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Biomedical subjects

K Kashiwabara

Publications and source records attributed to K Kashiwabara.

At least 19 recordsLinked to original sources
PubMed2001

Significance of contracted cholecystitis lesions as high risk for gallbladder carcinogenesis.

A precancerous change has been identified incidentally in resected specimens from patients who have undergone cholecystectomy. We focused on chronic cholecystitis, showing a thick and sclerotic wall caused by recurrent inflammation, e.g. contracted cholecystitis, and examined the malignant potential of these lesions. We studied 88 patients who had undergone cholecystectomy. Contracted cholecystitis was diagnosed, using our criteria, in 28 of these cases. Ordinary chronic cholecystitis was diagnosed in 50 cases and gallbladder carcinoma in ten cases. We examined the expression of p53, Ki-67, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) immunohistochemically. Severe dysplasia or carcinoma in situ in a very small portion of the specimen was identified with hematoxylin-eosin staining in four cases (14.3%) of contracted cholecystitis. These specimens revealed a positive expression of not only p53, but also Ki-67, iNOS, and COX-2. Statistical significance was shown among the three disease groups in terms of the incidence of p53 overexpression, respectively (P<0.05). The results of this study suggest that contracted cholecystitis could be an early change leading to carcinogenesis.

Cholecystitis↗
PubMed2001

Chronological change of serum carcinoembryonic antigen (CEA) concentrations and pulmonary function data after cessation of smoking in subjects with smoking-associated CEA abnormality.

We evaluated changes in serum carcinoembryonic antigen (CEA), peripheral neutrophil concentrations, and ratio of the forced expiratory volume in 1 s to the forced vital capacity (FEV1%) values after cessation of smoking in subjects with smoking-associated CEA abnormality (>5.0 ng/ml) (n=119). In all 25 subjects who gave up smoking (ex-smokers), CEA concentrations 1 year after the cessation decreased within the reference range and neutrophil concentrations were lower than those while smoking. However, both concentrations after 3 years were still higher than those who have never smoked (non-smokers) (n=86). Average CEA and neutrophil concentrations in 94 subjects who continued to smoke (smokers) were stable. There was no difference between chronological changes of FEV1% over 3 years in ex-smokers and in smokers. However, FEV1% values for 3 years in ex-smokers were lower than those in non-smokers. These findings suggest that the ex-smokers who gave up smoking 3 years ago are still affected by past smoking.

Adult↗
PubMed2001

A case of esophageal sarcomatoid carcinoma with molecular evidence of a monoclonal origin.

A case of polypoid tumor of the esophagus consisting of a sarcomatous tumor partly covered with superficial squamous cell carcinoma is described. The sarcomatous component consisted of anaplastic spindle and pleomorphic tumor cells that mimicked malignant fibrous histiocytoma (MFH). Both the sarcomatous and carcinomatous components were positive for p53 immunohistochemically. Further molecular analysis revealed that the two components had the same somatic mutation in the p53 gene. These results suggest a monoclonal origin of this biphasic tumor.

Aged↗
PubMed2001

Aberrant expression of pRb, p16, p14ARF, MDM2, p21 and p53 in squamous cell carcinomas of lung.

Expression of cell cycle regulatory proteins in both the RB and p53 pathways was investigated in 50 cases of squamous cell carcinoma (SCC) of the lung using immunohistochemical techniques. Abnormality of pRb and p16 expression was seen at the frequencies of 16% and 78%, respectively, and appeared to be in a reciprocal relationship. On the other hand, strong and diffuse p53 immunoreactivity was seen in 60% of SCCs. MDM2 and p14ARF expressions were each observed in about half of the cases of SCC and were not significantly associated with strong p53 immunoreactivity. Statistical analysis revealed that p14ARF expression was significantly correlated with both p16 and MDM2 expression. Moreover, strong p53 expression was not correlated with the expression of p21. In comparing clinicopathological status with the immunohistochemical results, lack of p16 immunoreactivity was observed in the elderly group (over 65 years) as compared with the younger group (less than 65 years). Strong p53 expression was frequently observed in higher stages of SCC, with the developing tumor located in the central field of the lung. Similarly, the frequency of p14ARF expression was high in centrally developed SCC, but low in SCC developed in the periphery. These results suggest that disruption of the RB and p53 pathways is a frequent event in SCC, and that abnormal expression of p16 and p53 plays a more critical role than that of pRB, p14ARF and MDM2 in the development of SCC of the lung.

Age Factors↗
PubMed2001

Analgesic-induced asthma caused by 2.0% ketoprofen adhesive agents, but not by 0.3% agents.

A 74-year-old woman was admitted with an asthma attack. She had a 40-year history of sinusitis, nasal polyp and analgesic-induced asthma; however, asthma had never occurred when she used a 0.3% ketoprofen adhesive patch (Mohrus) for stiff shoulder or lumbago. In the hospital, a life-threatening asthma attack suddenly occurred two and a half hours after application of a 2.0% ketoprofen adhesive tape (Mohrus tape) to her shoulder. She was treated with bronchodilator and glucocorticoid and extubated after 20 hours. A drug lymphocyte stimulating test (DLST) was strongly positive for ketoprofen. We suspected that drug-induced hypersensitivity coexisted in the present case, but it was not clear whether or not the hypersensitivity was related to the pathogenesis of analgesic-induced asthma.

Adhesives↗
PubMed2001

Sarcoid reaction in primary tumor of bronchogenic large cell carcinoma accompanied with massive necrosis.

A 49-year-old woman consulted our hospital for evaluation of a tumor with cavitation in the S6 segment of the right lung. She was given a diagnosis of pulmonary tuberculoma because percutaneous needle aspiration cytology revealed epithelioid cells with a background of necrosis. However, a diagnosis of large cell carcinoma with central necrosis (p-T2NOM0) was established by thoracoscopic lung biopsy six months later. Pathological findings of surgical resection specimens showed that epithelioid cell granulomas adjacent to the neoplasm had a sarcoid reaction and the necrosis was related to the rapidly growing tumor because there was no clinical evidence of systemic sarcoidosis and pulmonary mycobacterial or fungal infection. This is the first report in which sarcoid reactions were recognized in a primary large cell carcinoma.

Antitubercular Agents↗
PubMed2000

Prognosis in bronchogenic squamous cell carcinoma groups divided according to serum squamous cell carcinoma-related antigen and cytokeratin 19 fragment levels.

We examined differences in the 2-year survival rate in bronchogenic squamous cell carcinoma patients with normal serum levels of both cytokeratin 19 fragment (CYFRA 21-1) and squamous cell carcinoma-related antigen (SCC) (NL group, n=15), patients with only increased SCC levels (SCC+ group, n=14), patients with only increased CYFRA 21-1 levels (CYFRA+ group, n=14), and patients with elevated levels of both CYFRA 21-1 and SCC (EL group, n=65). The 2-year survival rates for the CYFRA+ and the EL group were lower than those for the SCC+ group and the NL group (0 and 12.9% vs. 66.7 and 85.6%, log rank: p<0.0001, Wilcoxon: p<0.0001). However, there were no differences between the rate for the SCC+ and the NL group and between that for the CYFRA+ and the EL group. Serum carcinoembryonic antigen (CEA) levels increased in the patients with the elevated CYFRA 21-1 levels. This results suggest that there may be some differences between squamous cell carcinoma patients with increased CYFRA 21-1 levels and those with normal levels and that it is CYFRA 21-1 levels, not SCC levels, that relate to the prognosis.

Aged↗
PubMed2000

Immunohistochemical inactivation of p14ARF concomitant with MDM2 overexpression inversely correlates with p53 overexpression in oral squamous cell carcinoma.

The CDKN2 gene encodes two structurally different proteins: a cyclin-dependent kinase inhibitor called p16, which regulates retinoblastoma protein (pRb)-dependent G1 arrest, and a cell cycle inhibitor designated p14ARF, which arrests cell growth in G1-S and also in G2-M. Whereas inactivation of p16 has been described as a frequent event in various cancers, including oral cancer, the current function of p14ARF is still poorly understood. A physical association between p14ARF and MDM2 blocks MDM2-induced p53 degradation, resulting in increased levels of p53, which in turn leads to cell cycle arrest. The present study immunohistochemically examined the expression of p16 and p14ARF together with pRb, MDM2 and p53 status in a series of oral cancers. The results showed that p14ARF was frequently absent in the oral cancers (15/37, 41%) as was p16 immunostaining. Concomitant immunopositivity for p14ARF and MDM2 overexpression was frequently observed in a subset of the cancers, whereas an inverse correlation between p14ARF and MDM2 expression and the diffuse staining of p53 was clearly detected. Moreover, the results showed that in most cases of oral cancer (35/37, 95%) at least one protein was altered, and lymph node metastasis was more frequent in the tumors with alterations in both the p16/pRb and p14ARF/p53 pathway (8/16, 50%) than in the tumors with one or no alteration of these two major pathways.

Adult↗
PubMed2000

Changes in squamous cell carcinoma-related antigen levels before and after hemodialysis in relation to the model of dialyzer employed.

OBJECTIVE: Although tumor marker levels in blood become elevated after hemodialysis as a result of the amount of fluid removed, serum squamous cell carcinoma-related antigen (SCC) levels have not been always reported to increase after hemodialysis. The purpose of this report is to determine whether there is a difference between the change of serum SCC levels before and after hemodialysis according to the model of dialyzer employed. PATIENTS AND METHODS: In ninety-four patients on hemodialysis (50 cases of diabetic nephropathy and 44 cases of glomerulonephritis), we examined serum SCC levels before and after hemodialysis. RESULTS: There was no overall difference between SCC levels before and after hemodialysis (3.2+/-1.5 ng/ml vs 3.3+/-1.7 ng/ml, p=0.2381). In patients treated with a cellulosic type membrane dialyzer (n=73), SCC levels after hemodialysis were higher than those before hemodialysis (3.7+/-1.7 ng/ml vs 3.5+/-1.5 ng/ml, p=0.0495). In patients treated with a synthetic type membrane (n=21), SCC levels after hemodialysis decreased when compared to those before hemodialysis (1.9+/-0.7 ng/ml vs 2.2+/-0.8 ng/ml, p=0.0018) and in all patients, the SCC levels after hemodialysis were lower than, or equal to, those before hemodialysis. CONCLUSION: The results suggest that the decline in serum SCC levels during hemodialysis treated with synthetic type membrane of dialyzers, concealed the increased SCC levels in hemoconcentration.

Antigens, Neoplasm↗
PubMed2000

[Sarcoidosis in a man and his identical twin sons].

Sarcoidosis is known to be a disease characterized by high familial aggregations. We reported on the genealogy of sarcoidosis in a man and his identical twin sons. The patient we encountered was a 49-year-old man admitted to our hospital because of abnormal chest X-ray findings observed during a medical checkup. Cervical and hilar lymph nodes were swollen on both sides, and lesions were observed in the right lung field. Biopsy specimens from cervical lymph nodes disclosed epithelioid cell granuloma without caseous necrosis. A diagnosis of sarcoidosis was made. The disease had also been diagnosed in the patient's identical twin sons 2 years earlier. They had been successfully treated and no recurrence has been observed. HLA typing disclosed that the father and his twin sons had identical A 33 (19), B 44 (12), DR 2, and DR 12 genes. This finding suggested that genetic factors are involved in the onset of this disease.

Adult↗
PubMed2000

[Mixed connective tissue disease-associated interstitial pneumonia complicated by pneumomediastinum during prednisolone therapy].

A 59-year-old woman was admitted to our hospital with exertional dyspnea. Linear and reticular opacities in the middle and lower fields of both lungs were observed on chest roentgenograms and chest computed tomograms (CT). The presence of anti RNP-antibody and Raynaud's phenomenon, sclerosis of the fingers, and leukopenia yielded a diagnosis of mixed connective tissue disease associated with interstitial pneumonia. The symptoms and lung involvement were alleviated after the administration of prednisolone (40 mg/day). However, the patient experienced the sudden onset of dyspnea during pulmonary function tests. A chest X-ray film disclosed mediastinal air around the left pulmonary artery, and a chest CT scan demonstrated some blebs in the left lower lung field. After tapering the dosage of prednisolone in 5 mg increments per week, the pneumomediastinum disappeared without treatment. The clinical features and laboratory data findings suggested the patient's interstitial pneumonia was associated with systemic lupus erythematosus rather than with progressive systemic sclerosis or dermatomyositis. The pneumomediastinum may have been due to the rupture of blebs secondary to interstitial pneumonia during pulmonary function tests or as a result of steroid therapy.

Acute Disease↗
PubMed1999

Serum cytokeratin 19 fragment levels in non-small cell lung cancer patients according to T factor in the TNM classification.

We examined changes in cytokeratin 19 fragment (CYFRA 21-1) levels in relation to the T factor in 64 non-small cell N2M0 lung cancer patients. Although a correlation between the levels and T factor was found (rho=0.627, p<0.0001), there was no difference between the levels in T3 and T4. Serum CYFRA 21-1 levels increased in the order of the following groups: the limited tumor group (T1+T2: n=28), the group with tumor extending to the pleura or chest wall (T3: n=13), and the group with tumor invading into the mediastinum (T4: n=12). The level was lower in the group with malignant pleural effusion (T4: n=11) than in the group with tumor invading into the mediastinum (6.7+/-4.7 ng/ml vs. 12.2+/-8.1 ng/ml, p=0.0046). We suspect that the presence of malignant pleural effusion is not directly related to the three-dimensional expansion of the tumor and this is a reason why CYFRA 21-1 levels in T4 are not higher than those in T3.

Antigens, Neoplasm↗
PubMed1999

Ki-1 (CD30)-positive anaplastic large cell lymphoma, sarcomatoid variant accompanied by spontaneously regressing lymphadenopathy.

Although it has been reported that primary Ki-1 (CD30)-positive anaplastic large cell lymphoma (ALCL) of the skin may undergo spontaneous regression, it is rare for ALCL without cutaneous involvement to have spontaneously regressing lymphadenopathy. We report a case of sarcomatoid variant of ALCL accompanied by spontaneously regressing lymphadenopathy. The patient had gastric and pulmonary involvement of ALCL in addition to systemic lymphadenopathy, but with no cutaneous involvement. The lymphadenopathy spontaneously improved gradually during a period of one month without any treatment. At the same time, multiple small nodules in both lung fields decreased on chest computed tomography and multiple elevated gastric tumors with dimples were endoscopically recognized to have improved. He has since been treated with combination chemotherapy because of recurrence of the lymphadenopathy.

Adult↗
PubMed1999

Cancer-associated retinopathy during treatment for small-cell lung carcinoma.

A 70-year-old woman with small-cell lung carcinoma (c-T4N2M0) was treated by six courses of combination chemotherapy (carboplatin and etoposide). After two weeks, she complained of a sense of darkness and night blindness. A Western blot analysis showed that the patient's serum bound with the recombinant 23-kDa retinal cancer-associated retinopathy (CAR) antigen at 1:1,000 dilution. Her visual acuity became so poor that she could only recognise a hand motion at 50 cm despite treatment with corticosteroids and combination chemotherapy. The patient was diagnosed as having a rare type of CAR because CAR is usually found before the diagnosis of primary cancer.

Adrenal Cortex Hormones↗
PubMed1999

[Holter electrocardiogram monitoring as an indicator of cardiac involvement of sarcoidosis].

Sarcoidosis was diagnosed in a 55-year-old non-smoking woman because biopsy specimens of a subcutaneous tumor in her right cheek disclosed a noncaseating epithelioid granuloma. The patient had experienced exertional dyspnea and palpitation. Two months later, she was admitted because a Holter electrocardiogram (ECG) revealed bradycardia, 2:1 atrioventricular block (Mobitz II type) and ventricular premature beat (1.091 beats/day). ECG findings on admission changed from 2nd-degree to 3rd-degree atrioventricular block. A permanent pacemaker was implanted and the patient's symptoms subsided. Mediastinal uptake of Gallium-67 was observed and a defect of the cardiac septum was disclosed by Thalium-201 scintigram. Closer examination of the first Holter ECG revealed a Mobitz II type 2:1 atrioventricular block for about 3 minutes a day. Although the findings of the first Holter ECG initially disclosed a 2nd-degree atrioventricular block in our patient, a complete block developed within about 2 months after admission. In the follow-up of sarcoidosis patients, it therefore seems important to not only evaluate Holter ECG findings carefully, but repeat the examination at regular intervals.

Cardiac Pacing, Artificial↗
PubMed1999

[Posterior mediastinal diffuse pleomorphic lymphoma].

A 26-year-old man presented with a 38 degrees C fever of undetermined origin in November 1977. His fever subsided in 1 month, but recurred concomitantly with dysphagia on December 10. For this reason, the patient visited our out patient clinic on December 15, and was hospitalized because a mass was found radiographically in the left lower lung field. A contrast-enhanced computed tomographic scan of the chest revealed an irregularly-shaped mass encircling the esophagus. Based on open-lung biopsy findings, the mass was diagnosed as non-Hodgkin's lymphoma, diffuse pleomorphic type. Neither swelling of the superficial lymph nodes nor hepatosplenomegaly was detected, and a bone-marrow aspiration specimen disclosed no atypical cells. Ga scintigraphy found accumulation only in this region, suggesting the posterior mediastinum as the origin of the lymphoma. Reports of non-Hodgkin's primary lymphoma in the posterior mediastinum are rare. Further, to our knowledge, there have been no reports at all on the diffuse pleomorphic type to date. This case was accordingly considered to be of highly informative value.

Adult↗
PubMed1999

[A case of Morgagni's foramen hernia difficult to differentiate from lipoma].

A 61-year-old woman was admitted for chest discomfort. She had been admitted before, in March 1995, because of a lesion detected on chest roentgenograms. At that time, she was given a diagnosis of mediastinal lipoma based on the findings of chest computed tomography (CT) and magnetic resonance imaging (MRI), but was discharged without active intervention due to lack of subjective symptoms. During follow-up, the patient again reported chest discomfort beginning in March 1998. Because chest radiography disclosed. The tumor had enlarged, the patient was admitted to the hospital by our department. Chest MRI disclosed a mass with a signal intensity equal to that of subcutaneous fat in the pericardial space on both T1-weighted and T2-weighted images. Although sagittal images demonstrated continuity of the mass into intraperitoneal fat, a conclusive diagnosis of diaphragmatic hernia could not be made at that time. On April 30, 1998, a thoracotomy was performed on the basis of a preoperative diagnosis of mediastinal lipoma. During surgery, a hernial ring was observed slightly to the right and behind the sternum. The hernia consisted only of greater omentum, and was diagnosed as Morgagni's foramen hernia.

Diagnosis, Differential↗