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Biomedical subjects

K Miyagishima

Publications and source records attributed to K Miyagishima.

10 recordsLinked to original sources

Food safety in international trade.

International approaches are indispensable in the management of foodborne risks to health. The contributions made by WHO and the World Trade Organization to achieving food safety are discussed below, and particular reference is made to the Agreement on the Application of Sanitary and Phytosanitary Measures and to the work of the Codex Alimentarius Commission.

Commerce↗

Healthy Marketplaces.

Explore the source record for details and available documents.

Conservation of Natural Resources↗

[A survey of goals and the utilization of numerical goals in the health planning of 47 prefectures].

Health plans of 47 prefectural governments based on the Medical Law of 1985, were evaluated regarding four health planning factors: final goal, implementation plan, development of resources, and evaluation planning. Results of the evaluation showed that 8.5% of the 47 prefectures had defined future level of health based on numerical goals. On the other hand, all of the prefectures had developed numerical goals specifying the number of hospital beds in each medical district. A major component of health planning is improvement in the accomplishment of the implementation plan. There were 14 prefectures which had numerical goals for the upgrading of facilities and for manpower development to meet future health care activities. The following factors are required in the health planning to meet the needs for improving the health status of the population. 1) Including in the future health goals, in addition to the number of medical bed in regional areas, objective levels of health that should be attained. 2) Development of practical plans for evaluation of effectiveness of health planning.

Health Planning↗

[Total body hyperthermia and continuous hyperthermic peritoneal perfusion as an adjuvant therapy in advanced gastric cancer].

Between September 1986 and July 1989, adjuvant hyperthermic therapy, consisting of either total body hyperthermia (TBHT) or continuous hyperthermic peritoneal perfusion (CHPP), was given to a total of 41 patients immediately following gastric resection for cancer. TBHT was performed in 1 curative- and 11 noncurative-gastrectomized patients (1 stage III and 11 stage IV), and CHPP in 18 curative- and 11 noncurative-gastrectomized patients (6 stage I/II, 10 stage III and 13 stage IV). For TBHT, the blood was warmed and maintained at 42 degrees C for 3 hours by means of a V-V bypass connected to an extracorporeal heater-pumping system. When the hyperthermic condition was established, anti-cancer drugs were administered intravenously. In CHPP, 46 degrees C saline containing anti-cancer drugs were infused at a constant rate through a tube placed at the Douglas fossa. The perfusate was drained out through another tube positioned at an uppermost part of the abdominal cavity. The hyperthermic condition was monitored by measuring the outflow temperature. Complications encountered were bone marrow depression, liver damage and pyrexia, and were more frequently experienced by the TBHT patients. Patients under 65 years of age who had had an absolute noncurative gastrectomy but with TBHT survived significantly longer than those without TBHT. When the patients who had undergone gastrectomy with CHPP for a cancer of more than se penetration were compared with those without CHPP, there was no significant difference in survival found between these two populations. This unsatisfactory result could be partly attributable to difficult maintenance of appropriate (sufficiently high) and constant perfusate temperature.

Adult↗

[Continuous hyperthermic peritoneal perfusion (CHPP) therapy in advanced gastric cancer].

In CHPP therapy for advanced gastric cancer, a perfusate containing 20 mg CDDP and 8 mg MMC in 1,000 ml physiologic saline warmed at 47 degrees C was infused at a constant rate of 200 ml/min into the pouch of Douglas. The intraperitoneal temperature at the supra-pancreatic region was around 39.0 degrees C. To obtain a more stable and higher intraperitoneal temperature, the infusing rate was increased to 400 ml/min. This yielded a 3 degrees C higher temperature (42 degrees C) at the same measuring site. However, the temperature recorded at various intraperitoneal sites did not always reach such an effective range. The maximal plasma concentrations of MMC determined during CHPP at the 200 and 400 ml/min infusion were 0.09 +/- 0.03 and 0.11 +/- 0.03 microgram/ml, and those of CDDP 1.6 +/- 0.4 and 1.7 +/- 0.3 microgram/ml, respectively, all of which were not significantly different. When an intraperitoneal dosage of 20 mg MMC was given to 3 patients, the portal venous blood, at 10 min after the administration, produced a 1.7 times higher concentration of the agent than did the peripheral venous blood. This discrepancy between the two concentrations was much smaller than found by other investigators in animal experiments.

Adult↗

[Adenoid cystic carcinoma of the esophagus].

A 56-year-old man was admitted with the complaint of dysphagia. X-ray studies and endoscopy revealed a protruding tumor at the middle third of esophagus. Under the diagnosis of esophageal cancer, subtotal esophagectomy was performed. A Borrmann type I like tumor measuring 6.7 X 3.8 X 2.2 cm was identified on the resected specimen. The surface of the tumor was irregular, nodular and covered with thin compressed esophageal mucosa. The histology of the tumor was consistent with adenoid cystic carcinoma. Incidentally, small foci of invasive squamous cell carcinoma were found adjacent to this tumor. There was no lymph node or remote organ metastasis.

Antineoplastic Combined Chemotherapy Protocols↗

[Primary adenosquamous carcinoma of the stomach--a case report].

A 56-year-old man was hospitalized with the complaint of upper abdominal discomfort. A gastrointestinal series revealed a filling defect in the body of the stomach. Under the diagnosis of gastric cancer, total gastrectomy was performed. Borrmann III type cancer measuring 5 X 4 cm, extending to the antrum and the upper portion of the body of the stomach, was identified in the body. Histologically, most of the tumor consisted of squamous cell carcinoma. Adenocarcinoma and a small nest of squamous metaplasia were observed at the peripheral wall of this tumor. The pathological diagnosis was adenosquamous carcinoma. In some regional lymph nodes, metastasis of adenocarcinoma was observed.

Adenocarcinoma↗