Biomedical subjects

M Noguchi

Publications and source records attributed to M Noguchi.

At least 325 records · Page 18Linked to original sources

PubMed1994

Reappraisal of internal mammary lymph node dissection in selected patients with invasive breast cancer.

We performed a new type of en bloc extended radical mastectomy (EXT) as a clinical trial in 118 patients from 1980 through 1985. A variety of conventional radical mastectomies (RDL) were also undertaken in 105 patients from 1973 through 1985. In this retrospective study, univariate and multivariate analyses were performed to compare the results of EXT and RDL. The univariate analysis showed that the 10-year survival rates for the EXT and the RDL groups were 86% +/- 3.3% and 77% +/- 4.2%, respectively (P = 0.073 with the Cox-Mantel test). For the subgroups stratified according to the status of axillary lymph node involvement, the EXT was significantly better in patients with one to three metastatic axillary lymph nodes (P = 0.016). The adjusted Cox regression analysis revealed that the favorable results of EXT were most encouraging in the patients with one to three metastatic axillary lymph nodes (P = 0.058). Therefore, it is suggested that an EXT may be more advantageous than RDL in selected patients with resectable invasive breast cancer.

Axilla↗

PubMed1994

The prognostic significance of epidermal growth factor receptor expression in breast cancer.

The association between epidermal growth factor receptor (EGFR) expression, clinicopathological variables, silver-stained nuclear organizer region (Ag-NOR) counts, and patient survival was determined in 93 patients with operable breast cancer. The EGFR expression was found to be significantly associated with the presence and number of axillary lymph node metastases (P = 0.0429), but not with age, menopausal status, tumor size, histologic type or grade, or Ag-NOR counts. In a univariate analysis, a significant difference was also observed in the survival of patients stratified by tumor size (P = 0.0091), histologic grade (P = 0.0352), axillary lymph node metastases (P = 0.0001), and EGFR expression (P = 0.0263). However, a multivariate analysis revealed that axillary lymph node metastases was the only strong independent predictor of survival (P < 0.0001). When axillary lymph node metastases were excluded from the Cox model, the EGFR expression tended to be an independent prognostic factor (P = 0.0558). The results of this study thus indicate that the prognostic value of EGFR expression is limited because the EGFR expression is significantly associated with axillary lymph node metastases.

Adult↗

PubMed1994

The relationship of p53 protein and lymph node metastases in invasive breast cancer.

The p53 expression in invasive breast cancers from 106 patients was correlated with clinicopathological variables to ascertain its usefulness for estimating prognosis. The p53 expression was significantly associated with the number of axillary lymph node metastases and the presence of internal mammary lymph node metastases; however, it was not associated with age, menopausal status, histologic type, or tumor size. Although p53 expression was a significant prognostic factor according to univariate analysis, it did not appear to be an independent prognostic factor according to multivariate analysis. Thus, the prognostic power of p53 expression is likely to be weak and therefore probably of limited clinical value. Nevertheless, the number of patients in our study was small, and we believe that an investigation of a larger series of patients is indicated.

Adult↗

PubMed1994

Presacral epidermal cyst found in an adult male with a high CEA content: report of an unusual case.

A 63-year-old Japanese man presented with constipation, having noticed flat stools for several years. Digital examination of the rectum, followed by barium enema, colono-fiberscopy, computed tomography (CT), and magnetic resonance imaging (MRI) revealed an oval mass located between the retrorectal and presacral space without any mucosal lesion. This mass had narrowed the rectal lumen by compressing the rectum anteriorly. Although the plasma levels of the tumor markers were within the normal range, those of the tumor contents were elevated with a carcinoembryonic antigen (CEA) of 118 ng/mL, while the alpha-fetoprotein (AFP) value was 1 ng/mL. The tumor was completely extirpated through an abdominal incision, and there has been no evidence of recurrence thus far. Histological examination showed that the tumor wall was made of keratinized stratified squamous epithelium without any cutaneous adnexal structure, and hence it was diagnosed as an epidermal cyst. CEA was identified in these benign epithelial cells by immunoperoxidase staining using a monoclonal antibody. To the best of our knowledge, there have been only four other cases with a presacral epidermal cyst documented in the Japanese literature, all of whom were female. Our patient is the first reported case of an adult male with a presacral epidermal cyst.

Carcinoembryonic Antigen↗

PubMed1994

Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis.

We report two cases of urogenital malignancies, prostatic cancer in a 72-year-old man and urinary bladder carcinoma in a 50-year-old man, that developed during maintenance haemodialysis. The former patient responded to hormonal therapy with diethylstilboestrol and is still alive on maintenance haemodialysis, but the latter patient did not respond to treatment, being past cure in the far advanced stage. There are few clinical symptoms suggesting the existence of urogenital malignancies in dialysis patients and screening methods such as urine cytology or roentgenology must be restricted because of extremely reduced urine volume. However, the high incidence of urogenital malignancies in such patients is well recognized. Screening examinations with ultrasonography and/or CT scan following digital rectal examination or testing for serum prostate-specific antigen should be performed at least every 6 months.

Aged↗

PubMed1994

Radioimmunodetection of cancer of gastrointestinal tract and liver metastasis with I-131 anti-CEA and I-131 anti-CA19-9 monoclonal antibody cocktail (IMACIS-1).

We evaluated the intravenous infusion of a cocktail of I-131 anti-CEA and anti-CA19-9 monoclonal antibody F(ab')2 (IMACIS-1) in patients with gastrointestinal neoplasm and liver metastases in order to assess its efficacy in detecting the presence of cancer. Seven patients with primary or recurrent gastrointestinal cancer in whom liver metastases were also detected were studied. Accumulation of radioactivity in the primary tumor was seen in only one patient. Visualization of the liver metastases was achieved in all patients. Thus detection of liver metastasis was better than in primary or recurrent tumors. While tumor visualization was most often seen in the 3 day image, optimal visualization of the tumor was seen at 5-7 days. There was no correlation between the serum concentration of CEA or CA19-9 and the visualization of tumors. Serum kinetics of I-131 IMACIS-1 showed biexponential components with a 1st phase T1/2 of 5.0 hours and 2nd phase T1/2 of 34.7 hours. The mean whole body (I-131) half-life determined from the whole-body scans was 1.95 days. The mean urinary excretion of I-131 in 7 days was 85%. This value agreed closely with total radioactivity retention detected by scanning. This series of studies demonstrated the potential utility of a cocktail of antibodies consisting of an anti-CEA and an anti-CA19-9 monoclonal F(ab')2.

Aged↗

PubMed1994

Simple surgical correction of Stahl's ear.

We describe a simple method of correction of the Stahl's ear deformity. The deformed portion of the auricular cartilage is cut into tiny pieces and put back into the abnormal area. The helix and the scapha are then moulded into a normal ear shape and maintained in position with a tie-over bolster. A gutta-percha splint is used for a further month. Over a 3-year period, 6 Stahl's ear deformities in 5 patients were treated with this procedure. All patients were followed up for at least 1 year. We believe that this procedure can be applied to other partial auricular deformities as well.

Adolescent↗

PubMed1994

Columnar cell carcinoma of the thyroid gland: a case report and review of the literature.

A rare case of columnar cell carcinoma of the thyroid gland is reported. The tumor was characterized by a predominantly papillary proliferation of tall columnar cells with marked nuclear stratification with associated focal areas showing solid or microfollicular growth. The nuclei of the tumor cells did not have the ground-glass appearance that characterizes papillary thyroid carcinoma; rather their nuclear features resembled follicular carcinoma. The tumor was found in an advanced stage and the patient died of lung metastases 2.5 years after surgery. The unique histopathological features and highly aggressive nature of columnar cell carcinoma require that this variant be differentiated from common papillary carcinoma of the thyroid. We also reviewed the literature emphasizing the lethal biological nature of this variant.

Carcinoma↗

PubMed1994

Hypotensive effects of lithospermic acid B isolated from the extract of Salviae miltiorrhizae Radix in the rat.

1. The in vivo and in vitro effects of lithospermic acid B (LSA-B), which was extracted from Salviae miltiorrhizae Radix, on vascular relaxation responses were examined in rats. 2. Intravenous injection of LSA-B (10-30 mg/kg) decreased the blood pressure in a dose-dependent manner. 3. In perfused mesenteric arterial bed precontracted with methoxamine (10(-5) M), LSA-B (10(-5) - 10(-3) M) produced a concentration-dependent relaxation. 4. Vasodilator response of the mesentery in response to LSA-B was reversed by 10(-4) M NG-monomethyl-L-arginine (L-NMMA). 5. The inhibition of vasodilation by L-NMMA was reversed by L-arginine (3 x 10(-4) M). 6. These results suggest that LSA-B-induced hypotensive effect may be due to the endothelium-dependent vasodilation of resistance artery such as mesenteric arterial bed.

Anesthesia↗

PubMed1994

Sarcoidosis of the thyroid gland manifested initially as thyroid tumor.

A rare case of a patients with sarcoidosis of the thyroid gland, who was preoperatively diagnosed as having thyroid carcinoma and who had no other clinical features of sarcoidosis, is reported. Thyroidectomy specimen revealed numerous noncaseating, epithelioid granulomas in the thyroid tissue. Mycobacteria, fungi and foreign body material were not identified. Similar granulomas were also found in the lymph nodes and muscular tissue adjacent to the thyroid gland and parathyroid gland After the diagnosis of sarcoidosis of the thyroid, systemic examination failed to reveal any involvement in other sites, including lung, eye and skin. This case demonstrated that sarcoidosis can manifest initially as a thyroid tumor with no other evidence of disease.

Aged↗

PubMed1994

Antigen-specific human monoclonal antibodies from mice engineered with human Ig heavy and light chain YACs.

We describe a strategy for producing human monoclonal antibodies in mice by introducing large segments of the human heavy and kappa light chain loci contained on yeast artificial chromosomes into the mouse germline. Such mice produce a diverse repertoire of human heavy and light chains, and upon immunization with tetanus toxin have been used to derive antigen-specific, fully human monoclonal antibodies. Breeding such animals with mice engineered by gene targeting to be deficient in mouse immunoglobulin (Ig) production has led to a mouse strain in which high levels of antibodies are produced, mostly comprised of both human heavy and light chains. These strains should provide insight into the adoptive human antibody response and permit the development of fully human monoclonal antibodies with therapeutic potential.

Adult↗

PubMed1994

Iron and erythropoietin measurement in autologous blood donors with anemia: implications for management.

BACKGROUND: The importance of autologous blood donation for elective surgery is recognized, and the method is being used at many hospitals. Not all patients are able to deposit a sufficient amount of blood before surgery because they cannot recover rapidly enough from phlebotomy-induced anemia. The ability to donate sufficient blood for autologous use was studied in patients who are particularly susceptible to phlebotomy-induced anemia. STUDY DESIGN AND METHODS: Of 840 patients who donated blood for autologous use in elective surgery from November 1987 through May 1993, 20 with rheumatoid arthritis, 24 with iron deficiency anemia, and 37 aged 65 years and above with normocytic anemia were compared with 24 nonanemic elderly patients who donated a total of 1000 mL of blood for autologous use. Patients received iron sulfate orally and donated blood once a week until operation. RESULTS: The amount of blood collected before surgery per control patient was more than that in others. Consequently, there was a tendency to allogeneic blood transfusion in patients with rheumatoid arthritis or elderly patients. The ferritin levels in controls and in patients with iron deficiency anemia during the donation period were almost within the normal range in spite of iron supplementation, which implied a good utilization of iron sulfate for erythropoiesis. On the other hand, the rise in ferritin levels in the elderly and in patients with rheumatoid arthritis suggested inappropriate iron availability for erythropoiesis and resulted in an increase in iron storage. Since an adequate endogenous erythropoietin response to phlebotomy-induced anemia was not observed in these patients, impaired erythropoietin production was considered one of the reasons for anemia. CONCLUSION: Patients with iron deficiency anemia are able to continue donating blood for autologous use so long as they have sufficient iron supplementation. However, the elderly or those with rheumatoid arthritis occasionally fail to donate a sufficient volume of blood before surgery as a result of phlebotomy-induced anemia, which is caused in turn by impaired erythropoietin production.

Adult↗

PubMed1994

Antinociceptive mechanism of the aconitine alkaloids mesaconitine and benzoylmesaconine.

We explored the possible role of the specific regions in the brain stem on the antinociceptive actions of mesaconitine (MA) and benzoylmesaconine (BM) by the microinjection of MA and BM into nucleus reticularis paragigantocellularis (NRPG), nucleus raphe magnus (NRM), and periaqueductal gray (PAG). MA microinjected into NRPG, NRM, or PAG elicited a dose-dependent antinociceptive action, whereas BM injected into NRM or PAG elicited a dose-dependent antinociceptive action but not in NRPG. The NRM appeared to be the most sensitive region among the three tested locations.

Aconitine↗

PubMed1994

Autonomously functioning (hot) nodule of the thyroid gland. A clinical and histopathologic study of 17 cases.

The authors present the clinical and pathologic findings of 17 patients with autonomously functioning (hot) nodule of the thyroid (AFNT). The patients were 13 to 68 years of age, and 12 were female. Five had obvious laboratory findings of hyperthyroidism, but the other 12 were euthyroid. Fifteen patients had solitary or multiple benign nodules. The remaining two had autonomously functioning carcinomas; one of these patients had a papillary carcinoma with no distant metastases, and the other had a follicular carcinoma with widespread metastases. Total thyroidectomy was performed in one patient, subtotal thyroidectomy was performed in four, and hemithyroidectomy in eight. Diagnostic large needle biopsy was performed in only four patients. Of the 13 patients undergoing thyroidectomy, 3 had multiple hot nodules, and 10 had a solitary hot nodule. The size of the nodules ranged from very small to 6 cm, with no definite correlation found between the size of the nodule and thyroid function. Pathologically, cystic change and hemorrhage to various degrees were common features of AFNT. On histologic examination of the nodules, 13 were diagnosed as follicular adenoma (6 predominantly macrofollicular; 4 mixed micro-, normo-, and macrofollicular; and 3 predominantly papillary) and 2 as adenomatous goiter (1 predominantly papillary and 1 predominantly macrofollicular). The remaining two were diagnosed as carcinoma (1 follicular variant of papillary carcinoma and 1 follicular carcinoma). Two children had benign nodules showing a predominantly papillary architecture. Microcarcinoma outside the nodules was found in two patients, and both microcarcinomas were a papillary type. The AFNTs showed characteristic pathologic findings, and the pathologic differentiation of AFNTs from usually observed nonfunctioning (cold) nodules was not difficult. Pathologists should pay particular attention to AFNTs showing a papillary architecture, because these papillary lesions are sometimes mistaken for papillary thyroid carcinoma.

Adenocarcinoma, Follicular↗

PubMed1994

Solid cell nests of the thyroid. A histologic and immunohistochemical study.

A histologic and immunohistochemical study was performed to identify the histogenesis of solid cell nests (SCN), which were found incidentally in 11 thyroid glands obtained by surgery. Histologically, SCN consisted of small nests showing solid and cystic structures. Cystic features of SCN were found in 3 of the 11 cases (27%), with mucinous materials in their lumens. Some goblet cells were also present in three cases (27%). In one case, SCN were associated with lymphocyte aggregation. Immunohistochemical analysis using serial sections of the SCN showed that the cells comprising SCN were positive for calcitonin in 5 cases (45%), for carcinoembryonic antigen (CEA) detected using polyclonal antibody in 11 (100%), for CEA detected using monoclonal antibody in 3 (27%), for calcitonin gene related peptide in 2 (18%), for chromogranin A in 5 (45%), and for keratin in 11 (100%). These antigens were expressed concomitantly in the same SCN, but the number and distribution of the positive cells for the antigens were different for each antigen in the same SCN in each case. These findings strongly support the view that SCN are derived from the ultimobranchial body. In addition, the biologic function to produce the antigens may vary greatly in individual cells comprising SCN.

Adenoma↗

PubMed1994

Surgically curable "early" adenocarcinoma in the periphery of the lung.

To define surgically curable "early" adenocarcinoma in the periphery of the lung, we examined histopathologic prognostic factors in 56 cases of stage I mucinous, nonmucinous, and sclerosing bronchioloalveolar carcinomas less than 2 cm in diameter. The death rate 5 years after surgery was only 1.8%, but the recurrence rate within 5 years after surgery was 8.9%. In addition, there were two cases of recurrence more than 5 years after surgery. Vascular invasion (p < 0.05) and mitotic index (p < 0.01) were the most important determinants of prognosis, and there was no recurrence or death in cases showing grades 1 and 2 collagenization in fibrotic foci. These results indicate surgically curable stage I adenocarcinomas to be less than 2 cm in diameter and without vascular invasion, with a low mitotic index and grade 1 or 2 fibrotic scarring, although the significance of nuclear atypia as a prognostic factor remains to be clarified. It may be possible to improve the cure rate by postoperative adjuvant chemotherapy for "early" adenocarcinoma with vascular invasion, high mitotic index, higher scar grade, and probably a high degree of nuclear atypia.

Adenocarcinoma↗

PubMed1994

Reconstruction of stenotic external auditory canal with a postauricular chondrocutaneous flap.

A case of stenosis of the external auditory canal secondary to a burn injury was reconstructed with a chondrocutaneous postauricular flap. Advantages of this technique include the use of a single flap to reconstruct the whole circumference of the canal, the fact that a chondrocutaneous flap is more likely to prevent restenosis than a skin flap alone, and the fact that reconstruction with an axial-pattern flap is more reliable than reconstruction with a random-pattern flap.

Burns↗

PubMed1994

Autologous blood donation elective surgery in children.

Studies were made on 59 children (cardiac 42, orthopaedic 13, miscellaneous 4) scheduled for autologous blood donation before elective surgery. The donor-patients' ages ranged from 3 to 15 years (mean 9.9 years) and their weights from 13 to 70 kg (mean 34 kg). All patients received 50-100 mg of oral iron sulphate per day. As a rule, about 10% of intravascular blood volume was drawn once a week. Before surgery, an average of 720 ml of autologous blood per patient was prepared. Two patients failed to donate autologous blood because of anxiety about the procedure; however, none of the donors was deferred due anaemia associated with the phlebotomy. Of the 53 patients undergoing surgery and participating in autologous predonation, 50 (94%) were able to avoid homologous blood transfusion. 600 ml of homologous blood were transfused to each of 2 orthopaedic patients and 400 ml to 1 cardiac patient. We conclude that a predeposit autologous transfusion programme is logistically possible in small children when the patients are cooperative.

Adolescent↗