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E Yabata

Publications and source records attributed to E Yabata.

10 recordsLinked to original sources

Adenocarcinoma of the ileum producing carbohydrate antigen 19-9: report of a case.

We report herein the case of an 81-year-old woman found to have small intestinal carcinoma producing carbohydrate antigen (CA)19-9, in whom recurrence on the abdominal wall was strongly suspected 4 months after resection. She presented to our hospital with acute abdominal pain with severe anemia. Marked serum elevation of CA19-9 to 164.8 U/ml suggested a progression to malignancy. A fluorography using an ileus tube revealed an abnormal mucosal pattern. An exploratory laparotomy showed an incomplete annular constrictive Borrmann type 2 tumor, located approximately 190 cm from Treitz's ligament, without any signs of peritoneal or hepatic metastases. Histological examination confirmed a diagnosis of papillotubular adenocarcinoma without metastases of the regional lymph nodes. CA19-9 antigenicity was detected in the cytoplasm and on the surface of the cancer cells, using the monoclonal CA19-9 antibody, NS19-9. In this report, we demonstrate the CA19-9 productivity and distribution of the cancer tissues in relation to their prognosis.

Adenocarcinoma, Papillary↗

[A case of unresectable gallbladder cancer responding to combination therapy with hyperthermia and local chemotherapy].

A 78-year-old woman was admitted to our hospital for the control of gallbladder cancer. A peritoneal metastasis, diagnosed as unresectable cancer, was detected during surgery in a previous hospital, and a biliary stent was introduced and gastrojejunostomy was performed. In our hospital she was treated weekly with local chemotherapy (PFL; cisplatin 2.5-5 mg/body ia, fluorouracil 300 mg/body ia, and calcium folinate 30 mg/body ia, via the common hepatic arterial port) at the time of hyperthermia. Hyperthermia was performed with a Thermox 500 (HEH-500 C) at the power of 500 watts for 45-60 minutes. To enhance the hyperthermia effect, mitomycin C 2-4 mg/body ia via the common hepatic arterial port and 500 ml of 7.5% glucose infusion were given. As a result of the combination therapy, the volume of the whole tumor was reduced to 60.9% on computed tomography, and diagnosed as PR. The serum level of CA19-9 decreased from 3,000 U/ml to 300 U/ml. The patient continued to receive the therapy for 1 year, and is now well. Therefore, we conclude that combination therapy with hyperthermia and local chemotherapy seems beneficial in managing unresectable advanced gallbladder cancer, especially for the elderly.

Aged↗

[A case of recurrent breast cancer with carcinoma erysipeloides responding to sequential therapy with docetaxel (TXT) and doxifluridine (5'-DFUR) accompanied by leucovorin (LV)].

A left radical mastectomy was performed on a 53-year-old woman, diagnosed with left inflammatory breast cancer, after local arterial chemotherapy with cyclophosphamide (CPA), doxorubicin and 5-fluorouracil (5-FU). Adjuvant therapy was added with irradiation and ECF. Four months after the operation, a red eruption was detected on the left upper chest wall. The lesion was diagnosed by skin biopsy as a recurrent breast cancer with carcinoma erysipeloides. Tumor marker levels suggested the recurrent cancer was ECF resistant, so we changed the chemotherapy regime to a single dose of TXT. Although tumor marker levels and the skin eruptions improved at the beginning of the therapy, pleuritis carcinomatosa was found. We changed the regime again to a continuous dose of 5'-DFUR and LV for day 1 to 7. With this regime the clinical symptoms improved, and 2 courses of this modified FL therapy were carried out. After the therapy, the tumor seemed resistant to this modified FL therapy. Therefore, we tried a sequential therapy with TXT and the modified FL, which induced an improvement in clinical symptoms. Two years later, the patient died from the breast cancer. Therefore, we conclude that the sequential therapy may be beneficial in managing untreatable carcinoma erysipeloides of recurrent breast cancer.

Antineoplastic Agents, Phytogenic↗

Feasibility of the transparent cap-fitted colonoscope for screening and mucosal resection.

PURPOSE: A transparent plastic cap of 17 mm in outer diameter, 15 mm in inner diameter, and 10 mm in length can be easily attached to the tip of a colonoscope. By using the cap, a better view of the lesions hiding at the opposite side of the fold can be obtained. When a flat colonic lesion is found, a submucosal injection of saline solution is performed, the target mucosa is sucked inside the cap, snared under a full endoscopic suction, and resected by an electrical current. This procedure is called endoscopic mucosal resection using transparent cap-fitted endoscope (EMRC). Feasibility of the cap-fitted colonoscope for screening colonoscopic examination and mucosal resection was evaluated. MATERIALS AND METHODS: One hundred forty patients were randomly allocated for screening with a normal colonoscope (NCF) or that with the cap-fitted colonoscope (CCF). Average time for insertion up to the cecum, patients' discomfort during insertion expressed in 4 degrees, and average number of lesions found in one patient were compared. Thirty lesions randomly allocated for mucosal resection with conventional strip biopsy or EMRC were also evaluated. RESULTS: Time consumed for insertion up to the cecum with the CCF (12.4 +/- 6.6 minutes) was the same as that with the NCF (12.3 +/- 5.2 minutes), and there was no significant difference in patients' discomfort; however, the average number of lesions found in one patient was larger when using the CCF (0.86 +/- 0.96) than when using the NCF (0.58 +/- 0.81). For mucosal resection, 40 flat or wide-based lesions including 6 mucosal carcinomas were resected with EMRC. We experienced only one pinhole perforation of the ascending colon by heat damage, which was treated successfully by surgery. There was no other major complication or recurrence. CONCLUSION: The cap-fitted endoscope was equal in maneuverability, was excellent in sensitivity in comparison with the regular colonoscope, and was thought to be feasible both in screening and mucosal resection.

Aged↗

A prospective, randomized clinical trial of preoperative bowel preparation for elective colorectal surgery--comparison among oral, systemic, and intraoperative luminal antibacterial preparations.

During a one year and six month period, 137 patients undergoing elective colorectal surgery for carcinoma were randomly allocated to three groups. Patients in group A received oral tobramycin and metronidazole for three days prior to surgery. Patients in groups B and C received systemic antibiotic, a second generation cephem cefmetazole, every 3 hours during surgery. Patients in group C also received a luminal preparation of tobramycin during surgery. All patients received mechanical bowel preparation in the same manner. The incidence of postoperative wound sepsis was 10.9% in group A, 9.8% in group B, and 10.0% in group C. There were no significant differences in postoperative wound sepsis among the three groups. The oral antibiotic regimen induced a greater change in intestinal flora and was associated with more frequent postoperative diarrhea. Although the preoperative bowel preparation taken for patients in group A could not sufficiently reduce the intestinal bacterial count, systemic antibiotic prophylaxis was simple and cost-effective. There was no additional advantage in combining the systemic and luminal antibiotic preparations. Therefore, for elective colorectal surgery, we recommend intravenous infusion of second generation cephem cephmetazole with mechanical bowel preparation.

Administration, Oral↗

[A randomized comparative study of surgical adjuvant chemotherapy using 5-fluorouracil and dl-leucovorin with CDDP 5-FU and dl-leucovorin for colorectal cancer].

A randomized comparative study of surgical adjuvant chemotherapy using dl-leucovorin (dl-LV) and 5-fluorouracil (5-FU) (FL-therapy) with CDDP, 5-FU, and dl-LV (PFL-therapy) was conducted. The following were the administration schedules: Arm A was 13 mg/m2 of CDDP, 300 mg/m2 of 5-FU, and 30 mg/body of dl-LV for 5 consecutive days and arm B was 300 mg/m2 of 5-FU and 30 mg/body of dl-LV for 5 consecutive days. Both regimens were followed by biweekly administration of the same dose of dl-LV and 5-FU in outpatients. Arm A was started at the 26th postoperative day and arm B at the 21st day on average. Some 26 cases composed of 11 cases of arm A and 15 cases of arm B completed the administration schedules. Only one case in arm A was complicated by local recurrence around 35 months after operation. Major toxicities were anorexia and neutropenia. Both toxicities were seen more in arm A than in arm B, showing complete recovery in all cases. These data suggest that PFL-therapy and FL-therapy seem to be possible and promising surgical adjuvant therapies for advanced colorectal carcinoma.

Adenocarcinoma↗

[Hepatic intra-arterial 5-fluorouracil and CDDP administration in patients with colorectal cancer metastasis to the liver].

Eleven patients with hepatic metastasis from colorectal cancer were treated by combined chemotherapy with 5-FU and CDDP. Metastatic tumor was not resected or incompletely removed in all cases. 5-FU (180 mg/m2/day) as a 7-day continuous hepatic arterial infusion (HAI) with CDDP (10 approximately 20 mg/2 weeks) or intermittent high dose 5-FU HAI (1,000 mg/m2/5 h) with CDDP (10 approximately 20 mg/2 weeks) was administered, followed by a one-week rest. The overall response rate was 63.8%. There was a significant prolongation in overall survival compared with controls. Drug-related toxicity was observed in 10 cases (91.0%), but nothing serious. Survival can be prolonged with almost normal quality of the life in patients with colorectal liver metastasis.

Adult↗

[Assessment of disturbance of urinary bladder function after an operation for rectal cancer].

Disturbance of urinary bladder function occurs frequently after operations on rectal cancer. Clinical studies of 15 male patients with resected rectal cancers revealed a close relationship between the disturbance of urinary bladder function and the extent to which the autonomic nerves in the pelvis were disturbed. Clinically, transection of the hypogastric nerve did not affect urinary function. Branches to the urinary bladder in the pelvic plexus controlled bladder function bilaterally. Transection of one side of the pelvic splanchnic nerve (PSN) did not affect bladder function. Partial transection of the bilateral PSN strongly affected bladder function, but in these cases, compensation by the non-disturbed PSN improved urinary bladder function 3 months after the operation. It seems possible that the lower-grade branches to the urinary bladder in the PSN may control bladder function. Uroflowmetry, amount of residual urine, cystometry, and urinary bladder compliance were all useful in assessing disturbance of branches to the urinary bladder in the PSN. To assess the grade of severe Clinical cases, it proved the most convenient to examine the uroflowmetry and amount of residual urine.

Adult↗

[Controversy on therapeutic modality to early colorectal carcinomas from the viewpoint of histopathological features].

We have investigated prognostic factors of early colorectal carcinoma mainly based on pathological aspects. We have experienced 175 lesions of early colorectal carcinomas, in which 116 lesions were obtained by operation and 59 lesions were endoscopically resected. Histologically, well differentiated adenocarcinoma was subclassified into two types, pure type and combined type. We expressed extent of submucosal invasion by sm depth and sm width. We represented specific pathological features in the invasive margin as single cell infiltration (SCI) and mucinous component (MUC), which were indicating biological invasiveness of submucosal invasive carcinomas. As a result of this research, we concluded that minimal submucosal invasion of early colorectal carcinoma should be defined as carcinoma having sm depth less than 1 mm and sm width less than 5 mm, on the contrary, sm massive invasion as sm depth above 1 mm or sm width above 5 mm. We guessed that SCI was good parameter of lymphatic invasion because of their correlation to other adverse prognostic factors. We make a policy that subsequent intestinal resection should be performed to early colorectal carcinomas, which having SCI or MUC concomitant with the degree of submucosal invasion more than our standard despite of absence of vascular permeation.

Adenocarcinoma↗