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1.
Phys Rev Lett ; 105(26): 263202, 2010 Dec 31.
Article in English | MEDLINE | ID: mdl-21231656

ABSTRACT

We measured kinetic energies of the fragment ions of argon dimers multiply ionized by low-energy Ar(9+) collisions. For (Ar2)(4+) dissociation, the asymmetric channel (Ar(3+) + Ar(+)) yield is found unexpectedly higher than the symmetric channel (Ar(2+) + Ar(2+)) yield in contrast with previous observation for covalent molecules or clusters. For the dissociation channel (Ar2)(2+)→Ar(+) + Ar(+), two well-separated peaks were observed, clearly evidencing that the direct Coulombic dissociation and the radiative charge transfer followed by ionic dissociation alternatively occur for the dicationic dimers. The respective intensity of these two peaks provides a direct mean to unravel the respective proportion of one-site and two-site double-electron capture, which are found equal for this collision system.

2.
Mol Cell Biol ; 14(5): 2958-65, 1994 May.
Article in English | MEDLINE | ID: mdl-8164654

ABSTRACT

We have isolated a cDNA (cNPK5) that encodes a protein kinase of 511 amino acids from suspension cultures of tobacco cells. The predicted kinase domain of NPK5 is 65% identical in terms of amino acid sequence to that of the SNF1 serine/threonine protein kinase of Saccharomyces cerevisiae, which plays a central role in catabolite repression in yeast cells. SNF1 positively regulates transcription of various glucose-repressible genes of the yeast, such as the SUC2 gene for a secreted invertase, in response to glucose deprivation: snf1 mutants cannot utilize sucrose as a carbon source. Expression of cNPK5 in yeast cells allowed the snf1 mutant cells to utilize sucrose for growth and caused constitutive expression of the SUC2 gene in wild-type cells even in the presence of glucose, an indication that the NPK5 protein is present in a constitutively active form in S. cerevisiae. On the other hand, expression of cNPK5 failed to suppress the growth defect of the snf4 mutant cells in the presence of sucrose and to induce expression of the SUC2 gene. These results indicate that SNF4 is required for the induction of SUC2 expression by NPK5, as by SNF1, even if NPK5 is constitutively active in S. cerevisiae. The recombinant NPK5 protein is capable of autophosphorylation in vitro in a reaction that requires Mn2+ rather than Mg2+ ions but is inhibited by Ca2+ ions. Both dicotyledonous and monocotyledonous plants have several copies of the NPK5-related gene, which probably constitute a small gene family. NPK5-related genes were found to be expressed in the roots, leaves, and stems of tobacco plants. The high degree of structural conservation and the functional similarity of NPK5 to SNF1 lead us to speculate that NPK5 (or a related kinase) also plays a role in sugar metabolism in higher plants.


Subject(s)
Gene Expression Regulation, Enzymologic , Genes, Fungal , Glucose/pharmacology , Glycoside Hydrolases/biosynthesis , Nicotiana/enzymology , Plants, Toxic , Protein Kinases/metabolism , Protein Serine-Threonine Kinases/metabolism , Saccharomyces cerevisiae/enzymology , Saccharomyces cerevisiae/genetics , Amino Acid Sequence , Base Sequence , Blotting, Southern , Cell Line , DNA/genetics , Enzyme Repression , Fungal Proteins/metabolism , Gene Expression Regulation, Enzymologic/drug effects , Glycoside Hydrolases/genetics , Molecular Sequence Data , Plasmids , Polymerase Chain Reaction , Protein Kinases/biosynthesis , Protein Kinases/isolation & purification , Protein Serine-Threonine Kinases/biosynthesis , Protein Serine-Threonine Kinases/isolation & purification , Reading Frames , Recombinant Fusion Proteins/biosynthesis , Recombinant Fusion Proteins/isolation & purification , Recombinant Fusion Proteins/metabolism , Recombinant Proteins/biosynthesis , Recombinant Proteins/metabolism , Restriction Mapping , Sequence Homology, Amino Acid , beta-Fructofuranosidase
3.
Plant Biol (Stuttg) ; 17 Suppl 1: 66-74, 2015 Jan.
Article in English | MEDLINE | ID: mdl-24942699

ABSTRACT

The plant circadian clock controls various physiological phenomena that are important for adaptation to natural day-night cycles. Many components of the circadian clock have been identified in Arabidopsis thaliana, the model plant for molecular genetic studies. Recent studies revealed evolutionary conservation of clock components in green plants. Homologues of clock-related genes have been isolated from Lemna gibba and Lemna aequinoctialis, and it has been demonstrated that these homologues function in the clock system in a manner similar to their functioning in Arabidopsis. While clock components are widely conserved, circadian phenomena display diversity even within the Lemna genus. In order to survey the full extent of diversity in circadian rhythms among duckweed plants, we characterised the circadian rhythms of duckweed by employing a semi-transient bioluminescent reporter system. Using a particle bombardment method, circadian bioluminescent reporters were introduced into nine strains representing five duckweed species: Spirodela polyrhiza, Landoltia punctata, Lemna gibba, L. aequinoctialis and Wolffia columbiana. We then monitored luciferase (luc+) reporter activities driven by AtCCA1, ZmUBQ1 or CaMV35S promoters under entrainment and free-running conditions. Under entrainment, AtCCA1::luc+ showed similar diurnal rhythms in all strains. This suggests that the mechanism of biological timing under day-night cycles is conserved throughout the evolution of duckweeds. Under free-running conditions, we observed circadian rhythms of AtCCA1::luc+, ZmUBQ1::luc+ and CaMV35S::luc+. These circadian rhythms showed diversity in period length and sustainability, suggesting that circadian clock mechanisms are somewhat diversified among duckweeds.


Subject(s)
Araceae/physiology , Circadian Rhythm/physiology , Araceae/radiation effects , Circadian Rhythm/radiation effects , Genes, Reporter , Light , Luciferases/metabolism , Luminescent Measurements , Species Specificity , Time Factors
4.
DNA Res ; 1(5): 213-21, 1994.
Article in English | MEDLINE | ID: mdl-7584043

ABSTRACT

We have isolated four genomic DNA clones that contain the transcription initiation site of the parA gene(s) from a tobacco genomic library by hybridization with the 5' segment of the parA cDNA previously isolated. They were classified into two types on the basis of their nucleotide sequences. Southern blot analysis indicated that two types of clones were respectively derived from the two parental species of tobacco, Nicotiana tomentosiformis and Nicotiana sylvestris. The genes corresponding to these clones were designated as parAt and parAs, respectively, and the parA cDNA clone was shown to code for mRNA from parAt on the basis of its nucleotide sequence. The 5' regions about 400 nucleotides upstream from the transcription initiation sites of the parAt and parAs genomic clones were highly homologous to one another, but regions further upstream showed no significant similarity. The coding sequence of the GUS (beta-glucuronidase) reporter gene was linked to the 5'-upstream regions of parAt and parAs, and the sites of expression of these fusion genes were examined in transgenic tobacco plants. In the absence of auxins, both fusion genes were expressed in capsules at a late stage of seed development, mature seeds, a root apex and a root-hair zone whereas no significant expression was seen in other organs. Their expression was enhanced by 2,4-dichlorophenoxyacetic acid in most of the organs of tobacco. The results show that expression of these genes is regulated by both organ-specific and auxin-inducible mechanisms.


Subject(s)
Gene Expression Regulation, Plant/physiology , Indoleacetic Acids/pharmacology , Nicotiana/genetics , Plant Proteins/genetics , Plants, Toxic , Amino Acid Sequence , Base Sequence , Cloning, Molecular , Gene Expression Regulation, Plant/drug effects , Genes, Plant/genetics , Glucuronidase/biosynthesis , Glucuronidase/genetics , Molecular Sequence Data , Plants, Genetically Modified , RNA, Messenger/biosynthesis , RNA, Plant/biosynthesis , Recombinant Fusion Proteins/biosynthesis , Sequence Analysis, DNA , Sequence Homology, Nucleic Acid , Transcription, Genetic/genetics
5.
Plant Cell Rep ; 16(10): 674-679, 1997 Jul.
Article in English | MEDLINE | ID: mdl-30727617

ABSTRACT

The human lysozyme gene, which is assembled by the stepwise ligation of chemically synthesized oligonucleotides, was introduced into tobacco (Nicotiana tabacum cv `SR1') by the Agrobacterium-mediated method. The introduced human lysozyme gene was highly expressed under the control of the cauliflower mosaic virus 35S promoter, and the gene product accumulated in the transgenic tobacco plants. The transgenic tobacco plants showed enhanced resistance against the fungus Erysiphe cichoracearum - both conidia formation and mycelial growth were reduced, and the size of the colony was diminished. Microscopic observation revealed that the transgenic tobacco plants carried the resistant phenotype, analogous to that of the resistant cultivar `Kokubu' which had been selected by conventional breeding. Growth of the phytopathogenic bacterium Pseudomonas syringae pv. tabaci was also strongly retarded in the transgenic tobacco, and the chlorotic halo of the disease symptom was reduced to 17% of that observed in the wild-type tobacco. Thus, the introduction of a human lysozyme gene is an effective approach to protect crops against both fungal and bacterial diseases.

6.
J Thorac Imaging ; 14(2): 105-8, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10210482

ABSTRACT

In order to clarify the characteristic computed tomographic findings of peripheral small cell lung cancer, the authors investigated 12 patients with surgically resected and histologically proven peripheral small cell lung cancer. Conventional computed tomography was performed on all, and additional high-resolution computed tomographic images were obtained for nine patients. Marginal, internal, and surrounding features of the tumors were analyzed, and these findings were correlated with histologic findings. All 12 tumors appeared as homogenous masses, and eight had well-defined margins. Lobulation was found in seven, marginal ground-glass opacity in three, fine spiculation in two, and both ground-glass opacity and spiculation in one. Cut specimens showed whitish medullary masses without large areas of necrosis, and microscopic specimens showed small areas of necrosis in 11 patients. Marginal ground-glass opacities corresponded to focal edema and hemorrhage in two patients and to intraalveolar invasion in one. Fine spiculation corresponded to vascular/lymphatic invasion in one patient and to irregular intraalveolar spread in another. The authors concluded that a homogenous mass without necrosis is the most characteristic feature of peripheral small cell carcinoma on computed tomography.


Subject(s)
Carcinoma, Small Cell/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Aged , Carcinoma, Small Cell/pathology , Carcinoma, Small Cell/surgery , Female , Humans , Image Processing, Computer-Assisted , Lung/pathology , Lung/surgery , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Radiography
7.
Comput Med Imaging Graph ; 12(2): 131-4, 1988.
Article in English | MEDLINE | ID: mdl-2838154

ABSTRACT

Malignant histiocytoma of the liver, a rare liver tumor, has not been reported in the radiological literature. The differential diagnosis of liver mass should be expanded to include primary malignant fibrous histiocytoma. Embolization of the mass was ineffective.


Subject(s)
Histiocytoma, Benign Fibrous/diagnosis , Liver Neoplasms/diagnosis , Aged , Angiography , Female , Histiocytoma, Benign Fibrous/blood supply , Humans , Liver Neoplasms/blood supply , Tomography, X-Ray Computed , Ultrasonography
8.
Radiat Med ; 11(2): 63-5, 1993.
Article in English | MEDLINE | ID: mdl-8391155

ABSTRACT

The case of a 47-year-old man with an oncocytic variant of carcinoid of the lung is reported. Chest radiography disclosed a well-defined round mass in the left upper lobe of the lung. Contrast-enhanced CT demonstrated a homogeneously well-enhanced mass. The oncocytic variant of a typical carcinoid is a rare histological entity, which can be established only by the ultrastructural features of mitochondrial hyperplasia and membrane-bound electron dense granules. Therefore, the definite diagnosis of oncocytic carcinoid tumor necessitates ultrastructural observation.


Subject(s)
Carcinoma, Adenoid Cystic/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Lung/ultrastructure , Carcinoma, Adenoid Cystic/ultrastructure , Humans , Lung/diagnostic imaging , Lung Neoplasms/ultrastructure , Male , Microscopy, Electron , Middle Aged , Tomography, X-Ray Computed
9.
Radiat Med ; 5(2): 42-7, 1987.
Article in English | MEDLINE | ID: mdl-3659410

ABSTRACT

We report a new technique for computed tomography (CT) of the pancreas during retrograde injection of contrast material into the pancreatic duct via an in situ balloon catheter placed by duodenoscopy (CT-RP). The method resulted in more stable ductgrams at CT than were obtained with other methods. Our data suggest that CT-RP provides useful information in evaluating pancreatic lesions that produce subtle or insignificant abnormalities of the outline of the pancreas and the ductal system on conventional CT and ERP.


Subject(s)
Catheterization , Pancreas/diagnostic imaging , Tomography, X-Ray Computed/methods , Catheters, Indwelling , Humans
10.
Radiat Med ; 7(5): 217-9, 1989.
Article in English | MEDLINE | ID: mdl-2697893

ABSTRACT

A rare inflammatory pseudotumor of the liver diagnosed by US-guided needle biopsy is reported.


Subject(s)
Fibroma/diagnosis , Liver Neoplasms/diagnosis , Adult , Biopsy, Needle , Fibroma/diagnostic imaging , Humans , Liver Neoplasms/diagnostic imaging , Male , Radiography , Radionuclide Imaging , Ultrasonography
11.
Radiat Med ; 6(2): 66-70, 1988.
Article in English | MEDLINE | ID: mdl-3175042

ABSTRACT

Renal angiomyolipoma (AML) composed of adipose tissue, smooth muscle, and vessels can be clearly visualized on computed tomography (CT). However, once hemorrhage occurs, it is difficult to distinguish this lesion from other solid tumors. While there are reviews of AML with hemorrhage, those with the subcapsular type are rare. We present a case of preoperatively diagnosed angiomyolipoma complicated with subcapsular hemorrhage, as evaluated on CT.


Subject(s)
Hemangioma/diagnostic imaging , Hematoma/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Lipoma/diagnostic imaging , Tomography, X-Ray Computed , Female , Hemangioma/complications , Hematoma/etiology , Humans , Kidney Neoplasms/complications , Lipoma/complications , Middle Aged
12.
Clin Nucl Med ; 22(4): 227-30, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9099477

ABSTRACT

A rare case of hyperthyroidism in the presence of a functioning bone metastasis secondary to an occult thyroid cancer is reported. A 59-year-old woman's pelvic bone metastasis was much too extensive and hypervascular to permit resection. An I-131 scan showed striking activity in the pelvic metastasis, which reflected ectopic excessive production of thyroid hormone by a functioning metastatic thyroid carcinoma. After total thyroidectomy, the patient received I-131 ablation and transcutaneous intra-arterial embolization therapy but her metastasis progressively enlarged. Microscopically, concomitant follicular and papillary cancer was found in close proximity to the thyroid. The patient now has vertebral metastases, and her hyperthyroid state still requires methymazole to prevent thyrotoxicosis.


Subject(s)
Bone Neoplasms/complications , Bone Neoplasms/secondary , Carcinoma, Papillary, Follicular/complications , Carcinoma, Papillary, Follicular/secondary , Hormones, Ectopic/biosynthesis , Hyperthyroidism/etiology , Thyroid Hormones/biosynthesis , Thyroid Neoplasms/pathology , Bone Neoplasms/diagnosis , Bone Neoplasms/therapy , Carcinoma, Papillary, Follicular/diagnosis , Carcinoma, Papillary, Follicular/therapy , Combined Modality Therapy , Embolization, Therapeutic , Female , Humans , Iodine Radioisotopes/therapeutic use , Middle Aged , Thyroid Neoplasms/therapy , Thyroidectomy
13.
Kaku Igaku ; 27(12): 1443-6, 1990 Dec.
Article in Japanese | MEDLINE | ID: mdl-2290216

ABSTRACT

We investigated the effect of biliary obstruction and cholangitis on serum SPan-1 level in 14 patients (5 patients with pancreatic cancer and 9 patients with biliary tract cancer) who were performed PTCD for biliary obstruction. 1 out of 5 cases with pancreatic cancer and 8 out of 9 cases with biliary tract cancer showed a decrease of SPan-1 level with improvement of jaundice. It suggested that the effect of biliary obstruction and cholangitis on serum SPan-1 level was much more in biliary tract cancer than in pancreatic cancer. There was no significant difference in changes of between serum SPan-1 level and serum CA 19-9 level after PTCD. We conclude that the effect of biliary obstruction and cholangitis on serum SPan-1 level is almost same on serum CA 19-9 level.


Subject(s)
Antigens, Neoplasm/analysis , Biliary Tract Neoplasms/blood , Biomarkers, Tumor/analysis , Cholangitis/blood , Cholestasis/blood , Pancreatic Neoplasms/blood , Antigens, Tumor-Associated, Carbohydrate/analysis , Cholestasis/surgery , Humans
14.
Kyobu Geka ; 54(3): 211-4, 2001 Mar.
Article in Japanese | MEDLINE | ID: mdl-11244753

ABSTRACT

We compared the operative outcomes among 14 patients who underwent the removal of left atrial myxoma with four different approaches; right lateral (n = 2), transseptal bi-atrial (Dubost, n = 4), conventional transseptal (n = 4) and superior transseptal approach (STA, n = 4). Concomitant operations were performed in 4 cases (CABG, two; aortic valvuloplasty, one; mitral valve replacement, one), and two out of 4 cases were in the STA group. The mean operation, cardiopulmonary bypass and aortic cross-clamp times were shorter in the STA group compared to the other three group. The total amount of postoperative drain discharge and the peak value of creatine kinase were also lower in the STA group compared to the other three groups. Among the patients in sinus rhythm before operation, the use of STA was associated with a greater incidence (100%) of postoperative atrial fibrillation or junctional rhythm. These rhythm disturbances were temporary, and all returned to sinus rhythms during hospital stay. We conclude that STA is an excellent approach with a nice surgical view to expose and remove the left atrial myxoma.


Subject(s)
Cardiac Surgical Procedures/methods , Heart Neoplasms/surgery , Myxoma/surgery , Adult , Aged , Coronary Artery Bypass , Female , Heart Atria/surgery , Humans , Male , Middle Aged
15.
Kyobu Geka ; 53(3): 212-4, 2000 Mar.
Article in Japanese | MEDLINE | ID: mdl-10714109

ABSTRACT

Systemic venous return to the heart is disturbed as a result of right heart failure. ICG clearance is known to be influenced by hepatic venous return to the right atrium. Under a hypothesis that right heart function could be evaluated by ICG clearance test, patients with mitral valve disease (Group M, n = 29), aortic valve disease (Group A, n = 16), ischemic heart disease (Group CABG, n = 19) were studied. Preoperative K-ICG (normal range > 0.17) in the Group M was significantly lower than those in the Group A and Group CABG (0.097 +/- 0.037 vs 0.166 +/- 0.032 and 0.171 +/- 0.027, p < 0.05). In the Group M, patients who underwent tricuspid annuloplasty (TAP) had significantly lower K-ICG than the others (0.077 +/- 0.026 vs 0.113 +/- 0.038, p < 0.05). Postoperatively, K-ICG of TAP patients significantly increased (0.092 +/- 0.031, p < 0.05) when compared to their preoperative value. ICG clearance test was useful to quantify the right heart function, especially in the postoperative evaluation.


Subject(s)
Heart Function Tests/methods , Indocyanine Green , Ventricular Function, Right , Female , Heart Valve Prosthesis Implantation , Humans , Male , Mitral Valve Insufficiency/physiopathology , Mitral Valve Insufficiency/surgery , Monitoring, Physiologic , Postoperative Period
16.
Kyobu Geka ; 53(7): 567-70, 2000 Jul.
Article in Japanese | MEDLINE | ID: mdl-10897569

ABSTRACT

We report the results of long-term follow up in 9 patients who underwent pericardiectomy for constrictive pericarditis. In order to test whether if congestive liver dysfunction due to the disease could be reversible or not after the surgical repair, the patients were evaluated by indocyanine green (ICG) clearance test. All the patients improved in NYHA classification after long-term periods following surgical repairs. The percentage of ICG retention at 15 minutes (ICG-R15) improved in most of the patients. However, two patients who had a long history from the onset before surgery became worse in ICG-R15. From the above reports, reversibility of hepatic function might be dependent on the duration of liver congestion before surgical repairs.


Subject(s)
Liver/physiopathology , Pericarditis, Constrictive/physiopathology , Adult , Aged , Coloring Agents , Follow-Up Studies , Humans , Indocyanine Green , Male , Metabolic Clearance Rate , Middle Aged , Pericardiectomy , Pericarditis, Constrictive/surgery , Time Factors
17.
Gan To Kagaku Ryoho ; 21(1): 103-6, 1994 Jan.
Article in Japanese | MEDLINE | ID: mdl-8291904

ABSTRACT

An advanced gastric cancer patient with multiple retroperitoneal lymph node metastases and bone metastases was treated with sequential MTX and 5-FU. Complete response was obtained against both gastric primary lesion and retroperitoneal lymph nodes observed endoscopically and by computed tomography. Partial response was obtained against bone metastases observed by bone scintigraphy. Side effects of the chemotherapy were not observed.


Subject(s)
Adenocarcinoma, Scirrhous/drug therapy , Adenocarcinoma, Scirrhous/secondary , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Neoplasms/secondary , Stomach Neoplasms/drug therapy , Drug Administration Schedule , Fluorouracil/administration & dosage , Humans , Infusions, Intravenous , Lymphatic Metastasis , Male , Methotrexate/administration & dosage , Middle Aged , Stomach Neoplasms/pathology
18.
Gan To Kagaku Ryoho ; 28(11): 1704-7, 2001 Oct.
Article in Japanese | MEDLINE | ID: mdl-11708014

ABSTRACT

A 56-year-old male patient with chronic C type hepatitis had HCC which invaded right portal vein trunk (Vp3). In August 2000, we performed intrahepatic artery infusion chemotherapy with CDDP and 5-FU under subcutaneous interferon alpha treatment. In addition, we used chemoradiation therapy for portal tumor thrombus in HCC. As the result of such therapy, the size of HCC and portal tumor thrombus reduced and the level of PIVKA-II decreased. There were no side effects except fever due to interferon alpha treatment. In February 2001, we performed devascularization and RFA therapy for HCC in S7 of liver under laparoscope. The level of PIVKA-II was within the normal range. It is important to perform interdisciplinary therapy appropriate for the HCC status.


Subject(s)
Carcinoma, Hepatocellular/therapy , Liver Neoplasms/therapy , Portal Vein , Venous Thrombosis/therapy , Antineoplastic Agents/administration & dosage , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/radiotherapy , Cisplatin/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Hepatic Artery , Humans , Infusions, Intra-Arterial , Interferon-alpha/administration & dosage , Liver Neoplasms/drug therapy , Liver Neoplasms/radiotherapy , Male , Middle Aged , Neoplastic Cells, Circulating/pathology , Radiotherapy Dosage
19.
Fukuoka Igaku Zasshi ; 82(6): 355-61, 1991 Jun.
Article in English | MEDLINE | ID: mdl-1715838

ABSTRACT

Diagnostic significance of serum immunoreactive elastase 1 (IRE) in pancreatic cancer was evaluated in 53 patients with pancreatic cancer. Frequency of abnormally high serum IRE levels in pancreatic cancer was 66.0%; 87.0% in head cancer (N = 23), 55.0% in body & tail cancer (N = 20) and 40% in diffuse cancer (N = 10). Serum IRE level in resectable cancer was significantly higher than that in unresectable cancer. Comparative studies of serum pancreatic enzymes revealed that serum IRE was the most sensitive marker for diagnosis of pancreatic cancer. The characteristic behavior of serum IRE throughout the course of pancreatic cancer was that abnormally high levels of IRE are maintained for a longer period of time when compared to that of pancreatitis. In the comparative study of serum IRE and CA19-9, of the 9 cases of pancreatic cancer with CA19-9 levels less than 100U/ml, 7 showed abnormally high values of IRE, and of these 4 were resectable. These results indicate that in order to detect early pancreatic cancer, any elevation of serum IRE before CA19-9 increase should be noted with care, and patients who particularly show elevated IRE values for more than one month should be subjected to more extensive morphological examinations.


Subject(s)
Pancreatic Elastase/blood , Pancreatic Neoplasms/diagnosis , Adult , Aged , Amylases/blood , Antigens, Tumor-Associated, Carbohydrate/analysis , Diagnosis, Differential , Female , Humans , Male , Middle Aged
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