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Michio Ogawa

Publications and source records attributed to Michio Ogawa.

At least 73 records · Page 4Linked to original sources
PubMed2002

Acute fulminant necrotizing colitis caused by amebiasis: report of a case.

Fulminating colitis rarely develops as a complication of amebiasis; however, it is difficult to diagnose and treat, and associated with a very high mortality rate. We report herein the case of a 62-year-old man with superacute fulminant necrotizing amebic colitis who, despite treatment with aggressive surgery and antiamebic agents, died of multiple organ failure following sepsis on the 25th day after onset. The patient had no immmunosuppressive disorders and claimed that he had never had homosexual intercourse, or traveled to the tropics in recent years. Since the incidence of amebiasis is increasing in developed countries, including Japan, more attention should be focused on the fulminating nature of this disease.

Acute Disease↗
PubMed2002

Successful new treatment for intractable cervical esophageal stenosis of a jejunal segment transpositioned with a vascular anastomosis: report of a case.

Strictures of the alimentary tract are conventionally treated by fluoroscopically guided bouginage and endoscopic balloon dilation, which is often very effective. However, severe and recurrent stenosis associated with ischemic injury in a jejunal segment transpositioned with a vascular anastomosis after reconstruction for cervical esophageal cancer is an intractable problem. We describe a new method using a Steno-Cutter to successfully treat a patient with this type of stricture following surgery for cervical esophageal cancer. The positive results achieved in this case suggest that our new method could represent a promising option of treatment for strictures when conventional modalities fail.

Adenocarcinoma↗
PubMed2002

Irinotecan plus low-dose cisplatin for alpha-fetoprotein-producing gastric carcinoma with multiple liver metastases: report of two cases.

Alpha-fetoprotein (AFP)-producing gastric carcinoma generally causes multiple liver metastases and has an extremely poor prognosis. There is no standard chemotherapy for this disease. Two recent consecutive patients who had AFP-producing gastric carcinoma were treated with a novel chemotherapy regimen: irinotecan hydrochloride (100 mg/body over 90 min) plus low-dose cisplatin (10 mg/body) by intravenous infusion. Treatment was done weekly during admission and once every 2 weeks on an outpatient basis. Both patients had multiple liver metastases with high serum levels of AFP, and one demonstrated resistance to 5-fluorouracil. In both patients, liver metastases showed a dramatic complete response to chemotherapy, and the serum AFP levels returned to normal. No significant toxicities were observed. These preliminary results suggest that the present regimen may cause fewer side effects while retaining its synergistic antitumor activity. This regimen may therefore be worth trying as first-line chemotherapy for patients with metastatic AFP-producing gastric carcinoma.

Aged↗
PubMed2002

BGP expression in gastric biopsies may predict the development of new lesions after local treatment for early gastric cancer.

BACKGROUND: Our previous studies have demonstrated the significant role of the generative cells of intestinal metaplasia (IM) expressing brain (fetal)-type glycogen phosphorylase (BGP) (BGP-IM) as a premalignant lesion of intestinal-type adenocarcinoma. The aims of the present study were to investigate the incidence of BGP-IM in gastric biopsy specimens and to establish BGP-IM as a predictor of the coexistence of accessory carcinoma and/or metachronous cancers before and after local treatment for early gastric carcinoma. METHODS: We studied the incidence of BGP-IM in eight endoscopic biopsy specimens of methylene blue-positive mucosa of the stomach obtained from patients with multiple gastric carcinomas (n = 14), a single carcinoma (n = 25), and atrophic gastritis (n = 20). RESULTS: BGP positivity was 93.3% in the multiple carcinomas and 80.0% in the single carcinomas. The incidences of BGP-IM (mean percentage +/- SD) in the stomachs with multiple carcinomas, single carcinoma, and atrophic gastritis were 83.2% +/- 22.8%, 36.5% +/- 41.3%, and 7.1% +/- 18.0%, respectively. The incidence was significantly higher in the stomachs with multiple carcinomas than in those with a single carcinoma or those with atrophic gastritis (P < 0.001). CONCLUSION: It is suggested that the frequent appearance of BGP-IM reflects the high potential of carcinogenesis of intestinal-type gastric cancer, and that the involvement of BGP-IM in more than 50% of the eight biopsies may be a predictor of the coexistence of accessory and/or metachronous carcinoma before and after local treatment for early gastric carcinoma.

Aged↗
PubMed2002

Extensive intraoperative peritoneal lavage and chemotherapy for gastric cancer patients with peritoneal free cancer cells.

The effects of extensive intraoperative peritoneal lavage (EIPL) for gastric cancer patients with peritoneal free cancer cells were investigated. This study was based on 22 consecutive patients with peritoneal free cancer cells, among 663 patients who underwent curative surgical treatment for advanced gastric cancer. The 22 patients were followed up for 2 years or until death. These patients were divided into three groups: group 1, patients with no additional intraoperative therapy (from 1989 to 1992; n = 8); group 2, patients with intraoperative intraperitoneal chemotherapy alone (from 1992 to 1995; n = 7); and group 3, patients with EIPL followed by intraoperative intraperitoneal chemotherapy (from 1996 to 1999; n = 7). Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed that viable cancer cells were not detected after the eighth EIPL in a gastric cancer patient with numerous intraperitoneal free cancer cells. In group 3, 4 of the 7 patients survived for more than 2 years, including 3 with cancer-free status, whereas no patient survived cancer-free in groups 1 and 2. The peritoneal recurrence rates and cancer-specific 2-year survival rates in groups 1, 2, and 3 were 100%, 85.7% and 42.9%; and 0%, 14.3%, and 57.1%, respectively. The 2-year survival rate of group 3 was significantly higher than that of group 1 (P = 0.017) and that of group 2 (P = 0.025). In a subset analysis, patients with peritoneal free gastric cancer cells but no macroscopic dissemination showed a statistically significant improvement in survival those treated with EIPL compared with those not treated with EIPL.

Antineoplastic Agents↗
PubMed2002

Differential distribution of basement membrane type IV collagen alpha1(IV), alpha2(IV), alpha5(IV) and alpha6(IV) chains in colorectal epithelial tumors.

In this study, we examined the relationship between the histopathological grade and immunohistochemical localization of six genetically distinct type IV collagen alpha chains, the major component of basement membrane (BM), in normal and neoplastic colorectal tissues. In the normal colorectal mucosa, alpha1/alpha2(IV) and alpha5/alpha6(IV) chains were stained in all epithelial BM. However, alpha3/alpha4(IV) chains were restrictively immunostained in the BM of the apical surface epithelium. Similar immunostaining profiles for alpha1/alpha2(IV) and alpha5/alpha6(IV) chains were observed in tubular adenomas with mild/moderate atypia. However, in intramucosal carcinomas, both alpha1/alpha2(IV) chains were linearly stained in the BM of cancer cell nests, while the assembly of alpha5/alpha6(IV) chains into the BM was inhibited in a discontinuous or negatively stained pattern. The normal colorectal mucosa forms a second network of BM composed of alpha5/alpha6(IV), partly alpha3/alpha4(IV) chains, in addition to the classic network of alpha1/alpha2(IV) chains. The differential immunohistochemical localization of the type IV collagen alpha5/alpha6 chains could be one diagnostic marker for the invasiveness of colorectal cancer.

Adenoma↗
PubMed2002

Preoperative evidence of circulating tumor cells by means of reverse transcriptase-polymerase chain reaction for carcinoembryonic antigen messenger RNA is an independent predictor of survival in non-small cell lung cancer: a prospective study.

OBJECTIVE: We conducted a prospective study of 103 consecutive patients with non-small cell lung cancer who underwent a curative lobectomy to test whether circulating tumor cells detected in the peripheral blood by means of reverse transcriptase-polymerase chain reaction of carcinoembryonic antigen messenger RNA is a prognostic indicator independent of tumor stage in patients with non-small cell lung cancer. METHODS: We assayed for carcinoembryonic antigen messenger RNA by means of reverse transcriptase-polymerase chain reaction in peripheral blood taken at the time of diagnosis before an operation and again 2 to 3 weeks after an operation from patients with non-small cell lung cancer who underwent a curative lobectomy between March 1996 and April 1998. We analyzed the prognostic value of carcinoembryonic antigen messenger RNA expression in the patients with non-small cell lung cancer in a univariate and multivariate manner. RESULTS: Patients with carcinoembryonic antigen messenger RNA in the preoperative blood samples had a poor survival when compared with those without carcinoembryonic antigen messenger RNA. Of these patients, the worst survival was seen in those with carcinoembryonic antigen messenger RNA in the postoperative blood samples. The multivariate stepwise analysis selected the preoperative carcinoembryonic antigen messenger RNA expression (P =.0004; relative risk, 0.21) and the pathologic stage of disease (P =.0002; relative risk, 1.43) as the independent prognostic factors for survival. CONCLUSIONS: The molecular detection of carcinoembryonic antigen messenger RNA in the preoperative peripheral blood is an independent prognostic factor in patients with non-small cell lung cancer who undergo a curative operation.

Adult↗
PubMed2002

Visualization of the heterogeneous internal structure of so-called "pancreatic necrosis" by magnetic resonance imaging in acute necrotizing pancreatitis.

INTRODUCTION: Contrast-enhanced computed tomography (CT) is the gold standard for assessing the severity of acute pancreatitis, especially for evaluating the presence of pancreatic necrosis (poorly perfused area). However, the contrast medium used for CT is potentially toxic to the pancreas and kidney. Therefore, medical institutions without facilities for hemodialysis hesitate to acquire contrast-enhanced CT images. Diagnostic values of magnetic resonance imaging (MRI) in pancreatic diseases have been shown. AIM: To evaluate the usefulness of MRI in the assessment of the severity of acute pancreatitis. RESULTS: All necrotic regions in the pancreas were visualized by gadolinium-enhanced MRI. Furthermore, MRI can discriminate the poorly perfused pancreatic area, namely so-called "pancreatic necrosis" judged on CT, into three parts: 1) necrotic area of the pancreatic parenchyma, 2) perinecrotic fluid collection, and 3) hemorrhagic foci. Inflammatory changes that were required for severity grading were also evaluated sufficiently by MRI. CONCLUSION: These results suggest that MRI is useful for the assessment of severity of acute pancreatitis.

Adult↗
PubMed2002

Development and use of a new staging system for severe acute pancreatitis based on a nationwide survey in Japan.

METHODOLOGY: In 1997, a cooperative nationwide survey of 192 patients diagnosed with severe acute pancreatitis in 1996 was carried out. RESULTS: Alcoholic pancreatitis was the major etiology (46%), and the male-to-female ratio was 2.6:1. Overall, the mortality rate was 27%, which was similar to the rate (30%) in the first nationwide survey of 1,219 patients diagnosed between 1982 and 1986 that was performed in 1987. A marked difference between the surveys was the early mortality rate within 2 weeks: 52% in the 1987 survey and 29% in the current survey. We devised a new stage classification system for acute pancreatitis. Stages 0 and 1 are equivalent to mild and moderate conditions, respectively, in the conventional classification, and stages 2 and higher correspond to severe acute pancreatitis. Severity scores of 2-8 are regarded as stage 2, scores of 9-14, as stage 3, and scores of > or =15, as stage 4. The mortality rates were as follows: 0, stages 0 and 1 at hospitalization; approximately 10%, stage 2; approximately 30-40%, stage 3; and approximately 70-100%, stage 4. CONCLUSION: We found that stage at hospitalization reflected the prognosis of acute pancreatitis.

Acute Disease↗
PubMed2002

[Genetics of pancreatic cancer: recent advances in molecular diagnosis].

Pancreatic cancer is an important cause of death from cancer throughout the world. Until recently, pancreatic cancer was a poorly understood disease. Research in the past decade has shown conclusively, however, that pancreatic cancer is primarily genetic in nature. Inactivation with a variety of tumor-suppressor genes such as p53, p16, and DPC4, and genome-maintenance genes such as BRCA2, coupled with the activation of oncogenes such as K-ras, are a few of the mutations that trigger the growth of cancerous cells. The genetic profile of pancreatic cancer has reshaped the nomenclature describing histological progression in pancreatic ductal tumorigenesis. K-ras mutations frequently occur early, whereas changes in the expression and genetic integrity of the p16 gene appear in intermediate lesions, and the inactivation of the p53 and DPC4 genes and activation of telomerase occur late in the neoplastic progression. Although the majority of pancreatic cancers occur sporadically, a minority has been shown to aggregate in families and has aided our understanding of pancreatic tumorigenesis. An improved understanding of the genetics of pancreatic cancer should lead to the development of gene-based screening tests and novel rational therapies.

DNA-Binding Proteins↗
PubMed2002

Pancreatic elastase IIIA and its variants are expressed in pancreatic carcinoma cells.

Ninety percent of pancreatic cancers are classified as ductal adenocarcinoma and are not known to secrete pancreatic elastases of the acinar enzymes. In the present study, we investigated the expression and the changes in elastase genes expressed in pancreatic ductal carcinoma cells. The expression of elastase gene family molecules in pancreatic cancer cells was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) method using primer sets for conservative active domains among pancreatic elastases (PEs) and neutrophil elastase (NE). The PCR products were subcloned, sequenced and analyzed. Three distinct products were isolated in pancreatic carcinoma cells using the RT-PCR analyses. The sequencing revealed that one was identical with the PE IIIA isoform, and the remaining two were alternatively splicing forms of the PE IIIA. Four of five pancreatic cell lines expressed these splicing variants in a cell-dependent manner. The present study is the first report to demonstrate the expression of PE IIIA and its splicing variants in pancreatic carcinoma cells might represent another infiltrative feature of the pancreatic ductal cell carcinoma.

Alternative Splicing↗
PubMed2002

[Case report--a patient who has survived more than 4 years with repeated resection for bilateral adrenal metastasis from hepatocellular carcinoma].

We report a patient with bilateral adrenal metastasis from hepatocellular carcinoma (HCC) who has survived for a long period as a result of repeated resection. A 55-year-old male patient with C type hepatitis underwent transcatheter arterial chemo-embolization (TACE) for HCC in November 1997. There was no recurrence in the liver, but left adrenal metastasis was detected in January 1998, followed by right adrenal metastasis in November 1998. We performed surgical resection for bilateral adrenal metastasis in March 1999. The histological diagnosis was well approximately moderately differentiated hepatocellular carcinoma. A recurrence in the right adrenal gland was detected eight months later. As there was no distant metastasis, we performed re-operation in December 1999. Recurrence in the liver was detected in October 2000 and was treated by TACE. He has survived more than 4 years since the first detection of adrenal metastasis. We conclude that surgical treatment is useful for patients with adrenal metastasis who have no distant viable lesion.

Adrenal Gland Neoplasms↗
PubMed2002

[A promising new procedure: laparoscopic devascularization for hepatocellular carcinoma with extra-hepatic feeding arteries].

We have developed a new therapeutic modality: laparoscopic devascularization (LDEV) for hepatocellular carcinoma (HCC). Thirteen patients with HCC were treated with LDEV from March 1998 to March 2002. All LDEV procedures were performed under laparoscopic surgery using laparoscopic coagulating shears (LCS), endo-clip and endo-GIA. To prevent recanalization of extra-hepatic feeding arteries, we always add local ablation therapy (LAT) intraoperatively. The results are as follows. 1. The right gastroepiploic artery in 11 patients, right gastric artery in 1 and right inferior phrenic artery in 2 were devascularized. 2. The amount of intraoperative bleeding ranged 5-150 g and the operating time for devasculalization ranged 5-50 min, with an average of 30 min. 3. LAT was also performed in all cases. 4. No complications occurred. 5. A recurrent feeding artery developed in only one case (8%). 6. Nine patients are living (6-52, average 27 months) and 4 have died (5-28, average 16 months).

Aged↗
PubMed2002

[A case report of advanced huge hepatocellular carcinoma (H.C.C.) accompanied by tumor embolism to the inferior caval vein (Vv3) that was treated with surgical extended right lobectomy after multimodal therapy].

We performed multimodal therapy for a huge hepatocellular carcinoma with tumor embolism (Vv3), for which excision was judged impossible. After treatment, a hepatectomy to the primary lesion was finally carried out and long-term survival was achieved. A 52-years-old man with right lateroabdominal pain had a huge occupied hepatocellular carcinoma that was detected in October 2000. A tumor embolism, which invaded the inferior vena cava, was also seen. The residual liver was judged to have insufficient capacity for a right hepatic lobectomy. A percutaneous transhepatic portal embolism (PTPE) was carried out against the right portal vein to increase in the left lobe capacity. The chemo-radiotherapy (36 Gy to the right hepatic vein and systemic administration of CDDP) and transcatheter arterial chemoembolization were added to the feeding arteries of the hepatic tumor. When a decrease in the postcaval vein tumor embolism was observed, the extended right hepatic lobectomy was performed. The postoperative course was good, and the patient was discharged from the hospital on postoperative day 41. Though lung metastasis and new lesions in left lobe were seen in a recurrence, two years and ten months since the start of the systemic chemotherapy. This case suggested that even if a huge liver cancer with vascular invasion is judged impossible to excise, multimodal therapy with the aim of surgical treatment helps retain the possibility to later chose hepatectomy for the primary lesion and improve prognosis.

Carcinoma, Hepatocellular↗
PubMed2002

[Treatment of hepatocellular carcinoma--partial hepatic resection under hand-assisted laparoscopic surgery and local ablation therapy with ethanol and radio frequency].

A 76-year old female patient with chronic B type hepatitis had HCC expanding into the extra-hepatic space. In July 2001, we safely performed partial hepatic resection under hand-assisted laparoscopic surgery (HALS). Three months after the treatment, computed tomography of the liver revealed HCC close to the first branch of right portal vein and bile duct. Although we performed transcatheter arterial chemoembolization (TACE) for the tumor, this treatment was not effective. So we treated percutaneous ethanol injection therapy (PEIT) for the tumor area neighboring Glisson's capsule and radiofrequency ablation therapy (RFA) for the tumor. After this treatment the tumor showed no viability on dynamic CT, and there was no liver infarction or damage to the bile duct. Four months after the final treatment, enhanced CT revealed no viable lesion, and serum alpha-fetoprotein level was declining toward the normal range. We conclude that selection of an applicable treatment and approach is of importance for safe and effective therapy.

Aged↗