Nobuaki Funada

Tokyo Metropolitan Cancer and Infectious Diseases Center, Edo, Tōkyō, Japan

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Publications (15)31.18 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: “Linitis plastica” refers to a histological characterization of diffusely infiltrating, poorly differentiated adenocarcinoma. Linitis plastica-type esophageal adenocarcinoma is extremely rare: this is thought to be only the sixth case report of linitis plastica involving the esophagus. A 60-year-old man was referred to our hospital after repeated endoscopic examinations over the course of a few months. Because he complained of dysphagia, upper endoscopy was performed, revealing stenosis with a few mucosal changes of the lower esophagus. Gastroesophageal reflux disease was initially diagnosed, but biopsy revealed adenocarcinoma. At the time of operation, peritoneal metastasis was noted. Macroscopically, the lesion was diffusely infiltrating, almost completely covered with normal squamous epithelium that showed positive staining with iodine. Pathological examination showed poorly differentiated adenocarcinoma. Despite the poor prognosis, the patient survived a comparatively long 18 months following esophagectomy with oral chemotherapy using S-1. Key wordsEsophageal adenocarcinoma-Linitis plastica type-Diffusely infiltrating type
    Esophagus 12/2010; 7(4):225-229. · 0.83 Impact Factor
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    ABSTRACT: A 55-year-old woman underwent colonoscopy due to a positive fecal occult blood test during a mass screening examination, and a 0-Ip type early cancer in the sigmoid colon was found. Endoscopic mucosal resection was performed for this lesion. Histological examination of the endoscopic resected specimen showed a well-differentiated adenocarcinoma invading submucosal layer (depth of invasion, 6,000 microm), positive lymph vessel invasion, and cut end negative. The patient was referred to our hospital, and an additional sigmoidectomy with lymphadenectomy was conducted. Histological examination revealed no residual cancer and no lymph node metastasis. One year after the surgery, an abdominal CT scan showed liver metastases in the segment 4 and 7. The patient underwent a medial segmentectomy and partial resection of the segment 7 of the liver. After the surgery, 8 courses of oral UFT/LV therapy as adjuvant chemotherapy were administered. The patient remains free of recurrence 2 years and 7 months after the first surgery.
    Gan to kagaku ryoho. Cancer & chemotherapy 12/2008; 35(12):2144-6.
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    ABSTRACT: A 70-year-old man with dysphagia was diagnosed as advanced esophageal cancer by a primary doctor, and he was admitted to our hospital for treatment in February, 2004. The pretreatment diagnosis was basaloid squamous carcinoma, Mt area, T4 (aorta) , N2 (No. 107) , M1 (liver), Stage IVb performed systemic chemotherapy by FAP (5-fluorouracil ( 5-FU)+doxorubicin (DXR)+cisplatin (CDDP) ) from March, 2004. After 4 courses, the local tumor almost entirely disappeared, and the liver metastasis was obviously reduced. We continued chemotherapy afterwards. As of March 31, 2007, he had local lesion CR and metastatic lesion PR. It is very important to perform FAP repeatedly, for local and metastatic lesion of esophageal cancer while maintaining the patient's general condition and avoiding adverse events.
    Gan to kagaku ryoho. Cancer & chemotherapy 05/2008; 35(4):629-31.
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    ABSTRACT: Once adenovirus infection extends to the kidney from the bladder in the immunosuppressive state after hematopoietic stem cell transplantation, most patients develop acute renal failure due to adenovirus-associated necrotizing tubulointerstitial nephritis. In the 6 years from 2000 to 2006, we retrospectively investigated the characteristics of adenovirus infection in 402 patients who had received a hematopoietic stem cell transplantation in our hospital. The incidence of adenovirus-associated hemorrhagic cystitis in patients who had received a hematopoietic stem cell transplantation was 3.5% (14/402). Among these 14 patients, 4 developed acute necrotizing tubulointerstitial nephritis all of whom died, which yielded the incidence and mortality rates of the disease of 1.0% and 100%, respectively. Once adenovirus infection extends to major organs in a rapid manner, the patient's general condition becomes fatal. Further study is necessary to establish the diagnosis and treatment of adenoviral infections in a compromised host.
    Nippon Jinzo Gakkai shi 02/2008; 50(8):1036-43.
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    ABSTRACT: Endoscopic placement of metal stents are used widely for patients with esophageal obstruction and fistula due to progressive esophageal cancer, but cause high rate of severe complications associated with the immediate causes of death. To determine severe complications caused by stents, we studied clinical data and autopsy of six patients who had been treated with stents for inoperable progressive esophageal cancer. Occording to the clinical records only two patients had severe complications due to stents. But at autopsy, three patients had massive hemorrhage in the stent placement, one patient had mediastinitis, and one patient were in imminent danger of perforation whose stent had been incorporated into the adventitia of the wall. More severe complications were revealed than those expected clinically. Endoscopic placement of metal stents have a great deal for the improvement of quality of life. But we should carefully decide the indication because endoscopic placement of metal stents could cause severe complications associated with the immediate causes of death.
    Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 08/2006; 103(7):812-8.
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    ABSTRACT: Bromodeoxyuridine (BUdR), a nonradioactive thymidine analogue, is taken up by cells in S-phase, and the ratio of BUdR-positive nuclei to the total number of cells counted is defined as the labeling index (LI). In this study, BUdR LI and the clinical course of 50 cerebral astrocytic tumors in adults were analyzed. The obtained LI distributed continuously in a broad range from 0% to 19%. The mean LI of 28 glioblastomas, 12 anaplastic astrocytomas, and ten astrocytomas were 8.5%, 4.2%, and 1.2%, respectively, and these differences were statistically significant (P = 0.05). In the analysis of LI and the recurrence-free period (RFP), regardless of the histologic findings, 23 patients with LI more than 5% had a median RFP of 9.0 months; the median RFP of nine patients with LI of 3% to 5% was 14.7 months. Nine of 13 patients with LI less than 3% have not yet recurred after a median follow-up of 36 months. These differences were also statistically significant by the generalized Wilcoxon test (P = 0.05). The proliferative potential reflected by the BUdR LI is a good clinical indicator for predicting the rate of tumor growth in cerebral astrocytic tumors. In combination with histologic diagnosis, BUdR LI could help in determining a patient's prognosis more precisely.
    Cancer 06/2006; 67(6):1629 - 1634. · 5.20 Impact Factor
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    ABSTRACT: Recent trends in the management of superficial esophageal cancer consist of improved detection and curative endoscopic therapy. However, successful endoscopic therapy has not been reported in Taiwanese patients with this disease. We describe the case of a male, 38-year-old habitual drinker admitted for a general health check-up, whose endoscopic examination revealed a slightly depressed discolored lesion in the middle esophagus. Chromoendoscopy with 3% Lugol's iodine solution showed a mesh-like unstained pattern occupying approximately two-thirds of the circumferential esophageal mucosa. Spraying with 2% toluidine blue solution stained a 3 x 6 cm suspect area pale blue. Endoscopic biopsy confirmed squamous cell carcinoma. Histopathologic examination revealed the lesion was a type IIc superficial esophageal cancer. Endoscopic ultrasonography showed the lesion was limited to the epithelial layer with no evidence of lymph node involvement. The lesion was removed en bloc using endoscopic mucosectomy. Microscopic examination of the resected specimen demonstrated that the depth of invasion was confined to the epithelial layer except for some areas with small nests of tumor cells within the lamina propria. Balloon dilatation to prevent post mucosectomy stricture was performed and the patient recovered uneventfully. At 1 year of follow-up, the patient was alive without any endoscopic signs of local recurrence. This case suggests that chromoendoscopy in combination with endoscopic resection is likely to benefit patients with early-stage esophageal cancer.
    Journal of the Formosan Medical Association 04/2002; 101(3):219-22. · 1.00 Impact Factor
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    ABSTRACT: The histological diagnosis of human gliomas is of great importance for estimating patient prognosis and guiding therapy but suffers from being subjective and, therefore, variable. We hypothesized that molecular genetic analysis could provide a more objective means to classify tumors and, thus, reduce diagnostic variability. We performed molecular genetic analysis on 91 nonselected gliomas for 1p, 19q, 10q, TP53, epidermal growth factor receptor, and cyclin-dependent kinase 4 abnormalities and compared with the consensus diagnoses established among four independent neuropathologists. There were six astrocytomas, seven anaplastic astrocytomas, 45 glioblastomas, 21 oligodendrogliomas, eight anaplastic oligodendrogliomas, three oligoastrocytomas, and one anaplastic oligoastrocytoma. Twenty-nine cases had either 1p or 19qloss of heterozygosity (LOH) while retaining both copies of 10q, of which 25 (86%) were histologically oligodendroglioma, anaplastic oligodendroglioma, oligoastrocytoma, or anaplastic oligoastrocytoma. As for the oligodendroglial tumors, unanimous agreement of the initial diagnoses was almost restricted to those cases with combined 1p/19qLOH, whereas all nine tumors without 1p loss initially received variable diagnoses. Interestingly, TP53 mutation was inversely related to 1pLOH in all gliomas (P = 0.0003) but not 19qLOH (P = 0.15). These data demonstrate that molecular genetic analysis of 1p/19q/10q/TP53 has significant diagnostic value, especially in detecting oligodendroglial tumors. In addition, 1pLOH and TP53 mutations in gliomas may be markers of oligodendroglial and astrocytic pathways, respectively, which may separate gliomas with the same histological diagnosis, especially oligodendroglial tumors and glioblastomas. Testing for those molecular genetic alterations would be essential to obtain more homogeneous sets of gliomas for the future clinical studies.
    Clinical Cancer Research 02/2002; 8(1):196-201. · 7.84 Impact Factor
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    ABSTRACT: The computed tomographic (CT) and magnetic resonance imaging (MRI) features of 73 histologically proven primary intracranial germ cell tumors were analysed. CT images were available for all 73 patients, and 22 of them were also examined by MRI. The tumors were classified as germinoma, mature teratoma, immature or malignant teratoma, yolk sac tumor, choriocarcinoma, embryonal carcinoma and mixed type. Germinoma was revealed as a high- or slightly high-density area on plain CT scan, and was enhanced homogeneously. MRI revealed iso- or slightly low signal intensity on T1-weighted images, and iso- or high intensity on T2-weighted images. Mature teratoma, which had a clear margin on neuroradiological images, was characterized by mixed density on CT scans, often showing large cysts and area of calcification. Immature or malignant teratoma had a similar pattern to that of mature teratoma, but the cystic components and area of calcification tended to be less and smaller respectively. The tumor margin was obscure in malignant teratoma, and perifocal edema was observed in some cases. The shape of yolk sac tumors was irregular. Plain CT scan revealed an iso- or low-density mass with good heterogeneous enhancement. Perifocal edema was observed in some cases. In mixed germ cell tumors, MRI imaging was useful for detecting teratomatous components, particularly fatty components. Although definite histological diagnosis cannot be achieved by CT and/or MRI alone, detailed analysis of neuroradiological images are useful for predicting the histological diagnosis.
    Journal of Neuro-Oncology 02/1994; 19(3):217-26. · 3.12 Impact Factor
  • M Matsutani, N Funada
    No shinkei geka. Neurological surgery 09/1992; 20(8):837-41. · 0.13 Impact Factor
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    ABSTRACT: Bromodeoxyuridine (BUdR), a nonradioactive thymidine analogue, is taken up by cells in S-phase, and the ratio of BUdR-positive nuclei to the total number of cells counted is defined as the labeling index (LI). In this study, BUdR LI and the clinical course of 50 cerebral astrocytic tumors in adults were analyzed. The obtained LI distributed continuously in a broad range from 0% to 19%. The mean LI of 28 glioblastomas, 12 anaplastic astrocytomas, and ten astrocytomas were 8.5%, 4.2%, and 1.2%, respectively, and these differences were statistically significant (P = 0.05). In the analysis of LI and the recurrence-free period (RFP), regardless of the histologic findings, 23 patients with LI more than 5% had a median RFP of 9.0 months; the median RFP of nine patients with LI of 3% to 5% was 14.7 months. Nine of 13 patients with LI less than 3% have not yet recurred after a median follow-up of 36 months. These differences were also statistically significant by the generalized Wilcoxon test (P = 0.05). The proliferative potential reflected by the BUdR LI is a good clinical indicator for predicting the rate of tumor growth in cerebral astrocytic tumors. In combination with histologic diagnosis, BUdR LI could help in determining a patient's prognosis more precisely.
    Cancer 04/1991; 67(6):1629-34. · 5.20 Impact Factor
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    ABSTRACT: Clinico-pathologic characteristics of radiation-induced brain atrophy were reviewed. Radiation-induced brain atrophy becomes obvious 2 to 3 months after radiation therapy in more than half of the patients who have been irradiated to the brain. Mental and neurologic deterioration were well correlated with the severeness of brain atrophy. Pathologically, demyelinating process secondary to direct neurotoxicity of irradiation seemed to be responsible for the entity. A large target field or whole brain irradiation and the senility of patients were major risk factors. The most important differential diagnosis is normal pressure hydrocephalus which is basically curable. The prognosis of radiation-induced brain atrophy is poor. The only possible method to protect the brain from this pathologic entity is to minimize target field as much as possible.
    Gan no rinsho. Japan journal of cancer clinics 10/1989; 35(11):1325-9.
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    ABSTRACT: Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed.
    Cancer 06/1989; 63(10):1962-74. · 5.20 Impact Factor
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    ABSTRACT: A rare case of growth hormone-secreting pituitary adenoma with hematogenous metastasis to the dura mater of the cerebral convexity is presented. Immunohistological staining was essential to the diagnosis. The histological findings demonstrated that the metastasis was blood-borne. Extensive removal of the tumor and postoperative chemotherapy resulted in partial remission. The mechanism of metastasis, the histological findings, the treatment, and the prognosis are discussed.
    Neurosurgery 07/1988; 22(6 Pt 1):1091-4. · 2.53 Impact Factor
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    ABSTRACT: A case of angioblastic meningioma with multiple metastases to the vertebra and the adjacent bones is presented. A 60-year-old man was admitted to our hospital complaining of pain in the left arm, right chest and abdominal wall, the left buttock, and on the posterior surface of the both legs. He had first undergone subtotal removal of tentorial meningioma eight years before admission. Histological diagnosis of angioblastic meningioma was confirmed. He subsequently received radiation therapy when the tumor recurred six years before admission and again underwent subtotal removal of the recurrent tumor, followed by radiation therapy, four years before admission. Bone scintigrams demonstrated abnormal uptake of radionuclide by the vertebral arches of Th 1, Th 10, Th 11, the vertebral bodies of L 4, L 5, the right 7th rib, and the left iliac bone. Myelography and CT examination with intrathecal infusion of metrizamide revealed marked cord-compression by the space-occupying lesions at the level of the first and the tenth thoracic vertebral bodies. Chest roentgenograms, ultrasonograms and whole body CT examinations showed no other lesions. The tumor was partially resected from the iliac lesion. The diagnosis of metastatic meningioma was confirmed by the histological findings. Postoperative radiation therapy to the first, tenth, and eleventh portions of the thoracic vertebra, and the fourth and the fifth portions of the lumbar vertebra--the causative lesions of the pain--relieved the pain.(ABSTRACT TRUNCATED AT 250 WORDS)
    No shinkei geka. Neurological surgery 06/1988; 16(6):785-9. · 0.13 Impact Factor

Publication Stats

244 Citations
31.18 Total Impact Points

Institutions

  • 2010
    • Tokyo Metropolitan Cancer and Infectious Diseases Center
      • Department of Surgery
      Edo, Tōkyō, Japan
  • 1994–2008
    • Tokyo Metropolitan Komagome Hospital
      Edo, Tōkyō, Japan
  • 2002
    • Taipei Medical University
      T’ai-pei, Taipei, Taiwan
  • 1992
    • The University of Tokyo
      • Department of Neuroscience
      Tokyo, Tokyo-to, Japan