Biomedical subjects

N Takeshima

Publications and source records attributed to N Takeshima.

At least 19 recordsLinked to original sources

PubMed2001

Prognostic value of the colposcopic tumor size in stage IB squamous cervical cancer.

BACKGROUND AND OBJECTIVES: To determine the prognostic significance of the colposcopic tumor size in the management of cervical cancer. METHODS: Clinicopathological analysis was performed in 751 consecutive patients with stage IB squamous cervical cancer who were surgically treated in a single institute. The colposcopic tumor size was measured postoperatively on surgical specimens. Univariate and multivariate analyses were performed to determine the prognostic significance of various pathological factors. RESULTS: Among the pathological factors examined, lymph node metastasis, parametrial extension, deep stromal invasion, vessel permeation, endometrial extension, and colposcopic tumor size were found to be prognostic factors in univariate analysis, whereas multivariate analysis has confirmed that only three factors, i.e., lymph node metastasis, parametrial involvement, and colposcopic tumor size were independently associated with the disease-free interval. CONCLUSIONS: These results indicate that the colposcopic tumor size is an independent prognostic factor in squamous cervical cancer and can be used as an indicator of treatment options.

Adult↗

PubMed2001

Positive peritoneal cytology in endometrial cancer: enhancement of other prognostic indicators.

OBJECTIVE: The goal of this study was to investigate the prognostic significance of positive peritoneal cytology in endometrial cancer. METHODS: A clinicocytopathological study was performed in 534 patients with endometrial cancer to assess the prognostic value of positive peritoneal cytology. The study population was divided into three groups: a low-risk group (disease limited to the uterus, grade 1, and depth of invasion < or =1/2), a moderate-risk group (disease limited to the uterus, grade 2 or 3, and/or depth of invasion >1/2), and a high-risk group (extrauterine disease). In each group, disease-free survival was compared in the patients who were positive or negative for malignant cells. RESULTS: The overall incidence of positive peritoneal cytology was 22.3% (119/534). The 5-year disease-free survival of patients positive or negative for malignant cells was 98.1% versus 100% in the low-risk group (n = 250), 77.5% versus 91.3% in the moderate-risk group (n = 211), and 42.9% versus 72.1% in the high-risk group (n = 73). A significant difference was noted in the moderate-risk (P = 0.044) and high-risk (P = 0.015) groups, but not in the low-risk group (P = 0.56). CONCLUSIONS: Positive peritoneal cytology is not a negative prognostic indicator itself, but it potentiates other prognostic indicators for endometrial cancer. Our findings also suggest that patients with positive peritoneal cytology in the absence of other adverse prognostic factors do not need upstaging.

Adult↗

PubMed2001

Validation of the functional fitness age (FFA) index in older Japanese women.

Functional fitness age (FFA), which we previously described, is a measure of functional age that reflects a person's overall physical ability to complete daily tasks such as preparing meals and performing various household chores. The purpose of this study was to validate FFA in two elderly populations: 1) older subjects from different communities, and 2) older subjects participating in an exercise intervention program. FFA was calculated from 4 performance tests: performing arm curls; moving beans with chopsticks; demonstrating functional reach; and sitting and walking around two cones. The first study group was selected from 4 different communities (N=127), and was subdivided into a less active group (N=87) and an active group (N=40). The results of the 4 tests for the less active group were not significantly different from those for the original validation group used in developing the FFA equation. The FFA of the less active group (71.1+/-7.7 yrs) was not different from their chronological age (70.4+/-6.6 yrs). In the active group, except for the arm curls, test scores were significantly higher than those of the original validation group. The FFA of the active group (66.2+/-5.1 yrs) was significantly younger than their chronological age (70.9+/-4.2 yrs). Another group of 14 older women (79.5+/-3.9 yrs) was recruited for pre- and post-training testing. After the 3-month exercise program, they showed significant improvements in sitting and walking around two cones and functional reach; their FFA decreased significantly from 81.5+/-5.0 yrs to 78.3+/-4.5 yrs. The control group selected from the same community (N=16, 79.8+/-5.3 yrs) showed no significant changes in the 4 performance tests, and their FFA remained unchanged. These results indicate that our FFA is highly cross-validated for different Japanese communities, and is sensitive to changes associated with participation in an exercise intervention program.

Activities of Daily Living↗

PubMed2001

Malignant potential of positive peritoneal cytology in endometrial cancer.

OBJECTIVE: To investigate the malignant potential of positive peritoneal cytology in endometrial cancer. METHODS: Fifty patients with clinical stage I-II endometrial cancer in whom the disease was completely surgically resected and positive peritoneal smears were found at surgery formed the study population. In these patients, a tube for cytologic analyses was inserted into the peritoneal cavity when closing the abdomen. The peritoneal cavity was irrigated with physiologic saline, and washings were obtained through the tube 7 and 14 days after the operation. RESULTS: Persistence of positive peritoneal cytology was observed in four of seven patients with adnexal metastasis, zero of nine patients with nodal disease, and one of 34 patients with disease confined to the uterus, for a total of 10% (5 of 50). In the remaining 45 (90%) patients, no malignant cells were found in any of the washings. CONCLUSION: The current series suggests that endometrial cancer cells found in the peritoneal cavity usually disappear within a short time and seem to have a low malignant potential. It also seems that only malignant cells from special cases, such as adnexal metastasis, may be capable of independent growth, and are possibly associated with intraperitoneal recurrence.

Adenocarcinoma↗

PubMed2001

Effects of increasing expenditure of energy during exercise on psychological well-being in older adults.

The purpose of present study was to examine the effects on psychological well-being of energy expended as a result of the exercise intervention. 33 older adults (M age=68.6 yr., SD=4.7) participated in three supervised water-based exercise sessions per week for 12 wk. Based on the relative changes in daily energy expenditure as measured by questionnaire between pre- and posttraining, the subjects were split into three groups. This classified each subject as either having experienced a relatively low change (n=11), moderate change (n= 11), or high change (n= 11) in daily energy expenditure. Our data showed that the group with the greater increase in energy expenditure as a result of exercise, when compared pre- and posttraining, improved only on Depression-Dejection on the Profile of Mood States more than did the group with low change. Consequently, we concluded that the amount of energy expended was partially related to improvement in psychological well-being.

Adult↗

PubMed2000

Treatment of fallopian tube cancer. Review of the literature.

OBJECTIVE: To contribute toward the understanding of the therapeutic management of fallopian tube cancer. METHODS: Recent studies related to the treatment of fallopian tube cancer were reviewed. RESULTS: Current evidence indicates that even patients in early stages have nodal disease, and often experience relapses in distant sites. In advanced stages, survival prolongation by the use of platinum-based chemotherapy has been demonstrated. Aggressive cytoreductive surgery followed by chemotherapy and negative second-look laparotomy offer the possibility of long-term survival. However, a significant fraction of patients eventually relapses after negative second-look laparotomy, and a poor survival rate after positive second-look laparotomy has been observed. CONCLUSIONS: This series suggests the need for thorough evaluation of lymph nodes at the time of surgery. The use of platinum-based chemotherapy is probably the best adjuvant therapy for both early stages and advanced stages. The clinical value of second-look laparotomy will remain limited until effective salvage therapy is developed. The potential benefits of neoadjuvant chemotherapy and the use of paclitaxel will be increasingly important.

Fallopian Tube Neoplasms↗

PubMed2000

Genetic aberrations detected by comparative genomic hybridization in ovarian clear cell adenocarcinomas.

Genetic abnormalities were detected by comparative genomic hybridization (CGH) in 12 ovarian clear cell adenocarcinomas. DNA sequence copy number abnormalities (CNAs) occurring in more than 20% of the cancers included increased copy numbers of 8q11-q13, 8q21-q22, 8q23, 8q24-qter, 17q25-qter, 20q13-qter and 21q22-qter and reduced copy numbers of 19p. Increases in copy numbers of 8q11-q13, 8q21-q22, 8q23 and 8q24-qter occurred more frequently in disease-free patients than in recurrent/non-surviving patients (p < 0.05). However, increases in copy numbers of 17q25-qter and 20q13-qter occurred more frequently in recurrent/non-surviving patients than in disease-free patients (p < 0.05). Furthermore, increases in copy numbers of 17q25-qter and 20q13-qter occurred together (p < 0.05). Additionally, there were negative correlations between increases in copy numbers of 8q21-q22 and 17q25-qter, and between 8q21-q22 and 20q13-qter (p < 0.05). It appears that ovarian clear cell adenocarcinomas can be classified into two subtypes, one being cancer with an increase in copy numbers of 8q and the other being cancer with increases in copy numbers of 17q25-qter and 20q13-qter.

Adenocarcinoma, Clear Cell↗

PubMed2000

Comparison of water- and land-based exercise in the reduction of state anxiety among older adults.

This study examined the effect of an acute exercise program of different exercise conditions on state anxiety among older adults. 73 healthy subjects were recruited and randomly assigned to either water exercise group (n = 36) or land exercise group (n = 37). State anxiety was assessed before exercise and following exercise. Subjects in the water exercise performed a 70-min. exercise program consisting of a 10-min. warm-up, a 20-min. brisk walking, a 20-min. rhythmic dancing, a 10-min. resistance training, and a 10-min. cool down exercise. The land exercise program contained a 10-min. warm up and a 30-min. combined endurance and resistance exercise, followed by a 10-min. cool down exercise. Analysis showed that both exercise groups scored significantly (p<.001) lower on anxiety after exercise, but there was no significant interaction for group by trial for scores on state anxiety. The data indicate that elderly persons who participate in these types of exercise report lower state anxiety.

Aged↗

PubMed2000

[Hemodynamic effects of propofol as an anesthesia induction agent in hyperthyroidism patients on chronic beta-blocker].

This study was designed to investigate the effect of propofol on the heart rate and blood pressure in the patients on chronic beta-blocker. Seventy two hyperthyroidism patients scheduled for subtotal thyroidectomy were enrolled. Thirty six patients who were on chronic beta-blocker received either propofol (group beta-P) or thiamylal (group beta-T) as an anesthesia induction agent. In control groups, patients who were not on beta-blocker also received either propofol (group C-P) or thiamylal (group C-T). Anesthesia was maintained with nitrous oxide in oxygen and sevoflurane. Heart rate and systolic blood pressures were monitored and recorded before and during anesthesia. Heart rate decreased significantly in group beta-P compared to three other groups through this study. Significant decreases in systolic blood pressure were observed in the groups beta-P and beta-T compared to group C-P. These results suggest that careful attention should be paid to the patients on chronic beta-blocker when propofol was selected as an anesthesia induction agent.

Adrenergic beta-Antagonists↗

PubMed2000

[Effect of olprinone hydrochloride on cerebral blood flow in patients after cardiac surgery].

This study was designed to investigate the effect of olprinone hydrochloride on cerebral blood flow in ten patients after cardiac surgery by transcranial Doppler sonography (TCD). We assessed cerebral blood flow in the middle cerebral artery by transtemporal approach and in the carotid siphon by transorbital approach. We measured the mean blood flow velocity in the left middle cerebral artery (Vmca) and the left carotid siphon (Vlca) and calculated the pulsatility index in the left middle cerebral artery (PImca) and the left carotid siphon (PIlca) using 2 MHz transcranial Doppler ultrasound system (DWL Multidop-P). After baseline measurement, the olprinone hydrochloride loading dosage was increased from 0.15 to 0.3 microgram.kg-1.min-1 every 60 minutes. The mean blood flow velocity was measured at each point. Vmca and Vlca significantly increased, and PImca and PIlca significantly decreased at the infusion rate of 0.3 microgram.kg-1.min-1. There were significant linear correlations between CI and Vmca, CI and Vlca, SVRI and Vmca, as well as SVRI and Vlca. Dose-response relationships were observed in CI, SVRI, Vmca, and Vlca. In conclusion, we demonstrated that olprinone hydrochloride led to an increase of cerebral blood flow in the patients after cardiac surgery.

Aged↗

PubMed1999

Assessment of the revised International Federation of Gynecology and obstetrics staging for early invasive squamous cervical cancer.

OBJECTIVE: The aim of this study was to investigate the value of the International Federation of Obstetrics and Gynecology (FIGO) classification (1995) for early invasive cervical cancer. Methods. Clinico-pathological analysis was performed in 402 patients with invasive squamous cervical cancer in whom the depth of stromal invasion was 5 mm or less. RESULTS: The incidence of lymph node metastasis was 1.2% (1/82) in patients with 3 mm or less depth of invasion; the node-positive patient was in stage IA1. The incidence of lymph node metastasis was 6.8% (5/73) in patients with 3-5 mm depth of invasion; this increased with increasing horizontal spread from 3.4% for 7 mm or less to 9.1% for more than 7 mm. None of the patients in this series had metastasis to the parametrial tissues. Of 4 patients with recurrence, 3 had horizontal spread of more than 7 mm and the remaining patient was in stage IA2. CONCLUSION: The FIGO definition of early squamous cervical cancer is generally acceptable in its present form.

Adult↗

PubMed1999

Low-grade endometrial stromal sarcoma with cardiovascular involvement--a report of three cases.

BACKGROUND: In low-grade endometrial stromal sarcoma, it has been reported that vascular space involvement in surgical specimens is found in over 50% of patients. However, in contrast to intravenous leiomyomatosis, it has been thought that further tumor extension to large vessels is rarely observed. CASES: We present three cases of low-grade endometrial stromal sarcoma with cardiovascular involvement by recurrent tumors observed on imaging studies. Two cases demonstrated tumor infiltration inside the inferior vena cava while the other case showed tumor growth in the left ventricle. CONCLUSION: This report suggests that attention should be paid to the possibility of cardiovascular invasion during the entire course of this disease.

Adult↗

PubMed1999

Utility of the monoclonal antibody HIK1083 in the diagnosis of adenoma malignum of the uterine cervix.

OBJECTIVES: The aim of this study was to qualify a staining technique for the diagnosis of adenoma malignum. METHODS: The gastric mucin expression of adenoma malignum, ordinary endocervical adenocarcinoma, and normal cervical glands was immunohistochemically compared using the monoclonal antibody HIK1083. RESULTS: The three categories were clearly distinguished, with 90% (9/10) of cases with positive adenoma malignum, 30% (3/10) of cases with weakly positive ordinary cervical adenocarcinoma, and no (0/10) cases of positive normal cervical glands. CONCLUSIONS: This preliminary report indicates that the use of HIK1083 is valuable in the diagnosis of adenoma malignum.

Adenoma↗

PubMed1998

The value of squamous cell carcinoma antigen as a predictor of nodal metastasis in cervical cancer.

Preoperative serum squamous cell carcinoma antigen (SCC) levels were examined in 148 cases of stage Ib squamous cervical cancer undergoing radical hysterectomy. The effect of the pelvic lymph node status on the marker level was examined by comparing 113 cases with cancer limited to the uterus and 23 cases with cancer confined to the uterus and pelvic lymph nodes using two different multivariate analyses. Ninety-five percent of patients with cancer limited to the uterus showed SCC levels of 4 ng/ml or below. Nearly two-thirds (65%) of patients with serum levels above 4 ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 4 ng/ml increased the risk of nodal metastasis by eight times, compared with serum levels of 4 ng/ml or below. Multivariate analyses confirmed that the pelvic lymph node metastasis had a larger impact on the marker level than did tumor size or depth of stromal infiltration. SCC levels greater than 4 ng/ml can be considered a high-risk zone for nodal metastasis.

Adolescent↗

PubMed1998

Ovarian metastasis in endometrial carcinoma.

A retrospective study was conducted to investigate the clinical significance of ovarian metastasis in 439 patients with clinical stage I endometrial cancer surgically treated by performing total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Histologic examination revealed that 22 patients (5%) had ovarian metastasis. The maximum diameter of the ovarian metastases ranged from 1 to 100 mm. In 18.2% (4/22) of patients with ovarian metastasis, the maximum diameter was less than 2 mm. Patients with metastasis limited to the ovarian surface showed 100% positive peritoneal cytology, 0% lymph node metastases, and 50% recurrence, while patients with metastasis inside the ovary showed 10% positive peritoneal cytology, 36% lymph node metastases, and 53% recurrence. The prognosis of patients with ovarian metastasis alone was situated midway between that of patients with cancer limited to the uterus and that of patients with lymph node metastasis alone. The lymph node status was of importance to determine the prognosis of patients with ovarian metastasis. The series also suggests that there may be two routes for ovarian metastasis; one is a route via the fallopian tube to the ovarian surface and the other is a route via the lymphatics to the inside of the ovary.

Analysis of Variance↗

PubMed1998

A clinicocytopathologic study of adenoma malignum of the uterine cervix.

OBJECTIVES: To investigate the nature and the clinical course of adenoma malignum (the so-called minimal deviation adenocarcinoma) of the uterine cervix by conducting a retrospective study of 6 cases consecutively treated in a single institute. METHODS: The pathologic classification of adenoma malignum was performed according to the WHO classification (1994). RESULTS: These tumors accounted for only 1.32% (6/453) of invasive cervical adenocarcinomas. All the cases showed either a watery discharge or atypical genital bleeding, or both, at the time of diagnosis. The preoperative cytologic diagnosis of adenoma malignum was made in 83.3% (5/6) of cases. The preoperative punch biopsy, on the other hand, failed to confirm the diagnosis of adenoma malignum in all cases, although the presence of the disease was suspected in 2 cases (33%). The 5-year survival rate and 5-year disease-free survival rate were 100 and 83.3%, respectively. CONCLUSIONS: This series demonstrates that cytologic examination is a potent screening method to detect this rare disease. When the presence of this disease is suspected by the cytologic examination, a deep biopsy is necessary to make an accurate diagnosis. An ordinary cervical biopsy is usually insufficient to detect deeply positioned tumor glands. The prognosis of the disease may be better than that for ordinary cervical adenocarcinoma.

Adenocarcinoma, Mucinous↗

PubMed1998

Prognostic validity of neoplastic cells with notable nuclear atypia in endometrial cancer.

OBJECTIVE: To investigate how the architectural grade of endometrial adenocarcinoma should be adjusted in the presence of neoplastic cells with notable nuclear atypia in order to assign the histologic grade. METHODS: Four hundred seventy-six patients with stage I endometrial cancer (endometrioid type) who were surgically treated in a single institute formed the study population. The architectural grade and the proportion of tumor cells with notable nuclear atypia were examined for each case. The effects of notable nuclear atypia on the disease-free survival of each architectural grade were analyzed. RESULTS: The disease-free survival of architectural grade 1 and grade 2 tumors was significantly affected and was worse than that of architectural grade 3 tumors when more than 25% of the tumor cells showed notable nuclear atypia. Tumors that had 26% to 50% of neoplastic cells with notable nuclear atypia showed a similar probability of recurrence as did tumors that had more than 50% of neoplastic cells with notable nuclear atypia. CONCLUSION: The series suggests that the upgrading of architectural grade 1 or 2 tumors, in which more than 25% of the neoplastic cells show notable nuclear atypia, into a grade 3 tumor may be more practical than upgrading by one architectural grade 1 or 2 tumors, in which the majority of neoplastic cells show notable nuclear atypia.

Adenocarcinoma↗

PubMed1997

Prognostic value of peritoneal cytology in patients with carcinoma of the uterine cervix.

Peritoneal cytology was obtained in 374 patients with carcinoma of the uterine cervix (stage IB-IIB) in whom gross intraperitoneal disease was absent at the time of radical hysterectomy and node dissections. The relevance of positive peritoneal cytology in relation to the cell type of the tumor was examined. An exceedingly small rate of peritoneal cytologic positivity was found in patients with squamous cell carcinoma (1.7%, 4/242). One of the four patients with positive cytology developed a lung recurrence. On the other hand, the incidence of positive peritoneal cytology in patients with adenocarcinoma and adenosquamous carcinoma was 11.4% (15/132). The 3-year disease-free survival rate in patients having adenocarcinoma and adenosquamous carcinoma with positive peritoneal cytology was 57.8%, while it was 80.7% in patients with negative peritoneal cytology. However, this factor was closely associated with other adverse prognostic factors. A multivariate analysis revealed that positive peritoneal cytology was not an independent prognostic factor in patients with adenocarcinoma and adenosquamous carcinoma. In addition, intraperitoneal recurrence was not correlated with the presence of cancer cells in the peritoneal fluid. The series indicates that peritoneal cytology in cervical cancer is of little value in treatment planning.

Adenocarcinoma↗