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Biomedical subjects

S Kitano

Publications and source records attributed to S Kitano.

At least 91 records · Page 5Linked to original sources
PubMed2000

Jejunal interposition to prevent postgastrectomy syndromes.

BACKGROUND: Postgastrectomy syndromes include reflux gastritis and oesophagitis, dumping syndrome, intractable diarrhoea and afferent loop syndrome. To prevent such syndromes, since January 1994 jejunal interposition has been used following distal gastrectomy. The aim of this study was to evaluate the benefit of this procedure. METHODS: A consecutive series of 42 patients who underwent distal gastrectomy for gastric cancer was studied. Twenty-two patients had a Billroth I procedure before January 1994, and 20 patients had isoperistaltic jejunal interposition using a 10-12-cm segment after January 1994. RESULTS: The mean operating time was 260 min for Billroth I and 352 min for jejunal interposition. No serious postoperative complications arose. Reflux gastritis occurred in 19 patients after Billroth I but in none after jejunal interposition. Five patients in the Billroth I group had complaints consistent with dumping syndrome, compared with none after jejunal interposition. The barium gastric emptying time was significantly shorter after Billroth I (mean(s.d.) 269(225)s) than after jejunal interposition (736(479) s) (P < 0.01). CONCLUSION: Jejunal interposition prevented reflux gastritis and inhibited rapid gastric emptying. Postgastrectomy syndromes were effectively prevented by this reconstruction procedure.

Adult↗
PubMed2000

Telomerase activity in peripheral blood for diagnosis of hepatoma.

BACKGROUND: Telomerase activity may be used as a molecular marker for the detection of circulating hepatoma cells in blood of patients with hepatoma. METHODS: Telomerase activity in peripheral blood from hepatocellular carcinoma (HCC) patients was assessed by using a highly sensitive and non-radioisotope telomerase polymerase chain reaction (PCR) ELISA. Initially, tissue telomerase activity was measured in the hepatoma and non-tumour portions by using PCR ELISA within the same specimen, to compare its sensitivity with the conventional telomeric repeat amplification protocol (TRAP) method. Second, telomerase activity was measured in the peripheral blood obtained from patients with HCC, patients with chronic liver disease and in healthy controls. RESULTS: Of the 17 HCC patients, telomerase activity was found to be positive in 14 (82%) by using TRAP and 15 (88%) by using PCR ELISA, indicating that PCR ELISA is a reliable tool for the measurement of telomerase activity. By using the Telomerase PCR ELISA assay, telomerase activities in the peripheral blood of 20 HCC patients was 1.65 +/- 0.78 units. This was significantly greater than the results obtained for 20 chronic liver disease patients (0.43 +/- 0.36 units) and 20 healthy controls (0.39 +/- 0.14 units; P < 0.0001).When the arbitrary cut-off level was set at 0.7 units (maximum value of healthy controls + 0.1), the positive frequency of telomerase activity was 25% for chronic liver disease and 80% for HCC patients (sensitivity 80%, specificity 75%). Among the HCC patients, high telomerase activity in the peripheral blood was shown at stage III HCC with vascular invasion (2.10 +/- 0.62 units, n = 9). This was significantly higher than patients at stage II of HCC (1.28 +/- 0.72 units, n = 11, without vascular invasion; P = 0.012). CONCLUSION: These results suggest that peripheral blood telomerase activity, which may reflect haematogenous micrometastasis, is potentially a practical diagnostic/predictive marker of HCC.

Biomarkers, Tumor↗
PubMed2000

Major hepatic resection may suppress the growth of tumours remaining in the residual liver.

Little is known as to how hepatectomy is associated with the growth of hepatic tumours, which may reside in the remaining liver after curative resection for hepatocellular carcinoma. Using an intra-hepatic tumour implantation model in rats, the effects of hepatectomy on tumour growth in the remaining liver were investigated. On post-operative day 7, the tumour weight in the remaining liver following 30% hepatectomy was 0.321+/-0.058 g (mean +/- SD) which was significantly greater than that (0.245+/-0.040 g) in sham operations (P<0.05). However, the tumour weight (0.156+/-0.067 g) in the remaining liver following 60% hepatectomy was significantly lower than that in sham animals (P< 0.005). The number of TdT-mediated dUTP nick-end labelling (TUNEL) positive tumour cells was significantly increased in 60% hepatectomy as compared with the sham and 30% hepatectomy group. The mRNA expression of TGF-beta1, TNF-alpha and Fas in the tumour portion of 60% hepatectomy, was higher than that in 30% hepatectomy group. Plasma levels of TGF-beta1 were inversely correlated with intra-hepatic tumour weights. These results suggest that major hepatic resection may lead to an increased induction of apoptosis for the remaining hepatic tumour.

Animals↗
PubMed2000

Effect of laparotomy and laparoscopy on the establishment of lung metastasis in a murine model.

BACKGROUND: Laparoscopic surgery is now applied to patients with gastrointestinal cancer. In animal studies, extraperitoneal tumor growth has been significantly less after laparoscopy than after laparotomy, but whether hematogenous metastasis occurs less frequently after laparoscopy is unknown. The aim of this study was to compare the frequency and growth of lung metastasis and serum levels of IL-6 and tumor necrosis factor-alpha (TNF-alpha) in mice treated by laparotomy and in mice treated by laparoscopy. METHODS: We used 182 male BALB/c mice. Colon 26 cancer cells (5 x 10(4)) were injected into the tail vein, and the mice were assigned to a laparotomy group (3-cm laparotomy), a laparoscopy group (carbon dioxide pneumoperitoneum at 6 to 8 mm Hg for 30 minutes), or a control group. Lung weight, number of lung metastases, and serum levels of IL-6 and TNF-alpha were measured and compared among the 3 groups. RESULTS: The lung weight and number of metastases on the lung surface and cut section in the laparotomy group (0.44+/-0.21 g, 55.7+/-46.7, 23.0+/-19.0) were significantly larger than those in the laparoscopy group (0.32+/-0.15 g, 29.9+/- 25.5, 13.1+/-9.9) or the control group (0.28+/-0.13, 29.3+/-26.2, 11.1+/-11.1). Three hours after the procedures, the serum level of IL-6 was significantly higher in the laparotomy group (1353 +/- 790 pg/mL) than in the laparoscopy group (671+/-353 pg/mL) or the control group (333+/-341 pg/mL). The lung weight, number of lung metastases, and levels of IL-6 and TNF-alpha were not different between the laparoscopy and control groups. CONCLUSIONS: Our results indicate that, although laparotomy accelerates tumor metastasis to the lung in this murine model, laparoscopy does not increase the frequency and growth of lung metastasis. The laparoscopic approach may suppress hematogenous metastasis to the lung because of decreased surgical stress and reduced cytokine response.

Animals↗
PubMed2000

Genomic analysis of Blastocystis hominis strains isolated from two long-term health care facilities.

The genotype Blastocystis hominis is highly polymorphic. Therefore, a genetic marker would be a powerful tool for the identification or classification of B. hominis subtypes and could be used as a means to resolve the transmission route or origin of the parasite. To this end, 32 B. hominis isolates were collected from patients and/or staff members of two long-term health care facilities (facilities A and B), and these organisms were subjected to genotype analysis based on diagnostic PCR primers and restriction fragment length polymorphism (RFLP) of small subunit rRNA gene (rDNA). Based on PCR amplification using diagnostic primers which were developed from randomly amplified polymorphic DNA analysis of known strains of B. hominis, the 32 isolates of B. hominis were classified into three different subtypes. Thirty isolates, including twenty-four that were isolated from patients and a staff member, from facility A and all isolates isolated from six patients from facility B showed the same genotype. Two of six patients of facility B had been transferred from facility A, and these two patients also had the same-genotype B. hominis that corresponded to 24 isolates from facility A. This genotype strain may have been transmitted by these two patients from facility A to facility B, suggesting human-to-human transmission. In contrast, 2 of 26 isolates from facility A showed distinct genotypes, suggesting that the colonization by these two isolates is attributable to another infectious route. These different subtypes were subjected to RFLP analysis, and the RFLP profiles were correlated with the results obtained by diagnostic PCR primers. This study presents the first molecular evidence of possible human-to-human B. hominis infection between and/or among two small communities.

Animals↗
PubMed2000

Increased expression of collagenase-3 (MMP-13) and MT1-MMP in oesophageal cancer is related to cancer aggressiveness.

BACKGROUND: Collagenase-3 (matrix metalloproteinase-13, MMP-13) is a recently identified human MMP with broad substrate specificity which can be activated by membrane type 1 (MT1) matrix metalloproteinase in vitro. These may play a critical role in cancer aggressiveness. AIMS: To examine the clinical significance of collagenase-3 expression and the cooperative role of MT1-MMP in human oesophageal carcinomas. PATIENTS: Forty five individuals with oesophageal carcinoma who underwent surgery without preoperative treatment. METHODS: The tumour/normal (T/N) ratios of collagenase-3 and MT1-MMP mRNA expression in 45 human oesophageal carcinomas were determined by northern blot analysis. The production and localisation of collagenase-3 and MT1-MMP proteins were investigated by immunohistochemistry, western blot analysis, and zymography. RESULTS: The mean T/N ratio of collagenase-3 mRNA was 3.5 and that of MT1-MMP 2.1. There was a significant correlation between collagenase-3 and MT1-MMP mRNA expression (p<0.001). Twenty two cases with a collagenase-3 T/N ratio >3.5 showed a significantly higher frequency of vascular involvement and lymph node metastasis, and tended to be at a more advanced stage than 23 cases with a T/N ratio < or =3.5 (p<0.05). Western blot analysis and zymography demonstrated production of collagenase-3 protein in tumour tissues but not in normal tissues. Immunohistochemical studies revealed that collagenase-3 was localised predominantly in tumour cells and MT1-MMP was detected in the same collagenase-3 positive cells; there was a significant association between collagenase-3 and MT1-MMP protein expression (p<0.05). With regard to prognosis, the survival time for subjects in the high collagenase-3 group (T/N ratio >3.5) was significantly worse (p<0.05). CONCLUSIONS: These data suggest that production of collagenase-3 together with MT1-MMP is implicated in tumour aggressiveness and prognosis in human oesophageal carcinomas.

Adult↗
PubMed2000

Nondiffuse fatty change of the liver: discerning pseudotumor on MR images enhanced with ferumoxides-initial observations.

PURPOSE: To clarify the findings of nondiffuse fatty change of the liver on ferumoxides-enhanced magnetic resonance (MR) images. MATERIALS AND METHODS: Of 202 patients who underwent ferumoxides-enhanced MR imaging, eight who had nondiffuse fatty change of the liver at computed tomography (CT) were examined as study subjects. MR imaging findings before and 1 hour after ferumoxides administration were compared with CT findings. RESULTS: Focal fatty areas of the liver showing low attenuation on CT images were depicted as areas of relatively high intensity on the ferumoxides-enhanced T1-weighted images in all patients. On enhanced T2-weighted images, focal fatty change showed relatively high intensity in three and isointensity in one of the four patients. Focal spared areas appearing as areas of relatively high attenuation on CT images were depicted as areas of relatively low intensity on the ferumoxides-enhanced T1- and T2-weighted images in all patients. CONCLUSION: Although prior reports of hepatic MR imaging with ferumoxides indicated that there is accumulation of ferumoxides within focal fatty areas that are no longer seen after the administration of contrast medium, this study revealed that focal fatty change and focal spared areas of fatty liver may be pseudotumors because of the relatively high intensity of fatty areas of the liver. Radiologists can distinguish these conditions from hepatic tumors by using the opposed-phase gradient-echo sequence or the fat-saturation technique.

Aged↗
PubMed2000

Endovascular treatment of huge cervicofacial hemangioma complicated by Kasabach-Merritt syndrome.

A 2-month-old girl with a huge cervicofacial hemangioma complicated by Kasabach-Merritt syndrome was presented. Two weeks corticosteroid treatment was ineffective, and deterioration of coagulation parameters and compromise of the airway and left vision due to huge hemangioma prompted use of endovascular treatment. Transfemoral arterial embolization using polyvinyl alcohol particles resulted in rapid clinical improvement. Endovascular treatment should be considered as an important therapeutic option for hemangioma complicated by Kasabach-Merritt syndrome.

Anemia, Hemolytic↗
PubMed2000

MAGE-specific cytotoxic T lymphocytes require non-specific CD54 adherence receptors on carcinoma cells.

We investigated several factors that could regulate the susceptibility of carcinoma cells to MAGE-2-specific CTL mediated lysis. Cytofluorometric analysis showed that the cytolysis correlated with the expression of CD54. IFN-gamma treatment induced the TAP-1 and LMP-2 genes, continuously up-regulated the HLA class I expression and increased cytolysis. Although HLA class I were highly induced in MRKnu1 cells, CD54 was not induced and the cytolysis was minimal. Cytotolysis of IFN-gamma-treated MKN-1 cells was completely inhibited by a monoclonal anti-CD54 antibody. These results suggest that HLA-restricted CTL lysis requires non-specific CD54 adherence receptors in addition to specific TCR signals.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2000

[Cervical pyogenic spondylodiscitis: 4 cases report and a review of the literature].

We report 4 cases of cervical spondylodiscitis presenting neurological and/or neuroradiological abnormalities. Such a lesion is rare in the cervical spine of adults, but should be suspected when the patient has radiculopathy and/or myelopathy associated with inflammatory signs. We discussed the clinical characteristics and the procedures of the diagnosis and treatment of cervical spondylodiscitis. Early and definitive diagnosis can be achieved by cervical X-ray, MR imaging and biopsy. It is very important to evaluate the pyogen for the lesion by needle biopsy. When the patient has the compression of the spinal cord and/or nerve roots and the neurological findings of radiculopathy and/or myelopathy, surgical exploration and decompression of the spinal cord and/or nerve roots should be carried out as soon as possible. Anterior debridement and fusion should be performed using the effective antibiotics. We were able to achieve good prognosis by treatment following this procedure of diagnosis in the four cases of cervical spondylodiscitis mentioned.

Adult↗
PubMed2000

[Development of endoscopic surgery in the 21st century].

After its introduction by Dr. K. Semm in the 1970s and subsequent refinement of laparoscopic cholecystectomy by Dr. Erich Mühe 1985, endoscopic surgery is now commonly performed in clinical practice. Although some institutions have still not embraced these techniques, surgery has been transformed, not only technically but also conceptually, by endoscopic procedures. Less invasive surgery results in a better quality of life for patients. The theme of this centennial anniversary meeting of the Japanese Surgical Society comes from the words of Keio University founder Yukichi Fukuzawa: "Act now for the future." At this meeting, robotic surgery and telesurgery techniques will be presented, and attendees will be updated on the latest developments in the field, including three-dimensional monitoring, telecommunications, robotics, and other new forms of instrumentation and technology.

Endoscopy↗
PubMed2000

Laparoscopic colectomy for Dukes A colon cancer.

The use of laparoscopic surgery to treat colon cancer has been well studied; however, the specific use of laparoscopic colectomy for Dukes A colon cancer has not been evaluated. The data of laparoscopic colectomy were compared with those of conventional open colectomy, and the surgical results of patients who underwent surgery for Dukes A colon cancer were evaluated. Between November 1993 and October 1997, 20 patients underwent laparoscopic colectomy for Dukes A colon cancer. Operation time, blood loss, first passage of flatus, day of resumption of oral intake, length of hospital stay after surgery, and number of dissected lymph nodes were compared between 20 patients who underwent laparoscopic colectomy and 23 patients who underwent conventional open colectomy for Dukes A colon cancer. In patients with laparoscopic colectomy, when compared with those with conventional open colectomy, mean blood loss was less (103 g vs. 318 g), flatus returned more quickly (3.5 days vs. 4.2 days), oral intake resumed earlier (3.7 days vs. 4.7 days), and postoperative hospital stay was shorter (16.4 days vs. 24.6 days). The mean number of dissected lymph nodes was not different between the two groups (9.2 vs. 9.2 for D2 dissection). No patient had port-site metastasis or recurrence during a follow-up period from 13 to 60 months (median, 38 months). Review of the literature and the authors' findings indicated that none of the 142 reported patients had port-site metastasis after laparoscopic colectomy for Dukes A colon cancer. The results indicate that laparoscopic colectomy is safe and useful when applied to patients with Dukes A colon cancer and performed carefully by trained surgeons.

Adult↗
PubMed2000

[Laparoscopic surgery for gastrointestinal malignancies].

Since 1991, laparoscopic surgery has been applied to treat the patient with gastrointestinal malignancies. Surgery seems to be a very useful modality from the viewpoint of curability. Nevertheless, stress due to surgical procedures induces physiological responses in clinical settings. In laparoscopic surgery, intensity of surgical stress is less than that in open surgery, and physiological response involving the immunological depression after laparoscopic surgery is also less than that after open surgery, while the mesothelium on the peritoneal surface is injured with the presence of both positive intraperitoneal pressure and CO2 gas. These physiological responses as systemic effects and the wound healing responses as local effects after laparoscopic surgery may modulate the growth, invasion, and metastasis of the remnant malignancies. Various studies have been reported to clarify these effects of pneumoperitoneum. We review, herein, the literature and our preliminary results with regard to the modulation on the behavior of the malignant cells after the laparoscopic surgery.

Cell Division↗
PubMed2000

Angiogenin expression in human colorectal cancer: the role of focal macrophage infiltration.

Tumor angiogenesis is essential for tumor growth and tumor metastasis, and it depends on angiogenic factors produced by tumor cells and/or infiltrating cells in tumor tissue. In this study, we evaluated the clinical significance of the expression of angiogenin, which is a potent angiogenic protein, and the relationship between its mRNA expression and focal macrophage infiltration in colorectal cancer. Furthermore, we investigated the induction of angiogenin mRNA expression by proinflammatory cytokines mainly produced by inflammatory cells in tumor tissues. When we examined the relationship between the mRNA expression of angiogenin, by semiquantitative reverse transcription-PCR, and clinicopathological features in 65 patients with colorectal cancer, there was a significant difference in the vascular involvement, lymph node metastasis, liver metastasis, and advanced stage in patients with high-expression of angiogenin compared with low expression (P < 0.05). With regard to prognosis, the survival time for subjects in the high angiogenin mRNA group (tumor:normal ratio >1.9) was significantly worse (P < 0.05). When we examined the localization of angiogenin in colorectal cancer, immunohistochemical analysis in 65 patients with colorectal cancer revealed that angiogenin was predominantly expressed in cancer cells compared with stromal cells or normal tissues. The intensity of staining of angiogenin was significantly correlated with microvessel counts and focal macrophage infiltration counts (P < 0.05). In an in vitro study, interleukin-1beta and tumor necrosis factor-alpha induced angiogenin mRNA expression in colon cancer cells in a dose- and time-dependent manner, and these cytokines significantly upregulated the expression of angiogenin mRNA, especially in colon cancer cells rather than in other cells in the stroma of tumor tissues (fibroblasts, tumor infiltrating lymphocytes, macrophages). These results suggest that tumor angiogenesis in colorectal cancer may be advanced, at least in part, by angiogenin induced by proinflammatory cytokines derived from infiltrating macrophages.

Colorectal Neoplasms↗
PubMed2000

Location of tumor and distribution of lymph node metastasis in gastric cancer: lesser curve or greater curve.

BACKGROUND: The aim of this study was to clarify the relationship between the location of tumor and distribution of lymph node metastasis in node-positive gastric cancer. Pathologic findings of tumors in which location of tumors or positive nodes was confined within the lesser or greater curve were evaluated, and candidates of limited resection were assessed. METHODS: A total of 211 patients with node-positive gastric cancer treated by D2 or D3 gastrectomy was studied. Location, size, gross type, and histologic type of tumors, presence or absence of serosal, lymphatic, and vascular invasions, and status of lymph node metastasis were investigated. Tumors were divided into lesser curve tumors, greater curve tumors, and others; and lymph node metastases were classified as lesser curve metastasis, greater curve metastasis, and both curves metastasis. RESULTS: Lesser or greater curve tumors were featured by small size, negative serosal invasion, negative vascular invasion, metastasis confined to the perigastric nodes, and number of positive nodes less than seven. Cases of lesser or greater curve metastasis were featured by tumor location within the lesser or greater curve, small size, grossly superficial type, negative serosal invasion, negative lymphatic invasion, and number of positive nodes less than seven. When size of lesser or greater curve tumors was less than 4 cm, lymph node metastasis was mostly restricted to the same lesser or greater curve. CONCLUSION: Among node-positive gastric cancers, tumors located within the lesser or greater curve were characterized by small size, negative serosal invasion, and a few metastases confined to the perigastric lymph nodes. When tumor size was less than 4 cm and tumor invasion was not into serosa, lesser or greater curve tumors rarely extend into lymph nodes along the other curve. Limited resection or less invasive treatment is acceptable for such small gastric cancers along the lesser or greater curve.

Gastrectomy↗
PubMed1999

Rate of detection of lymph node metastasis is correlated with the depth of submucosal invasion in early stage gastric carcinoma.

BACKGROUND: Gastric carcinoma invading the submucosa is often accompanied by lymph node metastasis. However, the relation between the depth of submucosal invasion and the status of metastasis has not been investigated. The objective of this study was to clarify the relation between lymph node status and the histologic features of gastric carcinoma invading the submucosa. METHODS: The histopathology of 118 patients who underwent gastrectomy and lymph node dissection for gastric carcinoma invading the submucosa was examined. These pT1 tumors with invasion of the submucosa were confirmed by histologic examination of the resected specimens. Tumor size, depth of submucosal invasion, histologic type, and macroscopic type were investigated in association with presence or absence of and anatomic level of lymph node metastasis. RESULTS: Among the 118 patients, 16 (14%) had lymph node metastasis, and the status of metastasis significantly correlated with tumor size and depth of submucosal invasion. The frequency of metastasis to perigastric lymph nodes and extragastric lymph nodes was 0% and 0% for < or =1-cm tumors, 5% and 1% for 1- to 4-cm tumors, and 46% and 15% for >4-cm tumors, respectively. There was no lymph from a node metastasis in tumors with less than 300 microm of submucosal invasion. The frequency of lymph node metastasis for tumors with 300-1000 microm and >1000 microm of submucosal invasion were 19% and 14%, respectively. CONCLUSIONS: Tumor size and depth of submucosal invasion serve as simple and useful indicators of lymph node metastasis in early stage gastric carcinoma. Optimal lymph node dissection levels are as follows: 1) local resection (D0) for lesions < or =1 cm, 2) limited lymph node dissection (D1) for 1- to 4-cm lesions, and 3) radical lymph node dissection (D2) for lesions >4 cm. When submucosal invasion of a locally resected tumor is more than 300 microm, additional gastrectomy and lymph node dissection are necessary.

Adenocarcinoma↗