BACKGROUND: Atypical adenomatous hyperplasia (AAH) is a possible precursor lesion of adenocarcinoma of the lung, but very few reports of AAH have focused on the autopsy lung. METHODS: We intended to clarify the characteristics of AAH in the general population by using 207 autopsy cases, ranging in age from 0 to 90 years old. RESULTS: A total of 179 eligible cases (86.5%) and 1265 tissue slides (7.0 per case) was examined independently by two pathologists. One hundred seventy-nine autopsy cases consisted of 125 males and 54 females, whose median ages were 38 (range 0-90) and 31 (range 0-81) years old, respectively. AAH was microscopically found in five of 179 autopsy cases (2.8%). The male/female ratio was 5/0 and age distribution was 52-63 years of age (median 57). One of five cases with AAH harbored esophageal carcinoma, but the others had no present or previous malignant neoplasm. One of five lesions was high grade and the others were low grade. All five cases showed positive immunoreactivity for proSP-C, a type II pneumocytes marker, but not for p53, Ki-67 or CEA. CONCLUSIONS: The incidence of AAH was very low in the general autopsy cases, as compared with the previously reported surgically resected lung and senile autopsy cases, and AAH seems to occur after middle age in general.

Adenocarcinoma↗

PubMedDate not supplied

Efficacy of sildenafil as the first-step therapeutic tool for Japanese patients with erectile dysfunction.

The aim of this study was to assess the efficacy of sildenafil as the first-step tool for erectile dysfunction (ED) in Japanese males. Between March 1999 and March 2003, 281 patients were prescribed five tablets of sildenafil (50 mg) as the first step in the therapeutic management of ED. Of the 281 patients, 206 were evaluable patients. The overall success rate in achieving sexual intercourse in subjects after taking sildenafil was 77.2% (159/206), while 22.8% (47/206) were unsuccessful. The success rates in men with functional ED and organic ED were 91.4% (85/93) and 65.5% (74/113), respectively (P<0.0001). Overall, transient adverse effects of sildenafil occurred in 16 (8%) males. Intolerable adverse effects (edema and dizziness) occurred in only 1% of patients (2/206). Sildenafil citrate may be recommended as the first choice drug for ED because of its high success rate and low invasiveness.

Adult↗

PubMedDate not supplied

Efficacy of sildenafil for Japanese patients with audio-visual sexual stimulation (AVSS) test by the RigiScan Plus.

Sildenafil is most effective in men with mild-to-moderate ED, but not severe ED in Japan. In order to evaluate the efficacy of sildenafil, we conducted the present study using the AVSS test by the RigiScan Plus. The subjects were 56 patients (age: 34-82 years, mean: 60.5 years) with ED. The IIEF5 questionnaire and the AVSS test were conducted before and after administration of sildenafil. The penile rigidity could not be measured in 19 patients. Of these 19, sildenafil was effective in 7 and not effective in 12. The 7 cases in whom sildenafil was effective were all false-negatives. The sensitivity of sildenafil was 84%, and its specificity was 100%. This study suggests that the AVSS test by RigiScan Plus can objectively evaluate the efficacy of sildenafil, and shows potential for predicting that efficacy.

Adult↗

PubMedDate not supplied

Thymoma with osseous metaplasia.

A 69-year-old woman with a 15-year history of abnormal chest shadow was referred to our hospital. An enhanced chest CT scan of the anterior mediastinum revealed a mass containing a high-density area. The preoperative radiologic diagnosis was thymoma. Operation was performed in October 2000. Histologically, multiple ossified areas were observed within the tumor. Intratumoral ossification has never been reported in thymoma. Therefore, we report the first case of thymoma associated with multiple foci of osseous metaplasia.

Aged↗

PubMedDate not supplied

Expression of E-cadherin, alpha-catenin, beta-catenin and plakoglobin in esophageal carcinomas and its prognostic significance: immunohistochemical analysis of 96 lesions.

It has been suggested that inactivation of the cadherin-mediated cell-cell adhesion system plays a role in the initial steps of cancer invasion and metastasis. Expression of E-cadherin and its intracytoplasmic binding molecules, alpha-catenin, beta-catenin and plakoglobin was examined immunohistochemically in 96 esophageal squamous cell carcinomas to investigate the association between their expression and the prognosis for patients with esophageal cancer. Reduced E-cadherin, alpha-catenin, beta-catenin and plakoglobin expression was observed in 44, 72, 73 and 88% of the tumors, respectively. Reduced E-cadherin, alpha-catenin, beta-catenin and plakoglobin expression correlated closely with the differentiation grade of the esophageal squamous cell carcinoma (p < 0.05). Downregulation of alpha-catenin was associated with a poor prognosis in patients with esophageal squamous cell carcinoma (p < 0.05). This result suggests that downregulation of alpha-catenin, which may reflect dysfunction of the cadherin-mediated cell-cell adhesion system, is a factor indicating a poor prognosis in patients with esophageal cancer.

Adult↗

PubMedDate not supplied

Clinicopathological significance of the expression of CD44v2 in colorectal cancer.

Expression of CD44 variant isoforms has been reported to be correlated with faster progression of neoplastic diseases, metastasis and reduced survival period. In this study, the correlation between the expression of CD44v2 (v2) or CD44v6 (v6) and clinicopathological features was examined in Dukes B and C colorectal cancer using immunohistochemistry. V6 expression was not correlated with any clinicopathological indices or prognosis in either Dukes B or C. On the other hand, v2 expression was correlated significantly with recurrence rate and poorer prognosis in Dukes B colorectal cancer although there was no correlation between v2 expression and prognosis in Dukes C patients. The results suggest that v2 is a candidate for a prognostic marker in Dukes B colorectal cancer. CD44v2 expression may be an indication for adopting adjuvant chemotherapy in patients without lymph node metastasis.

Colorectal Neoplasms↗

PubMedDate not supplied

Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma.

Peritoneal dissemination is one of the major patterns of postoperative recurrence and a major cause of death in pancreatic ductal adenocarcinoma. To predict the development of postoperative peritoneal dissemination (PPD), correlations between the occurrence of PPD and clinicopathological factors were analyzed in 23 patients with pancreatic ductal carcinoma who underwent tumor resection and were carefully monitored after the operation. Fifteen cases (65.2%) developed PPD, but the other 8 cases (34.8%) did not meet the criteria for a diagnosis of PPD. Location of the tumor in the pancreatic tail or body (p = 0.0041, HR = 10.827, 95% CI = 2.126-55.127) and the presence of extra-tumoral perineural invasion (ETNI) (p = 0.0490, HR = 0.114, 95% CI = 0.013-0.990) were found to have predictive value for the development of PPD. These results suggested that intensive therapy selectively focused on the peritoneum in cases with ETNI, might prevent the development of PPD and reduce the side effects of treatment in cases without ETNI.

Adult↗