Linked to original sources

Significance of hepatic resection combined with inferior vena cava resection and its reconstruction with expanded polytetrafluoroethylene for treatment of liver tumors.

BACKGROUND: Resection of the IVC is required when a liver tumor invading the IVC is completely removed. The purpose of this study was to evaluate the clinical significance of hepatectomy combined with IVC resection and reconstruction with an ePTFE graft for treatment of invasive liver tumors and to discuss the validity of this surgery. STUDY DESIGN: Eleven selected patients with liver tumors underwent various types of hepatectomy with retrohepatic IVC resection, followed by IVC reconstruction. The postoperative courses, clinicopathologic features of the tumors, operative procedures, and outcomes of the patients were studied. RESULTS: Ten of 11 patients did not require an active ventriculovenous bypass using a biopump. Invasion to the IVC was histologically proved in 9 of the 11 patients. After reconstruction, all artificial vessel grafts maintained patency throughout the observation period. Four patients are still alive with cancer-free status ranging from approximately 11 years to 5 months. One-year, 3-year, and 5-year survival rates were 63.6%, 38.2%, and 25.5%, respectively, with a 50% survival of 29 months. CONCLUSIONS: IVC resection and its reconstruction with ePTFE for treatment of liver tumors was safely performed on 11 selected patients with a 50% survival of 29 months. Patency of the graft was maintained for the longterm without infectious complications. This surgical procedure is indicated in some select patients in whom IVC invasion is extensive.

Adrenal Gland Neoplasms↗

Immune reconstitution and tolerance after allogeneic hematopoietic stem cell transplantation.

We have evaluated recovery of CD56 positive and other cell types following allogeneic stem cell transplantation and have found that the recovery of CD56 positive cells was faster than other lymphoid cells after allogeneic stem cell transplantation, while the recovery of CD4 positive cells was markedly delayed. Chimerism analysis showed that mixed chimerism was often observed in younger (<30 years old) patients. Mixed chimerism in older (> or =30 years old) patients was associated with rejection and relapse, while this was not found in younger patients. Among the chimerism of various cell populations, donor-derived CD56-positive cells are important in early engraftment when determined in allogeneic nonmyeloablative stem cell transplantation (allo-NST), regardless of the proportion of donor-derived CD3-positive cells. Complementarity-determining region three (CDR3) size spectratyping in T-cell receptor (TCR) chain subfamilies (Vbeta) showed that high level of diversity in TCR Vbeta repertoire is important for a late rejection and skewed TCR Vbeta repertoire is correlated with the occurrence of graft-versus-host disease (GVHD) especially chronic GVHD. Expression of inhibitory natural killer (NK) cell receptors such as CD158b and CD94/NKG2A on peripheral CD3-negative and -positive cells were increased in parallel with GVHD. Interestingly, these cells appeared to control GVHD, while preserving graft-versus-leukemia (GVL) effect. Analysis of cytokine gene expression in peripheral blood mononuclear cells showed that type 1 helper T cells (Th1)-derived cytokines increased in severe GVHD, while Th2-derived cytokines such as IL-4, IL-10 and IL-13 increased in mild GVHD. These results indicate that Th2 cells suppress GVHD, although Th1 cells augment GVHD. Taken together, evaluation of immune reconstitution and tolerance in patients receiving allogeneic stem cell transplantation from the various viewpoints is essential and useful to obtain better clinical outcome.

Adult↗

Myelofibrosis after essential thrombocythemia complicated by alveolar proteinosis.

Hematological diseases are often accompanied by respiratory disorders. Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by excessive accumulation of surfactant in the alveolar space. We describe a case of PAP complicated by myelofibrosis following essential thrombocythemia. The patient developed high fever, respiratory failure, and leuko-erythroblastosis during the progressive course of PAP. These symptoms were alleviated by prednisolone. The level of serum IL-6 was elevated when PAP was progressing rapidly. This may explain why the symptoms were alleviated by the steroids.

Bone Marrow↗

A case of leukemia of the appendix presenting as acute appendicitis.

A 71-year-old man was admitted to our hospital because of right lower abdominal pain. He was suspected of having acute appendicitis and soon after admission, appendectomy was performed. Macroscopically, the appendix was greatly swollen and reddened, but had no abscess. Microscopically, polymorphonuclear leukocytes were not found, but diffuse infiltration of atypical cells was observed. Examination of a bone marrow aspirate revealed 74% blasts that were peroxidase stain positive. We diagnosed acute myelogenous leukemia (FAB classification, M2). He received induction chemotherapy, but died 49 days after admission. Leukemic cell infiltration of the appendix is rare and acute appendicitis as the initial manifestation of leukemia is even rarer.

Aged↗

The higher immunoreactivity to ACE (angiotensin converting enzyme) in patients with type 2 diabetes mellitus than in non-diabetic individuals.

In a random sample of 200 patients with type 2 diabetes mellitus, immunoreactivities to ACE (angiotensin converting enzyme) were measured by ELISA. Immunoreactivities were positive for 129 (64.5%) patients, and were positive in 30 (83.3%) out of 36 patients in the early stage of clinical diabetic nephropathy. Serum ACE activity in rabbits immunized with ACE decreased to 50% of the control level after 7 months (78.0 +/- 3.8 IU/L/37 degrees C, basal, 42.0 +/- 5.0 at 7 months and 33.3 +/- 3.5 IU/L/37 degrees C at 8 months, respectively). When rabbit serum containing antiACE antibodies was mixed, after heat-treatment at 56 degrees C for 30 min, with normal human serum, the ACE activity was reduced in a concentration-dependent manner. These results suggested that anti-ACE autoantibody may be present in patients with type 2 diabetes mellitus. However, the absence of data on the epitope for the antibody does not allow any conclusion except that the immunoreactivities to ACE are higher in type 2 diabetic patients than in non-diabetic individuals.

Adult↗

[Effect of prophylaxis against myocosis in patients with hematological malignancy disease: efficacy of dosage of itraconazole].

Prophylactic effect of itraconazole (ITCZ) in mycosis associated with hematological malignancy was studied. In a total of 12 patients of hematological malignancy admitted to Hokkaido University Hospital from April, 2001 to March, 2002, six patients received 100 mg per day of ITCZ and the other six received 200 mg per day of ITCZ. ITCZ was administrated from the starting of chemotherapy, and from the time point capable of oral administration in bone marrow transplantation patients. ITCZ administration was finished based on docter's judgement. As the results of this study, three cases with 100 mg per day of ITCZ had mycosis, but none with 200 mg per day of this drug had it. Mild itching associated with ITCZ was found only one case. In conclusion, we suggest that ITCZ is effective and safe drug in terms of prophylaxis of mycosis.

Administration, Oral↗

[Evaluation of bone marrow involvement by FDG-PET for refractory Hodgkin lymphoma treated by unrelated allogeneic bone marrow transplantation].

A 23-year-old female patient was diagnosed as having Hodgkin lymphoma (mixed cellularity type, clinical stage III B) in September 2000. She underwent ABVD chemotherapy and irradiation of a mediastinal lesion, resulting in complete remission. However, the disease reoccurred three month after the completion of initial treatment. She was admitted to our hospital for allogeneic stem cell transplantation. Thoractic vertebra, lumbar vertebra and iliac bone lesions were detected by FDG-PET, and a diagnosis of bone marrow infiltration was made. She received re-induction chemotherapy but did not achieve complete remission. A residual lesion in her bone marrow was detected by FDG-PET. She underwent unrelated allogeneic bone marrow transplantation in May 2002. Preconditioning was VP-16, CY and TBI. Engraftment of white blood cells was on day 15. Skin GVHD was detected at the same time and she was treated with steroid hormones, resulting in improvement. No residual mass could be detected by FDG-PET on day 60. However, she suffered from fever on day 80. Aggravation of the disease was revealed and she died from progression of the disease on day 120. FDG-PET is useful for the monitoring disease status and for determining the optimal timing of various treatments.

Adult↗

[Target antigens for graft-versus-host disease (GVHD) and graft-versus-leukemia/tumor (GVL/T)].

The regulation of graft-versus-host disease (GVHD) and graft-versus-leukemia/tumor (GVL/T) effect is the most important issue in allogeneic stem cell transplantation. Although it is very difficult to separate GVHD and GVL/T, however, we should try to find the way to suppress GVHD and induce GVL/T at the same time. From that point of view, the induction of CTL against minor histocompatibility antigens such as HA-1 and tumor specific antigens such as BCR-ABL chimeric protein may be useful. Also, the new concept of alloreactive NK cells which have inhibitory NK cell receptor seem to be interesting to regulate GVHD and GVL/T. Further study is needed to establish new allogeneic cell therapy to obtain the clinical improvement.

Animals↗

Autocrine production of epithelial cell-derived neutrophil attractant-78 induced by granulocyte colony-stimulating factor in neutrophils.

Whereas mobilization to inflammatory sites is an important function of neutrophils, it remains to be determined whether granulocyte colony-stimulating factor (G-CSF) stimulates the mobilization of neutrophils to the inflammatory sites. This study compared the expression of more than 9000 genes in neutrophils treated with and without G-CSF with the use of a DNA microarray system to determine the effects of G-CSF on the function of neutrophils. It was found that messenger RNA expression of epithelial cell-derived neutrophil attractant-78 (ENA-78), which has been reported to be a chemotactic factor for neutrophils, was induced by G-CSF in neutrophils. The study demonstrated that the supernatant of G-CSF-treated neutrophils induced the chemotaxis of neutrophils and that anti-ENA-78 antibody and anti-CXCR-2 antibody inhibited the chemotaxis. These data suggest that G-CSF may enhance the mobilization of neutrophils and consequently augment the accumulation of neutrophils in the inflammatory sites through the secretion of ENA-78.

Autocrine Communication↗

Induction of CD94/NKG2A expression on T cells in mixed lymphocyte culture by CD14+ cells from granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cells.

We report the increased expression of inhibitory natural killer (NK) cell receptor, CD94/NKG2A, for human leucocyte antigen (HLA) class I on CD8+ T cells in granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cells (G-PBMC) after mixed lymphocyte culture (MLC). The addition of purified CD14+ cells to CD14-depleted G-PBMC-induced CD94/NKG2A expression in a dose-dependent fashion; however, this enhancing effect was inhibited by the membrane between responder cells and CD14+ cells. Therefore, CD14+ cells in G-PBMC induce CD94/NKG2A expression on CD8+ T cells, which in turn appear to downregulate alloresponses after allogeneic peripheral blood stem cell transplantation.

Antigens, CD↗

Analysis of T-cell repertoire and mixed chimaerism in a patient with aplastic anaemia after allogeneic bone marrow transplantation.

We analysed 26 T-cell receptor (TCR) beta chain subfamilies (VB) of a patient with aplastic anaemia (AA) who underwent allogeneic bone marrow transplantation (allo-BMT). The patient developed pancytopenia at d 80. The patient's T cells were skewed in 10 of 26 TCR-VB on d 83. These TCR-VB, especially VB15, which were almost entirely CD8-positive cells, were skewed throughout her clinical course. Chimaerism analysis of the CD8-positive cells indicated that they were of recipient origin. Therefore, some immune responses induced by the recipient CD8-positive T cells had an important role in pancytopenia in AA patients after allo-BMT.

Adult↗

MyD88 is involved in the signalling pathway for Taxol-induced apoptosis and TNF-alpha expression in human myelomonocytic cells.

Taxol is an effective anti-tumour drug against a variety of tumour cells. Taxol directly induces apoptosis in addition to a G2/M cell cycle arrest. However, it remains poorly understood how Taxol induces apoptosis in tumour cells. Taxol induces the secretion of inflammatory cytokines in murine macrophages in a toll-like receptor-4 (TLR-4)-dependent manner in addition to its anti-tumour effects, but the effect of Taxol on human macrophages is controversial. In this study, we demonstrated that low doses (less than 1000 nmol/l) of Taxol induced the expression of tumour necrosis factor (TNF)-alpha in human myelomonocytic cells and that the induction of TNF-alpha mRNA was inhibited by dominant-negative myeloid differentiation protein (dnMyD88). Furthermore, we demonstrated that the same doses of Taxol induced apoptosis of the same myelomonocytic cells and that the Taxol-induced apoptosis was also inhibited by dnMyD88. In accordance with the previous reports, Taxol induced the expression of TNF-alpha and apoptosis in a TLR4-independent manner. These results suggest that TNF-alpha expression and apoptosis, both induced by Taxol in human myelomonocytic cells, share the signal transduction molecule MyD88.

Adaptor Proteins, Signal Transducing↗

Decreased blood flow of the left thalamus during somnolent episodes in a case of recurrent hypersomnia.

A 24-year-old male with recurrent hypersomnia associated with decreased blood flow in the thalamus on single photon emission computed tomography (SPECT) is reported. In the hypersomnolent period, the decrease of blood flow in the left thalamus was revealed in the SPECT and slow waves appeared sporadically or sometimes as a burst on the electroencephalogram (EEG). In a phase of insomnia in the convalescent period there were almost no slow waves in the resting EEG but many slow waves appeared on hyperventilation EEG and the power spectrum at this hyperventilation resembled the power spectrum at the resting EEG in the hypersomnolent period. In the remission period there was no abnormal data in these testings.

Adult↗

Effects of aroma on sleep and biological rhythms.

The polysomnogram (PSG), blood melatonin concentration, rectal temperature, and answers to a self-evaluation questionnaire about the effects of agarwood (jinkoh in Japanese), which has been reported to have sleep-promoting effects were examined. The subjects tested were male medical students, who were free of otorhinolaryngological diseases and were non-smokers. The results of sleep stage and other sleep variables, and those of rectal temperature rhythm and blood melatonin concentrations showed no significant differences between the baseline nights, experimental nights, and recovery nights.

Adult↗

A case of testicular malignant lymphoma with extension to the epididymis and spermatic cord.

Findings of magnetic resonance imaging (MRI) in a case of testicular lymphoma are presented. The tumor was lower intensity than the normal testis on T2-weighted images. Coronal images clearly showed the tumor extending to the spermatic cord. Compared with seminoma, lymphoma more often invades the epididymis and spermatic cord. MRI is a useful method for differentiating between testicular lymphoma and seminoma because it clearly shows tumor extension to the epididymis and spermatic cord.

Contrast Media↗