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Biomedical subjects

S Kodaira

Publications and source records attributed to S Kodaira.

At least 55 records · Page 3Linked to original sources
PubMed1997

Laparoscopic adrenalectomy in asymptomatic pheochromocytoma.

A patient with asymptomatic pheochromocytoma associated with catecholamine hypersecretion but no hypertension was treated by right laparoscopic adrenalectomy. The 63-year-old male patient was referred to us for treatment of an incidentaloma. The diameter of the adrenal tumor was 50 mm, and the peripheral blood nonrepinephrine level was 1.12 ng/ml (normal level, 0.4 ng/ml). Blood pressure was normal. A flexible electron laparoscope was used for open laparoscopy, and four trocars were inserted. The retroperitoneum was incised to the right of the inferior vena cava, and the tumor was excised. During the operation, blood pressure rose transiently, and a blocker and nitroglycerin were administered. The tumor bled extremely easily. The duration of surgery was 3 hours and 20 minutes, and blood loss was 210 ml. The excised tumor was 55 mm in diameter. The patients's postoperative course was uneventful. If the size of asymptomatic pheochromocytoma is not large, and blood pressure and cardiac function are stable, laparoscopic adrenalectomy is indicated for this type of tumor as long as it is performed by experienced surgeons.

Adrenal Gland Neoplasms↗
PubMed1997

Postoperative adjuvant chemotherapy with mitomycin C and UFT for rectal cancer.

To evaluate the significance of postoperative adjuvant chemotherapy using mitomycin C (MMC) and UFT (tegafur and uracil) in combination, the Japanese Foundation for Multidisciplinary Treatment of Cancer conducted a prospective randomized controlled trial with 834 patients who had undergone curative resection for rectal cancer (T3 or T4 tumors and/or N1, N2, or N3 disease). The patients were randomly allocated to a treatment group (MMC/UFT, 416 patients) and a control group (surgery only, 418 patients). For patients in the treatment group, 20 mg of MMC was sprinkled on the operating field upon completion of surgery. MMC was intravenously injected at 6 mg/m2 on day 7, and then each month after surgery for 6 months. UFT was administered orally at 400 mg/day for 1 year. Although no difference was observed in the 5-year survival rate between the two groups, the 5-year disease-free survival rate in the MMC/UFT group was 69.1%, which was significantly higher than in the control group (59.3%, P = .005). The 5-year cumulative local recurrence rate was significantly lower in the MMC/UFT group (11.6%) than in the control group (19.0%) (P = .0071). We conclude that the adjuvant use of long-term oral UFT and intermittent intravenous MMC improves the disease-free survival rate of patients with curatively resected rectal cancer.

Adult↗
PubMed1997

[Prospective controlled study on the usefulness of Carmofur as a postoperative adjuvant chemotherapy for colorectal cancer].

A prospective controlled study, the 7th cooperative study of the Japanese Foundation for Multidisciplinary Treatment, was conducted to evaluate the usefulness of concomitant therapy with MMC + HCFU as a postoperative adjuvant therapy in patients with colorectal cancer who had undergone curative resection for a period of 2 years and 11 months from February, 1986. The Dukes B and C patients with colorectal cancer classified by macroscopic examination who had an intravenous MMC 6 mg/m2 on the day of operation and followed by oral HCFU for 12 months from 2 weeks after operation (Group X) were compared with patients who had operation only (Group Y). Some 978 patients with colon cancer and 713 patients with rectal cancer were enrolled in the study, 85 (5.0%) of whom were not eligible. The 5-year survival rate of Group X in colon cancer was 79.3% and that of Group Y was 76.4%: thus the survival rate of Group X was slightly better than that of Group Y, but no significant difference was found between the two groups. Subset analysis revealed that the survival rate of Group X in advanced cancer of stage III b + IV, according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus in Japan, was 62.4% and that of Group Y was 46.2%. Thus, the survival rate of Group X was significantly better than that of Group Y (logrank test: p = 0.035, generalized Wilcoxon test: p = 0.025). The disease-free survival rate was not significantly different between the groups with colon cancer and rectal cancer. The above results suggest that HCFU is useful for patients with a high risk of recurrence who had advanced colon cancer (stage III b + IV). However, additional prospective studies are required to verify them.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Tumor angiogenesis in pulmonary adenocarcinomas: relationship with basic fibroblast growth factor, its receptor, and survival.

Tumor angiogenesis was examined in tissue specimens from 120 patients with a pulmonary adenocarcinoma. The microvascular density (MVD) was determined by the factor 8-related antigen (F8RA), and the basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor 1 (FGFR1) protein expressions were immunologically studied with the MVD. Patients with over 30 counts of the MVD showed significantly poorer prognosis than those with less than 30 counts. bFGF and FGFR1 expressions correlated with tumor angiogenesis and prognosis. Univariate analysis showed that the MVD, bFGF, and FGFR1 had a significant effect on prognosis, and multivariate analysis of three prognostic factors revealed the MVD correlated with survival. Our findings suggest that bFGF and FGFR1 expressions play an important role in tumor angiogenesis and that the bFGF and FGFR1 expressions promote angiogenesis and metastasis in pulmonary adenocarcinoma, and that the MVD is a useful prognostic marker for assessing the outcome of a pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1996

Prognostic factors for patients with colon or rectal carcinoma treated with resection only. Five-year follow-up report.

BACKGROUND: The prognostic factors and natural history of recurrence in patients with colorectal carcinoma who underwent curative resection and no other therapy were analyzed. METHODS: The object of analysis was the potentially curative resection only subgroup in the randomized clinical trial (RCT) that we performed. Cox's proportional hazards model was used mainly to analyze recurrence rates during the first 5 years after surgery. RESULTS: The analysis was performed on a subgroup of the RCT (279 patients with colon carcinoma and 293 patients with rectal carcinoma). Five-year disease free survival rates were 76.3% and 56.5% for colon and rectal carcinomas, respectively. The prognostic factors for recurrence for colon carcinoma patients were different from those with rectal carcinoma. For colon carcinoma, only Dukes stage was significant, whereas for rectal carcinoma, Dukes stage, age, location of the tumor, and serosal and venous invasion by cancer cells were prognostic factors. Log-transformed disease free survival rates were linear in Dukes Stage B and biphasic in Dukes Stage C for both colon and rectal carcinoma. The two phases in Dukes Stage C intersected at 2.85 and 3.04 years, respectively. The annual hazard value was high for the first 3 years in both colon and rectal carcinoma. CONCLUSIONS: We conclude that follow-up of patients with colorectal carcinoma who undergo potentially curative resection is of particular importance in the first 3 years after surgery. Furthermore, the usefulness of adjuvant chemotherapy can be adequately evaluated from data yielded during this postoperative period.

Chemotherapy, Adjuvant↗
PubMed1996

Insulin-like growth factor-II as a prognostic factor in pulmonary adenocarcinoma.

We stained resected specimens from 117 patients with pulmonary adenocarcinoma for insulin-like growth factor-II (IGF-II) by the avidin-biotin-peroxidase (ABC) method and evaluated the usefulness of IGF-II as a prognostic factor. The patients were classified into the IGF-II (+) groups showing staining of 1% or more cancer cells (60 patients) and the IGF-II (-) groups showing staining of <1% (57 patients). The 5-year survival rate was 22% in the IGF-II (+) group and 54% in the IGF-II (-) group (P<0.01). Our results suggest the usefulness of IGF-II stainability as a prognostic factor of pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1996

Bilateral type diverticular disease of the colon.

7,543 double-contrast barium enema studied for the presence of diverticula which were classified into right-sided, left-sided and bilateral types, and the relationship of the frequency (detection rate) and numbers of diverticula to age were examined for the earlier (1982-87) and later (1988-92) periods. Diverticular disease was found in 22.2% of male and 15.5% of female examinees. The right-sided type predominated among the subjects. Frequency distribution by age of the bilateral type was similar to that of the left-sided type. Bilateral diverticular disease increased in frequency with advancing years in the sixth and seventh decade, the right-sided type increased in middle-aged subjects, and the left-sided type did not. The bilateral type was composed of diverticula in the right colon, where numbers were greater than in the pure right-sided type, but remained unchanged with increasing age, and diverticula in the left colon, where numbers were similar to the pure left-sided type, but did not increase with age. Increase in the prevalence of bilateral and not pure left-sided form has contributed to the recent increase in diverticula in the left colon among the Japanese, and might have been preceded by an increase in the right-sided type.

Adult↗
PubMed1996

Diffuse cavernous hemangioma of the rectum: MR imaging with endorectal surface coil and sphincter-saving surgery.

We describe the clinical features, diagnostic procedures, and treatment of two patients with diffuse cavernous hemangioma of the rectum. Sphincter-saving operations were performed in both patients, with satisfactory results. Magnetic resonance imaging (MRI) with an endorectal surface coil, as well as a conventional body coil, was used to determine the extent of the hemangiomas. We recommend sphincter-saving surgery for the treatment of this benign disease that can cause life-threatening hemorrhage. MRI with an endorectal coil achieves higher-resolution images than conventional MRI.

Adult↗
PubMed1996

Measurement of 5-fluorouracil in scalp hair: a possible index of patient compliance with oral adjuvant chemotherapy.

OBJECTIVE: Little is known about patient compliance with oral adjuvant chemotherapy. It is estimated to be poor especially in Japan, where it is still unusual for patients to be directly informed of their diagnosis of malignancy. 5-Fluorouracil (5-FU) was measured in hair samples to assess patient exposure to 5-FU, and its potential usefulness is discussed as an index of compliance with postoperative adjuvant chemotherapy. METHODS: Hair samples obtained from 55 patients, who had received oral 5-FU (total dose 27-41 g) as postoperative adjuvant chemotherapy over a 6-month period, were used for the analysis of 5-FU. The drug was extracted from the hair using ethyl acetate, and its fluorescence derivatization was employed for measurement with HPLC. The detection limit of 5-FU in hair was 0.01 ppm. RESULTS: In 22 out of 55 samples 5-FU content was under the detection limit, whereas in the remaining 33 samples the drug was detected in a range of 0.006-2.125 ng per hair strand; in addition, drug content showed a lognormal distribution. 5-FU was detected in the hair collected from those patients who were possibly compliant with the postoperative oral adjuvant chemotherapy. CONCLUSION: As many as 40% of the patients analysed were supposed to be much less compliant. Even in the possibly compliant patients, the degree of compliance with the therapy varied according to a log-normal distribution.

Animals↗
PubMed1996

The basic fibroblast growth factor and its receptor in pulmonary adenocarcinomas: an investigation of their expression as prognostic markers.

The expression of basic fibroblast growth factor (bFGF) and its receptor, the high-affinity type I basic fibroblast growth factor receptor (FGFR-1): were immunohistologically studied in tissues specimens from 167 patients with a pulmonary adenocarcinoma. Of the 167 specimens, 82 (49%) expressed bFGF and 104 (62%) expressed FGFR-1, bFGF and FGFR-1 were simultaneously expressed in 72 (43%). It was also found that many patients who showed intensely positive staining for bFGF were also positive for FGFR-1, and that the expression of bFGF or FGFR-1 or both was associated with p-stage, T and N factors. The overall prognosis was significantly poorer in the bFGF-positive or FGFR-1-positive patients than in negative patients (P < 0.01). The prognosis was also significantly poorer in all patients positive for both bFGF and FGFR-1 than in those negative for both (P < 0.01); this was also true for stage I patients (P < 0.05). Multivariate analysis showed that bFGF had a significant affect on prognosis, whereas FGFR-1 did not. As FGFR-1 is significantly linked with the bFGF expression, it may be that FGFR-1 interferes with the bFGF effect on survival. These findings suggest that bFGF and FGFR-1 play important roles in tumour progression, and that bFGF expression may be a useful prognostic marker for pulmonary adenocarcinomas.

Adenocarcinoma↗
PubMed1996

Expression of PDGF, IGF-II, bFGF and TGF-beta 1 in pulmonary adenocarcinoma.

Effects of the expression of the platelet-derived growth factor (PDGF), insulin-like growth factor-II (IGF-II), basic fibroblast growth factor (bFGF) and transforming growth factor (TGF)-beta 1 were studied individually and in combinations with the clinicopathologic features and prognosis of pulmonary adenocarcinoma using paraffin embedded tissue specimens. Tumor sections from 90 patients with pulmonary adenocarcinoma were stained immunohistochemically for PDGF, IGF-II, bFGF and TGF-beta 1 by the ABC method. The survival rate was worse in patients in whom each of the four growth factors was expressed than in those where growth factors were not expressed. The reduced expression of the four growth factors correlated with less tumor aggressiveness and better prognosis of pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1996

Association between preoperative plasma CEA levels and the prognosis of gastric cancer following curative resection. Tumor Marker Committee, Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan.

A large-scale retrospective study was undertaken to evaluate the association between preoperative plasma carcinoembryonic antigen (CEA) levels and the prognosis of 2768 gastric cancer patients who underwent curative gastrectomy between 1983 and 1984 at 66 leading medical institutions in Japan Postoperative follow-up was at least 5 years. Preoperative plasma CEA levels were also analysed against other prognostic factors. Preoperative plasma CEA levels showed strong correlations to the degree of lymph node metastasis (P < 0.001), TNM stage (P = 0.004) and the histopathology of the gastric cancer (P < 0.001). Preoperative CEA levels were also evaluated against survival, after being adjusted for the effect of clinically important factors by multivariate analysis. Patients with lower preoperative plasma CEA levels survived significantly longer than patients with higher CEA levels (P = 0.0001). This analysis demonstrates that curatively resected gastric cancer patients with higher preoperative plasma CEA levels have a poorer prognosis than those with lower levels, despite the adjustment for the effects of major prognostic factors.

Adolescent↗
PubMed1996

Immunohistochemical detection of basic fibroblast growth factor as a prognostic indicator in pulmonary adenocarcinoma.

The expression of basic fibroblast growth factor (bFGF) was studied immunohistochemically in tissue specimens from 157 patients with pulmonary adenocarcinoma. Tumor cells that expressed bFGF were found in 89 patients (74%). The expression of bFGF was correlated with T and M in the TNM classification, disease stage and curability. The 5-year survival rate was 24% in bFGF-positive patients but 66% in bFGF-negative patients, the difference being significant (P<0.01). The 5-year survival rate of patients with stage I disease was 73% in those who were bFGF-positive but 88% in those who were bFGF-negative, the difference being significant (P<0.05). Multivariate analysis showed that the expression of bFGF was significantly related to prognosis. These findings suggest that bFGF plays an important role in tumor progression and that its expression may be a useful prognostic indicator for pulmonary adenocarcinoma.

Adenocarcinoma↗
PubMed1996

Prognostic factors of colorectal cancer. Results of multivariate analysis of curative resection cases with or without adjuvant chemotherapy.

One thousand two hundred fifty-four cases (610 colonic and 644 rectal cancers resected during 2 years from 1984 and followed up for more than 5 years) were entered from 140 institutions in Japan and analyzed by means of Cox's proportional hazards model. The analyzed pathologic variables were the size and depth of invasion, Dukes' stage, venous invasion, lymphatic permeation, and other clinical features, such as the sex and age of the patient and location of the tumor. The extent of dissection, serum carcinoembryonic antigen (CEA) level, and the presence or absence of adjuvant chemotherapy were also analyzed. Adjuvant chemotherapy consisted of three arms for both colonic and rectal cancers. For colonic cancer, arm I was a combination of i.p. (intraportal) and i.v. mitomycin C (MMC) + p.o. 5-fluorouracil (5-FU); arm II was i.v. MMC + p.o. 5-FU; and arm III was surgery only. For rectal cancer, arm IV was a combination of i.a. (inferior mesenteric artery) and i.v. MMC + p.o. 5-FU; arm V was i.v. MMC + p.o. 5-FU; and arm VI was surgery only. As for the factors affecting the disease-free survival of the patient, multivariate analysis disclosed nodal involvement, venous invasion, an elevated CEA level, and the lower part of the rectum. The effect of adjuvant chemotherapy on the patient's survival was proven for rectal cancer but not for colonic cancer. We conclude that these factors should be considered in setting the stage of tumor pre- and postoperatively.

Aged↗
PubMed1996

[Tumor markers: neoplasmas in digestive organs].

Because they show high levels in hepatocellular carcinoma, alpha-fetoprotein and des-gamma-carboxyprothrombin are clinically useful tumor markers for differentiating hepatocellular carcinoma from other hepatic diseases. The two are useful complementary markers of hepatocellular carcinoma because they do not correlate with each other. A typical marker of pancreatic cancer is carbohydrate antigen (CA) 19-9. Over a period of more than 10 years, many markers resembling CA19-9 have been identified, but none are markedly superior to CA19-9, and the sensitivity of these markers in pancreatic cancer is only 65%-80%. Tumor markers are not useful for the early diagnosis of either hepatocellular carcinoma or pancreatic cancer. They are, however, considered to be useful for monitoring after treatment.

Biomarkers, Tumor↗
PubMed1996

[The indications for postoperative adjuvant therapy in node-negative breast cancer patients].

A clinicopathological study on prognosis has been carried out in 233 breast cancer patients with more than twenty inspected nodes and without lymph node metastasis. Multivariate analysis of clinicopathological findings in node-negative breast cancers showed that the best combination of clinical features predicting prognosis were age, menstruation status, tumor location and tumor diameter; and from 11 pathological features, three factors (histological type, histological grade and the grade of tumor infiltrating lymphocytes) were selected under condition of p<0.05. With solid-tubular carcinoma, histological grade III and negative tumor infiltrating lymphocytes as the 3 poor prognostic factors, node-negative breast cancers were classified. The recurrence rates of subgroups with the number of 3, 2, 1 and 0 were 28%, 16%, 7% and 0%, respectively. We conclude that the grade of tumor infiltrating lymphocytes is especially significant as the prognostic factor in node-negative breast cancers, and that postoperative adjuvant chemoendocrine therapy must be performed for patients with node-negative breast cancer with more than two poor prognostic pathological factors.

Adult↗