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Biomedical subjects

K Komaki

Publications and source records attributed to K Komaki.

At least 91 records · Page 5Linked to original sources

[Breast cancer detected by mass screening using physical examination alone].

In Tokushima prefecture, mass screening for breast cancer has been conducted using physical examination alone since 1970. Breast cancer was detected in 108 of 141,116 screened women up until 1986. The detection rate was 0.08% among total examinees, 0.12% among initial examinees, and 0.04% among subsequent examinees. Patients with breast cancer were divided into three groups. Group I consisted of 70 patients whose cancers were detected by initial screening examination. Group II consisted of 38 patients whose cancers were discovered by subsequent periodic screenings. Group III included "interval" patients, whose cancers were found in the interval within 2 years between a negative screening examination and the next screening; 19 patients were classified into this group. Serving as controls were 615 breast cancer patients who visited our outpatient clinic, independently of the screening program, during the same period as that of the mass screening. Of the 108 patients in Groups I and II, 51 patients (47%) had noticed a lump in the breast themselves by the time of the mass screening. The stage classification and nodal involvement showed significant differences between the mass screening group and the control group, but no significant differences among the three groups. The Group III cases (interval cases) were detected at an early stage, but some of these cases included patients with fast-growing tumors. When compared with cumulative survival curves according to age-matched case-control study, there was no significant difference between the patients whose tumors were detected in the mass screening and the controls.

Ambulatory Care↗

[A case of advanced breast cancer successfully treated with combined tamoxifen and epitiostanol].

A patient with stage IV advanced breast cancer with multiple metastasis (bones of the whole body, lungs) were treated by ovariectomy, administration of an non-steroidal antiestrogen (tamoxifen) and mild chemotherapeutic drugs, with favorable results. After four years, however, the patient had a relapse of the cancer. A steroidal antiestrogen (epitiostanol) was then administered with satisfactory results. When a breast cancer relapse occurs in patients once treated successfully with endocrinotherapy, a different form of endocrinotherapy should be tried. There is a possibility that the mechanism of action of Epitiostanol, which is regarded as a steroidal antiestrogen, is different from that of tamoxifen in which an estrogen receptor (ER) system is included.

Androstanols↗

Breast cancer detected by mass screening using physical examination alone.

In Tokushima prefecture, mass screening for breast cancer has been conducted using physical examination alone since 1970. Breast cancer was detected in 116 of 111,571 screened women up until 1984. The detection rate was 0.08 per cent in total examinees, 0.13 per cent in initial examinees, and 0.04 per cent in subsequent examinees. The patients with breast cancer were divided into three groups, i.e., 62 cases detected at initial screening, 28 cases detected at subsequent screenings, and 26 interval cancer cases. 510 patients with breast cancer in the outpatient clinic were serving as controls. The stage classification and nodal involvement were significantly different between the mass screening group and the control group, but not significantly different among the three groups. The interval cases were detected at an early stage. The survival rates were not significantly different between the three groups and the control group. Efforts should be doubled to educate women about the proper method of breast self-examination in order to promote the early detection of breast cancer.

Adult↗

[A clinical study of lobular carcinoma of the breast].

In a review of 549 cases of breast cancer in the last 16 years, 7 cases with lobular carcinoma have been studied. All of the patients appeared well and were without recurrence. Two cases had been lobular carcinomas in situ, one of which had arisen in a small fibroadenoma associated with malignant phyllodes tumor in the opposite breast, and the other had shown multicentric foci of a lobular neoplasm. The remaining 5 cases had been invasive lobular carcinomas. The incidence of lobular carcinoma represented 1.3% (7/549) of all primary breast carcinomas, and had been increasing chronologically. Estrogen and progesterone receptors were positive in 5 eligible cases.

Adult↗

[Prognostic value of hormone receptor in breast cancer].

The relationship of hormone receptor and postoperative prognosis was investigated in 166 patients with breast cancer who underwent curative operation and postoperative adjuvant chemotherapy. The endocrine therapy was performed only for the patients with recurrent disease. The content of estrogen receptor (ER) and progesterone receptor (PgR) were measured by binding assay using gel-filtration method. ER-positive cases accounted for 56% of 166 patients and PgR-positive ones for 36% of 124. The relapse free interval was not different between the ER-positive group and ER-negative one, but the survival curve after relapse was significantly different between the both groups. There was no significant difference in the relapse free interval and the survival curve after relapse between PgR-positive group and PgR-negative one. These results suggest that the ER is a good predictor as to the response to endocrine therapy given for recurrent disease, but not as to early recurrence.

Breast Neoplasms↗

[SAM sound studied by pulsed Doppler echocardiography].

The occurrence of a systolic sound in hypertrophic obstructive cardiomyopathy (HOCM) has been well known for more than 20 years. This was phonoechocardiographically regarded as the sound coincident with the abrupt halt of the systolic anterior movement (SAM) of the mitral valve echo, and it has been termed the SAM sound. A 58-year-old man with HOCM was admitted with right hemiplegia. He was found to have a SAM sound which waxed and waned in intensity, and at times moved earlier into systole. He was studied by cardiac catheterization, M-mode and two-dimensional Doppler echocardiography (pulsed, continuous wave and color flow Doppler methods). Asymmetric septal hypertrophy (interventricular septal thickness = 25 mm, left ventricular posterior wall thickness = 14 mm), as well as SAM and midsystolic aortic valve closure were demonstrated. The presence and intensity of the sound was not related to rhythm (normal sinus rhythm vs atrial flutter), heart rate, respiration, position, or inhalation of amyl nitrite. Two-dimensional Doppler echocardiography revealed the following: 1. In the left ventricular outflow tract just below the aortic valve, a systolic turbulent flow was always present. 2. In the left ventricular chamber near the apex, a systolic laminar flow was interrupted in those cycles where the SAM sound was present. Otherwise, in cycles lacking the SAM sound, laminar flow in this locality continued throughout systole (even shorter duration than normal). 3. In the left ventricular inflow tract, diastolic flow was unaffected by the presence of the sound. 4. No mitral regurgitation was observed using color flow Doppler echocardiography. In summary, a SAM sound appeared to be associated with sudden deceleration of blood flow from the apex to the mid left ventricle.

Cardiomyopathy, Hypertrophic↗

[The accuracy of frozen sections in the diagnoses of breast lesions].

To evaluate the accuracy in diagnosing breast lesions by frozen sections, 657 consecutive diagnostic biopsies seen during 1982 were reviewed. Of 559 lesions considered benign at frozen sections, 558 were also benign in paraffin sections, the remaining one being a papillary carcinoma (i.e. 1/559 or 0.2% false negative). All 78 cases diagnosed as malignant in frozen sections were also malignant in paraffin sections (i.e. 0% false positive). Of the 20 doubtful cases, in frozen sections, 15 showed a papillary lesions; 7 of them were malignant in paraffin sections and the rest 13 benign. It is concluded that the frozen sections are usefull in the diagnoses of mammary disorders except for those cases with papillary tumors.

Biopsy↗

Involvement of nipple and areola in early breast cancer.

In 141 mastectomy specimens, performed for invasive or noninvasive carcinomas, histopathologic study was performed to assess the extent of nipple-areola involvement by the tumor. In this study, patients were excluded if the tumor was located beneath the areola; and nipple and/or areola abnormalities were clinically present. Tumor involvement of the nipple and/or areola was found in 44 of 141 specimens (31%), with intraductal growth in 36 (82%) of 44, stromal invasion in 3 (7%), and ductal and stromal invasion in 5 (11%). Analysis of nipple-areolar involvement with consideration of the different variables indicates that it occurred in association with tumor size, tumor-areola distance, and histologic type. Such information provides clinically relevant guidelines in decision making for limited breast surgery.

Adenocarcinoma, Mucinous↗

[A clinicopathological study of 160 cases of mucinous carcinoma of the breast].

A clinicopathological study was performed on characteristics of mammary mucinous carcinoma and its 3 pathological subgroups: "gelatinous type"--with predominant mucin component, "epithelial type"--with predominant epithelial component, and "combined type"--with a small part of infiltrating ductal carcinoma and mucinous pattern. Among 4,653 primary breast cancers mastectomized at the C.I.H. between 1946 and 1981, 160 or 3.4% was mucinous carcinoma. They were divided into 106 gelatinous type, 20 epithelial type and 34 combined type. 10-year survival rate of mucinous carcinoma (75.3%) was better than whole breast cancer (65.6%). And it was 90.7%, 82.4% and 67.6% in gelatinous, epithelial and combined type, respectively.

Adenocarcinoma, Mucinous↗

[Effect of preoperative intra-arterial infusion of adriamycin on locally advanced breast cancer].

The effect of adriamycin (ADM) infused intraarterially as a preoperative procedure was analyzed retrospectively in 15 patients with primary advanced breast cancer. A high clinical response rate (CR+ PR) of 73% (11/15) was obtained by the treatment, and also remarkable degenerative changes of tumor cells were histologically noted in 10 out of 15 surgical specimens (67%). A correlation between the dose of ADM infused and the rate of tumor regression was observed. A significantly higher concentration of ADM was detected in metastatic lymph nodes and tumors obtained 3-4 weeks after intra-arterial infusion of ADM than that in normal mammary gland. As for side effects, alopecia, leukocytopenia, anorexia, nausea and vomiting occurred at high frequencies. The side effects due to this treatment were considered to be tolerable. Prognostically, a good survival rate was not observed using preoperative treatment with intra-arterial ADM infusion.

Adult↗

[Preservation of the nipple and areola for breast cancer--histopathological study on cancerous involvement of the nipple and areola].

In 141 mastectomy specimens, performed for invasive or non-invasive carcinomas, histopathologic study was performed to assess the extent of nipple-areola involvement by the tumor. In this study, patients were excluded when 1) the tumor was located beneath the areola, 2) nipple and/or areola abnormalities were clinically present. Tumor involvement of the nipple and/or areola was found in 44 of 141 specimens (31%), with intraductal growth in 36 (82%) of 44, stromal invasion in 3 (7%) and ductal & stromal invasion in 5 (11%). Analysis of nipple-areolar involvement with consideration of the different variables indicates that it occurred in association with tumor size, tumor-areola distance and histological type. Such information provides clinically relevant guide lines in decision making for limited breast surgery.

Breast Neoplasms↗

[Stromal sarcoma of the male breast].

A 63-year-old man who had been aware for 5 years of a tumor near his left nipple was admitted complaining of rapid tumor enlargement. He received standard mastectomy under the diagnosis of breast sarcoma. The regional lymph nodes were not involved and the excised tumor was 12.0 cm in diameter it showed a grayish-white cut surface and a sharp border. Histologically we made a diagnosis of stromal sarcoma of the breast showing diffuse proliferation of spindle shaped cells with high cellularity, moderate atypia and scattered mitosis. Postoperatively, he underwent chemotherapy with cyclophosphamide. Two years and five months after the operation, he is alive and well without any sign of recurrence.

Breast Neoplasms↗

[Non-epitherial malignant neoplasms of the breast--a clinicopathological study of 4 cases].

Between 1972 and 1981, 4 women with breast sarcoma underwent treatment at our department; they accounted for 1.1% (4 of 355) of all female breast malignancies. There was one case of malignant lymphoma and liposarcoma each, and 2 cases of malignant cystosarcoma phyllodes. The patients averaged 31.0 years of age. Of the two cases of cystosarcoma phyllodes, one had coexisting lobular carcinoma in situ arising in a fibroadenoma of the contralateral breast, the other had a coexisting lung cancer. Mastectomy was performed in 3 cases, irradiation in one (malignant lymphoma). All patients received concurrent chemotherapy. The regional lymph nodes were not involved, and 2 patients are alive and well without recurrence.

Adolescent↗

[Clinical results of cefadroxil in pediatric field (author's transl)].

Cefadroxil was administered at a daily dose of 50 mg/kg in 113 children including acute respiratory tract infections suspected to be a bacterial infection and other febrile diseases. Among 41 cases in which pharyngeal culture was made twice before and after administration or urine and feces cultures were made, 20 cases (48.8%) were good bacteriologically, 5 cases (12.2%) were poor, and 16 cases (39.0%) were unknown. Clinical efficacy was obtained in 105 cases (92.9%) out of 113 cases. Microbial substitution was noticed in 12 cases (29.3%) out of the cases of which pharyngeal culture was made after cefadroxil administration. Haemophilus influenzae was detected newly after the administration in 7 cases (58.3%) out of these 12 cases. Bacteriological efficacy was obtained in 5 cases of acute respiratory tract infection of which pathogen was considered to be Haemophilus influenzae. No microbial substitution was noticed in these 5 cases. As to the side effects of cefadroxil administration, only a slight diarrhea was observed in 2 cases.

Adolescent↗

[Clinical studies on cefoperazone in the pediatric field (author's transl)].

Cefoperazone (CPZ) at dose levels of 80 approximately 100 mg/kg/day, divided 3 approximately 4 times, was drip-infused or intravenously injected for a period of 2 approximately 6 days to 10 patients. All 10 cases, 4 cases of bronchopneumonia from which H. influenzae was detected (Group A S. pyogenes and S. pneumoniae were also detected in each 1 case). 2 cases of coli urinary tract infection, 1 case of acute colitis from which pathogenic E. coli was detected, 1 case of E. coli carrier, 1 case of acute bronchitis (bacteria were not detected), and 1 case of urinary tract infection (bacteria were not detected) showed rapid improvement of clinical symptoms with rapid eradication of the pathogenic bacteria. In one case of urinary tract infection where S. epidermidis and S. faecalis were simultaneously detected, S. epidermidis was removed but S. faecalis was merely decreased. The effective antibacterial concentration after intravenous injection of CPZ in the feces was determined and found to be present in sufficient concentrations to prevent colon infection. No particular side effects were observed during CPZ therapy.

Age Factors↗