Biomedical subjects

M Maeta

Publications and source records attributed to M Maeta.

At least 55 records · Page 3Linked to original sources

PubMed1998

[A clinical comparison of orthodox myringoplasty and a simple method with fibrin glue].

Orthodox myringoplasty was clinically compared with a simple method with fibrin glue which rapidly came into wide use after the report of Yuasa in 1989. In Okayama Saiseikai General Hospital, orthodox myringoplasty was performed in 109 ears from September 1988 to November 1995, and the simple method with fibrin glue was performed in 84 ears from May 1991 to November 1995. The results showed that 90.8% of all eardrum perforations treated by orthodox myringoplasty and 79.8% of all eardrum perforations treated by the simple fibrin glue method were successfully closed. The rate of closure with each method was low in patients with large perforations. Generally speaking the hearing prognosis with each method, hearing improvement was observed right after the operation, and the improved hearing became stable about six months later. The difference in hearing prognosis was investigated in patients with small or large perforations. In patients with large perforations, the improved hearing slightly worsened a year after treatment by orthodox myringoplasty. These results show that the simple method with fibrin glue had the advantage of good hearing prognosis over orthodox myringoplasty, while it was inferior in the rate of closure of large eardrum perforations. It was considered that a simple fibrin glue method should be devised to prevent reperforation and should be used for patients with large perforations.

Adolescent↗

PubMed1997

Enhanced induction of apoptosis of human gastric carcinoma cells after preoperative treatment with 5-fluorouracil.

BACKGROUND: It has been reported that anticancer drugs induce apoptosis, thus it is considered that apoptosis may be important in cancer chemotherapy. The authors examined whether the administration of 5-fluorouracil (5-FU) enhanced apoptosis of gastric carcinoma cells, and investigated the relationship between apoptosis and the expression of Ki-67 and the Bax gene. METHODS: Twenty patients with gastric carcinoma were divided into 2 groups. Ten patients received continuous intravenous 5-FU at 500 mg/body weight/day for 7 days preoperatively whereas the other 10 did not receive any chemotherapy or radiotherapy, and served as controls. For detection of apoptotic cells, apoptotic indices were examined by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end labeling (TUNEL) method. The expression of Ki-67 and the Bax gene were examined by immunohistochemical staining. RESULTS: Apoptosis of gastric carcinoma cells increased significantly to 6.1 +/- 3.6% in the 5-FU-treated group compared with the controls (3.2 +/- 1.8%; P < 0.05). The level of expression of Ki-67, a marker of cell proliferation, was inversely correlated with the extent of TUNEL staining that was specific for apoptosis. The percentage of cells that were immunopositive for Ki-67 fell to 50.8 +/- 7.3% of the apoptotic area in the 5-FU-treated group compared with 57.5 +/- 6.9% in the controls (P < 0.05). There was no significant correlation between frequency of apoptotic cells and the level of expression of the Bax gene. CONCLUSIONS: The authors demonstrated enhanced apoptosis in gastric tumors after continuous intravenous infusion of 5-FU for 7 days. This result suggests that it may be possible to evaluate the effects of chemotherapy by detecting apoptotic cells.

Antimetabolites, Antineoplastic↗

PubMed1997

Evaluation of facial palsy by moiré topography index.

We investigated the usefulness of moiré topography for evaluating facial nerve function in 51 patients with facial palsy and 10 normal volunteers. This method visualizes the shape of objects in three dimensions. We devised three moiré indexes as a simple method of quantifying the severity of facial palsy: the nasolabial groove moiré index, the oral angle moiré index, and the inner canthus moiré index. We compared the results obtained by the moiré indexes with findings obtained using the House-Brackmann grading system and found that they were highly correlated. These three moiré indexes included all the standard factors of the House-Brackmann grading system, allowing us to develop the total moiré index.

Adolescent↗

PubMed1997

Biological characteristics of esophageal squamous cell carcinoma associated with contiguous intraepithelial carcinoma.

To evaluate the biological significance of esophageal squamous cell carcinoma that is associated with contiguous intraepithelial carcinoma, we analyzed 95 patients with operated esophageal carcinoma. Of these 95 patients, eight had in situ carcinoma. Among 87 cases in which the tumo had invaded more deeply than the lamina propria, there were 42 cases (48.3%) of contiguous intraepithelial carcinoma associated with the main tumor. The biological characteristics (proliferative activity of cells, as revealed by immunostaining with the Ki-67 monoclonal antibody) of 45 tumors without contiguous intraepithelial carcinoma (group A) were compared with those of 42 tumors with contiguous intraepithelial carcinoma (group B). The more advanced was the main lesion, the lower was the incidence of contiguous intraepithelial carcinoma. The mean Ki-67 score of the main tumors in group A was 51.6% and that of the main tumors in group B was 45.9%. The mean Ki-67 score of the main tumors in group B was very similar to that of the contiguous intraepithelial carcinomas that were associated with the main tumors (44.4%, P = 0.682). Furthermore, the mean Ki-67 score of contiguous intraepithelial carcinomas associated with main tumors was very similar to that of carcinomas in situ (41.2%, P = 0.529). From our results, it is suggested that tumors with high proliferative activity may be assumed to grow rapidly and, as a result, the region of intraepithelial carcinoma may develop into an invasive tumor. By contrast, tumors with low proliferative activity may grow slowly and, in such cases, the carcinoma may remain in the epithelium around the invasive tumor.

Aged↗

PubMed1997

[A patient who recovered successfully from severe anemia which continued for one hour].

A 79-year-old woman had her cervical spinal cord injured and laminoplasty of the neck was performed. Uncontrollable venous bleeding was encountered during the operation and about 5000 ml of blood was lost in one hour. Massive infusion of 5% albumin and hydroxyethylstarch (HES) was done to maintain the intravascular volume. Therefore, her hematocrit value (Ht) decreased to 4.5%. Her rectal temperature went down to 34.5 degrees C. The operation was finished in haste. We studied leg pain experienced under spinal anesthesia in leprosy patients. Seven of twenty patients complained of the leg pain a few minutes after spinal block. The pain was localized in the parts of deafferentation or phantom limb, and was relatively mild and controllable. We consider that the inhibitory system is inactivated when the somatic impulse is blocked by spinal anesthesia, and as a result the abnormal burst activity of dorsal horn produced by peripheral nerve damage of leprosy causes phantom pain.

Aged↗

PubMed1997

Clinicopathologic significance of the expression of mutated p53 protein and the proliferative activity of cancer cells in patients with esophageal squamous cell carcinoma.

BACKGROUND: The aim of this study was to investigate the relation between the expression of mutated p53 protein and the proliferative activity of cancer cells in esophageal squamous cell carcinoma. In addition, the clinical and biologic significance of p53 status and the proliferative activity of cancer cells were evaluated in these patients. STUDY DESIGN: Samples of esophageal tumors from 94 patients were subjected to immunohistochemical staining with a monoclonal antibody against p53 and with the monoclonal antibody Ki-67. The immunoreactivity against p53 and the proliferative activity of cancer cells were compared with the clinicopathologic findings in each sample. Prognostic factors including p53 status and Ki-67 labeling index (LI; percentage of Ki-67-immunostained cells) were evaluated for 81 surviving patients by univariate and multivariate analysis. RESULTS: The mean Ki-67 LI of 50 p53-positive patients was higher than that of 44 p53-negative patients (p = 0.009). The Ki-67 LI increased according to the progression of tumors. Overexpression of mutated p53 protein was observed in 40.9% of tumors that invaded to the submucosa, and this percentage was not significantly changed in tumors with invasion to the adventitia. Metastases to the regional lymph nodes were observed in 3 of 22 patients with tumors that invaded to the submucosa, and these 3 tumors had both over-expression of mutated p53 protein and high Ki-67 LI. In 81 surviving patients, only lymph node metastasis (p = 0.045) and the curability of tumors (p < 0.001) were identified as independent prognostic factors by multivariate analysis. CONCLUSIONS: Overexpression of mutated p53 protein is detected in the early stage of esophageal cancer. This mutated p53 protein may not play an important role for tumor invasion. When tumor invasion is limited to the submucosa, cancer cells that overexpress mutated p53 protein may acquire high proliferative activity. Such cells might have considerable potential for metastasis to the lymph nodes.

Adult↗

PubMed1996

Apoptotic cell death and its relationship to carcinogenesis in colorectal carcinoma.

BACKGROUND: Apoptotic cell death plays an important role in the proliferation and turnover of cells in various tumors. The relationship between apoptosis and cell proliferation was studied to determine each of their roles in colorectal carcinogenesis. METHODS: Apoptotic cells were identified by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. The occurrence of apoptosis was examined in colorectal cancer that had invaded the submucosa. Specimens were obtained from 38 cases of cancer with adenoma and 29 cases of cancer de novo. Apoptotic indices (AIs) as percentages of TUNEL-positive cells relative to the number of tumor cells and Ki-67 labeling indices (PI) were investigated. The relationship between the frequency of apoptosis and the expression of p53 and c-myc proteins was also investigated. RESULTS: In cancer with adenoma, the ratio of AI/PI in adenoma cells was significantly higher than that of cancer cells (P < 0.0001). Mean AIs of cancer with adenoma were significantly higher than those of cancer de novo particularly in the flat-type cancers (P < 0.05). Among p53 negative tumors, the ratio of AI/PI for cancer de novo was significantly lower than that for cancer with adenoma (P < 0.05). AI of cancer de novo was lower than that of cancer with adenoma in cases with overexpression of c-myc protein (P < 0.05), whereas there was no significant difference in the ratio of AI/PI between cancer de novo and cancer with adenoma. CONCLUSIONS: Colorectal carcinogenesis is related to the inhibition of apoptosis and to the augmentation of proliferative activity both in cancer with adenoma and in cancer do novo. A reduction of the rate of apoptosis as compared with that of cell proliferation might explain the rapid-growing nature of cancer de novo particularly in cases with the flat-type appearance.

Antigens, Neoplasm↗

PubMed1996

Are argyrophilic nucleolar organizer regions good prognostic indicators of survival of patients with esophageal cancer with lymph node metastasis?

Argyrophilic nucleolar organizer regions (AgNORs) were evaluated in 95 samples from primary esophageal squamous cell carcinomas and 75 samples from metastatic lymph nodes. The number of AgNORs per nucleus in primary tumors with positive nodes (n=53, 6.1+/-1.8) was greater than that in primary tumors with negative nodes (n=42, 3.8+/-1.1, P<0.001). In 39 of 53 patients with positive nodes, the numbers of AgNORs per nucleus in metastatic lymph nodes were lower than those in primary tumors. The 5-year survival rate of these patients was 23.7%. However, the numbers of AgNORs per nucleus in metastatic lymph nodes were greater than those of primary tumors in 14 of 53 patients with positive nodes, and 11 of these 14 patients died from recurrence of cancer within 3 years after surgery. These observations suggest that the proliferative activity of cancer cells might be suppressed in the regional lymph nodes. However, cancer cells with higher proliferative activity in the regional lymph nodes than in the primary tumors might overcome immunological defenses and subsequent further metastasis might occur.

Aged↗

PubMed1996

Limited operation for gastric cancer in the elderly.

The relationship between operative procedures for treatment of patients with gastric carcinoma and complications was studied with special reference to the age of patients, who were divided into four groups: 50-59 years; 60-69 years; 70-79 years; and over 80 years. Preoperative risk factors that were common in patients over 70 years of age were hypertension and cardiac disease. The selected operative procedures were similar for each age group. However, neither proximal gastrectomy nor reconstruction by jejunal interposition was selected for patients of 80 years and over. In these patients, resection of the neighbouring organs was seldom performed and lymph node dissection was usually limited to the primary and secondary nodes. There was no significant difference in the rate of postoperative complications between groups. Although only limited surgery was performed for patients of 80 years and over, there was no significant difference in age-corrected cumulative survival rate between groups. Therefore, limited resection and/or lymph node dissection may allow safe surgical treatment for patients of 80 years and over with gastric carcinoma, without any negative effect on prognosis.

Age Distribution↗

PubMed1996

Hypotonic intraperitoneal cisplatin chemotherapy for peritoneal carcinomatosis in mice.

The intraperitoneal (i.p.) administration of cisplatin (CDDP) is one of the most effective therapies for cancers that are confined to the abdominal cavity. However, the effect of fluid osmolarity on the therapeutic efficacy of i.p. administration of CDDP has not been well established. In the current study, hypotonic (154 mosmol 1-1), isotonic (308 mosmol 1-1) and hypertonic (616 mosmol 1-1) solutions of CDDP were prepared for an evaluation of their therapeutic efficacy in an experimental system. After i.p. administration, uptake of CDDP in vivo by tumor cells in hypotonic solution was significantly greater than in isotonic or hypertonic solution. The 50% lethal dose (LD50) value of CDDP in hypotonic solution (12.1 mg kg(-1)) was lower than that in isotonic solution (16.9 mg kg(-1)) and than that in hypertonic solution (28.6 mg kg(-1)). However, when a dose equal to one-half of the LD50 was administered in each solution to mice with i.p. tumours, survival of mice given the CDDP in hypotonic solution was significantly prolonged as compared with the survival of the other mice. These results demonstrate that the therapeutic efficacy of i.p. CDDP in mice is augmented when the drug is administered in hypotonic solution.

Animals↗

PubMed1995

Infiltration of dendritic cells into regional lymph nodes in gastric cancer.

BACKGROUND: Dendritic cells (DC), including epidermal Langerhans cells, are potent antigen-presenting cells that can carry and present tumor antigens to helper T-cells. An immunohistochemical study was performed to clarify the relationship between the extent of infiltration by DCs in primary gastric cancer and that in the regional lymph nodes. METHODS: Paraffin blocks were prepared for staining with antibody against S-100 protein in 121 cases of gastric cancer. Infiltration of S-100 protein-positive DCs was evaluated in the primary tumor and in the peritumoral, primary, secondary, and tertiary nodes. RESULTS: The extent of infiltration by DCs into the regional lymph nodes decreased significantly with an increasing distance of the nodes from the primary tumor. Correlation of the extent of such infiltration was observed among the peritumoral, primary, secondary, and tertiary nodes. However, the extent of infiltration into the primary tumor did not correlate with that into the primary, secondary, and tertiary nodes. Infiltration by DCs of the peritumoral nodes correlated with that of the tumor, particularly when lymph node metastasis was absent. There was no significant difference in the extent of infiltration into the peritumoral nodes even when lymph nodes were involved. However, infiltration of DCs increased in the primary and secondary nodes when the primary nodes were involved. CONCLUSION: Infiltration of DCs may be regulated in the primary lesion of gastric cancer. The peritumoral lymph nodes serve as transmitters of DCs from the primary tumor to the regional lymph nodes. DCs in the regional lymph nodes are important for establishing immunologic defense mechanisms in cases of gastric cancer when metastasis is absent or limited to the primary nodes.

Dendritic Cells↗

PubMed1995

Aneuploidy of tumor cells in cases of gastric cancer with esophageal invasion: another indicator of poor prognosis.

The prognosis of patients with gastric cancer with esophageal invasion is extremely poor. To evaluate factors related to this poor prognosis, we analyzed 200 patients with gastric cancer located in the upper third of the stomach. These patients underwent gastrectomy and were divided into two groups in terms of the presence (E[+] group; n = 62) or absence (E[-] group; n = 138) of histological evidence of esophageal invasion. Even when apparently curative surgery was performed, the 5-year survival rate of patients with E[+] gastric cancer (45.8%) was significantly lower than of patients with E[-] gastric cancer (71.6%). In the E[+] group, the 5-year survival rate of patients who had tumors with infiltrative growth and DNA aneuploidy was only 10.0%. These patients had a high frequency of peritoneal metastasis at operation (5/16; 31.3%); even when apparently curative operations were performed, 50% of these patients died from peritoneal metastatic recurrence within 2 years after surgery. Gastric adenocarcinoma with esophageal invasion accompanied by infiltrative growth and DNA aneuploidy had a high potential for peritoneal metastasis. This combination is associated with the most pessimistic prognosis for patients with gastric cancer with esophageal invasion.

Adenocarcinoma↗

PubMed1995

Gastric cancer in the young, with special reference to 14 pregnancy-associated cases: analysis based on 2,325 consecutive cases of gastric cancer.

Clinicopathologic features of gastric cancer in young women were analyzed with special reference to pregnancy (P). Among 2,325 consecutive patients, there were 152 young patients under 40 years of age (57 males and 95 females), and 14 P-associated cases were identified. The male-to-female ratio was 1.7:1.0 on the whole, but 1.0:1.7 in the young group with more females predominating as the age of patients decreased. Among characteristics of gastric cancer in the young females, we noted a significantly higher frequency of both Borrmann type 4 cancer and poorly differentiated adenocarcinoma with the scirrhus type of growth and peritoneal metastasis. These characteristics were more pronounced in the P-associated cases. Although we were unable to determine the mechanism for these tendencies, our findings suggest that the development and growth of gastric cancer in young women may be influenced by their natural, biological and hormonal circumstances. The prognosis of the young women with or without associated pregnancy was good after curative surgery. Both early detection of gastric cancer and subsequent potentially curative surgery are the best ways to obtain good survival for young women, as is the case for members of other age and sex groups.

Adenocarcinoma↗

PubMed1995

Number of argyrophilic nucleolar organizer regions is a good indicator of lymph node metastasis in patients with esophageal carcinoma.

The number of argyrophilic nucleolar organizer regions (AgNORs) was evaluated as a predictor of lymph node metastasis in 45 patients who had undergone resection of advanced squamous cell carcinoma of the esophagus. The mean AgNOR score of carcinomas was 5.0 +/- 1.8, and it was greater than that of normal esophageal epithelium adjacent to a carcinoma (2.3 +/- 0.5, P < 0.001). The AgNOR score of tumors from 26 patients with lymph node metastasis was 6.1 +/- 1.6, and it was greater than that of tumors from 19 patients without lymph node metastasis (3.7 +/- 1.0, P < 0.001). The AgNOR scores of metastatic lymph nodes (4.9 +/- 1.5) from 26 patients with lymph node metastasis were closely related to the number of metastatic lymph nodes of individual patients (r = 0.582, P < 0.0001). The 3-year survival rate in patients with low AgNOR scores (AgNOR score < 5, n = 22) was 56.2%. By contrast, that in patients with high AgNOR scores (AgNOR score > or = 5, n = 20) was only 13.1%. There was a statistically significant difference between the two survival curves (P < 0.05). These results indicate that the AgNOR score is a good indicator of lymph node metastasis and suggest that it might also be a useful prognostic marker in patients with esophageal cancer.

Aged↗

PubMed1995

Long-term survival of 5 years following initial surgery for gastric cancer and simultaneous disseminated peritoneal metastasis: report of a case.

We report herein the rare case of a patient who survived for 5 years and 10 months after commencing treatment for gastric cancer with simultaneous disseminated peritoneal metastasis. A 45-year-old man was diagnosed as having advanced gastric cancer following the discovery of numerous nodules in the peritoneal cavity at laparotomy. The patient was treated by palliative gastrectomy and continuous hyperthermic peritoneal perfusion (CHPP) immediately after surgery on November 11, 1987. Postoperatively, he underwent radiofrequency (RF) hyperthermia with intraperitoneal cisplatin a total of seven times. He continued on a combination of uracil and tegafur (UFT) administered orally with a protein-bound beta-D-glucan extracted from the mycelia of Cariolus versicolor (PSK). Long-term survival was achieved following the initial palliative gastrectomy despite simultaneous disseminated peritoneal metastasis.

Adenocarcinoma, Scirrhous↗

PubMed1995

Effects of continuous hyperthermic peritoneal perfusion on prognosis of gastric cancer with serosal invasion.

OBJECTIVE: To evaluate the effects of continuous hyperthermic peritoneal perfusion (CHPP) together with standard chemotherapy on the prognosis of patients with gastric cancer invading the serosa. DESIGN: Retrospective study. SETTING: University hospital, Japan. SUBJECTS: 174 patients who had undergone curative resection for gastric cancer invading the serosa (T3) between 1980 and 1989, 78 of whom had been randomised to be treated with CHPP after operation and 96 who received standard chemotherapy. INTERVENTIONS: CHPP was done immediately after operation; 8-10 l fluid containing 80-100 mg/m2 mitomycin C was perfused at a rate of 100-200 ml/minute, and inflow and out flow temperatures were maintained at 44-45 degrees C and 40-42 degrees C, respectively. This was followed by a standard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil (1:4) (UFT). The control group received the standard regimen only. MAIN OUTCOME MEASURES: Five year survival and patterns of recurrence in three groups: no lymph node metastases, 1-9, and 10 or more. RESULTS: Only in the group with 1-9 lymph node metastases was there an appreciable but not significant difference in 5 year survival: 66% compared with 44% (p = 0.084). The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls. CONCLUSION: CHPP improved prognosis in patients with T3 gastric cancer who had only 1-9 metastatic lymph nodes.

Aged↗

PubMed1994

Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer. Final results of a randomized controlled study.

BACKGROUND: Continuous hyperthermic peritoneal perfusion (CHPP) with a solution that contained 10 micrograms/ml mitomycin C was devised initially as a method for intraperitoneal thermochemotherapy. The authors conducted a randomized clinical trial to evaluate the efficacy of CHPP as a prophylactic treatment for prevention of peritoneal recurrence of gastric cancer with serosal invasion. METHODS: Between January 1983 and October 1986, 82 patients with gross serosal invasion but no gross peritoneal metastasis were divided by random sampling into two groups before undergoing potentially curative surgery for gastric cancer: 42 patients were scheduled to receive CHPP, whereas 40 were not scheduled to receive this treatment. CHPP was administered immediately after closing the abdomen after gastric resections while the patients were still on the operating table under general anesthesia. RESULTS: The 5-year survival rate (64.2%) of patients in the CHPP group was higher than that (52.5%) of patients in the control group although the difference was not significant. Of several patterns of cancer recurrence, peritoneal recurrence was more frequent in the control group than in the CHPP group. The mortality rate from peritoneal recurrence in the case of patients in the CHPP group was much lower than that of patients in the control group (P = 0.0854). CHPP did not induce anastomotic breakdown or chemical peritonitis after surgery. CONCLUSIONS: The results indicate that CHPP is effective in preventing peritoneal recurrence of gastric cancer with serosal invasion, which is highly likely to reappear in the peritoneum.

Aged↗

PubMed1994

Clinicopathologic differences between carcinoma in the gastric remnant stump after distal partial gastrectomy for benign gastroduodenal lesions and primary carcinoma in the upper third of the stomach.

BACKGROUND: This study evaluated the prognosis of patients with carcinoma in the gastric remnant stump after distal gastrectomy for benign disease (stump cancer). METHODS: Twenty patients with resected stump cancer were studied and compared with 266 patients with resected primary cancer in the upper third of the stomach (primary cancer). RESULTS: The percentages of lymph nodes with metastases located at the lesser curvature and the left gastric artery, respectively, were 50.0% and 25.2% in patients with primary cancer and 15.0% and 5.0% in patients with stump cancer. In patients with remnant gastric cancer, lymph node metastases at jejunal mesentery near anastomotic site were found in 2 of 20 (10.0%). The 5-year survival rates were 62.1% and 52.5% for patients with curatively resected primary cancer (n = 203) and stump cancer (n = 17), respectively, and there was no statistical difference between the two groups. There was a distinct difference in terms of patterns of recurrence between patients with curatively resected primary cancer and those with stump cancer. The percentages of peritoneal and hematogenic metastases, respectively, were 40.6% and 31.3% in primary cancer and 0% and 83.3% in stump cancers. CONCLUSION: The lymph flow from the remnant stomach seems to be changed by the initial operation, and as a result, in stump cancer, metastatic lymph nodes are located at different places from those associated with primary cancer. Even when curative surgery is performed in patients with stump cancer, it is important to follow up patients and check for possible metastasis to the liver.

Carcinoma↗