Biomedical subjects

Akihito Watanabe

Publications and source records attributed to Akihito Watanabe.

At least 19 recordsLinked to original sources

PubMed2006

Head and neck cancer associated with esophageal cancer.

BACKGROUND: Multiple squamous cell carcinomas (SCCs) frequently arise in the aerodigestive tract. This study aims to clarify the incidence of squamous cell carcinoma of the head and neck (SCCHN) in esophageal cancer (EC) and clinical features of SCCHN. METHOD: We reviewed the records of 1118 EC patients treated from May 1995 to December 2001 in our institution. All patients with EC underwent otolaryngological examination and pharyngolaryngoscopy screening before and after its treatment periodically during their follow-up periods. The incidence, site and stage of SCCHNs were analyzed. RESULT: A total of 127 patients had associated SCCHNs among all patients with EC (11.4%). Of these, the index antecedent tumor was SCCHN in 49 and EC in 78 patients. One hundred and fifteen patients developed double cancers (SCCHN and EC), 9 patients developed triple cancers (2 SCCHNs and EC) and 3 patients developed fourth cancers (3 SCCHNs and EC). Of 49 patients with the index SCCHN, 30 ECs were detected metachronously after its treatment (Group A) and 20 were synchronously (Group B). Of 78 patients with index EC, 38 SCCHNs were detected synchronously (Group C) and 54 SCCHNs were metachronously (Group D). The stages of 54 SCCHNs in the Group D were 33, 14, 4, 3 (Stages I-IV, respectively), which was significantly earlier than that of 50 SCCHNs in the Groups A and B (p<0.001). CONCLUSION: The incidence of SCCHN in our EC patients was 11.4%. Periodic otolaryngological examination and pharyngoscopy screening can detect SCCHNs early in patients with primary EC.

Aged↗

PubMed2006

Impact of endoscopic screening on early detection of hypopharyngeal cancer.

BACKGROUND: The aim was to investigate whether periodic pharyngolaryngoscopy screening in high-risk patients with preceding carcinoma of the upper aerodigestive tract can detect early hypopharyngeal cancer and preserve the larynx. METHODS: The records of 122 patients with hypopharyngeal cancer were retrospectively reviewed. Patients were divided into the following two groups: (1) the screening (SCR) group (n = 65), patients whose hypopharyngeal cancer was detected by pharyngolaryngoscopy screening; and (2) the symptom (SYMP) group (n = 57), patients whose cancer was discovered by any symptoms. Patients' demographics and larynx preservation were compared. RESULTS: The number of patients with clinical stage I to IV disease at diagnosis was 44, 14, three, four for the SCR group, respectively, and six, six, 15, 30 for the SYMP group, which was significantly different (p < .0001). The rate of larynx preservation after radical treatment was 79.4% for the SCR group and 45.4% for the SYMP group (p < .001). CONCLUSIONS: Periodic pharyngolaryngoscopy screening in high-risk patients may contribute to detecting early hypopharyngeal cancer. Early detection of hypopharyngeal cancer may enhance the rate of larynx preservation and improve the quality of life.

Aged↗

PubMed2006

Phase I/II study of S-1 combined with carboplatin in recurrent and/or metastatic head and neck cancer as outpatient chemotherapy.

BACKGROUND: The aims of this study were to determine the recommended dose (RD) in combination chemotherapy of S-1 and carboplatin in recurrent and/or metastatic head and neck cancer (phase I) and to examine response rate and toxicities at RD (phase II). METHODS: S-1 was given orally at a fixed dose of 40, 50, or 60 mg twice daily based on the patient's body surface area for 21 days followed by a 14-day rest. In phase I, carboplatin was given intravenously to a cohort of three patients on day 8 at a dose of 2.5, 3.0, 3.5, or 4.0 area under the curve (AUC) values, depending on the dose-limiting toxicities (DLTs). RESULTS: In phase I, the RD was estimated as 2.5 AUC. In phase II, thrombocytopenia and leukopenia were most commonly found as hematologic DLTs, which were manageable without hospitalization. The response rate was 40.9%. CONCLUSIONS: This regimen is considered to be active against recurrent and/or metastatic head and neck cancer in an outpatient setting.

Adult↗

PubMed2006

Laryngoscopic detection of pharyngeal carcinoma in situ with narrowband imaging.

OBJECTIVES: Narrowband imaging (NBI) is a novel optical technique that enhances the diagnostic capability of endoscopes in characterizing tissues by using narrow-bandwidth filters in a video endoscope system. The purposes of this study were to verify the effectiveness of the NBI system in conducting endoscopic screening at the oropharynx and the hypopharynx. METHODS: This study was conducted between July 2005 and August 2005. During this period, 217 consecutive patients with esophageal cancer underwent endoscopic screening of the oropharynx and the hypopharynx with the NBI system at the Department of Otolaryngology, Keiyukai Sapporo Hospital. RESULTS: Among 217 patients, 6 superficial lesions, at the oropharynx (n = 1) and at the hypopharynx (n = 5), were discovered with the NBI system. On conventional electroendoscopic view, four of six lesions could be hardly recognized because of its small diameter measuring 5 mm or less. The NBI view was more beneficial in recognizing the superficial lesions than conventional electroendoscopic view. Endoscopic mucosal resection was performed for all six patients under general anesthesia in the operation room. The histologic examination exhibited a histologically proven squamous cell carcinoma (SCC) in situ. In our series, the NBI system might improve the sensitivity by about twofold over the conventional method. CONCLUSION: NBI may play an important role in the diagnosis of SCCs of the oropharynx and hypopharynx.

Aged↗

PubMed2006

[Combination chemotherapy with S-1 and carboplatin for head and neck cancers].

Chemotherapy plays an important role in the treatment of head and neck cancer (HNC) patients with recurrent and/or metastatic unresectable disease. The standard regimen for HNC has been a combination of cisplatin (CDDP) and 5-fluorouracil (5-FU). We planned to develop a new outpatient regimen that could be carried out safely and had an antitumor activity equivalent to the regimen of CDDP plus 5-FU. For this purpose, we selected a combination of S-1 and carboplatin. The overall response rate of 40.9% in this study was almost equivalent to the study previously reported on 5-FU plus CDDP. This regimen of S-1 plus carboplatin has the possibility of yielding tumor responses equivalent to a conventional regimen of 5-FU combined with CDDP in patients with recurrent and/or metastatic head and neck carcinoma as a second-line palliative chemotherapy.

Adult↗

PubMed2005

Secondary amyloidosis and eosinophilia in a patient with uterine leiomyosarcoma.

We report a rare case demonstrating the relationship between secondary amyloidosis and uterine leiomyosarcoma. A 59-year-old female with high fever was referred to our hospital. Laboratory tests revealed increased white blood cells, eosinophilia and an accelerated erythrocyte sedimentation rate. Endoscopic examination of the stomach and colon revealed amyloid deposits in their mucosa. The patient showed no symptoms that suggested amyloidosis. No other organs or tissues were surveyed for amyloid deposition. Ga scintigraphy, computed tomography and magnetic resonance imaging suggested necrotic infectious leiomyoma of the uterus, which was considered to be the cause of the fever. The patient underwent total hysterectomy. The histological diagnosis of the mass revealed a low-grade uterine leiomyosarcoma with necrosis. Amyloid deposits in the gastric mucosa disappeared 1 year after the operation. In this case, amyloid deposition was detected by endoscopic biopsy before clinical manifestations. The deposition was reversible and was successfully treated. Thus, it is logical and useful to undertake endoscopic mucosa biopsy to check for amyloid deposition in patients with systemic inflammation, whose serum amyloid A protein level has been high for several months. In addition, peripheral eosinophilia was also detected in this case. Although eosinophilia associated with malignant tumor has been recognized, it is an uncommon occurrence.

Amyloidosis↗

PubMed2005

[A case of oropharyngeal cancer with multiple bone metastases from prostate cancer that responded to docetaxel, ifosfamide and cisplatin combination therapy].

We encountered an oropharyngeal cancer patient with multiple bone metastases from prostate cancer who achieved a partial response to 3 cycles of combination chemotherapy including docetaxel, ifosfamide and cisplatin (DIP). A 72-year-old man was found to have advanced oropharyngeal cancer during hormonal treatment of bone metastases from prostate cancer. Combination chemotherapy was initiated with DIP. After chemotherapy, computed tomography revealed no residual tumor at the oropharyngeal region, but a small ulcer was seen at the base of the tongue by laryngopharyngoscopy. The patient obtained a partial response after 3 cycles of this regimen. During chemotherapy the patient could take oral meals because of no stomatitis. After chemotherapy the patient received radiation therapy (60 Gy/30 f). The oropharyngeal cancer disappeared completely after radiotherapy. It is suggested that combination chemotherapy with DIP is a potential new treatment modality for advanced head and neck cancer.

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PubMed2004

A computer image processing system for quantification of zebrafish behavior.

The tropical zebrafish (Danio rerio) has frequently been used for investigating developmental biology. Here, we developed a computer image processing system for quantifying zebrafish behavior. We could acquire an image of zebrafish freely moving in an aquarium using a CCD camera through a graphic I/O board. To acquire the image of moving zebrafish in real time, we required high spatial (256 x 256 pixels) and temporal (10 frames/s) resolution. Such a high speed of data analysis was accomplished using a skipping search method. By using a small aquarium, trackings of newborn zebrafish could be traced. The velocity of adult zebrafish (7.2 cm/s) was far faster than that of newborn zebrafish (1.8 cm/s). Furthermore, by separation of occluded images of two fish, we could acquire images of the two zebrafish. They behaved as in a school in which one fish chased the other. The chasing was defined by the distance, angle and approach of the two fishes. The chasing ratio of pairs of zebrafish was 37%, whereas those of pairs of different fish were significantly reduced to less than 20%. The present image processing system is a very useful tool for quantitatively scoring the schooling behavior of multiple fish.

Animals↗

PubMed2004

Olfactory impairment and Parkinson's disease-like symptoms observed in the common marmoset following administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine.

OBJECTIVE: Although olfactory disturbance appears to occur in the early stages of Parkinson's disease (PD) in humans, little is known about its mechanism. The aim of this study was to make a PD model using injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in the common marmoset and to discover the mechanism of olfactory disturbance in this animal. MATERIAL AND METHODS: Olfactory disturbance induced by MPTP in the common marmoset was observed by behavioral, biochemical and immunohistochemical means. RESULTS: Administration of MPTP caused common marmosets to enter an akinetic state within a few days and to show signs of impaired olfactory function. Biochemical study showed a decrease in dopamine levels, especially in tissue samples from the caudate nucleus and putamen. Immunohistochemical analysis revealed a lack of tyrosine hydroxylase immunoreactivity, not only in the substantia nigra, caudate nucleus and putamen but also in the olfactory tubercle. CONCLUSION: These results demonstrate that MPTP causes both PD-like symptoms and olfactory disturbance in the common marmoset. The olfactory disturbance observed in these animals may be due to the lack of dopamine in the olfactory tubercle.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMed2004

Adenocarcinoma arising from ectopic gastric mucosa in the cervical esophagus.

Ectopic (heterotopic) gastric mucosa (EGM) of the upper esophagus, referred as inlet patch, is an asymptomatic benign lesion that is often detected during endoscopic examination. Although it is considered a source of adenocarcinoma in the upper esophagus, only 17 cases of adenocarcinoma have been reported previously. We report a rare case of adenocarcinoma arising in EGM of the cervical esophagus.

Adenocarcinoma↗

PubMed2004

[Metastatic oropharyngeal cancer successfully treated with docetaxel, cisplatin, 5-FU and l-leucovorin].

We encountered a patient with metastatic disease of the lung from oropharyngeal cancer who achieved a complete response to 3 cycles of chemotherapy with docetaxel, cisplatin, 5-FU and l-leucovorin (TPFL). A 72-year-old man was found to have metastatic disease of the lung 32 months after treatment of oropharyngeal squamous cell carcinoma. Chemotherapy was initiated with TPFL and the patient obtained a complete response after 3 cycles. Twelve months after chemotherapy he had no recurrence. We conclude that the use of docetaxel cisplatin, 5-FU and l-leucovorin for metastatic squamous cell carcinoma of the head and neck is a viable option.

Aged↗

PubMed2003

1-methyl-4-phenylpyridinium (MPP+) decreases mitochondrial oxidation-reduction (REDOX) activity and membrane potential (Deltapsi(m)) in rat striatum.

Mitochondrial dysfunction has long been implicated in the death of nigrostriatal dopaminergic neurons in Parkinson's disease (PD) and its experimental models. Here we further analyzed changes in the mitochondrial oxidation-reduction (REDOX) activity and membrane potential (Deltapsi(m)) of striatal synaptosomes after the infusion of 1-methyl-4-phenylpyridinium (MPP+) into rat striatum. MPP+ (40 nmol) treatment produced decreases in mitochondrial REDOX activity and Deltapsi(m) at 18 h, as measured by fluorometric analysis with both Alamar blue and JC-1 (5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolyl-carbocyanine iodide) dyes. At this time point, tyrosine hydroxylase (TH) and dopamine transporter (DAT) protein levels were not altered, but both decreased at 7 days after MPP+ (40 nmol) infusion. Both measures of mitochondrial dysfunction induced by MPP+ (40 nmol) at 18 h were attenuated, at least in part, by pretreatment with a selective dopamine uptake inhibitor GBR-12909 (1-(2-(bis(4-fluorophenyl)methoxy)ethyl)-4-(3-phenylpropyl) piperazine). In addition, GBR-12909 partially attenuated MPP+ (40 nmol)-caused a loss of striatal nerve terminal as indicated by decreases in TH and DAT immunoreactivities as well as dopamine and its metabolites levels. The present study indicates that decreases in mitochondrial REDOX activity and Deltapsi(m) may play a role in MPP+ -induced dopaminergic neurotoxicity, and further provides that improvement of mitochondrial dysfunction may be a better way to slow progressive dopaminergic neurodegeneration commonly associated with PD.

1-Methyl-4-phenylpyridinium↗

PubMed2003

Periodic pharyngolaryngoscopy detects early head and neck cancer and improves survival in esophageal cancer.

BACKGROUND: Multiple squamous cell carcinomas (SCCs) frequently arise in the upper aerodigestive tract. The purposes of this study were to identify risk factors for SCC of the head and neck in patients with esophageal cancer (EC) and to investigate the value of periodic pharyngolaryngoscopic screening in detecting early SCCs of the head and neck and improving survival. METHODS: We reviewed the cases of 754 patients with EC treated surgically (n = 545) or nonsurgically (n = 209) from May 1995 to December 1999 in our institution. Of these patients, 541 underwent periodic pharyngolaryngoscopic screening after treatment of EC, whereas 213 did not because of hospital death, dropout from the program, and distance from the hospital. Data were compared between patients in whom SCCs of the head and neck developed synchronously or metachronously (EC + SCC group, n = 70) and patients without SCCs (EC group, n = 684). Survival rates were compared between patients receiving periodic pharyngolaryngoscopy and those followed without endoscopic screening. RESULTS: In the EC + SCC group, younger patients (p < 0.05), male patients (p < 0.05), and patients with a higher alcohol intake (p < 0.01) were more common than in the EC group. The 5-year survival rate was 40.9% in the EC group and 44.8% in the EC + SCC group (p = not significant). The survival rate of patients receiving periodic pharyngolaryngoscopy was significantly higher than that of patients followed without endoscopic screening (p < 0.001). Periodic pharyngolaryngoscopy was effective in detecting early SCCs of the head and neck and was beneficial for patients with EC in stages I to IV. CONCLUSIONS: Periodic pharyngolaryngoscopy can provide early detection of SCCs of the head and neck, which arose in 9.3% of patients with EC. Such screening particularly benefits male patients and heavy drinkers, who are at high risk for multiple SCCs. Periodic pharyngolaryngoscopy may prevent reduced survival resulting from associated SCCs of the head and neck and improve overall survival in patients with EC.

Age Distribution↗

PubMed2003

Induction chemotherapy with docetaxel, cisplatin, fluorouracil and l-leucovorin for locally advanced head and neck cancers: a modified regimen for Japanese patients.

Combination chemotherapy with docetaxel (T), cisplatin (P), fluorouracil (5-FU) and leucovorin has been reported to have major activity against squamous cell carcinoma of the head and neck (SCCHN) administered as a 4-day (TPFL4) or 5-day (TPFL5) regimen. The purpose of this study was to evaluate the efficacy and toxicity of a modified TPFL regimen (m-TPFL) for locally advanced SCCHN, consisting of a modified dosage with docetaxel, cisplatin, 5-FU and l-leucovorin (l-LV) designed for Japanese patients. Organ preservation of the primary tumor site was also assessed. Thirty-four Japanese patients with locally advanced SCCHN were eligible. Docetaxel was administered as a 1-h i.v. infusion at 48 mg/m2 on day 1; cisplatin, 24 mg/m2/day; 5-FU, 560 mg/m2/day and l-LV, 125 mg/body/day were delivered on days 1-4 by continuous i.v. infusion. This regimen was administered every 28 days. Patients who achieved a complete response (CR) after induction chemotherapy underwent radiation therapy alone. Ninety-one cycles were administered. The main hematological toxicity was neutropenia, classified as grade III or IV in 18.7% of cycles. The most common non-hematologic toxicities included anorexia, stomatitis and alopecia. The clinical overall response rate to m-TPFL was 88.2%, with 58.8% CRs and 29.4% partial responses. After definitive locoregional therapy, 25 of 34 patients were disease-free with preserved primary tumor site anatomy. Overall and progression-free survival rates at the 2-year follow-up are 92.8 and 75.3%, respectively. Our m-TPFL regimen designed for Japanese patients yielded excellent response rates with an acceptable toxicity profile in good-performance-status patients.

Adult↗

PubMed2003

[A case of a 91-year-old woman with maxillary sinus carcinoma who achieved a complete response to chemoradiotherapy with intra-arterial administration of docetaxel].

We treated a 91-year-old woman with advanced maxillary sinus carcinoma who achieved a complete response to chemoradiotherapy with intra-arterial administration of docetaxel. She received local irradiation with a total dose of 50 grays along with concomitant intramaxillary arterial infusion of docetaxel with a total dose of 80 mg. After treatment, pathological examination of a biopsy specimen from the maxillary sinus revealed no residual tumor, and a posttreatment CT scan showed no tumor. Twenty one months after chemoradiotherapy, she had no recurrence and no metastasis. We conclude that chemoradiotherapy using intramaxillary infusion with docetaxel would be useful for maxillary sinus squamous cell carcinoma.

Aged↗

PubMed2002

Efficacy of intense screening and treatment for synchronous second primary cancers in patients with esophageal cancer.

BACKGROUND: The optimum management of esophageal cancers with synchronous second primary cancer (SPC) has not been determined. The aim of this study was to evaluate the efficacy of intense screening and treatment for esophageal cancers with synchronous SPC. METHODS: Between 1981 and 1997, 1479 patients with esophageal cancers were screened for synchronous SPC during the process of initial staging. Radical treatment was recommended for esophageal cancer and synchronous SPC in cases for whom both cancers were curable. Treatment results for esophageal cancer patients with or without synchronous SPC were compared. RESULTS: Among 1479 patients, 155 (10.5%) were found to have 166 synchronous SPC. Primary sites included the stomach in 65, the head and neck in 44, the colon/rectum in 27, the lung in 14 and other sites in 16 patients. Clinical stages of synchronous SPC were stage I in 41%, stage II in 20%, stage III in 25% and stage IV in 14%. The 5-year overall survival rates by clinical stages of esophageal cancers (stage 0, I, II, III, IV) in patients with synchronous SPC were 51% (95% CI, 23-78%), 43% (95% CI, 18-68%), 11% (95% CI, 0-22%), 14% (95% CI, 0-28%) and 12% (95% CI, 1-22%), respectively. The 5-year overall survival rate for patients with or without synchronous SPC were 20% (95% CI, 13-28%) and 32% (95% CI, 29-35%), respectively. No significant difference was observed between both groups (p = 0.2562). CONCLUSIONS: Intense screening and treatment may be justifiable in the light of the high detection rate of curable SPC and the reasonable survival of patients with synchronous SPC. However, a prospective study including cost-benefit analysis is needed to provide the evidence to justify the intense screening and treatment.

Adult↗

PubMed2002

[Study of allergic fungal sinusitis in 40 surgical cases of chronic paranasal sinusitis].

Allergic fungal sinusitis is chronic and paranasal, related to fungal allergy. Many papers on allergic fungal sinusitis have been reported in the United State, and the incidence is 5% to 10% among patients with chronic paranasal sinusitis. Although cases of allergic fungal sinusitis have been reported in Japan, the incidence is unclear. We studied allergic fungal sinusitis in 40 consecutive patients--26 men and 14 women--undergoing endoscopic sinus surgery at Keiyukai Sapporo Hospital December 2000 to July 2001. We checked for allergic rhinitis and asthma, a history of surgery for nasal polyps and chronic sinusitis, the presence of nasal polyps, grading of sinusitis via computed tomography, nonspecific IgE and allergen-specific IgE for fungi in serum, eosinophilia in nasal smears, paranasal eosinophilic mucin, and histology and fungal culture of paranasal sinus mucus. None had typical allergic fungal sinusitis, but 1 had eosinophilic paranasal mucin, high IgE, and false-positive IgE for fungi. We studied clinical data and histology of fungi and paranasal mucosa in 9 cases with fungal maxillary sinusitis, but none had allergy or eosinophilic mucin. This suggested that few patients with allergic fungal sinusitis exist among those with chronic paranasal sinusitis.

Adult↗

PubMed2002

[Endoscopic endonasal sinus surgery for post-operative maxillary cysts].

Surgical treatment for postoperative maxillary cysts uses a Caldwell-Luc or endonasal approach. Endoscopic endonasal surgery has become the treatment of choice in postoperative maxillary cyst, and many postoperative maxillary cysts have been classified. Due to the importance of cyst medial wall sites, we classified cysts into 4 types by location. Those whose, medial wall was close to the middle meatus, inferior meatus, or nasal lateral wall, we termed middle meatus, inferior meatus, and nasal lateral wall types. When the lateral cyst was not close to the nasal cavity but to another cyst, we termed the cyst continuous. We opened all nasal cavity cysts as far as possible. For continuous types, we determined location of the lateral cyst 3-dimensionally before surgery. We first opened medial cysts and opened the lateral cyst through the medial cyst. The tube was placed the lateral cyst to the nasal cavity. We opened all 45 cysts in 29 patients to the nasal cavity. As of this writing, no cysts connected to the nasal cavity have recurred.

Adult↗