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Biomedical subjects

T Sugawa

Publications and source records attributed to T Sugawa.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Management of vulvar cancer].

In the treatment of vulvar malignancy surgery, chemotherapy, irradiation therapy and so on can be used. Actually, it was rarely performed only by a single method. For treatment by the stage of cancer progression, the superficial cancer was treated by wide local resection for the patients except old women who were done simple vulvectomy. For the invasive cancer, stage 1 or 2, the pre-operative bleomycin (BLM) was administered to reduce the tumor mass, thereafter, radical vulvectomy with inguinal lymph node resection was performed. If inguinal lymph nodes metastasis was found, area of resection was extended to pelvic lymph nodes. Recently, micro-invasive carcinoma was defined that the foci was below 2 cm and interstitial invasion below 1 mm. In this condition, it was needless to remove the lymph nodes. For the stage of 3 or 4 which was inoperable, chemotherapy (mainly BLM) combined with irradiation therapy was done. In the cases of good general condition, it was chosen by super-radical vulvectomy.

Bleomycin↗
PubMed1990

Uterine resting tonus and maternal hypertension during late pregnancy--existence of intrauterine capacity.

The uterine resting tonus was measured with an open-end catheter beginning from the 24th gestational week through the onset of labor in order to investigate changes in the intrauterine environment from the physical aspect. The measurements were performed in 183 primiparas for a total of 272 times and 102 multiparas for a total of 120 times. The uterine resting tonus was almost constant from the 2nd trimester through the 3rd trimester, but it tended to increase gradually beginning 2-3 weeks prior to the onset of delivery. This tendency was more pronounced in primiparas, and their mean tonus was about 5mmHg higher than that of multiparas throughout the pregnancy. In 55 subjects in whom both the resting tonus and blood pressure were simultaneously measured at least twice during pregnancy, the mean maternal blood pressure increased as the resting tonus increased. The above findings revealed a positive correlation between the resting tonus and the maternal blood pressure and suggested the presence of a critical point in terms of the intrauterine capacity, which derives from the properties of the uterine muscle and the intrauterine contents, consisting mainly of the fetus. The increase in the resting tonus is surmised to be related to this critical point.

Adult↗
PubMed1989

Saline solution amnioinfusion for oligohydramnios after premature rupture of the membranes. A preliminary report.

In the conservative management of premature rupture of the membranes, most patients have oligohydramnios caused by continuous leakage of amniotic fluid. To avoid unfavorable effects of oligohydramnios on fetal development and well-being, we infused physiologic saline solution continuously into the amniotic cavity at a flow rate of 10 to 20 ml/hr with a new cervical indwelling catheter (PROM-fence). As a result the average pocket size of amniotic cavity was 2.7 cm before amnioinfusion, 5.9 cm 1 day after, 5.8 cm 5 days after, and 5.0 cm 10 days after amnioinfusion. The saline solution amnioinfusion made it possible to keep the amniotic cavity fluid level adequate. Variable deceleration disappeared in one case. No side effects such as uterine contractions were observed. We recommend the method of saline solution amnioinfusion for its favorable effects on fetal environment during management of premature rupture of membranes.

Amniotic Fluid↗
PubMed1989

[Clinical evaluation of intermittent administration of CDDP in advanced ovarian cancer].

We examined the effects of intermittent cisplatin therapy (ICDDPT) on advanced ovarian cancer patients (OCP). Most OCPs had received surgical removal of primary lesion, and histopathological analysis indicated epithelial tumors. Four OCPs were stage 3, three were stage 4 and one was stage 2 (n = 8). After surgical treatment and induction chemotherapy, ICDDPT with 20-25 mg/day CDDP was given for 3 or 5 days, every 3 months. During the intervals, maintenance immunochemotherapy with Tegafur and OK-432 was given. Following ICDDPT all patients are alive, the longest survival time being 3 years and 10 months. Three have survived at least 3 years, 1 for at least 2 years and 3 for at least 1 year. Adverse drug reaction (ADR) was analysed with reference to the total dose of CDDP, i.e. under 500 mg, over 500 mg-under 1,000 mg and over 1,000 mg. Abnormal laboratory findings in platelets (thrombocytopenia), Hb, BUN, Creatinine, GOT and GPT were observed at the all doses. These ADR were not increased with the increasing dose so that accumulative toxicity was not observed. Therefore ICDDPT was seen to be effective in treating OCP.

Cisplatin↗
PubMed1989

[Study of the clinical background and therapeutic method in patients with vulvar cancer].

Forty-two cases of vulvar cancer were reviewed with regard to clinical condition and therapeutic method, especially the efficacy of local administration of BRM. By histological examination, koilocytosis was found in 45%. Furthermore, there was 90% positive koilocytosis rate in immunohistological study using anti-human papilloma virus antibody and in situ hybridization method by HPV DNA probe (type 6, 11, 16, 18). The HPA was mostly type 16. Therefore, vulvar cancer was considered to occur in close relation with HPV type 16. Some 12% of vulvar cancer was complicated with other gynecologic cancer. In these cases, NK activity was low. Thus, cancer may be considered to occur in association with low immunological status. With regard to the therapeutic method, surgery and radiotherapy were usually used after chemotherapy in our institute. At stage 3-4, combination therapy using surgery and radiotherapy were found to be most effective. In regard to local immunotherapy using OK-432 and LAK cell and IL-2, local administration of OK-432 was effective. Therefore, surgery and radiotherapy with local immunotherapy after chemotherapy were considered to be the most effective therapeutic method for vulvar cancer.

Aged↗
PubMed1989

[Human papilloma virus (HPV) antigens and DNA in dysplasia and carcinoma of the uterine cervix].

Routinely paraffin-embedded sections of dysplasia, carcinoma in situ (CIS) and invasive (squamous) carcinoma of the cervix were studied to determine the participation of human papilloma virus (HPV) in these tissues. Morphological observation (1,059 cases) revealed condylomatous changes to reach 54% in dysplasia, 25% in CIS and 25% in invasive carcinoma. Condylomatous changes were also found to be 25 to 40% in the non-cancerous epithelia adjacent to in situ or invasive carcinomas. The immuno-peroxidase-PAP-method using anti-HPV serum was applied to 98 selected sections in which condylomatous changes were morphologically observed. HPV antigens were found to reach 56% in dysplasia, 42% in CIS and 35% in invasive carcinoma, and this result suggested that the morphologically observed condylomatous changes did not always coincide with virus maturation in the infected cells. By means of the in situ hybridization technique, HPV type-6, -11, -16 and -18 DNAs were all detected in dysplasia sections, whereas HPV type-16 DNA was demonstrated distinctively at a high rate among in situ and invasive carcinomas.

Antigens, Viral↗
PubMed1989

[Estrogen production in epithelial tumors of the ovary--clinical and endocrinological study in postmenopausal women].

Estrogen-producing activity of common epithelial tumors (54 cases) and metastatic tumors (4 cases) of the ovary was clinically and endocrinologically studied in postmenopausal patients. High serum concentrations of E1 (greater than or equal to 50 pg/ml) and E2 (greater than or equal to 30 pg/ml) were demonstrated in 78% in the group of postmenopausal patients. Mucinous tumors were more commonly associated with high estrogen levels than serous tumors. Patients with malignant tumors more frequently have a high level of serum estrogen than those with benign tumors. Estrogen decreased to normal after complete resection of the tumor, but returned to the abnormal range following a recurrence. The local-peripheral gradient of the estrogen level was noted by measuring the estrogen concentration in the blood of the affected ovarian and peripheral veins at the time of laparotomy. These results indicated that serum estrogen in the patient was originally produced in the ovarian tumor mass. The increased estrogen were reflected in such target tissues as the endometrium and vaginal mucosa. Proliferation, hyperplasia, atypical hyperplasia and even a case of carcinoma of the endometrium were observed in patients with ovarian tumors. An increase in the karyopyknotic index (KPI) of the vaginal smear, as well as uterine bleeding, could be an important signs of asymptomatic ovarian tumors in postmenopausal women.

Biomarkers, Tumor↗
PubMed1989

[Estrogen production in epithelial tumors of the ovary--identification of estrogen-synthesizing cells].

Morphological, fine structural and enzyme histochemical investigation of common epithelial tumors of the ovary was aimed at identifying the estrogen-synthesizing cells in the stroma of the tumor. Histological changes in cell condensation or "thecosis" and cell enlargement or "luteinization" were commonly observed in the stromal area of the tumor. Two types of stromal cells were found by electron microscopic study; one had characteristic organelles of steroid hormone-producing cells, and the other had a similar cytoplasmic structure to that of fibroblastic cells. Both types of cells had lipid droplets in the cytoplasm. The former seemed to be transformed from the latter. Steroidogenesis-related enzymes such as 3 beta-hydroxy steroid dehydrogenase (HSD) and 17 beta-HSD were demonstrated in the stromal cells. Electron microscopy revealed that these enzymes were localized at the intercrystal space and inner membrane of mitochondria with tubular crystal. These findings indicated that thecosis appeared in the stroma of the epithelial tumor, and the stromal cell acquired estrogen-producing potential.

Cytoplasm↗
PubMed1989

[Ultrasonographic evaluation of the endometrium in postmenopausal women to select the high risk group of endometrial carcinoma of the uterus].

We examined the usefulness of ultrasonography (USG) for endometrial cancer screening in postmenopausal women. 207 postmenopausal women were ultrasonographically examined. The endometrial echo was classified into 4 types: 1, anechoic; 2, hair-line; 3, linear; and 4, navicular, and was compared with histological findings. No abnormal histological findings were observed in the cases showing type 1 and 2. On the other hand, abnormal histological findings including endometrial hyperplasia, atypical hyperplasia, and endometrial cancer, were seen in 57.7% (15/26) of type 3 cases, and 65.6% (21/32) of type 4 cases. Furthermore, type 3 and 4 women had enlargement of the uterus, and an increased incidence of postmenopausal bleeding. Positive rates in the progesterone challenge test (PCT) and karyopicnotic index (KPI) were higher in type 3 and 4 cases than in type 1 and 2. It was concluded that USG is able to accurately determine the endometrial condition and is useful for identifying high-risk patients in endometrial cancer screening.

Aged↗
PubMed1989

[Estrogen production in epithelial tumors of the ovary--localization of estrogen-synthesizing cells].

The origin of the elevated serum estrogen in postmenopausal patients with common epithelial tumors of the ovary was investigated by means of endocrinological, histochemical, immune histochemical and autoradiographic techniques. Estrone and estradiol and their precursors were quantitatively extracted from the tumor tissue homogenate, and the results indicated that the estrogen-producing pathway was not uniform among the tumors. On the tissue section Sudan-IV staining showed positive in the stromal area in the form of fine granules or droplets. The immune peroxidase method revealed that the Sudan staining-positive substance included estrogen and its precursors. Estrogen was also detected in the epithelium, but it seemed to be present in the epithelial (tumor) cells as an estrogen-estrogen receptor complex. Cholesterol staining was focally positive in the subepithelial stromal area and incorporation of 3H-cholesterol into the stromal cells was observed by microautoradiography. These findings indicated that steroid synthesis from cholesterol to estrogen appeared in the stroma of the tumor and high serum concentrations of estrogen in the patient were the result of accelerated estrogen-synthesis in the ovarian tumor.

Autoradiography↗
PubMed1988

Transcervical amnioinfusion of antibiotics: a basic study for managing premature rupture of membranes.

To determine the best method of preventing ascending infection in the management of premature rupture of membranes, antibiotics such as latamoxef sodium, cefoperazone sodium, and cefotaxime sodium were infused directly into the amniotic cavity in 64 patients undergoing induction of labor at term. A single infusion of 100 or 500 mg of each drug resulted in a concentration of 200 to 1000 micrograms/ml immediately after infusion, and the concentration remained above 10 micrograms/ml for about 24 hours without significant increase in fetal or maternal blood levels. Consequently, a daily single dose of 100 mg or more is probably effective prophylaxis in cases of premature rupture of membranes. When intrauterine infection is suspected, the dose can be increased to 500 mg or more, and transplacental administration may be added to achieve a higher concentration in fetal blood. The present study simulates well premature rupture of membranes, and an amnioinfusion of antibiotics will be reliable and effective in managing premature rupture of membranes.

Amnion↗
PubMed1988

Clinical effectiveness of a new cervical indwelling catheter in the management of premature rupture of the membranes: a Japanese collaborative study.

The aim of this multiinstitutional study was to evaluate a new cervical indwelling catheter in 84 patients with premature rupture of the membranes at less than 33 weeks' gestation. The average time of insertion of the catheter was 29.1 weeks' gestation, at an average of 2.0 days after rupture, and was left in place for an average of 6.5 days. The mean birth weight was 1417 gm. The mortality rate and the incidence of respiratory distress syndrome were 5.7% and 11.9%, respectively. Amniotic fluid culture was positive in 39.1% of patients before catheter insertion and only 4.3% at the time of delivery. Infection was noted in only four of 84 infants. The incidence of infection was very low in those treated for 3 days or more after catheter insertion.

Adult↗
PubMed1988

[Cancer and therapy for it--from gynecological standpoints].

Life phenomena have been studied scientifically for more than 160 years. Meanwhile many excellent technology and methodology which human race created have been used in the field of medicine. Analytical research for the constitution of life and impediments to life has remarkably advanced. Pathophysiology of many diseases has been clarified and reasonable and effective treatment for disorders has been organized. Many disorders which showed high mortality in the past are now listed as one of minor diseases in the textbook. However, the disease which cause is unclear and which deprives human race of life still exists. That is "CANCER". The society of medicine devotes the greatest energies to abolish the cancer. I am going to talk about the physiological characteristics of "the cancer in human race" from the gynecological standpoints and to present some facts of studies about the therapy for cancer in our department. I. Evolution of human and cancer 1. Life of species and life of individuals In the development from uni-nuclear cell creature to multicellular entity, to give new generation sexual reproduction was out-lasted for the adaptation to environment advantageously after the spread out of mutant gene in this entity. With this evolution, a living creature divided its cells into two types. One is somatic cells which would die in certain period and the other is germ cells which would not die on principle in good environment. In short well evolved living entity clearly established individual life span for the first time and its constituent, that is somatic cells demonstrated "AGEING" phenomena regulating life span.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvants, Immunologic↗