Development of superficial carcinoma of the stomach. Report of late recurrence.
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Adenocarcinoma↗
Biomedical subjects
S Inutsuka
Publications and source records attributed to S Inutsuka.
[Criticism and our opinion concerning "Malignolipin test" as a cancer reaction].
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Adult↗
Clinical value of SDI test for predicting effect of postoperative chemotherapy for patients with gastric cancer.
We retrospectively evaluated the clinical usefulness of the succinate dehydrogenase inhibition (SDI) test as a chemosensitivity test, using 168 resected specimens of gastric cancer, with special reference to the correlation between the results of the SDI test and clinical effects of the corresponding chemotherapy. The rate of sensitivity of these tissues to DDP, CQ, ACR, MMC, ADM, and 5-FU were 63.5%, 54.2%, 47.4%, 42.9%, 31.4%, and 10.8%, respectively. Survival rates for patients with a positive chemosensitivity to MMC and postoperatively prescribed more than 20 mg of MMC were significantly better than those without sensitivity to MMC, even when treated with MMC, although no statistical differences existed in clinicopathologic factors between the two groups. We conclude that the SDI test for human gastric cancer is a rapid, reliable, and useful assay to determine the compatibility between the results of assay and the clinical effects of corresponding chemotherapy. We propose that the regimen of postoperative adjuvant chemotherapy be tailored according to results of the SDI test, using tissues resected from individual patients.
Aclarubicin↗
Increased intestinal permeability correlates with gastrointestinal toxicity among formulations of the fluorouracil analogue tegafur in rats.
BACKGROUND: S-1 is a new antitumor agent which was developed based on biochemical modulation of fluorouracil. S-1 consists of tegafur (FT), 5-chloro-2,4-dihydroxypyridine (CDHP), and potassium oxonate (Oxo) in a molar ratio of 1:0.4:1. S-1 has been reported to enhance therapeutic effects and to reduce the gastrointestinal toxicity as compared with 5-fluorouracil. In this study performed in rats, S-1 was used to assess the relationship between gastrointestinal mucosal toxicity and changes in intestinal barrier function. METHODS: Fifteen rats were equally divided into three groups: group A (untreated controls), group B (FT and CDHP mixture), and group C (FT and CDHP in combination with Oxo). The animals in groups B and C received equitoxic doses of the drugs in their food for 14 consecutive days. The intestinal permeability was determined on the basis of the urinary recovery of orally administered lactulose and mannitol (L/M). Injury to the small intestines was evaluated by light microscopy. The cell surface expression of CD44 was evaluated immunohistochemically. RESULTS: Recovery of L/M in urine (expressed as a fraction of the dose administered) was 0.15 +/- (SE) 0.08, 0.23 +/- 0.13, and 0.09 +/- 0.04 in groups A, B, and C, respectively. The intestinal permeability in group B was significantly higher than that in group C (p < 0.05). Treatment with FT and CDHP (groups B and C) induced injury to the small intestine and decreased expression of CD44 within the intestinal mucosa, but the extent of damage was reduced by coadministration of Oxo (group C). CONCLUSION: This experimental study suggested that the gastrointestinal toxicity resulting from administration of anticancer drugs is accompanied by an impaired gut barrier function measurable as an increase in intestinal permeability to L/M.
Animals↗
Assessment of the intestinal permeability following postoperative chemotherapy for human malignant disease.
PURPOSE: Administration of anticancer drugs may damage gastrointestinal epithelium, thereby increasing the permeability of the gastrointestinal mucosa. We estimated the usefulness of oral lactulose and mannitol (L/M) test for assessment the extent of mucosal damage following postoperative chemotherapy for human malignant disease. METHODS: The permeability index (PI): the urinary recovery ratio of excreted L to M was measured before and after chemotherapy in 31 patients with gastrointestinal cancers who underwent surgical resection. These findings were compared with data on 12 patients with breast cancer. The effect of chemotherapy was evaluated by the ratio of increase in PI, which was designed as post-chemotherapy value on day 7 divided by pre-chemotherapy value. RESULTS: The mean PIs before chemotherapy in patients who underwent gastrectomy or colectomy were significantly higher than the value in those treated with mastectomy (p < 0.05). In the gastrointestinal cancer patients, the mean PIs significantly increased after chemotherapy compared with the pre-chemotherapeutic value (p < 0.01), however no significant difference was seen in breast cancer patients. When the ratios of increase in PI were calculated among gastric cancer patients, the total gastrectomy group showed a significantly higher increase in PI compared with the partial gastrectomy group (p < 0.05). CONCLUSIONS: Since the oral L/M absorption test is useful for assessing the degree of mucosal damage and measurement of intestinal permeability, this analysis should be recommended to determine the optimum timing and the adequate dosage of the anticancer drug administration.
Antineoplastic Agents, Phytogenic↗
Obstructing carcinomas of the colon and rectum have a smaller size compared with those of non-obstructing carcinomas.
The aim of the current study was to elucidate the histopathological characteristics of obstructing carcinoma of the colon and rectum. We studied 72 patients with colorectal carcinoma, including 13 with obstructing carcinoma. The obstruction carcinomas occurred in sigmoid colon significantly more frequently than did non-obstructing carcinomas (p=0.007). The mean size of the obstructing carcinomas was 3.7+/-0.9 cm, which was significantly smaller than that of non-obstructing carcinomas (5.4+/-1.9 cm, p=0.003). The proportion of lymph node metastasis in obstructing carcinomas was 66.9%, which was significantly higher than that in non-obstructing carcinomas (42.4%, p=0.021). The proportion of carcinomas classified into Dukes' C or D in obstructing carcinomas was 84.6% and was significantly higher than that in non-obstructing carcinomas (52.5%, p=0.026). The pathogenesis of obstruction in colorectal carcinoma can be also derived from the contraction of the intestinal lumen caused by the condensation of cancer cells.
Adult↗
Factors influencing the development of small intestinal obstruction following total gastrectomy for gastric cancer: the impact of reconstructive route in the Roux-en-Y procedure.
BACKGROUND/AIMS: The factors influencing the development of small intestinal obstruction following gastric surgery are controversial. METHODOLOGY: Univariate and multivariate analyses were carried out on data from 48 patients with gastric cancer who underwent total gastrectomy and Roux-en-Y reconstruction for a potential cure. RESULTS: Of these 48 patients, 11 (22.9%) presented with mechanical obstruction in the small intestine postoperatively. There were no statistically significant differences with regard to age, sex, and the presenting pathology. The development of obstruction was not related to a longer operation time, a greater estimated blood loss during surgery, an extensive lymph node dissection and a combined resection of adjacent organs. The probability that the antecolic anastomosis would cause obstruction was significant when compared with findings in case of the retrocolic anastomosis (P < 0.05). In the multivariate logistic regression analysis, the significant risk factors related to the development of small intestinal obstruction proved to be reconstructive route of jejunal loop. CONCLUSIONS: In potentially curative patients undergoing total gastrectomy, retrocolic anastomosis should be attempted to prevent the development of postoperative intestinal obstruction.
Aged↗
Simultaneous adenocarcinoma of the stomach and fourth portion of the duodenum: case report and review of the literature.
We treated a woman with simultaneous adenocarcinoma of the stomach and fourth portion of the duodenum. She complained of symptoms of obstruction in the duodenum, and both lesions were correctly diagnosed, preoperatively. Noncurative resection was done because of distant lymph node metastasis. The new adjuvant chemotherapy using THP-adriamycin and UFT was prescribed, and one year after surgery she remains in recession.
Adenocarcinoma↗
Minute gastric carcinoid tumor with regional lymph node metastasis.
A minute carcinoid tumor of the stomach developed into a regional metastasis around the celiac axis. There was marked lymphangitic and venous invasion of the tumor cell cluster around the tumor, in the submucosal layer. We wish to emphasize that radical gastrectomy with extended lymphadenectomy should be performed, even for a minute carcinoid tumor, as there will probably be a lymph vessel-related metastasis.
Adult↗
Iatrogenic paraesophageal hernia after endoscopy.
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Adult↗
Antitumor chemosensitivity differs between clinical sarcoma and adenocarcinoma tissues.
The chemosensitivity of 43 human sarcoma tissues, including 18 osteosarcomas, 16 leiomyosarcomas and 9 liposarcomas, was compared with that of 28 adenocarcinomas of the stomach, using the in vitro succinate dehydrogenase inhibition (SDI) test. These tissues were exposed for 3 days to each antitumor drug, including adriamycin (ADM), 5-fluorouracil (5-FU), mitomycin C (MMC), cisplatin (CDDP), aclacinomycin A (ACR) and carboquone (CQ), them the cell viability was estimated based on the succinate dehydrogenase (SD) activity, determined using [3-(4,5-dimethyl-2-thiazolyl) -2,5-diphenyl-2H tetrazolium bromide] (MTT). SD activity was significantly lower in the osteosarcoma as compared to that in the adenocarcinoma, for ADM, MMC, CDDP, ACR and CQ (p < 0.01), and was higher for ADM (p < 0.05) in cases of leiomyosarcoma and for CDDP (p < 0.01) and ACR (p < 0.05) in cases of liposarcoma. The sensitivity rate was higher in osteosarcoma than in adenocarcinoma for ADM, MMC and CDDP. These findings suggest that patients with osteosarcoma will probably show a fairly good response to antitumor drugs, and that when liposarcoma or leiomyosarcoma tumors show resistance to antitumor drugs, then resection at the time of initial exploration and combined modalities, including radiation and hyperthermia, should be considered.
Adenocarcinoma↗
Optimal scheduling increases therapeutic gain of adriamycin combined with hyperthermia.
To maximize the thermal enhancement of antitumor effect and minimize normal tissue damage, the timing of Adriamycin (ADM) administration in relation to hyperthermia was examined. Tumor growth of a subcutaneously transplanted fibrosarcoma as well as damage in normal tissues were measured in F344 rats treated with variable schedules of ADM and hyperthermia. Simultaneous application of 5 mg/kg i.v. of ADM with hyperthermia (120 min at 41.5 degrees C) resulted in a synergistic antitumor effect, but there was no thermal enhancement of the antitumor activity when 2.5 mg/kg ADM was given. Thermal enhancement of the antitumor effect induced by 5.0 mg/kg ADM was greater when ADM was given 30 min before or just prior to hyperthermia compared to that given during hyperthermia. ADM given prior to hyperthermia caused less damage to normal tissue than that given during hyperthermia, as evidenced by a prolonged survival and lower incidence of ascites and tendency to bleed. Thus ADM administration 30 min before or just prior to hyperthermia resulted in greater therapeutic gains than ADM given during hyperthermia. In the light of these results, the optimal scheduling of administration of ADM with hyperthermia is important for a therapeutic gain for cancer patients.
Animals↗
Preoperative diagnosis of Meckel's diverticulum in a 62-year-old man: utility of an angiographic technique.
A 62-year-old man with severe anal bleeding was admitted to our ward as an emergency patient. Angiography of the superior mesenteric artery revealed an omphalomesenteric artery. Methylene blue was injected superselectively into the artery through an angiographic catheter at the time of subsequent laparotomy. Blood supply through the artery to the restricted area of the diverticulum could thus be defined in situ.
Angiography, Digital Subtraction↗