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Biomedical subjects

F Hanyu

Publications and source records attributed to F Hanyu.

At least 19 recordsLinked to original sources

[The efficacy of pyloroplasty affecting to oral-intake quality of life using reconstruction with gastric tube post esophagectomy].

After resection of esophageal carcinoma, pyloroplasty was undergone due to vagal denervation. Especially the ability of oral-taking is related to the return of general societies after operation. This was a randomized study on whether pyloroplasty was effective by functional and nutritional evaluations. From 1992 to 1995, 67 patients with esophageal carcinoma underwent subtotal esophagectomy and reconstruction using a gastric tube. Thirty-four patients were randomized into the pyloroplasty group (P), and 33 into the control group (N). The functional evaluation was done with (1) food-taking scoring (2) A foods with barium granules ejection time (3) a gastric emptying time of 99m Technecium (4) 75 g OGTT. The nutritional evaluation were (1) Rapid Turn-over Protein (RTP) (2) Total Lymphocyte Count (TLC) (3) ONODERA's Prognostic Nutritional Count (PNI) (4) Fluctuation rate of body weight. The elevations were performed 1 and 6 months after operation. Functional evaluation were as follows. (1) Quantity of oral-intake was not significant different between (P) and (N) both improving those quantities in 6 months. Regarding several complaints including in regurgitation, (P) had a few symptoms comparing to (N), almost half of cases complained of some symptoms and did not improving in 6 months. (2) The food ejection time of foods were 19.6 +/- 31.0 min, in (P), 32.9 +/- 37.2 min, in (N), (3) In the Tc gastric emptying time, we calculated as 50% ejecting time and residual rate of 30 min. In 50% ejecting time less than 20 min., (P) shared in 65, 80%, (N) in 39, 40% in 1 and 6 months. (4) In 75 g OGTT there were no significant difference between both groups, though several cases showed the dumping syndrome. In the nutritional evaluation, in RTP, TLC, PNI, and postope, body weight, there were no differences between the two groups. In conclusion, pyloroplasty several symptoms related to oral intake including regurgitation feelings, and in functional evaluation, there shows faster gastric emptying though there were no significant differences in the nutritional phases at 6 months follow-up. The results suggest that this procedure is not essential but it affects to the oral-intake QOL effectively.

Aged

Expression of p53 protein related to human papillomavirus and DNA ploidy in superficial esophageal carcinoma.

We examined the p53 protein and human papilloma virus (HPV) by immunohistochemistry and DNA ploidy by cytofluorometry in paraffin-embedded esophageal carcinoma tissue specimens. Sixty-one patients with superficial esophageal carcinoma were operated on between 1983 and 1991 without any prior treatment. Immunostaining of the anti-p53 protein antibody (CM1) was positive in 32 carcinomas (52%). Patients with p53-positive tumors had a poorer outcome than those with p53-negative tumors (P < 0.05). In addition, patients with p53-positive tumors did not have any characteristic site of relapse. Only 5 of the 61 patients (8.2%) had HPV-positive tumors. One of these 5 carcinomas expressed both p53 protein and HPV. Three patients with HPV-positive tumors which had invaded the submucosal layer died of relapse. A determination of DNA ploidy revealed 30 patients with aneuploid tumors, 13 with polyploid tumors and 18 with diploid tumors. The outcome of the patients with aneuploid tumors was worse than that of the patients with diploid tumor (P < 0.05). p53 protein expression was not associated with DNA ploidy; however, the 16 patients who had both p53-positive and aneuploid tumors had a worse prognosis than patients with p53-negative and aneuploid tumors (P < 0.01). These findings suggest that p53 protein expression in conjunction with DNA ploidy may be a useful indicator in evaluating the prognosis of patients with superficial esophageal carcinoma.

Adult

[Clinico-pathological study of preoperative chemotherapy of esophageal cancer by combined use of three drugs--cisplatin, 5-FU and leucovorin].

We compared the clinical and pathological effects of preoperative combination chemotherapy using CDDP, 5-FU, and response rate for the primary lesion, an 81.8% response rate for intramural metastasis, 100.0% for intraepitherial spread, and a low response rate of 40.7% for lymph node metastasis. Pathological examination showed a 55.2% response rate for the primary lesion. There were seven cases in which the clinical assessment indicated that treatment was effective and pathological examination showed that it was ineffective, and three cases in which pathological examination showed a better response than clinical assessment. Cases showing a better clinical response included in which necrotic cancer lesion had disappeared due to absorption by the time of pathological examination, those with tumor regrowth after preoperative evaluation, those evaluated as showing a poor response due to residual cancer at the margin. Cases showing a better pathological response included those having remaining necrotic tissues and those having myoma beneath tumor. For intramural metastatic lesions, the pathological response rate was 42.9%, being lower than the clinical response rate. Metastasis to 209 lymph nodes showed a 23.0% response rate, with the abdominal nodes showing a poor response in comparison with those of the cervix and mediastinum. In 26 patients receiving preoperative radiotherapy, there was a significantly higher frequency of such changes as fibrous scar tissue, foreign body giant cells, vacuolation of tumor cells, and hyaloid degeneration of the lesion in comparison with the group receiving chemotherapy. Another difference was that the radiotherapy group showed a higher response of tumors with venous and lymphatic involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[Study on the relationship between concentrations of 5-FU and PyNPase activity in tumor tissue during oral 5'-DFUR treatment in patients with advanced colorectal cancer].

Fifty-three patients with advanced colorectal cancer were given single oral doses of 5'-DFUR, 400 mg/body, preoperatively to assess the pharmacokinetics of 5'-DFUR in the patients with colorectal cancer and to investigate schedules for 5'-DFUR treatment. The time courses of PyNPase activity and 5-FU concentration in the resected tissue specimens were determined. This study indicated that: 1) High 5-FU concentration and PyNPase activity were noted in tumor tissue and lymph nodes. 2) Effective 5-FU concentration in tumor tissue was maintained even 24 hours after treatment. 3) Effective lymph node concentration of 5-FU was maintained even 8 hours after treatment. 4) PyNPase activity in tumor tissue was significantly higher than that in the normal intestinal mucosa (p < 0.05). These results suggest that 400 mg of 5'-DFUR at 8-hour intervals provides effective tissue concentrations of 5-FU for the treatment of patients with advanced colorectal cancer.

Adenocarcinoma

Extensive varices of ileocecum. Report of a case.

A man was admitted to our hospital because of intestinal reddish bleeding. Colonic varices were found at the cecum by colonoscopy. Angiography of the superior mesenteric artery showed that blood vessels were scant from the end of the ileum to the ascending colon. An operative view revealed the varices, but there was no trace of the ileocecal vein. This case, presenting a deficit of the ileocecal vein, indicated that the blood flow could not return via the ileocecal vein, and therefore there was an outflow through the varices to the surrounding intestine or abdominal veins. Such a case is probably unrepresented in the literature because it was caused by the total deficiency of the ileocecal vein and it was in the right colon.

Angiography

Induction of autologous tumor-specific cytotoxic T cells in patients with liver cancer. Characterizations and clinical utilization.

To generate autologous-tumor-specific cytotoxic T cells (CTL), peripheral blood mononuclear cells (PBMC) obtained from cancer patients were cultivated with autologous tumor cells for 5 days, and restimulated with interleukin-2 for another 5 days. Subsequently, their cytotoxic activity was examined by an in vitro cytotoxic test as well as by Winn's assay utilizing nude mouse transplanted autologous tumors. The present results demonstrated that these in vitro-stimulated cells were able to kill autologous tumor cells but not allogeneic tumors, and that they also inhibited the growth of transplanted autologous tumors in the nude mouse. Their cytotoxic activity was completely abrogated by pre-treatment with either anti-CD3 or anti-CD8, but not with anti-CD4, plus complement. Based on these studies, we injected these CTL via the hepatic artery into patients having either nonresected tumors or recurrent tumors in the liver. Among 15 treated patients (13 with hepatocellular carcinoma and 2 with metastatic liver cancer) 2 complete responses, 3 partial responses and 4 minor responses were observed. During the 6 to 25 months following injection of CTL, no definite signs of tumor recurrence or regrowth were demonstrated in these 5 responding patients (complete plus partial).

Animals

Flowcytometric measurement of the cell cycle of experimental tumors: some devices for accurate measurement of proliferative activity.

In this paper we present the cell cycle analysis using the latest flowcytometer, FACScan and dedicated softwares. Although the 5-bromodeoxyuridine (BrdU) and anti-BrdU method developed by Gratzner has become popular for analysis of cell kinetics, contaminating interstitial cells and cell doublets are still factors responsible for some mistakes in measuring the cell cycle accurately. These hampering cells were almost gated out on the catogram consisting of the forward scatter and DNA content (propidium iodide, PI). After that, the bivariate distribution of BrdU and PI according to the tumor growth showed reliable patterns. In LLC tumor the population, of which DNA content was compatible with S phase cells, was detected in the cytogram. Thus, the two-dimensional analysis of the cell cycle can demonstrate each population clearly. The results obtained from the BrdU method are more beneficial than autoradiography or microspectrophotometry, and reproducible data of the cell cycle parameters can be acquired with some devices described here.

Adenocarcinoma

[Clinico-pathological studies on the effects of preoperative hyperthermo-chemoradiotherapy of advanced esophageal carcinoma].

We report clinico-pathological studies on the effect of preoperative hyperthermia and chemotherapy combined with radiotherapy (HCR) for progress of the local curability of advanced esophageal carcinoma. The subjects of these studies were 17 patients who underwent subtotal esophagectomy after preoperative irradiation 40 Gy from 1980 to 1989, of which 8 patients had HCR, 6 patients irradiation only (R), 3 patients both irradiation and chemotherapy (CR). The clinical response rate of the patients with R or CR was 33% (PR 3, MR 3, NC 3), and the histological effective (Ef3 or Ef2) rate was 56% (Ef3 1, Ef2 4, Ef1 4). The clinical response rate of the patients with HCR was 88% (PR 7, MR 1), and the histological effective rate was 100% (Ef3 1 Ef2 7). HCR was more effective than R or CR for the local lesion of esophageal carcinoma histopathologically (p less than 0.05). However, the survival rate of patients with HCR was similar to R and CR, respectively. These results suggest that further improvement of the heating methods and the methods of combining hyperthermia with irradiation and chemotherapy is needed.

Adult

[A case report on the perforation of a gastric tube ulcer after esophageal reconstruction for cancer].

The development of peptic ulcers in gastric tubes used for esophageal reconstruction for cancer are rare. However, they can potentially cause serious complications, including perforation and hemorrhaging. We experienced a case in which an ulcer of large size developed in the gastric tube, and it was very difficult to treat. The patient was a 72-year-old man, who had undergone an esophagotomy of the thoracic portion, an gastroesophagoplasty through the anterior portion of the sternum, and postoperative radiotherapy 2 years ago. Eight days after his admission, the ulcer began excessive bleeding, and we performed an emergency operation. The ulcer perforated into the mediastinum, and developed an abscess involving the intrathoracic artery. After hemostasis and debridement, we resected the upper half of the gastric tube, closed the oral side of the remaining portion, and converted the cervical esophageal stump into an external fistula. The wound was covered with a flap. A histological examination showed an ulcer with no evidence of malignancy, and without any signs of healing. Five months were required for the wound to heal completely. After that, we succeeded in reconstruction through jejunal free-transfer, using the microvascular surgery technique. Some pathogenesis is suggested for gastric ulcers after gastroesophagoplasty. Despite performing a vagotomy, the secretion of acid from the gastric mucosa is common. Both this condition, and the deterioration of the mucosal barrier caused by surgery, can play significant roles in the development of the ulcer. The histological influence of postoperative radiotherapy is also important, as this treatment aggravates the circulatory disturbance, and disturbs the histological reaction necessary for healing.

Aged

A case of biliary cystadenocarcinoma with morphologic and histochemical features of hepatocytes.

A case of biliary cystadenocarcinoma is presented in which the lesion seemed to partially differentiate into hepatocellular carcinoma. This patient had a cystic tumor in the left lobe of the liver, the interior being filled with papillary tumors. Histologic examination disclosed papillary growth of columnar tumor cells, together with tumor cells akin to hepatocytes (they had a distinct cell boundary, nuclear membrane, and nucleolus) showing a cobblestone appearance in some areas. Electron microscopic examination of this area showed bile canalicular structures. Histochemically, the tissue stained positively with the Luna-Ishak canalicular (LIC) technique; periodic acid-Schiff (PAS) staining demonstrated coexisting glycogen granulo-positive cells and mucus-producing cells. Thus, in this biliary cystadenocarcinoma, some tumor cells demonstrated the morphologic and histochemical features of hepatocytes.

Aged

[Basic study of chemo-embolization of the liver using hydroxyapatite granules].

The purpose of this study was to elucidate the availability of hydroxyapatite (HAp) granules as a chemoembolic agent in chemo embolization therapy. A mixture of adriamycin (ADM) and an embolic agent (HAp, Lipiodol) was injected via hepatic artery in normal Wistar rats. Then the concentration of ADM in the liver serum transaminase level were measured serially. The remaining ADM in the liver was higher in groups with HAp granules than the others. The serum transaminase, however, were lower in the HAp groups. There are some advantages of HAp using as a chemo embolic agent. (1) HAp is a physiological biomaterial and seem to be safe for human. (2) HAp granules injected into the liver are easily detectable by X ray and ultrasonography. (3) HAp granules have a large surface area and this characteristic is suitable for a carrier of drugs. It is concluded that HAp granules have some necessary prerequisites for a chemo embolic agent and the application to clinical practice may be expected.

Animals

[Localization of pancreatic insulinomas by combined radiographic methods].

Seventeen cases with a total of eighteen insulinomas were examined by ultrasonography (US), computed tomography (CT), angiography, percutaneous transhepatic portal and pancreatic venous sampling (PTPS) and intraoperative ultrasonography (IOUS). We discussed about diagnostic accuracy of insulinomas on these diagnostic modalities. Tumor localization was achieved by US in 39%, CT in 72% and angiography in 81%. Although total 15 tumors (83%) can be correctly detected, multiple lesions were not completely ruled out. We recommended the criteria in PTPS as follows: Insulin concentration level above 200 mu U/ml. Or, both of insulin concentration ratio (step-up site/control) above three and elevation of the CPR concentration level on the PTPS. According to these criteria, the accuracy rate was 91%. Overall preoperative diagnostic accuracy was 100%. IOUS allowed us to detect the localization of the tumors completely.

Adenoma, Islet Cell

[Photodynamic therapy--its application for the treatment of esophageal cancer].

Effect of Photodynamic therapy (PDT) for esophageal cancer was discussed in this study. PDT has been performed on 9 cases of superficial esophageal cancer. All cases were followed periodically by endoscopy for 2 years 2 months to 6 years and no case has any local recurrence. But in 2 cases invaded submucosal layer, lymph node metastasis was recognized. We think PDT is one of the very effective therapies in the treatment of intramucosal cancer.

Aged