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Biomedical subjects

S Sawai

Publications and source records attributed to S Sawai.

At least 19 recordsLinked to original sources
PubMed1996

Endoscopic variceal ligation versus endoscopic injection sclerotherapy: comparison of hepatic and renal function.

OBJECTIVES: The aim of the present study was to compare the safety of endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS) in terms of liver and kidney functions in patients with liver cirrhosis. METHODS: Forty-four patients admitted to Takatsuki General Hospital between February 1991 and March 1993 with esophageal varices due to liver cirrhosis were randomly assigned to receive either EVL or EIS. Serum levels of AST, ALT, total bilirubin (T-bil), direct bilirubin (D-bil), prothrombin time (PT), hepaplastin test (HPT), antithrombin III (ATIII), creatinine (Cr), and blood urea nitrogen (BUN) were measured before and 24 h, 3 days, 7 days, and 14 days after both forms of therapy. RESULTS: Significant elevations of serum T-bil, serum D-bil, and serum ALT and AST levels were observed in the EIS group but not in the EVL group. No significant increases of serum PT, HPT, ATIII, BUN, or Cr levels were observed after treatment in either group. CONCLUSION: EVL should be considered a first choice therapy for eradicating esophageal varices.

Endoscopy↗
PubMed1995

Comparison by carcinoembryonic antigen doubling time of hepatic injection and infusion for unresectable hepatic metastasis from colorectal cancer.

This study explored the efficacy of hepatic arterial therapy, comparing both injection and infusion of 5-fluorouracil (5-FU) in prolonging the survival of 92 patients with recurrent unresectable hepatic metastasis from colorectal cancer. With respect to pretreatment carcinoembryonic antigen doubling time (CEA-DT), 56 patients were treated with intra-arterial injection, and 36 with intra-arterial infusion. In 21 patients with a CEA-DT of less than 40 days, the cumulative survival of patients treated with arterial injection was significantly longer than that of patients treated with arterial infusion. In 45 patients with a CEA-DT of 40-80 days, the survival curves of patients did not differ from each other. Of the remaining 26 patients with a CEA-DT of more than 80 days, those treated using arterial infusion had an excellent prognosis, in contrast to those treated using arterial injection, with statistical significance. CEA-DT may be useful when choosing a chemotherapy regimen, and may help to accurately establish the prognosis of patients with unresectable hepatic metastasis from colorectal cancer.

Adult↗
PubMed1995

[Detection of loss of heterozygosity by microsatellite probe and DNA content analysis].

We examined replication error (RER) and loss of heterozygosity (LOH) in the region of microsatellites in 60 cases of resected lung cancer. We used microsatellite probes for the short arm of the 2nd chromosome (D2S123, D2S136), the short arm of the 3rd chromosome (D3S1067), and the short arm of the 17th chromosome (TP53). According to stage, the frequency of LOH was 25% in stage I, 33% in stage II, 44% in stage IIIA, 11% in stage III B, and 63% in stage IV. According to histological classification, the frequency of LOH was 41% for squamous cell carcinoma, 24% for adenocarcinoma, and 100% for small cell carcinoma. According to microsatellite probe results, the frequency of LOH was 6.7% for D2S123, 5.0% for D2S136, 16.7% for D3S1067, and 18.3% for TP53. Two of the 60 cases showed RER. One case was stage I squamous cell carcinoma, and the other was stage IV adenocarcinoma. Except for stage III B,LOH in the microsatellite region increases with the stage. LOH is often detected in the order of small cell carcinoma, squamous cell carcinoma, and adenocarcinoma. According to the chromosome number, LOH is detected more often in the 3rd and 17th chromosomes than in the 2nd chromosome. In 20 cases with LOH, only two showed DNA diploidy. Compared to LOH of the microsatellite region, DNA content analysis by flow cytometry has accuracy problems.

Aneuploidy↗
PubMed1995

[Expression of E-cadherin as related to prognostic factors and survivals in breast cancer].

E-cadherin (E-CD) expression and its clinicopathological implication were investigated in 26 patients with breast cancer by immunohistochemical staining. 12 out of 26 primary lesions (46%) express strong and homogeneous expression of E-cadherin (preserved type), while in 14 cases (54%), degree of E-CD expression was reduced, i.e., 8 patients with heterogeneous staining, 2 cases with weak but homogeneous, and 4 cases with lost expression of E-CD (reduced type). However, there was no statistically significant correlation among decrease of E-CD expression, histological features, and advanced stages of breast cancer. Analysis on survivals showed better prognosis in the group with preserved E-CD expression than without E-CD (follow up was more than 96 months or until death). These findings suggests that the patients with decreased E-CD expression may be associated with metastasis resulting in poor prognosis, and E-CD expression could be one of the prognostic factors.

Breast Neoplasms↗
PubMed1995

[The result of reoperation for lung cancer].

Twenty four patients with recurrent or multiple lung cancer were reoperated in our center. Five-year survival rate was 20% for 11 patients with recurrent, while was 25% for 13 patients with multiple after reoperation. The patients with limited operation had well survival and there was no significant difference in procedure. However all four patients with N2 had poor prognosis. Seven patients (29%) had the post reoperative complication in pulmonary system. All of them had the impairment of pulmonary function (FEV1.0% was less than 50%) or more than 75% perfusion ratio, measured with pulmonary perfusion scintigraphy, in the side of the reoperation.

Adenocarcinoma↗
PubMed1995

[Positive expression of c-myc and p53 products in two cases of pulmonary sclerosing hemangioma].

The c-myc and p53 genes are thought to be an oncogene and a tumor suppressor gene, respectively. These genes' products are characteristic of malignant tumors. We quantitatively analyzed the c-myc and p53 products by flow cytometry in two cases of pulmonary sclerosing hemangioma. In case 1, 32.3% of the tumor cells were found to have the c-myc product, and 8.9% were found to have the p53 product. In case 2, 6.7% of the tumor cells were found to have the c-myc product and 15.5% were found to have the p53 product. The percentages in both cases were twice as high as those in a negative control lymphocytes stained with c-myc and p53 products. Therefore, these two cases showed positive expression of the c-myc and p53 products. In addition DNA from six other patients with sclerosing hemangioma was analyzed with paraffin-embedded sections. All six had DNA diploidy, with DNA indexes ranging from 0.91 to 1.03 and coefficients of variation ranging from 3.0 to 5.5. We suggest that pulmonary sclerosing hemangioma is a very weakly malignant tumor.

Adult↗
PubMed1994

[Clinical study on the effect of intra-arterial injection of mitoxantrone-lipiodol emulsion for hepatocellular carcinoma].

To investigate the effect of intra-arterial injection of mitoxantrone emulsified with ethiodized oil, forty-eight patients with hepatocellular carcinoma were evaluated. After the treatment, ten of the patients underwent hepatectomy. In the thirty-eight unresected cases, there were 15 (39%) partial responses, which continued 1.2 to 11.8 months (mean, 5.8 months). The 1- and 2- year survival rates were 67% and 38%, respectively. The response rate was higher in cases with tumor under 5 cm in diameter. In the remaining 10 resected cases, the necrotic areas in main nodules ranged from 65% to 100% (mean, 85%). This treatment might be applied effectively to patients with small hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1994

[A case of solitary plasmacytoma of the chest wall].

A 58-year-old man with a solitary plasmacytoma of the chest wall is reported. He was admitted because of a painless tumor on the right lateral chest wall. The chest CT scan showed a chest wall tumor surrounding the 7th and 8th ribs without rib destruction. A transcutaneous needle biopsy of the tumor with a Sure-Cut-Needle revealed a plasmacytoma. The bone marrow biopsy findings were normal. Under a diagnosis of solitary plasmacytoma, the chest wall tumor was resected. The tumor was an extramedullary plasmacytoma. Southern blot analysis of the immunoglobulin light chain gene of the tumor cells detected a rearrangement of genes in the lambda chain, while no rearrangements of immunoglobulin genes were detected in the bone marrow specimen. Seven months later another solitary plasmacytoma was found at the left radius, and was resected. Southern blot analysis of the immunoglobulin light chain gene was useful in the differential diagnosis from systemic myeloma and in determining the monoclonality of the tumor.

Blotting, Southern↗
PubMed1994

[DNA content analysis and detection of c-myc and p53 products using flow cytometry in resected lung cancer cases].

We quantitatively analyzed the c-myc and p53 products using flow cytometry in 28 cases of resected lung cancer and one case each of chorio-carcinoma, plasmacytoma, malignant mesothelioma and sclerosing hemangioma. In the lung cancer cases, c-myc and p53 products were detected in 10 cases (35%) and 7 cases (21%), respectively. These rates are higher than the DNA abnormal expression rates of the c-myc and p53 genes (15% and 12%, respectively) in our own data. In the adenocarcinoma of lung cancer cases, c-myc and p53 products were detected in 9 cases (53%) and 5 cases (29%), respectively. Among the squamous cell carcinoma cases, there were one case (11%) of c-myc expression and one case (11%) of p53 expression. DNA content analysis of the lung cancer patients revealed 7 cases of DNA diploidy and 21 cases of DNA aneuploidy. All 10 c-myc-positive cases showed DNA aneuploidy; thus the positive rate for c-myc products in the DNA aneuploidy cases was significantly different compared with the DNA diploidy cases (p < 0.05). In the sclerosing hemangioma case, we detected both c-myc and p53 products. Sclerosing hemangioma has been thought to be a benign tumor, but it may be a malignant tumor.

Adenocarcinoma↗
PubMed1994

[Preoperative staging in T1 and T2 lung cancers by mediastinoscopy and mediastinal lymph node dissection].

Between 1975 and 1992, mediastinoscopy and thoracotomy were performed on 184 T1 and 271 T2 lung cancer cases consisting of adenocarcinoma and squamous cell carcinoma. Mediastinoscopy gave true negative findings in 90.8% of the T1 patients, true positive findings in 7.6% and false negative findings in 1.6%. The comparable rates were 76.7%, 17.0% and 6.3% in T2 patients. The 5-year survival rate was 91.3% for T1N0M0 patients (n = 64) who underwent non-radical dissection (= NRD), and 69.4% for those (n = 70) who underwent radical dissection (= RD). The rate with NRD was significantly better (p < 0.006). The 5-year survival rate was 63.2% for T2N0M0 patients (n = 62) undergoing NRD, and 49.8% for those (n = 72) undergoing RD, but the difference was not significantly. Distant metastasis was a common cause of death, whereas there were no deaths due to local recurrence in the T1N0M0 patients, whether NRD or RD was performed. These results support our opinions that preoperative mediastinoscopy and intraoperative node staging are sufficient for assessment of the N factor in T1 and T2 lung cancer, and that mediastinal node dissection should not be performed in T1N0M0 patients.

Adenocarcinoma↗
PubMed1993

Enhancement of LAK-like activity and cytokine induction in regional lymph nodes and spleen cells of mice after intralymphnodal injection of OK-432, a killed streptococcal preparation.

A single dose of inactivated streptococci (OK-432) was injected into the popliteal lymph nodes of male CDF1 mice and its effects on popliteal, inguinal, and para-aortic lymph node cells and spleen cells were investigated and compared with the effects of subcutaneous injections of the same dosage of OK-432. Regional lymph node cells and spleen cells obtained from intralymphnodally injected mice lysed not only natural killer (NK)-sensitive YAC-1 cells, but also NK-resistant P-815 and meth-A cells. Lysis of target cells was inhibited when effector cells were treated with anti-Thy-1.2 or anti-Lyt-2.2 monoclonal antibody and complement, but no inhibition was apparent after treatment with anti-asialo-GM1 or anti-Lyt-1.2 antibody and complement. These results suggest that the effector cells are lymphocyte-activated killer (LAK) cells. An enhanced capacity of lymph node cells to produce cytokines, tumor necrosis factor and interleukin 1 upon restimulation with lipopolysaccharide was found only in intralymphnodally injected mice. Thus, the induction of LAK-like cells and cytokine production in regional lymph nodes and spleen cells by the intralymphnodal administration of OK-432 should be effective for the inhibition or treatment of lymph node metastases.

Animals↗
PubMed1993

Defects of embryonic organogenesis resulting from targeted disruption of the N-myc gene in the mouse.

The highest expression of the N-myc gene occurs during embryonic organogenesis in the mouse ontogeny, with the peak of expression around embryonic day 9.5. Homozygous N-myc-deficient mice, produced by germline transmission of a disrupted allele in ES cells, developed normally to day 10.5, indicating dispensability of N-myc expression in the earlier period, but later accumulated organogenic abnormalities and died around day 11.5. The most notable abnormalities were found in the limb bud, visceral organs (lung, stomach, liver and heart) and the central/peripheral nervous systems, and were highly correlated with the site of N-myc expression. The limb buds and the lungs excised from N-myc-deficient mutant embryos were placed in culture to allow their development to stages beyond the point of death of the embryos. Analyses indicated that the mutant limbs failed to develop distal structures and the development of bronchi from the trachea was defective in the lungs. The latter defect was largely corrected by addition of fetal calf serum to the culture medium, suggesting that an activity missing in the mutant lung was replenished by a component of the serum. The phenotype of N-myc-deficient mutant embryos indicated requirement of the N-myc function in many instances of tissue interactions in organogenesis and also in cell-autonomous regulation of tissue maturation.

Animals↗
PubMed1993

[Correlation between DNA content and amplification of oncogenes (c-myc, L-myc, c-erbB-2) and correlation with prognosis in 143 cases of resected lung cancer].

DNA content analysis using flow cytometry and amplification of c-myc, L-myc, and c-erbB-2 oncogenes in 143 cases of resected lung cancer were analyzed using the same specimen, and we examined the correlation with prognosis of DNA content and amplification of oncogenes. There were 54 DNA diploid cases (38%), 81 DNA aneuploid cases (57%) and 8 DNA multiploid cases. Analysis of oncogene amplification revealed 22 cases of c-myc, 4 cases of L-myc, and 22 cases of c-erbB-2. In curatively resected cases, the 5-year survival rate was 65% in 31 DNA diploid cases, and 36% in 40 DNA aneuploid cases. There was a statistically significant difference between the two groups (p < 0.02). However, in non-curatively resected cases, the 5-year survival rate was 11% in 23 DNA diploid cases, and 33% in 49 DNA aneuploid cases. There were no statistically significant differences among these groups. The correlation between DNA content and amplification of oncogenes was as follows. In DNA diploid cases, there were 4 cases of c-myc, and 6 cases of c-erbB-2. In DNA aneuploid cases, there were 15 cases of c-myc, 4 cases of L-myc, and 15 cases of c-erbB-2. In DNA multiploid cases, there were 3 cases of c-myc, and 1 cases of c-erbB-2. Amplification of oncogenes was seen more frequently in DNA aneuploid and multiploid cases than in DNA diploid cases. In 71 curative resected cases, the 5-year survival rate for amplified cases of c-myc (10 cases) was 0%, and that of cases with no amplification was 61% (no statistically significant difference). The 5-year survival rate for amplified cases of c-erbB-2 (10 cases) was 40%, against 52% for cases with no amplification. DNA content analysis using flow cytometry was more convenient than analysis of amplification of oncogenes, and reflects the prognosis of resected lung cancer better than oncogenes. There was no relation between DNA content and gene amplification.

DNA, Neoplasm↗
PubMed1993

[Preoperative intra-arterial injection of mitoxantrone for locally advanced breast cancer].

Mitoxantrone (MIT) is a new anthraquinone anti-cancer agent. We successfully treated 3 patients with locally advanced breast cancer, including two inflammatory breast cancers, by pre-operative arterial injection of MIT. The treatment protocol was MIT 12 mg/m2 injected into both the internal mammary and the subclavian artery with oral administration of 5' DFUR 1,200 mg/day. In two cases of inflammatory breast cancer, the redness of skin was immediately reduced after the first course. After 2 courses, all tumors were decreased over 50% in size. Standard radical mastectomy could be carried out on all patients. Preoperative arterial injection of MIT might be the treatment of choice for locally advanced breast cancer. This preliminary result encourages further study.

Administration, Oral↗
PubMed1993

[A case of malignant thymoma associated with myasthenia gravis, pure red cell aplasia and high serum level of SCC antigen].

We present a case of 43-year-old man with pure red cell aplasia appearing 8 years after thymothymectomy. He underwent an operation and postoperative radiotherapy for malignant thymoma associated with myasthenia gravis in 1983. In 1991 high serum level of SCC antigen was noted and a metastatic tumor was found in the retroperitoneal region. After removal of the tumor pure red cell aplasia developed, which responded to steroid therapy. The serum level of SCC antigen is still abnormally high.

Adult↗
PubMed1993

[A resected case of leiomyosarcoma of the esophagus--the diagnosis was supported with DNA content analysis].

A case of leiomyosarcoma of the esophagus was reported. The tumor was located in the lower esophagus. The esophagus was very stenotic, but the mucosa was clear. We thought the tumor had not invaded the mucosa. Enucleation was performed on the tumor. The tumor was encapsulated, so at the time of operation, the microscopic diagnosis was leiomyoma. However, after the operation, the diagnosis was changed to the leiomyosarcoma, because there are many spindle-shaped atypical cells, and many mitoses. We also analyzed the DNA content of the tumor. The DNA index of this tumor was 0.9 and 1.48, therefore, this tumor was DNA aneuploidy. The result of DNA content analysis showed that the tumor is malignant. DNA content analysis is helpful for diagnosis of this kind of sarcoma, because microscopic examination can not readily distinguish benign leiomyoma from malignant leiomyosarcoma. This patient was still alive one year after the operation. Thus, we thought that enucleation of the tumor is a good operational procedure to the leiomyosarcoma of the esophagus, if the tumor is polypoid type and encapsulated.

Aneuploidy↗