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J Amano

Publications and source records attributed to J Amano.

At least 109 records · Page 6Linked to original sources
PubMed1998

Pure clear cell papillary thyroid carcinoma with chronic thyroiditis: report of a case.

We herein report a case of pure clear cell papillary thyroid carcinoma, which is the first reported case in Japan. The tumors measured 1.0 x 0.9 and 0.7 x 0.4 cm in size. An ultrasonographical examination revealed hypoechoic irregular-shaped lesions with fine internal calcifications. No lymph node metastasis was observed in any of the surgical specimens. Distant metastasis had not been observed as of 6 years after surgical treatment. The number of cases of pure clear cell papillary carcinoma reported so far are too few to clearly elucidate its characteristics; however, the ultrasonographical findings and biological behavior of this case were compatible with those of non-clear cell papillary thyroid carcinoma.

Carcinoma, Papillary↗
PubMed1998

Multiple carcinoids of the duodenum accompanied by type I familial multiple endocrine neoplasia.

A case of multiple carcinoid tumors of the duodenum accompanied by familial multiple endocrine neoplasia is reported. A 46-year-old man with duodenal polyps discovered during a mass screening was followed up for 5 years. In August 1994, a histological examination revealed carcinoid tumors, and he was thus referred to our hospital for surgery. He underwent a parathyroidectomy and cholecystectomy for primary hyperparathyroidism and cholecystolithiasis, respectively. The patient's sister had also undergone a parathyroidectomy and distal pancreatectomy for primary hyperparathyroidism and insulinoma of the pancreas. In addition, his two children were also followed up for hypercalcemia. A serum examination of the patient revealed high levels of somatostatin and pancreatic polypeptide, but normal levels of gastrin and serotonin. In November 1994, a pancreaticoduodenectomy with a D2 lymph node dissection was performed. The macroscopic findings of the resected specimen showed multiple polypoid lesions with delles on the top, measuring 3 to 15 mm in size throughout the duodenum. A microscopic examination revealed the tumor to have infiltrated into the submucosa extensively, and an immunohistochemical analysis also demonstrated the tumor cells to be positive for somatostatin, but not for pancreatic polypeptide. After surgery, the serum level of somatostatin returned to normal but the pancreatic polypeptide remained high. The post-operative course was uneventful, and the patient remains in good health.

Carcinoid Tumor↗
PubMed1998

Novel MEN1 gene mutations in familial multiple endocrine neoplasia type 1.

The recent isolation of the gene responsible for multiple endocrine neoplasia type 1 (MEN 1) has enabled direct genetic diagnosis for people with endocrine tumors and family members of affected patients. Although MEN 1 is rarely recognized in the Japanese population compared to its prevalence in Caucasians, we have previously reported a high prevalence of this disease in a limited area (Nagano Prefecture; population, 2.15 million). In this communication, we report mutations of the MEN1 gene in kindreds living in Nagano Prefecture. The absence of a common mutation among these kindreds indicates that the high prevalence of MEN 1 in this area is not due to a regional accumulation of patients descended from a common ancestor. This result implies that the prevalence of MEN 1 in other areas of Japan could also be higher than had been thought.

Frameshift Mutation↗
PubMed1998

Combined therapies for composite graft infection after Bentall's procedure.

We present a patient who suffered from composite graft infection and mediastinitis. After replacement of the infected composite graft, in addition to administration of antibiotics, continuous irrigation of the mediastinum with solutions containing povidone-iodine and cefazolin sodium and transposition of the greater omentum were performed. His postoperative course was uneventful. Combined therapies including mediastinal irrigation and omental transposition should be considered after an operation for composite graft infection complicated with mediastinitis.

Anti-Bacterial Agents↗
PubMed1998

Changes in thyroid function and immunological parameters long after subtotal thyroidectomy for Graves' disease.

OBJECTIVE: To find out whether subtotal thyroidectomy results in long term stable functional and immunological remission in patients with Graves' disease. DESIGN: Retrospective study. SETTING: Teaching hospital, Japan. SUBJECTS: 176 patients who underwent subtotal thyroidectomy for Graves' disease, 1970-79. INTERVENTION: Follow up surveys in 1984 and 1992. MAIN OUTCOME MEASURES: Changes in thyroid function, antibody titres, and lymphocyte subsets. RESULTS: 29/79 patients (39%) who were euthyroid in 1984 had evidence of thyroid dysfunction in 1992. Of the 8 patients with latent hypothyroidism in 1984, 3 (38%) had become euthyroid by 1992, and none required treatment. Of the 29 patients who were hypothyroid in 1984, 5 had latent hypothyroidism and 1 was euthyroid in 1992, and of the 18 patients with recurrent hyperthyroidism in 1984, 1 had become euthyroid by 1992. The number of positive titres to TSH-binding inhibitory immunoglobulin was significantly higher in the recurrence group (31/36, 86%) compared with the hypothyroid (7/26, 27%), latent hypothyroidism (8/37, 22%), and euthyroid (22/77, 29%) groups (p < 0.01). There were also significant differences in the mean (SD) number of Leu HLA DR subsets between the control (17 (3), n = 18) and recurrence (21 (6), n = 38), hypothyroid (22 (6), n = 35), latent hypothyroidism (22 (6), n = 22), and euthyroid (22 (9), n = 64) groups (p < 0.002). There were no differences in the number of T cell subsets among the groups. CONCLUSION: Treatment of Graves' disease by subtotal thyroidectomy does not necessarily result in stable late functional or immunological remission. Long term follow up of such patients may be necessary.

Antigens, CD↗
PubMed1998

Effectiveness of preoperative radioactive iodine (131I) therapy for locally advanced papillary thyroid cancer: a case report.

We report here the effectiveness of preoperative radioactive iodine-131 (131I) therapy for locally advanced thyroid cancer. A 57-year-old woman demonstrated a hard neck tumor that markedly invaded the surrounding organs. The cytological diagnosis of the tumor using fine-needle aspiration biopsy was papillary carcinoma. Because curative resection of the tumor appeared difficult at her first visit, 131I therapy was performed prior to surgery and was more useful than expected. After 3 131I treatments, the tumor size was greatly reduced, and the patient underwent a curative operation. Histopathological diagnosis was well differentiated papillary carcinoma, pT4 and pN1b. The postoperative clinical course was uneventful. There have been no definitive reports using 131I as preoperative treatment for inoperable thyroid cancer. We suggest that 131I therapy may also be beneficial as neoadjuvant therapy for locally advanced thyroid carcinoma.

Biopsy, Needle↗
PubMed1998

Synchronous gastric tumors associated with esophageal cancer: a retrospective study of twenty-four patients.

OBJECTIVES: Synchronous gastric tumors (including benign and secondary tumors) associated with esophageal cancer present diagnostic and therapeutic issues. We investigated this synchronous association, and retrospectively determined the frequency of the gastric tumors and the clinical characteristics. METHODS: In a series of 208 patients with esophageal cancer, we investigated the synchronous gastric tumors, as well as the frequency of association, clinicopathological characteristics, diagnosis, treatment, and the clinical outcome after surgery. RESULTS: Twenty-eight gastric tumors were found in 24 patients. Adenocarcinoma was most frequent. Most of these tumors were located at the upper or middle third of the stomach. Eight gastric tumors in six patients could not be detected preoperatively. Six of these tumors including a gastric remnant cancer were detected in the resected stomach, and two leiomyomas were detected during the operation. In one patient in which an endoscope could not pass through the esophagus, a leiomyoma was detected in the resected stomach. For the gastric cancers, total gastrectomy or proximal gastrectomy with lymph node dissections was performed. For the benign tumors, partial resection of the stomach was performed, and endoscopic resection was performed preoperatively for an adenoma. In both the postoperative hospital mortality rate and the survival rate after surgery, there were no significant differences between the patients with and without gastric tumors. CONCLUSIONS: Synchronous gastric tumors associated with esophageal cancer are not rare. When an endoscope cannot pass through the esophagus before surgery, other techniques must be performed to explore the stomach. For these patients, surgical treatment should be adapted positively.

Aged↗
PubMed1998

Expression of fibroblast growth factor-2 and fibroblast growth factor receptor-1 in thyroid diseases: difference between neoplasms and hyperplastic lesions.

We studied the expression of both fibroblast growth factor-2 (FGF-2) and FGF receptor-1 (FGFR-1) in various histological types of human thyroid neoplastic and hyperplastic tissues to clarify the biological behavior of FGF-2. A total of 37 malignant tumors (24 papillary carcinomas, 10 follicular carcinomas, 3 anaplastic carcinomas), 8 follicular adenomas, and 12 adenomatous goiters were examined by immunohistochemical methods. With immunohistochemical staining, both FGF-2 and FGFR-1 were frequently detected in human thyroid carcinoma (79.2 to 100% and 80 to 100%, respectively). In thyroid hyperplastic lesions such as adenomatous goiter, the FGF-2 immunoreactivity in follicular cells was detected in 2 of 12 adenomatous goiters (16.7%). In contrast, FGFR-1 immunoreactivity was detected in 66.7% of cases of this disease. The endothelial cells of microvessels in the stroma adjacent to the neoplasms and hyperplastic lesions also showed cytoplasmic FGF-2 immunoreactivity. The difference between FGF-2 and FGFR-1 expression in adenomatous goiters was statistically significant (P<0.05). Furthermore, the difference in FGF-2 immunoreactivity between carcinoma and adenomatous goiter was statistically significant (P=0.0001). The present investigation demonstrated the possibility of an autocrine mechanism of action of FGF-2 in human thyroid carcinoma. Moreover, in thyroid hyperplastic lesions, FGF-2 derived from the stroma might be involved in the formation of nodular and/or diffuse goiters.

Adenocarcinoma, Follicular↗
PubMed1998

[Feasibility of limited surgery for small peripheral lung cancer].

We investigated the pathologic factors of small (< or = 20 mm in diameter) peripheral non-small-cell lung cancer lesions and postoperative course of the patients with these lesions to evaluate feasibility of limited surgery for small peripheral lung cancer. From 1982 to 1997, 114 patients underwent resection for small (< or = 20 mm in diameter) peripheral non-small-cell lung cancer. The histologic type was adenocarcinoma in 92 and squamous cell carcinoma in 22. Lobectomy was performed in 111, pneumonectomy in two and segmentectomy in one patient. The systematic mediastinal dissection was carried out in all patients. In 33 patients with tumors 12 mm in diameter or smaller, there were no one with lymph-node metastasis or pulmonary metastasis. Likewise, all patients were survived without relapse. In conclusion, curative resection may be possible without mediastinal dissection or with lesser lung resection (segmentectomy or partial resection), when the tumor diameter is less than 10 mm, for small peripheral non-small-cell lung cancer.

Adenocarcinoma↗
PubMed1998

[Continuous intraportal chemotherapy for prevention of metachronous hepatic metastasis in colorectal cancer].

Fifty-five colorectal cancer patients who had continuous intraportal chemotherapy between 1990 and 1993 (treated group) and 130 colorectal cancer patients who did not have portal chemotherapy between 1982 and 1993 (untreated group) were studied to clarify the effects of continuous intraportal chemotherapy on the prognosis. After a catheter was placed in the portal vein through the right gastroepiploic vein at the time of radical operation, 10 mg of MMC was continuously infused for 4 hours at operation and 500 mg/day of 5-FU was continuously infused for 7 days postoperatively. The toxicities of this therapy were not serious. The five-year survival rate was 65.3% in the treated group and 65.6% in the untreated group. The five-year disease-free survival rate was 69.8% in the treated group and 58.6% in the untreated group, with no significant difference. In stage II patients, however, the five-year disease-free survival rate in the treated group was slightly higher than in the untreated group (90.0% vs 70.3%, p = 0.073), and the rate of hepatic recurrence in the treated group was significantly lower than in the untreated group. These results suggest that continuous intraportal chemotherapy may prevent metachronous hepatic metastases in stage II colorectal cancer patients.

Aged↗
PubMed1998

[Telomerase activity in benign proliferative breast disease and breast cancer].

The application of telomerase activity is expected to serve as a reliable indicator of biological malignancy in breast tumors. We performed a study to quantify telomerase activity, the results of which revealed that this activity tends to be unexpectedly low in scirrhous carcinoma having low histological differentiation. It is therefore felt that additional studies at the tissue level using in situ hybridization will be required in the future. Although we think that atypical cystic duct is a true pre-cancerous lesion in the sense of having a high possibility of progressing into breast cancer, it will be interesting to determine whether or not the tissue is composed of cells having telomerase activity.

Breast Diseases↗
PubMed1998

Mutational analysis of the p73 gene localized at chromosome 1p36.3 in colorectal carcinomas.

Genetic alteration of p53, which monitors DNA damage and operates cellular checkpoints, is a major factor in the development of human colorectal carcinoma (CRC). Recently, p73, a novel family member of p53, has been identified and found, like p53, to activate p21Waf1/Cip1 and to induce apoptosis. The p73 gene was mapped at chromosome 1p36.3 which is a region frequently deleted in CRCs and other cancers including neuroblastoma. To assess whether or not p73 is a tumor suppressor gene of CRC, we performed mutational analysis of p73 in 82 colorectal tumor tissues paired with constitutional DNA. Using a microsatellite marker for p73, the loss of heterozygosity (LOH) study was performed and allelic loss of p73 was found in 17% of the CRCs. RT-PCR single strand conformation polymorphism analysis showed no mutation except three polymorphisms in the p73 coding region. In addition, p73 was expressed at higher levels in the CRC tissues than in the normal mucosa or neuroblastoma tissues, though the transcripts were detectable only by the RT-PCR method. Our results suggest that, in CRCs, p73 may not play a role as a tumor suppressor, at least not in a classic Knudson manner.

Adolescent↗
PubMed1998

Mitral valve aneurysm as a sequela of infective endocarditis: review of pathologic findings in Japanese cases.

Mitral valve aneurysm is defined as a localized protrusion of the valve with a different radius from that of the remaining portion of the valve. The medical records and pathological findings of seven patients with mitral valve aneurysm [aged 48-69 years (mean 64), 4 males] and the pathological findings of other 29 Japanese cases were reviewed. All seven patients were diagnosed pathologically as infective endocarditis, but two patients had no documentation of clinical symptoms suggestive of infective endocarditis (latent infective endocarditis). The underlying lesion of the heart was aortic valve disease and/or fibrosal degeneration of the mitral valve. Only 29 of 36 Japanese case reports stated a precise description of the valve pathology. Of these 29 cases, 23 were associated with infective endocarditis, two with rheumatic valvular disease with fusion and/or shrinkage of the chordae tendineae, three with mitral valve prolapse or myxomatous degeneration of the mitral valve, and one with aortitis syndrome. Neovascularization was described in eight cases. Neovascularization with thick wall should be considered as post-inflammatory vascularization. This review indicates that patients with latent infective endocarditis and mitral valve aneurysm should be considered as potential candidates for valve surgery.

Aged↗
PubMed1998

Clinical significance of the increased multidrug resistance-associated protein (MRP) gene expression in patients with primary breast cancer.

The efficacy of cancer treatment is limited by either intrinsic or acquired resistance to various chemotherapeutic agents. To evaluate the clinically important factors related to prognosis in primary breast cancer retrospectively, we investigated the expression of the following genes involving acquirement of drug resistance: multidrug resistance 1 (MDRl), multidrug resistance-associated protein (MRP), and topoisomerase (Topo) I, II alpha, and II beta. Using an RT-PCR method, we semiquantified the gene expression level in untreated stage II breast cancer tissue (n = 27) and noncancerous breast tissue (n = 10). Among the 27 cancer patients, who were all treated by adjuvant chemoendocrine therapy after surgery, 10 patients showed relapse within the following 10 years whereas 17 patients did not. The gene expression levels of MDRl, MRP, and Topo I, II alpha, and II beta were normalized to the level of the beta 2-microglobulin RT-PCR product. MRP mRNA expression was detected in 70% of the breast cancer tissues and its expression levels were significantly increased in the cancer group compared with the noncancerous breast tissues. Furthermore, the MRP level was much higher in the relapsed patient group. On the other hand, there were no significant differences in the MDRl mRNA levels between the noncancerous and cancer groups. Although Topo II alpha mRNA was not detected in noncancerous breast tissues, it was detected in 52% of the breast cancer tissues. In cancer patients, no significant difference in Topo II alpha mRNA levels was observed between the relapsed and nonrelapsed groups. These findings suggest that MRP might be used as one of the markers for poor prognosis in patients with breast cancer.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1998

[An evaluation of pathologic T3 lung cancer].

A total of 35 pT3 patients of lung cancer underwent pulmonary resection from 1983 to 1997 in our department. The overall five-year survival rate of the 35 cases was 35.8%. There was no significant difference between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. A superior outcome was observed for cases of curative resection compared with that of non-curative resection. Five-year survival rates of 19 patients with N0 disease, 16 patients with N1 or N2 disease were 46.6% and 22.2% respectively (p < 0.05). There was no significant differences among the survival rates according to the site of tumor invasion. We concluded that the long-term survival of patients with pathologic T3 disease critically depended on the lymph node state and completeness of resection.

Adenocarcinoma↗
PubMed1998

[Catamenial pneumothorax under video-assisted thoracoscopic surgery: a case report].

A 46-year-old woman complained four times of chest pains due to repeated right pneumothorax. This was improved by the right thoracic drainage each time. She was diagnosed as having catamenial pneumothorax from the fact that each episode of pneumothorax began with the first day of her menstrual cycle. She was admitted to our hospital in Jan. 1996 and operated on by the obliteration of pleuro-peritoneal fistulas on right diaphragm under video-assisted thoracoscopic surgery (VATS). No other abnormal lesions were found in the right pleural cavity and right lung. In this case, the pathophysiological mechanisms of pneumothorax might have been caused by the air influx from the peritoneal cavity to the right pleural cavity through the fistulas on the right diaphragm. VATS is minimally invasive surgery and very useful for the treatment of pleuro-peritoneal fistulas on the diaphragm. It should be emphasized that hormonal therapy is necessary after VATS of catamenial pneumothorax.

Endoscopy↗
PubMed1997

A Case of Occult Breast Cancer With Paraneoplastic Polyneuropathy.

We encountered a very rarc case of occult breast cancer associated with paraneoplastic sensory polyneuropathy. A 59-year-old woman was admitted to our hospital complaining of numbness in all extremities, ataxia of left extremities and a tumor in the left axilla. From the neurological findings, a malignant tumor was suspected. The immunohistochemical analysis of the axillar swollen lymph node revealed metastasis from breast cancer and confirmed the primary lesion. On a preoperative diagnosis of suspected occult breast cancer, left mastectomy and resection of left axillar lymph nodes were performed. Furthermore, immunohistochemical staining of sural nerves and Western blot analysis of the serum of this patient showed the loss of axons and the presence of antineural antibody in the seurm. Immunological response was considered to be the remote effector system between the breast cancer and sensory polyneuropathy in this disorder.

Journal Article↗