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Biomedical subjects

S Kameoka

Publications and source records attributed to S Kameoka.

At least 19 recordsLinked to original sources
PubMed2000

Pathologic evaluation of surgical margins and local recurrences after breast-conserving surgery without irradiation.

This study was undertaken to evaluate the status of margins of the excised breast tissue using our own method. We also determined the indications for breast-conserving surgery without irradiation by examining the characteristics of patients with local recurrence and comparing relapse-free survival (RFS) and overall survival (OS) of patients who underwent wide excision without irradiation with those of 267 patients who underwent total mastectomy. Eighty-two patients with a 3 cm diameter or less invasive carcinoma were treated with wide excision and axillary dissection between 1987 and 1996. Patients who histologically had four or more axillary lymph node metastases, positive pathologic margins, or a high degree of in situ ductal carcinoma around the main tumor in consecutive step-sections were excluded from this study. During a median follow-up of 6 years (range 2-11 years), six patients (7.3%) had local recurrence and five (6.0%) had regional or distant recurrences as their site of first failure. At 11 years the life-table values for RFS and OS for the wide excision-treated group were 84.7% and 92.1%, respectively, compared with 85.0% and 90.0%, respectively, for patients treated by total mastectomy. RFS and OS were similar in the two treatment groups. Results in the present study indicate that if the patients treated by breast-conserving surgery are carefully selected and there are no foci in the pathologic margins, there is a low degree of in situ ductal carcinoma around the tumor, and no multicentricity, it might be unnecessary to administer

Adult↗
PubMed2000

Clinicopathologic study associated with long-term survival in Japanese patients with node-negative breast cancer.

This study was undertaken to determine the absolute and relative value of blood vessel invasion (BVI) using both factor VIII-related antigen and elastica van Gieson staining, proliferating cell nuclear antigen (PCNA), p53, c-erbB-2, and conventional prognostic factors in predicting relapse-free survival (RFS) and overall survival (OS) rates associated with long-term survival in Japanese patients with node-negative breast cancer. Two hundred patients with histological node-negative breast cancer were studied. We investigated nine clinicopathological factors, including PCNA, p53, c-erbB-2 using permanent-section immunohistochemistry, clinical tumour size (T), histological grade (HG), mitotic index (MI), tumour necrosis (TN), lymphatic vessel invasion (LVI) and BVI, followed for a median of 10 years (range 1-20). Twenty-one patients (10.5%) had recurrence and 15 patients (7.5%) died of breast cancer. Univariate analysis showed that BVI, PCNA, T, HG, MI, p53, c-erbB-2 and LVI were significantly predictive of 20-year RFS or OS. Multivariate analysis showed that BVI (P = 0.0159, P = 0.0368), proliferating cell nuclear antigen (PCNA) (P = 0.0165, P = 0.0001), and T (P = 0.0190, P = 0.0399) were significantly independent prognostic factors for RFS or OS respectively. BVI, PCNA and T were independent prognostic indicators for RFS or OS in Japanese patients with node-negative breast cancer and are useful in selecting high-risk patients who may be eligible to receive strong adjuvant therapies.

Adolescent↗
PubMed1999

Expression of antioxidant proteins in human intestinal Caco-2 cells treated with dietary flavonoids.

Dietary flavonoids are known to scavenge free radicals but little information is available on their roles in antioxidant protein gene expression. The goal of this paper is to investigate the effect of flavonoid treatment on the antioxidant protein expression in human intestinal Caco-2 cells. The antioxidant proteins of interest were metallothionein (MT), catalase (CAT), and superoxide dismutase (SOD). Treatment of Caco-2 cells with 100 microM genistein, biochanin A, daidzein or kaempferol significantly increased MT mRNA up to 15 fold. On the contrary, CAT mRNA level was not affected by various flavonoids. We also developed gel activity assays to determine the specific activities of CAT and Cu/Zn SOD in flavonoid-treated Caco-2 cells. Compared to the conventional spectrophotometric assays, the gel assays allow a separation of antioxidant activities of the enzymes from that of the flavonoids. CAT and Cu/Zn SOD were found not to be affected by 48-h treatment of 100 microM dietary flavonoids (genistein, biochanin A, daidzein, flavone, quercetin, or kaempferol). In conclusion, the effects of flavonoids on antioxidant protein expression are structure- and gene-specific. When evaluating antioxidant capacity of flavonoids, their ability to modulate antioxidant protein expression should also be taken into consideration.

Caco-2 Cells↗
PubMed1999

New Prognostic Factors Associated with Long-term Survival in Node-Negative Breast Cancer Patients.

BACKGROUND: This study was undertaken to determine the absolute and relative value of angiogenesis, proliferating cell nuclear antigen (PCNA) and conventional prognostic factors in predicting relapse-free survival (RFS) and overall survival (OS) rates associated with long-term survival in Japanese patients with node-negative breast cancer. PATIENTS AND METHODS: Two hundred patients with histological node-negative breast cancer were studied. We investigated nine clinicopathological factors, including angiogenesis, PCNA using per-manent-section immunohistochemistry, clinicaltumor size, histological grade (HG), tumor necrosis, lymphatic vessel invasion (LVI), histological extension, histological classification, and infiltrating growth (INF), followed for a median of 10 years (range, 1 to 20). RESULTS: Twenty-one patients (10.5%) had recurrence and 15 patients (7.5%) died of breast cancer. Univariate analysis showed that PCNA, clinical tumor size, HG, angiogenesis, and LVI were significantly predictive of 20-year RFS or OS. Tumor necrosis was significantly predictive of OS, not of RFS. Multi-variate analysis showed that clinical tumor size (P = 0.0003), angiogenesis (P = 0.0003), PCNA (P = 0.0064), and HG (P = 0.0401) were significant independent prognostic factors for RFS. PCNA (P< 0.0001) and clinical tumor size (P = 0.0112) were significant independent prognostic factors for OS, while angiogenesis was a borderline significant factor. CONCLUSION: PCNA and angiogenesis were important new prognostic factors in node-negative breast cancer patients.

Journal Article↗
PubMed1999

Clinical study on the ratio of glucose/fat in peripheral parenteral nutrition and the usage of a midline catheter.

Two important unsolved questions related to peripheral parenteral nutrition are the ratio of components in the intravenous (IV) solution and catheter-related complications. The present study was undertaken to evaluate the nutritional profiles of three kinds of IV solutions with different ratios of components, while maintaining the total energy at about 1 200 kcal/day and the amino acid level at 60 g. The IV solution formulas used were as follows : glucose/fat = 2:1, osmolarity ratio = 3.3 for group A, glucose/fat = 1:1, osmolarity ratio = 3.1 for group B, and glucose/fat = 1:2, osmolarity ratio = 2.6 for group C. The incidence and severity of complications were then analyzed in relation to the type of IV solution used, the indwelling time, and the type of catheter (midline catheter or short peripheral catheter). The results of peripheral parenteral nutrition were favorable when the glucose/fat ratio of the IV solution was either 1:1 or 1:2. The midline catheter was inserted for an average of 11.9 +/- 4.0 days, and the incidence of catheter-related complications following parenteral nutrition with a midline catheter was low when the osmolarity ratio of the IV solution was 3.1 or less. These results indicate that a midline catheter is useful when administering peripheral parenteral nutrition.

Catheterization↗
PubMed1999

The methodology of quantitation of microvessel density and prognostic value of neovascularization associated with long-term survival in Japanese patients with breast cancer.

The present study updates results on methodology of quantitation of tumor neovascularization and those on the prognostic value of microvessel density (MVD) in breast cancer tissue previously published in the World J. Surg. 21: 49-56, 1997. The follow-up period of observation of the series was extended to 20 years, and new biological indicators (i.e., proliferating cell nuclear antigen (PCNA), c-erbB-2, and p53) were included in the analysis. There were 109 patients with primary breast cancer, from 1971 to 1979, followed up for a median of 14 years (range, 1-20). A representative median longitudinal section of each breast tumor was immunohistochemically stained with factor VIII-related antigen and analyzed. The three methods of identifying MVD were: (1) average microvessel count (AMC)/mm2, (2) central microvessel count (CMC)/mm2, and (3) highest microvessel count (HMC)/mm2. Thirty-one patients (28.4%) died of breast cancer. There was a relationship between MVD and peritumor blood vessel invasion (AMC: p = 0.0114, CMC: p = 0.0319, and HMC: p = 0.0009). However, there was no relationship between MVD and other factors. Univariate analysis showed that node status (p < 0.0001), histological grade (p < 0.0001), clinical tumor size (T) (p = 0.0002), PCNA (p = 0.0033), p53 (p = 0.0043), mitotic grade (p = 0.0092), AMC (p = 0.0214), and peritumor lymphatic vessel invasion (p = 0.0467) were significantly predictive of overall survival. HMC was borderline significant (p = 0.0702), while CMC and c-erbB-2 were not significant. Multivariate analysis showed that T (p = 0.0005), node status (p = 0.0053), and AMC (p = 0.0485) were independent factors, but neither CMC nor HMC was independent. AMC, a significant independent prognostic factor, might be a better method than the others for evaluating angiogenesis, but further and larger studies are warranted.

Adult↗
PubMed1998

[Application of percutaneous trans esophageal gastro-tubing (PTEG) in to home care for a patient with terminal stage of gastric cancer].

PURPOSE: Since 1994, we devised and have continued to develop a percutaneous trans esophageal gastro-tubing (PTEG) as an effective technique to drain gastrointestinal contents of critical patients suffering from gastric carcinoma. Here we report our satisfactory experience with a critical gastric cancer patient for whom we improved QOL by the application of the PTEG technique. The patient suffered from severe stenosis or obstruction of the digestive tract. This method was found to be effective enough to enable the patient to receive further medical care at home. CASE: The patient was a 36-year-old female who had far-advanced, inoperable gastric carcinoma. It was therefore decided to use the PTEG method. METHOD: The PTEG method was performed using a rupture-free balloon (RFB) catheter to drain the gastrointestinal contents. A reservoir-port for IVH use was embedded to control the patient's nutrition. A morphine hydrochloride suppository was then given for the pain. REMARK: PTEG was found to be effective, safe and simple; moreover, it is a less-invasive, intestine-maintaining method, which enabled the patient to continue receiving further medical treatment at home.

Adult↗
PubMed1997

Clinicopathologic study of angiogenesis in Japanese patients with breast cancer.

To evaluate the clinicopathologic significance of angiogenesis as a prognostic factor and the objective methods for evaluating angiogenesis, we immunohistochemically stained a representative section of breast tumors with factor VIII-related antigen staining. There were 109 patients with primary breast cancer from 1971 to 1979. The two methods of identifying angiogenesis were the average microvessel count per square millimeter (AMC) and the highest microvessel count per square millimeter (HMC). There was no relation between microvessel count (AMC or HMC) or age, menopausal status, clinical tumor size (T), histologic classification, nuclear grade, node status, histologic grade (HG), mitosis index, or lymphatic invasion (LI). There was a relation between microvessel count and blood vessel invasion (BVI) (HMC:p = 0.0007) and tumor necrosis (TN) (HMC:p = 0.0050). Univariate analysis showed that AMC or HMC was a statistically significant predictor of overall survival in all patients (p = 0.0086 and p = 0.0307, respectively). Multivariate analysis showed that AMC was an independent predictor of node status when we fitted a model with node status, BVI, and either AMC or HMC; but HMC was not independent. However, when we fitted a model including all 11 of the other indicators and AMC or HMC, the node status, HG, and LI were independent predictors, but AMC and HMC were not. Although AMC was a better method than HMC for evaluating angiogenesis, we cannot confirm angiogenesis as a significant independent prognostic factor associated with long-term survival in Japanese breast cancer patients.

Adult↗
PubMed1997

Distribution of inducible nitric oxide synthase in ulcerative colitis.

OBJECTIVE: To investigate reports that the biosynthesis of nitric oxide (NO) is increased in the colonic mucosa of patients with active ulcerative colitis (UC), which suggests that serum NOx levels may be an important indicator of UC activity. METHODS: To determine the role of NO within the colon, we purchased polyclonal antibodies against human-inducible NO synthase (iNOS). We then examined the distribution of iNOS-reactive cells in UC colon tissues. RESULTS: In specimens from 12 UC patients, iNOS-positive neutrophils and macrophages were observed at the base of the ulcer but not in distant areas in the active stage. iNOS expression in colon mucosa was virtually absent during the inactive stage of UC and within the colon of patients with non-UC colitis. CONCLUSIONS: We conclude that NO in colonic mucosa may play a potential role in the pathogenesis of UC.

Adult↗
PubMed1997

[Home parenteral nutrition (HPN) for cancer patients].

We have treated thirty-five cancer patients with HPN since 1987. This paper describes its efficacy and problems. Their average age was 62 years old. The duration of HPN varied from 31 to 573 days (mean: 167 days). The catheter was removed in three cases because of catheter fever or obstruction. Metabolic complications arose in three cases, but they were easily treated. Twenty-three cases underwent pain control. Twelve cases were given cancer chemotherapy. We concluded that HPN for recurrent cancer patients is a relatively safe and effective means to improve the quality of life. We consider the following important in order to carry out HPN more smoothly. 1) Improvement of drug delivery system. 2) Establishment of home care system with other hospitals, clinics, and home care companies. 3) The easing of health-insurance restrictions on making out prescriptions to outpatients.

Adult↗
PubMed1996

[Ultrasonographic diagnosis of breast cancer with intraductal spreading of cancer cells].

The estimation of intraductal lesions of the breast has become possible due to the careful examination of ultrasonic ductal images. The diagnostic accuracy ratio of the lesions was 94.4% by using our classification of dilated ducts by ultrasonography. The characteristics of the findings of intraductal spreading of breast cancer are that the wall of the duct is thick and uneven because of the proliferation of cancer cells, the tumor usually has a broad base all along the walls, and, when the duct is filed with cancer cells, the circumference becomes so varied that it appears outwardly irregular in size and shape. Microcalcifications and irregular nodules along the ductal network are also sometimes apparent. The diagnosis of the area of intraductal spreading of cancer cells could come about from examining the continuous spreading throughout the network by ultrasonography. We have succeedingly obtained successful results from using this method for the past eight years. The diagnostic accuracy ratio to determine the indication for breast conservative surgery and the extent of the breast excision was 94.2% in cases in which the tumor size was less than 3.0cm and the distance from the nipple was over 3.1cm, and in nonpalpable cases. In breast conservative surgery, the firm establishment of a proper diagnostic method is needed to prevent any cancerous tissue from being left. At this point in the evolution of the diagnostic method for intraductal spreading, ultrasonography is one of the key elements to achieve this goal. From now on, ultrasonography will be in the spotlight and take a more leading role in the continuing development of this diagnostic procedure.

Breast↗
PubMed1996

[Development of quality of life questionnaire for patients with colorectal cancer in surgical area--a study of reliability and validity of Tokyo Yamabuki Forum Version].

We developed a new questionnaire in the surgical area based on a core quality of life (QOL) questionnaire for patients with gastrointestinal cancer. In this study, we investigated the validity and reliability of a QOL questionnaire (Tokyo Yamabuki Forum Version) for patients with colorectal cancer. The questionnaire was composed of 17 items including 5 scales (basic sensory scale, psychological scale, physiological scale, defection-related scale and active scale) and a face scale as an global scale. The time needed to answer questionnaires was expected to be around 7 minutes and the questionnaires should basically be answered by the patients themselves everyday in the hospital. The study was performed in 10 hospitals in the Tokyo area, and 394 samples collected from 21 patients with rectal and colonic cancers were analyzed. A number of respondents failed to answer the question "Do you feel your foods tasty?", so we judged this item inappropriate and deleted it from the analysis. Fifteen items, including 5 scales showed satisfactory internal consistency and construct validity in correlation and factor analyses. Performance status showed a low correlation between each item, each scale and the global scale, while SDS and STAI showed an inordinately negative correlation with the fundamental and physical scales. Especially, SDS revealed an extremely close correlation with the active scale, and STAI showed an excessive correlation with the psychological scale. In the time course of QOL under chemotherapy, reductions (aggravations) were observed in both the total score of 15 items and global scale within one week postoperatively, but after that recovered to preoperative levels at 2 weeks postoperatively. A tendency to QOL improvement was observed 2 weeks after starting chemotherapy or chemoimmunotherapy. QOL of 13 patients was measured over 3 months, and the longest term was 8 months. The results suggested that this QOL questionnaire has sufficient reliability and validity to be usable for patients with colorectal cancer in the surgical area and that this model is applicable for long-term QOL surveys and frequent measurement.

Adult↗
PubMed1996

[Attempt to create a HPN database].

We experienced fifty cases of HPN (home parenteral nutrition) from January 1987 to May 1994. Using effectively these important data, we attempted to make a database for these fifty cases of HPN. We constructed a database based on Windows 3.1-J and Access 2.0-J produced by Microsoft company. At this time, we introduce a part of the database, which must be completed in terms of input items and simplicity.

Humans↗
PubMed1994

Bu ji (hozai) for treatment of postoperative gastric cancer patients.

We proposed that postgastrectomy cancer patients with organ deficit were xu zheng, or of deficient constitution, and administered bu ji or supplementary regimen to them. With alleviation of the symptoms, our diagnosis seemed correct from the traditional medicine perspective. Interleukin 2 reactivity, natural killer activity, nutritional index and bone mineral indices also improved. Such results suggest that our diagnosis was also correct according to Western medical theory. In addition, nutrition seemed to have positive relationship with NK activity and bone mineral content. Therefore, administration of bu ji seemed useful to improve the quality of life of postoperative cancer patients.

Antineoplastic Agents↗
PubMed1994

[Home therapy approach in cancer patients-nutrition therapy (case 1-1)--a case of recurrent gastric cancer with home parenteral nutrition].

This paper describes a case of recurrent gastric cancer with home parenteral nutrition (HPN). A 48-year-old man underwent nutrition support with HPN for the last 6 months. We treated the patient with adjuvant chemotherapy and provided pain management along with HPN treatment. The patient was able to achieve a meaningful and satisfactory quality of life. We concluded that HPN for recurrent cancer patients is a relatively safe and effective means of improving and maintaining the nutritional status. We think the following is important in order to establish home infusion therapy. 1) Organization of a home care team (physician, nurse, pharmacist, dietitian, and caseworker) and a practice-team approach. 2) Establishment of a home infusion system in home care. 3) Preparation of patient manuals by the medical staff. 4) Establishment of sterility preparation and delivery system in home infusion therapy. 5) Establishment of a patient-information-communication system by connection with other hospitals, clinics, and home care companies.

Fluorouracil↗