[Analysis factors associated with bone density in young women].
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Adult↗
Biomedical subjects
T Kiyama
Publications and source records attributed to T Kiyama.
[Cross sectional study of the relationship between bone density to diet and life style using ultrasound bone densitometry].
The relationship between bone density to diet and life style was investigated in pre- and postmenopausal women in Kyoto Prefecture in 1994 by a cross-sectional study. Bone densities of 453 women aged 30-86 years were measured by ultrasound bone densitometry. History of pregnancy and delivery, menstruation, medical history, bone and arthral symptoms, life style, food intake frequency, current and past intake of dairy products, and physical activity were examined by self-administered questionnaire. Analysis of covariance and multiple-regression analysis were performed to determine the relation between bone density and life style adjusted for age and obesity index among 151 premenopausal women (PRE), 244 postmenopausal but not sedentary (under 65 years of age) women (POST), and 58 sedentary (older than 65 years of age) women (SED). The results were as follows; 1) A marked age-related decline in bone density was observed at 45-55 years of age. The correlation coefficient between age and bone density was significant at -0.65 (p < 0.01). 2) Obesity index and bone density were positively correlated in each group. 3) Among the PRE group women, there was no relation between life style and bone density. Those who experienced bone fractures tended toward low bone density. Among the POST group, time since menopause, exercise, and current milk intake were significantly correlated with bone density. In the SED group, women with arthralgia showed significantly lower densities. 4) From multiple-regression analysis, age, obesity index, and milk intake during childhood were shown to be related to bone density in each group.
Adult↗
Clinical significance of epidermal growth factor (EGF), EGF receptor, and c-erbB-2 in human gastric cancer.
The EGF stimulation system for growth regulation is implicated in normal and neoplastic cell proliferation. The role of EGF, the EGF receptor, and c-erbB-2 in human gastric cancer is reviewed on the basis of several reports, which have been mainly oriented toward their clinical significance. EGF has been shown immunohistochemically to be present in 26% of gastric cancers (n = 395). The presence of EGF in gastric cancer is correlated with the degree of gastric wall invasion and lymph node metastasis. The 5-year survival of patients with EGF-positive tumors is worse than that of patients with EGF-negative tumors. The presence of EGF in human gastric cancer may therefore represent a higher malignant potential. Fifteen percent of gastric cancers (n = 352) were also shown to be positive for both EGF and the EGF receptor immunohistochemically, and the simultaneous occurrence of EGF and the EGF receptor suggests that these tumors grow in an autocrine fashion. Tumors exhibiting EGF and the EGF receptor simultaneously show a greater degree of local invasion and lymph node metastasis. Increased expression of EGF receptor protein in gastric cancer appears to be related to biologic aggressiveness, although gene amplification has occurred only to a small extent. Twelve percent of gastric cancers (n = 486) were found to be positive for c-erbB-2. This type of tumor has a frequent metastasis, and patients with c-erbB-2-positive cancer have a poorer prognosis than those with c-erbB-2-negative tumors. Selective blockade of the EGF receptor and c-erbB-2 from their ligands with monoclonal antibodies (MoAbs) inhibits the growth of human gastric cancer xenografts. These MoAbs may therefore be effective antitumor agents against gastric cancer showing overexpression of EGF receptors or c-erbB-2.
Epidermal Growth Factor↗
[Prognostic evaluation of peritoneal lavage smears and gastric wall brushing smears in gastric cancer surgery].
We investigated the correlation of intraoperative peritoneal lavage smear and gastric wall brushing smear cytology with macroscopic and histologic findings and prognosis, in 216 patients with gastric cancer. Some 196 of these patients underwent gastric resection and 20 did not. The incidence of positive cancer cells determined by these methods was significantly correlated with gastric resection, tumor invasion, and peritoneal dissemination. Among patients without macroscopic peritoneal dissemination, four were found to have positive peritoneal lavage smears or gastric wall brushing smears, respectively. The prognosis of these patients did not differ from that of patients with metastases to the adjacent peritoneum but not the distant peritoneum. These results suggest that peritoneal lavage smears and gastric wall brushing smears are useful for predicting the peritoneal cancer dissemination. Therefore we intend to target patients with no peritoneal metastases (Po) showing positive peritoneal cytology for intensive treatment.
Female↗
[Pulmonary alveolar proteinosis with coincidental thoracic injury. Successful bronchoalveolar lavage with a modified fiberoptic bronchoscope].
A 65-year-old laborer suffered thoracic injury in an accident. Ribs were fractured and chest X-ray films showed coincidental ground-glass, like opacities in both lung fields. CT indicated the possibility of pulmonary alveolar proteinosis, which was confirmed by histological examination of the specimen obtained during therapeutic bronchoalveolar lavage. A modified fiberoptic bronchoscope with a wedge device was used for segmental bronchoalveolar lavage. The wedge derice on a pediatric flexible fiberoptic bronchosiope allowed irrigation of six independent pulmonary segments, with no complication. Six months after discharge, the patient had no evidence of relapse.
Aged↗
[Evaluation of a respiratory care unit on a 45-bed hospital ward].
With a limited number of beds for patients undergoing medical and surgical treatment for respiratory diseases, we set aside 6 of 45 beds on one floor to be used as a respiratory care unit. During the past 5 years, 1820 patients (1225 medical and 595 surgical) were admitted to the respiratory care unit; they were treated for an average of 5.02 days. Of the patients being treated medically, 451 received mechanical ventilatory support. The majority of those patients had acute exacerbations of chronic respiratory failure due to emphysema or to sequelae of pulmonary tuberculosis. Acute respiratory distress associated with asthma or with pneumonia were also relatively common, as was the adult respiratory distress syndrome. A total of 119 patients on home oxygen therapy are being seen as out-patients, and the respiratory care unit was found to be quite useful whenever they needed intensive management. Only 148 (8.1%) of the patients admitted to the respiratory care unit died before discharge, and the ratio of cost to performance was good. The respiratory care unit was most effective in allowing for continuity of care from the onset of respiratory distress, and including exacerbations, surgical interventions, postoperative management, and out-patient care.
Female↗
The presence of tumor necrosis factor-alpha and its antibody in the sera of cachexic patients with gastrointestinal cancer.
Although cancer cachexia has been shown to involve several cytokines, the tumor necrosis factor-alpha (TNF) has rarely been detected in such patients. In this study, sera from 21 patients with cancer cachexia were examined for the presence of TNF and the anti-TNF antibody using an enzyme-linked immunosorbent assay (ELISA) and Western blotting, respectively. All of the patients had recurrent cancer and manifested the characteristics of progressive body weight loss. TNF was found in the sera of four patients (20%) at levels ranging from 10.4 to 53.1 pg/ml, while a positive reaction for the anti-TNF antibody was detected in the sera from six patients (30%), two of whom showed both TNF and its antibody. Thus, either TNF or the anti-TNF antibody was present in the sera from 8 of 21 patients (40%). The results of this study indicate that TNF may be present in the circulation of at least 40% of cachexic patients, and suggest that it may be one of the main mediators of cancer-associated cachexia.
Adult↗
[Evaluation of peritoneal lavage smears and gastric wall brushing smears in gastric cancer surgery].
We investigated the utility of intraoperative peritoneal lavage smears and gastric wall brushing smears for diagnosis of peritoneal dissemination and serosal involvement during gastric cancer surgery. One hundred fifty-three patients with gastric cancer were examined; 138 who underwent gastric resection and 15 who did not. The incidence of cancer cell positivity determined by these methods was 8.0% in resected cases, and 80.0% in unresected cases. According to macroscopic serosal invasion, the incidence of positive cytology was 0% for S0, 15.4% for S1, 13.0% for S2, and 38.7% for S3. According to microscopic wall invasion, the incidence of positivity was 0% for m and sm, 6.3% for mp, 0% for ss, and 22.2% for se and si. In terms of macroscopic peritoneal dissemination, the incidence of positivity was 2.6% for P0, 28.6% for P1, 42.9% for P2, and 90.0% for P3. These results suggest that peritoneal lavage smears and gastric wall brushing smears are useful for predicting the spread of peritoneal dissemination. Thus, further study of intraoperative fast-smear cytology seems warranted.
Gastrectomy↗
[Treatment for peritoneal dissemination of gastric cancer by intraperitoneal administration of CDDP through Infuse-a-Port].
This report describes the effect of intraperitoneal administration of CDDP for the treatment of peritoneal dissemination (P) in 20 patients with gastric cancer. Eight patients after palliative resection, 4 after non-resection and 8 with recurrent cancer were given 25 mg of CDDP through a reservoir (Infuse-A-Port) implanted in the abdominal wall once a week. Simultaneously, 400 mg/body/day of UFT and 2 mg/body/week of Lentinan were administered. Twelve of the patients died of disease at 6-19 months (median 7 months), but 8 have survived 3 to 15 months (median 6 months). Complete and partial responses were obtained in 7 of the 8 patients with recurrence (88%) for malignant ascites. No patient showed any toxicity from treatment. All patients receive the treatment in the outpatient clinic after discharge, and 17 patients have shown a long hospital-free survival.
Administration, Oral↗
Sequential changes in the cell mediators of peritoneal and wound fluids after surgery.
The concentrations of cell mediators in the peritoneal and wound fluids of patients who underwent abdominal surgery or mastectomy were determined sequentially and compared with the concomitant changes in blood components. The level of interleukin-6 (IL-6) in the peritoneal and wound fluids was significantly higher than the plasma level after gastrectomy (P < 0.001), cholecystectomy (P < 0.05), and mastectomy (P < 0.05), although the level of plasma IL-6 was also higher postoperatively than before surgery (P < 0.001, P < 0.05). Significantly higher levels of tumor necrosis factor-alpha were detected in the peritoneal and wound fluids (P < 0.01, P < 0.05, respectively) after surgery despite its absence in plasma. A platelet-specific protein and a protein specific for fibroblasts were also measured. Thus, mediators derived from various cells were shown to be present in human peritoneal and wound fluids, indicating that the local production of these mediators plays an important role in the process of tissue repair.
Adult↗
Correlation of c-erbB-2 with invasion and metastasis in human gastric cancer.
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Adenocarcinoma↗
Correlation between epidermal growth factor receptor concentration and the growth of human gastric cancer xenografts in nude mice.
Seven human gastric cancer xenografts with different concentrations of EGF receptor were established in nude mice. The expression of EGF receptor in the tumors was demonstrated by Western blotting with anti-EGF receptor antibody, binding assay with 125I-EGF and immunohistochemistry with anti-EGF receptor antibody. Western blotting revealed EGF receptor doublet bands at molecular masses of 150 KDa and 170 KDa in all of the samples. The concentration of 125I-EGF binding activity in the tumors ranged from 36.0 to 11,000 fmol/mg protein, with a mean of 345 fmol/mg protein. EGF receptor was also demonstrated immunohistochemically on the apical border of the glands and the cell membrane of the tumor cells. There seemed to be a close correlation between the concentration of 125I-EGF binding activity and the doubling time of these tumors in nude mice (gamma = -0.68). However, no definite correlation was observed between EGF ligand binding and histological features of intestinal type or diffuse type. The expression of EGF receptor appears to facilitate the growth of human gastric cancer xenografts in nude mice.
Animals↗
[Phase I clinical study of combined cisplatin and carboplatin therapy in lung cancer].
A phase I clinical study (a dose escalation test) of combined cisplatin (CDDP) + carboplatin (CBDCA) therapy was carried out in patients with primary or secondary lung cancer (PS 0-2) who had given prior informed consent to the study. The dose level of CDDP was set at 80 mg/m2, while five dose levels (200, 250, 300, 350, 400 mg/m2) of CBDCA were used. Three patients were allocated to each CBDCA dose group. Blood samples were taken immediately before and 0.5, 1, 2, 4, 6 and 24 hours after injection, and were examined for total Pt and free Pt level. The maximum tolerated dose (MTD) was CDDP 80 mg/m2 + CBDCA 400 mg/m2. Thrombocytopenia and leukopenia served as dose limiting factors (DLF). Total Pt and free Pt levels in blood after this combined therapy were higher than those after treatment with CDDP alone. The results from this study suggest that CDDP 80 mg/m2 + CBDCA 350 mg/m2 would be a suitable dose for phase II study of this combined chemotherapy. A multi-center pilot study based on these findings is now under way.
Adenocarcinoma↗
[Sharp decline in plasma CEA and reduction of liver metastasis after UFT administration in a patient with recurrent gastric cancer].
Carcinoembryonic antigen (CEA) in plasma is useful for the detection of recurrent colonic or gastric cancer and the monitoring of plasma in patients with recurrent cancer displaying therapeutic effect. We report a sharp decline of CEA in a patient with recurrent gastric cancer by 6 months oral administration of UFT. The patient was an 81-year-old male who had undergone gastrectomy for advanced gastric cancer. Eight months post-operatively, the plasma CEA began to rise logarithmically, and recurrent tumor in the remnant stomach and liver metastasis were detected by fibergastroscope (FGS) and abdominal CT. After administration of UFT at a dose of 300 mg per day, CEA abruptly declined logarithmically and normalized in 6 months. Presently marked reduction of recurrent foci and metastases were found by FGS and abdominal CT. Therefore sequential changes in plasma CEA in this patient can be considered to reflect the effect of therapy for recurrent gastric cancer by UFT.
Adenocarcinoma↗
Serum CEA levels in patients with gastric carcinoma correlate with the tumorigenicity of their xenografts in nude mice.
We examined the correlation among preoperative serum carcinoembryonic antigen (CEA) levels, staining properties of the tumors by CEA immunohistochemistry and the tumorigenicity of their xenografts in nude mice, in 28 patients with gastric cancer. Eleven (40 per cent) of them were positive for serum CEA (greater than or equal to 2.5 ng/ml) and seven (25 per cent) of the xenografts were tumorigenic in nude mice. All the tumorigenic cases were positive for serum CEA (p less than 0.001) and the mean value of the serum CEA level in the patients with tumorigenic neoplasms was 20.8 ng/ml, being significantly higher than that (1.4 ng/ml) in the patients with non-tumorigenic neoplasms (p less than 0.001). Twenty-five of the 28 carcinomas (89 per cent) were positive for CEA staining in their cancer cells by the ABC method and CEA localization correlated with tumorigenicity (p less than 0.05). These results suggest that the serum CEA level in patients is correlated with the tumorigenicity of their gastric carcinoma xenografts in nude mice and may account for the poor prognosis of patients with high serum CEA.
Adolescent↗
[Bronchoalveolar lavage studies in a HTLV-1-positive case associated with interstitial pneumonia].
A 64-year-old housewife was hospitalized because of cough and dyspnea. Chest X-rays on admission showed diffuse interstitial shadows and loss of lung volume, suggesting acute interstitial pneumonia. Pulmonary function tests revealed decreased vital capacity and severe hypoxemia. Bronchoalveolar lavage studies showed that total cell counts and a proportion of lymphocytes were increased. Lymphocytes increased in lavage fluid consisted mainly of T cells with an elevated CD4+/CD8+ ratio. Furthermore, these lymphocytes spontaneously proliferated and responded well to recombinant IL-2 when cultured in vitro for 5 days, suggesting that lymphocyte activation occurred in the lung. Such lavage findings and lymphocytes activation in association with the presence of HTLV-1-specific IgA antibody in lavage fluid have been demonstrated in patients with HTLV-1-associated myelopathy. In this patient positive for HTLV-1, however, it could not be determined whether the pulmonary lesions were primarily related to HTLV-1 infection, because no IgA antibody specific for HTLV-1 was demonstrated in lavage fluid. In conclusion, when pulmonary abnormalities are found in HTLV-1 carriers, we should be careful in determining whether such pulmonary involvements are etiologically related to HTLV-1 infection.
Bronchoalveolar Lavage Fluid↗
[Changes in serum and tissue carcinoembryonic antigen with growth of human gastric cancer xenografts in nude mice].
Four human gastric cancer xenografts in nude mice were analyzed for tumor growth and associated levels of carcinoembryonic antigen (CEA) in sera and tissues. The xenografts were established from gastric cancer patients and transplanted serially over 20 passages in our laboratory. Histologically, two xenografts were intestinal type and the other two were diffuse type. All of them were positive for CEA immunohistochemically. Individual xenografts showed a positive correlation between tumor growth and serum CEA level, with correlation coefficients ranging from 0.73 to 0.91. Serum CEA levels rose continuously with increasing tumor weight after inoculation. A positive correlation was also observed between the tissue CEA level and tumor growth, the former increasing along with the latter, showing the correlation coefficients ranging from 0.69 to 0.81. Furthermore, the level of serum CEA closely paralleled to that of tissue CEA, showing the correlation coefficients ranged 0.54 to 0.90. The deviation of the ratio of serum CEA level/tissue CEA level was constant among the xenografts, although the mean ratio differed slightly. These results suggest that serum CEA level is closely correlated with tissue CEA level as well as tumor growth, and that the elevation of serum CEA is attributable to the tissue CEA level rather than tumor weight.
Animals↗
[Is airway occlusion pressure useful to predict successful weaning from mechanical ventilation in patients with acute respiratory failure?].
The purpose of this study was to evaluate whether airway occlusion pressure (P0.1) would be a useful predictor for successful weaning in mechanically ventilated patients with acute respiratory failure. We studied 23 marginal weaning candidates. Fourteen patients were able to be weaned from the ventilator, and 9 patients were not able to be weaned. P0.1 and other respiratory parameters were measured just prior to weaning and at the end of weaning or at the time of discontinuation of weaning. The mean value of P0.1 in the failed group was higher than that in the successful group both before and after weaning periods. However, P0.1 varied widely among patients and did not separate the failure group from the success group because of overlap between the two. There were significant differences between the two groups of the conventional weaning parameters, such as respiratory rate, minute ventilation, PaO2, and oxygen equivalent. We conclude that P0.1 is helpful to predict successful weaning. However, it can not be used as a single parameter for weaning because of the wide variations of absolute values among patients with acute respiratory failure.
Acute Disease↗