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Arata Tsutsumida

Publications and source records attributed to Arata Tsutsumida.

10 recordsLinked to original sources
PubMed2007

Prediction of metastases in melanoma patients with positive sentinel node: histological and molecular approach.

It is now established that sentinel node (SN) biopsy is a minimally-invasive procedure that accurately indicates the regional nodal status. In our institute, 14 consecutive patients had only one node micrometastases after elective lymph node dissection or positive SN for primary cutaneous melanoma. These 14 patients could be clearly divided into two groups: (i) patients who developed distant metastases or in-transit metastases (metastasized group); and (ii) and patients who remains free from metastases (non-metastasized group). The purpose of this study was to identify the histological and molecular factors that might predict the further dissemination beyond the SN. We assessed the maximum depth from the capsule to the deepest melanoma cells and the maximum diameter of melanoma nests in the lymph nodes as histological parameters and also evaluated the quantitative expression of tyrosinase mRNA as a molecular approach. The mean maximum depth and the maximum diameter were significantly smaller in the metastasized group than those in the non-metastasized group. Tyrosinase mRNA expression was strongly correlated with the histological tumor burden. Tyrosinase mRNA expression was higher in the former group than that in the latter group but there were no significant differences between them. Melanoma patients with small micrometastases (<0.5 mm deep, <1 mm in diameter) and a low level of tyrosinase mRNA had less chances for hematogenous metastases via lymph nodes.

Adult↗
PubMed2006

Melanoma of thumb: retrospective study for amputation levels, surgical margin and reconstruction.

For the treatment of melanoma of thumb, the evidence about amputation level (IP joint or MP joint) and cutaneous excision margin has not been fully presented. And reconstructions for lost thumbs need to be balanced against functional and aesthetic requirements of individual patients and overall prognosis. We report 15 patients, who underwent primary excision and reconstruction for thumb melanoma between 1986 and 2004 at Department of Plastic and Reconstructive Surgery, University of Hokkaido at Sapporo, Graduate School of Medicine. The patients were reviewed to evaluate the prognostic significance of variables including age and sex of the patient, tumour thickness, staging, level of amputation, and cutaneous excision margin. Our 15 cases were divided into two groups according to amputation level (MP or IP) and cutaneous excision margin (<40 mm or >or =40 mm) and prognosis was analysed statistically. The stage and thickness were identified as prognostic factors for disease-free survival; however, IP amputation and 10-30 mm margin did not compromise disease-free survival. Amputated thumb was reconstructed by pollicization, free toe to thumb transfer, reverse forearm flap, local flap, and skin graft. No major complication of reconstructed thumb occurred. Seven of eight cases of MP amputation were reconstructed by pollicization. On the other hand, five cases of IP amputation were reconstructed by volar skin flap in two cases, reverse forearm flap in two cases, and trimmed first toe transfer in one case. Although a small number of cases, our study is the first attempt focussing on melanoma of thumb, and evaluating amputation level and cutaneous margin separately. The reconstructive algorithm for the amputated thumb is proposed and has various tools including free toe to thumb transfer.

Adult↗
PubMed2005

Treatment strategy for cutaneous malignant melanoma.

The incidence of cutaneous malignant melanoma has been rising in Japan. With education, recent advances in accurate diagnosis and establishment of the concept, more lesions are being diagnosed as early melanomas, for which there is a high cure rate. However, many patients will still present with thicker lesions or nodal involvement, which carries a significantly worse prognosis. Recently there have been advances in the management and treatment of cutaneous melanoma. This article reviews the clinical evidence behind the current treatment recommendations for primary and recurrent cutaneous melanoma in Japan.

Humans↗
PubMed2005

Reconstructive considerations after resection of malignant melanoma in the head and neck.

Little has been written about reconstructive methods after resection of melanomas in the head and neck region. We investigated reconstructive methods retrospectively related to the site and size of the melanomas resected by examining the medical records of 28 patients who had malignant melanomas of the head and neck resected at our hospital from 1984 to 2001. The tumour distribution was 12 in the cheek, 6 in the conjunctiva, 2 in the upper lip, 2 in the lower lip, one each in the lower eyelid, eyebrow, scalp, nose, and auricle. Reconstructive methods were 18 skin grafts, seven local flaps, and three free flaps. Three patients who had skin grafts required secondary reconstruction using free flaps. No local recurrences were observed. Reconstructions with local flaps give better aesthetical and functional results than free flaps and skin grafts. Immediate reconstruction with a flap is safe and it does not affect observation of local recurrences.

Adult↗
PubMed2005

Management of superficial leiomyosarcoma: a retrospective study of 10 cases.

BACKGROUND: Superficial leiomyosarcoma is a rare soft-tissue tumor. Management of this tumor, including pathological evaluations and therapies, is not clearly defined in the existing literature. METHODS: Ten patients with superficial leiomyosarcoma treated in our institutes were recalled and scheduled for examination. Assessments were carried out according to clinical characteristics, therapies used, histological grade (based on the grading system of the Fédération Nationale des Centres de Lutte Contre Le Cancer), tumor-node-metastasis stage (using the American Joint Committee on Cancer staging system), recurrences rates, state of metastases, and the current condition of each patient. RESULTS: No local recurrences or distant metastases were seen in eight patients with low-grade and early-stage disease, whereas two patients with high-grade and advanced-stage disease had recurrence and one of these two patients died of the disease. CONCLUSIONS: This study indicates that evaluations using the Fédération Nationale des Centres de Lutte Contre Le Cancer grading system and the American Joint Committee on Cancer tumor staging system were useful. The authors advocate that surgical treatment of low-grade cutaneous leiomyosarcoma by complete excision with a narrow margin is adequate. For low-grade and early-state subcutaneous or soft-tissue leiomyosarcoma, wide excision with a minimum 2-cm lateral margin and one-tissue barrier deep margin is recommended. Management of high-grade leiomyosarcomas is still difficult; adequate wide excision may be the only option.

Adult↗
PubMed2004

Epigenetic silencing of E- and P-cadherin gene expression in human melanoma cell lines.

The degree of E- and P-cadherin expressions inversely correlate with the progression stage of human melanoma. In the present study, we analyzed mechanisms of down-regulation of E- and P-cadherin gene expressions in 8 human melanoma cell lines. In 5 of the 8 melanoma cell lines, E-cadherin expression was lost or markedly decreased compared to that in normal melanocytes, and 4 of the 5 melanoma cell lines lost P-cadherin expression. All of the melanoma cell lines expressed snail, which is known to encode a transcription repressor for E-cadherin, at a higher level than melanocytes whereas expression levels of the snail varied among cell lines. Transduction of snail gene into MMAc cells which expressed a high level of E-cadherin and an extremely low level of snail decreased expression of E-cadherin but not P-cadherin. In contrast, transduction of antisense-snail gene into A375M cells which expressed no E-cadherin and a high level of snail restored expression of E-cadherin but not P-cadherin. Methylation-specific PCR analysis revealed CpG methylation in the promoter region of E-cadherin of MeWo and AKI cells. Further, the treatment with a demethylating agent, 5-azacytidine led AKI and A375M cells to re-express both E- and P-cadherin. The results show E-cadherin gene is silenced by at least two distinct mechanisms (methylation and transrepression by Snail) in human melanoma cell lines whereas P-cadherin gene seems to be silenced by methylation but not by snail.

Cadherins↗
PubMed2003

Alternative approach using the combined technique of nerve crossover and cross-nerve grafting for reanimation of facial palsy.

An alternative approach, using a combination of nerve crossover and cross-nerve grafting technique in a single-stage procedure, was developed for the reconstruction of reversible facial palsy. This combined technique provides some benefits such as early facial reanimation resulting from the single-stage procedure, less morbidity and sufficient innervation with an application of the end-to-side anastomosis method, and efficient neural regeneration due to coaptation of the intratemporal facial nerve. Facial nerve rehabilitation, based on double innervation by hypoglossal and contralateral healthy facial nerves, takes advantage of reliable and physiological facial reanimation.

Aged↗
PubMed2003

Indications for lymph node dissection in the treatment of extramammary Paget's disease.

BACKGROUND: In extramammary Paget's disease, compared with patients with carcinoma in situ (CIS), patients with malignancies underlying dermis and subcutaneous tissues or lymph node metastasis appear to have a much worse prognosis. OBJECTIVE: The purpose was to examine our extramammary Paget's diseases patients in terms of pathological tumor invasion, lymph node metastasis, and prognosis and to refer to indications of lymph node dissection. METHODS: The 34 patients were divided into four groups by pathological tumor invasion: CIS, microinvasion to the papillary dermis (MIPD), invasion to the reticular dermis (IRD), and invasion to subcutaneous tissues (IST). Their age, sex ratio, follow-up periods, history of other cancers, lymph node metastasis, and prognosis were compared among the four groups and referred to indications of lymph node dissection. RESULTS: In the groups of CIS and MIPD, all patients appeared to have no lymph node metastasis and death caused by this disease. In the groups of IRD and IST, 8 of 12 patients showed pathological lymph node metastasis, and all of them died due to metastasis of the tumor. In the cumulative survival rate of the patients according to the level of invasion, 5-year survival rate was 100% in CIS and MIPD groups, 33.3% in the IRD group, and 0% in the IST group. CONCLUSION: In the treatment of extramammary Paget's disease, indications of lymph node dissection are an important issue as well as wide local excision. From this prospective study, we have developed an algorithm for indications of lymph node dissection.

Adult↗
PubMed2002

Transduction of HOXD3-antisense into human melanoma cells results in decreased invasive and motile activities.

Homeobox genes regulate sets of genes that determine cellular fates in embryonic morphogenesis and maintenance of adult tissue architecture by regulating cellular motility and cell-cell interactions. Our previous studies showed that a specific member, HOXD3, when overexpressed, enhanced cell motility and invasiveness of human lung cancer A549 cells (Hamada et al. Int. J. Cancer 2001; 93: 516-25 [19]). In the present study, we investigated the roles of HOXD3 in motile and invasive behavior of human malignant melanoma cells. Of seven melanoma cell lines examined here, six cell lines expressed the HOXD3 gene, whereas normal melanocytes did not. We transduced the HOXD3-antisense gene expression vector into two cell lines (A375M and MMIV). The cell transduced with the HOXD3-antisense gene showed reduced in vitro invasion of Matrigel. The transduction of the HOXD3-antisense gene also decreased cell spreading, haptotactic activity to vitronectin and laminin-1, and phagokinetic activity. To find the difference of gene expression between the HOXD3-antisense-transduced A375M cells and the control A375MNeo2 cells, we carried out cDNA microarray analysis. The results of the microarray analysis indicated that the increased expression of cdc42-interacting protein 4, KIAA0554 and tropomyosin 1, which are all associated with the cytoskeletal system, may be involved in the reduction of motile and invasive activity by the HOXD3-antisense gene transduction.

Animals↗