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Biomedical subjects

N Sakuragi

Publications and source records attributed to N Sakuragi.

At least 73 records · Page 4Linked to original sources
PubMed1992

[An analysis on prognostic significance of histopathologic risk factor in uterine endometrial carcinoma].

Prognostic risk factors in histopathologic findings were analyzed in the data for one hundred and thirteen patients with uterine endometrial carcinoma who were treated surgically. Univariate survival analysis with Kaplan-Meier methods revealed that the nuclear grade (p less than 0.005), lymph-vascular space invasion (p less than 0.005), histologic grade (p less than 0.01) and histologic type (p less than 0.01) correlated with the patient's prognosis. Among surgical FIGO stages II and III, there was similar significance in the correlations in the nuclear grade (p less than 0.05), lymph-vascular space invasion (p less than 0.0001) and histologic type (p less than 0.05), although there was difference (p less than 0.05) only between grade 1 and grade 3 in the histologic grade. Multivariate survival analysis with a proportional hazard regression model showed that the nuclear grade (p less than 0.005) and lymph-vascular space invasion (p less than 0.01) correlated significantly with the prognosis. The hazard ratios with a 95% confidence interval for each of these factors were 19.2 (3.2-115.7) and 16.9 (2.1-135.3), respectively. The 3-year survival rate was 98% for a hazard ratio less than 64.7, and 45% for one more than 67.4, between which there was a significant difference (p less than 0.0001). And univariate survival analysis of this hazard ratio also revealed strong correlations with the patient's prognosis. These results suggest that it is of great importance to adopt the hazard model including such factors as the nuclear grade and lymph-vascular space invasion in estimating the patient's prognosis and proceeding to adequate post-operative therapy for individual patient.

Adenocarcinoma↗
PubMed1991

Extracorporeal spread and its prognostic impact in stages I and II (FIGO) endometrial carcinoma.

Prognostic risk factors were statistically analyzed from the histopathologic data obtained from 90 Japanese women with stages I and II endometrial carcinoma treated surgically, including systemic retroperitoneal lymph node dissection, between June 1979 and June 1989. In stage Ia endometrial carcinoma, pelvic and paraaortic nodes metastasis were seen in 13.8(4/29)% and 0.0(0/19)% of patients, respectively. In stage Ib, the incidence of pelvic and paraaortic node metastasis was 25.6(11/43)% and 9.7(3/31)%, respectively. In stage II, the incidence was 38.9(7/18)% and 13.3(2/15)%, respectively. Prognosis of patients even with deep myometrial invasion (greater than or equal to 2/3) or G3 tumor was fairly good (5-year survival rate: 87.5% and 85.7%, respectively) if the disease was histologically confined to the uterine corpus. Once the tumor spread outside the corpus uteri, the survival rate of patients was strongly affected by the grade of the tumor, moderate to marked lymph-vascular space invasion of tumor cells, or tumor invading middle or outer third of myometrium (P less than 0.05 for each factor). In summary, endometrial cancer frequently metastasize to pelvic and paraaortic lymph nodes even in the early stages, and lymph node metastasis and other extracorporeal spread of disease have a serious impact on patient survival. Prognosis of patients with extracorporeal spread of disease seems to be determined by the high grade of tumor and lymph-vascular space invasion. These results suggest that surgical exploration including paraaortic lymph node dissection to accurately evaluate the extent of the disease is essential to estimate the patient's prognostic risk and to individualize the treatment schedule.

Female↗
PubMed1991

Evaluation of the improvement of cephems on the prophylaxis of pelvic infection after radical hysterectomy.

Antibiotics, especially cephems, have been improved remarkably in the last 20 years. In order to evaluate the improvement of antibiotics used for the prophylaxis of infections after radical hysterectomy, two groups of patients (group A, 1978-1979, n = 54; group B, 1985-1987, n = 55) were examined in regard to bacteriological and clinical effects. In spite of the improvement of antibiotics, the positive rate of bacteriological analysis had increased from 44.4 to 76.4%. Obvious decrease of gram-negative bacilli and increase of gram-positive cocci (GPC), e.g. Enterococcus, were observed. In contrast, fever index and febrile morbidity of group B decreased significantly more than those of group A. These results indicate that the improvement of antibiotics has brought more effective prophylaxis in the postoperative infection in spite of the high positive rate of GPC.

Cephalosporins↗
PubMed1991

[Changes in serum levels of gynecological tumor markers throughout the period from early gestation to puerperium].

The aim of this study is to elucidate the change in serum levels of gynecological tumor markers throughout the period from the early gestational stage to puerperium. We measured eight tumor markers of--CA 125, TPA, SCC, AFP, haptoglobin, ferritin, CA19-9 and CEA--in 17 healthy women with a normal course of pregnancy, delivery and puerperium, and obtained the following results: 1) Profiles of change in serum levels of CA125, SCC, haptoglobin and ferritin were similar during pregnancy, with those levels being the highest at 4-15 weeks of gestation and declining gradually from 16 to 27 weeks. Serum levels of these four markers decreased significantly (p less than 0.01) at 16-27 and 28-40 weeks of gestation, respectively. 2) A significant (p less than 0.01) increase in CA125 and SCC was observed 2 hours after delivery compared with the levels in the first stage of delivery. However, these two markers decreased to the normal range after the fifth day postpartum. 3) Serum TPA decreased significantly (p less than 0.05) in 16-27 weeks of gestation, comparing with those of 4-15 weeks. Serum CA19-9 and CEA remained almost unchanged within the normal range throughout the period from pregnancy to puerperium. 4) Tumor markers of CA125, TPA, SCC, haptoglobin, ferritin and CEA of which serum levels decreased during the course of pregnancy and puerperium might be a clue to judge whether gynecological tumors in pregnant women are malignant or benign.

Antigens, Neoplasm↗
PubMed1991

[An analysis of prognostic significance of new FIGO staging (1989) of endometrial cancer].

Histopathologic factors were investigated in the data for ninety-one patients with endometrial carcinoma who were treated surgically. Each of these subjects was reclassified according to the new FIGO surgical criteria (1989) for stages and the relationship between the new classifications and the prognosis of patients was analyzed. One third of the patients (24/72) with clinical FIGO stage I (1983) had extracorporeal spread of the disease and these cases were reclassified as surgical stages II and III. Among clinical stage Ib patients there were many more with extracorporeal spread than among those in clinical stage Ia (p less than 0.005) although there was no difference between the histopathological characteristics (histologic grade, myometrial invasion, cervical involvement, adnexal involvement and pelvic lymph node metastasis) of the stage Ia and Ib groups. Univariate survival analysis revealed that the histologic grade (p less than 0.05), myometrial invasion (p less than 0.05), cervical involvement (p less than 0.005) and pelvic lymph node metastasis (p less than 0.005) correlated with the patient's prognosis. Multivariate survival analysis with the proportional hazard regression model showed that cervical involvement (p = 0.05) and the new stage classification (p = 0.03) correlated significantly with the prognosis. The cumulative 5-year survival rate by clinical stage (1983) was 87% for stage I (Ia: 96%, Ib: 80%) and 72% for stage II, between which no significant difference was determined. The survival rate for stage III was not calculated because there was only one case with stage III disease in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1990

[The incidence and clinical significance of paraaortic lymph node metastases in patients with uterine cervical cancer].

Paraaortic lymph node dissection was performed in the treatment of patients with carcinoma of the cervix who were subjected to radical hysterectomy between June, 1982 and March, 1988 at the Department of Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan. Thirteen out of 246 (5.3%) patients had metastases in the paraaortic lymph node. Of the patients with stage I carcinoma of the cervix, 1.0 per cent had positive paraaortic lymph node. Of the patients with stage II carcinoma, 4.9 per cent had metastases in the paraaortic lymph nodes, and of the stage III patients, 16.7 per cent had positive paraaortic lymph nodes. The incidence of paraaortic node involvement increased along with the advance of the disease. Of the patients with squamous cell carcinoma of the cervix, 4.6 per cent had paraaortic lymph node metastases. Of the patients with adenocarcinoma of the cervix including mixed carcinoma, 6.8 per cent had positive paraaortic node. All the patients with positive paraaortic lymph nodes had metastatic diseases in the pelvic nodes. In addition, the number of groups of positive pelvic nodes in the patients with positive paraaortic lymph nodes was significantly larger than that in those with negative paraaortic nodes. At the time of reporting, seven out of 13 patients with positive paraaortic lymph node have died of the disease. The mean survival period of those seven patients was 14.9 +/- 12.2 (mean +/- SD) months. Of the remaining six surviving patients, three have been doing well for more than three years.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1988

The serum pregnancy-specific beta 1-glycoprotein to beta-human chorionic gonadotrophin ratio as an index of prognosis in patients with choriocarcinoma.

The ratio of serum pregnancy-specific beta 1-glycoprotein (SP1) to the beta-subunit of human chorionic gonadotrophin (beta-hCG) before and after chemotherapy was measured in 12 patients with metastatic choriocarcinoma. The ratios before chemotherapy ranged between 0.03 and 0.75, with a mean value of 0.34 (SD 0.21). The ratio increased to over 1.0 (1.05-53.3) after one or two courses of chemotherapy in seven of the 12 patients. These women achieved complete remission. In the other five patients who died of the disease due to drug resistance of the tumour, the ratio after chemotherapy was low (0.04-0.74) and tended to decline. These data suggest that the serum SP1/beta-hCG ratio can be used to predict the prognosis of patients with choriocarcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Incidence of ovarian metastasis in patients with cancer of the uterine cervix.

During the period from 1970 to 1985, 706 patients with cervical cancer of stage 0 and Ia were treated by a simple hysterectomy without oophorectomy. In 326 patients with invasive carcinoma in stage Ib to stage III, who were treated by a radical hysterectomy from 1977 to 1985, histological examinations were performed to detect ovarian metastasis. A total of 674 autopsy specimens were obtained from the Annual of the Pathological Autopsy Cases in Japan. (Japanese Pathological Society, 1965 to 1978). Follow-up observations on stage 0 and stage Ia revealed no recurrence in the ovaries. In invasive cases of epidermoid carcinoma (stage Ib to stage III), no ovarian metastases were detected, despite discovery of metastases to the pelvic lymph node in 21.6% of the cases. Conversely, in the cases of cervical adenocarcinoma (pure adenocarcinoma and mixed carcinoma), 6 of 48 cases (12.5%) showed ovarian metastases. Ovarian metastases were found in 22 of 77 (28.6%) autopsy cases of adenocarcinoma, but in only 104 of 597 (17.4%) cases of epidermoid carcinoma. This finding is statistically significant (P less than 0.02). Both corpus invasion and metastasis to the ovaries were found in 20 of 54 cases (37.0%). This rate was significantly higher than the rate of ovarian metastasis in cases without corpus invasion (P less than 0.001).

Adenocarcinoma↗
PubMed1987

8-Bromo-adenosine 3',5'-monophosphate regulates expression of chorionic gonadotropin and fibronectin in human cytotrophoblasts.

Addition of 8-bromo-cAMP to primary cultures of human placental cytotrophoblasts results in significant alterations in the synthesis of secreted proteins, as detected by labeling with pulses of [35S]methionine. Using immunoprecipitation techniques, we demonstrated that exposure to 8-bromo-cAMP prevented the de novo synthesis and secretion of the extracellular matrix component fibronectin, but enhanced the production of hCG subunits. The effects of the cyclic nucleotide on synthesis and secretion of these proteins were evident within 24 h. 8-Bromo-cAMP increased the cellular content of mRNA encoding the hCG alpha- and beta-subunits and prevented the increase in fibronectin mRNA, as determined by blot hybridization analysis using specific cDNA probes. These findings demonstrate that cyclic nucleotides regulate the synthesis of several specific proteins in cultured human trophoblast by regulating levels of the mRNAs encoding the proteins. The actions of cyclic nucleotides in this regard may be essential for the normal expression of trophoblast endocrine function.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1987

[Effects of ovarian wedge resection (WR) and spironolactone administration on pulsatile LH release and serum steroid hormone levels in women with polycystic ovarian disease].

The exact mechanism(s) by which WR induces ovulation in women with PCOD is still uncertain. The aim of this study is to observe the change in sex steroids and pulsatile LH release (pul-LH-R) after WR. Before and either 7-8 days after the surgery (n = 8) or after 30 days of spironolactone treatment (n = 4), serum LH levels were measured every 15 min for 2-4 hours in PCOD women. Sex steroids were radioimmunoassayed before, and 3-4 and 7-8 days after WR. Testosterone (T) and androstenedione (A) in 7 women in whom spontaneous ovulation occurred after WR decreased significantly either 3-4 or 7-8 days after the surgery (p less than 0.001). Estrone decreased significantly (p less than 0.001) 7-8 days after the operation. The mean level of LH after WR in the 7 women decreased significantly (p less than 0.001). Furthermore, significant decreases both in the mean values of LH pulse amplitude (p less than 0.001) and frequency (p less than 0.01) were observed after WR. Ovulation occurred after 45 and 58 days of spironolactone administration in 2 PCOD women who showed changes in pul-LH-R and a drop in serum testosterone levels after 30 days of treatment. The data suggested that changes in pul-LH-R and decreased sex steroids after WR seemed to play key roles in the mechanism(s) by which WR induces ovulation.

Adult↗
PubMed1986

[Ceftazidime: placental transfer and pharmacokinetic parameters in the third trimester pregnancy].

Ceftazidime (CAZ), a newly developed cephalosporin with very high stability to beta-lactamase, was evaluated for its transfer into fetus and amniotic fluid in the third trimester pregnancy, following a single bolus intravenous injection at a dose of 1 g. In subjects with various conditions (background factors) standardized, concentrations of CAZ in maternal venous blood, venous and arterial blood in umbilical cord, and amniotic fluid were determined. High concentration of CAZ (10 micrograms/ml or higher) was found to be maintained in fetal blood and amniotic fluid for ca. 4 hours and ca. 8 hours, respectively, after intravenous injection, showing good placental transfer of CAZ. In view of MICs of CAZ, satisfactory clinical efficacy is expected in perinatal infections.

Amniotic Fluid↗
PubMed1986

[Incidence of ovarian metastasis in patients with cancer of the uterine cervix].

With the recent advances in general surgery, the treatment of cervical cancer has been markedly improved to increase the five-year survival rate after radical hysterectomy. Therefore, the operative main attention has recently been directed towards conservative surgery for the function of pelvic organs as well as towards the therapeutic improvement of cervical cancer. The most crucial point for the preservation of the ovary at the time of the operation is whether the cancer metastasizes to the ovaries or not. In order to answer this question, the factors influencing metastasis, such as; the clinical stages, the cancer cell types and the cancer extension to the uterine corpus, were studied. A total of 679 cases of cervical cancer stage 0 and stage Ia were treated surgically with a simple hysterectomy preserving the ovaries in orthotopic position during the period of 1970 to 1984. Three hundred eleven patients of invasive carcinoma in stage Ib to stage IIIb were operated on by a radical hysterectomy with lymphadenectomy from 1977 to 1985. Histopathological examination was performed on specimens of the ovaries to determine the metastasis. In order to study the incidence of the ovarian metastasis in advanced cancer patients, the data of the autopsied 674 cases who died of cervical cancer without surgical therapy were obtained from Annual of the Pathological Autopsy Cases in Japan (1965-1978). Follow-up observations on the 679 patients of stage 0 or stage Ia after the operation revealed no recurrence in these cases. This indicates that almost no ovarian metastasis occurs in the patients of early cervical carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗