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R Kashiwagi

Publications and source records attributed to R Kashiwagi.

9 recordsLinked to original sources
PubMed2001

Genetic analysis of a local recurrent tumor after colonic polypectomy.

After polypectomy, the cut end of the polyp is usually examined by light microscopy to assess the risk of recurrent cancer. Here, we report a recurrent tumor that appeared in the colon 6 years after polypectomy, although cancer cells were not observed in hematoxylin and eosin-stained sections of the cut end of the primary polyp. Retrospectively, the primary polyp and the recurrent tumor were analyzed for mutations of the p53 gene. We detected p53 mutations in the primary polyp, even in the cut end of the polyp. The same set of two p53 mutations was detected in the recurrent tumor. These observations indicate a common origin of the primary tumor and the recurrent tumor. We conclude that it is important to analyze p53 mutations in colonic polyps, especially when the cut end of the polyp is difficult to evaluate histologically, in order to predict recurrence.

Adenocarcinoma↗
PubMed2001

Aging increases, and duodenal ulcer reduces the risk for intestinal metaplasia of the gastric corpus in Japanese patients with dyspepsia.

BACKGROUND AND AIMS: The classification of gastritis by using the revised Sydney system suggests that there are two types of Helicobacter pylori-related gastritis. The aim of the present study was to examine the risk factors that might be involved in the presence of either atrophic gastritis or intestinal metaplasia of the gastric corpus of Japanese patients. METHODS: Biopsy samples were obtained from the gastric corpus in 154 patients with dyspepsia, and the degree of atrophy or intestinal metaplasia was determined histologically. The correlation between several variables and presence of atrophy or intestinal metaplasia was evaluated by using multivariate analysis. RESULTS: Among the 11 variables, which included age, peptic ulcer diseases and H. pylori infection, H. pylori infection was the major risk factor associated with the presence of atrophic gastritis or intestinal metaplasia of the gastric corpus. In contrast, duodenal ulcer (DU) disease reduced the risk of contracting both conditions. Age was an independent risk factor only for intestinal metaplasia of the gastric corpus. When 128 H. pylori-positive subjects were analyzed, DU and age were similarly associated with the presence of both conditions. CONCLUSIONS: These results suggest that DU reduces the risk for contracting atrophic gastritis and intestinal metaplasia, and age is an independent risk factor for intestinal metaplasia of the gastric corpus in dyspeptic Japanese patients.

Adult↗
PubMed2001

Concurrent occurrence of gastric adenocarcinoma and duodenal neuroendocrine cell carcinoma: a composite tumour or collision tumours ?

BACKGROUND: Neuroendocrine cell (NEC) carcinoma is occasionally accompanied by adenocarcinoma but the relationship between these two morphologically distinct tumours is unclear. Two hypotheses have arisen regarding the mechanism for the association of adenocarcinoma and NEC carcinoma. One is that both are derived from a common multipotential epithelial stem cell. The second hypothesis is that adenocarcinoma and NEC carcinoma arise from a multipotential epithelial stem cell and a primitive NEC, respectively. AIMS: To elucidate the relationship between the two histologically distinct tumours, adenocarcinoma of the stomach and NEC carcinoma of the duodenum. PATIENT/METHODS: We present a case in which the tumour extended across the pyloric ring, the gastric portion of which revealed adenocarcinoma while the duodenal portion showed argyrophil NEC carcinoma. The two histologically distinct lesions of the tumour were examined by immunohistochemistry and genetic analysis of p53. RESULTS: The gastric region was negative for chromogranin A staining but positive for carcinoembryonic antigen (CEA) staining. In contrast, the duodenal region was positive for chromogranin A but negative for CEA. All tumour regions showed a point mutation in p53 gene at exon 7 (GGC (glycine)-->GTC (valine) at codon 245). The distal portion of the duodenal tumour showed an additional point mutation in p53 gene at exon 5 (GCC (alanine)-->GTC (valine) at codon 129). CONCLUSIONS: The two histologically distinct tumours, adenocarcinoma of the stomach and NEC carcinoma of the duodenum, appear to be derived from a common epithelial cell.

Adenocarcinoma↗
PubMed2000

3D-CT diagnosis for ingested foreign bodies.

Ingested foreign bodies can be hard to diagnose but cannot be missed. We report two cases where helical computed tomography (three-dimensional computed tomography) was used for the effective preoperative diagnosis (swallowed fish bone-induced perforation of sigmoid colon and a case of ileus caused by ingested PTP [press-through package]). Other traditional diagnostic methods could not identify the foreign bodies. Three-dimensional computed tomography is useful for the diagnosis of foreign body ingestion and should be used for the difficult cases.

Abdominal Pain↗
PubMed1999

Plasma lipoprotein (a) levels in children with minimal lesion nephrotic syndrome.

We studied the plasma lipoprotein (a)[Lp(a)] levels in 31 children with minimal lesion nephrotic syndrome (MLNS) in both stages of acute NS and remission. The mean Lp(a) levels in acute NS were significantly higher than those of the controls. The Lp(a) levels in remission were significantly lower than the Lp(a) levels in acute NS. In addition, the Lp(a) levels in remission were not significantly different from those of the controls. However, there were 5 patients whose Lp(a) levels remained higher than 30 mg/dl (the generally accepted limit for cardiovascular risk) after remission. Two of these 5 patients had Lp(a) levels greater than 40 mg/dl. In these patients apoprotein (a) [apo(a)] phenotypes were of lower molecular weight than those of the other 23 patients whose apo(a) phenotypes were examined. Additional episodes of relapse may put the patient with sustained elevated Lp(a) levels at significant risk for the development of cardiovascular disease in the long term.

Adolescent↗
PubMed1999

Clinical significance of apolipoprotein (a) deposition in kidney diseases of children.

AIM AND METHOD: To address the clinical significance of lipoprotein (a) (Lp(a)) deposition in renal diseases of children, we examined renal localization of apolipoprotein (a) (apo(a)), which is the major apoprotein of Lp(a), using a new monoclonal antibody as a probe, and compared histological changes and clinical courses between the cases with and without apo(a) accumulation. Our study comprised 78 cases with various renal diseases. RESULTS: Of the 78 cases, 45 showed apo(a) deposition (group A) and the other 33 did not (group B). Nephrotic syndrome was similarly presented in groups A and B (46.7% vs 36.3%). Histological findings were analyzed in 62 proliferative and 16 non-proliferative original diseases separately. In the cases with proliferative diseases, severe histological changes were observed in group A more than in group B, severe proliferation (50.9% vs 26.1%: p < 0.01) and crescent formation (11.9% vs 5.1%: p < 0.01) were observed in group A over that of group B. However, the clinical status at the latest follow-up were quite similar, there was no difference of favorable (60.5% vs 62.5%) and unfavorable outcome (15.9% vs 16.7%) in groups A and B. In the cases with non-proliferative diseases, global sclerosis was more often encountered in group A than in group B (28.3% vs 6.5%). Group A carried poorer prognosis than group B in non-proliferative diseases. CONCLUSION: These results suggest that apo(a) deposits just passively follow the histological injury, and they do not always accelerate it.

Adolescent↗
PubMed1999

[Renal glucosuria and membranous glomerulonephritis in chronic inflammatory demyelinating polyradiculoneuropathy: CIDP].

Glucosuria was detected in a 7-year-old boy by a routine school mass examination in April 1991. The diagnosis of renal glucosuria was made in the affiliated hospital of the University of Tsukuba. The patient developed muscle weakness and gait disturbance in February 1993. Spinal fluid examination revealed a protein level of 62 mg/dl and a cell count of 4/3. Under the diagnosis of Guillain-Barré syndrome, he was treated with i.v. immunoglobulin and oral prednisolone. Although the therapy somewhat improved the symptoms, his muscle strength had not fully recovered at the end of the treatment. In November 1995, the muscle weakness became worse; he could not go up stairs, nor stand upright on one leg. In April 1996, proteinuria was detected in a school mass examination. He was referred to the University Hospital of Tsukuba for a full renal study in March 1997. Renal biopsy revealed global sclerosis in 16 of 19 glomeruli with extensive interstitial fibrosis and mononuclear cell infiltration. A diagnosis of membranous glomerulonephritis was established based on the findings of spikes in PASM staining, weak IgG deposition in the glomerular capillary and subepithelial deposits by electron microscopic study. Additionally, pituitary growth hormone deficiency was found by endocrinological examination. The diagnosis of CIDP was established by fibulal neuron biopsy, which revealed neuronal degeneration and profound demyelinization. The clinical course of the present case was unlike that of the few reported cases of MGN associated with CIDP described in the literature. The initial renal symptom was glucosuria, which started 5 years prior to the onset of proteinuria. Second, glomerulosclerosis was more extensive than that seen in the literature. We surmise that chronic interstitial nephritis of insidious onset was followed by MGN which developed subsequently, probably at the time of the start of proteinuria.

Adolescent↗
PubMed1996

Recombinant human c-Mpl ligand is not a direct stimulator of proplatelet formation in mature human megakaryocytes.

To evaluate the effect of the c-Mpl ligand on platelet production by megakaryocytes, we investigated proplatelet formation in isolated human megakaryocytes cultured in serum-free medium, with or without the c-Mpl ligand, interleukin-6 and erythropoietin. When interleukin-6 was added to the culture medium, the percentage of megakaryocytes displaying proplatelets was approximately 1.5-fold the control value; whereas, in the presence of the c-Mpl ligand, the percentage of megakaryocytes displaying proplatelets decreased in a dose-dependent manner and did not increase compared to control values at any dose tested. However, the viability of megakaryocytes after a 4 d culture in the presence of the c-Mpl ligand was significantly higher than that of the cells cultured without it. The c-Mpl ligand did not stimulate the proplatelet formation in megakaryocytes in vitro.

Blood Platelets↗