Biomedical subjects

M Igawa

Publications and source records attributed to M Igawa.

At least 73 records · Page 4Linked to original sources

PubMed1996

Estramustine-binding protein in carcinoma and benign hyperplasia of the human prostate.

For the purpose of elucidating whether the biological characteristics of estramustine-binding protein (EMBP) are different in benign prostatic hypertrophy (BPH) and prostatic carcinoma (PC) and also to determine the clinical value of EMBP in the tissue, the EMBP concentration in 19 patients with BPH and 26 with untreated PC was measured by means of radioimmunoassay (RIA) using an antibody raised against EMBP obtained from the rat ventral prostate and compared simultaneously with the dihydrotestosterone (DHT) level in the same tissue. The level of serum prostate-specific antigen (PSA) was also measured in these patients. The EMBP concentration was significantly correlated with the tissue DHT level in BPH and well-differentiated PC (r = 0.745, p < 0.0001), whereas it did not correlate in moderately and poorly differentiated PC (r = -0.159, p = 0.542). By comparing well-differentiated PC with moderately and poorly differentiated PC, the EMBP concentration was significantly lower in the former than in the latter two conditions (p < 0.005) in spite of the highest tissue DHT level in well-differentiated PC. The ratio of the EMBP concentration to the DHT level in moderately and poorly differentiated PC was significantly higher when compared with that observed in either BPH or well-differentiated PC (p < 0.005, respectively). However, the level of serum PSA did not reflect the histological differentiation of PC. These results suggest that: (i) the correlation of the EMBP concentration to the DHT level changed with the progression of the histological grade, and (ii) the ratio of the EMBP concentration to the DHT level in the tissue is clinically valuable in elucidating the biological potential of individual tumors.

Aged↗

PubMed1996

Relationship of genetic instability with immunoreactivities for p53 protein and proliferating cell nuclear antigen in transitional cell carcinoma of the bladder.

OBJECTIVE: To elucidate the relationship between genetic instability and tumor development in transitional cell carcinoma (TCC) of the bladder. METHODS: The genetic instability as assessed by 2c deviation index (2cDI) and 5c exceeding rate (5cER) was compared with immunoreactivities for p53 protein and proliferating cell nuclear antigen (PCNA) in specimens obtained from 65 patients with primary untreated TCCs. RESULTS: Both p53 and PCNA immunoreactivities significantly correlated with histological grade as well as stage. The immunoreactivity of p53 significantly correlated with that of PCNA, while a dissociation of the positive correlation between p53 immunoreactivity and PCNA expression was noted in the TCCs with high 2cDI value (> or = 2.0) and/or high 5cER (> or = 10%). In addition, PCNA expression became higher as the genetic instability increased, however, the p53 immunoreactivity was not parallel with the change of genetic instability. Moreover, some TCCs with high genetic instability (2cDI > or = 2.0 and 5cER > or = 10%) showed concomitant expression of high PCNA and low p53 protein, whose clinical outcome was poor in general. CONCLUSIONS: The inactivation of p53 may represent a rather early event in the development of TCC of the bladder. However, the proliferative activity in itself rather than the effect due to a specific alteration in p53 plays an important role in the development and progression in TCC of the bladder.

Carcinoma, Transitional Cell↗

PubMed1996

Association of nm23 protein levels in human prostates with proliferating cell nuclear antigen expression at autopsy.

OBJECTIVE: To investigate nm23-H1 gene expression in the human prostate. METHODS: The nm23-H1 protein levels of normal prostatic tissues, latent cancers of the prostate and primary and metastatic sites of clinical prostate cancers from autopsied men were evaluated using immunohistochemical analysis. Cell proliferation in serial sections using proliferating cell nuclear antigen immunoreactivity was also estimated. RESULTS: Intense nm23-H1 staining was observed in metastatic sites of clinical prostate cancers. The incidence of intense nm23-H1 staining cells in primary sites of clinical prostate cancers was significantly higher than that found in latent cancers and normal prostates (p < 0.01). The staining pattern of nm23-H1 was heterogeneous in latent cancers of the prostate. A significant relationship was observed between nm23-H1 staining and positive proliferating cell nuclear antigen staining (p < 0.01). CONCLUSIONS: These results seem to indicate that the nm23-H1 gene expression is related to cell proliferation and tumor metastatic potential, and appear to show the existence of a biologically different population of cells within the latent cancer.

Aged↗

PubMed1996

[Effects of nicorandil on coronary collateral circulation depend on the donor arteries].

The effects of nicorandil on coronary collateral circulation during exercise-induced ischemia were compared between the different donor arteries in 13 patients with effort angina, 7 with complete obstruction of the left anterior descending artery (LAD) with well-developed collateral vessels from the right coronary artery (RCA) (LAD group), and 6 with complete occlusion of the RCA (segment 2-3) with well-developed collateral vessels from the LAD (RCA group). Initial percentage thallium (%TI) uptake (thallium-201 single photon emission computed tomography) and washout rate were measured in the anterior, septal and posterior regions during ergometer exercise. The submaximal treadmill exercise test was also performed using a cardiopulmonary monitoring system to measure Vo2 at anaerobic threshold (AT). After the controls were obtained, nicorandil (15 mg/day) was administered for 4 weeks, during which ergometer exercise and treadmill exercise tests were carried out repeatedly. A significant improvement of initial %TI uptake on exercise was observed in the LAD group with nicorandil therapy, but no improvement was shown in the RCA group. The AT significantly increased after nicorandil treatment in the LAD group (13.9 +/- 0.38-->16.8 +/- 1.18 ml/min/kg), reflecting the improvement of cardiac function through the increased collateral flow. However, in the RCA group, it remained unchanged, suggesting no improvement of cardiac function. Nicorandil was effective to increase collateral flow from the RCA, but ineffective on that from the LAD. Nicorandil is an effective coronary dilator and is reported to affect both large and small coronary arteries. The effect on the collateral circulation is dependent on the donor artery supplying different areas. The vasodilator effect of nicorandil is mainly on the LAD, which is large enough to supply blood to a wider area of the heart, rather than the RCA.

Adult↗

PubMed1995

Pulmonary nodules in patients with a history of radical nephrectomy for renal cell carcinoma.

BACKGROUND: Nine patients with a history of radical nephrectomy for renal cell carcinoma underwent surgical removal of newly detected pulmonary nodules at the Hiroshima University Hospital. Six patients had metastatic lung tumors two patients had bronchogenic primary carcinomas and one had a granulomatous infection. METHODS: To determine if any characteristics can distinguish a new primary carcinoma from metastatic renal cell carcinoma, we reviewed the nine patients described above. The patients with pulmonary metastases and those with new primary lung cancers did not differ in age, sex, history of smoking, clinical stage and pathological findings of the renal primary site, on the location and size of the pulmonary nodules. RESULTS: Only the interval between the nephrectomy and the appearance of the new pulmonary lesion may be a predictive factor. This interval was 48 and 51 months for the patients with new primary lung cancers but varied from 0 to 39 months for the patients with metastatic renal cell carcinoma. A solitary nodule had an equal chance of being metastatic or primary. CONCLUSIONS: These results indicate that a solitary nodule that is detected at a longer interval after radical nephrectomy may be a new primary lung cancer. Once new pulmonary nodules are identified in a patient with a history of radical nephrectomy for renal cell carcinoma, surgical excision is required for a final diagnosis before initiating therapy for metastases.

Adult↗

PubMed1995

Immunohistochemical analysis of nm23 protein in transitional cell carcinoma of the bladder.

OBJECTIVES: To elucidate the clinical significance of the nm23 gene product in transitional cell carcinoma (TCC) of the bladder. PATIENTS AND METHODS: The immunoreactivity of nm23 protein and proliferating cell nuclear antigen (PCNA) were evaluated in paraffin-embedded tumour samples obtained from 74 patients with TCC of the bladder who underwent total cystectomy between 1981 and 1993 and compared with the histological findings and clinical outcome. RESULTS: The immunoreactivity of nm23 protein was positive near basement membrane in normal transitional epithelium and superficial TCCs; it could also be positive at the invasive front of TCCs. The immunoreactivity of nm23 protein in TCCs was significantly higher than that in normal transitional epithelium and correlated significantly with the expression of PCNA and with histological grade. Similarly, immunoreactivity was significantly higher in invasive TCCs than in superficial TCCs; however, there was no significant difference between superficial TCCs and normal transitional epithelium. Immunoreactivity of nm23 protein was not associated with the early development of metastasis after radical surgery or with a favorable clinical outcome. CONCLUSION: Immunoreactivity of nm23 protein appeared to be associated with the proliferation and progression of TCC of the bladder. The potential role of nm23 as a suppressor of the metastatic activity of tumours was less prominent, partly because of mutations of nm23 in TCCs of the bladder.

Adult↗

PubMed1995

Long-term results with M-VAC for advanced urothelial cancer: high relapse rate and low survival in patients with a complete response.

OBJECTIVE: To describe the long-term results of treating patients with advanced urothelial cancer using a combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC). PATIENTS AND METHODS: Fifty-one patients (37 men and 14 women, median age 66 years, range 41-82) with inoperable or metastatic carcinoma of the bladder, ureter or renal pelvis were treated with M-VAC and their responses evaluated for up to 7 years. Relative dose intensity (RDI) was calculated by dividing the actual dose intensity by the projected total dose intensity and related to outcome. Overall survival was assessed from the date of initiation of treatment with M-VAC, using the Kaplan-Meier method. RESULTS: Of the 51 patients. 10 (20%) had a complete and 18 (35%) had a partial response, giving an overall response rate of 55% (95% CI, 41-68%). There was no significant difference in the median values of RDIs with response to the M-VAC regimen. The median duration of response was 11.9 months for the 10 patients with a complete response and of these, eight relapsed at a median of 10 months after treatment and died at a median of 8.5 months from the time of disease recurrence. Survival of patients with a complete response differed significantly from those with no response at 1 year after the start of treatment, but not subsequently. CONCLUSION: Long-term follow-up revealed a high relapse rate and poor prognosis in patients with a complete response who received the M-VAC as induction therapy. Therefore, new adjunctive therapies are needed for patients with locally unresectable or metastatic urothelial cancer.

Adult↗

PubMed1995

Clinical value of argyrophilic organizer region in bladder transitional cell carcinoma.

For the purpose of elucidating whether or not argyrophilic organizer regions (AgNORs) predict the biological behaviors of bladder tumors, the AgNOR was analyzed in 80 primary bladder transitional cell carcinomas (TCCs), using the computer-assisted image analyzer. The AgNOR parameters used were the mean AgNOR count (C-AgNOR) and the percentage of cells exhibiting more than 3 AgNOR dots or 4 AgNOR dots within nuclei (3P-AgNOR and 4P-AgNOR, respectively). The correlation of C-AgNOR with 3P-AgNOR and 4P-AgNOR reached a high statistical significance (p < 0.0001, respectively). All of these three AgNOR parameters correlated with histological grade, whereas the difference between grade I and II proved to be higher in 3P-AgNOR and in 4P-AgNOR (p < 0.01, respectively) as compared with that in C-AgNOR (p < 0.05). Similarly, these three parameters correlated with histological stage, whereas the statistical significance of the correlation was less prominent in C-AgNOR. Moreover, the prognostic relevance was noted in C-AgNOR (p = 0.041), whereas it was indicative in 3P-AgNOR as well as in 4P-AgNOR (p = 0.090 and p = 0.061, respectively). These results suggest that 3P-AgNOR and 4P-AgNOR reflect the difference in the proliferative activity of individual TCCs more precisely than C-AgNOR. Since the biological behaviors of individual TCCs cannot be predicted by the proliferative activity alone, the AgNOR in TCCs has a rather limited value regarding the prediction of survival.

Adult↗

PubMed1995

Preliminary results of methotrexate, etoposide and cisplatin in the treatment of urothelial cancer.

Thirty-seven patients with urothelial cancer were given combination chemotherapy with methotrexate, etoposide and cisplatin. Thirty patients were evaluated for response. Response rates were 50% in the primary organ, 50% in the lymph nodes, 0% in lung and bone lesions. Two patients (7%) had a complete response and 12 (40%) had a partial response, for an overall response rate of 47%. The overall response rate rose to 57% in 7 patients treated with escalated doses of methotrexate and cisplatin. The median durations of response were 14 months for complete responders and 16 months for partial responders. Of the 30 evaluable patients, 16 (53%) are alive at a median survival of 30 months. The toxicity of the present regimen was acceptable. The methotrexate-etoposide-cisplatin combination chemotherapy seems to be an effective and safe regimen for urothelial cancer.

Adenocarcinoma↗

PubMed1995

A clinical study of upper urinary tract calculi treated with extracorporeal shock wave lithotripsy: association with bacteriuria before treatment.

To study the characteristics of upper urinary tract calculi associated with bacteriuria, we determined the relationships between the frequency of bacteriuria and some clinical factors such as location and size of calculi. Nine hundred and fifty-eight patients, 596 with renal calculi and 362 with ureteral calculi, were subjects in the present study. Bacteriuria was found in 75 patients, 57 with renal calculi (10%) and 18 with ureteral calculi (5%). The frequency of bacteriuria was significantly higher in patients with renal calculi than in those with ureteral stones (p < 0.05). In the patients with renal calculi, bacteriuria was most frequently associated with stones having a diameter of > 30 mm (19%), and secondarily with stones of 20-30 mm (12%). In contrast, the presence of bacteriuria was not related to the size of ureteral calculi. In conclusion, patients with renal stones of > 20 mm diameter have an increased risk of bacteriuria.

Adolescent↗

PubMed1995

Neoadjuvant chemotherapy for locally advanced urothelial cancer of the upper urinary tract.

Cisplatin-based multiple-drug chemotherapy is currently considered the most effective treatment for advanced and metastatic urothelial cancers. We treated 15 patients with locally advanced urothelial cancers of the upper urinary tract using the cisplatin-based multiple-drug regimen in a neoadjuvant setting. The regimens administered were: M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin); MEC (methotrexate, etoposide and cisplatin), or M-VEC (methotrexate, vinblastine, epirubicin and cisplatin). Total nephroureterectomy was performed in all patients and response was evaluated pathologically Of 15 patients 2 (13%) achieved a pathological complete response, 6 (40%) a pathological partial response, for an overall response rate of 53% (95% confidence limits 29-77%). The median durations of response were 54 months for patients with a pathological complete response and 15.5 months for patients with a pathological partial response. One of six patients with a pathological partial response and 4 of 7 with no remission died of cancer. While a positive relationship between the pathological response and prognosis was observed, adequate follow-up is needed to assess the ability of neoadjuvant chemotherapy to improve the prognosis of patients with locally advanced urothelial cancer of the upper urinary tract.

Adenocarcinoma↗

PubMed1995

Fever after extracorporeal shock wave lithotripsy for patients with upper urinary tract calculi associated with bacteriuria before treatment.

The present study was carried out to determine the relationship between fever (> or = 38 degrees C) after extracorporeal shock wave lithotripsy (ESWL) and the history of bacteriuria before ESWL. The subjects of this study comprised 958 patients. Significant bacteriuria before ESWL was found in 75 patients. These patients were treated with antibiotics and underwent ESWL after bacteriuria disappeared. Despite treatment with antibiotics, the patients with bacteriuria before ESWL had a significantly higher incidence of fever after ESWL than those without bacteriuria. Among the 14 patients whose high fever persisted after ESWL, the patients with bacteriuria included 7 (50%) with stones > 20 mm in size. The patients with stones > 20 mm and bacteriuria before ESWL had a high risk of persistent high fever after ESWL.

Adolescent↗

PubMed1995

[Acid phosphatase (ACP)].

The acid phosphatases are a group of enzymes capable of hydrolyzing esters of orthophosphoric acid in an acid medium. Acid phosphatase activity is widely distributed in human tissues and acid phosphatases represent a heterogeneous group of enzymes containing many isoenzymes, each specific for one type of tissue. The human prostate is particularly rich in this enzyme (PAP) and serum enzyme levels have been used as a tumor marker of prostate cancer. While PAP was markedly increased in patients with bone metastases of prostate cancer, it is unable to detect earlier stage tumors reliably. The sensitivity and specificity of serum acid phosphatases and PAP are low in diagnosing, staging and following patients with prostate cancer. Presently, prostate-specific antigen (PSA) is superior to PAP for diagnosis, screening, and monitoring prostate cancer. PAP may have an adjuvant value in the management of prostate cancer because a combination of PSA and PAP testing has revealed a high sensitivity and specificity in detecting prostate cancer.

Acid Phosphatase↗

PubMed1995

[Acid phosphatase].

Explore the source record for details and available documents.

Acid Phosphatase↗

PubMed1995

A mapping of histology and cell proliferation in human bladder cancer: an immunohistochemical study.

Transitional cell carcinoma of the urinary bladder is a multifocal disease and the whole bladder mucosa is more or less involved in the neoplastic process. A mapping study of 5 cystectomy specimens was performed, and cell proliferation was evaluated immunohistochemically using anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody. A correlation between the pathological findings and the rates of PCNA-positive cells was observed in both the tumor and the surrounding mucosa in 4 of the 5 cases. The rates of PCNA-positive cells increased in areas with normal mucosa adjacent to those with dysplasia or transitional cell carcinoma, and in areas with normal mucosa or dysplasia adjacent to those with carcinoma in situ or transitional cell carcinoma in 2 cases. These features may indicate that a field change observed in the mapping study of a bladder with cancer is a manifestation of a stepwise progression of the mucosal disease.

Aged↗

PubMed1995

Factors related to the outcome of M-VAC in 101 patients with advanced urothelial cancer.

The objective of this study is to identify factors related to the results of intravenous methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) for 101 patients with advanced urothelial cancer. The effects of various factors on response and survival were evaluated using univariate and multivariate analyses. The factors included in the analyses were sex, age, performance status (PS), primary site, histological type, grade, T category, N category, M category, prior chemotherapy, prior radiotherapy, and dose of chemotherapeutic drugs. Univariate analysis revealed that M category and prior chemotherapy had a significant correlation with the response, and that factors significantly related to survival were PS, primary site, N category, M category, prior chemotherapy and prior radiotherapy. A multiple logistic regression model showed that N category, M category and prior chemotherapy were related to response. The response rates of patients with N1-4 or M1 or prior chemotherapy were lower than those with N0 or M0 or without prior chemotherapy. A Cox regression model demonstrated that PS and M category independently contributed to survival. Patients with high grade PS or distant metastases showed a lower survival rate than those with low grade PS or localized diseases. M category was the most important factor related to response and survival. These results seem to indicate the low effectiveness of M-VAC for distant metastases, and the inability of this regimen to improve the outcome of patients with advanced urothelial cancer.

Adolescent↗

PubMed1995

Cisplatin-based neoadjuvant chemotherapy for invasive bladder cancer.

Between February 1988 and March 1993, 24 patients with locally advanced bladder cancer (stages T2-4N0-3M0) were included in this study. Combination chemotherapy consisting of methotrexate, vinblastine, epirubicin (doxorubicin) and cisplatin (M-VAC) was given to the patients in a neoadjuvant setting. The clinical stage was T2N0M0 in eight patients, T3aN0M0 in three, T3bN0M0 in seven, T4N0M0 in five and T4N3M0 in one. After chemotherapy, total cystectomy was performed in 20 patients and partial cystectomy 4. Of 24 patients, one (4%) showed a pathological complete response, and eight (33%) had a pathological partial response, for an overall response rate of 38% (95% confidence limits 20 to 57%). Nine patients who achieved a pathological response to chemotherapy had a significantly higher survival rate than the nonresponders (p <0.01). In the relationship between the clinical stage and the response to chemotherapy, clinical T2 and T3a diseases were more likely to respond to chemotherapy than clinical T3b and T4 diseases, with a response rate of 64% and 15%, respectively. While a positive relationship between the pathological response and survival was observed, adequate follow-up is needed to assess the ability of neoadjuvant chemotherapy to improve the prognosis of patients with locally advanced bladder cancer.

Adult↗

PubMed1994

High levels of nm23 expression are related to cell proliferation in human prostate cancer.

Reduced expression of the nm23 gene has been correlated with high metastatic potential in rodent mammary tumors and human breast cancer. The expression of this gene was studied in human prostate cancer tissue from 43 patients by immunohistochemistry using anti-nm23-H1 antibodies. Intense immunostaining was observed in 71.4% of the patients with clinical stage D disease as compared to 23.1% in clinical stage B and 18.7% in stage C disease (P < 0.05). Similarly intense immunostaining was present in 75% of poorly differentiated cancers versus only 28.6% in men with moderately differentiated cancer. nm23-H1 mRNA expression was measured by Northern blot analysis during phases of the cell cycle in DU 145, PC-3, LNCaP, and TSU-Prl human prostate cancer cell lines. Cells were synchronized in G0-G1 phases by serum deprivation and at the G1-S boundary by aphidicolin. nm23-H1 mRNA levels declined during serum deprivation and increased rapidly following serum addition. Although nm23-H1 was expressed continuously throughout the cell cycle, higher expression was observed in late G1, early S, and G2-M phases. These results indicate that nm23-H1 gene expression is related to the proliferative phase of cell growth.

Adenocarcinoma↗