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Biomedical subjects

H Habu

Publications and source records attributed to H Habu.

At least 19 recordsLinked to original sources

[A case of cardiac lipoma of the anterior tricuspid leaflet].

A 42-year-old man with cardiac lipoma of the anterior tricuspid leaflet is reported. He had a chief complaint of epigastric discomfort, and a pansystolic murmur was heard at the left sternal border in the 4th intercostal space. Two-dimensional echocardiography disclosed a mobile high density stalkless mass having several areas of low density. Two-dimensional Doppler echocardiogram revealed a moderate degree of tricuspid regurgitation. These findings were more clearly visualized on transesophageal echocardiogram. MRI revealed a high signal intensity on the T1-weighted image and a high radiodensity surrounding the mass using a contrast medium of Gd-DTPA. A 2.0 x 1.3 x 0.8 cm hemispherical, lobulated and sessile yellow mass was excised by means of open heart surgery, and tricuspid valvuloplasty was performed. The mass was adipose tissue and was surrounded by fibrous tissue just under the lamina fibrosa. These findings were compatible with those of the preoperative examinations, although the preoperative diagnosis was not conclusive. This was our first case of cardiac lipoma in which the tricuspid valve was successfully excised.

Adult

Multiple carcinoid tumors of the stomach with hypergastrinemia.

A 42-yr-old woman presented with multiple carcinoid tumors in her stomach and a markedly elevated serum gastrin level. Total gastrectomy was performed, and 22 small carcinoid tumors were found in the gastric fundus and body. A high serum gastrin level was revealed in the gastric drainage veins; still more gastrin was detected in the carcinoid tumors by the immunohistochemical method, and many secretory granules were found in the tumor cells with an electron microscope. The fundic gland showed marked atrophy, and there was some conglobation of endocrine cells (ECL cells). This case suggests a hypothetic sequence of anacidity due to atrophic gastritis----hypergastrinemia----proliferation of ECL cells----multiple carcinoids. A search of the Japanese literature revealed that 26 cases of multiple carcinoid tumors in the stomach have been reported so far, and most of them support this hypothesis.

Adult

The use of endoscopic ultrasound in determining the depth of cancer invasion in patients with gastric cancer.

Endoscopic ultrasonography (EUS) was performed in 110 patients with gastric cancer to examine the depth of cancer invasion. The normal gastric wall has a five-layer structure on EUS. In 19 lesions, changes on EUS were limited to the first and/or second layers, suggesting that invasion was limited within the mucosa. In 91 lesions, changes were evident in the third or deeper layers. Alterations in the EUS appearance could be divided into two types: type A, with destruction of the layered structure and type B with thickening of the layers. The amount of interstitial tissue in cancer was classified as medullary or intermediate in 90% of type A, and as scirrhous in 82% of type B tumor. The EUS diagnosis of invasion was 95% accurate for stage M cancers, 75% for SM, 64% for PM, 100% for SS, 79% for SE, and 100% for SI lesions. The overall accuracy was 81%. Accompanying fibrosis and metastatic perigastric nodes were the main reasons for overestimating the extent of disease.

Gastroscopy

[Diversity of complement activation by lentinan, an antitumor polysaccharide, in gastric cancer patients].

Lentinan, a pure polysaccharide, augments many immune responses in vivo but not in vitro. Therefore reaction with any factor is thought to be required for triggering of immunopotentiation by lentinan. To clarify the role of complement in this effect, we investigated whether lentinan could activate alternative pathway of complement or not and the relation with the immunopotentiation in 13 gastric cancer patients. C3, C3a, C5 and C5a levels as parameters of complement activation and interleukin-2 producing activity as parameter of immunopotentiation were assayed before and immediately after intravenous injection of lentinan. Among these complement components, remarkable change was observed only in C3a level. C3a level elevated to more than 1000ng/ml from less than 300ng/ml. And according to the degree and continuation of the elevation, these patients were classified into 3 types-(1) every time little elevation, (2) first remarkable and thereafter little elevation and (3) continuous remarkable elevation. Such an elevated C3a level returned to the level before lentinan injection within one day. When C3a level elevated to more than 1000ng/ml, leukocyte counts of peripheral blood decreased significantly and interleukin-2 producing activity increased concomitantly. Thus, there was diversity in response to lentinan and complement activation was suggested to have contribution in immunopotentiation by lentinan.

Adjuvants, Immunologic

Results of surgery in patients with gastric cancer extending to the adjacent organs.

Of 1,211 gastric cancer patients who underwent operations, 196 (16%) had cancers extending to the adjacent organs. Palliative procedures were performed in 66 (34%), and gastrectomies in 130 (66%). Operative mortality for the former was 6% (4/66), but was 0% for the latter. Among 130 gastrectomized patients 91 (70%) underwent combined resections of the invaded organs. With respect to the mean survival, significant differences were noted between gastrectomized (18 months) and non-gastrectomized patients (4 months), between the patients with (20 months) and without (12 months) combined resections, and between curative (27 months) and non-curative resections (13 months). Presence or absence, and degree of peritoneal, liver and lymph node metastases were also prognostic among gastrectomized patients. Combined resections of the involved organs showed slight, but positive, effects on survival of patients with liver metastases, but they seemed to be ineffective in the presence of peritoneal metastases. In the case of patients with apparently incurable factors such as P2-3, H2-3 or N4, gastrectomy was prognostically ineffective.

Colonic Neoplasms

Clinical studies of early gastric cancer.

Three hundred and seventy-four cases of early gastric cancer in which invasion was limited to within the submucosa have been resected in our hospital during the past 15 years. The incidence of early gastric cancer was 31% among the total of 1,214 cases of gastric cancer operated on. There were 37 cases with multiple lesions and 5 cases with insufficient data. In this series, clinical investigations were performed in 332 cases excluding the above 42 cases.

Adenocarcinoma

[A case of pancreatic carcinoma coexist with pancreatic pseudocyst].

Report of Pancreatic carcinoma coexist with Pancreatic pseudocyst is rare. We have experienced a case of pancreatic carcinoma which was diagnosed and resected by coexisted pancreatic pseudocyst. The patient aged 53 years, complained of epigastric distension and visited our hospital. There was no past history of abdominal injuries and he didn't drink much. A cyst 7cm in diameter was found at pancreatic tail lesion by our examination. By blood chemistry tumor marker CA19.9 was 310 and he complicated diabetes mellitus. We suspected pancreatic carcinoma coexist with pancreatic pseudocyst, so distal pancreatectomy and splenectomy was performed. We found a solid tumor sized about 3cm in diameter at just proximal of pancreatic cyst. Since perioperative histological examination revealed adenocarcinoma, we performed lymph node dissection. The tumor was highly differentiated adenocarcinoma which invaded retroperitoneum in some lesion. The patient died 10 months later by recurrence. We concluded that we must take into account not only laboratory finding but their clinical course in such cases.

Adenocarcinoma

[Manipulation of gallium restorative materials. 1. Control of wetting action of mixture by mulling with ethanol].

The wetting action of gallium alloy is a handicap when handling the material. Ethanol mulling after mixing was assayed in an attempt to control the wetting action of such mixtures. A mixture of gallium and Ag-Sn-Cu spherical alloy particles was mulled with a small piece of an ethanol-soaked sponge for 10 seconds following mixing by an amalgamator. The effect of this mulling on the adherence of the mixture to the capsules, physical properties and microstructures was determined. Mulling with ethanol effectively controlled the wetting action of the mixture, and reduced adherence to the capsules without affecting physical properties. A decreased reaction phase around the alloy particles was observed in the microstructure of the ethanol-mulled specimen.

Dental Alloys

[Study on the disinfection of alginate impressions. 2. Dimensional stability and surface roughness after immersing or spraying treatment with povidone-iodine solution].

The dimensional changes of four alginate impression materials and the surface roughness of stone casts following the treatment with 0.07% Povidone-Iodine solution were evaluated. The impressions were treated by either immersing or spraying. The dimensional change was measured by an electronic micrometer with a non-pressure direct method for 60 minutes. The surface roughness of stone casts obtained from the impressions following optimal treatment was also measured. Two products were dimensionally stable for 60 minutes after spraying with the solution, while the other two were stable for 30 minutes in the solution. No effect of the treatment was observed on the surface roughness of stone casts.

Alginates

[Improved method for combined agar/alginate hydrocolloid impression. Bond strength of combination agar-gel/alginate].

The authors have been developing an improved method that an alginate mix is applied to gelled agar to obtain precise impressions. In the present study, the bond strength of the improved method was investigated. Thirty-one agar impression materials and thirteen alginate impression materials were used. The tensile-bond strength between an alginate (VAd) and various agars (exp. 1), and between an agar (DBRS) and various alginates (exp. 2), was measured by means of the Instron Testing Machine (model 1123) operated at a cross-head speed of 500 mm/min. The bond strength varied with the combinations of the products of agar and alginate. The bond strength of some combinations was higher than the stress in removing impressions from the mouth. Comparing the products of the same manufacture, the bond strength varied with the different colors (composition) of agar, but didn't vary with the different types of cartridge++ or syringe. The result suggested that the bond strength between agar and alginate depended, not only on the agar, but also on the alginate.

Agar

[Prognostic factors in gastric cancer with serosal invasion--importance of the extent of cancer infiltration in the subserosal layer].

The extent of cancer infiltration in the subserosal layer has been examined in 214 stomachs resected for cancer with a serosal invasion. The extent was 4 cm or less in 109 patients (Group A) and 5 cm or more in 105 patients (Group B). The resection was estimated as being non-curative in 26% of Group A and in 52% of Group B (p less than 0.001). Peritoneal dissemination was the outstanding non-curative factor in the latter. The five-year survival rate was 39% in Group A and 14% in Group B (p less than 0.001). The survival rate after the curative resection was 49% and 26%, respectively (p less than 0.01). In Group B, peritoneal dissemination was the main mode of recurrence after the curative resection.

Adult

Gastric cancer in elderly patients--results of surgical treatment.

Between 1972 and 1984, a total of 848 patients underwent gastrectomies for gastric cancer. One hundred and thirty-nine patients (16%) were aged 70 and over (elderly group), the remaining 709 being under 70 (control group). The operative morbidity and mortality rates were 29.5% and 4.3% in the elderly group, as compared with 23.0% and 1.8% in the controls. The 5-year survival rate was 47.2 +/- 5.3% in the former and 53.9 +/- 2.4% in the latter. In neither comparison was the difference statistically significant. The mortality rate after total gastrectomy in the elderly group was 8.6% for the overall period, but it has reduced to 5.3% in the past five years. These data would seem to justify a liberalized indication for radical surgery in elderly patients. In the elderly group, the mean operating time and the amount of bleeding in the operative-death patients significantly exceeded those in the surviving patients. Non-curative resection in elderly patients could not be generally accepted, since the mean survival time was only 11 months, with high morbidity (40.5%) and mortality rates (8.1%).

Age Factors

[Clinico-pathological study on recurrent gastric cancer after curative resection].

Among 675 patients who had undergone curative resection of gastric cancer during last 13 years, 113 died of cancer recurrence. One hundred and forty-five patients who had survived longer than 5 years were used as controls. In the recurrence group, the primary lesion was larger and the lymph node metastasis more common as compared with the surviving controls. Moreover, these lesions were often located at the upper third of the stomach and exhibited Borrmann 3 or 4 type. Prognostic serosal invasion was positive in 75 per cent of the recurrence group and negative in 84 per cent of the surviving controls. The most frequent mode of recurrence was hematogenous metastasis in negative prognostic serosal invasion (54%) and peritoneal disseminated metastasis in positive prognostic serosal invasion (52%). There were no differences in the distribution of gross and histological types of cancer in the modes of recurrence. It was found that peritoneal dissemination and/or local recurrence dominated as the mode of recurrence (51%), followed by hematogenous metastasis (34%), but that lymph node recurrence was uncommon (15%). In peritoneal disseminated cases, long-term survival following reoperation should not be expected. It was suggested that in order to improve the prognosis in the case of hematogenous metastasis, postoperative immunochemotherapy should be applied.

Adenocarcinoma

[Surgical treatment of esophageal cancer and gastric cancer in relation to a questionnaire on the daily lives of the patients].

A questionnaire on the daily life was mailed to patients who had undergone esophagectomy and retrosternal esophagogastrostomy. Replies came from 29 patients. Employment of the patients was 66%. However 97% of the patients could go out and enjoy their own ordinary lives. Replies of questionnaires came from 66 patients aged 70 and over who had undergone gastrectomy. Employment of the patients who had worked before operation, was decreased, 60%. However, 88% of the patients could go out and enjoy their own ordinary lives.

Employment

Prognostic factors of early gastric cancer--results of long-term follow-up and analysis of recurrent cases.

The prognosis of early gastric cancer (EGC) is generally excellent, however, EGC is not an exception to recurrence. In order to know what type of EGC is liable to recur, long-term results were studied in 304 cases of resection. The cumulative 10-year survival rate was poorer in patients with positive lymph nodes than in those with negative nodes (52.8 +/- 15.8 per cent vs 94.1 +/- 2.4 per cent; p less than 0.05). It was also less favorable when the EGC was greater than 5 cm in diameter (61.5 +/- 13.2 per cent vs 92.9 +/- 2.4 per cent; p less than 0.05). Among 50 cases which died postoperatively, six deaths were due to recurrence. A predominant mode of recurrence was hematogenous metastasis (4/6). The characteristics of EGC which recurred later included large cancer (greater than or equal to 5 cm) (6/6), macroscopically combined-type cancer (5/6), cancer of depth invasion to the submucosa (4/6) and histologically differentiated cancer (6/6). Lymph node dissection was not carried out in two of these patients at their primary operation. Adjuvant therapy should be added in the EGC bearing risk factors depicted above. Primary cancer in other organs, either metachronous or synchronous, was found in 13 cases (4.3 per cent). Colonic cancer, in particular, was seen in three, and it was 4.8 times as frequent as the expected number of the general population, calculated using the person-year method.

Adenocarcinoma

[A tentative subgrouping of the stage IV gastric cancer based on their postoperative prognosis].

Out of 211 patients with the Stage IV gastric cancer who survived gastrectomy, 105 died within one year (short-lived group) and 40 survived more than two years (long-lived group). The grades of the four factors, P, H, N and S, were compared between them. Combination of P0 and H0 was seen less often in the former group than in the latter (48% vs. 78%, p less than 0.005). While no patient with P3, H2-3 or N4 could live more than two years. The year-by-year survival rates were calculated according to the grades of the four factors. The 1-year, 2-year, 3-year and 4-year survival rates for the patients with both P0 and H0 were significantly higher than those of the remaining patients. The 1-year and 2-year survival rates for the patients with N0-3 significantly exceeded those of N4 patients. Based on these findings, we finally proposed a new subgrouping of Stage IV:IVa [P0, H0, N3, S3] and IVb [P1-3, H1-3, N4]. At every year up to five, the survival rates for IVa significantly exceeded those of IVb. Another merit of this classification consists in that most cancer in IVa might be radically resected if we add the lymph nodes dissection of R3 and the combined resection of the invaded organs.

Adult