PubMed HealthSearch

Biomedical subjects

S Akimoto

Publications and source records attributed to S Akimoto.

At least 19 recordsLinked to original sources

[Assessment of a coaxial system accommodated to a 0.035 inch guide wire in superselective hepatic angiography and embolization].

A special coaxial catheter system accommodated to a 0.035 inch guide wire was recently developed. The four-part coaxial system is composed of a central 0.035 inch flexible guide wire, a 4-French inner catheter (straight, 90 cm in length), a 6-French outer catheter (fork-shaped, 60 cm in length), and a hemostatic valve. The 4 French inner catheter is large enough in diameter to allow a larger volume of contrast medium and greater amount of embolic material than the earlier coaxial system. Using this coaxial catheter system, we performed successful superselective hepatic arteriography and embolization in 44 patients with malignant hepatic tumors. Catheterization of the celiac and superior mesenteric arteries with the 6 French outer catheter was easy, and the angiogram obtained was very distinct. The 4 French inner catheter was easily and safely advanced into the segmental hepatic artery, and even common hepatic arteriography with this catheter provided clear images on conventional cut films. Therefore, in most cases, both angiography and embolization can be accomplished using this coaxial system alone.

Aged

Mutations in the P53 tumour suppressor gene in primary lung cancer in Japan.

The reverse transcription-polymerase chain reaction-single strand conformation polymorphism (RT-PCR-SSCP) analysis and sequencing were used to examine p53 gene alterations in 18 surgical specimens of primary lung cancers obtained in Japan. Somatic mutations resulting in amino acid changes were found in eight of the 18 cases (44%). Seven missense mutations were located in amino acid-conserved domains or their vicinities (codons 110 to 307). Most mutations were found at G-C pairs, suggesting that specific carcinogens are involved in the etiology of lung cancer. The p53 mutations showed a significant association with a history of smoking (P = 0.0294). We suggest that the p53 mutations may be associated with smoking-induced lung carcinogenesis.

Adenocarcinoma

Argyrophilic nucleolar organizer regions in benign hyperplastic and cancerous human prostates.

Argyrophilic nucleolar organizer regions (AgNORs) were examined histologically in cells of benign hyperplastic and cancerous human prostates. Individual dots of AgNORs inside nucleus that were stained as separate granules or as parts of clusters were counted as one, and the average number of dots per cell was obtained by counting 100 nuclei. The number in epithelial cells was similar to that in stromal cells of hyperplastic prostates. In cancerous prostates, the number was larger than in hyperplastic prostates and increased along with upgrading. The number in incidental cancers was smaller than in clinical cancers as compared with cells of the same Gleason pattern. Number correlated with T factor, but not with N and M factors. Response to treatment and cause-specific survival in stage D2 patients receiving endocrine therapy did not correlate with number, although a relationship between Gleason pattern and survival was shown in these patients. It was concluded that AgNORs might not be an indicator to predict prognosis after endocrine therapy, since a number of AgNORs did not influence response to the therapy.

Humans

Clinical course of bone metastasis from prostatic cancer following endocrine therapy: examination with bone x-ray.

X-ray findings of bone metastatic lesions from 81 cases of stage D2 prostatic cancer were examined before and following endocrine therapy. Untreated lesions were classified into five types; osteoblastic (15%), mixed, but mainly osteoblastic (31%), mixed, but mainly osteolytic (17%), osteolytic (10%), and undetermined with a positive bone scan (27%). Patients with two mixed types had a tendency of widely speeded areas of metastasis and elevated serum prostatic acid phosphatase. Temporal enlargement of sclerotic lesion immediately after the start of therapy did not indicate disease progression. In many cases, changes from osteolytic to osteoblastic patterns were noticed in the same lesion regardless of the effects of endocrine therapy. Remodeling to the sclerotic pattern appeared as curative changes. From these findings, it was concluded that the natural course of bone lesions showed a tendency to change from the osteolytic to osteoblastic type and relapse was often accompanied by an increase of the osteolytic type lesion. Evaluation of therapeutic effects based on remodeling, changes in number and areas of lesions, and the appearance of new lesion correlated well with prognosis.

Aged

Disaccharide analysis of the skin glycosaminoglycans in systemic sclerosis.

The disaccharides constituting chondroitinase-digestible glycosaminoglycan (GAG) in the skin lesions of patients with systemic sclerosis were determined using high-performance liquid chromatography (HPLC). In scleroderma there was an increase in the amount of delta Di-4S(DS), the main disaccharide unit of dermatan sulphate, and a decrease in delta Di-HA, the disaccharide unit of hyaluronic acid, as compared with normal skin from a similar site. The distribution pattern of the main disaccharides constituting chondroitin sulphate and dermatan sulphate in scleroderma differed from that in scars or scleredema.

Adult

Role of intestinal microflora in metabolism of glutathione conjugates of 1-nitropyrene 4,5-oxide and 1-nitropyrene 9,10-oxide.

DNA adduct formation in the liver of B6C3F1 mice after administration of 1-nitropyrene (1-NP) was shown by the 32P-postlabeling technique. The major adduct was not N-(deoxyguanosin-8-yl)-1-aminopyrene, which was easily formed in in vitro nitroreduction of 1-NP in the presence of DNA, but the major spots migrated to the same position as the in vitro DNA adduct spots of K-region epoxides of 1-NP (1-NP 4,5- and 9,10-oxide). 1-NP oxides formed by the oxidative activation of 1-NP in the liver were excreted into the bile as detoxified glutathione conjugates which were changed to cysteine conjugates in the upper intestinal tract. The cysteine conjugates were degraded by cysteine conjugate beta-lyase (beta-lyase) of intestinal microflora in the lower intestinal tract. The mutagenicity of cysteine conjugates of 1-NP oxides for Salmonella typhimurium was enhanced by addition of beta-lyase and was decreased by addition of aminooxyacetic acid, a beta-lyase inhibitor. The in vitro binding of the cysteine conjugates to calf thymus DNA was increased by addition of beta-lyase and xanthine oxidase. We administered glutathione conjugates of 1-NP oxides to two groups of mice that had been treated with antibiotics or saline by gavage and analyzed the DNA adducts in the lower intestinal mucosa. The specific DNA adducts were detected in the saline-treated group but not in the antibiotics-treated group. These results suggest that intestinal microflora play an important role in activation of glutathione conjugates of 1-NP oxides.

Animals

[Relationship between extent of bone metastases and effect of endocrine therapy evaluated with bone scintigraphy in stage D2 prostatic cancer].

Bone scintigraphy of metastatic lesion on 128 patients with prostatic cancer were classified according to the proposal by Soloway et al (Cancer, 61; 195-202, 1988). Since all patients received endocrine therapy, the response to therapy and survival were examined in relation to bone lesion. In extent of disease (EOD) 1, main metastatic lesions were located in the pelvis, lumbar spine, and with increasing number of EOD, metastases in the upper spine, rib, and skull appeared. Longer survival were noticed in EOD 1, followed by EOD 2 and EOD 3, and EOD 4 revealed the shortest survival. The survival of EOD 2 was similar to thus of EOD 3. However, when grades of tumor were considered, moderately differentiated cancer showed longer survival than poorly differentiated cancer in EOD 2 and EOD 3. The response as assessed by bone scintigraphy following 6-month therapy was well correlated with the number of EOD. When individual items for evaluation of response were examined, the results of local response of the prostate and values of PAP showed good correlation with survivals, however, that of bone lesions with bone scintigraphy failed to show such a correlation with prognosis. Therefore, it is concluded that the therapeutic evaluation of bone lesions with bone scintigraphy is difficult to interpret 6 months after initiation of treatment.

Adenocarcinoma

Comparison of various assay systems for prostate-specific antigen standardization.

To avoid confusion between serum prostate-specific antigen (PSA) values among various assay systems, clinical studies on the possibility of conversion among detection values were performed. The assay kits used for the PSA comparisons were MARKIT-F PA, MARKIT-M PA, EIKEN PA, PA test WAKO, Ball ELSA PSA, E-Test Tosoh II PA, PROS-CHECK PSA, DELFIA PSA and TANDEM-R PSA. Using each kit, the standards attached to each assay system were detected, and 142 sera samples from benign hypertrophies or prostate cancers were assayed for serum PSA values. By detecting the standards for each kit, slopes were obtained which were almost identical to those obtained from original assay system. The coefficients of correlation among the PSA detection systems, using patients' sera, were very high, and linear regression lines were also obtained. The results suggest that almost identical serum PSA values may be detected either by multiplying by a coefficient to bring it to the standard or using the conversion formula.

Adenocarcinoma

Inverted papilloma of the renal pelvis associated with renal cell carcinoma: a case report.

Twenty-one cases of inverted papilloma of the renal pelvis have been described in the literature. A 71-year-old man was admitted to our hospital to examine a right renal mass. We diagnosed a right renal tumor on the basis of the findings from excretory urogram (IVP), computerized tomography (CT) and magnetic resonance imaging (MRI). Surgical material revealed an inverted papilloma in the renal pelvis. We report on the first case of an invested papilloma of the renal pelvis associated with renal cell carcinoma.

Aged

[Clinical course of bone metastases by prostatic cancer studies with conventional X-ray].

The clinical courses of bone metastases in 81 cases of prostatic cancer were examined using conventional X-ray. All patients received endocrine therapy as the initial treatment; castration and estrogen were given to 46 cases, castration and antiandrogen to 19, LH-RH analog to 11, flutamide to 5. The response to endocrine therapy was evaluated every 6 months after the start of the treatment according to National Prostatic Cancer Project criteria. The prognosis was calculated by cause-specific survival. The types of untreated bone metastases on X-ray were classified into five: sclerotic in 12 cases (15%), mixed but mainly sclerotic in 25 (31%), mixed but mainly lytic in 14 (17%), lytic in 8 (10%) and undetermined with positive scintigraphy in 22 (27%). Two mixed types showed more spread metastases and tendency of elevated prostatic acid phosphatase when compared with other types. Temporary enlargement of sclerotic area within 6 months after start of the treatment did not correlate with deterioration of disease. Remodeling of metastatic areas occurred 6-36 months after start of the treatment showed curative course and the prognosis of these groups were favorable. Most of lytic areas tended to sclerotic finding following endocrine therapy regardless of effects by endocrine therapy. Sclerotic and two mixed types showed better and worse tendencies, respectively. On viewpoint of remodeling, change of metastatic area and newly appearance of metastases, an evaluation criteria of response to the therapy was proposed, which showed good correlation with prognosis. From these observations, it was concluded that bone metastases tended from lytic to sclerotic changes and that lytic-sclerotic cycles occurred repeatedly along with disease progression regardless of effect to therapy. Remodeling seemed to be curative signs of metastatic area.

Aged

[Radiotherapy of prostatic carcinoma].

Forty-one patients with adenocarcinoma of the prostate localized in the pelvis (stage A2, NX; 3, A2, pN0; 5, B, NX; 5, B, pN0; 1, C, NX; 13, C, pN0; 7, C, pN1; 7) underwent curative external radiotherapy. Thirty-two cases were treated by fast neutron combined with or without Liniac X-ray and 9 cases were treated by Liniac X-ray. Twenty-six cases were well controlled by radiotherapy, but 15 cases recurred and were followed by endocrine therapy. The types of recurrence were local growth in 3, distant metastases in 11, and both in 1. These recurrences occurred in the cases of large prostatic carcinoma, small radiation field in NX cases or low radiation dose. The five-year disease-free survival rates of stage A2, B, C were 86, 66, and 47%, respectively and the five-year overall survival rates were 100, 100, and 53%, respectively. The cases with well differentiated carcinoma had better prognosis than those with poorly differentiated carcinoma (p less than 0.05). As 58% of the cases which were given concomitant endocrine therapy were controlled for over 2 years, endocrine therapy seems to be effective in the cases of failure after radiotherapy. Most of the complications were slight and only one case with complication of sacral decubitus needed surgical treatment. It was concluded that external radiotherapy was a good modality for prostatic carcinoma localized in the pelvis.

Adenocarcinoma

[Response to chemotherapy in endocrine therapy-relapsed and -resistant prostate cancer].

Effects of chemotherapy to endocrine therapy (castration with estrogen/antiandrogen)-relapsed (24 cases) or endocrine therapy-resistant (14 cases) prostate cancer were compared. Pretreatment clinical stages in these groups were stage D1 (3 cases) and D2 (35 cases). Regimens of chemotherapy in this study were as follows: cis-platinum (CDDP) (1 case), phosphamide (3 cases), combination of vincristine, phosphamide and peplomycin (5 cases), combination of cyclophosphamide, adriamycin (ADM) and CDDP (8 cases) and combination of phosphamide, ADM, and CDDP (21 cases). Response to chemotherapy and subsequent survival in these two groups were examined. When evaluated at 3 months after the start of the chemotherapy, partial response and stable cases were 50% and 36% in endocrine therapy-relapsed and -resistant groups, respectively. Because the worse performance status contained more cases in the endocrine therapy-resistant group, the response was compared at the same base of performance status, and the response was almost equal in the two groups. Survival in the endocrine therapy-relapsed group was better than that in the therapy-resistant group. When compared at the same base of performance status, the difference in survival time between the two groups was not evident. In conclusion, the response of chemotherapy was similar between endocrine therapy-relapsed and -resistant patients, and performance status was a main factor influencing the prognosis of endocrine therapy-refractory prostate cancer.

Aged

Serum gamma-seminoprotein determination in prostatic cancer.

Serum gamma-seminoprotein (gamma-Sm) was evaluated as a new marker for prostatic cancer in comparison with prostatic acid phosphatase (PAP). The sensitivity of gamma-Sm and PAP for untreated prostatic cancer was 81% and 67%, respectively. gamma-Sm showed a higher positive rate over all stages than in benign prostatic hypertrophy (BPH). There was no correlation between gamma-Sm and PAP in prostatic cancer. Improved sensitivity was obtained by simultaneous measurement of gamma-Sm and PAP. Specificity of gamma-Sm and PAP for BPH was 87% and 90%, respectively. gamma-Sm normalized after endocrine therapy for stage D2 more often than did PAP. These results indicate that gamma-Sm is another useful marker to evaluate prostatic cancer.

Acid Phosphatase

[Clinical study of RU 23908 (nilutamide) in prostatic cancer].

To investigate the efficacy and the safety of RU23908 for the treatment of prostatic cancer, an early phase 2 study with the oral administration of 150 or 300 mg daily was performed in 47 patients with stage C or D prostatic cancer at 15 institutions from April 1987 to June 1988. Forty patients were evaluable for efficacy. Concerning the effect on the object lesion, the results of the overall evaluation revealed that complete or partial response (CR + PR) was obtained in 34 of the 40 cases (85.0%). As to the effect classified by site, CR + PR were observed in 35 out of the 40 cases with primary lesion (87.5%), in 10 of the 22 cases with bone metastasis (45.5%), in 5 of the 6 cases with lymph node metastasis (83.3%) and CR was observed in one case with lung metastasis. In the PAP evaluation, 33 out of the 34 cases were judged to be CR + PR (97.1%). The improvement rate of clinical symptoms was 88.9% for bone pain, 83.3% for dysuria and 45.5% for performance status. Adverse reactions were observed in 29 of the 47 cases (61.7%) investigated and 7 cases (14.9%) were withdrawn. During the study period of 12 weeks and the subsequent period of continued administration, 6 cases (12.8%) and 2 possible cases of interstitial pneumonia were diagnosed. From the above results, the treatment of prostatic cancer with RU23908 150 mg/day or 300 mg/day in combination with surgical castration showed an excellent clinical effect compared to conventional endocrine therapy, but has a problem of safety. Therefore, this drug may be expected to be a highly useful therapeutic drug, if safely is improved in the future by reviewing the dose.

Administration, Oral

Immunohistochemical study of androgen receptor in benign hyperplastic and cancerous human prostates.

Androgen receptor was detected immunohistochemically in benign as well as malignant prostatic tissues by using a monoclonal rat anti-human androgen receptor antibody (AN 1-15). In both benign and malignant cells, the androgen receptor was exclusively localized in nuclei. In hyperplastic prostate, the androgen receptor was stained in the glandular and the stromal cells. In the gland, cells facing the lumen were stained more intensively than those adjacent to the basal membrane. In cancer tissue, receptor-positive and -negative cancer cells were intermingled. The percent of strongly positive cancer cells was correlated inversely with grade. Relapsed cells showed a low population of strongly positive cells irrespective of grade.

Antibodies, Monoclonal

Histochemical examination of expression of ras p21 protein and R 1881-binding protein in human prostatic cancers.

Expression of ras p21 was examined with monoclonal antibody RASK-3 in normal, benign hyperplasic, and cancerous prostates. In patients with stage D2 disease who received endocrine therapy, the relation between ras p21 expression, response to therapy, and prognosis was studied. In these patients, R 1881-binding protein (androgen receptor and progestin-binding protein) was also examined. Non-cancerous cells and most cancer cells from stage A patients did not express ras p21, while expression increased with both higher staging and grading. Staging pelvic lymphadenectomy was done in some stage A2-C cases, and presence of nodal metastasis was correlated with ras p21 expressions in the primary tumours. In stage D2, there was no correlation between ras p21 expression and R 1881-binding protein. Response to therapy and survival did not correlate with expression of ras p21, but was influenced by presence of R 1881-binding protein.

Androgen-Binding Protein