Details of a Researcher - UHARA Hisashi

Papers - UHARA Hisashi

Division display 301 - 320 of about 327 ／ All the affair displays >>

Neutrophilic dermatoses with acute myeloid leukemia associated with an increase of serum colony-stimulating factor

Hisashi Uhara, Toshiaki Saida, Hideyuki Nakazawa, Toshiro Ito

Journal of the American Academy of Dermatology 59 ( 2 ) S10 - S12 2008.08 [Refereed]

A case of primary Epstein-Barr virus-associated cutaneous diffuse large B-cell lymphoma unassociated with iatrogenic or endogenous immune dysregulation

Yasutaka Tokuda, Mana Fukushima, Koh Nakazawa, Shinji Oguchi, Yoko Koganehira, Maki Yamaura, Miwako Iijima, Hiroshi Murata, Hisashi Uhara, Minoru Takata, Toshiaki Saida, Tsutomu Katsuyama, Sigeo Nakamura

Journal of Cutaneous Pathology 35 ( 7 ) 666 - 671 2008.07 [Refereed]

Cutaneous Epstein-Barr virus (EBV)-associated B-cell lymphoma (EBVBL) in non-immunocompromised patients is very rare. Here, we report a case of cutaneous EBVBL in a 72-year-old Japanese woman without any signs of immunosuppression. She showed repeated high fever and skin eruptions on the face, limbs and palms. Histological diagnosis was diffuse large B-cell lymphoma. EBV infection was detected by in situ hybridization and Southern blotting. Immunostaining for viral proteins showed the patient to be positive for latent membrane protein 1 (LMP-1) and negative for Epstein-Barr virus nuclear antigen-1 (EBNA-2), indicating that a type II latency EBV infection pattern. © Blackwell Munksgaard 2008.

DOI PubMed

The Relationship between Tumor Thickness and the Metastatic Rate of Sentinel Lymph Nodes in Japanese Patients with Melanoma

Uhara Hisashi, Yamamoto Akifumi, Kiyohara Yoshio, Saida Toshiaki

The Japanese Journal of Dermatology ( Japanese Dermatological Association ) 118 ( 14 ) 3083 - 3088 2008

Objective: To establish the relationship between tumor thickness (TT) and metastatic rate of the sentinel lymph nodes (SLN) in Japanese patients with melanoma. Methods: A retrospective review of 259 patients who underwent successful SLN mapping and biopsy in 13 facilities in Japan from April of 2003 to June of 2006. The data were analyzed with the χ² or Fisherʼs tests. Result: The metastatic rate of SLN in each T-classification category was as follows: pTis: 0% (0/36), pT1: 11.3% (6/56), pT2: 21.0% (13/63), pT3: 34.0% (35/103), and pT4: 62.4% (63/101). Two of T1 cases with SLN metastasis were T1b, and the remaining 4 cases with SLN metastasis were T1a, in which TT was 1.0, 0.8, 0.55, and 0.50 mm. Metastatic rates of SLN in patients with primary lesions over 4 mm in thickness were as follows: 4.01–5 mm: 40.0%, 5.01–6 mm: 57.9%, 6.01–7 mm: 53.8%, 7.01–8 mm: 62.5%, 8.01–9 mm: 87.5%, 9.01–10 mm: 87.5%, and 10 mm<: 72.0%. The metastatic rates of SLN were significantly higher in cases with ulcerated primary lesions than in those without ulceration in T1–T4 and T1–T3 groups (p<0.001). Conclusion: In melanoma patients with thicker primary lesions, the indication for SLN biopsy should be decided taking into consideration the predictive metastatic rates and locations of SLN. Further study is needed to define criteria for performing SLN biopsy in patients with melanomas less than 1.0 mm thick.

DOI CiNii

A pilot study of human interferon β gene therapy for patients with advanced melanoma by in vivo transduction using cationic liposomes

Kazuhiko Matsumoto, Hitomi Kubo, Hiroshi Murata, Hisashi Uhara, Minoru Takata, Shinichi Shibata, Satoshi Yasue, Akihiro Sakakibara, Yasushi Tomita, Toshiro Kageshita, Yutaka Kawakami, Masaaki Mizuno, Jun Yoshida, Toshiaki Saida

Japanese Journal of Clinical Oncology ( Oxford University Press ) 38 ( 12 ) 849 - 856 2008 [Refereed]

Background: Cationic liposomes containing the human interferon β (HuIFNβ) gene (IAB-1) was used for the clinical trial for glioma patients. HuIFNβ gene therapy showed much higher anti-tumor activity compared with the administration of HuIFNβ protein for melanoma. These results suggest that HuIFNβ gene therapy is an attractive strategy for the treatment of melanoma. Methods: Stage IV or III melanoma patients with cutaneous or subcutaneous metastatic lesions were enrolled in this pilot study. IAB-1 was dissolved by sterile PBS at a concentration of 30 μg DNA/ml and was injected into cutaneous or subcutaneous metastatic nodules three times a week for 2 weeks and the effect on the injected and non-injected metastatic lesions was evaluated. Results: Clinical responses were as follows (five patients): mixed response (MR) and no change in each one patient, and progressive disease in three patients. In the MR patient, the IAB-1 injected lesion disappeared clinically and histopathologically and one-half of IAB-1 non-injected skin metastases were transiently inflamed and mostly regressed. In the responded non-injected lesions of this patient, histopathologically, infiltration of CD4 positive T cells was observed around the melanoma cells in the dermis, which expressed the HLA-Class II antigen. Adverse events due to this gene therapy were not recognized in any of the patients. Conclusions: The efficacy of this gene therapy was generally insufficient however, some immunological responses were recognized in one patient. No adverse events were observed. HuIFNβ gene therapy could be an attractive strategy for treatment of a variety of malignancies, including melanoma, though some modifications should be required. © The Author (2008). Published by Oxford University Press. All rights reserved.

DOI PubMed

Multiple hypersonographic spots in basal cell carcinoma

Hisashi Uhara, Koichi Hayashi, Hiroshi Koga, Toshiaki Saida

Dermatologic Surgery 33 ( 10 ) 1215 - 1219 2007.10 [Refereed]

BACKGROUND: High-frequency ultrasound is a useful method to obtain preoperative information regarding extension of basal cell carcinoma. Its contribution to diagnosis is generally limited, however. Recently, we observed hypersonographic spots in some cases of basal cell carcinoma. OBJECTIVE: The present study was performed to determine the diagnostic value of this finding in this type of tumor. MATERIALS AND METHODS: We conducted a retrospective study of archived sonographic images with a 30- or 15-MHz scanner and histology specimens of a total of 85 lesions, consisting of 29 basal cell carcinomas and 56 melanomas. RESULTS: The findings were classified into four patterns as follows: Type A, multiple (more than five spots/lesion) hypersonographic spots (14 cases, 48%) Type B, sparse (3-5 spots/lesion) hypersonographic spots (7 cases, 24%) Type C, multiple moderate sonographic spots (3 cases, 10%) and Type D, sparse moderate sonographic spots (5 cases, 17%). Three of 56 melanoma lesions examined as controls showed the Type D pattern, but none showed Type A, B, or C patterns. Histopathologically, these hypersonographic spots in BCCs seemed to correspond to calcification, horn cysts, or clusters of apoptotic cells in the centers of nests of basal cell carcinoma. CONCLUSION: Multiple hypersonographic spots might become a useful finding for differential diagnosis between basal cell carcinoma and melanoma. © 2007 by the American Society for Dermatologic Surgery, Inc.

DOI PubMed

Eccrine porocarcinoma: Clinical and pathological studies of 12 cases

Junko Shiohara, Hiroshi Koga, Hisashi Uhara, Minoru Takata, Toshiaki Saida

Journal of Dermatology 34 ( 8 ) 516 - 522 2007.08 [Refereed]

DOI PubMed

Estrogen-receptor-alpha-positive extramammary Paget's disease treated with hormonal therapy

M. Iijima, H. Uhara, Y. Ide, S. Sakai, H. Onuma, M. Muto, K. Hayashi, F. Mitsura, S. Kobayashi, A. Yoshizawa, T. Saida

Dermatology 213 ( 2 ) 144 - 146 2006.08 [Refereed]

The patient was an 80-year-old man with scrotal and penile extramammary Paget's disease and prostate cancer. Both diseases were in advanced stages. Tumor cells of extramammary Paget's disease strongly expressed estrogen receptor α. The patient was concurrently treated with two kinds of hormonal therapy: the anti-estrogen tamoxifen (20 mg/day orally) for extramammary Paget's disease and the anti-androgen bicalutamide (80 mg/day orally) for prostate cancer. The toxicity of the therapy was mild. All of the metastatic lesions remained stable for 2 months after initiation of dual hormonal therapy. During a follow-up period of 22 months, performance status was well maintained for 17 months. Hormonal therapy may be an alternative for selected cases of advanced extramammary Paget's disease. Copyright © 2006 S. Karger AG.

DOI PubMed

【透析と皮膚】臨床例血栓性微小血管症を伴う高血圧性腎クリーゼを発症した全身性強皮症

古賀弘志, 宇原久, 斎田俊明

皮膚病診療 ( (株)協和企画 ) 25 ( 5 ) 533 - 536 2003.05

66歳男性.血栓性微小血管症を伴う高血圧性腎クリーゼを発症した全身性強皮症の1例を経験した.高血圧症でカルシウム拮抗剤内服中.両手足のむくみで受診した.両手首,両足首から末梢にび漫性の硬化性浮腫と舌小帯の短縮を認めた.病理組織所見は手背や前腕では汗腺分泌部以下にまで膠原線維が増生し,血管および付属器周囲にリンパ球主体の炎症性細胞浸潤認めた.自己抗体のプロフィールならびにKL-6値の上昇から全身性強皮症と診断し,D-ペニシラミン内服を開始したが,KL-6はさらに上昇し,胸部CTでは右下肺に間質性肺炎像が認められ,皮膚硬化も進行した.その後,クレアチニン値の上昇や腎生検より高血圧性腎クリーゼと診断され,あわせて種々検査から高血圧性腎クリーゼに合併した血栓性微小血管症と診断された.ACE阻害剤による降圧と血液透析,濃厚赤血球輸血とアルブミン,新鮮凍結血漿の輸注で症状は改善した

CD30陽性cutaneous large T cell lymphoma

吉澤さえ子, 太田桂子, 宮嵜敦, 芦田敦子, 六波羅詩穂, 宇原久, 斎田俊明

日本皮膚科学会雑誌 ( (公社)日本皮膚科学会 ) 113 ( 5 ) 815 - 815 2003.04

Lymphangitis of the foot demonstrating lymphatic drainage pathways from the sole

Hisashi Uhara, Toshiaki Saida, Tomomi Watanabe, Yoshihiro Takizawa

Journal of the American Academy of Dermatology ( Mosby Inc. ) 47 ( 4 ) 502 - 504 2002.10 [Refereed]

Background: There are two main lymphatic routes from the lower extremity: the fibular route to the popliteal node and the tibial route to the distant groin node. However, little is known about lymphatics from the sole. Objective: We attempted to obtain detailed knowledge of the lymphatics from the sole. Methods: Eight patients with lymphangitis were examined and compared with the drainage patterns visualized by blue-dye injection in 7 cases of melanoma. Results: Six lymphangitic streaks started from the lateral edge of the plantar surface, 2 from the heel, and 1 each from the center of the sole and the little toe. All streaks ran to the tibial side and went up along the foot branch of the great saphenous vein. These findings were similar to those of the dye-injected melanoma cases. Conclusion: Lymphangitis makes visualization of lymphatic routes possible and may provide useful information about drainage.

DOI

Evaluation of 5-S-cysteinyidopa as a marker of melanoma progression: 10 years' experience

K Wakamatsu, T Kageshita, M Furue, N Hatta, Y Kiyohara, J Nakayama, T Ono, T Saida, M Takata, T Tsuchida, H Uhara, A Yamamoto, N Yamazaki, A Naito, S Ito

MELANOMA RESEARCH ( LIPPINCOTT WILLIAMS & WILKINS ) 12 ( 3 ) 245 - 253 2002.06 [Refereed]

5-S-Cysteinyldopa (5-S-CD) has been used as a biochemical marker of melanoma progression. In this study, we measured serum levels of 5-S-CD in 2648 samples taken from 218 patients in order to evaluate the usefulness of this parameter in following melanoma progression and prognosis. 5-S-CD levels were significantly elevated above the upper limit of the normal range (10 nmol/l) in stage IV melanoma patients. The sensitivity of elevated serum 5-S-CD levels in detecting distant metastasis was 73%, while the specificity was 98% and the positive predictive value 94%. The sensitivity was improved to 77% when cases of amelanotic melanoma were excluded. Patients without metastases had elevated 5-S-CD values in 5% of the 1480 serum samples. Changes in serum 5-S-CD levels were followed during disease progression until the end stage in 49 patients. In 33% of the patients, elevation of serum 5-S-CD levels preceded clinical detection of visceral metastases, and in 37% elevation of 5-S-CD levels occurred at the same time as visceral metastasis. Patients with elevated 5-S-CD levels before or after surgical treatment had significantly shorter survival times than those with normal levels. These results show that the level of 5-S-CD in the serum is a sensitive and specific marker in predicting distant metastases. Elevated serum levels of 5-S-CD, before or after surgical treatment, is associated with a poor prognosis. (C) 2002 Lippincott Williams Wilkins.

DOI

Docetaxel induced durable response in advanced extramammary Paget's disease: A case report

S Oguchi, M Kaneko, H Uhara, T Saida

JOURNAL OF DERMATOLOGY ( JAPANESE DERMATOLGICAL ASSOC ) 29 ( 1 ) 33 - 37 2002.01 [Refereed]

The patient was a 54-year-old Japanese man with a seven-month history of an eroded lesion on the scrotum. Skin biopsy confirmed the diagnosis of extramammary Paget's disease, and a CT scan revealed multiple metastases to the lymph nodes along the iliac artery and aorta. The patient underwent combination chemotherapy with mitomycin C, epirubicin, vincristine, cisplatin, and 5-fluorouracil. After two courses of the regimen, the primary lesions on the scrotum regressed, however, the lymph node metastases did not respond. A regimen of continuous administration of low-dose cisplatin and 5-fluorouracil was not effective for the metastases either. Hence, administration of docetaxel at a dose of 60 mg/m(2)/every four weeks was started. After two courses, the lymph node metastases decreased by 75% compared to the pre-treatment size, and the effect was judged a partial response. The major toxicities were neutropenia, alopecia, pitting edema, and facial erythema, but these were tolerable. Five courses of this regimen were followed by four courses of weekly administration of 25 mg/m(2) docetaxel. The partial response persisted for more than 12 months and the patient was able to enjoy daily life. Docetaxel may be an effective drug for patients with advanced extramammary Paget's disease.

Chemotherapy and chemoimmunotherapy for advanced malignant melanoma

Hisashi Uhara, Toshiaki Saida

Biotherapy 16 ( 3 ) 227 - 232 2002

Metastatic melanoma (MM) is resistant to chemotherapeutic agents. Only 10-20% of patients respond to single-drug chemotherapy. Although multi-drug combination chemotherapy increased the response rate to 30-40%, none of these regimens have improved survival compared with dacarbazine alone. Recently, two regimens, the combination of dacarbazine, carmustine, cisplatin and tamoxifen (Dartmouth regimen), and cisplatin/IL-2/interferon alfa-based chemoimmunotherapy, have shown evidence of activity against MM. The response rates were in the range of 40-50% with 10% complete responses. However, randomized studies of these regimens did not show improvement in survival. Recent evaluations of therapeutic regimens for MM are reviewed here.

Proposition of Guidelines for Chemotherapy of Malignant Melanoma Based on the Data Obtained from Relevant Literatures

SAIDA Toshiaki, UHARA Hisashi

Skin Cancer ( The Japanese Skin Cancer Society ) 16 ( 2 ) 158 - 169 2001.10

As members of the expert committee of the Japan Society of Clinical Oncology for the proposition of guidelines for cancer chemotherapy, we collected and evaluated relevant literatures of chemotherapy of malignant melanoma. Each literature was critically evaluated using an evaluation form and quality of evidence of each study was classified into 4 grades. Summing up all the available information, recommendation statements were described on several issues concerning chemotherapy of malignant melanoma, and strength of each recommendation was evaluated using standardized criteria. Critical response from readers to this paper is welcomed. [Skin Cancer (Japan) 2001; 16: 158-169]

DOI CiNii

Sequential biochemotherapy with cisplatin, interleukin-2 and interferon α or βin patients with metastatic melanoma

UHARA Hisashi, SAIDA Toshiaki

Skin Cancer ( The Japanese Skin Cancer Society ) 15 ( 3 ) 309 - 314 2000.12

We evaluated efficacy and toxicity of the combination of cisplatin, interleulin-2 (IL-2) and interferon (IFN) α or β in patients with metastatic melanoma. Ten patients received cisplatin, 50 or 80 mg/m² intravenously on day 1, IL-2, 70×10⁴ IU intravenously on days 4-7, 18-22 and IFN β, 300×10⁴ IU subcutaneously or intravenously on every second days (regimen A). Six patients received cisplatin 80 mg/m² intravenously on day 1, IL-2, 140×10⁴ IU subcutaneously on days 2-8 and IFNα, 500×10⁴ IU subcutaneously on days 2, 4, 6, 8 (regimen B). The induction cycle was repeated on day 29 in both regimens. There was no responder in 6 patients (A) and 4 patients (B) assessed for clinical response. Main toxisities were thrombocytopenia, neutropenia, anemia and nausea. Vitiligo-like depigmentation was seen in one patient, whose disease progressed during the therapy. There were no treatment-related death. These regimens had low activities in the treatment of advanced malignant melanoma. [Skin Cancer (Japan) 2000; 15: 309-314]

DOI CiNii

Solid facial edema in a patient with rosacea

Hisashi Uhara, Shigeo Kawachi, Toshiaki Saida

Journal of Dermatology ( Japanese Dermatological Association ) 27 ( 3 ) 214 - 216 2000 [Refereed]

We report a 53-year old man with symmetrical nonpitting edema, conjunctivitis, and acneiform eruptions on the face. Histopathological examination showed perifollicular lymphohistiocytic infiltration and telangiectasias in the upper dermis. Loosely aggregated non-caseating granulomas were scattered through the dermis some of them were seen in the perifollicular regions. The patient was treated with fleroxacin (100 mg/day, orally) for two weeks with a marked reduction of both solid facial edema and periorbital edema.

DOI PubMed

Newest knowledge of chemotherapy and chemoimmunotherapy for advanced malignant melanoma.

UHARA Hisashi, SAIDA Toshiaki

Skin Cancer ( The Japanese Skin Cancer Society ) 14 ( 1 ) 15 - 23 1999

Recently developed regimens for the treatment of patients with advanced malignant melanoma were reviewed. Combination chemotherapy of CDDP/BCNU/DTIC/tamoxifen (Dartmouth regimen) and sequential (concurrent) chemoimmunotherapy composed of CDDP based chemotherapy associated with IL-2 and IFN α have been reported to increase overall response rates and CR rates. However, they are still in the clinical trial setting. Temozolomide is an analogue of DTIC that has the advantage of being orally absorbed and crossing into the central nervous system (CNS). Fotemustine, a new nitrosourea, is also active in CNS metastasis. Results of the following two clinical trials of our study group were also described: DAC-Tam therapy using DTIC, ACNU, CDDP and tamoxifen, and sequential biochemotherapy using CDDP, IL-2 and IFN β.

DOI CiNii

Immunohistochemical detection of CDK4 and p16(INK4) proteins in cutaneous malignant melanoma

YL Wang, H Uhara, Y Yamazaki, T Nikaido, T Saida

BRITISH JOURNAL OF DERMATOLOGY ( BLACKWELL SCIENCE LTD ) 134 ( 2 ) 269 - 275 1996.02 [Refereed]

p16(INK4) gene, which encodes a specific inhibitor of cyclin-dependent kinase 4 (CDK4), has been recently reported as an important tumour suppressor gene. It is mapped to chromosome 9p21, which is frequently deleted or mutated in many tumour cell lines including malignant melanoma. Since the CDK4/cyclin D complex propels a cell to go through the G(1) check point of the cell cycle, a critical phase of cell division, alteration of the p16(INK4) gene could lead a cell to uncontrolled proliferation and malignant transformation. To clarify any role for p16(INK4) and CDK4 proteins in the development of human malignant melanoma, we have examined, immunohistochemically, the expression of these two proteins in melanocytic neoplasms including 19 primary lesions of nonfamilial melanoma. Intense nuclear and/or cytoplasmic expression of the CDK4 protein was observed in 11 of 19 cases (58%) of melanoma. In contrast, virtually no nuclear or cytoplasmic staining for CDK4 protein was detected in 28 benign melanocytic naevi, including six Spitz naevi. Expression of p16(INK4) protein was observed in three of 19 melanomas (16%) and in 17 of 28 benign naevi (61%). Inverse expression of CDK4 and p16(INK4), at individual cell level, was detected in one case of melanoma. The present study suggests that CDK4 overexpression is characteristic for malignant melanoma, and probably reflects its autonomous accelerated cell proliferation. The expression rate of p16(INK4) protein in malignant melanoma was lower than that in benign naevi, although the significance of p16(INK4) deletion in melanoma development has not been definitely confirmed.

Expression of α subunit of guanine nucleotide‐binding protein Go in Merkel cell carcinoma

Hisashi Uhara, Yu‐Lai Wang, Sachiyo Matsumoto, Shigeo Kawachi, Toshiaki Saida

Journal of Cutaneous Pathology 22 ( 2 ) 146 - 148 1995 [Refereed]

The α subunit of guanine nucleotide‐binding protein Go(Goα), which was initially isolated from bovine brain, interacts with muscarinic cholinergic receptors and regulates neuronal calcium channels. Goα is known to be localized in neural tissues, some endocrine cells, and neuroendocrine tumors. We have immunohistochemically investigated the expression of Goα in 4 cases of Merkel cell carcinoma using the method of microwave treatment. In all cases of Merkel cell carcinoma, Goα was consistently detected on the plasma membrane and cytoplasm of the tumor cells. Nerve fibers in the skin were also positive for Goα, but other epidermal or dermal components such as keratinocytes, melanocytes, fibroblasts, or lymphoid cells were negative. Tumor cells of squamous cell carcinoma, cutaneous lymphoma, sweat gland carcinoma, and malignant melanoma were negative for Go4aL. The present study indicates that Goα may be a useful immunohistochemical marker of Merkel cell carcinoma. Copyright © 1995, Wiley Blackwell. All rights reserved

DOI PubMed

Primary cutaneous plasmacytosis: Report of three cases and review of the literature

H. Uhara, T. Saida, S. Ikegawa, Y. Yamazaki, H. Mikoshiba, S. Nijoh, K. Kitano, C. S. Koh

Dermatology 189 ( 3 ) 251 - 255 1994 [Refereed]

Background: Cutaneous plasmacytosis is a rare disease characterized by peculiar multiple eruptions and hypergammaglobulinemia. More than 40 cases have been reported, mainly in Japan, although information concerning the disorder was limited to individual case reports. Objective and Methods: To clarify the clinicopathological and laboratory features, we reviewed 41 cases. Results: All patients were Japanese and the male-to-female ratio was 1:0.6. The onset ages ranged from 20 to 62 years, with a mean and median of 37 and 37 years. A superficial lymphadenopathy was detected in 58% (22/38), and polyclonal hypergammaglobulinemia was found in 93% (38/41). No cases were associated with any apparent underlying diseases. The course was chronic without spontaneous remission. Four patients died, 3 of whom succumbed to leukemia, respiratory failure or renal failure, respectively. Conclusion: The results suggest that the condition appears to be a variant of reactive plasmacytic disorders of unknown origin. © 1994 S. Karger AG, Basel.

DOI PubMed

　 PREV - NEXT 　

<UHARA Hisashi>

Papers - UHARA Hisashi