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Biomedical subjects

S Tsutsui

Publications and source records attributed to S Tsutsui.

At least 19 recordsLinked to original sources
PubMed1992

A flow cytometric analysis of DNA content in primary and metastatic lesions of esophageal squamous cell carcinoma.

BACKGROUND: DNA content of malignant tumors has been considered a significant prognostic factor, but intratumor variations in DNA content and differences in DNA content between primary and metastatic lesions have been found in various tumors. METHODS: DNA indexes of multiple samples obtained from different sites in each tumor were determined by flow cytometry (FCM) in 27 esophageal squamous cell carcinomas. RESULTS: Intratumor variation in DNA indexes in primary lesions was found in 10 (37%) of the 27 specimens. Of the rest, all DNA indexes were diploid in 5 and all identically aneuploid in 12 samples. A DNA index differing from that of the metastatic lesion was found in four (50%) of eight primary lesions; however, a component of the DNA index identical to that of metastatic lesion was found in seven (88%) of eight primary lesions. CONCLUSIONS: Recurrence after a "curative" operation was frequent in patients with a tumor that had an aneuploid DNA index, with or without a variation in DNA indexes. There was no recurrence in the five patients with tumors that had only a diploid DNA index. These results suggest that differences in DNA content between primary and metastatic lesions reflect intratumor variation in DNA content in the primary lesions. The presence of a tumor cell population with an aneuploid DNA content, even when the DNA content varied in the primary lesion, may indicate an aggressive clinical course in patients with esophageal squamous cell carcinoma.

Adult↗
PubMed1992

Early depressed adenocarcinomas of the large intestine.

From January 1987 to December 1990, five cases of early depressed cancer of the large intestine were seen. Endoscopically, almost all of these tumors were located in the proximal colon and looked like a reddish depression (similar to the sucker of an octopus). Histologically, all of these cancers were well differentiated and tended to reach deeper layers at an early stage. Four (80%) of these cancers were not associated with adenoma and were thought to have arisen de novo.

Adenocarcinoma↗
PubMed1992

Influence of preoperative treatment and surgical operation on immune function of patients with esophageal carcinoma.

Multiple immunological parameters, including total lymphocyte count, lymphocyte subpopulations (CD2+, CD19+, CD3+, CD4+ and CD8+), phytohemagglutinin (PHA) response, and natural killer (NK) activity, were measured in 66 patients with previously untreated esophageal carcinoma. The influence of preoperative treatment and/or surgical operation on the immune function were evaluated in 40 patients. The PHA response and NK activity of the patients with esophageal carcinoma were 229 +/- 103 S.I.% and 18.5 +/- 11.9% lysis, respectively, and were significantly depressed as compared with the control. The CD4+/CD8+ ratio, PHA response, and NK activity in stage IV were also significantly depressed compared to that in stages I-III. Preoperative treatment induced significant reductions in the total lymphocyte count (1,994 +/- 644 to 670 +/- 274/mm3), PHA response (219 +/- 77 to 159 +/- 59 S.I.%), and NK activity (19.7 +/- 13.2 to 11.1 +/- 10.3% lysis) as well as a significant gradual decrease in the CD4+/CD8+ ratio (2.09 +/- 1.42 to 0.69 +/- 0.48), while the surgical operation significantly influenced only the total lymphocyte count. This study demonstrates that preoperative treatment induces a more pronounced influence on the immune function than surgical operation alone, in patients with esophageal carcinoma in which the immune function is disturbed prior to these treatments.

Adult↗
PubMed1992

Promoting effect of ovariectomy on hepatocellular tumorigenesis induced in mice by 3'-methyl-4-dimethylaminoazobenzene.

The treatment of female C57BL/6 x DS-F1 mice with 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB) at 10, 12, 14, 16 and 18 days of age resulted in the development of hepatocellular adenomatous nodules after 10 months of age. Ovariectomy in these mice at 1 month of age hastened the development of adenomatous nodules, which then first appeared at 8 months of age. The incidence of adenomatous nodules in females ovariectomized at the age of 1 month was much higher than that in intact females of the same age. These results showed that the ovaries exerted a suppressive effect on the development of adenomatous nodules. To determine the time from which the ovaries exert this suppressive effect, females were ovariectomized at 4, 6, 8, and 10 months of age, and the incidences of adenomatous nodules were compared at 10 and 12 months of age. Delayed ovariectomy after 8 months of age did decrease the incidence of adenomatous nodules at 10 and 12 months of age, but ovariectomy after 4 and 6 months of age did not. When the incidence of adenomatous nodules in females ovariectomized at 10 months of age was examined over the subsequent 6 months, it became significantly higher after 14 months of age compared with that in intact females. The results show that the ovariectomy has the promoting effect on the development of adenomatous nodules in the liver induced by 3'-Me-DAB after 6 months of age.

Aging↗
PubMed1992

Multivariate analysis of postoperative complications after esophageal resection.

To determine the contributing factors for eight postoperative complications after esophagectomy through a right thoracoabdominal approach, a multivariate analysis was carried out on preoperative and intraoperative variables in 141 patients with thoracic esophageal cancer. Although postoperative complications occurred in 125 patients, only 7 died of such complications. The multivariate analysis indicated that the retrosternal route was a significant factor predisposing to postoperative atelectasis. Age, preoperative arterial oxygen tension, and volume transfused were significant factors predisposing to postoperative hypoxemia, whereas age, routes other than the intrathoracic route, and volume transfused were significant factors predisposing to prolonged respiratory support. In addition, preoperative total serum bilirubin level and volume transfused were significant factors predisposing to postoperative hyperbilirubinemia; preoperative serum creatinine level was a significant contributing factor for postoperative renal insufficiency; and sex, antesternal route, and substituted colon were significant contributing factors for anastomotic leakage. There were no significant factors predisposing to postoperative pneumonia and liver dysfunction. These significant factors should be taken into consideration not only during perioperative management but also when choosing the operative procedures and extending the surgical indication for esophagectomy through a right thoracoabdominal approach.

Age Factors↗
PubMed1992

Hyperthermo-chemo-radiotherapy as a definitive treatment for patients with early esophageal carcinoma.

Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery.

Aged↗
PubMed1991

Growth patterns and prognosis of submucosal carcinoma of the esophagus. A pathologic study.

Sixteen cases of esophageal carcinoma invading the submucosa were analyzed in terms of growth patterns. Seven were classified into the massively penetrating (down growth) type, four into the superficially spreading (spreading growth) type, and five into the unclassified type. In the down growth type, the ratio of the submucosal area to the total (mucosa and submucosa) area was more than 0.2 (one fifth), and in the others that ratio was less than 0.2. The down growth type is characterized by a tendency toward elevated lesions, a high incidence of vessel invasions and lymph node metastasis, and a poor prognosis after surgery. Lymphatic and/or vascular invasions were recognized in six of seven cases, and the 5-year survival rate was 0%. In contrast, the spreading growth and unclassified types was characterized by superficial lesions, a low incidence of vessel invasions and lymph node metastasis, and a favorable prognosis. In only one with the spreading growth type was there lymphatic invasion. Three of the four with the spreading growth type survived over 5 years, and the other one with the spreading growth type and all of five with the unclassified type are alive without recurrences 15 to 52 months after surgery. Thus, growth patterns reflect well the prognosis of the submucosal carcinoma of the esophagus.

Aged↗
PubMed1991

Predicting recurrence time of esophageal carcinoma through assessment of histologic factors and DNA ploidy.

Cytophotometric analysis of nuclear DNA content was done in 128 patients with squamous cell carcinoma of the esophagus. The relationship among histopathologic features, DNA distribution pattern, and survival time was investigated from the standpoint of recurrence. Of 128 patients, 77 (60.1%) died of recurrence within 2 years after surgery: 16 (12.5%) from 2 to 5 years and two (1.6%) over 5 years. The rate of death of recurrence within 2 years was higher in patients with T4 or N1 than T1, T2, and T3 or N0 (P less than 0.01). Survivors over 5 years more frequently possessed type II DNA pattern than types III and IV (P less than 0.05). The rate of death of recurrence within 2 years was 34.4% in type II, which was lower than the 59.6% rate in type III (P less than 0.05) and the 76.6% rate in type IV (P less than 0.01). Survivors from 2 to 5 years were higher in type III than in type IV (P less than 0.05), and recurrence over 5 years was found only in type II. This inclination was more apparent in those with curative resection. In the patients with type II, careful follow-up may be needed over 5 years for late recurrence. However, in those with type IV, no recurrence over 2 years could be regarded as healed because most of their recurrences occur within 2 years. These findings suggest that the growth rate of esophageal carcinoma should reflect DNA aneuploidy, and the DNA analysis of esophageal carcinoma should be a valuable parameter for postoperative follow-up planning.

Carcinoma, Squamous Cell↗
PubMed1991

Comparison of characteristics of esophageal squamous cell carcinoma associated with head and neck cancer and those with gastric cancer.

In ongoing reviews of 339 patients with surgically treated primary squamous cell carcinoma, there were 19 (5.6%) with concurrent gastric cancer and 11 (3.2%) with head and neck cancer. The incidences of intra-esophageal multiple occurrence of esophageal cancer are 27.3% and 26.3% in those with associated head and neck cancer and gastric cancer, respectively, and higher than 7.1% in those without such a concurrent cancer. There was no difference in the clinicopathological characteristics of those with concurrent head and neck and gastric cancers, except for the higher incidence of metachronous occurrence in the former. These findings suggest that, in cases of esophageal cancer associated with concurrent head and neck cancer and gastric cancer, intraesophageal multiplicity of the esophageal carcinoma is frequent and that preoperative serial evaluations is most important to design treatment and estimate the prognosis.

Aged↗
PubMed1991

Lugol stain for intraoperative determination of the proximal surgical margin of the esophagus.

An adequate proximal surgical margin is difficult to determine particularly in cases of esophageal carcinoma with surrounding intraepithelial invasion. We report here readily facilitated intraoperative approaches for detection of the exact margin of carcinomatous invasion of the esophagus. The resected specimen of the esophagus is incised longitudinally and placed in a 1% Lugol bath for 2-3 minutes. The normal squamous epithelium includes glycogen that interacts with the iodine of Lugol's solution and the normal epithelium of the esophagus becomes a uniform greenish-brown. A squamous cell carcinoma does not include glycogen, hence is not stained with this solution and a clear identification is feasible. Thus, a carcinomatous infiltration not recognizable in routine examinations becomes macroscopically visible when Lugol's solution is used.

Adult↗
PubMed1991

Comparison of cell nuclear DNA contents between intraepithelial and invasive components of oesophageal squamous cell carcinoma.

Detailed cytophotometric analyses of cell nuclear DNA content were performed on 132 different areas from 24 oesophageal squamous cell carcinomas with an intraepithelial component. Measurements of DNA content were performed at the three different areas within each of the intraepithelial and invasive components. There were no differences in the overall incidence of DNA distribution patterns which were classified according to the degree of dispersion and the peak value on the DNA histogram between intraepithelial and invasive components, as well as the average of mean values of the DNA content. In 13 (54%) of 24 cases, there was a variation among the DNA distribution patterns obtained from three different areas of the intraepithelial components, whereas there was a variation in 4 (22%) of the 18 invasive components. In 11 of 13 intraepithelial components with a variation, the same DNA distribution pattern as seen in the invasive component was present. Provided that the DNA content remains stable, variations in intraepithelial components may reflect various tumour cell populations. These findings support the idea of a multicentric carcinogenesis of oesophageal carcinoma, and shed light on the mechanisms in which a single cell population is selected from various cell populations in the progression from an intraepithelial to an invasive lesion.

Carcinoma in Situ↗
PubMed1991

Comparative studies on distribution and fine morphology of the intestinal Peyer's patches in Mongolian gerbils (Meriones unguiculatus) and mice.

The intestinal Peyer's patches (PP) were significantly different in distribution and fine morphology between Mongolian gerbils and mice. The PP of gerbils were evenly distributed from the duodenum to ileum, whereas the PP of mice were more densely distributed in the lower ileum than other parts of the intestine. In gerbils, each PP had a much greater number of lymphoid follicles than in mice, although the total number of PP was smaller. Electron microscopy revealed that the PP dome of gerbils was covered with two types of epithelial cells, one with shorter microvilli and the other with longer ones, whereas the epithelial cells of the murine PP dome was uniform-shaped with numerous medium-sized microvilli. Some dome absorptive cells of gerbils were morphologically similar to poorly differentiated crypt cells of mice, suggesting to be immature M cells.

Animals↗
PubMed1991

[A consideration of the definition of early esophageal cancer on the basis of clinicopathologic viewpoint].

A review of 323 patients with carcinoma of the esophagus disclosed 50 cases (15.5%) with glandular and/or mucus-secreting components, in addition to the ordinary component of squamous cell carcinoma. These tumors could be grouped into three type according to representative histologic features of glandular and mucus-secreting portions: glandular type (28 cases), cribiform type (14 cases), and mucoepidermoid type (8 cases). The histologic features of the three types were reminiscent of those of adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma of salivary glands, respectively. Moreover, areas showing glandular or mucus-secreting differentiation were in greater part located in the submucosa and the lamina propria mucosae, thereby suggesting that such differentiation had arisen in the esophageal glands or their ducts. From these findings, in addition to intraepithelial and mucosal carcinomas, carcinoma restricted to the submucosal layer without lymph node metastases should be also defined as "early" esophageal cancer and definition of it according to the existing Guide Lines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus is thought to be adequate at present.

Adenocarcinoma↗
PubMed1990

Development of diagnosis and surgical treatment for patients with carcinoma of the esophagus.

Early-stage esophageal carcinomas are extremely difficult to detect because the patients have no complaints, and findings on the X-rays are nil. Lugol-combined endoscopy is the most effective method for detecting the presence of small carcinoma of the esophagus. This paper was, first, conducted on the diagnostic features of early-stage esophageal carcinoma, detected through the use of Lugol-combined endoscopy. As the prognosis of patients with esophageal carcinoma is related to many factors, we investigated the prognostic contribution of 15 discrete variables with multivariate analysis. The variables are resectability of the malignant lesion, DNA distribution pattern of the cancer cells, and postoperative complications. As the DNA pattern of cancer cells cannot be changed by surgeons, early detection and postoperative care play key roles in determining the survival of patients with esophageal carcinoma.

Adult↗
PubMed1990

Esophageal carcinoma in young patients.

The clinicopathological features of esophageal carcinoma were examined from the viewpoint of age differences in a study of 364 consecutively treated patients. The three groups studied were: group I, aged less than 49 years; group II, aged between 50 and 69 years; and group III, aged more than 70 years. There were no significant differences among the three groups with regard to sex ratio, site and length of the lesion, gross types, histological grade, depth of tumor invasion, vessel permeation, lymph node metastasis, TNM classification, incidence of incomplete resection, or crude actuarial 5-year survival curves. The malignant potentiality of the esophageal carcinoma in young patients did not differ from that in older patients in terms of deoxyribonucleic acid distribution pattern. The only difference clearly evident between young and older patients was the number of hospital deaths due to complications: That of the young patients was significantly lower than that of the older patients (p less than 0.05). Esophageal carcinoma in persons aged less than 50 years appeared to behave biologically like the same neoplasm in older people, whereas gastric and colorectal carcinomas behave differently in various age groups.

Adult↗
PubMed1990

Correlation between hyperthermoradiosensitivity and clinical effect in carcinoma of the esophagus.

The correlation between hyperthermoradiosensitivity evaluated by an in vitro succinate dehydrogenase inhibition (SDI) test and the histopathologic effects of hyperthermochemoradiotherapy (HCR therapy) were investigated in 43 patients with carcinoma of the esophagus. The succinate dehydrogenase (SD) activity of tissue fragments taken at biopsy was assayed after exposure to heat (43 degrees C.) and radiation (6 grays) was done. The sensitivity to radiation plus heat treatment was estimated by the percentage of SD activity of the treated cells, compared with that of the control cells. The 43 patients were divided into three groups according to the degree of SD activity after exposure to radiation plus heat treatment. The SD activity was less than 50 per cent in group 1 (highly sensitive), between 50 and 70 per cent in group 2 (moderately sensitive), more than 70 per cent in group 3 (less sensitive). Eighteen of 20 in group 1, 11 of 17 in group 2 and two of six in group 3 were classified as being histopathologically "effective" for HCR therapy. The two year survival rate for groups 1, 2 and 3 were 55.5, 34.9 and zero per cent, respectively, while there were no statistical differences with regard to prognostic factors. These data suggest that in vitro activities of SD correlate well with the clinical effectiveness of HCR therapy. Therefore, it is recommended that a SD inhibition test be included among the guidelines for clinical management.

Adult↗
PubMed1989

[Clinical evaluation of systematic lymph node dissection for the intrathoracic esophageal carcinoma].

We evaluated the effectiveness and complication of systematic lymph node dissection for the intrathoracic esophageal carcinoma, which includes cervical, intrathoracic and abdominal lymph node dissection. Two hundred and thirteen individuals with intrathoracic esophageal carcinoma underwent esophageal resection in the Department of Surgery II, Kyushu University from 1979 to 1988. Of these 213, systematic lymph node dissection in addition to esophageal resection was performed on 19 patients. Lymph node recurrence has been reduced with this procedure and survival rate was more favorable in the cases with systematic lymph node dissection than those without it at present. On the other hand, although the occurrence of postoperative recurrent nerve palsy in the cases with systematic lymph node dissection and in those without it were 47.4 and 11.9%, rates of postoperative pulmonary complications were 5.2 and 16.0%, respectively. Operative death was none in those with systematic lymph node dissection. Therefore, this procedure has been performed in safety with intensive perioperative cares and it would contribute more favorable prognosis.

Aged↗