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Biomedical subjects

S Tsutsui

Publications and source records attributed to S Tsutsui.

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

Cytophotometric DNA content and argyrophilic nucleolar organiser regions of oesophageal carcinoma.

The cytophotometric DNA content and the argyrophilic nucleolar organiser regions (AgNORs) of biopsy specimens taken before undergoing any treatment were examined in 91 surgically treated oesophageal carcinoma cases. There was a significant linear dependence between the mean DNA content and the number of AgNOR per nucleus (AgNOR number) (r = 0.615, P < 0.001). The DNA distribution pattern and the range of the AgNOR number also showed a significant correlation (P < 0.01). Twenty three of 28 cases with a low AgNOR number (< 4) were then determined to have a diploid pattern (type II), while 17 out of 22 cases with a high AgNOR number (> or = 6) had high ploidy values (type IV). The patients with a type II DNA distribution pattern and a low AgNOR number thus showed a good post-operative course with a 5 year survival rate of 55.2%, whereas no patients survived over 4 years among the 17 cases with both a type IV DNA pattern and a high AgNOR number (P < 0.001). These data thus demonstrate the close relationship between cytophotometric DNA content and AgNOR number and suggest that the combined detection of these two parameters, using biopsy specimens, should be of benefit in making an accurate preoperative evaluation of prognosis for patients with oesophageal carcinoma.

Adult↗
PubMed1993

Prevention of estrus in bitches by subcutaneous implantation of chlormadinone acetate.

The efficacy and clinical safety of chlormadinone acetate (CAP) in preventing estrus were assessed in bitches on condition that CAP was subcutaneously implanted in silastic silicon rubber. To evaluate the long-term efficacy of implantation, 19 bitches were divided into 4 groups given doses of 2.5, 5, 10 and 25 mg/kg, respectively. Although estrus was observed within 13 months after implantation in all of the bitches given CAP in the 2.5 mg/kg dose, and in 13 to 15 months in 3 of the 5 bitches given the 5 mg/kg dose, it was prevented for at least 24 months in all of the bitches given doses of 10 mg/kg or more. Plasma progesterone levels remained low throughout the period of estrus prevention, indicating a close correlation with the effect of CAP. The mean body weight of the bitches in groups receiving higher doses increased slightly over the course of the experiment. Except this, no clinical, hematology or biochemistry abnormalities were found in any of the treated bitches. Another 6 bitches were given 10 to 30 mg/kg of CAP, but the implants were removed to observe the recurrence of estrus and to measure the amount of CAP in the removed implant. Estrus recurred after removal even in the bitch given 30 mg/kg. The concentrations of CAP in the plasma and the amounts of CAP remaining in the implants demonstrated the sustained release of CAP from the implants. The concentrations of CAP in the individual bitches indicated that the lowest concentration effective in preventing estrus is 0.7 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

[Alcoholic liver injury accompanied with various metabolic and endocrinological disorders--a case report].

We report a young female case of alcoholic liver injury accompanied with various metabolic and endocrinological disorders. A 29 year-old woman was admitted because of general fatigue and hyperlipidemia. She was a heavy drinker. Laboratory data on admission revealed liver dysfunction and hyperlipidemia (type II b) with a quite high serum gamma-glutamyltranspeptidase (gamma GTP) level. The microscopic finding of the liver biopsy specimen showed fatty metamorphosis and ballooning of hepatocytes, and she was diagnosed as heavy alcoholic liver injury. The endocrinological examination revealed the elevated plasma cortisol level, though the urinary 17-hydroxycorticoids (17-OHCS) and 17-ketosteroids (17-KS) excretion and the plasma adrenocorticotropic hormone (ACTH) level were reduced. Cortisol secretion showed the normal circadian rhythm and the normal response to ACTH provocation. The levels of plasma triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were also reduced. These endocrinological and metabolic disorders were normalized in company with recovery of the liver function by temperance, diet therapy and nutritional education. Thus, these abnormalities were considered to be resulted from the alcoholic liver injury and the effect of the ethanol to the hypothalamic-pituitary system.

Adult↗
PubMed1993

How to detect early carcinoma of the esophagus.

In order to identify the most effective approaches for detecting early carcinoma of the esophagus, 46 patients with such lesions, including three epithelial, 13 mucosal and 30 submucosal carcinomas, were studied. Among 16 patients with epithelial and mucosal carcinomas, five (31%) were symptomatic, and in 15 (94%), the lesions were detected by endoscopy. Among 30 submucosal carcinomas, 17 (57%) were associated with symptoms such as mild dysphagia and a sharp pain, and 22 (73%) were detected by endoscopy. With respect to the gross appearance of early esophageal carcinoma, a protruded type frequently caused symptoms (70%) and was often detected by radiology (50%). Although endoscopy always permitted a correct diagnosis of the lesion (100%), radiology often failed to detect it (47%), especially when the lesion was of the superficial type. In asymptomatic patients, most early esophageal carcinomas were detected during the follow-up of gastric diseases, mass-screening or medical examination for gastric cancer, and in connection with abdominal pain due to other diseases. These results indicate that, in order to detect early carcinoma of the esophagus, it is important to perform Lugol-combined endoscopy with biopsy rather than radiology.

Adult↗
PubMed1993

DNA ploidy as a prognostic factor in early esophageal carcinoma.

Cell nuclear DNA content was cytophotometrically determined in biopsy specimens obtained from thirty-five patients with superficial esophageal carcinoma. The relationship between the DNA distribution pattern and histopathological features, prognosis and postoperative survival time was then investigated. Patients with a low ploidy pattern had a more favorable postoperative course, with 62% attaining a 5-year survival rate, than those with high ploidy, of whom 34% attained a 5-year survival rate (p < 0.01). The recurrence rate was higher for the high ploidy pattern (64.3%) than for the low ploidy pattern (35.3%). Moreover, the rate of recurrence within 2 years was 50% in high ploidy, which was higher than the 5.9% rate in the case of low ploidy (p < 0.05). Although there was no clearly established relationship between the DNA distribution pattern and clinicopathological features, a multivariate analysis revealed that the DNA distribution pattern was one of the independent and significant prognostic factors of superficial esophageal carcinoma. These results thus suggest the usefulness of a preoperative DNA analysis of biopsy specimens in predicting the prognosis and determining perioperative therapeutic strategy for both superficial esophageal carcinoma and for advanced cases.

Adult↗
PubMed1992

A flow cytometric analysis of DNA content in primary and metastatic lesions of esophageal squamous cell carcinoma.

BACKGROUND: DNA content of malignant tumors has been considered a significant prognostic factor, but intratumor variations in DNA content and differences in DNA content between primary and metastatic lesions have been found in various tumors. METHODS: DNA indexes of multiple samples obtained from different sites in each tumor were determined by flow cytometry (FCM) in 27 esophageal squamous cell carcinomas. RESULTS: Intratumor variation in DNA indexes in primary lesions was found in 10 (37%) of the 27 specimens. Of the rest, all DNA indexes were diploid in 5 and all identically aneuploid in 12 samples. A DNA index differing from that of the metastatic lesion was found in four (50%) of eight primary lesions; however, a component of the DNA index identical to that of metastatic lesion was found in seven (88%) of eight primary lesions. CONCLUSIONS: Recurrence after a "curative" operation was frequent in patients with a tumor that had an aneuploid DNA index, with or without a variation in DNA indexes. There was no recurrence in the five patients with tumors that had only a diploid DNA index. These results suggest that differences in DNA content between primary and metastatic lesions reflect intratumor variation in DNA content in the primary lesions. The presence of a tumor cell population with an aneuploid DNA content, even when the DNA content varied in the primary lesion, may indicate an aggressive clinical course in patients with esophageal squamous cell carcinoma.

Adult↗
PubMed1992

Early depressed adenocarcinomas of the large intestine.

From January 1987 to December 1990, five cases of early depressed cancer of the large intestine were seen. Endoscopically, almost all of these tumors were located in the proximal colon and looked like a reddish depression (similar to the sucker of an octopus). Histologically, all of these cancers were well differentiated and tended to reach deeper layers at an early stage. Four (80%) of these cancers were not associated with adenoma and were thought to have arisen de novo.

Adenocarcinoma↗
PubMed1992

Influence of preoperative treatment and surgical operation on immune function of patients with esophageal carcinoma.

Multiple immunological parameters, including total lymphocyte count, lymphocyte subpopulations (CD2+, CD19+, CD3+, CD4+ and CD8+), phytohemagglutinin (PHA) response, and natural killer (NK) activity, were measured in 66 patients with previously untreated esophageal carcinoma. The influence of preoperative treatment and/or surgical operation on the immune function were evaluated in 40 patients. The PHA response and NK activity of the patients with esophageal carcinoma were 229 +/- 103 S.I.% and 18.5 +/- 11.9% lysis, respectively, and were significantly depressed as compared with the control. The CD4+/CD8+ ratio, PHA response, and NK activity in stage IV were also significantly depressed compared to that in stages I-III. Preoperative treatment induced significant reductions in the total lymphocyte count (1,994 +/- 644 to 670 +/- 274/mm3), PHA response (219 +/- 77 to 159 +/- 59 S.I.%), and NK activity (19.7 +/- 13.2 to 11.1 +/- 10.3% lysis) as well as a significant gradual decrease in the CD4+/CD8+ ratio (2.09 +/- 1.42 to 0.69 +/- 0.48), while the surgical operation significantly influenced only the total lymphocyte count. This study demonstrates that preoperative treatment induces a more pronounced influence on the immune function than surgical operation alone, in patients with esophageal carcinoma in which the immune function is disturbed prior to these treatments.

Adult↗
PubMed1992

Promoting effect of ovariectomy on hepatocellular tumorigenesis induced in mice by 3'-methyl-4-dimethylaminoazobenzene.

The treatment of female C57BL/6 x DS-F1 mice with 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB) at 10, 12, 14, 16 and 18 days of age resulted in the development of hepatocellular adenomatous nodules after 10 months of age. Ovariectomy in these mice at 1 month of age hastened the development of adenomatous nodules, which then first appeared at 8 months of age. The incidence of adenomatous nodules in females ovariectomized at the age of 1 month was much higher than that in intact females of the same age. These results showed that the ovaries exerted a suppressive effect on the development of adenomatous nodules. To determine the time from which the ovaries exert this suppressive effect, females were ovariectomized at 4, 6, 8, and 10 months of age, and the incidences of adenomatous nodules were compared at 10 and 12 months of age. Delayed ovariectomy after 8 months of age did decrease the incidence of adenomatous nodules at 10 and 12 months of age, but ovariectomy after 4 and 6 months of age did not. When the incidence of adenomatous nodules in females ovariectomized at 10 months of age was examined over the subsequent 6 months, it became significantly higher after 14 months of age compared with that in intact females. The results show that the ovariectomy has the promoting effect on the development of adenomatous nodules in the liver induced by 3'-Me-DAB after 6 months of age.

Aging↗
PubMed1992

Multivariate analysis of postoperative complications after esophageal resection.

To determine the contributing factors for eight postoperative complications after esophagectomy through a right thoracoabdominal approach, a multivariate analysis was carried out on preoperative and intraoperative variables in 141 patients with thoracic esophageal cancer. Although postoperative complications occurred in 125 patients, only 7 died of such complications. The multivariate analysis indicated that the retrosternal route was a significant factor predisposing to postoperative atelectasis. Age, preoperative arterial oxygen tension, and volume transfused were significant factors predisposing to postoperative hypoxemia, whereas age, routes other than the intrathoracic route, and volume transfused were significant factors predisposing to prolonged respiratory support. In addition, preoperative total serum bilirubin level and volume transfused were significant factors predisposing to postoperative hyperbilirubinemia; preoperative serum creatinine level was a significant contributing factor for postoperative renal insufficiency; and sex, antesternal route, and substituted colon were significant contributing factors for anastomotic leakage. There were no significant factors predisposing to postoperative pneumonia and liver dysfunction. These significant factors should be taken into consideration not only during perioperative management but also when choosing the operative procedures and extending the surgical indication for esophagectomy through a right thoracoabdominal approach.

Age Factors↗
PubMed1992

Hyperthermo-chemo-radiotherapy as a definitive treatment for patients with early esophageal carcinoma.

Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery.

Aged↗
PubMed1991

Growth patterns and prognosis of submucosal carcinoma of the esophagus. A pathologic study.

Sixteen cases of esophageal carcinoma invading the submucosa were analyzed in terms of growth patterns. Seven were classified into the massively penetrating (down growth) type, four into the superficially spreading (spreading growth) type, and five into the unclassified type. In the down growth type, the ratio of the submucosal area to the total (mucosa and submucosa) area was more than 0.2 (one fifth), and in the others that ratio was less than 0.2. The down growth type is characterized by a tendency toward elevated lesions, a high incidence of vessel invasions and lymph node metastasis, and a poor prognosis after surgery. Lymphatic and/or vascular invasions were recognized in six of seven cases, and the 5-year survival rate was 0%. In contrast, the spreading growth and unclassified types was characterized by superficial lesions, a low incidence of vessel invasions and lymph node metastasis, and a favorable prognosis. In only one with the spreading growth type was there lymphatic invasion. Three of the four with the spreading growth type survived over 5 years, and the other one with the spreading growth type and all of five with the unclassified type are alive without recurrences 15 to 52 months after surgery. Thus, growth patterns reflect well the prognosis of the submucosal carcinoma of the esophagus.

Aged↗
PubMed1991

Predicting recurrence time of esophageal carcinoma through assessment of histologic factors and DNA ploidy.

Cytophotometric analysis of nuclear DNA content was done in 128 patients with squamous cell carcinoma of the esophagus. The relationship among histopathologic features, DNA distribution pattern, and survival time was investigated from the standpoint of recurrence. Of 128 patients, 77 (60.1%) died of recurrence within 2 years after surgery: 16 (12.5%) from 2 to 5 years and two (1.6%) over 5 years. The rate of death of recurrence within 2 years was higher in patients with T4 or N1 than T1, T2, and T3 or N0 (P less than 0.01). Survivors over 5 years more frequently possessed type II DNA pattern than types III and IV (P less than 0.05). The rate of death of recurrence within 2 years was 34.4% in type II, which was lower than the 59.6% rate in type III (P less than 0.05) and the 76.6% rate in type IV (P less than 0.01). Survivors from 2 to 5 years were higher in type III than in type IV (P less than 0.05), and recurrence over 5 years was found only in type II. This inclination was more apparent in those with curative resection. In the patients with type II, careful follow-up may be needed over 5 years for late recurrence. However, in those with type IV, no recurrence over 2 years could be regarded as healed because most of their recurrences occur within 2 years. These findings suggest that the growth rate of esophageal carcinoma should reflect DNA aneuploidy, and the DNA analysis of esophageal carcinoma should be a valuable parameter for postoperative follow-up planning.

Carcinoma, Squamous Cell↗
PubMed1991

Comparison of characteristics of esophageal squamous cell carcinoma associated with head and neck cancer and those with gastric cancer.

In ongoing reviews of 339 patients with surgically treated primary squamous cell carcinoma, there were 19 (5.6%) with concurrent gastric cancer and 11 (3.2%) with head and neck cancer. The incidences of intra-esophageal multiple occurrence of esophageal cancer are 27.3% and 26.3% in those with associated head and neck cancer and gastric cancer, respectively, and higher than 7.1% in those without such a concurrent cancer. There was no difference in the clinicopathological characteristics of those with concurrent head and neck and gastric cancers, except for the higher incidence of metachronous occurrence in the former. These findings suggest that, in cases of esophageal cancer associated with concurrent head and neck cancer and gastric cancer, intraesophageal multiplicity of the esophageal carcinoma is frequent and that preoperative serial evaluations is most important to design treatment and estimate the prognosis.

Aged↗
PubMed1991

Lugol stain for intraoperative determination of the proximal surgical margin of the esophagus.

An adequate proximal surgical margin is difficult to determine particularly in cases of esophageal carcinoma with surrounding intraepithelial invasion. We report here readily facilitated intraoperative approaches for detection of the exact margin of carcinomatous invasion of the esophagus. The resected specimen of the esophagus is incised longitudinally and placed in a 1% Lugol bath for 2-3 minutes. The normal squamous epithelium includes glycogen that interacts with the iodine of Lugol's solution and the normal epithelium of the esophagus becomes a uniform greenish-brown. A squamous cell carcinoma does not include glycogen, hence is not stained with this solution and a clear identification is feasible. Thus, a carcinomatous infiltration not recognizable in routine examinations becomes macroscopically visible when Lugol's solution is used.

Adult↗
PubMed1991

Comparison of cell nuclear DNA contents between intraepithelial and invasive components of oesophageal squamous cell carcinoma.

Detailed cytophotometric analyses of cell nuclear DNA content were performed on 132 different areas from 24 oesophageal squamous cell carcinomas with an intraepithelial component. Measurements of DNA content were performed at the three different areas within each of the intraepithelial and invasive components. There were no differences in the overall incidence of DNA distribution patterns which were classified according to the degree of dispersion and the peak value on the DNA histogram between intraepithelial and invasive components, as well as the average of mean values of the DNA content. In 13 (54%) of 24 cases, there was a variation among the DNA distribution patterns obtained from three different areas of the intraepithelial components, whereas there was a variation in 4 (22%) of the 18 invasive components. In 11 of 13 intraepithelial components with a variation, the same DNA distribution pattern as seen in the invasive component was present. Provided that the DNA content remains stable, variations in intraepithelial components may reflect various tumour cell populations. These findings support the idea of a multicentric carcinogenesis of oesophageal carcinoma, and shed light on the mechanisms in which a single cell population is selected from various cell populations in the progression from an intraepithelial to an invasive lesion.

Carcinoma in Situ↗