This paper examines the applicability of psychosocial group intervention for Japanese patients with primary breast cancer. The study included two phases. First, we examined the applicability for Japanese patients of an intervention model developed in a Western country. The model, based on the work of Fawzy and Fawzy (1994) on a structured psychosocial group intervention for cancer patients, is a series of six 1.5-h sessions that incorporate health education, coping-skills training, relaxation training and psychological support. Second, we formulated a Japanese version of the intervention model by modifying areas identified as inappropriate by participants in the first-phase study. We then evaluated this by conducting sessions of the modified model with 44 additional breast cancer patients. Of the ten participants in the first-phase pilot study, three (30%) dropped out and several inappropriate areas were reported. The areas requiring significant change were the provision of medical information and communication style with family members and doctors. No participants dropped out of the modified version, and very few found any program areas to be inappropriate. The findings suggests that psychosocial group intervention is applicable for Japanese breast cancer patients when the model accounts for cultural differences.

Adaptation, Psychological↗

PubMedDate not supplied

Participation in psychosocial group intervention among Japanese women with primary breast cancer and its associated factors.

Though psychosocial group intervention is considered in the West to be an important source of support for reducing psychosocial distress in cancer patients, in Asian countries, there has been no research as yet on the needs for such intervention. This study investigated the level of participation and interest in psychosocial group intervention plus any associated factors in 151 primary breast cancer patients. All were less than 65 years old at 4-18 months post-surgery. Of the 126 subjects who responded (response rate 83%), 53 (42%) participated (participants) and 73 (58%) did not (non-participants). Participation was greater among those with a high level of anxiety measured by the Hospital Anxiety and Depression Scale (HADS) (odds ratio [OR], 3.25; 95% confidence interval [CI], 1.07-10.42), those who had undergone surgery within the last 12 months (OR, 3.10; 95% CI, 1.35-7.55), and those who were 50-65 years old (OR, 3.08; 95% CI, 1.33-7.66). Among the non-participants, 53 (73%) were interested in the intervention while 20 (27%) were not. Non-participants without any interest in the psychosocial group intervention had significantly higher anxiety levels than those with interest (t=-2.08; df=71; p=0.03). These results suggest that most Japanese breast cancer patients who need psychological support can be sought out by asking whether they are willing to participate in a psychosocial group intervention. However, the minority not interested in any psychological group intervention might need other supports such as medication or individual psychotherapy.

Aged↗

PubMedDate not supplied

Digital TV tomography: description and physical assessment.

A digital TV tomography system, capable of retrospective reconstruction of multiple digital tomographic images, has been developed and its basic physical characteristics have been evaluated. The multiple tomographic images were formed through retrospective reconstruction of digital data acquired on a linear tomographic x-ray unit and an image intensifier-television system. Digital data were obtained with a series of 30 pulsed exposures during linear motion of the system. A distortion correction algorithm for the convex surface of the image intensifier was developed in order to reduce image distortion. A phantom study showed that the square-wave response at the fulcrum plane was slightly inferior to that in conventional tomography. There was also a slight decrease in the square-wave response away from the fulcrum plane and upon application of a correction algorithm, as compared with the response of the original reconstructed image at the fulcrum plane. The exposure dose for a single image was approximately half that in conventional tomography. Because of many advantages, including low exposure, short examination time, digital image manipulation, and applicability to picture archiving and communication systems, this is likely to become an important method in radiology when further technical refinements have been made.

Angiography, Digital Subtraction↗

PubMedDate not supplied

Cytologic diagnosis of signet-ring cell carcinoma of the breast.

OBJECTIVE: To examine the cytologic features of signet-ring cell carcinoma (SRCC), defined as carcinoma dominated by signet-ring cells, of the breast and to discuss problems that occur in cytodiagnosis. STUDY DESIGN: Five cases of SRCC of the breast were examined cytopathologically. Signet-ring cells were subclassified into intracytoplasmic lumina (ICL) type and non-ICL type. ICL type had large ICL containing mucin. Non-ICL-type cells had wide, amorphous cytoplasm diffusely dispersed with mucin. RESULTS: In cases 1 and 2, fine needle aspiration biopsy (FNAB) revealed many signet-ring cells (non-ICL type), suggesting SRCC. Histologic diagnoses were ductal SRCC containing many signet-ring cells (non-ICL type). In cases 3 and 4, signet-ring cells (ICL type) were found sporadically among carcinoma cells without signet-ring features. Signet-ring cells were not regarded as the major component of the cells; thus, the cytologic diagnoses were lobular carcinoma, not otherwise specified. Pathologic diagnoses were lobular SRCC. Signet-ring cells were mostly ICL type. In case 5, most carcinoma cells on the smears showed signet-ring features (non-ICL type), suggesting SRCC. The histologic diagnosis was lobular SRCC, and signet-ring cells were mostly non-ICL type. CONCLUSION: Ductal SRCC yielded more cellular smears as compared with lobular SRCC; therefore, cytologic diagnosis was easier in the former.

Adult↗

PubMedDate not supplied

Dysplastic glioneuronal lesion arising in the cerebellum: a clinicopathological, immunohistochemical and ultrastructural study.

We describe a case of dysplastic glioneuronal lesion in the right cerebellar hemisphere. A 13-year-old boy presented with headache since 1998. He had no neurological deficits. The computerized tomograph (CT) scan showed prominent calcification, and magnetic resonance imaging (MRI) revealed a non-enhancing mass of 15 x 15 x 5 cm in the right cerebellar hemisphere. The mass had low intensity in T1- and high intensity in T2-weighted images. Histologically, the lesion was composed of poorly defined small to intermediate sized cells arranged in fibrillar background. Although few neuronal cells having large nuclei with small nucleoli were present, no ganglion cells could be seen. Immunohistochemically, these poorly defined cells were non-reactive to various glial and neuronal markers. However, GFAP, synaptophysin, neurofilament and vimentin-reactive intercellular matrix and few nonneoplastic GFAP-positive glial cells and neurofilament-positive neuronal cells were seen. A very low MIB-1-labelling index of less than 0.1% was noted. Ultrastructurally, two different populations of the cells were seen. A few neuronal cells were larger and had an oval nucleus with small nucleolus and cytoplasm containing various cytoplasmic organelles, Golgi apparatus, mitochondria, ribosomes, lipofuscin, rough endoplasmic reticulum, microtubules and neurofilaments. Many other cells had a scant cytoplasm and thus poorly defined. Cytoplasmic processes with axono-dendritic synapses and foci of bundles of intermediate filaments were present in the intercellular areas of the lesion. Based on these radiological, histological and ultrastructural findings of the lesion of low proliferative potential, we considered it dysplastic in nature.

Adolescent↗

PubMedDate not supplied

The expression of cell cycle regulatory proteins in oligodendroglial tumors.

Oligodendroglial tumors are mainly classified histologically into 2 types of tumors--oligodendrogliomas and oligoastrocytomas--whether the tumor includes astrocytic component or not, and these are, respectively, divided histologically into 2 different malignant groups, low-grade (WHO grade II) and high-grade or anaplastic (WHO grade III). In this study, we investigated the expression of the cell cycle-related proteins and analyzed the relationship between the labeling index (LI: the percentage of positive nuclei) of these proteins and 2 histopathological phenotypes, grade and prognosis. Forty-four specimens were examined, including 11 oligodendorogliomas (0), 5 oligoastrocytomas (OA), 18 anaplastic oligodendrogliomas (aO) and 10 anaplastic oligoastrocytomas (aOA), according to the WHO classification. Of these, 19 specimens were obtained from recurrent tumors of 8 cases. The mean LI of all the investigated proteins between O and OA, and aO and aOA showed no significant differences. The mean MIB-1 LI, pRb LI, p53 LI and p14 LI of GIII were significantly higher than GII, while the mean p27 LI of GIII was significantly lower than GII. In the recurrent cases, we noted correlations between the disease-free period and MIB-1 LI (inverse), p27 LI and p14 (inverse). Significant correlations were noted between MIB-1 LI and pRb LI, MIB-1 LI and cycD1 LI, MIB-1 LI and p27 LI (inverse), pRb LI and cycD1 LI, cycD1 LI and cdk4 LI and pRb LI and p27 LI (inverse) in the pRb/cycD1-cdk4/p27 pathway, and between MIB-1 LI and p53 LI, MIB-1 LI and p14 LI, p53 LI and p14 LI, p53 LI and MDM2 LI and MDM2 LI and p14 LI in the p53/MDM2/p14 pathway. In conclusion, both pRb/cycD1-cdk4/p27 and p53/N4DM2/p14 pathways correlate with malignant progression, and MIB-1 LI, pRb LI, p27 LI, p53 LI and p14 LI reflect the histopathological malignancy of oligodendroglial tumors. MIB-1 LI, pRb LI and p27 LI are especially useful as indicators of malignancy of oligodendroglial tumors.

Adolescent↗

PubMedDate not supplied

Cerebrospinal fluid cytology in immature teratoma of the central nervous system. A case report.

The present case shows the usefulness of cerebrospinal fluid (CSF) cytology in the diagnosis of leptomeningeal dissemination by immature teratoma. The tumor arose in the thoracolumbar spinal cord of a 14-year-old male. The initial histopathologic diagnosis was made on the tumor tissue taken at laminectomy. Postoperatively, CSF cytology revealed epithelial cell clusters, scattered squamous epithelial cells and small bundles of striated muscle fibers in the background of many histiocytes and inflammatory cells. Although these cells showed only slight cytologic atypia, their presence in the subarachnoid space suggested the leptomeningeal spread of well-differentiated portions of the immature teratoma. The postmortem examination revealed the primary tumor in the spinal cord and multiple metastatic nodules in the brain.

Adolescent↗

PubMedDate not supplied

Clinical evaluation of digital TV tomography.

A unit for digital TV tomography (DTT) was constructed on the basis of retrospective reconstruction of digital data acquired during a linear tomographic motion of an X-ray tube and an image intensifier with a television camera (I.I.-TV) assembly. Following descriptions of the basic principle and system, clinical results obtained with this unit are presented. Comparison with conventional tomography of the chest, skull, abdomen, and bones and joints showed equal diagnostic information in more than 50% of cases. Application to intra-arterial and intravenous DSA provided excellent images, but no new information was obtained. DTT has the advantages of technical simplicity, short examination time, low exposure dose, and compatibility with a PACS system. This technique will become an important part of a modern radiology department.

Aged↗

PubMedDate not supplied

Cytologic features of peripheral squamous cell carcinoma of the lung.

Cytologic features of 32 peripheral squamous cell carcinomas of the lung were reviewed. Fine needle aspiration biopsy and curettage showed most of the tumor cells to be arranged in irregular cell fragments consisting of relatively small cells with scanty cytoplasm. They possessed round to oval nuclei with coarsely granular chromatin, and some had large, prominent nucleoli. Keratinization was usually observed in small numbers of scattered cells, and a nuclear streaming arrangement was noted in some areas. When both keratinization and streaming arrangements were absent, correct subtyping was impossible (12 cases). These cytologic features were different from those of 31 hilar squamous cell carcinomas studied as controls; there many carcinoma cells showed keratinization, and small carcinoma cells were infrequent. However, in all cases, sputum cytology was correctly interpreted because squamous differentiation was easily recognized.

Adenocarcinoma↗