[Round table discussion: significance of patient guidance in nursing].
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Biomedical subjects
Publications and source records attributed to M Noguchi.
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Biopsied specimens from 55 patients with squamous cell carcinoma (SCC) of the oral cavity were examined immunohistopathologically as to the clinical significance of basement membrane (BM) deposition and T-cell infiltration at the tumor-stromal border using monoclonal anti-laminin and anti-CD3 antibodies. According to the immunoreactivity, all specimens could be divided into three groups: group A, a continuous linear pattern of positive staining for BM around tumor nests; group B, an alteration of BM deposition around tumor nests with T cell infiltration into those tumor nests; and group C, an alteration of BM deposition around tumor nests without T cell infiltration into those tumor nests. These groups were correlated with clinical manifestations, such as tumor size, tumor regression rate with induction chemotherapy, and regional lymph node metastatic rate. In these groups, tumors classified as group C showed a trend toward resistance to chemotherapy and high metastatic characteristics. Tumors classified as group B, which showed the same alteration of BM deposition as a result of T cell infiltration into the tumor nests, showed a sufficient tumor regression rate with chemotherapy. The visualization of the staining for BM laminin and T cells in oral SCC appeared not only to increase our understanding of the biologic and clinical behavior of individual tumors, but could be a prognostic indicator.
Bilateral nasolabial flaps pedicled on the infraorbital vessels, and costal cartilage grafts were used to reconstruct a severe nasal deformity caused by Wegener's granuloma. We believe this flap is another useful method for nasal reconstruction, when nasolabial flaps pedicled on the angular vessels cannot be used.
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Two patients and a healthy blood donor were found to be Lan negative and to have anti-Lan in their sera. These are the first three examples of the Lan-negative phenotype to be described in Japanese. The families of two of the propositi were studied: the parents of both were first cousins and one of the propositi had a Lan-negative sibling. No Lan-negative examples were found in 15,000 Japanese donors screened with anti-Lan.
The electron-microscopic features of a thyroid follicular adenoma with clear cell change is described. The tumor was 7 mm in size and located in the upper portion of the left lobe of the thyroid of a 29-year-old Japanese female. Its cut surface was pale brown in color and well demarcated. The lesion consisted of solid nests with pinpoint lumina. The cytoplasm of the tumor cells was completely clear, but slightly vesicular without oncocytic change. Electron-microscopic examination revealed that the cytoplasm of the tumor cells was filled with numerous empty vacuoles. The vacuoles consisted of dilated membranous structures, indicating that they had been formed from rough endoplasmic reticulum and Golgi apparatus. There was no accumulation of glycogen, mucin, or lipid. The dilated membranous structures in the cytoplasm may be related to the increased thyroglobulin synthesis by the tumor.
We report a case with intravenous leiomyomatosis of uterus that showed characteristic appearances on MR. Magnetic resonance demonstrated a tangle of distended and folded tubular structures, well enhanced by Gd-diethylenetriamine pentaacetic acid. It was confirmed by surgery that these tubular structures reflected the vessels markedly dilated by intravascular tumor.
OBJECTIVE: The purpose of our study was to determine the cause of a unique deformity of the uterus, in which the cervix is elongated and appears fixed to the anterior abdominal wall. MATERIALS AND METHODS: Imaging from 2,558 consecutive MR studies of the pelvis of women were retrospectively reviewed for the simultaneous presence of elongation of the uterine cervix, angulation of the uterine isthmus just beneath the anterior abdominal wall, and vertical orientation of the long axis of the uterine corpus. RESULTS: Fourteen cases exhibited the uterine deformity; 13 of these cases had histories of cesarean section (CS) performed from 9 to 33 years (mean 18.2 years) previous to MRI. Among them, six patients had a history of multiple CS. The remaining case had a history of enucleation at 13 weeks' gestation of uterine leiomyoma, located at the anterior wall of the lower uterine segment. Thirteen patients had not become pregnant after the last CS (no. = 12) or the myomectomy (no. = 1). CONCLUSION: This unique uterine deformity strongly indicates a history of incision in the lower uterine segment especially at late gestational age. Since all but one patient with this deformity did not become pregnant after the last surgery, this deformity may be one reason for infertility after CS.
An asymptomatic 59-year-old man was admitted with an initial suspicion of mediastinal tumor. He was diagnosed as having a left-sided cervical aortic arch (Haughton type D) with arch aneurysm by using contrast-enhanced CT and angiography. The arch aneurysm was surgically removed. This is the 20th reported case of cervical aortic arch with aneurysm formation.
Endometrial in situ extension of cervical cancer is extremely uncommon. Previous reports only present the cases of squamous cell carcinoma or related category. This report presented adenosquamous carcinoma of the uterine cervix that showed a paradoxical extension of each component in a 72-year-old patient. Main tumor in the cervix was revealed to be adenosquamous carcinoma. The glandular component extended to the vagina, while the squamous component grew into the entire uterine cavity and replaced the glandular epithelium. We presented the first case of adenosquamous carcinoma of the uterine cervix with vaginal and endometrial extension. Furthermore, the endometrium was replaced with squamous component, while the vagina was invaded by glandular component. The observed paradoxical extension of the present case was extremely rare.
We investigated the effects of piroxicam, a cyclooxygenase inhibitor, and esculetin, a lipoxygenase inhibitor, on 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary carcinogenesis in female rats. Seven days after receiving a 5-mg dose of DMBA, rats were fed either a high-fat (20% soybean oil) or low-fat (0.5% soybean oil) diet. One third of the rats received diets containing 0.01% piroxicam and one third received diets containing 0.03% esculetin. Esculetin significantly inhibited mammary tumorigenesis and tumor proliferation in the rats fed the high-fat and the low-fat diets. Piroxicam had no inhibitory effect. Our findings indicate that DMBA-induced mammary tumorigenesis is affected by lipoxygenase products rather than by cyclooxygenase products.
We investigated the effects of cyclooxygenase and lipoxygenase inhibitors on a human breast cancer cell line (MDA-MB-231) in culture. Indomethacin (INDO), piroxicam, esculetin, and nordihydroguaiaretic acid (NDGA) significantly suppressed cell growth, although piroxicam caused significant suppression only at high concentrations. Esculetin and NDGA caused significantly reduced secretion of leukotriene B (LTB), while INDO and piroxicam caused significantly reduced secretion of prostaglandin E (PGE). Consequently, cell growth was significantly correlated with the LTB concentration when the cells were treated with esculetin or NDGA, whereas it was significantly correlated with the PGE concentration when they were treated with INDO or piroxicam. Therefore, MDA-MB-231 cell growth in vitro was independently associated with both the PG and LTB concentrations.
We have reviewed the literature concerning the role of fatty acids and eicosanoid synthesis inhibitors in breast carcinoma. The omega-6 polyunsaturated fatty acids (PUFAs), primarily linoleic acid, promote breast cancer tumorigenesis and tumor cell proliferation directly and indirectly via increased synthesis of cyclooxygenase- and lipoxygenase-catalyzed products. The omega-3 PUFAs, primarily docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), suppress breast carcinoma tumorigenesis and tumor cell proliferation, although the effect of DHA may be partly ascribed to increased amounts of EPA derived from DHA. Both cyclooxygenase and lipoxygenase inhibitors suppress tumorigenesis and/or tumor proliferation, with the latter being more active. Thus, arachidonic acid-derived eicosanoids play an important role in breast cancer, and the balance of the various eicosanoids may be a critical determinant of cell proliferation. However, the exact mechanism by which fatty acids and eicosanoid synthesis inhibitors exert stimulatory and inhibitory effects on breast carcinoma is still not well understood.