Search PubMed⌕ Search

Biomedical subjects

C Konaka

Publications and source records attributed to C Konaka.

At least 55 records · Page 3Linked to original sources

Chemoprevention effects on bronchial squamous metaplasia by folate and vitamin B12 in heavy smokers.

The purpose of this study was to observe the effects of folate and vitamin B12 on bronchial squamous metaplasia with cellular atypia, known to be a precancerous change, in heavy smokers. Cases of squamous metaplasia were recognized on sputum cytologic study. The location of bronchial lesions was identified by bronchofiberoscopy in all cases. The grade of cellular atypia was evaluated on the basis of histologic specimens. Thirty-eight patients with squamous metaplasia, including 21 patients receiving folate and vitamin B12 and 17 patients without any medication, were investigated prospectively for 1 year. Consecutive bronchofiberoscopic examinations were performed in each patient in 3 to 4 months after the first examination in order to evaluate the lesions. Grades of cellular atypia were examined by histologic specimens using a scoring system from 0 to 3. There was no significant difference in mean scores at entry in the medication group (1.7) and control group (1.4). The medication group showed significant decrease in mean scores (0.4) while the control group had no change in mean scores (1.2) at termination. Plasma levels in the medication group were significantly increased at termination of the study while those of the control group showed a slight decrease. The results show that the cellular atypia squamous metaplasia in heavy smokers can be reduced by administration of folate and vitamin B12.

Adult↗

Clinical and experimental studies of anti-tumoural effects of electrochemical therapy (ECT) alone or in combination with chemotherapy.

The present experimental study shows that anticancer agents may accumulate around electrodes placed in saline and in lung when the electrodes are charged with direct electric current. We also observed that electrochemical therapy (ECT) in combination with chemotherapy was more effective for treatment of localized tumours (human lung cancer PC-13 transplated to nude mice) than was ECT or systemic chemotherapy alone. In a clinical study, 26 patients (27 lesions) received ECT with or without systemic chemotherapy. We observed a decrease in tumour size in more than 70% of the cases, and in two cases the use of ECT alone resulted in complete regression of the tumour. In one case there was an increase in tumour size. The main side-effects observed during treatment of lung cancer was pain during treatment, fever after treatment, and pneumothorax. We conclude that ECT may be effective in controlling localised tumours. The clinical use of ECT is, however, associated with several problems and the mechanism of this treatment has not yet been completely established.

Adult↗

[Significance of lymph nodes dissection of lung cancer treatment].

From 1950 to 1991, 1,221 lung cancer cases were treated with surgery in Tokyo Medical College Hospital. The 5-year survival rate was achieved in 70.1% for stage I, 49.5% for stage II, 17.0% for stage III A, 0% for stage III B and 8.3% for stage IV respectively. Considering for the survival rate with pN factor in 753 resected cases, the 5-year survival rate of N0, N1, N2 and N3 cases was 65.8%, 38.1%, 16.3% and 0% respectively. In these pN2 group, the 5-year survival rate of single mediastinal lymph node metastasis cases was 35.5%, while that of multiple mediastinal lymph node metastasized cases was 6.9%. The relationship between lymph node metastasis and DNA ploidy pattern was also discussed. The most of N0 cases showed diploid pattern, while N2 cases indicated aneuploid pattern. A mediastinal lymph node dissection of pN2 lung cancer cases may be effective to improve the prognosis of a kind of cases showing biologically low malignant lung cancer.

Humans↗

A prospective phase II study on photodynamic therapy with photofrin II for centrally located early-stage lung cancer. The Japan Lung Cancer Photodynamic Therapy Study Group.

PURPOSE: A phase II study was conducted between June 1989 and February 1992 to evaluate the activity and toxicity of photodynamic therapy (PDT) with photofrin II in centrally located early-stage lung cancer and to determine the complete response (CR) rate as the primary end point. PATIENTS AND METHODS: Patients had histologically proven lung cancer and endoscopically superficial thickening or small protrusions. All lesions were located in subsegmental or larger bronchi. All patients had a performance status (PS) of 0 to 2 and arterial oxygen pressure tension (PaO2) > or = 60 mm Hg. No lymph node or distant metastases were present. All patients received photofrin II (2 mg/kg) intravenously 48 hours before PDT. Tumor lesions were superficially photoradiated by an argon dye laser or an excimer dye laser. RESULTS: Of 54 patients with 64 carcinomas, 51 with 61 carcinomas were eligible for toxicity evaluation and 49 with 59 carcinomas were assessable for response. Of the 59 assessable carcinomas, 50 (84.8%; 95% confidence interval, 73.0% to 92.8%) showed a CR after initial PDT. The median duration of CR was 14.0+ months (range, 2.0+ to 32.4+). The multiple regression model indicates that estimated length of longitudinal tumor extent was the only independent prognostic factor for CR (P = .002). Five carcinomas that had a CR had a local recurrence at 6, 10, 12, 16, and 18 months after initial PDT, respectively. Toxicity assessment (World Health Organization [WHO] grade 2) showed transient elevation of ALT (1.9%), pulmonary toxicity (7.7%), and allergic reaction (7.7%), as well as sunburn (1.9%). CONCLUSION: PDT with photofrin II has an excellent effect on patients with centrally located early-stage lung cancer who have limited tumor invasion extending over a small area (< or = 1 cm).

Aged↗

[Quantitative cytochemical analysis of T1 breast cancer].

The authors attempted to estimate the relationship between three biological parameters (nuclear DNA content, PCNA (proliferating cell nuclear antigen)/cyclin, HER-2/neu oncoprotein) and lymph node metastasis. We evaluated 37 breast cancers which were less than 2 cm in maximum dimension. Quantitative analysis was performed using a CAS 200 Image Analysis System, after Feulgen staining and immunochemical staining using anti-PCNA/cyclin monoclonal antibody and anti-HER-2/neu oncoprotein polyclonal antibody. In lymph node-negative cases 20.0% were aneuploid, while in lymph node-positive cases 58.8% were aneuploid. A total of 20.0% lymph node-negative cases were in the high proliferation group, as opposed to 52.9% of lymph node-positive cases. This analysis revealed a significant relationship between cell proliferation and lymph node metastasis. Analysis of the expression of HER-2/neu oncoprotein revealed no significant relationship between overexpression of HER-2/neu oncoprotein and lymph node metastasis, but the expression of HER-2/neu oncoprotein was significantly related to a shorter relapse-free survival.

Breast Neoplasms↗

[Photodynamic therapy (PDT) in roentgenographically occult lung cancer by photofrin II and excimer dye laser].

UNLABELLED: Patients (pts) with hilar type early lung cancer from 5 hospitals served as the subjects to assess the complete response rate and toxicity of PDT with Photofrin II (PHE) and excimer dye laser (PDT EDL-1). ENTRY CRITERIA: 1. Histologically proven lung cancer with endoscopically superficial thickening or small protrusion. 2. All lesions that were located proximally from the subsegmental bronchus, were visible to the distal margin of the lesions. 3. N0M0. METHOD: All pts received PHE (2 mg/kg) i.v., 48 hours before PDT. Tumor lesions superficially photoradiated by an excimer dye laser via flexible bronchoscope. RESULTS: From September 1990 to March 1992, 39 pts with 46 carcinomas (CA) were enrolled. Thirty-three pts with 40 CA were evaluable. 1. RESPONSE: Thirty-five in 40 CA showed a complete response (CR) (87.5%, 95% confidence limit: 73.2-95.8%). All 32 cases of CA equal to or less than 1 cm of tumor length were CR, but 3 CA relapsed locally. Thirty-three of 35 CA visible to the distal margin were CR (91.7%, 95% confidence limit: 77.5-98.3%). 2. Toxicity (> WHO grade 2): Three pts (7.7%) had transient dermatitis and sunburn, while another pt (2.6%) had symptoms due to obstructive pneumonitis. CONCLUSIONS: Tumors equal to or less than 1 cm in length and visible to the distal margin are curable by PDT.

Aged↗

Asymptomatic solitary papilloma of the bronchus: review of occurrence in Japan.

A case of solitary papilloma of the bronchus is described, and 15 other cases occurring in Japan are reviewed. A 57 year old asymptomatic male was referred to our hospital because many squamous metaplastic cells with moderate atypia were observed in sputum cytology, twice in 3 months. The chest X-ray showed no abnormal findings. Endoscopic examination revealed a polypoid tumour at the bifurcation of the right B6a and B6b. The tumour was removed completely by endoscopic biopsy, and histological findings showed squamous papilloma. There has been no evidence of recurrence for 3 yrs. We are not aware of a previously reported case of bronchial papilloma without symptoms or abnormal shadow on chest X-ray. Considering the fact that malignant change was reported in only one case in Japan, and that there is a possibility of cancer subsequently developing at another location in the lung which might also require resection, lobectomy should be avoided if the tumour can be removed completely through endoscopy. If the lesion is limited to a small area in the bronchus, conservative treatment such as photodynamic therapy and/or yttrium aluminium garnet (YAG) laser vaporization might be sufficient to obtain a complete cure.

Biopsy↗

Fine-needle aspiration cytology of metastatic breast tumor originating from leukemia.

Two cases of metastatic breast tumor originating from leukemia are reported. Fine-needle aspiration (FNA) specimens showed a large number of isolated small-to-medium-sized atypical lymphocytic cells. It is difficult to distinguish metastatic breast tumors and primary breast cancers by physical findings alone. FNA cytology is an effective method for qualitative diagnosis. When atypical lymphocytic cells are obtained in aspiration materials of the breast, past history and general examination are necessary for diagnosis. In some cases of leukemia with breast involvement, good outcomes are obtained. Therefore, earlier detection is necessary in order to begin suitable therapy earlier and to avoid unnecessary excisional biopsy in patients with leukemia and breast tumors. To achieve this it is also necessary to first take into consideration the possibility of metastasis or infiltration of leukemia, and second to prepare two types of specimen for Papanicolaou stain and Giemsa stain before operation.

Biopsy, Needle↗

Primary lung cancer producing alpha-fetoprotein.

Reports of alpha-fetoprotein-producing lung tumors are rare. Only 24 such patients with these tumors have been previously studied. We report the case of a patient with a large cell carcinoma of the lung and a serum alpha-fetoprotein level of 9,300 ng/mL, with no evidence of hepatic or other systemic abnormalities. Serum levels of alpha-fetoprotein returned to normal postoperatively.

Biomarkers, Tumor↗

A comparison between argon-dye and excimer-dye laser for photodynamic effect in transplanted mouse tumor.

Photodynamic therapy (PDT) utilizing a hematoporphyrin derivative (HpD) as a sensitizer has become a viable option for the local treatment of neoplastic disease. The argon-dye laser system is commonly used as a light source in this treatment modality. The excimer-dye laser, on the other hand, delivers high-energy red light in a pulsatile fashion. In this investigation, we treated BALB/c mice bearing mouse kidney sarcoma cell tumors with PDT using HpD at the dose of 5 mg/kg body weight as a photosensitizer and either a standard argon-dye laser or the pulsatile excimer-dye laser as the light source. At equal light energy doses (50 J/cm2), necrotic changes at depths averaging 4 mm from the tumor surface were obtained with the argon-dye laser (200 mW power output) while tumor necrosis at depths exceeding 15 mm from the tumor surface was obtained using the excimer-dye laser (6 mJ/pulse, 5 Hz). To determine the best conditions for photoirradiation with the excimer-dye laser, tumor-bearing mice were treated with different total light doses (10, 30 and 50 J/cm2), dose rates (1, 3 and 6 mJ/cm2), and frequencies (5, 15 and 50 Hz) of light exposure. Our results indicate that the optimal effects obtained with the excimer-dye laser are related to the total light dose used and the dose rate, but not to the frequency of light exposure.

Animals↗

Sputum cytology-positive, bronchoscopically negative adenocarcinoma of the lung.

Among a total of 114 cases of resected lung adenocarcinoma that were examined by sputum cytologic study before bronchoscopy, 17 were sputum cytology-positive, but had no abnormal bronchoscopic findings. In most of these cases, the reason for detection was sputum and bloody sputum (58.8 percent). Pathologically, many cases were classified as stage III A or more (82.4 percent) due to mediastinal lymph node metastases. More than 70 percent of the cases showed vascular invasion. The proportion of well-differentiated cases was also high (52.9 percent). The prognosis of these cases was worse than sputum cytology-negative adenocarcinoma without abnormal bronchoscopic findings and better than sputum cytology-positive adenocarcinoma with abnormal bronchoscopic findings. There was no significant difference between these cases and sputum cytology-negative adenocarcinoma with abnormal bronchoscopic findings. Combined with the bronchoscopic findings, sputum cytologic study is useful for preoperative evaluation of lymph node metastasis and prognosis. This combined approach can provide information necessary to perform sufficient dissection of mediastinal lymph nodes and proper adjuvant therapy in sputum cytology-positive adenocarcinoma cases, even though there are no abnormal bronchoscopic findings.

Adenocarcinoma↗

[The local hyperthermochemotherapy for pleural carcinomatosis].

Local hyperthermochemotherapy was performed in 17 cases to control malignant effusion and intrathoracic disseminated lesions. Of these 15 patients, 11 cases primary lung cancer, 4 cases metastatic lung cancer had pleural carcinomatosis and 2 cases were malignant diffuse mesotheliomas. The procedure was radiofrequency hyperthermia (13.56 MHz) maintaining the peripleural temperature at 42-43 degrees C for 45-60 minutes, combined simultaneously with the intrathoracic administration of cisplatin (1-2 mg/m2, bolus) through a thoracic double lumen trocar tube. The treatment was repeated from 2 to 4 times at 7-day intervals. In 14 cases (87.5%) complete or partial response according to the criteria of the Japan Lung Cancer Society were obtained. There were 2 cases of no change and one case that was impossible to evaluate. In one lung cancer case, the disappearance of pleural disseminated lesions was confirmed by flexible thoracoscopy after the procedure. In 12 cases, there were abdominal complaints due to side effects of the hyperthermochemotherapy, such as vomiting and nausea, but these symptoms were milder than those caused by intravenous injection of anti-cancer agents, for example cisplatin, in conventional chemotherapy treatment. The median survival time and 2 years survival of the patients with the present procedure were 15 months and 41.7% respectively. Although distant metastases appeared in most cases, none had local recurrence and particularly noteworthy pleural effusion was well controlled. The above experience suggested that the local hyperthermochemotherapy is useful to control pleural effusion and can improve the quality of life of patients with pleural carcinomatosis.

Aged↗

[A case of squamous cell carcinoma of the lung treated by right sleeve upper lobectomy after photodynamic therapy].

This patient, a 62-year-old female, with squamous cell carcinoma of the lung was inoperable because of poor pulmonary function due to severe bronchial stenosis by a tumor at the orifice of the right main bronchus. As the tumor decreased in size after photodynamic therapy (PDT), the bronchial stenosis decreased and her pulmonary function improved sufficiency to permit surgery. When right upper sleeve lobectomy was performed, only limited peribronchial inflammation related to PDT procedure was detected indicating only slight extrabronchial influence of PDT. This suggests that PDT is a viable adjunct modality in case in which surgery might possible be performed. The patient has a good postoperative course and is alive 18 months after surgery without any evidence of recurrence.

Carcinoma, Squamous Cell↗

[Cases of residual tumor at the surgical margin after resection of lung cancer].

Sixty-one cases of primary lung cancer with residual cancer at the surgical margin were studied. The tumor remained at the bronchial stump in 27 cases, in the pleura in 18 cases, in the pulmonary artery or vein in 7 cases, the chest wall in 5 cases, adjacent organs in 5 cases and in the lung in 3 cases. The median survival time (MST) of the surgical margin-positive cases was 17 months and the 5-year survival rate was 24.1%. On the other hand, the MST of surgical margin-negative cases in the same period was 62 months and the 5-year survival rate was 50.7%. The poorer prognosis of the surgical margin-positive cases was statistically significant and this factor was related to the poor prognosis of stage I and II SMP cases. In stage IIIA and stage IIIB cases, the MST of the radiotherapy group was shorter than that of the non-radiotherapy group. The difference concerning prognosis between the bronchial margin-positive cases and other positive cases was not significant. Long survival cases consisted of squamous cell carcinomas with negative lymph nodes in which the residual sites were the bronchial mucosa or parietal pleura. Radiotherapy appeared useful for these cases.

Adenocarcinoma↗

Photodynamic therapy for multiple primary bronchogenic carcinoma.

In recent years, multiple primary lung cancers have been reported with greater frequency, partly as a result of technologic advances in the detection of lung cancer and therapeutic achievements in its management. Photodynamic therapy (PDT) is a relatively new therapy used with increasing frequency in the treatment of a wide variety of malignancies, including central lung cancers. In PDT, the differential retention of an injected photosensitizer by malignant tissue is exploited by treatment with a low-power laser beam delivered endoscopically. Since 1980, 145 patients with central lung cancers, including 35 cases of endoscopically evaluated early-stage lesions were treated with PDT at Tokyo Medical College. Thirteen of these 145 patients had multiple primary bronchogenic carcinomas, five cases of which were synchronous with the rest, metachronous. Three of 13 patients with multiple tumors had early-stage lesions and were treated with endoscopic PDT alone. In the other ten cases, PDT was used to treat accessible early-stage foci although operative excision was required for advanced lesions. Mean survival after PDT, alone or in combination with surgery, was 38 months (range, 14 to 87 months), and seven patients remain alive to date. It was concluded that PDT is useful in extending the therapeutic options for, and improving the prognosis of patients with, multiple primary bronchogenic carcinomas.

Adenocarcinoma↗