Ichiro Taki

Prophylactic chemotherapy for hydatidiform mole: five to 15 years follow-up

The effectiveness of the prophylactic chemotherapy was evaluated in 420 patients with molar pregnancy. All patients were followed for 5 to 15 years after the evacuation. Twenty‐two (7.5%) of 293 patients with prophylactic chemotherapy and 23 (18.1%) of 127 patients without prophylactic chemotherapy (control) developed secondary trophoblastic disease. The prophylactic chemotherapy could reduce the occurrence of secondary trophoblastic disease. In these secondary trophoblastic diseases, 5 (22.7%) of 22 patients in the prophylactic chemotherapy group and 5 (21.7%) of 23 in the control had metastatic trophoblastic disease. Choriocarcinoma after the molar pregnancy developed in two patients (0.7%) of the prophylactic chemotherapy group and two (1.6%) of the control. Prophylactic chemotherapy did not eliminate the occurrence of choriocarcinoma. The complication of the prophylactic chemotherapy was seen in 27.3% of the patients. Neither severe complication nor death were related to the toxicity. Cancer 58:624‐629, 1986.

Choriocarcinoma occurring within the normal placenta with breast metastasis

Abstract Choriocarcinoma of the breast was found during pregnancy in a patient who had been delivered of a hydatidiform mole 3 years earlier. Serial sections of the grossly normal placenta revealed multiple, minute foci of Choriocarcinoma. Two sections showed the very early developmental stage, or the borderline lesion, of Choriocarcinoma. We are presenting this unusual case with a review of the literature.

Abortifacient effect and uterine cervix-dilating action of 16,16-dimethyl trans Δ2 PGE1 methyl ester (ONO 802) in the form of a vaginal suppository (a randomized, double-blind, controlled study in the second trimester of pregnancy)

A newly synthesized 16, 16-dimethyl trans delta 2 PGE1 methyl ester (ONO 802) was clinically applied in the form of a vaginal suppository for therapeutic abortion of second trimester pregnancies. Its effects were studied in a double-blind test comparing it with an inactive placebo suppository. The study was conducted at 12 Japanese university hospitals. The number of patients was 125 in total, i.e. 63 receiving ONO 802 vaginal suppository (containing 1.0 mg ONO 802) and 62 receiving inactive placebo suppository. ONO 802 was more effective than placebo with a success rate of 87% (complete (71%) and incomplete (16%) abortions). The onset of uterine contractions was observed in 154.3+/-18.1 min. and the onset of uterine bleeding in 323.6+/-41.0 min. The expulsion of the fetus and placenta was observed in 955.4+/-97.0 and 961.6+/-97.0 min., respectively. The cervix dilating effect of ONO 802 was observed in 63.5% of the patients at 3 hours after the start of administration. Nausea, vomiting, abdominal cramps, diarrhea and pyrexia were noticed. However, all these side effects were transient and mild, requiring no treatment. No abnormality was observed in the puerperal course, duration of uterine bleeding or onset of subsequent menstruation following the therapeutic abortion. Therefore, the present study demonstrated that ONO 802 vaginal suppository was an effective and valuable drug for therapeutic abortion of second trimester pregnancies.

Histological study of microinvasive carcinoma of the uterine cervix

Abstract Fifty-three cases of microinvasive carcinoma, 107 cases of carcinoma in situ , and 52 cases of dysplasia were studied histologically. When the original squamocolumnar junction (SCJ) was defined as it was at the last cervical gland, most of the abnormal epithelia located in the zone between this SCJ and 10 mm proximal to SCJ. Concerning the spreading extent of abnormal epithelium there was an apparent tendency that the more severe the lesion, the wider was the extent. The circumferential extent of the lesions was closely correlated to the longitudinal extent. The type of invasion was classified into four groups: drop, fingerlike, bulky, and confluent type. Since many invasions which began from the surface epithelium remained within 1 mm in depth, and invasions from a cervical gland were initially noted in deeper areas, the depth of invasion measured from the surface epithelium may not directly reflect the progression of the lesions.

Human gynecologic cancers heterotransplanted into athymic nude rats

Abstract The serial transplants of human ovarian and endometrial tumors in nude mice were transplanted into nude rats. The transplants consisted of three lines of yolk sac tumors, designated as YST-1, YST-2, and YST-3 and two lines of endometrial adenocarcinoma, AD-30 and AD-35. The transplanted tumors grew much larger in nude rats than in nude mice, reaching more than 150 g in weight. The overall grafting success rate of these tumors was about 70% in nude rats whereas it had been almost 100% in nude mice. The histology of the transplanted tumor in nude rats was similar to that of the same tumor in nude mice. YST-1, YST-2, and YST-3 tumors produced the marker α-fetoprotein (AFP). Thus the transplanted tumors in nude rats seemed to preserve the characteristics of the original tumors. The usefulness of the nude rat as a tool for studying the efficacy of treatments on human malignant tumors is discussed.

Ovarian sex cord tumor with annular tubules

Abstract A rare case of ovarian sex cord tumor is presented in which simple and complex annular tubules lined by Sertoli cells, aggregation of Leydig cells, hyalinoid degeneration, and calcification of the stromal tissue are identified. The patient did not develop Peutz-Jeghers syndrome, but did have menstrual disorders.

Evaluation of the colposcopically directed biopsy and the cone biopsy

Abstract Cytology and colposcopically directed biopsy were performed in 110 cases of borderline lesions of the cervix, of which 90 cases had cone biopsy. The correct diagnosis rate of colposcopically directed biopsy and the role of cone biopsy were evaluated. The correct diagnosis rates of directed biopsy of dysplasia, carcinoma in situ (CIS), and microinvasive carcinoma were 73, 77, and 45%, respectively. Cone biopsy was considered necessary in making an exact diagnosis of borderline lesions, since there was a fair discrepancy between the results of cone biopsy and colposcopically directed biopsy. Seventy-five of 90 cases had hysterectomy following cone biopsy. Though there were residual lesions found in the cervices of the removed uteri, they were not more severe than those found by cone biopsy. The frequency of the residual lesion in the removed uteri was 35% in total, 26% in CIS, and 52% in microinvasive carcinoma. There was a trend that, the more progressive the lesion, the more residual lesions were found. It is therefore very dangerous to perform conization as a definitive therapeutic method.

Angiography of trophoblastic tumors: Analysis of pelvic angiography correlated with microangiography and histopathological examination of uterine specimens

Abstract Pelvic angiography of 61 patients with trophoblastic disease was studied. Twenty-four patients were studied in detail correlating direct 4-fold magnification angiography, microangiography, and histopathological examination. Increased myometrial vessels, central vascular pooling, and central avascularity on pelvic angiograms were confirmed by magnification angiography or microangiography, but the diagnosis of tumor vessels by pelvic angiography was often disproved by microangiography. It is usually possible to detect and diagnose established malignant tumors with pelvic angiography, but there were exceptions which impose limitations to pelvic angiography. Differential diagnosis of chorionepithelioma and destructive mole is not always possible. Central vascular pooling is more suggestive of destructive mole than chorionepithelioma, because diffuse infiltration of contrast media into intervillous spaces which were found on destructive mole were represented as central vascular pooling on pelvic angiograms.

Cytologic Studies of Endometrial Adenocarcinoma

子宮体癌患者38例について, 治療前細胞診と病理組織診との関連性を検討した. 内膜スメアでは癌の分化度と異型細胞出現率との間に関連性はなく, 高分化型腺癌, 低分化型腺癌いずれにも高い出現率が認められたが, 頸管スメアでは低分化型腺癌ほど異型細胞出現率が高いという結果が得られた.癌の筋層浸潤度による異型細胞出現率の違いでは, 頸管スメア, 内膜スメアいずれにおいても筋層浸潤度と異型細胞出現率との問に関連性は認められなかった. しかし頸管浸潤のあるものでは, 高い異型細胞出現率が頸管スメアで得られた.体癌細胞診の特徴について, 細胞診の背景と正常内膜細胞の出現状態という点から検討を行った. 腫瘍性背景は頸管スメアよりも内膜スメアにおいて高い頻度でみられ, また頸管スメアでは腫瘍性背景を示しながら異型細胞が認められないものもあった. 閉経後体癌患者の頸管スメアでは, 比較的高頻度に正常内膜細胞が認められるものがあり, このなかには異型細胞が認められないものもあった.