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Biomedical subjects

S Saiki

Publications and source records attributed to S Saiki.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Neoadjuvant endocrine therapy in patients with locally advanced prostate cancer].

Recently, there has been an increasing interest in the application of preoperative endocrine therapy prior to radical prostatectomy. The main purpose of this treatment modality is to enhance surgical curability and increase survival. Endocrine therapy was performed before radical prostatectomy on 40 patients between 1986 and 1993; 15 had stage B2 and 25 had stage C disease. The median duration of preoperative endocrine therapy was 3.8 months. All patients subsequently underwent radical prostatectomy, pelvic lymphadenectomy and castration. There was on average a 25.5% (0-71.8%) decrease in maximal cross-sectional area of prostate gland as determined by transrectal ultrasonography. Treatment-related histological effects, divided into three grades were as follows; excellent in 17, moderate in 11 and poor or no regression in 12. Pathological downstaging of disease status from the diagnosis made at the initial clinical examination was seen in 13 of the 40 patients (33%). At a median follow-up of 50 months (19-118 months), 36 of the 40 patients are disease-free and two died of cancer 43 and 50 months postoperatively. These findings suggest that preoperative endocrine therapy plays an important role in the management of locally advanced prostatic cancer.

Aged↗
PubMed1996

[A case of plasma cell granuloma associated with cerebral infarction].

A 36-year-old male complained of double-vision and pain of left orbita. On admission, T1-weighted Gd-enhanced MR image of his head showed high intensity lesion in the left carvenous sinus, and his chest X-P showed multiple coin lesions. Microscopic findings of lung open biopsy specimen showed prolifelation of mature plasma cell in the granuloma and the patient was diagnosed as having plasma cell granuloma. Although the lung lesions had a tendency to spontaneous remission, we started the steroid pulse therapy and betamethasone (8 mg/day) therapy for intracranial lesion. Then the lung lesions vanished and we decreased the dose of betamethasone from 8 mg/day to 6 mg/day. As the results, the intracranial lesion of this patient expanded and left middle cerebral artery occluded, resulting in right hemiparesis and total aphasia. This is the first case report of plasma cell granuloma with a lesion in the central nervous system associated with cerebral infarction.

Adult↗
PubMed1996

[Prostatic cancer with cystic formation: a case report].

A 60-year-old man was admitted to our hospital with the chief complaints of dysuria and sense of abdominal fullness. On digital rectal examination, an enlarged prostate with a smooth surface and elasticity was palpated. The concentration of prostate specific antigen (PSA) was elevated to 78 ng/ml. Pelvic computed tomographic (CT) scan and magnetic resonance imaging (MRI) revealed a large prostate, 8 cm in diameter, with a cystic mass, and extra-iliac lymph node swelling. On needle biopsy of the prostate and cyst, the histology was poorly differentiated adenocarcinoma, and the aspirate comprised bloody fluid with a negative test for cytology. He was diagnosed with prostatic cancer of T4N3M0. This is the 19th case of prostatic cancer with cystic formation reported in Japan.

Adenocarcinoma↗
PubMed1995

Six cases of microscopic polyarteritis exhibiting acute interstitial pneumonia.

Out of 21 autopsy cases of microscopic polyarteritis (MPA), six cases that died of acute respiratory failure are described. All of these six cases exhibited pauci-immune necrotizing glomerulonephritis. Of these six cases, systemic vasculitis and respiratory failure occurred almost simultaneously in two, whereas respiratory failure developed when vasculitis recurred in the other four. Pathologically, pulmonary changes were diffuse and almost uniform in each case. Interstitial inflammatory cells (alveolitis), hyaline membrane, restructuring, and fibrosis were observed. The degrees of these changes differed from case to case; four cases showed predominantly exudative changes and two cases exhibited proliferative or organizing ones. Clinical and pathological features were consistent with acute interstitial pneumonia (AIP). Immunofluorescent and ultrastructural studies did not suggest deposition of immune complexes at the lesions of alveolitis. An etiologic agent could not be identified in these cases. Some lung lesions including pulmonary hemorrhage have been described in association with MPA; however, cases such as those presented here have rarely been reported. It was considered that AIP could be one of the pulmonary disorders in MPA. Furthermore, the possible pathogenetic role of antineutrophil cytoplasmic antibodies (ANCA) in the evolution of present lung lesion is discussed. Although ANCA were not examined in the present cases, these antibodies should be investigated in future cases.

Acute Disease↗
PubMed1995

[Multicentricity and concomitant tumors in renal cell carcinoma: analysis by serial section of resected kidneys].

Nephron-sparing surgery was initially limited to the patients with localized renal cancer (RCC) present bilaterally or in a solitary kidney. Recently there is controversy in the indication for partial nephrectomy or enucleation to incidentally defined small RCC with normal opposite kidney. We examined the incidence of multicentricity in 43 kidneys removed for RCC with a diameter of less than 80 mm. The mean diameter of the predominant tumors was 45 mm (range 12 to 80 mm). The kidneys were serially sectioned at 5 mm intervals. Three of 43 kidneys (7%) had multiple RCC. The size of the concomitant tumors ranged from 2 to 15 mm. The multicentricity had no relation to pathological grade, stage, vascular invasion or infiltration pattern. In addition, the other 4 kidneys had 2 adenomas, 1 angiomyolipoma and 1 fibroma. Therefore we observed a 16% incidence of small renal nodules and a 7% multicentricity of RCC in the nephrectomized kidneys with normal opposite kidney.

Adenoma↗
PubMed1995

Preoperative endocrine therapy in patients with locally advanced prostate cancer.

Recently, there has been increased interest in the application of preoperative endocrine therapy prior to radical prostatectomy for locally advanced cancer in order to enhance surgical curability and increase survival. Between 1986 and 1993, 40 patients with prostate cancer were given endocrine therapy before radical prostatectomy. Fifteen patients had stage B2 disease and 25 stage C. The median duration of preoperative endocrine therapy was 3.8 months, and all the patients subsequently underwent radical prostatectomy, pelvic lymphadenectomy and castration. There was an average 25.5% (0-71.8%) decreases in the maximal cross-sectional area of the prostate gland as determined by transrectal ultrasonography. Twenty-four of 25 patients with elevated levels of serum prostate-specific antigen (PSA) showed normal values after preoperative endocrine therapy. Evaluation of treatment-related histological effects, divided into three grades, revealed that 17 patients had pronounced, 11 moderate and 12 poor or no regression. Thirteen of the 40 patients (33%) demonstrated pathological downstaging of disease status from the diagnosis made at the initial clinical examination. After a median follow-up period of 36 months (3-100 months), 36 of the 40 patients are disease-free; two died of cancer 43 and 50 months after surgery, respectively. These results suggest that preoperative endocrine therapy may play an important role in the management of locally advanced prostatic cancer.

Adenocarcinoma↗
PubMed1995

[A patient with cryptogenic organizing pneumonitis who presented with multiple patchy shadows].

A 62-year-old woman was admitted to our institution for abnormal shadows on a screening chest roentgenogram. An immunoelectrophoresis test on admission revealed a polyclonal gammopathy. In her bronchoalveolar lavage fluid, the percentage of lymphocytes was found to be high: 47%. These results indicated an abnormal immunological state. A chest X-ray film showed multiple patchy shadows in both lungs. A chest CT scan revealed that the shadows were distributed peripherally, and abutted the pleura. Before treatment, the lesions enlarged toward the hilum concentrically, and cleared from the pleural side. This change is characteristic of cryptogenic organizing pneumonitis. The pathological finding at open lung biopsy was organizing pneumonitis. Bronchiolitis obliterans was not pathologically recognized. The shadows on the chest X-ray film almost completely disappeared after treatment with predonisolone at a daily dose of 30 mg. We diagnosed this as a case of cryptogenic organizing pneumonitis with typical shadows.

Female↗
PubMed1995

[Histological evaluation of bronchial tissue from elderly individuals with bronchial asthma].

We studied morphologic and morphometric characteristics of the bronchial walls in lungs obtained at autopsy form elderly patients who had had bronchial asthma. Thirteen patients (age at time of death 57 to 98 years; average, 81 years) were divided into three groups: AS, died of severe asthma attack (n = 4); AC, admitted with asthma symptoms but died of other diseases (n = 6); and NA, died of other diseases and had had no asthma symptoms in the year before death (n = 3). Lungs from ten non-smokers with no history of bronchial asthma or other lung disorders were used as control. Transverse sections of segmental and subsegmental bronchi were prepared, and four quantities were analyzed: 1) the ratio of total bronchial gland area to total area of the bronchial wall (Yamanaka index), 2) the thickness of the basement membrane, 3) the thickness of the smooth muscle bundle, and 4) the ratio of luminal area to total area of the bronchial wall (bronchial dilation ratio). In the AS group, the Yamanaka index and the thickness of the smooth muscle bundles and of the basement membrane were significantly greater than those in the control group at both the segmental and subsegmental levels, with massive eosinophil infiltration into the bronchial walls. Furthermore the bronchial dilation ratio at the subsegmental level correlated closely with the Yamanaka index. Thickness of the smooth muscle bundle seemed to be most representative of the severity of asthma symptoms. In conclusion, morphometric findings of bronchial walls in elderly patients with asthma symptoms seem to be similar to those in their younger counterparts.

Age Factors↗
PubMed1994

Adjuvant and neoadjuvant chemotherapy for invasive bladder cancer.

A total of 20 patients with primary invasive bladder cancer who underwent radical cystectomy received postoperative adjuvant chemotherapy using a CAP (cyclophosphamide, doxorubicin, and cisplatin) or modified M-VAC (methotrexate, vinblastine, pirarubicin, and cisplatin) regimen. In all, 16 of the patients were treated with CAP and 4 received the modified M-VAC regimen. Of the 20 patients, 17 had transitional-cell carcinoma with or without non-transitional-cell elements. All of the patients had tumors with a histological grade of G2 (6 cases) or G3 (14 cases). As for lymph-node metastasis, there were ten N0 cases, three N1 cases, six N2 cases, and one N3 case. Adjuvant chemotherapy was usually commenced 2 weeks after the surgery and was given every 3-4 weeks for two or three cycles. The 5-year survival rate of these 20 patients was 65.9%, whereas that of 49 patients who did not receive any adjuvant chemotherapy was 30.2%. Regarding toxicity, both of the adjuvant chemotherapy regimens used in this study were generally well tolerated. The most common toxic effects were gastrointestinal symptoms, alopecia, and myelosuppression. Another 19 patients with invasive transitional-cell carcinoma of the bladder received 2 or 3 cycles of neoadjuvant chemotherapy using the modified M-VAC or MEC (methotrexate, epirubicin, and cisplatin) regimen. Of 18 pathologically evaluable patients who underwent radical cystectomy or partial cystectomy, the stage was pT0 in 3 cases (17%), pTis in 3 (17%), pT1 in 3 (17%), and pT2 or higher in 9 (50%). The 4-year survival rate of 18 patients who received neoadjuvant chemotherapy was 71.5%. Regarding toxicity, one patient died of a bowel complication after surgery, and the complication was suggested to be drug-induced.

Adenocarcinoma↗
PubMed1994

Anastomotic recurrence at hepaticojejunostomy in a long-term survivor of bile duct carcinoma: report of a case.

A rare case of autopsy-proven recurrence 10 years after a radical resection for lower bile duct carcinoma is herein reported. The subject is a 53-year-old man who underwent a curative resection of distal bile duct carcinoma with pancreatoduodenectomy in 1981. The lesion was a 1.0 x 1.5 x 1.0 cm well-differentiated papillotubular adenocarcinoma invading the fibromuscular layer of the bile duct with a slight infiltration to the lymphatics but without any extension to the vessels, nerves, connective tissues, or nodes. The patient demonstrated a recurrence 10 years after the initial operation and died 4 months later. An autopsy revealed a 2.0 x 2.5 x 1.6 cm mass at the anastomotic site of hepaticojejunostomy without any distant metastases. Although a late anastomotic recurrence after more than 10 years is unique, this case highlights the difficulty of the operative eradication of bile duct carcinoma. As a result, all possible maneuvers either during or after operation to promote the prophylaxis of recurrence are warranted.

Adenocarcinoma, Papillary↗
PubMed1994

Characterization of mouse monoclonal antibody B1.4 reactive with human invasive bladder cancer and some other malignant tumors but not with normal urinary epithelium.

Immunohistochemical analysis by indirect immunoperoxidase staining demonstrated that monoclonal antibody (mAb) B1.4 derived from a mouse immunized with a bladder cancer cell line EJ-1 was reactive with a high proportion of high-grade and invasive bladder tumors, but not with the majority of low-grade and superficial bladder tumors, or normal urinary epithelium. Among 71 primary bladder tumors classified by pathological grading, positive stainings were observed in 1 of 34 tumors (3%) of grade 1, 8 of 20 tumors (40%) of grade 2 and 14 of 17 tumors (82%) of grade 3. When the tumors were classified by pathological staging, positive stainings were observed in only 8 of 54 (15%) superficial tumors of stages Ta and T1, but in 15 of 17 (88%) invasive tumors of stages T2 and T3. mAb B1.4 showed restricted positive stainings with normal tissues including renal glomerulus, vascular endothelium, squamous epithelium of esophagus, glandular epithelium of prostate, and epithelium of pancreatic acinar gland and minute duct, while positive stainings were observed in a range of tumor tissues other than bladder tumor. Mixed hemadsorption assays with a panel of cell cultures showed also that the antigen recognized by mAb B1.4 was expressed on a range of tumor cell lines. These findings suggest that the antigen recognized by mAb B1.4 may appear after malignant transformation, and be an indicator of malignant potential of bladder cancer.

Animals↗
PubMed1994

Blood supply of the parathyroid gland from the superior thyroid artery.

BACKGROUND: There is considerable controversy about the arterial supply to the superior parathyroid glands. Knowledge of this blood supply should be important for the surgeon performing thyroid and parathyroid operations. The purpose of this investigation was to document whether the superior parathyroid glands receive their blood supply from the superior thyroid artery. METHODS: We injected contrast material into the superior thyroid artery in 52 cadavers and determined the arterial blood supply to the parathyroid glands by using a dissecting microscope. RESULTS: The upper parathyroid gland was identified in 51 instances and the upper and lower glands in 26 instances on the side of injection. Of 92 parathyroid glands identified, 57 glands (62%) had a single artery, 26 (28%) had two, and 9 (10%) had three or more arteries. In 9 (45%) of the 20 cases specifically examined, a distinct anastomosing branch was identified between the inferior and the superior thyroid arteries, from which the upper parathyroid artery arose. CONCLUSIONS: Our study documented that the superior thyroid artery almost always supplies the upper parathyroid glands. Forty-five percent of the subjects had a distinct anastomosing branch between the superior and inferior thyroid arteries, which should be kept intact at operation to preserve the upper parathyroid function. One third of the parathyroid glands have two or more parathyroid arteries.

Arteries↗
PubMed1993

The lung in polyarteritis nodosa: a pathologic study of 10 cases.

Polyarteritis nodosa (PAN) is characterized by necrotizing arteritis of medium-sized and small arteries in various organs. Pulmonary artery involvement in PAN has been considered rare. Previously, it also has been thought that patients with PAN do not have interstitial pneumonitis and fibrosis. A detailed pathologic analysis of pulmonary diseases associated with PAN was made in 10 autopsy cases of PAN. Arteritis affecting bronchial arteries was present in seven patients (70%). The data obtained suggest that arteritis in the lung in patients with PAN is more common than has been recognized previously. Diffuse alveolar damage (DAD) involving all lobes bilaterally was present in five patients; it was acute in two patients and organizing in three. In the patients with organizing DAD the degree of fibrosis in the interstitium differed among the lobes, and the fibrosis was more severe in the lower lobe than in the other lobes. Two patients presented with interstitial fibrosis with honeycomb lung of the posterior and lateral basal segments of the lower lobes of both lungs; in one of these patients interstitial fibrosis was present in an area of organizing DAD. Five patients died of respiratory failure resulting from DAD. In conclusion, it is important to consider DAD and interstitial fibrosis as complications of PAN.

Adolescent↗
PubMed1993

[Neoadjuvant therapy for prostatic cancer].

Neoadjuvant therapy for prostatic cancer might be important to increase cure rates of the disease and preservability of the organs. There were 43 cases in a period of 1975-1990 in which total prostatectomy were performed after neoadjuvant therapy. According to the clinical stage, there were 14 cases in B, 23 in C, 4 in D1 and 2 in D2. The median duration of neoadjuvant therapy was 4 months. Clinical response of the prostate in 37 evaluable cases was as follows; 6 cases were PR (16%), 12 cases were MR (32%) and 19 cases were NC (52%). Histopathological effect was as follows; 5 cases were grade 0a (12%), 12 cases were grade 0b (28%), 16 cases were grade 1 (37%), 8 cases were grade 2 (19%) and 2 cases were grade 3 (5%). In 2 cases with histopathological effect of grade 3, lymph node metastases were thought to have obviously disappeared. Histopathological effect seemed related to clinical response. In cases given neoadjuvant therapy for less than 2 months, no adequate clinicopathological effect was obtained. Cases that could achieve downstaging were 8; 1 in grade 0a, 2 in grade 1, 3 in grade 2 and 2 in grade 3. These results suggest that neoadjuvant therapy plays an important role in advanced prostatic cancer.

Aged↗
PubMed1993

[Successful interferon therapy of renal cell carcinoma with tumor thrombus extending into the inferior vena cava--a case report].

It is a fact that there are few effective drugs available except for interferon for that treatment of renal cell carcinoma, and the efficacy rate of interferon is less than 10% even if multiple drug regimens are included. We have experienced a case of renal cell carcinoma in whom interferon therapy was successful in reducing the primary lesion and tumor thrombus extending into the inferior vena cava. A 57-year-old man was admitted to our department with a complaint of macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a right renal tumor and the tumor thrombus. Because of the past history of his myocardial infarction, a radical operation was considered risky. So we started interferon therapy. Four months after the start of interferon therapy, the primary lesion and the tumor thrombus markedly reduced in their size, and the clinical response was evaluated as partial response by response criteria for urological cancer treatment. Therefore, radical nephrectomy and tumor thrombectomy were performed with extracorporeal circulation. Histopathologically, necrosis and lymphocyte infiltration into the cancer cell focus were seen, and these immunologic reactions were considered at the affection of interferon. In some case, interferon therapy is a useful and safe in the treatment of the primary lesion of renal cell carcinoma, and further investigation must be studied.

Carcinoma, Renal Cell↗