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Biomedical subjects

S Kitano

Publications and source records attributed to S Kitano.

At least 127 records · Page 7Linked to original sources
PubMed1999

Diagnostic usefulness of endorectal magnetic resonance imaging with dynamic contrast-enhancement in patients with localized prostate cancer: mapping studies with biopsy specimens.

BACKGROUND: New diagnostic criteria for dynamic magnetic resonance (MR) imaging in prostate cancer are presented. The diagnostic usefulness of endorectal MR imaging with dynamic contrast-enhancement in localized prostate cancer and the validity of these criteria were evaluated. METHODS: Eighteen untreated patients who were suspected of localized prostate cancer were included in the study. They received endorectal dynamic MR imaging before systematic sextant needle biopsy. First. a mapping study with the findings of MR images and histopathology of biopsy specimens was performed in eight patients out of 18 to compare the difference in T2-weighted images with the endorectal coil and the body coil in the same individuals. Second, another mapping study was performed in all 18 patients by analyzing the findings of endorectal dynamic MR images. For the diagnosis of prostate cancer in MR imaging, we offered diagnostic criteria from our experience in addition to those in plain T2-weighted images from the literature. RESULTS: The overall diagnostic rates of endorectal dynamic MR imaging were 88.9% in accuracy, 100% in sensitivity, and 81.8% in specificity. In the comparison of the endorectal and body coils in T2-weighted images in eight patients, there was no difference in the diagnostic rates except for one more histopathologic false positive portion in endorectal MR imaging. In the second mapping study in 18 patients, the diagnostic rates were 92.6% in accuracy, 88.9% in sensitivity and 93.3% in specificity. Endorectal dynamic imaging raised the diagnostic sensitivity from 77.8 to 88.9%. CONCLUSION: The data demonstrated the validity of this diagnostic criteria and the diagnostic usefulness of endorectal dynamic MR imaging in localized prostate cancer.

Aged↗
PubMed1999

Quality of life after laparoscopy-assisted Billroth I gastrectomy.

OBJECTIVE: To evaluate the quality of life of patients who had undergone laparoscopy-assisted Billroth I gastrectomy (LAG) for cure of cancer. SUMMARY BACKGROUND DATA: In 1994, the authors reported the first case of LAG for early gastric cancer, and this approach quickly has been adopted by Japanese surgeons. However, little is known about the subjective clinical results of this less invasive surgery. METHODS: Quality of life was estimated using the 24-item questionnaire with a scoring system of 1, 2, and 3 and was compared between 41 consecutive patients with LAG and 35 with conventional open gastrectomy. All patients underwent Billroth I gastrectomy for early gastric cancer from January 1993 to July 1997 and were alive without recurrence. RESULTS: Patients who had undergone LAG were taking a normal diet (100%) with >66% of volume at each meal (90%), showed no decreased performance status (90%), and were satisfied with their surgical results (88%). Patients with LAG, when compared with open gastrectomy, showed significantly better results with regard to weight loss, difficulty in swallowing, heartburn and belch, early dumping syndrome, and total score. LAG was better accepted by the patients. CONCLUSIONS: Quality of life after Billroth I gastrectomy was significantly better in patients in whom a laparoscopic technique was used than in those who underwent a conventional method. LAG is less invasive and better accepted by patients and is the procedure of choice for the treatment of early gastric cancer.

Aged↗
PubMed1999

Clinical results and prognostic factors of radiologically node-positive gastric carcinoma.

Lymph node metastasis determined by histologic examination is an important prognostic indicator in gastric carcinoma. However, prognostic value of lymph node metastasis detected by computed tomography (CT) is unknown. The aim of this study was to evaluate clinical results and prognostic factors of patients with radiologically node-positive gastric carcinoma. The study included 78 patients with primary gastric carcinoma and lymph node metastasis confirmed by CT. The level of lymph node metastasis was simply graded as follows: level I included perigastric nodes; level II included intermediate nodes along the left gastric, common hepatic, and celiac arteries; and level III included distant nodes along the hepatoduodenal ligament, pancreas, spleen, and abdominal aorta. Sixty patients (79%) had stage IV tumors showing one or more of the following: level III lymph node metastasis in 37, pancreatic invasion in 27, peritoneal dissemination in 23, and liver metastasis in 19. Overall 1- and 5-year survival rates were 29% and 6%, respectively, and the 1-year survival rate was significantly influenced by the level of lymph node metastasis on CT (55% for level I, 27% for level II, 7% for level III, P < 0.01). In patients with gastrectomy, prognostic factors were tumor size (<10 cm versus >10 cm, P < 0.01), gross type (localized versus infiltrative, P < 0.01), histologic type (well differentiated versus poorly differentiated, P < 0.01), and curability of the disease (curative versus noncurative, P < 0.01). Our study indicates that prognosis of patients with radiologically node-positive gastric carcinoma is poor because of high frequency of extensive tumor spreads. Patients having only positive level I nodes on CT are candidates for curative gastrectomy, which may offer long-term survival.

Adenocarcinoma↗
PubMed1999

Utility of digital camera-derived intraoperative images in the planning of epilepsy surgery for children.

OBJECTIVE: This study was undertaken to assess the utility of digital camera-derived intraoperative images in the planning of neurosurgery for children with epilepsy. METHODS: A hand-held digital camera was used to capture the exposed surgical field at the time of craniotomy for 11 children with medically intractable seizure disorders. Intraoperative somatosensory evoked potential recordings of phase reversals and direct cortical stimulation were used to map areas of eloquent brain tissue. Digital camera images were obtained to mark regions of functional brain tissue with respect to cortical surface landmarks and subdural grid placement. The digital camera images were then immediately downloaded, in the operating room, to a laptop computer, which was placed next to the electroencephalographic recording device. Using computer software, the epileptologist highlighted the primary and secondary zones of epileptogenesis, as well as the functional brain areas identified during the monitoring period, on the digital camera images on the computer screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and multiple subpial transections. RESULTS: With the images obtained using the digital camera, the epilepsy team was able to observe the contacts of the grid electrodes with the brain during the procedure. Color printouts of the images served as references during the period of invasive monitoring. Zones of primary and secondary epileptogenesis, as well as areas of functional brain tissue, were identified and plotted on the digital camera images. Other benefits of the digital camera-derived images included the ability to accurately reposition the grids or letters marking eloquent brain tissue if they were inadvertently shifted during the procedure, the ease with which the images could be obtained and manipulated, the ability to assess postresection epileptiform activity of the surrounding brain tissue with images obtained while an electrocorticographic array was in place, the ability to provide the entire epilepsy team with updated information on the neurosurgical field while minimizing movement in the operating room, and facilitation, with neurosurgical maps, of discussions with the patients and their families concerning proposed cortical resections. CONCLUSION: Digital camera images have become essential components for the planning of cortical resections for children with intractable epilepsy at our institution. We envision widespread application of this technology to other neurosurgical fields.

Adolescent↗
PubMed1999

Delayed healing of acetic-acid-induced gastric ulcer in portal hypertensive rats.

The aim of the present study was to determine the effect of portal hypertension on the healing of gastric ulcers in rats. Portal hypertension was induced by staged portal vein ligation. Sham-operated (SO) rats served as controls. Gastric ulcers were induced by application of acetic acid to the serosal surface of the stomach. Healing was assessed by determining the ulcer area on days 3, 7, and 10 after ulcer induction. Epithelial proliferation at the ulcer margin was assessed by evaluating the proliferating cell nuclear antigen labeling index. On days 3 and 7, the proliferating cell nuclear antigen labeling index was lower in portal hypertensive (PHT) rats than in SO rats. On day 10, the ulcer area in PHT rats was nearly twice that in SO rats (4.13 +/- 0.29 vs. 2.28 +/- 0.22 mm(2), p < 0.05). These results suggest that portal hypertension may delay gastric ulcer healing. Furthermore, the inhibition of epithelial proliferation at the ulcer margin may be involved in the delayed healing in portal hypertension.

Acetic Acid↗
PubMed1999

Augmentative effect of cyclosporin A on rat liver regeneration: influence on hepatocyte growth factor and transforming growth factor-beta(1).

We investigated the effect of cyclosporin A (CsA) on rat liver regeneration following partial hepatectomy with reference to cytokine production. Rats were divided into two groups: those without CsA pretreatment (group 1) and those with CsA pretreatment (group 2). Animals were given olive oil vehicle or CsA (10 mg/kg) dissolved in olive oil daily by gavage from 4 to 1 days before hepatectomy. The ratio of regenerating liver weight to initial body weight in group 2 was significantly higher than that in group 1 at 72 h. Although a peak 5-bromo-2-deoxyuridine labeling index was found at 24 h after hepatectomy in both groups, the peak value in the CsA-treated animals was significantly higher than in controls. In both groups, hepatocyte growth factor concentrations in both plasma and liver tissue showed maximal values at 12 h. Liver tissue values in group 2, however, were significantly higher from 1 to 12 h compared to group 1. Transforming growth factor-beta(1) (TGF-beta(1)) concentrations showed minimal serial changes in group 1, while those in liver tissue of group 2 rats were significantly lower than in group 1. Plasma TGF-beta(1) concentrations did not differ. These results suggest that upregulation of hepatic regeneration with CsA pretreatment might be attributed in part to changes in production of these mitogenic and mitoinhibitory cytokines.

Animals↗
PubMed1999

Proximal gastrectomy and gastric tube reconstruction for early cancer of the gastric cardia.

BACKGROUND: Advances in diagnostics and techniques have increased the number of detections of early cancer of the gastric cardia. The aim of this report is to describe a new technique of proximal gastrectomy and gastric tube reconstruction using an autosuture stapler. METHODS: At operation, the upper part of the stomach was fully mobilized, and the abdominal esophagus was transected. The stomach was cut between the points of the distal three fourths of the lesser curvature and a half of the greater curvature, and a gastric tube measuring 20 cm in length and 4 cm in width was made. A circular stapler was inserted through a stapled line, and direct anastomosis between the esophagus and gastric tube was completed. RESULTS: When compared with the patients who underwent proximal gastrectomy and jejunal interposition, those who underwent gastric tube reconstruction showed a significantly shorter operation time. All 3 patients who underwent proximal gastrectomy and gastric tube reconstruction recovered uneventfully and took foods satisfactorily. Good passage through the gastric tube was recognized on roentgenography, and reflux esophagitis or stomal ulcer was not found on fiberscopy. CONCLUSIONS: We believe the procedure is technically simple and safe, and provides good postoperative results in patients with early cancer of the gastric cardia.

Adenocarcinoma, Mucinous↗
PubMed1999

Intracellular interleukin-1 alpha production in human gingival fibroblasts is differentially regulated by various cytokines.

Interleukin-1 (IL-1) may play a critical role in immune and inflammatory responses in inflamed gingiva, and it is synthesized by a wide variety of host cells. In this study, we examined the regulatory effects of various cytokines on bioactive membrane IL-1 and intracellular IL-1 alpha production in cultured human gingival fibroblasts (HGF). Recombinant human (rh) IL-1 beta stimulated membrane IL-1 activity, which was mainly attributed to IL-1 alpha. rhIL-1 beta and rh tumor necrosis factor (TNF)-alpha stimulated HGF to produce intracellular IL-1 alpha, whereas rh interleukin-6 (IL-6), rh interleukin-4 (IL-4), and rh interferon (IFN)-gamma did not do so. Intracellular IL-1 alpha production induced by rhIL-1 beta or rhTNF-alpha may be partially related to protein kinase C (PKC) activation, because rhIL-1 beta or rhTNF-alpha-induced intracellular IL-1 alpha production was stimulated by pre-treatment with 12-o-tetradecanoylphorbol 13-acetate (TPA), a PKC activator, but was suppressed by the pre-treatment with 1-(5-isoquinoline-sulfonyl) -2-methylpiperazine dihydrochloride (H-7), which is a PKC inhibitor. rhIL-4 inhibited rhIL-1 beta- or rhTNF-alpha-induced intracellular IL-1 alpha production, but rhIL-6 had no effect on this production. Pre-treatment with rh IFN-gamma remarkably enhanced intracellular IL-1 alpha production induced by subsequent treatment with rhIL-1 beta or rhTNF-alpha. Simultaneous treatment with rhIFN-gamma and rhIL-1 beta inhibited rhIL-1 beta-induced intracellular IL-1 alpha production, but co-treatment with rhIFN-gamma and rhTNF-alpha enhanced rhTNF-alpha-induced intracellular IL-1 alpha production. These results suggest that in inflamed gingiva, pro-inflammatory cytokines such as IL-1 beta and TNF-alpha may induce bioactive intracellular IL-1 alpha production in human gingival fibroblasts and that this production can be differentially modulated by T-cell-derived cytokines such as IFN-gamma or IL4.

Adult↗
PubMed1999

High incidence of persistent primitive arteries in moyamoya and quasi-moyamoya diseases.

This study investigated the incidences of persistent primitive arteries in patients with moyamoya disease, unilateral moyamoya disease, and quasi-moyamoya disease. Cerebral angiograms of 50 patients (39 moyamoya disease patients, 6 unilateral moyamoya disease patients, and 5 quasi-moyamoya disease patients) were retrospectively reviewed. There were 35 females and 15 males, aged from 3 to 63 years (mean 27.4 years). Persistent primitive carotid-basilar artery anastomoses were observed in three patients: primitive hypoglossal artery in one moyamoya disease patient, primitive trigeminal artery variant in one unilateral moyamoya disease patient, and an anastomosis between the accessory meningeal artery and the anterosuperior cerebellar artery in one quasi-moyamoya disease patient. The ophthalmic artery originated from the middle meningeal artery in three moyamoya and two quasi-moyamoya disease patients. The incidence of the persistent primitive arteries is significantly higher in patients with moyamoya disease (10.7%) and quasi-moyamoya disease (60%) than in patients with other disease (0.67%) (p < 0.001), so congenital factors may be important in the pathogenesis of moyamoya disease.

Adolescent↗
PubMed1999

Reduction of operating time and blood transfusion for craniosynostosis by simulated surgery using three-dimensional solid models.

Preoperative planning of craniofacial synostosis can be achieved through the use of two- or three-dimensional (3D) computed tomography (CT) images and by 3D solid models. The advantage of using 3D models was evaluated by calculating the amount of blood transfused and the operating time for 36 craniosynostosis procedures, 21 planned with 3D models and 15 with CT images performed in the past 7 years. The use of 3D models reduced both blood loss and operating time for fronto-orbital advancement with reshaping, LeFort III advancement, and LeFort IV minus Glabellar advancement; blood loss for fronto-orbital advancement without reshaping; and operating time for total cranial reshaping.

Adolescent↗
PubMed1999

Transumbilical embolization of a congenital dural arteriovenous fistula at the torcular herophili in a neonate. Case report.

A neonate, in whom a congenital cerebral vascular anomaly had been diagnosed prenatally, exhibited progressive high-output congestive heart failure soon after birth. Cerebral angiography revealed a congenital dural arteriovenous fistula (AVF) with a huge dural lake located at the torcular herophili. In addition to the meningeal blood supply, an unusual pial blood supply from all cerebellar arteries was observed to feed the fistula. The patient was treated by repeated transarterial and transvenous embolization through the umbilical venous route. To the authors' knowledge, neither the existence of a congenital dural AVF at the torcular herophili presenting with an enormous pial blood supply or the technique of trans-umbilical venous intervention has been reported in the literature.

Arteriovenous Fistula↗
PubMed1999

[A clinical study on long-term outcome in patients with syringomyelia associated with Chiari malformation].

To investigate the long-term outcome in patients with syringomyelia associated with Chiari malformation (chronic tonsilar herniation), we investigated the actual factors of the patient's problems by a questionnaire for the patient. Replies to the questionnaires were obtained from 44 patients with syringomyelia who had been treated with expansive suboccipital cranioplasty with dural plasty (with plugging of the central canal in 20 patients). In 25 cases (68%) in whom the motor dysfunction of the upper extremities remained, the symptoms improved in 16 cases (43%) and were unchanged in 9 cases (24%). In 18 cases (64%) in whom the motor dysfunction of the lower extremities remained, the symptoms improved in 10 cases (36%) and were unchanged in 8 cases (29%). In 31 cases (78%) in whom the sensory disturbance remained, the symptoms improved in 19 cases (48%) and were unchanged in 12 cases (30%). The motor dysfunction of the upper extremities persisted significantly in more patients having a duration of illness over 2 years than in patients with those less than 2 years. Sensory disturbance persisted significantly in more patients with a duration of illness over 3 years than in patients with that less than 3 years. These results suggest that firstly, sensory disturbance (disturbance of the posterior horn) is most apt to remain, then motor dysfunction of the upper extremities (disturbance of the anterior horn) and followed by motor dysfunction of the lower extremities (disturbance of the pyramidal tract). We conclude that patients should be treated before having irreversible spinal cord disturbance.

Adolescent↗
PubMed1999

Identification of a MAGE-2-encoded human leukocyte antigen-A24-binding synthetic peptide that induces specific antitumor cytotoxic T lymphocytes.

Because MAGE-2 gene is expressed in a wide variety of malignant tumors and HLA-A24 is the most common allele in the Japanese population and is also frequently present in Caucasians, the identification of MAGE-2-encoded peptide presented by HLA-A24 is, therefore, considered to be important in order to develop specific immunotherapy for malignant tumors using peptides as a vaccine. By using a MHC-binding assay, eight peptides derived from MAGE-2 were found to bind with sufficient affinity to the HLA-A24 molecule. When the induction of specific cytotoxic T lymphocytes (CTLs) was examined using a simplified method, the highest human lymphocyte antigen (HLA) binder (EYLQLVFGI) in these peptides was able to elicit CTLs from unseparated peripheral blood mononuclear cells in HLA-A24 healthy donors by stimulation with freshly isolated, peptide-pulsed peripheral blood mononuclear cells as antigen-presenting cells and also by using interleukin 7 and keyhole-limpet hemocyanin in a primary culture. The induced CTL could, thus, lyse HLA-A24 tumor cells expressing MAGE-2, as well as the peptide-pulsed target cells, with antigen specificity in a HLA class I-restricted manner. The identification of this peptide may, thus, be of therapeutic value in peptide-based vaccines for the treatment of several types of malignant tumors expressing MAGE-2.

Amino Acid Sequence↗
PubMed1999

Convenient murine pneumoperitoneal model for the study of laparoscopic cancer surgery.

To investigate the effects of laparoscopic surgery on the progression of cancers, it is necessary to establish a reliable and economical animal model. We describe a convenient murine pneumoperitoneal model for the study of laparoscopic cancer surgery. Under anesthesia using diethyl ether, peritoneal cavity was insufflated with gas through an intravenous catheter placed in the left lower quadrant. Syringe pump was used for continuous gas insufflation, and intraperitoneal pressure was measured. Intraperitoneal pressure increased and reached 10 cm H2O when 15 mL of CO2 gas was injected, but fell to 1 cm H2O 5 min after stopping the injection. When the continuous flow was adjusted by syringe pump between 20 and 160 mL/hour, intraperitoneal pressure was easily maintained at 8 cm H2O for >60 min. We believe that this murine model for pneumoperitoneum may be useful for the study of laparoscopic cancer surgery.

Animals↗
PubMed1999

A disposable sealing device (Dispo-sand) for conversion between pneumoperitoneum and minilaparotomy.

During laparoscopic procedures, minilaparotomy is a safe technique for removal of large specimens and for the performance of complicated procedures. However, it is time consuming and troublesome to close the minilaparotomy to recreate the pneumoperitoneum. We describe a new device (Dispo-sand) that enables instant conversion between pneumoperitoneum and minilaparotomy.

Disposable Equipment↗