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S Fukuzawa

Publications and source records attributed to S Fukuzawa.

53 records · Page 3Linked to original sources
PubMed1993

Quantitative histopathology in the prognostic evaluation of patients with transitional cell carcinoma of the urinary bladder.

BACKGROUND: Morphologic grading of malignancy is considered to be of prognostic value in patients with transitional cell carcinomas of the urinary bladder (TCC). This qualitative approach is, however, associated with low reproducibility. Grading of malignancy can be carried out on a reproducible, quantitative scale. METHODS: A retrospective, prognostic study of 110 patients treated for TCC in clinical Stages Ta-T4 (median follow-up time, 6 years) was performed, evaluating various grading techniques. Unbiased estimates of the volume-weighted mean nuclear volume (nuclear vV), nuclear volume fraction, estimates of nuclear mean profile area (aH(nuc)), nuclear profile density index (NI), and mitotic profile density index (MI) were obtained by stereologic and morphometric techniques. RESULTS: The T-stage and morphologic grade of malignancy were closely cross-correlated (+0.63 < Kendall tau < +0.71, 2P < 6.7 x 10(-16)). The estimation of nuclear vV was highly efficient, with more than 85% of the associated variation attributable to differences between tumors. A positive significant correlation between estimates of nuclear vV and aH(nuc) was detected (r = +0.79), whereas an inverse correlation was documented between nuclear vV and NI (r = -0.63). Estimates of nuclear volume fraction showed no correlation with nuclear vV. Comparisons between categorical and quantitative data revealed the following: a decrease in averaged estimates of NI for tumors in advanced T-stage and malignancy grade (2P < 0.0008); and nuclear vV and aH(nuc) increased on average, in tumors of high T-stage and malignancy grade. Estimates of MI were also positively correlated with the T-stage and the malignancy grade (+0.42 < Kendall tau < +0.49). Single-factor analyses showed prognostic effect of T-stage, grade of malignancy, and, apart from nuclear volume fraction, all quantitative histopathologic variables with regard to overall survival (2P < 0.03). None of the morphometric and stereologic parameters were of prognostic values with regard to recurrence-free survival (2P > 0.26). Multiple hazards regression analysis (Cox models) revealed that clinical stage of disease was the sole independent prognostic variable. Only estimates of nuclear vV added significant independent prognostic prediction with regard to recurrence-free survival in the 48 patients with Ta tumors (2P = 0.03). CONCLUSIONS: The results suggested that estimates of nuclear vV are prognostically superior to morphologic grading of malignancy in noninvasive TCC, whereas both morphologically and quantitatively based malignancy grading are without prognostic value in invasive TCC.

Adult↗
PubMed1993

Hemangioma of the left ventricular cavity: presumptive diagnosis by magnetic resonance imaging.

In a 16-year-old boy, magnetic resonance imaging (MRI) revealed a 1 x 1.5-cm tumor on a stalk attached to the anterior ventricular wall. The tumor showed homogeneous enhancement after the administration of gadolinium(Gd)-DTPA, indicating it was highly vascular. The tumor was excised during surgery and the histological examination led to a diagnosis of juvenile hemangioendothelioma. MRI therefore allowed a definitive diagnosis of cardiac hemangioma to be made preoperatively. This case represents the first reported instance of a benign left ventricular hemangioma diagnosed by MRI.

Adolescent↗
PubMed1993

[Multifocal renal oncocytoma: a case report].

A case of multifocal renal oncocytoma in a 55-year-old man admitted for further examination following the detection of left renal tumors, is reported. Computerized tomographic (CT) scanning and magnetic resonance imaging (MRI) revealed 2 masses in the left kidney. A left radical nephrectomy was performed and two tumors were found. Both tumors were confirmed to be renal oncocytomas by light and electron microscopic examination. Including this patient, 42 cases of bilateral and multifocal renal oncocytoma have been reported in the literature to date. The clinical features of bilateral and multifocal renal oncocytomas are discussed accordingly.

Adenoma↗
PubMed1992

Reverse redistribution on Tl-201 SPECT images after reperfusion therapy for acute myocardial infarction: possible mechanism and prognostic implications.

So-called reverse redistribution on stress Tl-201 imaging has been reported previously, but its significance and clinical implications are not well understood. In patients who received reperfusion therapy for acute myocardial infarction, we frequently observed reverse redistribution on stress Tl-201 images. To investigate the significance of reverse redistribution, 61 patients who underwent reperfusion within 4 h of the onset of chest pain underwent submaximal exercise Tl-201 imaging 3 weeks later. We performed simultaneous coronary arteriography and left ventriculography. We divided these 61 patients into three groups based on the pattern of Tl-201 images. Reverse redistribution was found in 19 patients (Group A), 12 patients had redistribution (Group B), and 30 patients had nonreversible defects (Group C). All patients in Group A had less residual stenosis than those in the other groups, and showed significant improvement of left ventricular function. Furthermore, 12 patients (Group A) demonstrated reverse redistribution or a normal pattern in a follow-up study performed 12 months later. However, in the delayed images the defect was smaller than that shown in the previous study. None of the patients had any symptoms and all returned to their previous occupations. In conclusion, reverse redistribution was common in patients undergoing reperfusion therapy for acute myocardial infarction, especially those with little residual stenosis. Reverse redistribution appears to indicate improved regional wall function in such patients.

Aged↗
PubMed1992

Anti-promoting effect of nordihydroguaiaretic acid on N-butyl-N-(4-hydroxybutyl)nitrosamine and sodium saccharin-induced rat urinary bladder carcinogenesis.

The effects of oral administration of nordihydroguaiaretic acid (NDGA), an antioxidant and inhibitor of arachidonic acid metabolism, on rat bladder carcinogenesis were examined. Six-week-old male Fischer 344 rats were given drinking water containing 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine for 4 weeks. Following this 4-week period, diet containing 5% sodium saccharin (SS) with or without 0.1% NDGA supplement was given to the rats for 36 weeks. The incidences of papillary or nodular (PN) hyperplasia and of papilloma in the group treated with SS plus NDGA were significantly lower than those in the group treated with SS alone. The number of PN hyperplasic foci per 10 cm of basement membrane in rats treated with SS plus NDGA was also lower than that in the group treated with SS alone. These results suggest that NDGA has an anti-tumor-promoting effect on rat bladder carcinogenesis.

Animals↗
PubMed1992

[Clinical significance of stereological estimation of mean nuclear volume in human bladder carcinoma--further analysis of nuclear morphometric variables].

Recently, nuclear morphometry methods have been used to quantitatively analyze the malignant potential of cancer cells. We have previously shown that the malignant potential of human bladder carcinoma can be analyzed quantitatively through mean nuclear volume measurements. In the present study, we examined other measurements obtained from nuclear morphometry and evaluated their usefulness as indicators of the outcome of bladder carcinoma. Our subject group consisted of 161 patients with untreated bladder carcinoma. Four nuclear morphometric values were measured on each subject: the mean nuclear volume (MNV), the mean nuclear area (MNA), the nuclear roundness factor (NRF) and the variation of nuclear area (VNA). MNV, MNA and VNA values increased as the tumors progressed to a more advanced stage and grade of malignancy. Patients were then divided into two subgroups based on each morphometric value: small MNV (< 186.9 microns3) and large MNV (> or = 186.9 microns3); small MNA (< 33.6 microns2) and large MNA (> or = 33.6 microns2); low NRF (< 81.1) and high NRF (> or = 81.1); and low VNA (< 33.0) and high VNA (> or = 33.0). Survival rates were significantly higher among patients with a small MNV, a small MNA and a low NRF (5-year survival rate; 93.0, 84.9 and 84.6%), compared to patients exhibiting high values (5-year survival rate; 59.7, 61.3 and 61.9%). For patients with grade 2 tumors, those with a small MNV had a high survival rate (5-year survival rate; 95.2%), similar to that of patients with grade 1 tumors (5-year survival rate; 95.2%)(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Clinical significance of the stereological estimation of mean nuclear volume in human bladder carcinoma--relation to tumor grade, stage and prognosis].

Quantitative analysis of the malignant potential in cancer cells is a method currently under discussion. Recently the stereological estimation of cancer cells has been utilized in making an objective and quantitative pathological diagnosis. In this study, we estimated the mean nuclear volume (MNV) of untreated bladder carcinomas in 128 patients by stereological methods and attempted to quantitatively analyze the malignant potential of the carcinoma. The MNV was significantly enlarged as the tumor advanced in grade and stage. MNV was largest in grade 3 tumors (340.2 +/- 100.1 microns3) followed by grade 2 tumours (206.2 +/- 90.6 microns3) (P less than 0.01), and grade 1 tumors (130.6 +/- 46.7 microns3) (P less than 0.01). MNV was larger in pT1 tumors (278.2 +/- 126.9 microns3) than in pTa tumors (156.9 +/- 60.5 microns3) (P less than 0.01). MNV was also larger in invasive tumors (T2, T3 and T4: 318.2 +/- 104.0 microns3) than in superficial tumors (Ta and T1: 203.5 +/- 109.2 microns3) (P less than 0.01). Patients were then divided into two subgroups, one with large nuclei (MNV greater than or equal to 197.3 microns3), and the other with small nuclei (MNV less than 197.3 microns3). Survival and disease-free rates in patients with small nuclei (5-year survival rate: 92.9%, 5-year disease-free rate: 24.4%) were significantly better than in patients with large nuclei (5-year survival rate: 58.0%, 5-year disease-free rate: 12.5%). For patients with grade 2 tumors, those with small nuclei had a good survival rate (5-year survival rate: 95.5%), similar to that of patients with grade 1 tumors (5-year survival rate: 95.0%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[A case of advanced seminoma treated effectively with single agent carboplatin therapy].

Cisplatin has played a major role in the treatment of germ cell tumors. However, it causes renal damage, severe nausea and vomiting. It is also neurotoxic and ototoxic. Carboplatin is an analog of cisplatin which, does not cause renal damage at therapeutic doses. It is not neurotoxic or ototoxic and it produces less gastrointestinal toxicity than cisplatin. We used carboplatin alone as an initial chemotherapy in a 36-year-old man with stage IIB seminoma. Following left radical orchiectomy the patient received 4 courses of carboplatin chemotherapy. After the first course of chemotherapy, tumor markers (LDH, beta-HCG) returned to the normal range. After 4 courses, the size of the retroperitoneal metastases was significantly reduced. The toxicity of 4 courses of carboplatin chemotherapy was generally milder than that of cisplatin-based combination chemotherapies such as PVB or VAB-6. There were no episodes of septicemia, thrombocytopenic bleeding or renal deterioration. The patient did not suffer from alopecia, neuropathy, symptomatic hearing loss, severe nausea or vomiting. Nine months after the completion of carboplatin chemotherapy, the patient remains well and free from disease progression. This case strongly suggests that single agent carboplatin therapy could be an effective and less-toxic treatment for advanced seminoma.

Adult↗
PubMed1986

[VAB-6 combination chemotherapy in patients with stage II, III testicular tumor].

Between 1983 and 1985, six patients with advanced testicular cancer were treated with 3 cycles of vinblastine, actinomycin D, bleomycin, cyclophosphamide and cisplatinum (VAB-6 combination chemotherapy without maintenance). The histology of the primary tumor was seminoma in one patient and nonseminomatous germ cell testicular tumor (NSGCTT) in 5. Five men with stage III or bulky stage II diseases received no prior chemotherapy but one had received another chemotherapy without cisplatinum. Two patients showed a complete response to chemotherapy. Three were partial responders free of disease after a debulking operation and additional chemotherapy. The other patient who had NSGCTT had recurrence 5 months after the last induction chemotherapy and received additional chemotherapy (PVeBV regimen). Median follow-up was 16 months (range 2 to 28 months) and all patients are alive with no evidence of disease. Severe myelosuppression and serious renal toxicity were not experienced. Marked, but transient elevation of serum transaminase were observed in all patients. These data suggest that this protocol is highly effective and minimally toxic in the treatment of disseminated testicular tumor.

Adolescent↗
PubMed1985

[A case of pentalogy of Fallot with numerous collaterals evaluated by magnetic resonance imaging: a report of an adult case].

In this report, the diagnostic value of magnetic resonance imaging (MRI) was compared with that of two-dimensional echocardiography, computed tomography and cardiac catheterization in a patient with pentalogy of Fallot who survived to her fortieth year. The advantages and disadvantages of MRI in diagnosing the present case were as follows: The cardiovascular system, with the exception of atrial septal defect, was evaluated precisely. Collateral vessels were detected using MRI, but impossible with other non-invasive methods. MRI was particularly suitable for imaging the cardiovascular system because of the high contrast between the lower intensity signal of the blood and higher intensity signal of the myocardium and blood vessel walls. Using MRI, data acquisition time was 1.5 min per section. Gated MRI required more time for data acquisition. However, various oblique tomographic projections and very clear static images could be obtained using gated MRI. MRI should be one of the best diagnostic techniques for diagnosing congenital heart disease.

Adult↗
PubMedDate not supplied

Angiotensin-converting enzyme inhibitor therapy affects myocardial fatty acid metabolism after acute myocardial infarction.

BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitor therapy has an early mortality benefit in unselected patients with acute myocardial infarction (AMI). However, the effects of ACE inhibition on myocardial fatty acid metabolism in this patient population have not been studied. We tested the hypothesis that ACE inhibitor therapy improves myocardial fatty acid metabolism and decreases mortality rate in patients after AMI. METHODS: Forty-two patients after first anterior AMI and primary angioplasty were randomly assigned to titrated oral enalapril (n = 24) or placebo therapy (n = 18). Iodine 123-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) single photon emission computed tomography imaging was performed an average of 4.8 days after AMI and 1 month after AMI. BMIPP abnormalities were quantified as a severity index by a polar map. RESULTS: There were no significant changes in baseline characteristics, cardiac function, and angiographic findings between patients in the enalapril group and patients in the placebo group. However, BMIPP severity index from acute phase to chronic phase was significantly decreased in the enalapril-treated group (118+/-48 to 82+/-36, P<.05), but not in the placebo group (123+/-65 to 115+/-58, P not significant). CONCLUSION: ACE inhibition therapy improved myocardial fatty acid metabolism and regional left ventricular function in patients after anterior AMI. BMIPP single photon emission computed tomography findings imply that this better outcome may be attributable to an improvement of cellular function with ACE inhibitors.

Adult↗
PubMedDate not supplied

Nicorandil affords cardioprotection in patients with acute myocardial infarction treated with primary percutaneous transluminal coronary angioplasty: assessment with thallium-201/iodine-123 BMIPP dual SPECT.

BACKGROUND: It has been reported that nicorandil restores blood flow to reperfused myocardium in patients with acute myocardial infarction. However, whether nicorandil might decrease infarct size remains unclear. The aim of this study was to assess the effect of nicorandil on infarct size with thallium-201/beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) dual-isotope single photon emission computed tomography. METHODS: A total of 62 patients were randomly assigned to receive intravenous nicorandil (4 mg in 5 minutes at admission, immediately followed by 6 mg/hr over a 24-hour period) or placebo. All patients were divided into 4 groups: Group N-a, 16 patients with preexisting angina treated with nicorandil; N-b, 15 patients without preexisting angina treated with nicorandil; C-a, 14 patients with preexisting angina given placebo; C-b, 17 patients without preexisting angina given placebo. Tl-201/BMIPP imaging was performed in the 62 patients within 7 days after admission. Dual-isotope single photon emission computed tomographic images were quantified by severity index with a polar map. RESULTS: The BMIPP severity index was similar among the 4 groups. Only the thallium severity index in the N-a group was significantly less (P<.05). The ratio of the thallium severity index to that of BMIPP in the N-a group was significantly decreased compared with those of the other groups. CONCLUSION: Nicorandil has a protective effect in patients with acute myocardial infarction and preexisting angina treated with primary balloon angioplasty.

Angina, Unstable↗