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Biomedical subjects

H Fukuma

Publications and source records attributed to H Fukuma.

At least 37 records · Page 2Linked to original sources

[A case of acute eosinophilic pneumonia: bronchoalveolar lavage findings before and after steroid treatment].

An 18-year-old woman presented with coughing, fever, progressive dyspnea, and diffuse infiltrates on the chest X-ray film. Analysis of bronchoalveolar lavage fluid showed 73% eosinophils. Acute eosinophilic pneumonia was diagnosed. Methylprenisolone, 1 g per day was given for three days and her condition improved dramatically. No relapse was observed. Analysis of bronchoalveolar lavage fluid also showed lymphocytosis, abnormally high concentrations of ECP, GM-CSF, IL-5 and sICAM-1, and hypersegmentation of eosinophil nuclei. After steroid treatment almost all these findings returned to normal; only lymphocytosis remained. Precipitating antibodies against four kinds of fungi, including Trichoderma viridae, were noted in the serum, but the environmental provocation test was negative and those fungi were not detected in the environmental culture growth. Comparison of bronchoalveolar lavage findings obtained before and after steroid treatment can provide information on the mechanism of eosinophil accumulation in the lung. This case also draws attention to the relationship between acute and chronic eosinophilic pneumonia.

Acute Disease↗

Pulmonary resection for metastatic soft tissue sarcomas.

The therapeutic results of pulmonary resection for metastatic soft tissue sarcomas were analyzed. From 1970 to 1992, 23 patients (15 male and 8 female) underwent 40 pulmonary resections for metastatic soft tissue sarcomas. Nine (39%) patients had multiple thoracotomies for recurrences (range, 2-6). The 5-year actuarial overall survival was 32% (median, 28 months). Statistical analysis showed that age, gender, location of primary tumor, histology, site of pulmonary metastasis, tumor doubling time, or chemotherapy did not impact on survival. Significant prognostic factors associated with improved survival (p < 0.05) included a disease-free interval, and completeness and extent of the initial pulmonary resection. Patients with disease-free intervals > or = 12 months survived longer (5-year survival, 48.5%) than patients with disease-free intervals < 12 months (12%). Patients who could be rendered free of disease at their initial thoracotomy, without extended chest-wall resection, achieved a better outcome (5-year survival, 44%) than the others (5-year survival, 0%).

Actuarial Analysis↗

Extraskeletal osteosarcoma: a clinicopathologic study of four cases.

Four cases of extraskeletal osteosarcoma which were treated at the National Cancer Center Hospital have been reviewed. There were three males and one female. The ages of the patients were 32, 48, 48 and 59 years. Three patients had a solitary tumor located in the lower leg, thigh or postirradiated abdominal wall. The remaining patient had multiple tumors in the ipsilateral thigh and buttock. The predominant histologic subtype was osteoblastic in two cases, chondroblastic in one and malignant fibrous histiocytoma-like in one. Only one patient with a subcutaneous tumor was free of disease 16 years after a wide local excision without chemotherapy. The other three patients, two having undergone inadequate initial surgery, and one with multiple tumors, developed pulmonary metastases within 24 months of their initial surgical treatment. All of them died of the pulmonary metastases eight, 36 and 63 months after their initial treatment. Postoperative intensive chemotherapy was given to two patients. Although both had developed metastases to the lung, they received resection of the metastases combined with additional chemotherapy, surviving for more than 24 months after the occurrence of their first metastases.

Adult↗

FUS/TLS-CHOP chimeric transcripts in liposarcoma tissues.

Myxoid liposarcoma and malignant fibrous histiocytoma (MFH) are common soft tissue sarcomas of adulthood. Histopathologically they often show intratumor heterogeneity. In some cases, differential diagnosis of liposarcoma and MFH is difficult. It has been reported that myxoid liposarcomas are characterized by chromosomal translocation t (12; 16) (q13; p11), and that this results in two types (type I and type II) of FUS/TLS-CHOP fusion transcripts. In this study, the FUS/TLS-CHOP chimeric transcripts in seven malignant soft tissue tumors of Asian patients were analyzed by reverse transcription-polymerase chain reaction, DNA blot hybridization and nucleotide sequencing. One myxoid liposarcoma and two round cell liposarcomas possessed a chimeric transcript whose fusion point was the same as that of the type I fusion transcript reported previously for myxoid liposarcoma. We were thus able to detect the type I FUS/TLS-CHOP fusion transcript in clinical specimens of liposarcoma from Asian patients, including the first examples of round cell liposarcoma. These results suggest that the detection of FUS/TLS-CHOP chimeric transcripts or chimeric genes can be used as a diagnostic tool for the pathological diagnosis of liposarcomas.

Adult↗

Nuclear immunoreaction of p53 protein in soft tissue sarcomas. A possible prognostic factor.

BACKGROUND: Tumor suppressor gene p53, located on the short arm of chromosome 17, frequently mutates in various types of cancers and plays a critical role in the multiple stages of carcinogenesis. However, there is little information about the clinicopathologic significance of alterations of the p53 gene in soft tissue sarcomas (STS). METHODS: Because it is known that nuclear accumulation of p53 protein correlates closely with the presence of mutations in the p53 gene, immunohistochemical detection of this protein was performed. A polyclonal antibody (RSP-53) raised against synthetic human p53 peptide was used to detect nuclear accumulation of the protein. Pathologic specimens of 96 patients with STS were collected from the surgical pathology files of the National Cancer Center Hospital and examined. RESULTS: Nuclear accumulation of p53 protein was detected in 31 (32.3%) patients. The percentage of patients with a positive immunoreaction was high in patients with malignant schwannoma (100%), rhabdomyosarcoma (71.4%), and synovial sarcoma (50.0%), whereas it was low in patients with liposarcoma (13.6%) and 0% in those with fibrosarcoma. It was closely associated with the histologic grade of malignancy (grade 1, 12.0%; grade 2, 30.8%; grade 3, 44.4%) and the patient's age (younger than 40 years, 46.9%; 40 years of age or older, 25.0%). Both overall and metastasis-free survival rates were significantly lower for patients with a nuclear p53 immunoreaction than for those without it. CONCLUSIONS: The nuclear p53 immunoreaction is considered a marker of tumor aggressiveness and appears to be a useful prognostic factor for STS.

Adolescent↗

Direct dissolution of gallstones with methyl tert-butyl ether (MTBE) via endoscopic transpapillary catheterization in the gallbladder (ETCG).

In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial dissolution was seen in 2 (16%) patients. In one of the 8 complete dissolution patients, combined extracorporeal shock wave lithotripsy (ESWL) and dissolution therapy was carried out successfully. These 8 patients were followed up for 12-20 months with regular ultrasonography. During this period, 1 patient underwent laparoscopic cholecystectomy due to stone recurrence. Thickening of the gallbladder wall was seen in 2 patients, but there were no other complications. Using Tsuchiya's classification based on ultrasound, complete dissolution was seen in type Ia stones. This pilot study suggests that the direct dissolution of gallstones with MTBE via ETCG might be a useful and safe non-invasive treatment in patients with cholesterol stones in preserved gallbladders.

Adult↗

On clinical usefulness of Tl-201 scintigraphy for the management of malignant soft tissue tumors.

The purpose of this study was to investigate Tl-201 as a tumor scanning agent in patients with malignant soft tissue sarcomas and to establish the sensitivity of this type of scintigraphy concerning local recurrences or metastases that may remain clinically suspected. Seventy-eight patients with malignant soft tissue sarcomas and 22 with benign soft tissue tumors were studied. Of these 78 malignant soft tissue sarcomas patients, the sensitivity of Tl-201 (81.2%) was higher than that of Ga-67 (68.8%). Thirty-three out of 78 patients received a total of 95 consecutive scintigraphic follow-up examinations. Therapeutic effects was assessed by comparing the results of Tl-201 examinations with the clinical findings. Of these 33 patients, the therapeutic effects observed were as follows: complete remission 1, partial remission 8, progress of disease 1, and no remarkable change 23. Tl-201 scintigraphy has proved itself very useful not only in clinically detecting the malignant soft tissue sarcomas and in assessing therapeutic effects on these diseases, but also in assessing the follow-up patients with malignant soft tissue sarcomas.

Adolescent↗

[Criteria for the evaluating treatment on primary bone sarcoma].

The criteria for the evaluation of the treatment on primary bone sarcoma proposed by the Musculoskeletal Tumor Committee of the Japanese Orthopaedic Association (JOA) were accepted in 1993 by the Joint Committee for Cancer Therapy of the Japan Society for Cancer Therapy. The responses to treatment are classified as a complete response (CR), a partial response (PR), no change (NC), or as progressive disease (PD). It is a requirement that the condition of CR, PR, or NC continues for at least 4 weeks. The radiographical criteria are as follows: CR, the disappearance of the intramedullary lesions and the bone trabeculae recovering a normal appearance; PR, the circumscription of the extraosseous tumor and an appearance of sclerotic foci within the intramedullary lesion; NC, no changes noted in the extraosseous and intramedullary lesions; PD, an increase in the extraosseous or intramedullary lesion and/or the appearance of new lesions. Histopathological criteria are as follows: CR, no tumor cells appearing viable in any of the histologic sections; PR, greater than 90% tumor necrosis attributable to treatment; NC, 50 to 90% tumor necrosis and other secondary changes attributable to treatment; PD, less than 50% tumor necrosis. Responses in the clinical signs and symptoms including tumor size (or circumference of the extremities at the site of the tumor), pain and local heat are also graded as follows: PR, subsiding symptoms and/or decrease in the tumor size; NC, neither exacerbation nor decrease in the symptoms and no change in size; PD, the exacerbation of symptoms or an increase in size. Additionally, the serum alkaline phosphatase level can be used for evaluating the effect of the treatment on the osteosarcoma. The extent of the response to preoperative chemotherapy is a powerful predictor of patient survival.

Bone Neoplasms↗

Interferon-gamma, interleukin (IL)-2 and IL-2 receptor expressions in hepatitis C virus-infected liver.

Cytokine response to viral infection can be of critical importance in the host defense against virus. Interferon (IFN)-gamma and interleukin (IL)-2 have wide ranges of activities in host defense mechanisms. Therefore, these cytokine genes in the liver were investigated in a series of patients with hepatitis C virus (HCV) infection using a reverse transcribed-polymerase chain reaction (RT-PCR). Total RNA was purified from liver biopsies, reverse transcribed to cDNA, amplified by specific primers, and the products were detected by agarose gel and slot blot hybridization. All samples from acute hepatitis (AH; n = 4) and chronic hepatitis patients (CH; n = 19) were positive for IFN-gamma at varying degrees. AH patients showed strong signals compared to CH patients, liver cirrhosis (LC; n = 12; 72% positive) patients, and hepatocellular carcinoma (HCC; n = 21; 19% positive) patients. IL-2 gene was undetectable in all patients tested. IL-2 receptor (IL-2R) was detectable in AH, CH and LC patients but not in HCC patients. We conclude that IFN-gamma has important roles in the cytokine network that indeed present in the liver of HCV patients while the presence of IL-2R gene may indicate that the signaling pathway for IL-2 is intact.

Gene Expression↗

[Preoperative systemic chemotherapy of patients with osteosarcoma: a preliminary study of nine cases].

Nine patients with osteosarcoma were treated with cisplatinum and high-dose methotrexate therapy. According to the clinical responses to each drug, we selected and used the effective one with adriamycin or bleomycin, cyclophosphamide and actinomycin-D combination therapy. We treated patients with these protocols for several months (two and one-half to eight months). Both high-dose methotrexate and cisplatinum were effective in two cases, methotrexate or cisplatinum was effective in two patients individually (both resistant), but ifosfamide was effective in one case. No differences between any drug in the pattern of effective drug response. It is possible to exclude non-effective drugs from the preoperative schedule according to the degree of clinical responses manifested within one or two weeks. This preliminary study suggested that intensive systemic preoperative chemotherapy will control primary and micrometastatic lesions of osteosarcoma and improve the treatment for primary and advanced osteosarcoma.

Adolescent↗

[Cis-dichlorodiammineplatinum in osteosarcoma. Osteosarcoma Cooperative Study Group report].

Thirty-two patients with primary osteosarcoma and 18 patients with advanced osteosarcoma were treated by iv or ia infusion of cisplatinum at a dose of 100 mg/m2 every three weeks. The efficacy of the agent for primary osteosarcoma was mainly estimated by X-ray findings and histologic examination. One patient had a partial response, and 7 patients had a minor response. Pathologic evaluation of the extent of the primary tumor necrosis was performed on 27 resected specimens. Eight of 27 cases showed a good response (Ayala III A less than). One of 18 patients with advanced osteosarcoma had a partial response, and 2 a minor response. Nausea and vomiting (88%), liver dysfunction (42%), leukopenia (36%), nephrotoxicity (20%) and auditory disturbance (20%) were the main side effects in 50 patients. However, side effects of cisplatinum were generally reversible. The results suggest that cisplatinum is effective against osteosarcoma and may enhance the therapeutic results in osteosarcoma.

Adolescent↗

[Evaluation of adjuvant chemotherapy of osteosarcoma with special reference to adriamycin (final report)].

Adjuvant chemotherapy mainly with ADR performed in 117 patients (pts) with primary osteosarcoma of the extremity for the purpose of preventing pulmonary metastasis after radical ablative surgery. The mean follow-up period for 117 pts was 51.7 months (range: 3 to 137), for 53 survivors, 90.1 months (range: 60 to 137) and for 64 decreased, 20.5 months (range: 3 to 73). ADR was administered intravenously with 0.6-0.8 mg/kg/day for 3 consecutive days at monthly intervals after surgery until reaching 600 or 500 mg/m2 of the total cumulative dose. Five-year overall and disease-free survival rate of all pts was 50.2% and 39.4%, respectively. Thirty-seven pts (multi-drug group) with the combination of ADR and HDMTX had a higher survival rate (63.1% in 5-year overall survival rate and 47.8% in 5-year disease-free survival rate) than that of 80 pts with ADR alone (ADR group) (44.4% in 5-year overall survival rate and 35.6% in 5-year disease-free survival rate). Five-year survival rate for 65 pts administered the greater than 500 mg of ADR was 59.3% compared to 36.9% for 52 pts the less than 500 mg (p less than 0.05). In 65 pts administered the greater than 500 mg of ADR, 5-year survival rate (76.5%) of the multidrug group (17 pts) showed superiority to that 52.1%) of the ADR group (48 pts) (p less than 0.01). Even in the multi-drug group, 5-year survival rate (76.5%) of 17 pts administered the greater than 500 mg of ADR was higher than that (41.3%) of 20 pts given the less than 500 mg (p less than 0.01). Distant metastases were recognized at lung in 52 pts (lung group), lung + extrapulmonary organs in 14 (+ extragroup), and only extrapulmonary organs in 3 (extra group). Five-year survival rate of 66 pts with pulmonary metastasis was 17.1% and 21.2% in the lung group compared with 0% of the extra group (P less than 0.01). Five-year survival rate for 23 pts treated with thoracotomy was 43.5% compared to 2.6% for 43 without it (p less than 0.01).

Adolescent↗

Experimental model for predicting metastatic ability of tumors using chick embryo.

At present, there is no established diagnostic method by which the metastatic ability of an individual human cancer can be accurately predicted. We used chicken chorioallantoic membrane (CAM) to predict the metastatic ability of three B16 murine melanoma variant lines and also of human giant-cell carcinoma of the lung. Tumor cells were deposited on the CAM of eggs 10 days after fertilization. On day 7 after the tumor inoculation, the embryos were killed, and the lungs removed, minced and implanted on the CAM of other 10-day-old embryos. On day 7 after this inoculation, the tumors on the CAM were inspected under a surgical microscope, and were also checked histologically. The results accurately reflected the differing metastatic abilities of the B16 melanoma variant lines. Metastases were observed in the lungs of the embryo bearing human giant-cell carcinoma of the lung on the CAM. Using CAM seems to be a suitable way of predicting the malignancy of tumors with metastatic ability.

Animals↗