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A total of 1,270 nursing students of Nagasaki University School of Health Sciences were examined for serum HBsAg and anti-HBs at their first year between 1990 and 2006. The prevalence of HBsAg was 0.39% (5/1,270); 0.52% (4/762) in 1990-1999, 0.27% (1/368) in 2000-2004, and 0% (0/140) in 2005-2006. The prevalence of anti-HBs was 1.81% (23/1,270); 1.97% (15/762) in 1990-1999, 0.82% (3/368) in 2000-2004, and 3.57% (5/140) in 2005-2006. A total of 650 students who were negative for HBsAg and anti-HBs in 1998-2006 received a primary series of hepatitis B vaccinations. Subsequently, 98.2% (638/650) acquired anti-HBs. The median titer of anti-HBs concentrations at 4 weeks after primary vaccination was 2,145.0 mIU/mL. Eleven among 12 students who did not acquire anti-HBs after a primary vaccination received a second series of vaccinations, after which eight (72.7%) acquired anti-HBs. Overall 99.4% (646/650) of the students vaccinated acquired anti-HBs. Among 286 students who acquired anti-HBs after the primary series of vaccinations, 17 (5.9%) became negative for anti-HBs in their third year. Nursing students should be educated about the risks for and prevention of blood borne infections, including the need to be vaccinated against hepatitis B. Moreover, nursing students who do not acquire anti-HBs after primary vaccination should receive a 3-dose revaccination series., Acta medica Nagasakiensia. 2007, 52(3), p.83-86

To clarify the relationship with development of colorectal cancer, we investigated chromosomal aberrations in 715 specimens of the colorectal neoplasm by cytogenetic analysis. A gain of chromosome 17 was observed in the transitional epithelium around non-polypoid carcinomas, although the normal epithelium exhibited diploidy. Most tubular adenomas were diploid, however, loss of chromosome 11 and gain of chromosome 17 were increased in adenomas in association with an increased villous component. DNA aneuploidy, aneusomy and p53 deletion were predominantly observed in carcinomas, even in early cancers. Alterations of chromosomes 11 and 18 reflected different tumor morphologies in the early carcinomas. Gains of chromosomes 11, 17 and 18, and deletion of chromosomes 11 and 17p and p53 became more frequent following an increase in the depth of invasion. Aneusomy of chromosome 11 was a risk factor for patient survival after operation. Gains of chromosome 20 and 20q13.2 were associated with liver metastasis. Aneusomy and translocations of chromosome 17 and the p53 locus were predominantly observed in patients with multiple cancers and hereditary non-polyposis colorectal cancer. Our results indicate that in the process of development of colorectal carcinomas, specific chromosomal aberrations might be related to each step of development, or an alternative pathway of de novo carcinogenesis., Acta medica Nagasakiensia. 2004, 49(1-2), p.25-32

This study was designed to provide quantitative analysis using flow cytometry (FCM) and immunohistochemical analysis (IH) for p53 protein in 85 patients who underwent pulmonary resection for non-small cell lung carcinoma (NSCLC). We also examined the relationship among numerical aberrations of chromosome 17 and p53 locus, clinicopathological parameters and patient prognosis in NSCLC. PAb 1801 was used as the primary antibody for p53 and the Fluorescence Index (F.I.) was calculated by FCM. Fifty-six patients (66%) showed a higher F.I. (?0.5), and had a higher rate of lymph node metastasis, more advanced stage and poor survival, while a positive expression of p53 protein by IH was associated with no clinicopathologic factors or patient survival. The F.I. of p53 protein was significantly higher in cases with imbalanced numbers between chromosome 17 and the p53 locus, particularly in patients with higher F.I. This indicated that quantitative analysis by FCM was the most useful method to detect the over-expression of p53 protein compared to that by IH. Higher F.I. (?0.5) is a prognostic indicator for predicting malignant behavior and poor survival in patients with NSCLC., Acta medica Nagasakiensia. 2004, 49(1-2), p.33-38

Angiogenic factors play a major role in tumor growth and metastasis. Vascular endothelial growth factor (VEGF)- D is a ligand for VEGF receptor-3 (VEGFR-3/Flt-4), which mainly expressed on the lymphatic endothelium. Recent experimental studies have shown that VEGF-D induces tumor lymphangiogenesis and promote metastatic spread of tumor cells via lymphatic vessels. However, the contribution of VEGFD to lymph node metastasis in human colorectal cancer is less understood. We therefore examined VEGF-D and VEGFR-3 expression in patients with colorectal cancer. Sections of formalin-fixed and paraffin-embedded specimens from 76 colorectal cancers were immunohistochemically stained for VEGF-D and VEGFR-3. Staining for VEGF-D was positive in the cytoplasm of tumor cells in 43 of 76 examined tumors (56.6%). Staining for VEGFR-3 was positive in endothelial cells in 38 (50.0%) tumors. Univariate analysis showed that both VEGF-D and VEGFR-3 expressions correlated significantly with lymph node metastasis, histological type and depth of tumor invasion. However, logistic regression analysis indicated that VEGF-D expression, but not that of VEGFR-3, was an independent predictor for lymph node metastasis. Our data suggest that VEGF-D plays an important role in lymph node metastasis in colorectal cancer., Acta medica Nagasakiensia. 2002, 47(3-4), p.155-160

Activation of poly(ADP-ribose) polymerase-1 (PARP-1) and its subsequent cleavage are early markers of apoptosis. PARP-1 is associated with DNA repair and so chromosome stability, cell cycle regulation, as well as tumorigenesis. To investigate the role of PARP-1 expression in colorectal carcinoma and its metastasis of liver, we compared the expression of PARP-1 in primary colorectal cancers with (n=15) and without liver metastasis (n=17) using a semi-quantitative reverse transcription - polymerase chain reaction. We also examined the expressions of poly(ADP-ribose) (PAR) and p53 in these tumors by immunohistochemistry. A significantly higher PARP-1 mRNA expression was noted in tumors with liver metastasis than those without liver metastasis (p, Acta medica Nagasakiensia. 2002, 47(3-4), p.111-115

Malignant fibrous histiocytoma (MFH) of the retroperitoneum is relatively rare in Japan. MFHs often recurs even if the tumor is resected completely. We describe a case with recurrent MFH of the retroperitoneum. A 49-year-old male was-admitted to our hospital for a palpable mass in the right lower abdomen. Ultrasonography and computed tomography demonstrated a solid mass with cystic compartment in the lower pole of the right kidney. The tumor was resected completely, and histological examination showed it was MFH, storiform-pleomorphic type. Thirty-three months later, a local recurrence developed and a second operation was performed. The resected tumor was 4.5 ﾃ・3.9 ﾃ・3.1 cm in size and histological diagnosis was recurrent MFH. We also examined the cytological characteristics of the tumor, using DNA flow cytometric quantification and fluorescence in situ hybridization (FISH) with a set of 14 chromosomespecific DNA probes. DNA contents showed a DNA diploid pattern, however, FISH analysis showed various aberrations of chromosome number such as +1, +2, +7, +8, -10, +11, +12, -16, -17, -18, and +20. These results suggested that chromosomal aberrations may reflect a higher biologic aggressiveness of recurrent MFH., Acta medica Nagasakiensia. 1998, 43(3-4), p.88-91

We report 4 cases of sternal resection and reconstruction for para-sternal recurrence after radical mastectomy for breast cancer. All 4 had partial sternotomy combined with rib resection. Double Marlex mesh and muscular or myocutaneous flap were employed to close the sternal defect. Postoperative complications occurred in 2 cases : respiratory failure and partial skin necrosis. All patients are alive 12, 59, 77 and 117 months after sternal resection. Surgical management for parasternal recurrence after radical mastectomy can provide long-term survival and improve the quality of life of patients, especially those with solitary recurrences., Acta medica Nagasakiensia. 1995, 40(1-4), p.26-29

Postoperative pulmonary function is essential for ensuring the quality of life for aged lung cancer patients who underwent pulmonary resection. The operative procedures of bronchoplasty and pulmonary angioplasty are reliable for maintaining pulmonary function. The values of this procedures were evaluated on the basis of clinical experience. Pulmonary angioplasty which was concurently performed in 28 patients with bronchoplasty (29.2 %) and in eight with lobectomy was subjected to this study in relation to the survival and postoperative pulmonary function. The operative procedure of pulmonary angioplasty was of great use to preserve the pulmonary function as well as to predict the favorable survival in the selected patients with localized hilar carcinoma of squamous cell carcinoma and with no nodal involvement In addition, direct cancer infiltration to the wall of the pulmonary artery is better candidate rather than by way of metastatic nodes with respect to the survival. In conclusion, pulmonary angioplasty should be widely used in combination with lobectomy and brochoplasty to ensure high quality of life following pulmonary resection., Acta medica Nagasakiensia. 1994, 39(4), p.153-156

We analyzed the data for patients with small cell lung cancer, especially as regards comparison of the results of surgical treatment before and after the introduction of multimodal chemotherapy treatments. Sixty cases with small cell lung cancer were admitted in our department between January, 1955 and December, 1993. Among them, 38 cases underwent pulmonary resection. To evaluate the efficacy of the multimodal treatment including cisplatin with surgical therapy, patients were devided whether pulmonary resection was performed before 1983 (Group A) or after 1984 (Group B). There were no differences in sex and stage between two groups, but ages and operative proceduress were significantly different (p, Acta medica Nagasakiensia. 1994, 39(1-3), p.126-129

It was confirmed that combined resection of the trachea and the bronchus is feasible and available for advanced cancer patients on the basis of 9 patients of our clinical experience. However, meticulous postoperative cares are necessary for prevention of fatal outcome of postoperative complicatios. Anatomical drawback of tracheobronchoplastic operation is able to be overcome in combination with the procedure of omentopexy which facilitates neovascularity to the reconstructed trachea and bronchus., Acta medica Nagasakiensia. 1993, 38(2-4), p.196-199