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Biomedical subjects

S Umezawa

Publications and source records attributed to S Umezawa.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Rectosigmoidectomy following neoadjuvant chemotherapy for advanced ovarian cancer].

Eleven women underwent rectosigmoidectomy as part of an en bloc removal of the adnexal masses, uterus, and pelvic peritoneum during cytoreductive surgery following neoadjuvant chemotherapy for advanced ovarian cancer. While 7 patients with stage IIIc underwent an exploratory laparotomy, 4 cases with stage IV did not because of their poor performance status (PS). Histologic subtypes were as follows: serous, 10 cases; endometrioid, 1 case. Patients with pleural effusion and ascites received immunotherapy. Thereafter, all patients were treated with 4-6 courses of neoadjuvant chemotherapy with cisplatin containing combinations, which delivered 9 PR, 1 MR and 1 NC. The PS score was improved by neoadjuvant chemotherapy and immunotherapy which may contribute to the low mortality and morbidity. Residual tumor of the largest diameter after debulking surgery were as follows: absent (5 cases), present (< 0.5cm; 2 cases, < 2cm; 3 cases, > or = 2cm; 1 case). The median survival for the entire group was 32.6 months. None of the 7 cases with residual disease < 0.5cm died of the disease within 2 years. Rectosigmoidectomy following neoadjuvant chemotherapy might be a useful procedure for patients who will be left with minimal residual disease after completion debulking surgery.

Adult↗
PubMed1994

[Comparison between old and new FIGO staging of endometrial carcinoma--the significance of positive peritoneal cytology].

Three hundred fifty-two patients with endometrial adenocarcinoma who underwent primary surgical therapy between 1984 and 1991 were evaluated. (1) Eighty-three (23.6%) had positive peritoneal cytology (PPC). (2) The cumulative 5-year survival rates (5-y. survival rate) for the former clinical stages were 88.8%, 86.1%, 52.9% and 0% for stages I-IV, respectively, showing a significant difference between stage III and IV (p < 0.05). The new clinical stage 5-5. survival rates were 97.5%, 100%, 69.9% and 25.9% for stages I-IV, respectively. There was no significant difference between stages I and II, but there were significant differences between stages I.II and III (p < 0.001) and between stages III and IV (p < 0.05). (3) In cases of new stage III, 5-y. survival rates for stage IIIA and IIIB.C were 83.7% and 33.6%, respectively (p < 0.01). Those for stage IIIA with PPC were very good in comparison with stage IIIA cases with other factors (90.3% vs 49.2%; p < 0.05). When the patients in stage IIIA with only PPC were separated into 2 groups, i.e., a myometrial invasion less than 1/2 and no cervical involvement group and a myometrial invasion greater than 1/2 or/and cervical involvement group, their 5-y. survival rates were 97.2% and 75.1% respectively (p < 0.05). (4) Recurrence developed in 15.3% of patients in stage IIIA with only PPC, and in 64.7% of patients in stage IIIA with other factors (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Pelvic lymph node metastasis in endometrial cancer].

Various factors associated with pelvic lymph node metastasis were analysed in 393 cases with stage I endometrial cancer treated with extended total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The results are as follows. 1. The positive rates for lymph node metastasis and the relapse rate in 393 cases were 8.4% and 12.5%, respectively. 2. Myometrial invasion, tumor size, vessel permeation, cervical involvement, peritoneal cytology and adnexal metastasis were significant factors for lymph node metastasis. 3. Internal iliac nodes were the most common metastatic sites for cases with a single node metastasis, whereas external iliac nodes were the most common in all cases with lymph node metastasis. 4. The relapse rate for cases with single node metastasis was 40%, while the relapse rate for cases with three or more metastatic lymph nodes was 70%. 5. The relapse rate for 33 cases with lymph node metastasis was 54.5% and all of the relapse cases showed distant recurrence, whereas the relapse rate for 360 cases without lymph node metastasis was only 8.6%. It is therefore considered that pelvic lymphadenectomy is important in detecting high-risk patients and to reduce the relapse rate. Cytotoxic chemotherapy seems to be more adequate as adjuvant therapy for cases with lymph node metastasis.

Adult↗
PubMed1994

[Recurrent endometrial cancer after complete surgery].

Between 1974 and 1991, 576 patients with endometrial cancer were treated with complete surgery. 1. The overall relapse rate was 14.4%. No recurrence was observed in surgical stage Ia, whereas 56.8% relapse was noted in stage IIIc. 2. The relapse rate in cases with adenocarcinoma was 13.0%. The relapse rate increased with poorer differentiation. Five of 6 cases with serous adenocarcinoma developed recurrence. 3. Myometrial invasion, size of tumor, vessel permeation, cervical involvement, adnexal metastasis and lymph node metastasis were significant factors for relapse. 4. Distant recurrence was noted in 63.9% of recurrent cases and 28.9% developed pelvic recurrence. The most common recurrent sites were lung, peritoneal cavity, and para-aortic lymph node in distant relapse and vaginal vault and parametrium in pelvic relapse. 5. The time to relapse ranged between 106 days and 5,518 days after complete surgery. Thirty one point three % of the recurrent cases manifested relapse within the first year, 60.2% within 2 years and 93.9% within 5 years. The mean time to relapse was 561 days. It was concluded that adjuvant therapy for cases with adnexal metastasis, lymph node metastasis, cervical involvement, adenocarcinoma (G3), and serous adenocarcinoma should be established urgently.

Adenocarcinoma↗
PubMed1993

Synthesis of 5-deoxy-5-fluoro- and 5-deoxy-5,5-difluoro-netilmicin.

5-Deoxy-5-fluoro- (9) and 5-deoxy-5,5-difluoro-netilmicin (27) have been prepared from the corresponding 5-epi and 5-oxo derivatives of netilmicin by treatment with DAST. Structures of the fluorinated by-products (10, 11, and 12) obtained in one of the synthesis of 9 were determined. 5-Epi-netilmicin (13) and 5-epi-6'-N-methyl-netilmicin (21) have also been prepared.

Animals↗
PubMed1993

Biocompatibility of surface-modified intraocular lenses.

We evaluated the biocompatibility of three kinds of intraocular lenses: heparin-surface-modified, surface-passivated, and regular poly(methyl methacrylate). Each lens type was implanted in 30 eyes. The cases were followed for one year. Biocompatibility was assessed by the degree of postoperative inflammation and capsule opacification. There was no significant difference between the surface-passivated and regular groups on both indices, but there was less postoperative inflammation in the heparin-surface-modified group. The incidence of posterior capsule opacification was greater in the heparin-surface-modified group than in the surface-passivated and regular groups, but the difference was not statistically significant.

Aged↗
PubMed1993

Synthesis of 3-deoxy-3,4-didehydro derivatives of 5-O-mycaminosyltylonolide, 5-O-(4-deoxymycaminosyl) tylonolide, and desmycosin.

The 3-deoxy-3,4-didehydro derivatives of 5-O-mycaminosyltylonolide, 5-O-(4-deoxymycaminosyl)tylonolide, and desmycosin have been prepared by treatment of the corresponding 3-O-sulfonyl derivatives with NaI in 2-butanone as the key step. The mechanistic difference in the formation of the 2,3- and 3,4-unsaturated derivatives from the same 3-O-sulfonyl derivative is discussed.

Anti-Bacterial Agents↗
PubMed1993

[Studies on the point mutation of ras oncogene in ovarian tumor].

Thirty-five patients with ovarian tumors operated on between December, 1989 and June, 1991 were studied to detect K-ras codon 12 point mutation (PM). (1) Five of 35 ovarian tumors (14.3%) disclosed K-ras PM at codon 12 and all the PM cases were in transition from GGT to GAT. On the other hand only one case (5.3%) with K-ras oncogene amplification was found and no C-myc or erbB-2 amplification was detected. (2) The incidence of PM according to clinical stages was seen in 3 of 11 stage I cases (27.3%), in 1 of 3 stage II cases (33.3%), in 1 of 14 stage III cases (7.1%) and in neither of 2 stage IV cases. PM was therefore seen in relatively early stages. (3) The occurrence of PM according to the histologic type was found in 3 of 16 serous tumors (18.8%), in 2 of 5 mucinous tumors (40.0%) and in none of 7 clear cell carcinomas or 2 endometrioid carcinomas. (4) Concerning the relation of PM to the involvement of serosal surface of ovarian tumors and to the ascitic cytology, no particular correlation was observed in our study. (5) Regarding the cytologic findings in imprint smears of the tumors in reference to PM, such as nuclear size, shape, N/C ratio, chromatin pattern, nucleolar size and number, the cases with PM tended to have more multiple nucleoli than PM negative cases. No other findings seemed to indicate the clinical progress of cancer. In conclusion, our study indicated that PM in ovarian cancers was a relatively early event in carcinogenesis.

Adult↗
PubMed1993

[Chemotherapy of ovarian cancer with a combination of low-dose consecutive CDDP and cyclophosphamide].

Sixty-six patients with ovarian cancer were treated with low-dose consecutive CP (LDC-CP) consisting of cyclophosphamide (CPM: 500 mg/m2, day 1) and CDDP (10 mg/m2, days 1-7). Two-9 (median: 4) courses of LDC-CP were given following reduction surgery (42 cases) or preceding primary debulking (24 cases). Among 66 cases, 12 with stage Ic were not evaluable (NE). The response rate (CR + PR/evaluable) for stages II-IV was 57.4% (12 + 19/54). Histologically, serous and endometrioid type showed a significantly (p < 0.001) higher response rate (77.5% among 40 evaluable) compared to the other histologic type (0% among 14). Toxicities including nausea/vomiting and renal impairment were markedly mild or almost absent despite the lack of any particular care. Grade 3 leucopenia and thrombocytopenia were observed only in 4.2%, and 2.5% of total 284 courses, respectively. Mean survival time by stage was 1,309 days for stage I, 809 days for stage II, 1,180 days for stage III, and 691 days for stage IV, with a significant difference among stages (p = 0.0452). In stages III and IV disease, significant prognostic factors included 1) response to chemotherapy, 2) no. of LDC-CP courses, 3) histologic subtype, 4) performance status, and 5) tumor size. Thus, LDC-CP is considered to be a useful chemotherapeutic regimen for serous and endometrioid type ovarian cancer.

Adult↗
PubMed1992

Synthesis of 5-deoxy-5-fluoro and 5-deoxy-5,5-difluoro derivatives of kanamycin B and its analogs. Study on structure-toxicity relationships.

5-Deoxy-5-fluoro- (1), 5.3'-dideoxy-5-fluoro- (2), and 5,3',4'-trideoxy-5-fluoro-kanamycin B (3) have been prepared by treatment of 5-epihydroxyl precursors (prepared by the Mitsunobu reaction) with DAST as the key step. 5,3'-Dideoxy-5,5-difluoro- (26) and 5,3',4'-trideoxy-5,5-difluoro-kanamycin B (27) were also prepared by treatment of the corresponding 5-oxo derivatives with DAST. These 5-deoxy-5-fluoro and 5-deoxy-5,5-difluoro derivatives showed markedly decreased toxicity as compared with the parent compounds.

Carbohydrate Sequence↗
PubMed1992

Synthesis of 4'-deoxy-4'-fluorokanamycin A and B.

4'-Deoxy-4'-fluorokanamycins A (17) and B (25) have been prepared through fluorinative ring-opening of the D-galacto-3',4'-oxiranes (8 and 21) derived from kanamycin A and B with potassium hydrogenfluoride in ethane-1,2-diol. The mechanism of preponderant formation of the 4'-deoxy-4'-fluoro-D-gluco (9 and 22) over the 3'-deoxy-3'-fluoro-D-gulo derivatives was discussed. In the synthesis of 25, the unusual 3',6'-epimine (23) was the main product along with the 4'-deoxy-4'-fluoro derivative. The mechanism of this reaction is also discussed. Both 17 and 25 were active against resistant bacteria producing aminoglycoside-adenylylating enzymes for HO-4'.

Anti-Bacterial Agents↗
PubMed1992

[Report of a case with aortic regurgitation in progressive systemic sclerosis].

Aortic valve lesions in progressive systemic sclerosis (PSS) are very uncommon. To our knowledge, aortic regurgitation (AR) associated with PSS has not been reported previously. We would like to report the case of a 58-year-old woman who had PSS with AR due to Raynaud's symptom, fever, positive ANA, accelerated ESR, and diastolic blowing murmur along the left sternal border. After treatment with adreno-cortico steroid and an immunosuppressive agent, the patient improved serologically and symptomatically. However, she was later admitted to our hospital again due to heart failure with progressive AR. She died of refractory heart failure with severe AR and tricuspid regurgitation (TR). The former was caused by aortic cusp lesions and the latter by pulmonary hypertension. An autopsy confirmed the diagnosis of PSS, which was found to have involved the heart, lungs and pancreas. Vasculitis with infiltration and fibrotic changes were noted in these organs. Moreover, there were fibrotic thickenings and shortenings in the aortic cusps with cell infiltration. There were no indications of rheumatic disease. These results suggest that the cause of our patient's aortic valve disease may have been PSS vasculitis.

Aortic Valve Insufficiency↗