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Biomedical subjects

N Goseki

Publications and source records attributed to N Goseki.

At least 19 recordsLinked to original sources
PubMed2001

Laparoscopic enucleation of an insulinoma of the pancreas tail.

A 29 year-old woman with a tumor of the pancreatic tail was referred to our institute. The tumor was confirmed to be a solitary benign insulinoma that protruded from the pancreas and was distant from the main pancreatic duct. A laparoscopic enucleation was performed with Laparoscopic Coagulating Shears (LCS). The postoperative course was uneventful. The laparoscopic enucleation for benign pancreatic tumor was thought to be a feasible procedure when the appropriate instruments were used.

Adult↗
PubMed2001

Enhanced expression of mRNAs of antisecretory factor-1, gp96, DAD1 and CDC34 in human hepatocellular carcinomas.

To identify differentially expressed genes in hepatocarcinogenesis, we performed differential display analysis using surgically resected hepatocellular carcinoma (HCC) and adjacent non-tumorous liver tissues. We identified four cDNA fragments upregulated in HCC samples, encoding antisecretory factor-1 (AF), gp96, DAD1 and CDC34. Northern blot analysis demonstrated that these mRNAs were expressed preferentially in HCCs compared with adjacent non-tumorous liver tissues or normal liver tissues from non-HCC patients. The expression of these mRNAs was increased along with the histological grading of HCC tissues. These mRNA levels were also high in three human HCC cell lines (HuH-7, HepG2 and HLF), irrespective of the growth state. We also demonstrate that sodium butyrate, an inducer of differentiation, downregulated the expression of AF and gp96 mRNAs, supporting in part our pathological observation. Immunohistochemical analysis revealed that gp96 and CDC34 proteins were preferentially accumulated in cytoplasm and nuclei of HCC cells, respectively. Overexpression of these genes could be an important manifestation of HCC phenotypes and should provide clues to understand the molecular basis of hepatocellular carcinogenesis.

Adult↗
PubMed2000

[Intraperitoneal administration of CPT-11 in rats--experimental study for pharmacokinetics].

The pharmacokinetics of CPT-11 administered into rats to evaluate the future possibility of i.p. administration was investigated. Serum, bile juice, and intraperitoneal fluid was collected to measure the concentration of CPT-11, its metabolite SN-38, and SN-38 glucuronized (SN-38 glu). The concentration of CPT-11 was elevated after CPT-11 administration into the peritoneal cavity. The serum and biliary concentrations of SN-38 and SN-38 glu were increased and prolonged shortly after i.p. administration of CPT-11. These results suggest the possibility of i.p. administration of CPT-11 in the future.

Animals↗
PubMed1999

Identification and characterization of genes associated with human hepatocellular carcinogenesis.

Eight cDNAs encoding galectin 4 (Gal-4), UGT2B4 (UDP-glucuronosyltransferase), ribosomal phosphoprotein P0 (rpP0), dek, insulin-like growth factor binding protein (IGFBP) 1, vitronectin, retinoic acid-induced gene E (RIG-E), and CYP3A4 (cytochrome P450 nifedipine oxidase) were identified as differentially expressed genes between human hepatocellular carcinoma (HCC) and matched nontumorous liver tissues. Higher levels of UGT2B4, rpP0, dek, vitronectin, Gal-4, and IGFBP-1 mRNAs combined with a lower level of RIG-E mRNA were observed in at least four of five primary HCCs compared to matched nontumorous liver tissues. Furthermore, a pathological study suggested that the levels of UGT2B4, rpP0, dek, and vitronectin increased and the level of RIG-E decreased with the histological grading. On the other hand, the expression of CYP3A4 mRNA and CYP3A7 (P-450 Fla) mRNA, a transcript found in the fetus and highly homologous to CYP3A4, was higher in all nontumorous liver and some of the carcinoma tissues from five HCC patients, whereas it was significantly lower in normal liver tissues from two non-HCC patients. The examination using HCC cell lines HuH-7 and HepG2 under different growth conditions suggested that the expression of dek mRNA was growth-associated. In contrast, the expression of Gal-4, UGT2B4, IGFBP-1, and RIG-E mRNAs was regulated in a cell density-dependent manner: the levels of Gal-4, UGT2B4, and IGFBP-1 were undetectably low, whereas the level of RIG-E was high in rapidly proliferating, subconfluent HCC cells in 10% serum; however, the expression levels were reversed in dense, overcrowded cultures. In addition, IGFBP-1 and Gal-4 mRNAs were also induced by reducing the serum concentration to 0.1%. We also demonstrated that sodium butyrate, an inducer of differentiation, up-regulated and down-regulated RIG-E and dek mRNAs, respectively, in a dose-dependent manner in HuH-7 cells, supporting, in part, our pathological observation. In summary, therefore, high expression of Gal-4, UGT2B4, rpP0, dek, IGFBP-1, and vitronectin, together with low expression of RIG-E, was correlated with the malignant potential of HCC. CYP3A4 and CYP3A7 could be induced in HCC-bearing livers. These transcripts are differentially regulated depending on cell-cell contact, serum growth factors, growth and differentiation status, and/or other mechanisms in premalignant and malignant liver cells.

Antigens, Surface↗
PubMed1999

Regulation of methionine adenosyltransferase activity by the glutathione level in rat liver during ischemia-reperfusion.

Hepatic ischemia was induced by clamping the hepatic artery, portal vein, and bile duct. After 15 min of ischemia, the hepatic glutathione (GSH) content rapidly decreased. On the other hand, after the start of reperfusion, the hepatic GSH levels promptly increased and reached a peak at about 1 h, and thereafter decreased to a minimum level by 2 h. Under such conditions, we examined the changes in the methionine adenosyltransferase (MAT) activity in the liver. Though the time course of MAT activity was somewhat delayed compared with that of the hepatic GSH levels, both patterns were substantially similar during ischemia-reperfusion. In contrast to the changes in the MAT activity during ischemia-reperfusion, the levels of MAT protein were unchanged during these periods. When endogenous antioxidant coenzyme Q(10) (CoQ(10)) was administered to rats prior to ischemia, both the reduction in the MAT activity and hepatic GSH levels induced by ischemia-reperfusion were protected. Our findings suggest that CoQ(10) may posttranslationally regulate the MAT activity via the changes in the GSH level in the liver.

Animals↗
PubMed1999

Spatial arrangement of the pancreatic ducts in the head of the pancreas with special reference to the branches of the uncinate process.

BACKGROUND: It remains very difficult to clarify the spatial arrangement of the branches of the pancreatic ducts in the head of the pancreas despite recent progress in diagnostic imaging techniques. METHODS: We minutely dissected the head region from 15 cadavers after injection of silicone rubber into the ducts through the papilla of Vater to investigate the distribution of these ducts. RESULTS: We found that the branches that drained the uncinate process not only joined the main pancreatic duct but also constantly joined the accessory pancreatic duct. In addition, the branches of the uncinate process that joined the accessory duct ran anterior to those to the main duct. We classified the arrangement of the pancreatic ducts into type 1 (10 cases) and type 2 (5 cases) on the basis of the pattern of the branches of the uncinate process. The distance from the papilla of Vater to the junction of the main and accessory pancreatic ducts in type 1 (> 23.0 mm) was significantly longer than that in type 2 (< 22.0 mm). CONCLUSIONS: Careful attention should be paid to the branches of the uncinate process to the accessory pancreatic duct to enable more accurate diagnoses of the pancreas head region.

Aged↗
PubMed1998

Extraperitoneal retrograde transhepatic biliary drainage for common bile duct exploration for prevention of tube dislodgment and its earlier removal.

Primary bile duct closure with retrograde transhepatic biliary drainage (RTBD) using an RTBD tube (RTBDT) is a feasible surgical technique after common bile duct exploration in choledocholithiasis in comparison to conventional T-tube insertion. But, unfortunately, this technique is not popular because of the difficulty to introduce a catheter into a proposed intrahepatic bile duct branch without hepatic injury. In addition, the time for its safe removal is not shorter than that with T-tube insertion. So, we have devised a special needle-attached RTBDT (n-RTBDT) to guide the tube via the intrahepatic bile duct of the liver with minimal hepatic injury, and proposed a new surgical technique, namely extraperitoneal RTBD (Ep-RTBD), using the n-RTBDT providing earlier removal without fistula formation in the general peritoneal cavity. In all patients with common bile duct calculi who underwent this surgical procedure, the tube could be revoved within 10 postoperative days with no complication.

Biliary Tract Surgical Procedures↗
PubMed1996

Acceleration of proliferative activity of esophageal squamous cell carcinoma with invasion beyond the mucosa: immunohistochemical analysis of Ki-67 and p53 antigen in relation to histopathologic findings.

BACKGROUND: The authors observed patients with superficial esophageal squamous cell carcinoma (s-ESC). Those with cancer invasion beyond the muscularis mucosae (SM-carcinoma) had an extremely poor prognosis, compared with those with intramucosal carcinoma (M-carcinoma). Therefore, we surveyed cell proliferative activities in relation to pathologic findings of the s-ESC. METHODS: p53 protein expression and Ki-67 labeling index (LI) were surveyed with detailed pathologic examinations of 75 s-ESC lesions from 70 patients who underwent esophagectomy. The results were compared by statistical analysis using the chi-square test and unpaired Student's t-test. RESULTS: p53 protein expression was observed in 57.3% of the patients with s-ESC. The frequency and intensity of its accumulation correlated with the depth of cancer invasion and was markedly elevated in invasion beyond the muscularis mucosae. The LI of Ki-67 positive nuclei was also increased with cancer invasion. The values in the intraepithelial carcinoma and in carcinoma with invasion to the muscularis mucosae were 48.5 +/- 13.7% [mean +/- standard deviation (SD)] and 66.6 +/- 12.9%, respectively, and the difference is significant, P < 0.01. In the SM-carcinomas, the LIs of Ki-67, with or without lymph node metastasis, were 73.5 +/- 10.0% and 64.4 +/- 11.3%, respectively, and the former was higher than the latter with a significant difference, P < 0.05. CONCLUSIONS: Cancer cell proliferative activities were markedly accelerated in s-ESC cases with cancer invasion beyond the muscularis mucosae and lymph nodal involvement, which was associated with a poorer prognosis of the SM-carcinoma compared with the M-carcinoma, and must be one of the important indices to decide the indication of local resection for s-ESC.

Aged↗
PubMed1996

Esophageal carcinoma and coexisting hepatocellular carcinoma resected simultaneously.

We have experience with two cases in which esophageal carcinoma and coexisting hepatocellular carcinoma were resected simultaneously. One patient had advanced esophageal carcinoma located in the thoracic esophagus and solitary hepatoma in the posterior segment of the liver with normal liver function. The other patient had superficial esophageal carcinoma in the thoracic esophagus and solitary hepatoma in the posterior segment of the liver with impaired liver function. Subtotal resection of the esophagus and posterior segmentectomy of the liver were performed simultaneously in both patients. In the patient with impaired liver function, postoperative management of respiration and bleeding was difficult, and intensive care was needed. Mediastinal lymph node resection was modified. Postoperative course was considered to have a close relationship to liver function. Thus, close evaluation of liver function is important to decide suitable treatment of patients with primary hepatocellular carcinoma and coexisting malignant neoplasms. With close evaluation of liver function and intensive postoperative care, simultaneous resection of esophageal carcinoma and hepatocellular carcinoma is not impossible or difficult.

Aged↗
PubMed1996

Fishing-rod-type abdominal wall lifter for gasless laparoscopic surgery.

We have designed a new abdominal wall lifter for gasless laparoscopic surgery which consists of stainless steel rods and iron lifters. They elevate the abdominal wall up like a dome-type camping tent, which does not disturb any manipulation of scope or X-ray camera. We received a good view of the peritoneal cavity without CO2 gas insufflation in ten patients with cholecystitis. This will be helpful for general laparoscopic surgery or laparoscopic assisted surgery with the use of conventional forceps or extracorporeal suturing through a valveless trocar.

Abdominal Muscles↗
PubMed1996

Giant epiphrenic diverticulum with achalasia occurring 20 years after Heller's operation.

We report a case of giant epiphrenic diverticulum in a 43-year-old woman who underwent Heller's myotomy because of achalasia 20 years earlier. She complained of heartburn and dysphagia from March of 1991 and was hospitalized in our institution. An upper gastrointestinal X-ray examination with contrast medium revealed a large hemispheric lesion (7.8 x 4.8 cm) occupying the right posterior wall of the lower thoracic and abdominal esophagus. Manometry revealed a motility disorder and high pressure of the lower esophageal sphincter due to achalasia. Therefore she was diagnosed as having a giant diverticulum with achalasia after Heller's operation. She underwent transhiatal esophagectomy and reconstruction with placement of a gastric tube on June 4, 1992. Pathology results on the resected specimen revealed a false diverticulum. She has been doing well for 4 years since the operation. It has been said that a complication of incomplete long myotomy causes pulsion diverticulum, but we could not find a case of epiphrenic diverticulum after myotomy for achalasia reported in the literature in the last 10 years.

Diverticulum, Esophageal↗
PubMed1996

Enhanced anticancer effect of vincristine with methionine infusion after methionine-depleting total parenteral nutrition in tumor-bearing rats.

Methionine-depleting total parenteral nutrition (Met(-) TPN), in which an amino acid solution devoid of L-methionine and L-cysteine is infused, is thought to reduce tumor cell growth through acting as a partial late S-G2 (i.e., late-S and G2 phases) blocker. The antitumor effect of vincristine (VCR), which acts on mitotic phase cells, was examined with methionine infusion immediately after Met(-) TPN in Yoshida sarcoma (YS)-bearing rats. Rats were given Met(-) TPN for 8 days immediately after inoculation with YS cells (days 0 to 8), which was followed by methionine-containing (Met(+)) regular TPN for 3 days (days 9-11) along with intraperitoneal administration of 0.05 mg/kg/day VCR. All rats were then fed solid food and water ad libitum until they died, with 0.1 mg/kg VCR administration on days 12 and 13. As controls, a Met(-) TPN only group, Met(+) TPN groups with and without VCR, and freely fed groups with and without VCR were studied. The progression of YS was markedly suppressed by Met(-) TPN with VCR. The median survival time in days was 25 days, significantly longer (P<0.001) (generalized Wilcoxon's tests) by 11 to 14 days than that of any of the other groups. In conclusion, VCR appears to have greater efficacy as an anticancer agent when administered together with methionine after Met(-) TPN.

Animals↗
PubMed1996

Multiple endocrine neoplasia type 1 associated with spinal ependymoma.

A 51-year-old man was hospitalized with a gait disturbance and hypoesthesia below the level of his chest. These symptoms were due to a spinal tumor which was surgically resected and identified as an ependymoma. Additionally, the patient had hypercalcemia and a family history of insulinoma. An endocrine evaluation revealed parathyroid hyperplasia and a pancreatic islet cell tumor. Magnetic resonance imaging disclosed a pituitary microadenoma. He was diagnosed with spinal ependymoma and multiple endocrine neoplasia type 1 (MEN 1). A review of the literature revealed that chromosome 11q13 abnormalities have been reported in both ependymoma and MEN 1. We discuss the pathogenesis of these diseases.

Chromosome Aberrations↗
PubMed1996

Increased plasma atrial natriuretic peptide and endothelin concentrations after surgery in patients with esophageal and gastric cancer.

Endothelin-1 (ET-1) and human atrial natriuretic peptide (hANP) are known as vasoactive substances. In the present study, an attempt was made to evaluate the mode by which these substances are secreted in patients having severe surgical stress. Plasma ET-1 and hANP concentrations were measured in 15 patients with esophageal carcinoma who underwent subtotal esophagectomy via right-thoraco-ventrotomy (EC group) and 10 patients with gastric carcinoma who underwent total gastrectomy via ventrotomy (GC group). The volume of intraoperative hemorrhage was significantly larger and operation time was significantly longer in the EC group than in the GC group. Plasma ET-1 concentration in the EC group increased remarkably on the first operative day (1st POD), whereas that in the GC group did not. Plasma levels of hANP in both the EC and GC groups gradually increased until they peaked on the 2nd POD. The increment of plasma hANP secretion for the EC group was significantly higher than that for the GC group on the day of the operation, suggesting that ET-1 stimulated hANP in the EC group. Plasma hANP levels reached their peak values on the 2nd POD and returned to the preoperation level on the 5th POD, while PCWP did not change significantly after the surgery. Since this discrepancy between the postoperation patterns of PCWP and hANP cannot be explained by changes in the circulating blood volume, hANP secretion may be regulated by certain factors in addition to the left ventricular pressure experienced by patients receiving heavy operation stress, such as those in the EC group.

Atrial Natriuretic Factor↗
PubMed1995

Nourishment of hepatocellular carcinoma cells through the portal blood flow with and without transcatheter arterial embolization.

BACKGROUND: Although transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) is very effective, local recurrence is not so rare. The reason is thought to be related to portal blood flow. The changes in the nourishing vessels in HCC after TAE were examined from the viewpoint of cell kinetics with direct reference to intracellular transportation of biochemical substrates, namely 5 bromo-2'-deoxyuridine (BrdU), an analogue of thymidine. METHODS: To examine the cell kinetics of carcinoma cells, BrdU was infused intraoperatively in 23 patients with HCC (12 without TAE and 11 post-TAE patients) directly into the portal branch feeding the region to be resected. Specimens were prepared for immunohistochemical staining using BrdU monoclonal antibodies and analyzed using the labeling index (LI). The distribution of the labeled S-phase cell was also examined. RESULTS: The LI in post-TAE patients was about six times higher than patients without TAE, with a significant difference at P < 0.001. Labeled cells were distributed not only peripherally but in the central part of the tumor, although the number was extremely small. CONCLUSIONS: Some HCC cells, although small in number, are nourished by the portal blood flow directly throughout the viable tumor mass, which may act as the main blood supplier during the period after TAE. For greater local control of HCC, complete resection of HCC and/or the use of chemotherapy via not only the hepatic artery but also the portal blood flow are beneficial.

Adult↗
PubMed1995

Morphological changes in gastric carcinoma with progression.

By combining morphological two indices, namely, (1) the degree of differentiation of glandular tubules (well or poor) and (2) the amount of intracellular mucus (rich or poor), we previously classified histological types of gastric carcinoma into four types. Using this histological classification, we studied the morphological changes of gastric carcinoma according to extra-gastric invasion in 200 autopsy and 200 resected cases. In cases in which the predominant histological type in the lamina propria was "tubular differentiation--well, mucus in cytoplasm--poor," there was a greater incidence of co-existence with other histological types. In many of these cases, the predominant histological findings changed to "tubular differentiation--poor" in the subserosa, followed by direct invasion into neighboring extra-gastric tissues. In all cases in which the predominant histological type in the lamina propria was "tubular differentiation--poor," the predominant histological type in the subserosa was also "tubular differentiation--poor." To understand the mode of extension of gastric carcinoma in relation to the histological type, we must consider not only the characteristics of the predominant histological types of carcinoma but also those of co-existing types, especially in cases of "tubular differentiation--well, mucus in cytoplasm--poor."

Autopsy↗