Masahiko Sugitani

Randomized placebo-controlled trial assessing the effect of bifidobacteria-fermented milk on active ulcerative colitis

Background : Probiotics are efficacious for treating and maintaining remission of ulcerative colitis.

Sensitivity of serological assays to identify blood donors with hepatitis C viraemia

Blood donors at high risk of hepatitis C virus (HCV) infection were tested for viraemia by the polymerase chain reaction (PCR). PCR results were accepted as positive only if reactive in 3 of 4 tests and if confirmed in an independent laboratory. The sera were also tested by 6 different assays to determine the ability of current serological assays to detect viraemic blood donors. Of 19 PCR-positive sera, only 13 (68%) were detected by the most sensitive of the serological assays. If these results are confirmed, automated PCR assays may be required for blood-donor screening to prevent transmission of HCV.

Survivin as a prognostic factor for osteosarcoma patients.

Purpose: Survivin is one of the apoptosis inhibitor genes and is rarely expressed in adult tissues. However, survivin expression has been detected in various human cancers and correlations have been recognized between the level of expression of this gene in tumors and prognosis. In this study, we investigated the correlations between survivin mRNA expression in osteosarcoma tissues and clinicopathological parameters. Methods: There were 22 osteosarcoma patients in our hospital with paraffin-embedded tissues which could be extracted from biopsy specimens. We used the RT-PCR method after extracting total RNA and conducted a densitometric analysis to determine the ratio of survivin relative to h-GAPDH as an internal marker. Results: Expression of survivin mRNA was detected in all osteosarcoma samples. Patients with metastasis had high survivin mRNA levels in initial biopsy specimens (p<0.01). Moreover, there was a statistically significant difference in survivin mRNA expression between patients with and without metastasis (p<0.01). Conclusion: We concluded that high levels of survivin mRNA expression suggest poor prognosis for osteosarcoma patients.

Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis

PurposeIdiopathic granulomatous mastitis (IGM) is a rare inflammatory pseudotumor. No therapeutic modality has been established because of the rareness of this disease. The aim of this study was to investigate the clinical course of IGM treated with corticosteroid, and to evaluate the optimal methods of observation during corticosteroid therapy of IGM.MethodsThe retrospective study included eight women who met the required histological criteria of IGM. The clinical data of the presentation, histopathology, and management were analyzed by reviewing the medical records.ResultsThe mean age of the patients was 44.8 years (range, 28–75 years) and all patients complained of a breast mass. Seven of them had pain. All of them underwent a core needle biopsy and were diagnosed as having IGM. Five took prednisolone orally and three received prednisolone plus antibiotics; one patient of the latter group underwent a resection due to severe pain. Seven patients healed without surgery and it took from 4 to 10 months to achieve a cure. The period until confirmation of the disappearance of a mass was the shortest by palpation, followed by contrast magnetic resonance imaging and ultrasonography in that order.ConclusionSteroid therapy was effective for the treatment of IGM, which was cured without surgery in seven of eight cases. Ultrasonography was considered an excellent method for evaluating the treatment outcomes.

Collision Tumor of the Stomach A Rare Case of an Adenocarcinoma and Carcinoid Tumor

We report a rare case of gastric collision tumor composed of moderately differentiated tubular adenocarcinoma and carcinoid in an 84-year-old woman. On endoscopic examination, an invasive tumor was noted at the cardia of the stomach, and a pathologic examination of the biopsy specimen revealed adenocarcinoma. After total gastrectomy, a thorough histopathologic examination of the resected tumor revealed the concurrent presence of moderately differentiated adenocarcinoma and a typical carcinoid tumor, which had a colliding pattern of tissue proliferation. There was no intermixing or transition area between the 2 components. The final pathologic diagnosis was collision tumor of the adenocarcinoma and carcinoid tumor. The presence of either tumor individually would not be especially noteworthy, but this collision-type tumor of both histopathologic types in the stomach is, to our knowledge, only the sixth such case in the literature.

Application of liquid-based preparation to fine needle aspiration cytology in breast cancer.

OBJECTIVE To examine the performance of liquid-based cytology (LBC) in breast cytology to confirm the diagnosis of carcinoma. STUDY DESIGN Using cell clusters directly scratched from surgically removed tumor masses, we examined the immunocytochemistry, molecular biology and cytomorphology of the specimens. RESULTS LBC was very useful for gene analysis and evaluating the immunocytochemistry. The cytologic features of LBC were slightly different from those ofa conventional aspiration cytology smear. CONCLUSION LBC is a promising method for improving the standardization ofpreparations in breast cytology, although care should be taken to account for its characteristic cytologic features. The quantitative analysis of HER-2 mRNA correlated with the results of immunohistochemistry.

Comparison of amino acid sequences in hypervariable region-1 of hepatitis C virus clones between human inocula and the infected chimpanzee sera.

We analyzed nucleic and amino acid sequences of the hypervariable region (HVR)-1 of the hepatitis C virus (HCV) from inocula and the infected chimpanzee sera. One milliliter each of 10(-5), 10(-3) and 10(-2) dilutions of serum no. 4, and those of 10(-4), 10(-5) and 10(-6) dilutions of serum no. 6 were inoculated to six different chimpanzees. Both inocula nos. 4 and 6 contained 10(7) copies of HCV RNA/ml. The two chimpanzees inoculated with 10(-4) and 10(-5) dilutions of no. 6 were infective, while none of the dilutions from inoculum no. 4 were infective. Our results indicated that HCV RNA titer in sera did not correlate with in vivo infectivity. RNA from both inocula and the infected chimpanzee sera were extracted and transcribed to cDNA. The PCR products amplifying the HCV HVR-1 were incorporated into a vector, followed by transformation. Twenty colonies were picked up randomly from each sample. DNA was extracted and the DNA and amino acid sequences were determined. Genetic variations of 20 clones from inoculum no. 6 were divided into six groups, whereas, 40 clones from infected chimpanzees were completely identical to the major quasispecies of inoculum no. 6 in amino acid sequences. The study suggested that the major quasispecies in the diluted inocula were transmitted and replicated.

A case of solitary fibrous tumor of the kidney: an immunohistochemical and ultrastructural study with a review of the literature

A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually arises in the pleura but rarely occurs in the kidney. Despite its rarity, histological diagnosis of SFT is crucial to avoid misdiagnosis with other malignant tumors in the kidney. We report a SFT of the left kidney that presented as a malignant tumor on radiographic findings in a 75-year-old Japanese woman. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands with no areas of necrosis or cystic changes noted macroscopically or microscopically. Electron microscopy showed fibroblast-like cells with well-developed rough endoplasmic reticulum, surrounded with collagen fibers. Immunohistochemistry revealed reactivity for vimentin, CD34, Bcl-2, and CD99, but no staining for cytokeratin, S-100, desmin, actin, D2-40, or epithelial membrane antigen (EMA). These findings were compatible with those of SFT. Although SFT of the kidney is extremely rare, this tumor must be included in the differential diagnosis when we encounter renal tumors consisting of mesenchymal elements. Immunohistochemical study is the key to diagnosis for SFT, and ultrastructural study is useful for its diagnosis.

Expression of Inducible Microsomal Prostaglandin E Synthase in Local Lesions of Endometriosis Patients

Recently, an inducible microsomal human prostaglandin E synthase (mPGES) was identified. This enzyme converts the cyclooxygenase (COX) product, prostaglandin (PG) H2, to PGE2, an eicosanoid linked to carcinogenesis. Although elevated levels of PGE2 have been observed in many tumor types including colorectal adenomas and cancers, its role in the pathophysiology of endometriosis is unknown. We previously reported increased expression of COX‐2 messenger RNA (mRNA) in local lesions of endometriosis. To further elucidate the mechanism responsible for the elevated levels of PGE2 in endometriosis, we examined the expression levels of mPGES.

Efficacy of antibiotic combination therapy in patients with active ulcerative colitis, including refractory or steroid-dependent cases.

Background and Aims:  We previously demonstrated that antibiotic combination therapy is effective for induction and maintenance of ulcerative colitis (UC) remission. Herein, we assessed whether antibiotic combination therapy is effective for active UC, including cases with steroid refractory or dependent disease.