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K Sawai

Publications and source records attributed to K Sawai.

18 recordsLinked to original sources

Prophylaxis with carbon-adsorbed mitomycin against peritoneal recurrence of gastric cancer.

Attempts to prevent peritoneal carcinomatosis after surgery for gastric cancer by intraperitoneal administration of anticancer drugs have not been successful, largely because the drugs are not retained in the peritoneal cavity. We have assessed the prophylactic efficacy of a delayed-release preparation--mitomycin adsorbed onto activated charcoal (M-CH). 50 patients with gastric cancer and serosal infiltration were randomly assigned intraperitoneal treatment with M-CH (50 mg mitomycin intraoperatively) or no anticancer prophylaxis (control). Survival rates for the 3 years of follow-up were significantly higher among the 24 M-CH recipients (1 was lost to follow-up) than among the 25 controls (p less than 0.01). There were significant differences in survival between the groups at 1.5 years after randomisation (difference 34.6% [95% confidence interval 8.5-60.8%]; p less than 0.01) and at 2.0, 2.5, and 3.0 years (41.7% [14.2-69.1%]; p less than 0.005). The concentration of mitomycin was significantly higher in peritoneal exudate than in plasma for 24 h after drug administration. Side-effects were slight and well tolerated. Thus, peroperative intraperitoneal treatment with M-CH seems to improve survival after gastrectomy for gastric cancer, presumably by a prophylactic effect on peritoneal recurrence.

Adsorption

Parthenogenetic development of bovine oocytes treated with ethanol and cytochalasin B after in vitro maturation.

The present study was conducted to investigate the effects of different culture durations (24-36 hr) on bovine oocyte maturation in vitro and the effect of the presence or absence of cumulus cells at the time of treatment to induce parthenogenetic activation (exposure to ethanol and cytochalasin B; CB) (experiment I). The effects of dosage (2.5 or 5.0 micrograms/ml) and incubation time (2.5, 5, or 10 hr) in CB (experiment II) on the subsequent development to the blastocyst stage in vitro was also investigated. In experiment I, cleavage and development to the blastocyst stage were not affected by the presence or absence of cumulus cells at the time of parthenogenetic activation. However, the 24-hr culture duration for in vitro maturation had a significantly lower rate of development to the blastocyst stage than the longer culture durations (27-36 hr). In experiment II, treatment with 5 micrograms/ml CB for 5 hr showed the highest percentage of development to blastocyst in the oocytes matured for both 27 and 30 hr. To determine the viability of the parthenogenetic embryos (morulae and blastocysts), four recipient heifers received two embryos each, and one heifer was found to be pregnant on day 35 following transfer. Although fetal heartbeat was not observed, the subsequent estrus was prolonged in all heifers. The present results demonstrate development of in vitro-matured, parthenogenetically activated bovine embryos up to the preimplantation stage.

Animals

Lymph nodal vital staining with newer carbon particle suspensions compared with India ink: experimental and clinical observations.

CH40 and CH1500AA are newly prepared carbon suspensions which were examined as vital staining dyes for their usefulness in visualizing lymphatics at operation and to blacken lymph nodes. In mice, these carbon suspensions at 0.001 ml/g of body weight and India ink were injected subcutaneously into the footpad of the right hindpaw. Regional lymph nodes were visualized and were examined stereomicroscopically to determine how intensely these nodes blackened with carbon suspensions. Compared with India ink, CH40 and CH1500AA blackened the regional lymph nodes much faster and more vividly (1-8 min. after subcutaneous injection). As analyzed by centrifugal particle size distribution, CH40 and CH1500AA are narrowly distributed with a small particle size (150 and 167 nm, respectively, in mean diameter). By contrast, India ink is comprised of widely distributed and relatively large particles in suspension (mean diameter--254 nm). In 10 patients undergoing radical gastrectomy for treatment of stomach cancer, CH40 blackened 69% of regional lymph nodes with metastases (38 of 55) and 76% of those nodes without metastases (387 of 512).

Animals

Enhancement of cytotoxicity in mouse regional lymph nodes by local tissue injection of aclacinomycin A.

The effect of local tissue injection of activated carbon particle adsorbing aclacinomycin A (ACR-CH) on the cytotoxicity in popliteal, inguinal, paraaortic, and axillary lymph nodes was investigated in mice. Aclacinomycin (0.2 mg/kg), a potent antineoplastic drug was injected subcutaneously into the footpad of mice in the form of ACR-CH or as an ACR solution. After a single injection of ACR-CH, the regional nodal cytotoxic response against mouse YAC-1 lymphoma cells was markedly increased and sustained for 7-10 days. The immune response was also increased after ACR solution but to a much lesser extent. These effects were found in popliteal, inguinal, and paraaortic lymph nodal effector cells but not in the more remote axillary nodes. Absorption of adherence cells largely abrogated the cytotoxic response. These results suggest that ACR-CH did not impair but rather stimulated nodal immunoregulatory cells. Potentially ACR-CH may enhance immune responsiveness of regional lymph nodes after subcutaneous administration while concomitantly curtailing neoplastic growth in these same lymph nodes.

Aclarubicin

[Principles of lymphadenectomy for gastric cancer according to depth of wall invasion, tumor site and regional lymphatic flow].

The principles of lymphadenectomy for gastric cancer are discussed based on the 1010 gastric cancer patients who underwent gastrectomy with curative intent between 1970 and 1990. In 147 of these patients, regional lymphatic flow was examined by injecting activated carbon particles CH40. 1) One hundred and ninety patients (19.8%) with cancer invasion confined to the mucosa had lymph node metastases limited to the perigastric nodes (n1). 2) Two hundred and five patients (20.3%) had cancer invasion to the submucosa. For 99.0% of them the lymph node metastases were limited to compartment II (n2). 3) Three hundred and twenty-two patients (31.9%), with cancer invasion to the muscle layer or serosa and limited to the upper or middle third of the stomach, had lymph node metastases in compartment II and No. 12 (n 2 + No. 12). 4) Two hundred and ninety-three patients (29.0%) with cancer invasion to the muscle layer or serosa and limited to lower third of the stomach or to its extension, had lymph nodes metastases in compartment III (n3). 5) Consequent to observations on the regional lymph flow of the stomach by CH40, we now perform paraaortic lymph node dissection, when gastric cancer patients with serosal invasion have metastases lymph nodes No. 2, 7, 8a, 9, 11, 12 or No. 14V.

Humans

[Two cases of pulmonary metastasis of colorectal cancer successfully treated with oral 5'-DFUR].

Two patients with pulmonary metastasis of colorectal cancer, who had previously undergone radical resection of primary tumor, were orally administered 5'-DFUR at 1,200 mg per day. Complete responses were obtained in both. The duration of response was 42 and 13 weeks, respectively. Some side effects such as diarrhea and aguesia were found in each patient, but the treatment could be continued after temporary suspension for a while or by decreasing the dosage. We concluded that pulmonary metastasis of colorectal cancer can respond remarkably to oral administration of 5'-DFUR at 1,200 mg per day, if the tumor cells have sensitivity to this drug.

Adenocarcinoma

The significant reduction of high molecular weight-kininogen in synovial fluid of patients with active rheumatoid arthritis.

It has been proposed that kinin system was implicated in inflammatory joint diseases such as rheumatoid arthritis. Our present work provides further support on the involvement of the kinin system. In osteoarthritis patients, the total, high molecular weight (HMW)-, and low molecular weight (LMW)-kininogen levels in synovial fluid were not different from those in plasma. On the contrary, in rheumatoid patients, HMW-kininogen level in synovial fluid was significantly lower than that in plasma, whereas LMW-kininogen level in synovial fluid was not different from that in plasma. The reduction of HMW-kininogen level in synovial fluid was much more marked in active cases of those who showed high blood sedimentation rate and high C-reactive protein value. Furthermore, the reduction was closely related to the clinical severity. In active rheumatoid patients, HMW-kininogen level was further reduced in the synovial fluid after withdrawal of indomethacin.

Adult

The epidemiological study on the correlation between serum lipids and cerebro-cardiovascular disease.

1. There were significant correlation between hyperlipidemia and obesity, hypertension, abnormal ECG and abnormal eyeground. 2. The incidence of cerebral hemorrhage was closely associated with hypertension but not with hyperlipidemia. 3. It was proved that hypertension with both hyper-Ch and hyper-TG was highly related to the development of cerebral infarction. 4. It seemed that the incidence of myocardial infarction and angina pectoris was related to hypertension with hyper-Ch. 5. Therefore, the present study suggested that the control of hypercholesterolemia and hypertriglyceridemia was useful for the prevention of cerebro-cardiovascular disease.

Adult