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Biomedical subjects

I Fujimoto

Publications and source records attributed to I Fujimoto.

At least 55 records · Page 3Linked to original sources
PubMed1994

Incidence of second primary cancers in Osaka residents, Japan, with special reference to cumulative and relative risks.

This study was conducted to examine the incidence rates and cumulative risks of second primary cancers in Osaka and to compare the observed number of second primary cancers with the expected number calculated using cancer incidence rates among Osaka residents. Study subjects were all reported cases aged 0-79 who were first diagnosed as having a first primary cancer between 1966-86. Incidence of second primary cancer among the study subjects was examined through to the end of 1989. The total number of study subjects was 217,307. During the follow-up period (mean duration: 3.7 years), second primary cancers developed in 5,071 patients (2.3%). Incidence of synchronous (interval < 3 months) and metachronous (interval > or = 3 months) second primary cancers increased in the later years. Incidence rates of second primary cancers were significantly associated with gender (male), age and calendar year at diagnosis of the first cancer. Based on the incidence rates, cumulative risk of developing metachronous second primary cancer was calculated. The ten-year cumulative risk was estimated as 10% for those who developed their first cancer during their sixties in 1978-83. The observed number of second primary cancers (including synchronous) was compared with the expected number. The ratios of observed-to-expected numbers were generally lower than 1.0 among those who developed their first cancer in 1966-77, while these ratios were higher than 1.0 among those who developed their first cancer in 1978-86. The ratios were much higher than 1.0 among those who developed their first cancer in their childhood and youth. Patients who had developed cancer of the colon, larynx, lung, bladder, or breast (female) showed significantly higher risk of developing second primary cancer during the period 1-4 years after diagnosis of the first cancer.

Adult↗
PubMed1994

Case-control study for lung cancer and cigarette smoking in Osaka, Japan: comparison with the results from Western Europe.

In order to clarify the relation between cigarette smoking and lung cancer, a case-control study was conducted. The case series consisted of 1,376 lung cancer patients (1,082 males and 294 females) who were newly diagnosed and admitted to eight hospitals in Osaka during 1986-88. Smoking histories were compared with those of 2,230 controls (1,141 males and 1,089 females) admitted to the same hospitals during the same period without established smoking-related diseases. Odds ratios of current smoker versus nonsmoker were 18.1, 1.9, 21.4, and 3.8 for squamous, adeno, small, and large cell carcinoma, respectively, for males, and 9.7, 1.3, 12.1, 3.7, respectively, for females. Compared to the results from previous studies in Japan, the magnitude of the odds ratios for squamous and small cell carcinoma is approaching the level of Western Europe in the late 1970s. Population attributable risk of exsmokers has also been increasing to the level of Western Europe. Among male current smokers, smoking intensity, such as number of cigarettes per day or fraction smoked per cigarette, seemed to have a slightly greater influence on squamous cell carcinoma than adenocarcinoma, while factors associated with the spread of cigarette smoke, such as inhalation, seemed to have greater influence on adenocarcinoma. The difference in the distribution of these smoking characteristics between Japan and Western Europe could not fully explain the difference in lung cancer incidence and distribution of histologic types between the two areas.

Adenocarcinoma↗
PubMed1994

Cumulative risk of hepatocellular carcinoma in hepatitis C virus carriers: statistical estimations from cross-sectional data.

The probability of developing hepatocellular carcinoma (HCC) among hepatitis C virus (HCV) carriers during their life-time is unknown. This paper addresses the estimation of the cumulative risk of HCC among HCV carriers using cross-sectional data. Age-specific prevalences of HCV carriers among the general population were estimated according to 5-year age group, based on the data of 2nd-generation anti-HCV assay in blood donors resident in Osaka (33,226 males and 29,054 females). Seropositivity of anti-HCV among 422 HCC cases, and the Osaka Cancer Registry data on HCC were used in the estimations of 5-year age-specific incidence rates of HCV-linked HCC. Using these data, the cumulative risk, i.e., the probability of contracting HCC within the following 15 years in 50-year-old HCV carriers, was estimated as 28% for males and 6% for females.

Carcinoma, Hepatocellular↗
PubMed1994

Interhospital differences in cancer survival: magnitude and trend in 1975-1987 in Osaka, Japan.

This study addresses the disparity in cancer survival rates among hospitals in Osaka, Japan. Using data from the Osaka Cancer Registry, four-year survival rates for stomach cancer patients (n = 8,845) diagnosed in 1976, 1981 and 1986, and lung cancer (n = 9,795) and breast cancer patients (n = 7,377) diagnosed in 1975-77, 1980-82 and 1985-87 were calculated according to four hospital categories (teaching hospitals, large hospitals: 400 + beds excluding teaching hospitals, medium-size hospitals: 150-399 beds, and small hospitals: 20-149 beds). Cox's proportional hazards model was employed with adjustment for sex, age, clinical stage at diagnosis, and treatment status. Stomach and lung cancer patients treated in large, medium-size and small hospitals showed significantly higher risks of death than those treated in teaching hospitals in 1975-87. Interhospital differences in breast cancer survival appeared to increase in 1975-87, whereas those in stomach and lung cancer survivals decreased during the same period.

Breast Neoplasms↗
PubMed1994

[Role of population-based cancer registry in cancer epidemiology--epidemiological studies in the Cancer Registration Scheme in Osaka, Japan].

A population-based cancer registration scheme started in three areas in Japan in the 1950s solely for studying cancer incidence in their respective areas. Soon thereafter, several prefectural governments started their own schemes as part of their cancer control programs, effectively expanding the aims of cancer registration: to clarify cancer facts, to elevate the medical care for cancer patients, and to plan and evaluate cancer control programs. The Osaka Cancer Registry (OCR) started in 1962, and has been using epidemiological methods as a tool in constructing its registration scheme, as well as analyzing and utilizing registry data. This report deals with the results obtained in the OCR, classifying these results into four activities of epidemiology. 1. Clarifying cancer facts (descriptive epidemiology): The OCR has been observing incidence, medical care for cancer patients, distribution of cases by clinical stage, and the 5-year relative survival rate, and has estimated the prevalence rate, cured-case rate, and future incidence into the 21st century. Population-based data on histology and multiple cancers collected at the OCR have also contributed to the new approaches in cancer epidemiology. 2. Research on risk factors (analytical epidemiology): The OCR developed a computerized record-linkage system in 1970. This not only made registry work more effective and reliable, but many cohort studies were able to be conducted with relatively little effort and highly reliable results. The cancer case file in the OCR has been linked with the newly prepared data file of the study group, and cancer incidence among the study group has been observed. Finally, cancer risks of possible causal factors in that group have been estimated quantitatively. 3. Evaluation of control programs: Secondary prevention programs (early detection) have been conducted in Japan as major cancer control programs, because effective risk factors were not previously defined. OCR data have been used for estimating sensitivity and specificity of screening tests for various cancers, as well as for evaluating the effect of clinical work on improving survival and on decreasing cancer deaths. 4. Planning future cancer control programs: The OCR has reported on the probable rapid increase of cancer incidence in the 21st century, especially of elderly cancer cases, and cancer cases with poor survival. To control these difficult problems, new cancer programs should be urgently designed and implemented. The authors have recommended that programs be prepared by cancer site, and have already presented a detailed program for lung cancer control.

Cohort Studies↗
PubMed1994

[Pelvic lymph node metastasis in endometrial cancer].

Various factors associated with pelvic lymph node metastasis were analysed in 393 cases with stage I endometrial cancer treated with extended total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The results are as follows. 1. The positive rates for lymph node metastasis and the relapse rate in 393 cases were 8.4% and 12.5%, respectively. 2. Myometrial invasion, tumor size, vessel permeation, cervical involvement, peritoneal cytology and adnexal metastasis were significant factors for lymph node metastasis. 3. Internal iliac nodes were the most common metastatic sites for cases with a single node metastasis, whereas external iliac nodes were the most common in all cases with lymph node metastasis. 4. The relapse rate for cases with single node metastasis was 40%, while the relapse rate for cases with three or more metastatic lymph nodes was 70%. 5. The relapse rate for 33 cases with lymph node metastasis was 54.5% and all of the relapse cases showed distant recurrence, whereas the relapse rate for 360 cases without lymph node metastasis was only 8.6%. It is therefore considered that pelvic lymphadenectomy is important in detecting high-risk patients and to reduce the relapse rate. Cytotoxic chemotherapy seems to be more adequate as adjuvant therapy for cases with lymph node metastasis.

Adult↗
PubMed1994

[Recurrent endometrial cancer after complete surgery].

Between 1974 and 1991, 576 patients with endometrial cancer were treated with complete surgery. 1. The overall relapse rate was 14.4%. No recurrence was observed in surgical stage Ia, whereas 56.8% relapse was noted in stage IIIc. 2. The relapse rate in cases with adenocarcinoma was 13.0%. The relapse rate increased with poorer differentiation. Five of 6 cases with serous adenocarcinoma developed recurrence. 3. Myometrial invasion, size of tumor, vessel permeation, cervical involvement, adnexal metastasis and lymph node metastasis were significant factors for relapse. 4. Distant recurrence was noted in 63.9% of recurrent cases and 28.9% developed pelvic recurrence. The most common recurrent sites were lung, peritoneal cavity, and para-aortic lymph node in distant relapse and vaginal vault and parametrium in pelvic relapse. 5. The time to relapse ranged between 106 days and 5,518 days after complete surgery. Thirty one point three % of the recurrent cases manifested relapse within the first year, 60.2% within 2 years and 93.9% within 5 years. The mean time to relapse was 561 days. It was concluded that adjuvant therapy for cases with adnexal metastasis, lymph node metastasis, cervical involvement, adenocarcinoma (G3), and serous adenocarcinoma should be established urgently.

Adenocarcinoma↗
PubMed1994

[Trends of lung cancer incidence and its prognosis in Osaka, Japan].

Lung cancer incidence figures in Japan were estimated as 30,000 for males and 11,000 for females for 1989 and represented the second and the fifth leading site of cancer, respectively, according to the Research Group for Population-based Cancer Registration in Japan. It is also estimated that lung cancer will steadily increase in the future. In relative frequencies of the major histological types, squamous cell carcinoma showed a decreasing trend, while small as well as large cell carcinomas showed an increasing trend in Osaka. In the distribution of clinical staging, the proportion of localized cases accounted for only 20% of the lung cancers in 1990. Five-year relative survival rates for lung cancer were 11.3% for all patients and 43.0% for localized cases in Osaka in 1984-1986. The rates were reported as 13.5% and 36.6% for total patients and localized cases, respectively, among caucasians from the SEER Program, a NCI project including 10 population-based cancer registries in the US. No noticeable difference was observed between Japan and the US. To control lung cancer in Japan it is considered vitally important and urgent to develop (1) new examination methods for diagnosing lung cancer in the earlier stage, (2) an efficient and effective cessation campaign for cigarettes smoking and (3) non-smoking based education.

Carcinoma, Squamous Cell↗
PubMed1993

Risk factors for hepatocellular carcinoma among patients with chronic liver disease.

BACKGROUND AND METHODS: To detect potentially curable cases of hepatocellular carcinoma, outpatients with chronic hepatitis or compensated liver cirrhosis who were seen at the Center for Adult Diseases (Osaka, Japan) were examined periodically by means of ultrasonography and measurement of serum alpha-fetoprotein. Risk factors for hepatocellular carcinoma were identified with a Cox proportional-hazards model. RESULTS: A total of 917 patients, 40 to 69 years old, were registered from May 1987 to March 1991. By the end of September 1991, liver cancer had developed in 54. The three-year cumulative risk of liver cancer was 12.5 percent for 240 patients with liver cirrhosis at enrollment and 3.8 percent for 677 patients with chronic hepatitis. Cox regression analysis showed that the risk of liver cancer was increased almost sevenfold in patients with hepatitis B surface antigen (rate ratio, 6.92; 95 percent confidence interval, 2.92 to 16.39) and fourfold in patients with hepatitis C antibody (rate ratio, 4.09; 95 percent confidence interval, 1.30 to 12.85). A high alpha-fetoprotein value at enrollment was also a risk marker for liver cancer. CONCLUSIONS: Patients with hepatitis C virus infection have a greatly increased risk of liver cancer. Further studies are required to clarify the roles of other risk factors, including drinking and smoking habits.

Adult↗
PubMed1993

Studies on ras oncogene activation in endometrial carcinoma.

The frequency of K-ras point mutation(PM) at codon 12 was studied in 45 patients with endometrial carcinoma. In vitro amplification of target sequences of DNA extracted from endometrial cancer tissues by polymerase chain reaction and dot blotting with oligonucleotide hybridization were performed. Ten of 45 endometrial carcinomas disclosed K-ras PM at codon 12 (22.2%). Transition from GGT to GAT was most frequent in PM(41.7%). Simultaneously, double PM (GAT/GCT) were also detected in 2 cases. No relationship appeared to be present between PM and clinical prognosis such as clinical stage, histological type, histological grade of differentiation, depth of myometrial invasion, and ascitic cytology. The positive rates of lymph node metastasis tended to be higher in the group with positive PM than in the group without PM. K-ras and C-myc gene amplifications were found in 2 (5.1%) and 3 (7.7%) of 39 cases, respectively. No PM of H-ras at codons 12 and 61 was detected. Our results showed that the PM of K-ras gene at codon 12 was a fairly common event in genetic abnormality and suggested it would have some role in the progression of carcinogenesis in endometrial carcinoma.

Adenocarcinoma↗
PubMed1993

Lung cancer incidence rate for male ex-smokers according to age at cessation of smoking.

Lung cancer incidence rate after the cessation of smoking was assessed for male ex-smokers according to the age at cessation, using the results from a case-control study for ex-smoker versus continuing smoker, and the lung cancer incidence rate function for continuing smoker estimated from Japan Vital Statistics and the "Six-prefectural Cohort Study" in Japan. This hospital-based case-control study consisted of 776 lung cancer cases (553 current smokers and 223 ex-smokers) and 772 controls (490 current smokers and 282 ex-smokers) who started smoking at ages 18-22. The odds ratio of developing lung cancer for ex-smokers compared to continuing smokers according to years since the cessation of smoking was estimated for four age groups (55-64, 60-69, 65-74 and 70-79). Given that the number of years since cessation of smoking is the same, reduction of the odds ratio appeared to be greater for the younger age group than for the older age group, reflecting the shorter period of exposure for the younger age group. Lung cancer incidence rate (per 100,000) was assumed to be expressed by the following function; 1.7 x 10(-5) x (age -24.3) for continuing smokers and 0.15 x 10(-5) x (age) for nonsmokers. Lung cancer incidence rate among ex-smokers according to years since cessation was then estimated to be the above function multiplied by the odds ratio from the case-control study for each age group. In contrast to the greater reduction of the odds ratio among younger ex-smokers, reduction of the incidence rate, in terms of rate difference, was considerably greater for older ex-smokers due to a high incidence rate of lung cancer for older continuing smokers. This indicates that the absolute magnitude of reduction of the lung cancer incidence rate after cessation of smoking is greater for older ex-smokers, although the relative magnitude of reduction is greater for younger ex-smokers.

Age Factors↗
PubMed1993

[Studies on the point mutation of ras oncogene in ovarian tumor].

Thirty-five patients with ovarian tumors operated on between December, 1989 and June, 1991 were studied to detect K-ras codon 12 point mutation (PM). (1) Five of 35 ovarian tumors (14.3%) disclosed K-ras PM at codon 12 and all the PM cases were in transition from GGT to GAT. On the other hand only one case (5.3%) with K-ras oncogene amplification was found and no C-myc or erbB-2 amplification was detected. (2) The incidence of PM according to clinical stages was seen in 3 of 11 stage I cases (27.3%), in 1 of 3 stage II cases (33.3%), in 1 of 14 stage III cases (7.1%) and in neither of 2 stage IV cases. PM was therefore seen in relatively early stages. (3) The occurrence of PM according to the histologic type was found in 3 of 16 serous tumors (18.8%), in 2 of 5 mucinous tumors (40.0%) and in none of 7 clear cell carcinomas or 2 endometrioid carcinomas. (4) Concerning the relation of PM to the involvement of serosal surface of ovarian tumors and to the ascitic cytology, no particular correlation was observed in our study. (5) Regarding the cytologic findings in imprint smears of the tumors in reference to PM, such as nuclear size, shape, N/C ratio, chromatin pattern, nucleolar size and number, the cases with PM tended to have more multiple nucleoli than PM negative cases. No other findings seemed to indicate the clinical progress of cancer. In conclusion, our study indicated that PM in ovarian cancers was a relatively early event in carcinogenesis.

Adult↗
PubMed1993

Interhospital differences in cancer survivals in Japan. The Research Group for Population-based Cancer Registration in Japan.

The present study was an investigation of variations in cancer survival rates among hospitals in Japan, focusing in particular on the number of hospital beds as an institutional characteristic. Using data from 11 population-based cancer registries, the three-year survival rates for stomach cancer (n 1665), colorectal cancer (n 1090) and lung cancer (n 895) patients diagnosed in 1985 were calculated according to three different hospital categories (100-299, 300-499, 500+ beds). Cox's proportional hazards model was conducted, with adjustments for sex, age, clinical stage at diagnosis and treatment status, excluding patients who had been detected by screening (asymptomatic cases). The stomach and lung cancer patients treated in small hospitals (100-299 beds) were at a significantly higher risk of death than those treated in large hospitals (500+ beds) (hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.11-1.65; HR = 1.41, 95% CI = 1.13-1.77, respectively). Similar findings were observed among colorectal cancer patients although they were not statistically significant. The findings can provide some information useful for the development of future public health policies aimed at controlling cancer mortality rates in our country.

Adult↗
PubMed1993

[Chemotherapy of ovarian cancer with a combination of low-dose consecutive CDDP and cyclophosphamide].

Sixty-six patients with ovarian cancer were treated with low-dose consecutive CP (LDC-CP) consisting of cyclophosphamide (CPM: 500 mg/m2, day 1) and CDDP (10 mg/m2, days 1-7). Two-9 (median: 4) courses of LDC-CP were given following reduction surgery (42 cases) or preceding primary debulking (24 cases). Among 66 cases, 12 with stage Ic were not evaluable (NE). The response rate (CR + PR/evaluable) for stages II-IV was 57.4% (12 + 19/54). Histologically, serous and endometrioid type showed a significantly (p < 0.001) higher response rate (77.5% among 40 evaluable) compared to the other histologic type (0% among 14). Toxicities including nausea/vomiting and renal impairment were markedly mild or almost absent despite the lack of any particular care. Grade 3 leucopenia and thrombocytopenia were observed only in 4.2%, and 2.5% of total 284 courses, respectively. Mean survival time by stage was 1,309 days for stage I, 809 days for stage II, 1,180 days for stage III, and 691 days for stage IV, with a significant difference among stages (p = 0.0452). In stages III and IV disease, significant prognostic factors included 1) response to chemotherapy, 2) no. of LDC-CP courses, 3) histologic subtype, 4) performance status, and 5) tumor size. Thus, LDC-CP is considered to be a useful chemotherapeutic regimen for serous and endometrioid type ovarian cancer.

Adult↗
PubMed1992

K+ channel involvement in induction of synaptic enhancement by mast cell degranulating (MCD) peptide.

A bee venom, mast cell degranulating peptide (MCD), which induces long-term potentiation (LTP) of synaptic transmission in hippocampal slices, was found to possess multiple functions. They include (1) binding and thereby inhibiting a voltage-dependent K(+)-channel in brain membranes, (2) incorporation in a lipid bilayer to form voltage-dependent and cation-selective channels by itself, and (3) activation of a pertussis toxin (Ptx)-sensitive GTP-binding proteins. In this study, we prepared several derivatives and analogues of MCD and investigated which function is more closely related to the induction of LTP. Another bee venom, apamin, formed ion channels in a lipid bilayer which were indistinguishable from those formed by MCD. D-MCD, an optical isomer of MCD, activated a Ptx-sensitive GTP-binding protein. However, these peptides did not induce LTP in the hippocampal slices. A snake venom, dendrotoxin-I (DTX-I), bound to the same K(+)-channels as MCD and did induce LTP. These results suggest that the most potent aspect of MCD involved in LTP inducibility is its interaction with the voltage-dependent K(+)-channel.

Animals↗
PubMed1992

Diagnostic validity of fecal occult blood tests for detecting gastroenterological cancers.

In order to estimate the diagnostic validity of chemical fecal occult blood tests, i.e. orthotolidine (Shionogi A) and guajac (Shionogi B) slides for detecting cancers of the esophagus, stomach and colorectum, the authors followed up all the examinees (n = 3,449) of comprehensive medical check-ups at the Center for Adult Diseases, Osaka, by means of record linkage to the Osaka Cancer Registry's files. Then, diagnostic validity was calculated based on the results of two years' follow-up. Sensitivity for the respective cancers was 20.0%, 11.8% and 62.5% for Shionogi A, and 20.0%, 5.9% and 43.8% for Shionogi B slides. Likelihood ratio for the respective cancers was 1.4, 0.8 and 4.5 for Shionogi A, and 3.3, 1.0 and 7.5 for Shionogi B. Specificity was analogous among the three cancer sites, being 86% for Shionogi A and 94% for Shionogi B. These results suggest that the diagnostic validity of chemical occult blood tests for detecting cancers of the esophagus and the stomach is very poor, and therefore imply that close examinations of these sites for screening positives is unnecessary in mass screenings for colorectal cancer.

Adult↗
PubMed1992

Second primary cancer following laryngeal cancer with special reference to smoking habits.

The risk of developing a second primary cancer following laryngeal cancer was estimated by following-up 472 male laryngeal cancer patients for an average of 8.6 years by means of record linkage to the Osaka Cancer Registry. Of these patients, 115 developed a second cancer other than laryngeal cancer, whereas the expected number derived from the incidence rates among Osaka residents was 51.4 (relative risk (RR) = 2.2, 95% confidence interval = 1.85-2.69). Cumulative risk of developing a second primary cancer was estimated to be 31.1% at 15 years after laryngeal cancer. By site, the risks were significantly increased for tobacco-related cancers, RR = 24.5, 6.1 and 2.3 for cancers of the oral cavity & pharynx, esophagus and lung, respectively. Also, the risks were higher among heavy smokers for cancer of the oral cavity & pharynx and esophagus than among light smokers. No adverse effects of radiotherapy for laryngeal cancer on the development of thyroid cancer, lymphoma and leukemia were observed. The present study suggests the necessity of following-up laryngeal cancer patients over a long period in order to enable the early detection of tobacco-related cancer.

Adult↗