Biomedical subjects

O Ishiko

Publications and source records attributed to O Ishiko.

At least 91 records · Page 5Linked to original sources

PubMedDate not supplied

Clinical outcomes of uterine sarcomas: results from 14 years worth of experience in the Kinki district in Japan (1990-2003).

To review clinical outcomes and therapeutic varieties, we were invited to submit data from the patients who were treated for uterine sarcomas in Japan from 1990 to 2003. Uterine sarcomas were defined as leiomyosarcoma (LMS), endometrial stromal sarcoma (ESS), and carcinosarcoma (CS). Of a total of 97 patients, 36 (37.1%) were diagnosed with LMS of the uterine corpus, 15 (15.5%) with ESS, 46 (47.4%) with CS. Median age at diagnosis was 59 (21-85) years. Clinical stages based on FIGO were 41 (42.3%) with stage I disease, 6 (6.2%) with staged II, 34 (35.1%) with stage III, and 16 (16.5%) with stage IV. The median follow-up period for all patients was 13 (1-108) months and median disease-free period was 9 (0-96) months. The 1-year survival rate and disease-free survival (DFS) rate were calculated in patients with all sarcomas (overall survival [OAS], 61.3%; DFS, 46.6%). Statistical analysis showed that younger age (less than 50 years), early stage (stages I and II), and surgical procedure (extended hysterectomy [EH] and radical hysterectomy [RH]) were associated with significantly better OAS. Histologic types did not affect the survival period. In conclusion, aggressive surgery including EH or RH at the time of initial operation offers the possibility of prolonged survival.

Adult↗

PubMedDate not supplied

Transient rapid growth of uterine leiomyoma in a postmenopausal woman.

We report a case of transient rapid growth of uterine leiomyoma in a postmenopausal woman. A 58-year old woman presented with a rapidly enlarging pelvic tumor, from a 14-week to a 20-week gestational size in the one month. Transcervical needle biopsy revealed a smooth muscle tumor with 5 mitotic figures per 10 high power fields. However, surgical specimen obtained 1 month later revealed less than 1 mitotic figure per 100 high power fields. This variation may influence the final histopathological diagnosis because mitotic index is believed to be one of the most reliable histopathological parameters for differentiating between uterine leiomyoma and leiomyosarcoma.

Cell Division↗

PubMedDate not supplied

Diagnostic accuracy of needle biopsy of uterine leiomyosarcoma.

We previously reported on the efficacy of transcervical needle biopsy of a uterine muscle tumor. In this study, to examine diagnostic accuracy of our needle biopsy with small specimen size, previous slide preparations were used from 8 cases diagnosed with leiomyosarcoma and from 24 post-operative leiomyoma cases. Each tissue specimen was examined through needle biopsy-sized slit that had been randomly positioned over the slide. Three predictors: mitotic index, cytologic atypism, and tumor cell necrosis were evaluated on a 3-point scale (0, 1, or 2 points). When the diagnostic cut-off value was set to two, the sensitivity was 92.5% and the specificity was 100%.

Biopsy, Needle↗

PubMedDate not supplied

Angiogenesis in ovarian clear cell carcinoma and its relation to endometriosis.

Twenty-five patients with ovarian clear cell carcinoma (CC-Ca) were enrolled in this study, and tumor cell expression of vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor (PD-ECGF) was investigated, and correlated with the microvessel count (MVC) and the impact of complication endometriosis. Expression of VEGF was strongly positive in 16 cases, weakly positive in 6 cases, and negative in 3 cases. Expression of PD-ECGF was strongly positive in 11 cases, weakly positive in 6 cases, and negative in 8 cases. VEGF expression and the MVC were significantly correlated (p<0.01), and there were no correlations among complication by endometriosis, expression of VEGF, expression of PD-ECGF, and MVC.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Clinical evaluation of mature teratomas containing malignant elements.

We investigated the possibility of preoperative diagnosis and clinical features of mature ovarian teratoma containing malignant elements (MOTME). Between 1982 and 1998 in our hospital, MOTME accounted for 2.0% (5 cases) of the total of 251 patients with mature ovarian teratoma (ages, 37-72; mean age, 60.6). Serum CA19-9, CA125, SCC and CEA levels were high. All cases were strongly suspected malignancies, preoperatively diagnosed using serum tumor markers with diagnostic imaging. Two cases of stage I squamous cell carcinoma and one case of borderline malignancy survived, while the other two advanced cases died within 8 months.

Adult↗

PubMedDate not supplied

Estrogen-producing ovarian mucinous cystadenomas in postmenopausal women.

Cells from benign and borderline malignant mucinous cystadenomas surgically resected from three postmenopausal women with elevated serum estradiol levels were found to have different abilities to synthesize estrogen from [14C]-cholesterol. Addition of gonadotropins to cultured cells with low levels of estrogen synthesis did not result in any significant increase in estrogen synthesis. Immunohistochemical studies of these mucinous cystadenomas showed that LDL receptors were distributed in the benign cystadenoma cells and in the stromal cells of borderline tumors, but not in the cystadenoma cells of borderline tumors. Sterol regulatory element binding protein was immunohistochemically shown to be distributed in the mucinous cystadenoma cells of borderline tumors, but not in the benign cystadenoma cells.

Cholesterol↗

PubMedDate not supplied

Tumor marker and MR imaging criteria for evaluating the efficacy of cyclic balloon-occluded arterial infusion for advanced cancer of the uterine cervix.

We have already reported satisfactory therapeutic results of cisplatin-based cyclic balloon-occluded arterial infusion chemotherapy (BOAI) enabling treatment by simple total hysterectomy (STH) in patients with advanced cervical cancer of the uterus (cervical cancer), with 2- and 5-year survival rates of 88.9% and 66. 7%, respectively. Considering the fact that 3 to 4 months are needed to complete BOAI, the present study was a retrospective assessment of 18 cervical cancer patients to prepare criteria for the early determination of the efficacy of BOAI in patients who can be treated by STH. The results showed that STH could be performed after the first BOAI in patients with SCC value decreased to 34.3+/-8.2% of the pretreatment value (p=0.0001) and whose tumor size had decreased by 45.1+/-7.5% (p=0.0002).

Aged↗

PubMedDate not supplied

Clinical significance of mucin staining in keratinizing-type squamous cell carcinoma of the uterine cervix.

Tumor tissue from 57 cases of keratinizing-type squamous cell carcinoma of the uterine cervix that had been stored in the archives of Osaka City University Hospital between May 1986 and October 1994 were stained with periodic acid-Schiff (PAS) reagent following amylase and alcian blue to identify the presence of intracellular mucin and to assess the value and significance of demonstrating the presence of mucin. Nineteen specimens (33.3%) stained positive for mucin with alcian blue or PAS following diastase. The results of mucin staining were not significant in terms of survival by Kaplan-Meier's analysis.

Adult↗

PubMedDate not supplied

Angiogenesis in metastatic verrucous carcinoma of the uterine cervix.

A 65-year old woman operated on for verrucous carcinoma of the uterine cervix 13 years previously was found to have multiple small recurrent tumors in the retroperitoneal space. Tumor cell expression of vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor (PD-ECGF) was investigated at the second operation. Expression of VEGF was strongly positive in the tumor cells and expression of PD-ECGF was strongly positive in both the tumor cells and the interstitial cells.

Aged↗

PubMedDate not supplied

Bleomycin, actinomycin-D, and cisplatin treatment of ovarian germ-cell malignancies contributes to reducing adverse drug reactions.

Sixteen ovarian germ-cell malignancy (OGCM) patients between 1983 and 1999 were randomly divided into the BEP group (n=6; bleomycin, etoposide and cisplatin) and the BAP group (n=10; bleomycin, actinomycin-D and cisplatin). The patients were evaluated for adverse drug reactions (ADRs) based on severity-grading of the National Cancer Institute Common Toxicity Criteria. The ADRs in the BAP group were milder than in the BEP group, as seen in regard to alopecia (p=0.0126), low hemoglobin (p=0.0147), and decreased neutrophil count (p=0.0197). The five-year survival rate was 87.5% in the BAP group and 83.3% in the BEP group, and the difference was not significant (p=0.5954). BAP therapy is likely to be more beneficial for OGCM patients than BEP therapy, because ADRs are reduced with no difference in outcome.

Adolescent↗

PubMedDate not supplied

Kinetics of plasma platinum in a hemodialysis patient receiving repeated doses of cisplatin.

The pharmacokinetics of cisplatin were studied in a 46-year-old hemodialysis patient treated for uterine cancer with weekly cisplatin. Hemodialysis was performed immediately before, one-hour after, and two-hours after cisplatin administration for two consecutive cycles each. The concentrations of total and free platinum were measured. The decay curve of both total platinum and free platinum showed a biphasic pattern characterized by an alpha-phase and a beta-phase, the same as in non-hemodialysis patients. There were no differences between the individual cycles in the peak platinum concentration or the decay pattern. The plasma platinum concentration decreased to below detection limit 3 months after the final dose.

Antineoplastic Agents↗

PubMedDate not supplied

Diagnosis of metastasis of ovarian clear cell carcinoma to the peritoneum of the abdominal wall by positron emission tomography with (fluorine-18)-2-deoxyglucose.

A 43-year old woman, operated on for ovarian clear cell carcinoma (stage IIc) four years previously was found to have a small mass under the abdominal wall in the right lower quadrant of the abdomen. Neither diagnostic imaging (ultrasonography and MRI) nor tumor markers showed any evidence of recurrence, but positron emission tomography revealed a hot spot area, and it was diagnosed as recurrence of the ovarian carcinoma. The postoperative histopathological diagnosis was metastasis of ovarian carcinoma to the peritoneal wall.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Platelet-derived endothelial cell growth factor in keratinizing-type squamous cell uterine cervical cancer.

The purpose of this study was to determine whether intratumor expression of platelet-derived endothelial cell growth factor (PD-ECGF) is a prognostic factor. We examined specimens from 61 cases of carcinoma of uterine cervix (Ca-Cx). Specimens were stained with periodic acid-Schiff preparation with diastase (d-PAS) and alcian blue (pH 2.5) to identify the presence of intracellular mucin. PD-ECGF expression and microvessel count (MVC) were assessed by immunohistochemical staining. Twenty specimens stained positive for mucin. MVC correlated with clinical stage (p<0.01). There was a correlation between PD-ECGF expression and survival time (p<0.05), but no correlation was seen between mucin staining positivity, MVC, and PD-ECGF expression and survival time by the Cox proportional hazard model. Intratumor PD-ECGF expression was not a prognostic factor in keratinizing-type squamous cell carcinoma of the uterine cervix.

Adult↗

PubMedDate not supplied

Combined diagnostic imaging for retroperitoneal schwannoma.

Retroperitoneal tumors are occasionally encountered by gynecologists, and differential diagnosis from adnexal tumors is important, however, it is difficult in many cases. We report a case in which we preoperatively diagnosed a benign solid tumor in the retroperitoneum of the pelvic cavity on the basis of a variety of diagnostic images, including FDG-PET. Postoperative histological examination showed a benign schwannoma in the pelvis. We discuss the usefulness of FDG-PET combined with MRI and other diagnostic images as a means of differentiating between the characteristics of retroperitoneal tumors.

Biomarkers, Tumor↗

PubMedDate not supplied

Excellent results of radiotherapy for neuroendocrine carcinoma of the uterine cervix.

Neuroendocrine carcinoma of the uterine cervix is a rare neoplasm that is associated with a poor prognosis, and there have been no reports of excellent results of radiotherapy to treat it. We report a case of neuroendocrine uterine cervical carcinoma, as stage IIIa (FIGO), in which the patient showed a complete clinical response to radiotherapy.

Aged↗

PubMedDate not supplied

The usefulness and limits of magnetic resonance imaging in the differential diagnosis of pelvic tumors.

Three cases of benign pelvic tumors are presented (2 leiomyomas and 1 fibroma). All three tumors were suspected of being malignant neoplasms because they were visualized as heterogeneous high signal intensity on T2-weighted images, and thus they were difficult to diagnose preoperatively. One of the leiomyomas was located in the retroperitoneum and had been misdiagnosed as an ovarian tumor. All three tumors exhibited secondary myxoid changes, these changes may have been responsible for the high signal intensity on the T2-weighted MR images. Since benign tumors sometimes mimic malignant tumors on MR images, exploratory laparotomy is essential to make a definitive diagnosis.

Female↗

PubMedDate not supplied

Cyclooxygenase-2 expression in an adenoid cystic carcinoma of the uterine cervix.

Adenoid cystic carcinoma (ACC) of the uterine cervix is extremely rare, frequently metastasizes to distant organs, and its prognosis is poorer than squamous cell carcinoma of the uterine cervix. The reasons for its poor prognosis are unclear. This case had both an ACC and a carcinoma in situ (CIS) of the uterine cervix, so the expressions of CD34, vascular endothelial growth factor (VEGF) and cyclooxygenase-2 (COX-2) were investigated in both tumors. Hysterectomy was performed on a 76-year old woman and the uterine cervical tissues immunohistochemically analyzed. Expressions of CD34 were positive in the ACC lesions but negative in the CIS ones and angiogenesis was confirmed in ACCs. Furthermore, expressions of VEGF and COX-2 were shown in ACC, but were absent in CIS. In conclusion, the expression of COX-2 in ACC may induce the expression of VEGF, increase angiogenesis and enhance tumor growth and invasion.

Aged↗

PubMedDate not supplied

Conservative management of placental polyp with oral administration of methotrexate.

Surgical treatment is usually selected for placental polyp accompanied by massive bleeding but patients wishing to conserve their fecundity require conservative management. A 35-year old nullipara was diagnosed as having placental polyp on the basis of typical episodes, and detection of placental polypeptide hormones and blood flow by Doppler ultrasonography and dynamic magnetic resonance imaging. Oral administration of methotrexate (2.5 mg, three times a day for 5 days) was repeated for three cycles because surgical treatment was rejected. Serum human placental lactogen, blood flow and the polyp disappeared sequentially following chemotherapy. This report thus advocates considering conservative management for placental polyp.

Administration, Oral↗