PubMed Health⌕ Search

Biomedical subjects

S Kusano

Publications and source records attributed to S Kusano.

At least 19 recordsLinked to original sources
PubMed2005

Liver abscess formation after hepatic chemoembolization for metastatic pancreatic neuroendocrine tumor.

Hepatic chemoembolization is an effective treatment of unresectable hypervascular hepatic tumors, but history of bilioenteric anastomosis is a major risk factor for liver abscess due to the retrograde enteric bacterial contamination. We report a case of culture-negative liver abscess developed after hepatic chemoembolization for a metastatic pancreatic endocrine tumor, and discuss the pathogenesis of liver abscess formation. We also present a potential pitfall for the prophylactic antibiotic therapy in a patient with a history of bilioenteric anastomosis. This is the first report of a culture-negative liver abscess caused by hepatic chemoembolization for a metastatic pancreatic endocrine tumor.

Journal Article↗
PubMed2005

Elevated immunoglobulin G antibodies to the proline-rich amino-terminal region of Epstein-Barr virus nuclear antigen-2 in sera from patients with systemic connective tissue diseases and from a subgroup of Sjögren's syndrome patients with pulmonary involvements.

Associations of Epstein-Barr virus (EBV) and autoimmune diseases have been hypothesized. We have analysed IgG antibodies to EBV nuclear antigen (EBNA)-2 in sera from Japanese patients with autoimmune systemic connective tissue diseases (CTD), exemplified by systemic lupus erythematosus (SLE), primary Sjogren's syndrome (SS), rheumatoid arthritis (RA), systemic sclerosis (SSc) and secondary SS (classical CTDs complicated with SS). An enzyme-linked immunosorbent assay (ELISA) which uses glutathione-S-transferase polypeptides fused to EBV nuclear antigen (EBNA)-2 and EBNA-1 was developed. Ratios of IgG antibody reactivity to whole IgG concentrations of sera were calculated to normalize EBNA-2 and EBNA-1 antibody levels to the hypergammaglobulinaemia that occurs in CTD. The ELISA optical density OD(450) readings of IgG antibodies to both the amino-terminal aa 1-116 of EBNA-2 and carboxyl-terminal aa 451-641 of EBNA-1 were elevated significantly in patients with SLE, primary SS, RA, SSc and secondary SS when compared to EBNA-1. The OD readings were divided by serum IgG concentrations to normalize for the hypergammaglobulinaemia. The specific levels of IgG antibodies to the amino-terminal region of EBNA-2 were elevated in patients with SLE, primary SS or RA, as well as those with secondary SS complicated with SLE or RA. The EBNA-2 amino-terminal region contains a polyproline tract and a proline-rich sequence and has considerable amino acid sequence homology with many cellular proline-rich proteins. High ratios of EBNA-2 aa 1-116 to EBNA-1 aa 451-641 IgG antibody levels which probably suggest reactivation of EBV latent infection were associated significantly with pulmonary involvement in SS patients. These results are consistent with the hypothesis that the sequence similarity between the amino-terminal region of EBNA-2 and proline-rich cellular proteins is associated with pathogenesis in a subpopulation of CTD patients, possibly by the molecular mimicry-epitope shift mechanism.

Adult↗
PubMed2002

Primary Sjögren's syndrome initially manifested by optic neuritis: MRI findings.

We herein describe the MRI findings in a patient clinically diagnosed with primary Sjögren's syndrome (SjS) initially manifested by retrobulbar optic neuritis. A 63-year-old woman suddenly had left ocular pain and progressive visual disturbance. MR T2-weighted images revealed hyperintensity in the left optic nerve, with swelling. Contrast-enhanced T1-weighted images showed no abnormal enhancement. Follow-up MRI 6 months after admission revealed no significant changes in the affected optic nerve. To our knowledge, optic neuritis as a complication of SjS has been reported in ten patients [1, 2, 3, 4, 5, 6] and MRI findings in only one of them [6]. We thought MR images were useful for visualizing optic nerve involvement in SjS and observing its course.

Female↗
PubMed2002

Severe complications after hypofractionated high dose rate intracavitary brachytherapy following external beam irradiation for oesophageal carcinoma.

The purpose of this study was to evaluate severe complications that developed after high dose rate (HDR) intracavitary brachytherapy for oesophageal carcinoma. Six consecutive patients with oesophageal carcinoma were treated by external beam irradiation (60 Gy in 30 fractions over 6 weeks) followed by hypofractionated intracavitary HDR brachytherapy (10 Gy in 2 fractions). Two of the six patients were alive and well for more than 2-3 years following therapy, but three of the six patients developed treatment-related oesophageal fistulae and died. HDR intracavitary brachytherapy following external beam irradiation is an effective method for radical treatment of oesophageal carcinoma. However, hypofractionated HDR brachytherapy should be used with care.

Aged↗
PubMed2002

Picture archiving and communication system: prospective study.

OBJECTIVES: To evaluate the use of a picture archiving and communication system and user satisfaction in order to further improve its quality. DESIGN: Prospective study. SETTING: Medical college hospital, Japan. MATERIALS AND METHODS: An automated computerised method was used to collect the data from March 1999 to February 2000. MAIN OUTCOME MEASURES: Each workstation automatically recorded data on the rank of the user, purpose of use, use of postprocessing tools, and user satisfaction. RESULTS: The number of resident users in the radiology reading room increased and those outside the reading room decreased, but the number of staff users changed little. The purpose of use and the use of postprocessing functions in the reading room were not significantly different from those outside it (P=0.179 and P=0.269, respectively). The average numbers of images accessed to per workstation monthly in the reading room, the general practice ward, and the gastroenterology ward were 1081, 970 and 741, respectively. Only 12 images in the orthopaedic surgery out-patient clinic and 70 images in the orthopaedic surgery ward, however, were accessed per month. The percentages of satisfied users decreased both inside and outside the reading room. The degree of satisfaction of users in the reading room was significantly different from that outside it (P=0.004). The most common reason for dissatisfaction was the length of time necessary to retrieve images. CONCLUSIONS: It is necessary to shorten response times of picture archiving and communication system workstations. Repeated data collection and evaluation, however, are also important.

Hospital Departments↗
PubMed2001

Computed tomography-guided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: a 5-year experience.

PURPOSE: Stereotactic radiotherapy (SRT) is highly effective for brain metastases from non-small-cell lung cancers (NSCLCs). As such, primary lesions of NSCLC may also be treated effectively by similar focal high-dose SRT. METHODS AND MATERIALS: Between October 1994 and June 1999, 50 patients with pathologically proven T1-2N0 M0 NSCLC were treated by CT-guided frameless SRT. Of these, 21 patients were medically inoperable and the remainder were medically operable but refused surgery. In most patients, SRT was 50-60 Gy in 5-10 fractions for 1-2 weeks. Eighteen patients also received conventional radiotherapy of 40-60 Gy in 20-33 fractions before SRT. RESULTS: With a median follow-up period of 36 months (range 22-66), 30 patients were alive and disease free, 3 were alive with disease, 6 had died of disease, and 11 had died intercurrently. Local progression was not observed on follow-up CT scans in 47 (94%) of 50 patients. The 3-year overall survival rate was 66% in all 50 patients and 86% in the 29 medically operable patients. The 3-year cause-specific survival rate of all 50 patients was 88%. No definite adverse effects related to SRT were noted, except for 2 patients with a minor bone fracture and 6 patients with temporary pleural pain. CONCLUSIONS: SRT is a very safe and effective treatment for Stage I NSCLC. Additional studies involving a larger patient population and longer follow-up periods are warranted to assess this new treatment for early-stage lung cancer.

Adenocarcinoma↗
PubMed2001

Gastrointestinal stromal tumor of the rectum.

Gastrointestinal stromal tumors (GISTs) are characterized by remarkable variability in their differentiation potential, but most of these lesions do not display convincing smooth muscle or neuronal differentiation. The GISTs arising from the rectum or anal canal are extremely uncommon. We present a case of immunohistochemically proven GIST of the rectum, which was characterized by homogenous isointensity mass without necrosis or hemorrhage on T2-weighted image and by enhancement on gadolinium-enhanced study.

Carcinoma↗
PubMed2001

Lesser sac hematoma as a sign of rupture of hepatocellular carcinoma in the caudate lobe.

The purpose of this study was to evaluate the CT findings of rupture of hepatocellular carcinoma (HCC) in the caudate lobe of the liver. The CT scans of five cases of rupture of HCC in the caudate lobe of the liver were retrospectively reviewed and correlated with clinical records. All cases showed exophytic tumors in the caudate lobe of the liver and high-attenuation hematomas in the lesser sac on CT. A lesser sac hematoma may be a sentinel clot sign of rupture of HCC in the caudate lobe.

Aged↗
PubMed2001

Sex ratio in the offspring of male radiologists.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine if male radiologists predominantly father daughters and, if so, to investigate the association between this skewed sex ratio of offspring and radiation exposure. MATERIALS AND METHODS: Questionnaires completed by 586 male radiologists in Japan provided data regarding the radiologist's age, length of employment in radiology, if he had ever received radiation doses higher than that recommended by the International Commission on Radiological Protection, the sex of each child fathered, and the birth date of each child. RESULTS: As a group, male radiologists tended to father a lower proportion of boys (48.47%) compared with the control group (51.46%), and the relative risk was 1.13 (95% confidence interval [CI]: 1.00, 1.27). Offspring of highly irradiated radiologists, however, had a reduced proportion of males (34.48%), with a significantly (P = .002) increased relative risk of 2.01 (95% CI: 1.29, 3.13). CONCLUSION: X-ray exposure may explain the reduced percentage of sons in the offspring of male radiologists.

Adult↗
PubMed2001

Does the presence of distant and local malignancy alter parenchymal perfusion in apparently disease-free areas of the liver?

Our objective was to investigate if hepatic arterial (HAP) and portal venous perfusion (PVP) in apparently normal areas of liver, as measured by functional CT, are affected by the presence of extra- and intrahepatic malignancy Three patient groups were compared: A, controls with no malignancy (N = 10); B, extrahepatic malignancy without liver involvement (N = 12); and C, subjects with metastases elsewhere in the liver (N = 13). HAP, PVP, and a CT hepatic perfusion index (CT-HPI) calculated as HAP/(HAP + PVP) were calculated on a section free of metastatic disease, using a previously published method. Figures for PVP were (median and interquartile range) in group A were 1.06 (0.9-1.30), in B 1.03 (0.81-1.09), and in C 0.75 (0.54-1.02) ml/min/ml; for HAP group A values were 0.07 (0.052-0.078), in B 0.07 (0.053-0.147), and in C 0.12 (0.091-0.146) ml/min/ml and for CT-HPI Group A values were 4.9% (4.8-6.6%), in B 5.6% (3.8-13.6%), and in C 14.3% (10.4-15.4%). Significant differences in all indices were seen between groups A and C. A significant difference (P = 0.017) was seen between groups B and C in the CT-HPI values. In conclusion, patients with liver metastases show abnormal blood flow in apparently normal liver compared to controls. This difference was not seen in subjects with malignancy without liver metastases. Possible explanations would be either the unmasking of occult metastatic disease or vasoactive or mechanical effects due to liver malignancy.

Adult↗
PubMed2001

Management of the axilla in breast cancer: a comparative study between sentinel lymph node biopsy and four-node sampling procedure.

BACKGROUND: The aim of this study was to compare the efficacy of sentinel lymph node biopsy and that of four-node sampling for predicting other nodal status in breast cancer. METHODS: 206 patients with operable breast cancer were enrolled. The identification of sentinel lymph nodes (SLNs) was carried out in 110 patients using a gamma probe after injection of radioactive tin colloids. Four palpable lymph nodes (FNs) were removed from the lower axilla at the first step of axillary dissection in 98 patients. The predictive value of nodal status was compared between SLNs and FNs, based on the pathological findings of all dissected lymph nodes. To examine the relationship between SLNs and FNs, we chose the FNs retrospectively (defined as rFNs) from among all nodes in SLNs. RESULTS: SLNs were identified in 108 (98%) of 110 patients. With one patient having skip metastasis, the accuracy and sensitivity were 99 and 98%, respectively. In the four-node sampling (FNS) group, two in 98 patients had skip metastasis and the accuracy and sensitivity were 98 and 96%, respectively. Findings on the relationship between these methods of biopsy were as follows: (i) rFNs included SLNs in 79 patients (73%); (ii) rFNs partially included SLNs in 24 patients (22%); and (iii) no relationship was evident in five patients (5%). CONCLUSIONS: The accuracy/sensitivity of FNs was comparable to that of SLNs. FNS can be considered to represent a highly promising approach and may be used as an alternative procedure that can be performed safely and easily in any institute.

Adult↗
PubMed2001

An Epstein-Barr virus protein interacts with Notch.

The Epstein-Barr virus (EBV) BamHI A mRNAs were originally identified in cDNA libraries from nasopharyngeal carcinoma, where they are expressed at high levels. The RNAs are differentially spliced to form several open reading frames and also contain the BARF0 open reading frame at the 3' end. One cDNA, RK-BARF0, included a potential endoplasmic reticulum-targeting signal peptide sequence. The RK-BARF0 protein is shown here to interact with the Notch4 ligand binding domain, using yeast two-hybrid screening, coimmunoprecipitation, and confocal microscopy. This interaction induces translocation of a portion of the full-length unprocessed Notch4 to the nucleus by using the Notch nuclear localization signal. These effects of RK-BARF0 on Notch intracellular location indicate that EBV possibly modulates Notch signaling. Unprocessed Notch4 was also detected in immunoprecipitated complexes from EBV-infected cells by using a rabbit antiserum raised against a BARF0-specific peptide. This finding provides additional evidence for expression of RK-BARF0 and its interaction with Notch during EBV infection. In EBV-infected, EBNA2-negative cells, RK-BARF0 induced the expression of EBV latent membrane protein 1 (LMP1), and this induction was dependent on the RK-BARF0/Notch interaction domain. The activation of LMP1 expression by RK-BARF0 may be responsible for expression of LMP1 in EBV latent infections in the absence of EBNA2.

Animals↗
PubMed2001

Carcinoma of the uterine cervix: twice- versus once-weekly high-dose-rate brachytherapy.

PURPOSE: To compare the effectiveness and safety of once- versus twice-weekly high-dose-rate (HDR) brachytherapy for cervical cancer. MATERIALS AND METHODS: From 1980 to 1997, 124 consecutive previously untreated patients with cervical cancer were treated with external-beam irradiation (50 Gy) and HDR brachytherapy. Clinical stages were I, 4 (3%) patients; II, 51 (41%); III, 64 (52%); and IV, 5 (4%). From 1980 to 1992, 74 patients (group A) were treated with HDR brachytherapy once weekly (about three fractions of 7 Gy each to point A [2 cm superior and 2 cm lateral to the inferior end of the intrauterine radioactive source]), while from 1992 to 1997, 50 patients (group B) were treated twice weekly (about six fractions of 4.5 Gy each to point A). RESULTS: Overall survival rate at 5 years was 65.2% in group A and 65.3% in group B (P=.96). Local recurrence-free survival rate at 5 years was 69% (51 of 74 patients) in group A and 90% (45 of 50 patients) in group B (P<.001). The rate of grade 2 (moderate) and grade 3 (severe) complications was significantly lower in group B (6% vs. 32% in group A, P<.001). At multivariate analysis, the variables significantly associated with increased local-regional recurrence rates were having stage III-IV lesions (P=.04) and with fewer than six sessions of HDR brachytherapy (P=.02). CONCLUSION: The twice-weekly HDR regimen may improve the local control rate with fewer complications.

Adenocarcinoma↗
PubMed2001

Amino acid substitution analyses of the DNA contact region, two amphipathic alpha-helices and a recognition-helix-like helix outside the dimeric beta-barrel of Epstein-Barr virus nuclear antigen 1.

OBJECTIVES AND METHODS: Epstein-Barr virus (EBV) nuclear antigen 1 (EBNA-1), which is essential for EBV latency, homodimerizes and binds to the EBV replication origin, oriP. We analyzed the dimerization/DNA-binding domain of EBNA-1 by random and site-directed amino acid substitution. RESULTS: Random point mutations that resulted in reduced DNA binding clustered in the DNA contact region (a.a. 461-473) and at or near the termini of alpha-helix II (514-527). Three substitutions of Gly in the DNA contact region each greatly reduced binding to a single binding site oligonucleotide. Substitutions at and near the termini of alpha-helix II diminished DNA binding. A helix-deforming substitution in alpha-helix I (477-489) blocked DNA binding. A helix-deforming substitution in alpha-helix III (568-582) abolished dimerization and DNA binding. Similarities in surface electrostatic properties and conserved amino acids were found between alpha-helix II and recognition helices of papillomavirus E2 proteins. CONCLUSIONS: The basic DNA contact region is crucial for the specific interaction of EBNA-1 with a single binding site. Alpha-helix I477 is indispensable for oriP binding, and alpha-helix III568 contributes to the homodimeric structure of EBNA-1. Alpha-helix II514 contributes to oriP binding, perhaps changing its alignment with DNA.

Amino Acid Sequence↗
PubMed2001

Epstein-Barr virus nuclear antigen-1-dependent and -independent oriP-binding cellular proteins.

OBJECTIVE: Epstein-Barr virus (EBV) nuclear antigen-1 (EBNA-1) and the replication origin, oriP, are essential for the replication and maintenance of latent EBV DNA in cells, but no enzymatic activity has been associated with EBNA-1 protein alone. In this study, we have searched for host cellular proteins that interact with EBNA-1 protein in various B cell lines latently infected with EBV, including a recently EBV growth-transformed cell line. METHODS: By using gel shift analysis, we investigated the interactions of an oligonucleotide containing a single EBNA-1 recognition site, derived from the family of repeats (FR) element of oriP, with protein from cell extracts. RESULTS: The FR oligonucleotide bound a (72-kD) cellular protein in the absence of EBNA-1 and without induction of the previously reported 'anti-EBNA-1 proteins'. The FR oligonucleotide formed complexes with additional proteins from EBNA-1-synthesizing cell lines; these complexes were abolished or supershifted by anti-EBNA-1 monoclonal antibodies. SDS-PAGE analyses of 35S-Met-labeled proteins that bound to a biotin- conjugated FR oligonucleotide, fractionated by a glycerol gradient centrifugation and affinity-purified with streptavidin, showed three major bands, a 72-kD protein, the FR binding of which seemed to be independent of EBNA-1, a 64-kD protein in both EBNA-1-transfected and latently EBV-infected cell lines, and a 45-kD protein in EBV-infected cell lines, which was most prominent in a recently EBV growth-transformed cell line. CONCLUSIONS: The FR element forms complexes with cellular proteins in the absence and presence of EBNA-1. These 72-, 64- and 45-kD cellular proteins might be involved in the function of the oriP and EBNA-1 system.

Binding Sites↗
PubMed2001

Isolation of antidiabetic components from white-skinned sweet potato (Ipomoea batatas L.).

We have already reported that white-skinned sweet potato (Ipomoea batatas L.) (WSSP) shows antidiabetic activity in streptozotocin (STZ) induced diabetic rats and genetically diabetic models (yellow KK, db/db mice and Zucker fatty rats). In this study, isolation and purification of the antidiabetic component of WSSP were attempted. Almost all antidiabetic activity was found in the cortex of WSSP. The fractionation of the antidiabetic component in the WSSP cortex was done by the following methods: dialysis of the water extract, 85% ethanol precipitation, 15% trichloroacetic acid (TCA) treatment, butyl-, phenyl-hydrophobic column chromatography, and ultrafiltration treatment. The antidiabetic component was not eliminated during dialysis and was soluble in 85% ethanol and 15% TCA, but it passed through a filter that allows the passage of substances of a molescular weight of 30,000. The uniformity of this isolated active component was analyzed using HPLC. A single peak was seen with three different columns (C8 reverse-phase column, anion exchange QA column, and gel filtration column (GFC)), indicating that the component is a uniform substance. The molecular weight of this antidiabetic component was estimated to be 22,000 by GFC analysis. This active component was presumed to be an acidic glycoprotein because it contained protein and sugar and was adsorbed onto the QA column at pH 7.0.

Animals↗