[Primary pulmonary leiomyosarcoma--report of a case].
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Biomedical subjects
Publications and source records attributed to N Kako.
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Effects of intravenous hyperalimentation (IVH) were studied in 38 patients with anastomotic leakage following gastrointestinal surgery. Spontaneous closure of the leakage were found in 23 patients (60%), and surgical closure were needed in 9 patients (24%). The duration required for spontaneous closure was 5 weeks on the average; and closure occurred readily in cases of tubular fistula. Death occurred in 6 patients (16%); among these, 5 were MOF cases. The following three points are emphasized concerning measures to increase IVH efficacy in serious cases such as MOF. GFX-solution is efficacious for reduced glucose tolerance. Administration of canrenoate potassium(Soldactone), linoleic acid and BCAA enriched amino-acid mixture is effective for accelerated albumin synthesis. Concomitant treatment by IVH and ED(elemental diet) is efficacious in cases of high caloric administration.
An artificial esophagus was made of silicone rubber (Phycon) tube covered with a Dacron mesh. A segment of thoracic esophagus of 16 dogs was replaced with this graft using three different types of anastomosis--overlayer end-to-end anastomosis with flanged tube, two-layer end-to-end anastomosis with flanged tube, and monolayer end-to-end anastomosis with no flange tube. Seven of 16 dogs (44%) survived more than 12 months without complications, four of them surviving more than 6 years. In six of seven of the prolonged survivors, extrusion of the graft was recognized in the 3 to 6 months after operation. Esophageal stricture increased slightly up to 6 months after extrusion of the graft, but it did not further advance until sacrifice. In these dogs, mucosal regeneration of the neoesophagus was complete with muscle layers and mucous glands in the submucosa recognized microscopically. Proximal esophagus from the replaced portion was apparently dilatated more than that of the distal portion. There was no definite difference between the anastomotic techniques with regard to complication or prognosis. These results suggest that this artificial esophagus should be considered as a possibility for clinical trials in the future.
Ninety-six cases of cancer patients were treated with long-term oral administration of Futraful ranging more than one to five years. Group A consisted of 57 cases receiving the drug for 1-2 years and Group B of 39 cases receiving the drug for 3-5 years. In Group A abnormality of TTT was observed in 49% and also abnormality of LHD in 32% of the patients, abnormalities of hemoglobin, leucocyte count, lymphocyte per cent, GOT, GPT, ALP, Bilirubin and ZST were respectively reported in 10-20%. On the other hand, in Group B abnormalities of TTT (64%), hemoglobin (26%), LDH (21%) were observed as well as abnormalities 10-20% of leucocyte count, lymphocyte, GOT, and ALP in each approximately 10-20% of the patients. But all of the disorders were not severe and clinically not serious. These results suggested and safety of long-term oral administration of Futraful to out-patients.
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When duodenal content is allowed to reflux into the esophagus of nitrosamine-treated rats, esophageal cancer is induced more rapidly and at higher frequency than after carcinogen treatment alone. The purpose of the present study was to identify the components of the duodenal content that are responsible for enhancing esophageal carcinogenesis. Eight-week-old Sprague-Dawley rats underwent one of four operations as follows: diversion of bile alone, pancreatic juice alone, both bile and pancreatic juice into the esophagus, or a control operation with no induced reflux. Two weeks after surgery, rats were treated with the esophageal carcinogen 2, 6-dimethylnitrosomorpholine (48 mg/kg [0.1 of LD50] intraperitoneally weekly for 20 weeks). The rats were killed at age 30 weeks. The esophagus was removed and full-length strips were examined under a microscope; separate segments were taken for flow cytometric evaluation. The prevalence of DNA aneuploidy and histologic esophageal papillomas or squamous cancer was increased in carcinogen-treated rats with pancreatic juice reflux (P <0.05 vs. control) and the combination of pancreatic and bile reflux (P <0.05 vs. control) but not in rats with bile reflux alone. We conclude that pancreatic juice is the most potent component of the duodenal refluxate in the promotion of esophageal carcinogenesis in rats.