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Biomedical subjects

S Kuwao

Publications and source records attributed to S Kuwao.

At least 73 records · Page 4Linked to original sources
PubMed1993

Long-term impact of conservative management on localized prostate cancer. A twenty-year experience in Japan.

The clinical outcome of 107 patients with localized prostate cancers over the past twenty years was analyzed retrospectively. Immediate endocrine therapy was administered in 55 patients after diagnosis. The other group of 52 patients did not receive any anti-tumor treatment until progression. Overall, 22 patients (21%) died of prostate cancer, while 45 (42%) died of other known causes. During a mean observation period of thirty-seven months, 27 (25%) experienced progression of the disease (local in 9, distant metastasis in 25, and both in 7 patients). The cancer-specific survival rates for these 107 patients were 78 percent at five years and 71 percent at ten years. The timing of endocrine therapy and age at diagnosis did not influence patient's prognosis. Tumor stage failed to demonstrate any prognostic significance after being controlled for other factors including tumor grade. Poorly differentiated histology appeared to be the sole and the strongest predictor for both tumor progression and cancer death. Prostate cancer may not differ significantly among races once it becomes clinically manifest. Expectant management for localized prostate cancer in well and moderately differentiated cancer may be justified because of the higher probability of dying of other intercurrent causes especially in the elderly group of patients. However, definitive forms of therapy should be considered for the group of patients with poorly differentiated tumor who have reasonably long life expectancy.

Age Factors↗
PubMed1993

[Role of prostate specific antigen, transrectal ultrasonography, and digital rectal examination in the search for clinical prostate cancer].

Two hundred and thirty-four patients who visited the urology clinic in Kitasato University Hospital were evaluated with digital rectal examination (DRE), serum prostate specific antigen (PSA) study and prostate ultrasonography. Of 71 men who underwent ultrasound-guided transrectal biopsy 19 (26.8%) were found to have prostate cancer, accounting for 8.1% (19/234) of the whole population. When PSA levels were arbitrarily divided into 0 to 2, 2.1 to 10 and greater than 10 ng/ml, the positive DRE was associated with cancer detection rate of 3.3%, 77.8% and 100%, respectively, with an overall detection rate of 32.6%. However, a normal DRE (benign-feeling gland) is associated with much less cancer detection rate of 5.9%, 28.6% and 100%, respectively, with an overall rate of only 16.0%. The positive biopsy rate was 30% (18/60) in the presence of hypoechoic lesions on sonography, but 9.1% (1/11) if absent. The positive predictive value of DRE (32.6%, 15/46) increased to 36.6% (15/41) if a hypoechoic lesion was identified sonographically and to 87.5% (14/16) if PSA levels were abnormal. One patient was found to have a microfocus of well differentiated adenocarcinoma in one of the 6 biopsy cores. Radical retropubic prostatectomy was performed in 9 of the 19 patients with clinically localized prostate cancer. On pathologic examination of the prostatectomy specimens 5 of them were upstaged to positive seminal vesicle or lymph node metastasis. The spectrum of prostate cancer detected by these modern techniques is broad and extends from tiny clinically insignificant cancer to advanced disease in its incurable stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Prognosis of incidental (stage A) prostatic cancer].

Incidentally discovered prostatic cancer can pursue a benign clinical course or it can rapidly progress. For the purpose of this study, we summarized pathological and clinical results of 107 (5.3%) stage A prostatic cancer patients in 2008 transurethral resection of the prostate for clinically diagnosed benign prostatic hyperplasia. For each patient, 3.9 slides, 13.6 tissue chips per slide and 52.5 tissue chips per patient (from 16 to 140 chips) were examined microscopically. The survival rates of patient with well, moderately and poorly differentiated groups were 62, 37 and 12% at 10 years, and those with Gleason score 2 to 4, 5 to 7 and 8 to 10 group were 63, 42 and 0% respectively. The survival rates in stage A1 (well differentiated or Gleason score 4 or less in less than 5% of the tissue removed during transurethral resection of the prostate) and stage A2 (anything other than stage A1) were 63 and 41% at 10 years, respectively. And cancer specific survival rates in stage A1 and stage A2 were 96% and 64% at 10 years, respectively. The number of cancer specific death were 1 in 30 (3.3%) in stage A1 group and 14 in 77 (18.2%) in stage A2 group. Our results indicated that tumors with low potential for aggressive behavior had a volume extent of less than 5% and a well differentiated group. Aggressive treatments should be recommended to all patients who were diagnosed stage A2 prostatic cancer.

Aged↗
PubMed1993

[Reassessment of the sonographic criterion of prostate cancer--nonspecificity of a hypoechoic lesion].

Of 71 patients who underwent ultrasound guided transrectal needle biopsy at the urology clinic in Kitasato University Hospital 19 (26.8%) patients were found to have prostate cancer. The positive predictive value for transrectal ultrasonography (hypoechoic lesion) was disappointing-only 30% (18/60). While hypoechogenicity has been increasingly accepted as the most sensitive ultrasonographic indicator of malignancy, the specificity of hypoechogenicity is related to benign structures that may also appear hypoechoic. Sonographic detection of prostate cancer is also confounded by the presence of iso- and hyperechoic tumors. Experienced sonographer should be alert to this limitation of the current technology of transrectal ultrasound. The advent of the Biopty gun enabled us to take multiple biopsy cores easily and quickly. Liberal use of random systematic biopsy in addition to directed cores from a hypoechoic lesion should enhance the detection of prostate cancer regardless of the tumor echogenicity.

Aged↗
PubMed1993

[Immunohistochemical study of the prostatic tissues with monoclonal antibody against gamma-seminoprotein. Analyses of benign prostatic hyperplasia, metastatic foci from adenocarcinoma of the prostate and malignant neoplasms other than adenocarcinoma of the prostate].

The immunohistochemical specificity of the monoclonal antibody (43-21-1-1) against gamma-seminoprotein (gamma-Sm) in the prostatic tissues was evaluated by avidin-biotin peroxidase complex method. The normal tissues of various organs, other than male genitourinary organs already examined in the previous study, the brain, skin, spinal cord, tongue, esophagus, stomach, small intestine, rectum, trachea, lung, pleura, diaphragm, liver, spleen, pancreas, mesentery, kidney, lymph node, bone, bone marrow and striated muscle were examined for control study. The prostatic tissues obtained by surgery or biopsy, benign prostatic hyperplasia (BPH; 72) urethral polyp with prostatic-type epithelium (1), bone (3) or testicular (2) metastases from adenocarcinoma of the prostate and malignant neoplasms other than adenocarcinoma of the prostate, including primary small-cell carcinoma (1), secondary embryonal carcinoma (1) and secondary mucinous adenocarcinoma (1) of the prostate were then examined. Since all but 2 (97%) specimens of BPH were obtained by transurethral resection (TUR), which might cause non-specific staining due to electro-mechanical effects, the tissue of BPH obtained by suprapubic prostatectomy were examined simultaneously, serving as a control for immunostaining. The normal tissues of various organs were never stained positively for gamma-Sm. Positive reactions of gamma Sm with this monoclonal antibody were recognized in the cytoplasms of urethral polyp with prostatic-type epithelium, bone or testicular metastases from adenocarcinoma of the prostate. The malignant neoplasms other than adenocarcinoma of the prostate examined in this study, were never stained positively. There was obviously evidence of non-specific staining in the TUR tissues of BPH.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1993

[Immunohistochemical study of monoclonal antibody against gamma-seminoprotein in the prostatic tissues. A significant correlation between the degree of staining and the histological grade of adenocarcinoma of the prostate].

The tissues consisted of adenocarcinoma of the prostate were examined by immunohistochemical study with monoclonal antibody (43-21-1-1) against gamma-seminoprotein (gamma Sm)2). The degree of staining regarding any correlation with the histological grade was evaluated. The prostatic tissues were obtained by transurethral resection or by fine needle biopsy from untreated 38 patients. The avidin-biotin peroxidase complex technique was used to stain on 3 microns-sections of 10% formalin fixed, paraffin embedded tissue. In addition, immunohistochemical staining with the commercialized antibodies to prostate-specific antigen (PSA; polyclonal, DAKO) and to prostatic acid phosphatase (PAP; polyclonal, DAKO) was done simultaneously for a comparative study. The degree of immunoperoxidase stain was classified into two categories, namely location and pattern, and was graded from 0 to 3, respectively. The product of the degree of location and the degree of pattern was noted as the total score. The mean of score was calculated in each histological grade. Then the means of total scores were compared and evaluated as having any statistical difference by Student's t test among 3 histological grades as well as among 3 primary antibodies used in this study. When the monoclonal antibody to gamma-Sm was used for immunoperoxidase staining, the means of total scores and the rates of negative reactions (% Negative) in 3 histological grades were 6.8 +/- 1.8 (M +/- SD) and 0% in well (N = 9), 4.4 +/- 2.4 and 14% in moderately (N = 22), and 1.8 +/- 2.3 and 54% in poorly differentiated lesions (N = 11), respectively. There were statistically significant differences (P < 0.05) among 3 histological grades.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1993

[Clinico-pathological study of the mechanism of initiation and progression of right ventricular infarction].

To clarify the mechanism of initiation and progression of right ventricular myocardial infarction, 35 cases were examined among 236 cases of consecutively autopsied hearts. Twenty-six (52%) of 50 cases with posterior left ventricular infarction showed right ventricular infarction, and no statistical differences were observed in the age, gender, and number of impaired vessels among patients with and without right ventricular infarction. However, more proximal occlusion or more extensive thrombi in the right coronary artery did play a very important role in the genesis of the infarction and its progression. Right ventricular dilatation was frequently associated, probably resulted from the functional disorder of contraction and relaxation of the myocardium. Unusual asynchronous ischemia was observed in the right ventricle concomitantly with posterior left ventricular infarction, suggesting the presence of a protective mechanism against ischemia by the abundant collateral circulation of the right ventricle. In conclusion, right ventricular infarction occurs only with the cease of collateral circulation due to proximal occlusion and the presence of long thrombi in the right coronary artery.

Adult↗
PubMed1993

A case of severe IgA nephropathy associated with psoriatic arthritis and idiopathic interstitial pneumonia.

A patient is described with severe IgA nephropathy associated with psoriatic arthritis, idiopathic interstitial pneumonia and brain hemorrhage that developed serially over one and a half years. The histological findings of the renal biopsy showed severe endo- and extracapillary proliferative glomerulonephritis. Massive IgA deposits were observed by immunofluorescence not only in the mesangium but also along the capillary walls. Electron microscopy revealed abundant electron-dense deposits in the mesangial and subendothelial areas. The overlapping or coexistence of these conditions has rarely been reported.

Adult↗
PubMed1992

Sialosylated Lewis chi expression in CD30-positive anaplastic large-cell lymphomas.

The expression of sialosylated Lewis chi (SLEX), a ligand for endothelial leukocyte adhesion molecule 1 in malignant lymphomas, was immunohistochemically examined, using the monoclonal antibody, CSLEX1, which specifically reacts with SLEX. It was expressed in 6 out of 64 non-Hodgkin's lymphomas, which consisted of 1 nasal large-cell lymphoma and 5 of 8 (62%) Ki-1-positive anaplastic large-cell lymphomas (ALCL). One nasal lymphoma positive for SLEX co-expressed a T cell marker, cluster of differentiation (CD) 5, and natural killer (NK) cell markers such as CD56 and CD16, indicating that SLEX+ nasal lymphoma cells are possibly malignant counterparts of SLEX+ NK cells. SLEX did not react with 30 B cell lymphomas or most Hodgkin's disease lymphomas, though it did with one lymphocyte predominance type. Although SLEX+ ALCL exhibit T cell markers in some cases, some ALCL expressing SLEX may represent histiocytic differentiation of the neoplastic cells. The lymphoma cells of ALCL were preferentially positive for SLEX, in contrast to Hodgkin's disease cells, and thus CSLEX1 in conjunction with CD30 and CD15 should be of use for analyzing and making differential diagnoses of routine paraffin-embedded sections of ALCL.

Antigens, CD↗
PubMed1992

Case report of primary cardiac lymphoma. The applications of PCR to the diagnosis of primary cardiac lymphoma.

A 75-year-old man initially complained of pollakiuria and low abdominal pain, and died of massive bleeding from an exacerbated gastric ulcer. The diagnosis of primary cardiac lymphoma was made postmortem. The tumor involved only the epicardium and myocardium, which met the criteria of primary cardiac lymphoma as defined by the Armed Forces Institute of Pathology. The lymphoma consisted of large cells and expressed the B cell marker, CD20. Although chronic inflammation due to chronic renal failure was observed in the pericardium around the lymphoma, polymerase chain reaction (PCR) was conducted to detect monoclonality at the DNA level in lymphoma cells, which were shown to comprise a monoclonal population.

Aged↗
PubMed1992

Immunogenic deposition and destruction of glomerulus in IgA nephritis.

The correlation between glomerular immune deposition and histological alteration was studied in serial paraffin sections of kidney biopsy specimens from patients with IgA nephritis using the peroxidase-antiperoxidase (PAP) method. IgA deposition was detected in preserved glomerular extracellular matrix or in newly formed interposed matrix along the capillary loops (mesangial interposition). On the other hand, deposition of IgA was scanty or absent in the distorted extracellular matrix where severe exudative inflammation or extracapillary escape of exudates was occurring segmentally. Ultrastructurally such extracellular matricial destruction was expressed as splitting or thinning of the lamina densa, as well as mesangial edema, reticulation or mesangiolysis of the axial matrix. Therefore it appears that at least two types of change in the extracellular matrix are induced by IgA immune complexes in IgA nephritis; immunogenic deposition and destruction.

Adolescent↗
PubMed1992

Characterization of transmural and subendocardial infarction by typing and grading of ischemic lesions in autopsied human hearts.

Two types of myocardial infarction, transmural and subendocardial, were macroscopically examined, and the gross and microscopic findings were correlated. The transmural type usually consisted of yellowish-brown coagulation necrosis in the center of an infarcted focus and coagulative myocytolysis at the marginal zone. The subendocardial type was characterized by coagulative myocytolysis throughout the entire focus. Wavy fiber and colliquative myocytolysis of non-specific ischemic lesions were seen only microscopically in both peripheral and subendocardial areas of infarcted foci. Coagulation necrosis was associated with obstructive thrombus formation in 79% of cases as a result of absolute ischemia in the transmural type. Coagulative myocytolysis was associated with obstruction by plaque hemorrhage in 27% of cases, and multivessel disease was frequently encountered in the subendocardial type due to insufficient blood supply. Based on histochemical and immunohistochemical examinations, the ischemic lesions were graded in descending order of coagulation necrosis, coagulative myocytolysis, wavy fiber, and colliquative myocytolysis. The close relation between coagulation necrosis and the transmural type as well as that of coagulative myocytolysis with the subendocardial type suggests two different pathogenetic mechanisms of transmural and subendocardial infarction.

Adult↗
PubMed1992

A case report of inflammatory pseudosarcoma of the urinary bladder.

A case of inflammatory pseudosarcoma of the urinary bladder in a 35-year-old Japanese male is presented. This benign lesion can easily be mistaken for spindle cell sarcoma since it consists of rhabdomyoblast-like elongated strap cells showing infiltrative growth, and whether it is benign or malignant is difficult to determine by microscopic examination. In this case, spindle cell proliferation extended among bundles of the superficial muscle layer. However, no abnormal mitoses, severe nuclear atypia or cellular pleomorphism could be seen, thus indicating inflammatory pseudosarcoma. Although the lesion was not completely resected, no recurrent disease has been clinically observed for two years following transurethral resection. Urologists and surgical pathologists must be able to detect this lesion in order to avoid unnecessary surgical procedures.

Adult↗
PubMed1992

Renal dehydropeptidase-I stability of LJC 10,627, a new carbapenem antibiotic.

LJC 10,627 is a new parenteral carbapenem antibiotic. LJC 10,627 stability against human renal dehydropeptidase-I was compared with that of imipenem. Hydrolysis of this compound was not detectable by spectrophotometrical assay. Even after a 2-h incubation of antibiotics with this enzyme at 30 degrees C, the concentration of LJC 10,627 remained at 92.3% of the initial concentration, whereas imipenem completely disappeared. Thus, it was found that this compound was highly stable against human renal dehydropeptidase-I. Furthermore, LJC 10,627 had a low affinity for this enzyme, as indicated by the high Ki value (0.38 mM).

Animals↗
PubMed1992

Dietary protein loading and the oral adsorbent AST-120 in the progression of chronic renal failure in the rat.

Excess protein intake enhances the progression of renal failure. The oral carbonaceous adsorbent, AST-120, was found experimentally and clinically to retard the progression of renal failure. This study was designed to determine whether deterioration of renal function by dietary protein loading can be prevented or mitigated by this oral adsorbent. Rats with uremia induced by partial renal infarction were fed a normal or high-protein diet for 70 days with or without AST-120, in which the inorganic phosphate content was adjusted to the same level. The survival rate deteriorated with the high dietary protein, but was improved from 30% to 100% with AST-120. Dietary protein loading reduced renal function, based on creatinine clearance. AST-120 improved renal function and renal histopathology not only in the normal diet group but in the high-protein group as well. The progression of renal failure induced by protein loading is thus shown to be prevented by oral AST-120. The mechanism for its action remains to be clarified.

Administration, Oral↗
PubMed1991

[Pathological study on the effect of oral adsorbent AST-120 on chronic renal failure in rats].

In order to evaluate the direct or indirect effect of AST-120 on chronic renal failure (CRF) in rats, histological and electron microscopical examinations were performed. A total of 30 Sprague-Dawley rats (aged 11 weeks and weighing 226 to 229 gm) with CRF induced by 5/6 nephrectomy were prepared. Rats were fed by a commercial diet (CE-2, Japan Kurea) and were divided into two groups: A (16 rats) and B (14 rats). AST-120 (5% content) was only administered to group B. After two months, kidneys were removed and prepared for the histological and electron microscopical examinations. On histological examination, group A kidneys showed severe glomerular hyalinization (more than 80%) and frequent crescents, as well as tubulo-interstitial fibrosis and many protein casts. In contrast, segmental glomerular lesions were identified in group B kidneys. Tubulo-interstitium were also well preserved. Furthermore, the ultrastructural findings of group B were milder than that of group A. The preservation of renal tissue in group B revealed the beneficial effect of AST-120 on CRF rats' kidneys. In conclusion, this beneficial effect is provided by the removal of the serum toxic metabolite (uremic toxin) and the precursor substance of the toxin by orally administered AST-120.

Administration, Oral↗