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Biomedical subjects

M Iwafuchi

Publications and source records attributed to M Iwafuchi.

At least 73 records · Page 4Linked to original sources
PubMed1990

Treatment of advanced neuroblastoma with emphasis on intensive induction chemotherapy. A report from the Study Group of Japan.

One hundred nine newly treated patients with advanced neuroblastoma were entered in this study between January 1985 and May 1989. The eligible patients included infants younger than 12 months of age with Stage IVA disease (bone cortex, distant lymph node, and/or remote organ metastases) and patients aged 12 months or older with Stage III or IV disease (IVA plus IVB with tumor crossing the mid-line and with metastases confined to bone marrow, liver, and skin). The patients first received six cyclic course of intensive chemotherapy (regimen A1), consisting of cyclophosphamide (1200 mg/m2), vincristine (1.5 mg/m2), tetrahydropyranyl adriamycin (pyrarubicin; 40 mg/m2), and cisplatin (90 mg/m2). Original tumors and the regional lymph node metastases were removed some time during these first six cycles of chemotherapy. The patients were further divided into three groups. Patients in course 1 received alternating treatment by regimen B (cyclophosphamide and ACNU) and intensified regimen A1, and those in course 2 were treated with alternating administration of regimen C (cyclophosphamide and DTIC) and intensified A1. Patients in course 3 were treated with bone marrow transplantation (BMT) preceded by high-dose preconditioning chemotherapy. Survival rates were 77% in Stage III and 54% in Stage IV at 2 years, and 70% in Stage III and 45% in Stage IV at 3 years. The major toxicities encountered were bone marrow suppression with leukocyte counts down to 100/mm3, mild cystitis, and hearing impairment. The 2-year survival rate was 78% in 21 patients who underwent BMT when complete remission was achieved. We concluded that our intensive induction chemotherapy is of significant value in increasing the rate of complete response, and in widening the indications for and achieving improved results of treatment with BMT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Familial occurrence of congenital bile duct dilatation.

The occurrence of congenital bile duct dilatation (CBD) in both a mother and her daughter was recently experienced at Niigata University Hospital and Niigata Shimin Hospital. Bile duct dilatation with anomalous pancreaticobiliary ductal junction (AP-BDJ) was disclosed in both. Intrahepatic bile duct dilatation was only in the mother. Removal of dilated bile duct, cholecystectomy, and hepaticojejunostomy were performed in both. Fourteen cases of CBD from seven families were collected from literature and discussed.

Adult↗
PubMed1990

Immunohistochemical and ultrastructural studies of twelve argentaffin and six argyrophil carcinoids of the appendix vermiformis.

Endocrine cell types in 12 argentaffin and six argyrophil carcinoids and in nonneoplastic epithelia of the appendix vermiformis were investigated histochemically, immunohistochemically, and ultrastructurally. The nonneoplastic epithelia contained serotonin (Ser), peptide YY (PYY), glicentin (Gli), neurotensin (Neu), and somatostatin (So) cells in decreasing frequency. Out of 30 nonneoplastic Ser cells examined ultrastructurally, 28 cells were EC1 cells and two were non-EC cells. Eleven of 12 argentaffin carcinoids could be immunostained with anti-Ser serum and all of those 11 were composed almost totally of Ser cells. One of the 11 contained a small number of Neu cells. Ultrastructurally, 11 argentaffin carcinoids were composed predominantly of EC1 and/or ECn cells, and one was composed primarily of non-EC cells. Out of the six argyrophil carcinoids, five were argyrophil, non-argentaffin carcinoids; three consisted almost totally of PYY cells; one consisted of 60% PYY cells, 40% So cells and a few Gli cells; and one consisted of Ser cells alone. Ultrastructurally, the first four of those tumors were composed of D1 and/or L cells and the latter tumor was composed of ECn cells. The remaining one argyrophil carcinoid contained a few Ser-positive argentaffin cells and consisted almost totally of ECn cells which were found in both parts, with and without argentaffinity. It is concluded that the appendiceal carcinoids comprise two distinct groups on the basis of the main constituting cell type: Ser-positive, argentaffin carcinoids, composed of EC cells and peptide (especially of PYY)-positive, and Ser-negative, argyrophil non-argentaffin carcinoids of D1 and/or L cells.

Adolescent↗
PubMed1990

Primary benign histiocytosis X of the stomach. A report of a case showing spontaneous remission after 5 1/2 years.

A 49-year-old Japanese woman was found to have innumerable, small sessile elevations throughout the stomach as revealed by radiographic and endoscopic examination. Endoscopic biopsy showed that the elevations were formed by a diffuse proliferation of histiocytes in the lamina propria mucosae. The histiocytes were characterized by abundant interdigitating cytoplasmic projections, Birbeck granules, an oval or indented nucleus, and an absence of phagocytosis. They stained for S-100 protein but not for lysozyme, alpha-1-antitrypsin, or nonspecific antigen cross-reacting with carcinoembryonic antigen. Five and a half years after the first diagnosis, most of the elevated lesions disappeared, but a few histiocytoid cells were noted microscopically. Systemic examination showed no abnormalities outside the stomach. The patient has continued to be well. This case was diagnosed as primary benign histiocytosis X of the stomach. Four similar cases have been reported. This is the first case that was diagnosed using biopsy techniques and in which the natural history--i.e., from multiple polypoid extension throughout the stomach to spontaneous remission--was observed.

Female↗
PubMed1990

Adenocarcinoma arising in Barrett's esophagus after total gastrectomy.

A 64-yr-old Japanese male who underwent a partial gastrectomy for a duodenal ulcer at the age of 21, a total resection of the remnant stomach for a stomal ulcer at age 25, and in whom Barrett's esophagus was diagnosed at age 47, was found to have a tumor at the distal esophagus and was operated on by thoracic esophagectomy. The tumor was a well to moderately differentiated adenocarcinoma invading down to the muscularis propria. The entire esophageal mucosa in the resected specimen was lined by columnar epithelium. This tumor was thought to derive from the Barrett's esophageal epithelium.

Adenocarcinoma↗
PubMed1989

Multiple carcinoids and endocrine cell micronests in type A gastritis. Their morphology, histogenesis, and natural history.

Six cases of type A gastritis associated with multiple carcinoids and/or endocrine cell micronests (ECM) in the atrophic fundic mucosa were examined light microscopically, immunohistochemically, and ultrastructurally. The ECM and carcinoids were mainly composed of enterochromaffin-like (ECL) cells. The cells were hyperplastic only in the atrophic fundic glands and pseudopyloric glands, but not in the intestinal metaplastic gland. It is suggested that the development of both the ECM and the carcinoids is highly related to the atrophic change of the fundic mucosa and a trophic action of subsequently raised serum gastrin in type A gastritis and that the both lesions arise from the pseudopyloric glands or atrophic fundic glands. In addition, the definition of neoplastic ECM (microcarcinoid) of the stomach was made with comparative study on both the cases with ECM and multiple carcinoids and the cases with ECM alone.

Adult↗
PubMed1989

Immunocytochemical demonstration of IGF-II-like immunoreactivity in human paraganglioma of the craniocervical region.

Insulin-like-growth factor (IGF)-II-like immunoreactivity was examined in two carotid bodies and six extra-adrenal paragangliomas with use of monoclonal antibody against rat IGF-II, which crossreacts with human IGF-II. Chief cells but not sustentacular cells of the carotid body were positive at about 10% in one case and less than 1% in another case. Among four carotid body tumours, a possible vagal body tumour and one glomus jugulare tumour, all but the glomus jugulare tumour exhibited positive tumour cells irrespective of histological variations. The frequency of positive cells ranged from 20 to 60%. IGF-II like immunoreactivity, therefore, might be widely distributed in human extra-adrenal paraganglionic tissues and tumours, although its biological role in these cells remains to be elucidated.

Adult↗
PubMed1989

IGF-II-like immunoreactivity in human tissues, neuroendocrine tumors, and PC12 cells.

We looked for cells that reacted with monoclonal antibodies against rat insulin-like growth factor II (IGF-II). We found them in human fetal kidneys in the 14th week of gestation and in adult adrenal medullas but not in human liver, pancreas, pituitary gland, or thymus. Every pheochromocytoma in a group of 20 had IGF-II-like immunoreactive cells, as did three out of four ganglioneuroblastomas (one of which was heterotransplantable in athymic nude mice) and one carotid body tumor. Using the electron microscope we localized the immunoreactivity in pheochromocytoma cells to their neurosecretory granules of the non-catecholamine type. We failed to find any IGF-II-reactive cells among the pancreatic islet cell tumors, neuroblastomas, medullary carcinomas of the thyroid, retinoblastomas, and Wilms' tumor we studied. One line of human neuroblastoma cells did show some immunoreactivity after treatment with dbcAMP. Additionally, the rat pheochromocytoma cell line PC12 and its subline PC12h occasionally produced a few immunostained cells. These results strongly indicate that human IGF-II is primarily produced in paraganglionic tissues and tumors.

Adrenal Gland Neoplasms↗
PubMed1989

Studies on intestinal motility and mechanism of cholangitis after biliary reconstruction.

Cholangitis is a serious complication of biliary reconstruction for congenital biliary atresia. To observe the effect of intestinal motility on the mechanism of cholangitis, we studied intestinal motility in dogs after experimental common duct ligation and reconstruction by Roux-en-Y or interposition cholecystojejunostomy. One year after operation, bipolar electrodes were implanted in the canine intestine and electromyograms were performed. Distinct patterns of propagation and the direction of intestinal motility characteristic of each procedure were observed. The animals with Roux-en-Y loops showed a decrease in motility of the duodenum and upper jejunum. Those with an interposed segment demonstrated stagnation in both the duodenum and jejunum, and poor coordination of intestinal movement. The myoelectric activity of the Roux-en-Y loop suggests that it is the reconstruction technique most likely to prevent reflux cholangitis.

Anastomosis, Roux-en-Y↗
PubMed1989

Histogenesis of gallbladder carcinoma from investigation of early carcinoma and microcarcinoma.

Carcinomas of the gallbladder can be grossly divided into two types: carcinoma in adenoma (CIA) and carcinoma without adenoma (CWA). The histogenesis of both types of gallbladder carcinoma (CIA and CWA) was investigated in association with metaplastic changes in 35 early carcinomas larger than 5 mm in diameter and 16 microcarcinomas up to 5 mm in largest diameter. In five early CIAs and two micro-CIAs, the carcinoma was surrounded by the adenoma, and the areas of both carcinoma and adenoma mainly showed gastric-type metaplasia (GM). On the other hand, 90% of the other 30 early CWAs showed GM and/or intestinal-type metaplasia (IM) in the tumor, and all of them were surrounded by GM and/or IM. Seven of the other 14 micro-CWAs showed GM and/or IM in the tumor as well as in the surrounding mucosa, and had non-neoplastic metaplastic glands underneath the carcinoma tissue. The remaining seven micro-CWAs showed no or only mild metaplasia in the tumor and were surrounded by proper mucosa without metaplasia. From these data, it is concluded that carcinoma of CIA possibly arises from adenoma mainly with GM, and that CWA originates either from the upper part of the metaplastic mucosa or from the proper mucosa of the gallbladder. In addition, some CWA may undergo secondary metaplastic changes during tumor growth.

Adenocarcinoma↗
PubMed1989

[Clinical evaluation of A 1 protocol in advanced neuroblastoma].

UNLABELLED: For the purpose of studying clinical evaluation of A 1 protocol for advanced neuroblastoma, chemotherapy with vincristine, cyclophosphamide, THP-adriamycin and cisplatin was performed in 8 pediatric patients with advanced neuroblastoma undergoing second look operation (4) or delayed primary operation (4). Tumor volume measured on CT, histological finding of tumor obtained at operation, blood and urinary tumor marker level were studied. RESULTS: 1) The chemotherapy is supposed to be effective for round cell type neuroblastoma. On the other hand, it is ineffective for composite type ganglioneuroblastoma. 2) More than 3 courses of A 1 protocol are necessary to yield a good effect. 3) There is no relationship between the effect of the chemotherapy and the prognosis.

Adrenal Gland Neoplasms↗
PubMed1988

A case report of intrahepatic biliary atresia showing an unusual liver histology.

The extrahepatic biliary tract of a male infant, including both the left and right hepatic ducts, was proven to be patent up until his time of death, however, histologic examination of the liver revealed severe fibrosis of the portal areas with ductular proliferation, scattered bile thrombi, and subsequent biliary cirrhosis. In this case, since the obstructive lesion occurred at the secondary branching of the bilateral hepatic duct and because fewer changes were present in the interlobular bile ducts, it seemed possible to consider that the liver histology revealed findings similar to those of extrahepatic biliary atresia.

Bile Ducts, Intrahepatic↗
PubMed1988

Evaluation of lower esophageal sphincter function in infants and children following esophageal surgery.

Esophageal manometry was performed before and after the operations for esophageal disorders in children to evaluate lower esophageal sphincter (LES) function and motility of the esophagocardiac region in each disease. Patients who underwent radical operations for gross C-type esophageal atresia (EA) and those with hiatal hernias considered to have gastroesophageal reflux (GER) showed reduction in LESP and LESL and eosphagocardiac motor abnormalities. Lower esophageal sphincter pressure and length, and motility of the esophagocardiac region improved in six patients who underwent an antireflux operation. Abnormal esophageal waves in EA patients persisted even after improvements in LES function by the antireflux operation and were considered to be a congenital problem, as the literature suggests. Effects of surgical intervention on the esophagus on the LES function were studied. Lower esophageal sphincter and esophagocardiac function were preserved, and GER did not develop after Livaditis' procedure for EA or esophageal transection and sectioning the esophageal branch of the vagus nerve for esophageal varices. Anatomic abnormalities that lead to LES dysfunction are considered to cause GER.

Child↗
PubMed1988

[Surgical treatment and problem of massive small intestinal resection in children--assessment of background diseases and actual management].

From 1971 to 1986, massive small intestinal resection was done in twenty-five cases; intestinal atresia 12, intestinal volvulus 9, necrotizing enterocolitis 2, intussusception 1 and gastroschisis 1. Thirteen cases (52%) of them have survived. Of 12 cases with intestinal atresia undergoing small intestinal resection, 7 cases had atresias of multiple type, on the other hand, in intestinal volvulus, 4 of 9 cases without malrotation have had massive small intestinal resection, compared with 5 of 30 cases with malrotation. Many clinical problems have occurred after massive small intestinal resection, especially in cases with short bowel syndrome (shorter than 30 cm in length), but home parenteral nutrition has become one of the key treatments for cases with short bowel syndrome.

Child↗
PubMed1987

A case of congenital colonic atresia associated with atresia ani.

The association of atresia ani with congenital colonic atresia is extremely rare, with only one such case having been reported up to date. We have recently treated a female infant with atresia ani (covered anus complete) accompanied by atresia of the sigmoid colon, who was managed by three stage surgery.

Anal Canal↗
PubMed1987

Neoplastic endocrine cells in carcinomas of the small intestine: histochemical and immunohistochemical studies of 24 tumors.

Endocrine cells in 24 primary carcinomas and in the nonneoplastic mucosa of the small intestine were investigated histochemically and immunohistochemically with antisera against serotonin and 10 kinds of peptide hormones. Argyrophil-positive endocrine cells were found in four of eight duodenal, all of eight jejunal, and six of eight ileal carcinomas. The density of the positive cells was higher in the ileal tumors than in the duodenal and jejunal ones. Immunoreactive endocrine cells were detected in three duodenal, six jejunal, and five ileal carcinomas. Immunoreactive serotonin cells were present most frequently and most densely without respect to the site of origin of the carcinomas. In general, the population of endocrine cells among the tumor cells was higher in the ileal carcinomas than in the duodenal and jejunal ones. The ileal carcinomas frequently and densely demonstrated somatostatin, peptide YY, neurotensin, glucagon, and glicentin cells in addition to serotonin cells. The kinds of endocrine cells and the relative frequency of each kind of endocrine cell in carcinomas of the small intestine were similar to those in the nonneoplastic mucosa from which the carcinomas originated. This is the first systematic immunohistochemical study on endocrine cells in carcinoma of the small intestine.

Adult↗
PubMed1987

Argyrophil, non-argentaffin carcinoids of the appendix vermiformis. Immunohistochemical and ultrastructural studies.

Five argyrophil, non-argentaffin classical carcinoids of the appendix were found in 19 appendiceal classical carcinoids and were investigated histochemically, immunohistochemically and ultrastructurally. All tumors consisted entirely of argyrophil cells. Three of the five carcinoids were composed almost totally of peptide YY cells and were negative for serotonin. One of them consisted of peptide YY cells (60%), somatostatin cells (40%), and a few cells with glucagon-like immunoreactivity (GLI). The remaining one without peptides was homogeneously immunoreactive for serotonin alone. Ultrastructurally, each of the four peptide-positive carcinoids was composed of one kind of endocrine cell type with round secretory granules. Average diameter of granules were 150, 160, 190, and 210 nm, respectively. The non-argentaffin, serotonin-positive carcinoid showed predominant round secretory granules and a few irregular ones, both being 150 nm in largest diameter. It is suggested that the argyrophil, non-argentaffin carcinoids of the appendix are subdivided into two groups; carcinoids composed mainly of peptide (especially, peptide YY)-positive cells with round granules of D1 and/or L cell type and those of serotonin-positive cells with pleomorphic granules of ECn cell type.

Adolescent↗