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Postoperative Infections after Hysterectomy and the Efficacy of Prophylactic Antiboitics

J Gynecol Tech 6 107 - 110 2001

産後15ヵ月で発見された子宮内膜癌の1例

石岡伸一, 寒河江悟, 斎藤豪, 杉村政樹, 芥川典之, 西村誠, 江坂嘉昭, 工藤隆一

The Journal of Obstetrics and Gynaecology Research ( John Wiley & Sons Australia, Ltd ) 26 ( 6 ) 417 - 420 2000.12

25歳,一妊一産で1997年10月に妊娠40週にて女児分娩した.妊娠経過及び出産時の異常は認めていない.産後7ヵ月より月経発来し,その後ほぼ30日周期で順調に発来していた.産後15ヵ月に不正出血を主訴に近医受診し,子宮内膜細胞診V型,内膜組織診にて類内膜腺癌と診断された.入院後,準広汎子宮全摘出術,両側付属器摘出術,骨盤内リンパ節郭清術を施行し,子宮内膜癌Ib期と診断された.術後経過は順調で現在まで再発徴候を認めていない.本症例は肥満,糖尿,月経不順といった子宮内膜癌の危険因子と考えられる因子はもたず,産後比較的早期に発生した若年性の原発性子宮内膜癌であった

HMB-45 staining for cytology of primary melanoma of the vagina - A case report

M Takehara, E Ito, T Saito, Y Nishioka, K Ashihara, S Yamashita, M Koizumi, R Kudo

ACTA CYTOLOGICA ( SCI PRINTERS & PUBL INC ) 44 ( 6 ) 1077 - 1080 2000.11

BACKGROUND: Malignant melanoma in the vagina is very rare, but its diagnosis is usually easy if a melanin pigment is present. With cytodiagnosis, however, it is difficult to differentiate amelanotic melanoma or scantily pigmented melanoma from other conditions. In the present case, monoclonal antibody HMB-45, the efficacy of which has been established in histologic studies, was used in the cytodiagnosis of amelanotic melanoma in the vagina. CASE: A woman, aged 78 years, presented with a brownish, nodular tumor, diameter 3 cm, in the vagina. Scraping smears with Papanicolaou staining showed nonepithelial malignant cells without granules suggesting melanin. Smears stained with HMB-45 showed positive immunoreactivity. The diagnosis underwent histologic confirmation of amelanotic melanoma on the initial biopsy. CONCLUSION: Cytodiagnosis was made with HMB-45, which proved very effective in the differential cytodiagnosis of amelanotic melanoma and scantily pigmented melanoma, particularly because it obviated the need for tissue invasion.

Human hemangiosarcomas have a common polymorphism but no mutations in the connexin37 gene

T Saito, Krutovskikh, V, MJ Marion, KG Ishak, WP Bennett, H Yamasaki

INTERNATIONAL JOURNAL OF CANCER ( WILEY-LISS ) 86 ( 1 ) 67 - 70 2000.04

Gap junctional intercellular communication is often impaired in cancers, and the genes which encode the connexin gap junction proteins are considered to be tumor-suppressor genes. In this study, we analyzed the presence of mutations in the connexin 37 (Cx37) gene in 22 human hepatic angiosarcomas, 6 and 4 of which were associated with exposure to vinyl chloride and Thorotrast, respectively, The other 12 samples were from patients with no history of exposure to these 2 agents. In 9 samples, a proline (ACC) to serine (ACT) amino acid change in codon 319 was detected. However, DNA from non-tumorigenic tissue of the same patients also showed this amino acid change, suggesting that this is a polymorphism rather than a mutation. Subsequent analysis of 84 DNA samples from normal donors revealed the frequencies of Pro/Pro, Pro/Ser and Ser/Ser alleles to be 65.5%, 23.8% and 10.7%, respectively, while among the group of angiosarcoma patients the corresponding figures were 59.1%, 31.8% and 9.1%, respectively. Thus, there was no correlation between the polymorphism at codon 319 and hepatic angiosarcoma occurrence. However, among the 6 cases of vinyl chloride-associated angiosarcoma, the percentages of the polymorphic alleles were 33.3%, 66.7% and 0%, respectively. While the number of samples was too small to allow us to conclude that the Ser(319) allele in Cx37 predisposes to this rare type of human cancer, it may be noted that codon 319 is located at the cytoplasmic tail of Cx37, where most regulatory sequences reside, and that it could be a site of phosphorylation for some protein kinases, which may in turn affect the function of Cx37, including intercellular communication, Int. J. Cancer 86:67-70, 2000. (C) 2000 Wiley-Liss, Inc.

DOI PubMed CiNii

婦人科悪性腫瘍の化学療法における悪心・嘔吐に対する経口5-HT3受容体拮抗薬の効果と問題点

石岡伸一, 寒河江悟, 斎藤豪, 木谷保, 杉村政樹, 芥川典之, 梅村康太, 伊東英樹, 工藤隆一

癌と化学療法 ( (株)癌と化学療法社 ) 27 ( 4 ) 593 - 598 2000.04

A new technique for radical hysterectomy with emphasis on preservation of bladder function

E. Ito, R. Kudo, T. Saito, M. Koizumi, M. Noda

Journal of Gynecologic Surgery ( Mary Ann Liebert Inc. ) 16 ( 4 ) 133 - 140 2000

Bladder dysfunction always occurs, to varying degrees, following radical hysterectomy. In Japan, various techniques for preserving the pelvic autonomic nerves in a radical hysterectomy have been used to reduce the severity of bladder dysfunction. The authors describe a newly developed technique for preserving the pelvic autonomic nerves and present the postoperative urodynamic findings in cases in which this technique was used. Preservation techniques can be broadly classified into three types: preservation of the pelvic parasympathetic nerves, preservation of the pelvic sympathetic nerves, and preservation of the nerves to the bladder. In this new technique, as many of the pelvic parasympathetic nerves as possible are preserved when the cardinal ligament is cut. Then, the cardinal ligament is inserted into and pulled through the anterocranially located connective tissue in front of the pelvic plexus, which lies below the ureter. Finally, as many as possible of the vesical branching nerves are preserved when the posterior layer of the vesicouterine ligament is cut. Between July 1996 and February 1999, 23 women were treated for Stage IB1-IIA cervical cancer, and two women were treated for Stage IIB endometrial cancer. The results of urodynamic studies performed ∼1 month after surgery were all within normal ranges: mean duration of bladder drainage, 17.1 ± 6.4 days mean maximal flow rate, 19.5 ± 12.9 ml/sec mean postvoiding residual urine volume, 30.5 ± 25.8 ml and mean maximal desire to void, 311.4 ± 124.0 ml. None of the patients required intermittent self-catheterization. It is concluded that this new technique for preservation of the pelvic autonomic nerves is effective in reducing the severity of bladder dysfunction after a radical hysterectomy and would therefore improve the patient's quality of life.

DOI

A case of a screlosing stromal ovarian tumor that expresses VEGF

Shin-Ichi Ishioka, Satoru Sagae, Tsuyoshi Saito, Tamotsu Kiya, Noriyuki Akutagawa, Masaki Sugimura, Ryuichi Kudo

Journal of Obstetrics and Gynaecology Research ( University of Tokyo Press ) 26 ( 1 ) 35 - 38 2000

DOI PubMed

A case of uterine endometrial carcinoma 15 months post-partum

S. I. Ishioka, S. Sagae, T. Saito, M. Sugimura, N. Akutagawa, M. Nishimura, Y. Ezaka, R. Kudo

Journal of Obstetrics and Gynaecology Research ( University of Tokyo Press ) 26 ( 6 ) 417 - 420 2000

DOI PubMed

[Effects of oral 5-HT3 antagonists on chemotherapy-induced emesis in patients with gynecologic cancers]

Gan To Kagaku Ryoho 27 593 - 8 2000

A case of Stage-IVb cervical adenocarcinoma successfully treated by combination chemotherapy: Case report

Masaki Takehara, Yoshihiro Nishioka, Tsuyoshi Saito, Tsuyoshi Baba, Takahiro Suzuki, Eiki Ito, Ryuichi Kudo

Journal of Obstetrics and Gynaecology Research ( University of Tokyo Press ) 26 ( 2 ) 133 - 136 2000

DOI PubMed

Nuclear localization of beta-catenin in normal and carcinogenic endometrium

H Nei, T Saito, H Yamasaki, H Mizumoto, E Ito, R Kudo

MOLECULAR CARCINOGENESIS ( WILEY-LISS ) 25 ( 3 ) 207 - 218 1999.07

We have previously shown that the connexin (Cx) 26 and 32 genes are expressed during the secretory phase of the human endometrium and that their expression is downregulated during the proliferative phase, suggesting a role for intercellular transduction in cell growth control in human endometrium. To further study the possible role of cell-to-cell interaction in growth regulation, we immunohistochemically analyzed 80 endometrial samples (30 of normal endometrium, 20 of endometrial hyperplasia, and 30 of endometrial cancer) for the expression of E-cadherin; alpha-, beta-, and gamma-catenin; adenomatous polyposis coli (APC) protein, and sex-steroid hormone receptors at three points in the cells: the cell-to-cell border, the cytoplasm, and the nucleus. In this study, moderate or strong staining of beta-catenin in the nuclei was observed in 60.0% of endometrial hyperplasia samples and 30.0% of endometrial cancer samples, although the beta-catenin gene was mutated in only two of the nine samples that showed the intensive nuclear staining. Western blotting analysis showed that the samples that had intense nuclear staining of beta-catenin had much higher expression of beta-catenin than the samples that did not have nuclear staining. Furthermore, normal endometrium showed nuclear localization, especially in the mid- and late-proliferative and early-secreting phases of the menstrual cycle. The results suggest that the nuclear localization of beta-catenin observed in endometrial hyperplasia and endometrial cancer, as in other tumors, implies that beta-catenin/wnt-1 signal transduction is highly activated in carcinogenesis of the endometrium as well as in normal physiological conditions. (C) 1999 Wiley-Liss, Inc.

DOI PubMed CiNii

当科における過去10年間の胚細胞腫瘍の後方視的検討

本間寛之, 杉村政樹, 芥川典之, 岩崎雅宏, 水元久修, 斎藤豪, 寒河江悟, 工藤隆一

日本産科婦人科学会東北連合地方部会報 ( 日本産科婦人科学会-東北連合地方部会 ) ( 46 ) 68 - 68 1999.03

当科における過去10年間の上皮性卵巣癌(I・II期)の検討

杉村政樹, 本間寛之, 芥川典之, 岩崎雅宏, 水元久修, 斎藤豪, 寒河江悟, 工藤隆一

日本産科婦人科学会東北連合地方部会報 ( 日本産科婦人科学会-東北連合地方部会 ) ( 46 ) 68 - 68 1999.03

Primary malignant melanoma of the uterine cervix: A case report

Masaki Takehara, Eiki Ito, Tsuyoshi Saito, Yoshihiro Nishioka, Ryuichi Kudo

Journal of Obstetrics and Gynaecology Research ( University of Tokyo Press ) 25 ( 2 ) 129 - 132 1999

DOI PubMed

Combination Chemotherapy with Cisplatin, Aclacinomycin A, and Mitomycin C for Primary, Advanced, or Recurrent Cervical Adenocarcinoma

J Gynecol Tech 5 151 - 155 1999

[Small cell lung cancer associated with paraneoplastic cerebellar degeneration and Lambert-Eaton myasthenic syndrome]

Nihon Kokyuki Gakkai Zasshi 37 992 - 6 1999

Induction of cell transformation by mutated 16K vacuolar H+-ATPase (ductin) is accompanied by down-regulation of gap junctional intercellular communication and translocation of connexin 43 in NIH3T3 cells

T Saito, R Schlegel, T Andresson, L Yuge, M Yamamoto, H Yamasaki

ONCOGENE ( STOCKTON PRESS ) 17 ( 13 ) 1673 - 1680 1998.10

The 16 K subunit of the vacuolar H+-ATPase (ductin) has been suggested to also play a role in gap junction channels. Since mutated 16 K subunits have transforming ability when transfected into NIH3T3 cells and since aberrant gap junctional intercellular communication (GJIC) is a hallmark of cancer cells, we hypothesized that mutated 16 K subunits might transform these cells via alteration of GJIC, When GJIC was measured by the dye-transfer assay, NIH3T3 cells transfected with the mutant 16 K protein genes (deletion of the fourth transmembrane domain or a point mutation at codon 143 from glutamic acid to arginine) showed significantly lower levels of GJIC than those transfected with the vector alone or with the wild-type 16 K subunit gene. GJIC levels of NIH3T3 cells transformed by v-ras and v-src were not significantly decreased, suggesting that low GJIC levels are not necessarily the result of cell transformation pel se. NIH3T3 cells express Cx 43 as a major connexin gene. Although cells transfected with mutated 16 K subunits showed a level of Cx 43 protein expression similar to non-transfectants, their Cx43 protein was localized aberrantly, i.e. intracytoplasmically, These results indicate that mutant 16 K subunits with transforming ability translocate Cx43 proteins, thus inhibiting GJIC of NIH3T3 cells.

DOI PubMed CiNii

Electron microscopic examination of cytologic samples

E Ito, H Nei, M Noda, T Saito, M Koizumi, R Kudo

ACTA CYTOLOGICA ( SCI PRINTERS & PUBL INC ) 42 ( 5 ) 1095 - 1103 1998.09

OBJECTIVE: To review the results of observations of cytologic samples performed in our laboratory by light microscopy (LM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM) performed in succession (LM-SEA I-TEM examination) using the same cytologic sample and to assess the diagnostic value of this method of successive examination. STUDY DESIGN: Using a previously reported method of LM-SEM-TEM sample preparation and observation, we analyzed 201 cytologic specimens over a seven-year period (1986-1993) and investigated whether the histologic origin and malignancy can be estimated from SEM and TEM findings on the cells. RESULTS: Observations of many cytologic samples over a seven-year period (by LM, SEM and TEM) showed that several basic interpretations of cellular ultrastructure are possible. In cases where cell identification was difficult by LM, electron microscopic findings were sometimes useful for determining the biologic characteristics of cells and for estimating their tissue origin. Electron microscopic findings also provided important information for cytodiagnosis. CONCLUSION: SEM and/or TEM findings are useful for determining the morphologic (including biologic) characteristics of cells in cases where they cannot be determined by LM. With the accumulation of data on electron microscopic examination of cytologic samples, it is expected that in the future, electron microscopy will continue to provide new information that can be used to improve the accuracy of cytodiagnosis by LM.

A case of protein-losing gastroenteropathy in association with mixed connective tissue disease which was successfully treated with cyclophosphamide pulse therapy

K. Nosho, H. Takahashi, Y. Ikeda, Y. Hanai, T. Mizukoshi, R. Murakami, T. Tokunou, Y. Kawahito, Y. Makiguchi, K. Imai, S. Inomata, T. Saito, T. Ikeda

Ryumachi 38 ( 6 ) 818 - 824 1998

A 47-year-old man had been given a diagnosis of mixed connective tissue disease (MCTD) on 1987 when he had presented with Raynaud's phenomenon, polyarthralgia, sclerodactyly, and a high titre of anti-RNP antibody. Once his symptoms had improved following the administration of prednisolone orally and the treatment was discontinued since 1995. He noticed dyspnea and chest pain in February 1997. The bilateral pleural effusion was pointed out in the local hospital and he was admitted to our hospital in March 1997 for further examination. In addition to pleural effusion and ascites, laboratory studies revealed hypoalbuminemia and low serum levels of complements. Renal and liver function tests were normal and the urine gave a trace test for protein. The presence of protein loss in the gut was confirmed by an elevated 1/4 - antitrypsin clearance and 99mTc-albumin scintigraphy showing abnormal radioactivity in the gastrointestinal tract. Although endoscopic examination showed no abnormal findings macroscopically and gastrointestinal biopsies revealed nonspecific inflammation only, immunofluorescent studies demonstrated deposits of C3, C4 and IgG in the stomach, colon, and pleura. These findings supported the pathogenesis that immune deposits in tissues caused protein-losing gastroenteropathy (PLGE) in MCTD. Intravenous administration of cyclophosphamide started since July 1997, while the high- dose corticosteroid therapy including methylprednisolone pulse therapy were not effective. Hypoalbuminemia and low serum levels of complements improved remarkably and the pleural effusion and ascites disappeared after cyclophosphamide pulse therapy four times monthly. Cyclophosphamide pulse therapy should be considered as a possibly effective treatment for PLGE in association with collagen disease resistant to corticosteroid therapy.

PubMed

Co-ordinated expression of connexins 26 and 32 in human endometrial glandular epithelium during the reproductive cycle and the influence of hormone replacement therapy

T Saito, M Oyamada, H Yamasaki, M Mori, R Kudo

INTERNATIONAL JOURNAL OF CANCER ( WILEY-LISS ) 73 ( 4 ) 479 - 485 1997.11

Hormones are involved in the regulation of intercellular communication, and gap junction intercellular communication may play an important role in the prevention of endometrial cancer. We have investigated changes in the expression of the gap junction proteins connexin 26 (Cx26) and Cx32 in human endometrial glandular epithelium during the reproductive cycle as well as the influence of hormone replacement therapy. Frozen sections from 71 endometrial tissue samples (53 taken from women who had undergone hysterectomy during the menstrual cycle, 3 early pregnancy deciduae and 15 from menopausal women, some of whom were receiving estrogen alone or estrogen plus progesterone) were analyzed by immunofluorescence and confocal laser scanning microscopy. Cx26 and Cx32 were expressed weakly in the proliferative phase, markedly during ovulation and most strongly in the mid-secretory phase; by the late secretory phase, they decreased drastically. Cx26 and Cx32 also were expressed in early pregnancy. Women who had received estrogen and progesterone expressed the Cxs, but those who had received estrogen only or no therapy did not. These results were confirmed by Western blot analysis. They indicate that expression of Cx26 and Cx32 is correlated with cell differentiation and with the glandular function of the endometrial epithelium and suggest that expression of Cxs is controlled by serum progesterone. (C) 1997 Wiley-Liss, Inc.

DOI PubMed CiNii

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