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Biomedical subjects

M Niimoto

Publications and source records attributed to M Niimoto.

At least 73 records · Page 4Linked to original sources

[Advanced gastric cancer with DIC and multiple bone metastasis treated with surgical resection and chemotherapy].

Endoscopic examination of a 35-year-old patient complaining of tarry stool, palpitation and lumbago led to a diagnosis of gastric cancer of Borrmann type 4. Laboratory data and bone scintigraphy revealed findings of DIC and multiple bone metastasis. He was treated with continuous intravenous infusion of FOY, but laboratory data with DIC went from bad to worse. It was considered that resection of the tumor was effective for DIC, then total gastrectomy and partial transverse colonectomy were performed, and the patient recovered from DIC. For the multiple bone metastasis, he received chemotherapy using cisplatinum and mitomycin C, and subsequent bone scintigraphy showed a dramatic improvement. Doxorubicin and 5-fluorouracil controlled peritoneal dissemination of the cancer.

Adenocarcinoma↗

[Clinical studies on the complaints of survivors living more than 3 months after total gastrectomy].

From 1973 to 1983, 802 patients with gastric cancer were operated on. Out of them, 292 (36.4%) received total gastrectomy. Reconstruction was performed mainly by the Billroth II procedure associated with the closure of the afferent loop according to Plenk's method. 90 patients living more than 3 months complained of the following: heartburn, 18 (20%); reflux, 12 (13.3%); retrosternal pain, 3 (3.3%); stenotic sensation, 23 (25.6%); diarrhea, 10 (11.1%); abdominal pain, 14 (15.6%); and dumping syndrome, 6 (6.7%). It seems to indicate that the quality of life after total gastrectomy is satisfactory.

Employment↗

[Clinical trials of the subrenal capsule assay].

Clinical trials of 4-day subrenal capsule assay (SRC assay) were carried out. One hundred and forty-one cases were investigated in order to evaluate the clinical utility of the assay. A total evaluability rate of 81.0% and a response rate of 36.5% were obtained in the SRC assay. The overall predictive accuracy between the tumor sensitivity of the assay and the clinical response was 82.1%. The percentage inhibition of %DNA/protein content of the implanted tumor, as a new predictor of the tumor growth inhibition, also indicated a good prediction rate for the assay. Correlation between the sensitivity test and the end results after chemotherapy in cases of inoperable gastric cancer classified as stage IV was investigated, retrospectively. Comparison of the survival curves between the patients treated with sensitive agents and those with insensitive agents exhibited a significant advantage for the former (p less than 0.01). These results suggest the utility of the SRC assay for clinical use, but histological studies exhibited certain limitations of this assay due to the existence of early host rejection of the implanted tumor. The utility of the SRC assay should be finally evaluated using more histological assessments and clinical trials.

Animals↗

[Dependency on sex hormone in human esophageal cancer--measurement of the androgen receptor in resected specimens].

Clinically it is well known that the incidence of esophageal cancer is much higher in men that in women. Further, the prognosis of the esophageal cancer is worse for men than for women. This seems to be dependent on the difference of environment of the sex steroid. In this paper, the androgen receptor (AR) has been measured in 21 cases of human esophageal cancer. Two cases of esophageal cancer that were implanted into nude mice were AR positive. In this EH-1 cell line, the binding sites were increased and the tumor growth was enhanced by testosterone administration, but the tumor growth was not inhibited by estrogen administration.

Aged↗

A cohort study on second malignancies in gastrectomized patients with gastric cancer. I. Second malignancies other than cancer of the gastric remnant.

In a retrospective cohort study, a total of 235 (2.32 per cent) second malignancies were clinically observed in 10,138 patients during the average 8.8-year follow-up period. The patients had undergone gastrectomy for gastric cancer during 1960-1975, in seven different institutions. This observed number was smaller than the expected one of 340.9 (p less than 0.01). Among the 235, cancers of the gastrointestinal tract (111) were the most frequent and followed by respiratory (54) and urogenital (25) cancers. Twelve cases of malignant lymphoma and five of leukemia were also noted. With regard to adjuvant chemotherapeutic agents such as mitomycin-C (MMC), 5-fluorouracil (5FU) or its derivative Tegafur, and cyclophosphamide (EDX), no significant differences in the rate of second malignancies were obtained between the chemotherapy and non-chemotherapy groups. The occurrence rate of second malignancies tended to be higher in the Billroth II group than in the Billroth I, the significance of which is yet to be determined.

Adult↗

A cohort study on second malignancies in gastrectomized patients with gastric cancer. II. Second malignancies in the gastric remnant.

In a retrospective cohort study, a total of 22 (0.22 per cent) carcinomas of the gastric remnant were clinically observed, as second malignancies, in 7,672 patients during the average of a 9.4-year follow-up period. All had undergone distal subtotal gastrectomy for gastric cancer from 1960-1975 in seven different institutions. Of 22 carcinomas of the gastric remnant, 5 were at the anastomotic site, 14 distant from the anastomosis; the location was unknown in three. All five carcinomas of the anastomotic site occurred after Billroth II operation. Time intervals between the first operation and the occurrence of second cancer varied from two to 21 years. With regard to the administration of adjuvant chemotherapeutic agents such as mitomycin-C (MMC), 5-fluorouracil (5FU) or its derivative Tegafur, no significant differences in the rate of second malignancies were obtained between the chemotherapy and non-chemotherapy groups. The occurrence rate of cancer of the gastric remnant between Billroth I and Billroth II groups showed no statistically significant difference, although it did tend to be slightly higher in the latter.

Adult↗

Prediction of individual tumor chemosensitivity in subrenal capsule assay.

Fifty-three tumor specimens, including thirty-one stomach and seven esophageal cancers, were examined to determine the individual tumor sensitivity to chemotherapeutic agents. Using the subrenal capsule assay (SRC assay), tumor specimens were implanted under the renal capsule of male, 8 week old ddY mice, after cutting the tissues into 1.5 mm cubed fragments. Following the implantations, chemotherapeutic agents were injected daily for 3 days and the relative variations of tumor weights were calculated. An 84.9 per cent of the total evaluability rate was obtained and implanted tumor specimens responded to chemotherapeutic agents in 26.7 per cent. The correlation rate between tumor sensitivity in SRC assay and clinical responses was obtained in 72.9 per cent. The predictive accuracy rate of the clinical responses was 50.0 per cent, while 100 per cent of the prediction rate of clinical resistance was obtained. With regard to upper gastro-intestinal cancers, 83.9 per cent of the evaluability rate and 18.2 per cent of response rate in SRC assay were obtained. These results indicate that this assay is equivalent to other procedures for predicting individual tumor sensitivity.

Animals↗

Clinical studies on the transabdominal resection of esophagocardial cancer and cervical anastomosis using bypass methods. Analysis of data on 76 patients.

Transabdominal resection for esophagocardial cancer and reestablishment of alimentary continuity using bypass methods were performed in 76 patients. Thirteen underwent a bypass with a gastric tube and in 30, a colonic segment was prepared. In the remaining 33, a jejunal segment was used as a bypass organ, with considerable success. The 5 year survival rates were 68.8 per cent in those with stages (I + II), 16.5 per cent in those with stage III, 12.6 per cent in those with stage IV and 22.5 per cent in all cases, indicating similar results compared to those with cancer located in the upper third of the stomach with the limited proximal extension within the esophagocardial junction and operated on during the same period.

Adenocarcinoma↗

Effects of oxygen tension on tumor colony formations assessed by human tumor clonogenic assay.

To clarify the effects of oxygen tension on colony formation of fresh human tumor cells, we examined 25 fresh human tumor samples (sixteen gastric cancers, three colon cancers, three breast cancers, one esophageal cancer, one leiomyosarcoma and one malignant lymphoma), using the human tumor clonogenic assay (HTCA) technique. Three different oxygen tensions (2 per cent, 5 per cent, 20 per cent) were tested. At 5 per cent O2, which is considered to be physiological oxygen tension, 19 out of 26 tumors (13/16 in gastric cancer, 2/3 in colon cancer, 1/3 in breast cancer, 1/1 in esophageal cancer, and 1/1 in leiomyosarcoma) showed significant increases of plating efficiencies as compared to those at 20 per cent O2. On the other hand, decreases in plating efficiencies were observed at 2 per cent O2 in seven out of 12 tumors as compared to 20 per cent O2 and eight out of 12 tumors, as compared to 5 per cent O2.

Cell Division↗

Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: a report of fifteen cases.

In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects.

Adult↗

[Comparative study of estrogen receptor assays between immunocytochemical assay using monoclonal antibody and the dextran- coated charcoal method].

Estrogen receptor (ER) was measured by the estrogen receptor-immunocytochemical assay (ER-ICA) using monoclonal antibody in 36 mammary carcinomas. Simultaneously, ER and progesterone receptor (PgR) were measured by the dextran coated charcoal (DCC) method. In ER-ICA, tumor cells with estrogen receptors were histologically observed. The proportion of ER-positive tumor cells among tumor tissues and the levels of staining intensity were also examined. Results were compared to those obtained by the dextran coated charcoal (DCC) method. Tumors were evaluated as ER-ICA-positive when they contained more than 10% ER-positive cells. ER at a level of more than 5.0 fmol/mg protein was evaluated ER-positive and PgR at more than 5.0 fmol/mg protein as PgR-positive by the DCC method. Twenty-one out of 24 ER-ICA-positive tumors were ER-positive by the DCC method, and 11 out of 12 ER-ICA-negative tumors were ER-negative by the DCC method. Correlation of ER-ICA and ER by the DCC method was 88.9%. There were 11 PgR-positive tumors, and all were included among ER-ICA-positive tumors which had a high proportion of ER-positive cells and high staining intensities.

Antibodies, Monoclonal↗

[Sensitivity test of anticancer agents by subrenal capsule assay (SRC assay). II--Determination of tumor sensitivity by percentage inhibition of DNA protein].

Subrenal capsule assay(SRC assay) has been reported to be an effective and rapid method for predicting the tumor sensitivity of individual patients to anti-cancer agents. In order to establish a more objective method of determining sensitivity in SRC assay the DNA content was measured by the schmidt-Thannhauser-Schneider method and the protein content was estimated using Bio-Rad protein assay, after removal of a tumor implanted in the subrenal capsular space of ddY mice. Percentage inhibition of DNA/protein had a high correlation with that of relative increase of tumor weight, although three groups treated with mitomycin-C, 5-fluorouracil and cyclophosphamide indicated different values of tumor sensitivity. From these results, the percentage inhibition of DNA/protein seems to be more objective than microscopic measurement for predicting tumor sensitivity.

Animals↗

[In vitro phase II-III study by clonogenic assay: the combined effects of mitomycin C with alpha-interferon].

Using the human tumor clonogenic assay technique, the combined effects of mitomycin C (MMC) with alpha-interferon (HLBI) were surveyed in comparison with 33 fresh human tumor specimens. Tumors in this study were 16 gastric cancers, five breast cancers, four liposarcomas, three colon cancers, two gall bladder cancers, two esophageal cancers, and one hepatoma. When the survival fraction observed in drug combination was smaller than the multiplication of each survival fraction observed in each drug alone, the combined effects were considered to be synergistic. Twenty-two of 33 tumors (gastric cancer 11/16, breast cancer 5/5, liposarcoma 2/4, colon cancer 1/3, gall bladder cancer 2/2, esophageal cancer 1/2, and hepatoma 0/1) formed adequate colony numbers for the evaluation of combined drug effects. Synergistic effects were observed in seven tumors (three gastric cancers, one breast cancer, one gall bladder cancer, one liposarcoma and one esophageal cancer), although three tumors (one gastric cancer, one gall bladder cancer, and one colon cancer) exhibited antagonistic effects.

Cell Division↗

[Microangiopathic hemolytic anemia associated with gastric cancer].

A case of advanced gastric cancer associated with metastatic carcinomatosis of the bone marrow, microangiopathic hemolytic anemia (MAHA) and disseminated intravascular coagulation (DIC) was reported. A 71-year-old woman complained of lumbago and general fatigue. At the time of admission, besides anemia, jaundice and a tendency to bleeding, the laboratory data showed, hyperbilirubinemia, elevated FDP and hemolytic anemia with fragmented red cells. The bone marrow was infiltrated by carcinoma, and an upper GI series examination showed Borrmann II type gastric cancer on the greater curvature of the antrum. After remission of both MAHA and DIC by mitomycin C, neothramycin and FOY, the patient successfully underwent subtotal gastrectomy. However, she died of cerebral hemorrhage on the 96th postoperative day.

Adenocarcinoma↗

[Clinical studies on a rapid screening assay for anticancer agents with nude mice and isotopic evaluation].

A rapid method using nude mice has been established as an in vivo model for assessing the chemosensitivity of individual human tumors, in which the final evaluation is made with 3H-thymidine (3H-TdR) incorporation into the treated tumor. In 234 of 289 cancers, the chemosensitivity of anticancer agents was evaluated by this method. This assay proved to be feasible in a sufficiently high percentage of human primary tumors (81.0%). The rate of positive sensitivity against all tumors was 23.8% for MMC, 12.3% for 5-FU, 29.1% for CPM and 23.5% for ADM, respectively. The sensitivity of anticancer agents varied according to the type of cancer. Correlation between the sensitivity test and the end results after chemotherapy in cases of inoperable gastrointestinal cancers was investigated, prospectively. Out of 19 cases, the 50% survival time of 11 patients treated with sensitive agents was longer than that of 8 patients treated with insensitive agents. From a prospective-correlative study carried out on 25 patients, this assay appeared to be correlated with clinical response (overall agreement, 76.0%) with specific agreements of sensitivity and resistance of 37.5% and 94.1%, respectively. From these results, it seems reasonable to conclude that this sensitivity test using a human/nude mouse system is a useful screening assay for revealing appropriate agents for the treatment of patients with cancer.

Animals↗

[Secondary malignancies after gastrectomy for gastric cancer].

In patients who have undergone gastrectomy for gastric cancer, the use of adjuvant chemotherapy has now become very widespread in Japan. The possibility of secondary malignancies in these patients emerges as a long-term effect of these therapeutic agents. This collaborative study was done to examine the possibility of secondary malignancies resulting from both operative methods and anticancer agents at the surgical departments of seven major institutions in Japan. The study was carried out using questionnaires for all patients with gastric cancer who had undergone gastrectomy between 1960 and 1975 in those hospitals and who had survived more than one year after gastrectomy. A total of 235 secondary malignancies (2.32%) were noted among 10,138 gastrectomized patients, and 22 cancers of the gastric remnant (0.29%) were recorded among 7,672 subtotal gastrectomized cases. Cancers suspected to be recurrent gastric cancer were all excluded. As to anticancer agents, Mitomycin C (MMC), 5-Fluorouracil (5-FU) or Tegafur and Cyclophosphamide (EDX) were analyzed. The occurrence rate of secondary cancers in gastric cancer patients was calculated in many instances by dividing the actual number of secondary cancers by the total time at risk (person-years). Patients with gastric cancer who had undergone gastric resection revealed a lower incidence of secondary malignancies than had been expected. The most common secondary cancers were those occurring in the digestive system, followed by those of the respiratory system. With regard to MMC, 67 secondary cancers (2.21%) occurred in the MMC group and 168 cancers (2.36%) in the non-MMC group. Although the overall incidence of secondary cancers showed no difference between MMC and non-MMC groups, secondary cancers of the digestive system were less common in the MMC group than in the non-MMC group. A total of 22 cancers originated in the gastric remnant out of 7,672 subtotally resected stomachs. The interval between the first operation and cancer of the gastric remnant varied greatly without showing any detectable trend. Nine cancers were observed to involve the anastomotic site while 14 did not involve the anastomotic site. The incidence of cancer of the gastric remnant tended to be slightly higher with the Billroth II method than in the Billroth I method, but there was no difference in the site of secondary malignancy between the two groups.

Adult↗

[Late results of operative removal of esophageal cancer with special reference to blunt dissection].

From 1973 to 1985, 185 patients with squamous cell carcinoma of the esophagus were admitted. For such advanced cases as those with penetration into the adventitia, multidisciplinary treatment with bypass surgery, irradiation, hyperthermia and immunochemotherapy was preferably performed. For those with limited invasion not beyond the adventitia, esophagectomy was performed as a first choice. For carcinoma of the lower thoracic and abdominal esophagus, blunt dissection of the thoracic esophagus was undertaken associated with reconstruction of the alimentary tract using a gastric tube via the posterior mediastinum. Of the 185 patients 90 (48.6%) underwent esophagectomy and 77 (41.6%) bypass surgery. Five-year survival rates after operative removal were 69.2% in stage 0, 40.1% in stages I + II, 38.9% in stage III, 4.5% in stage IV and 30.4% overall.

Aged↗