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Biomedical subjects

S Natsugoe

Publications and source records attributed to S Natsugoe.

At least 109 records · Page 6Linked to original sources
PubMed1993

[A basic study on usefulness of bleomycin incorporated in poly DL-lactic acid].

Poly DL-lactic acid (PLA) is one of the biodegradable polymers. Bleomycin (BLM) incorporated into small cylinders of PLA blends was prepared as a new dosage (BLM-PLA). When BLM-PLA was preserved in saline, the dissolution rate of BLM from BLM-PLA was 49.2% after 7 days, 85.2% after 14 days and 99.7% after 21 days, respectively. BLM-PLA was implanted subcutaneously into the back of 36 rats. On days 3, 7, 14, 21, 28 and 35, the connective tissues near the implants, lymph node, lung, liver and kidney were removed and BLM activity was measured. The BLM concentration was maintained at a high level in the connective tissues until 14 days, and in the lymph node between 21 and 28 days. On the other hand, the BLM level was low in the lung, liver and kidney. Consequently, it was suggested that PLA is useful as a carrier for drug delivery system and that administration of BLM-PLA is an effective anti-cancer modality, especially in local chemotherapy.

Animals↗
PubMed1993

Uptake of bleomycin adsorbed on to activated carbon particles by regional lymph nodes of the esophagus in dogs.

Two bleomycin (BLM)-containing agents (BLM-CH, BLM-SOL) were prepared, and the possible usefulness of BLM-CH in the targeting of chemotherapy for esophageal cancer was studied. BLM-CH is an agent in which BLM is adsorbed on to activated carbon particles, and BLM-SOL is an aqueous solution of BLM. BLM-CH or BLM-SOL was injected into the submucosa of the middle thoracic esophagus of 14 mongrel dogs under endoscopic control. Three days after the administration, regional lymph nodes, connective tissues, liver, lung and spleen were removed, and BLM in the specimens was measured. When BLM-CH was administered, BLM was demonstrated not only in the lymph nodes near the injection site but also in the cervical and abdominal ones. In contrast, BLM was not detected in any lymph nodes when BLM-SOL was administered. Light and electron microscopic observation showed that activated carbon particles diffused and were distributed in the lymph nodes. The latter findings also revealed their existence in the interstices of lymphatic tissues and macrophages. When BLM-CH was injected, BLM in the blood was significantly lower when compared with the results of BLM-SOL administration. The results obtained indicate that BLM-CH may probably become a useful tool in targeting chemotherapy for esophageal cancer.

Adsorption↗
PubMed1992

[Postoperative changes in acute phase protein in patients with esophageal cancer].

Thirty-three patients with esophageal cancer were studied to assess the relationship between nutritional state and the acute phase protein responses. Blood samples taken preoperatively and days 1, 4, 7 and 14 after operation were analyzed for C-reactive protein, fibrinogen, alpha 1-antitrypsin, alpha 1-acid glycoprotein and haptoglobin. Significant Spearman's coefficients were found between percent of ideal body weight (IBW) and alpha 1-acid glycoprotein (r = -0.42), between prealbumin and alpha 1-anti-trypsin (r = -0.55), and between retinol-binding protein and alpha 1-antitrypsin (r = -0.51). Postoperatively, the levels of C-reactive protein, fibrinogen, alpha 1-anti-trypsin and alpha 1-acid glycoprotein were significantly lower in the poorly nourished group than in the other groups. The changes of acute phase proteins in the immediate postoperative period were affected by the preoperative nutritional state, and were less marked in the poorly nourished patients. Between two groups of patients in whom lymph node dissection was carried out in 2 or 3 areas, no significant differences were observed in the acute phase protein responses postoperatively. The measurement of acute phase proteins is very important in assessing the body defense capacity of the patient, but it should be noted that the changes may be affected by several factors including malnutrition.

Acute-Phase Proteins↗
PubMed1992

[Histopathological features of the lymph node metastases in patients with thoracic esophageal cancer].

Histopathological features of the lymph node involvement were studied in 104 patients with thoracic esophageal cancer who underwent subtotal esophagectomy combined with extended radical lymph adenectomy in cervicothoracoabdominal region. Metastatic involvement was found in a total number of 503 lymph nodes from 73 patients by histologic examination. The mean of long and short diameter was found to be less than 5mm in 125 (24.9%) of these 503 nodes. The involved area on the section was less than one third in 149 nodes (29.6%), and was significantly smaller in mediastinal lymph nodes than those in cervical or abdominal ones. Sixty-seven (13.3%) of 503 nodes were partially invaded by micrometastasis of 1mm or less in diameter. Micrometastasis also more frequently occurred in mediastinal nodes with a statistically significant difference. Extranodal proliferation (ENP) of cancer cells was found in 106 nodes (21.1%), and extranodal lymphatic and/or blood vessel invasion (ENly, v) was also recognized in 60 nodes (11.9%). Micrometastasis and ENP with or without ENly, v were found in 24 (32.9%) and 29 (39.7%) of 73 patients with positive lymph node metastasis, respectively. Postoperative survival rate in patients with micrometastasis and/or ENP with or without ENly, v was inferior to that in patients with neither of them.

Esophageal Neoplasms↗
PubMed1992

Significance of lymph nodal metastases in treatment of esophagogastric adenocarcinoma.

Between 1973 and 1990, 104 patients with adenocarcinoma of the esophagogastric junction (EGJ) (i.e., primary tumor within 2-3cm of and including the EGJ) were operated upon. Preoperatively, all were deemed potentially resectable. In 70, the esophagogastrectomy was combined with en-bloc resection, that is, wide excision of the primary mass in conjunction with radical lymph node dissection of the posterior mediastinum and upper abdomen. Postoperative staging was done using the WNM system [i.e., wall penetration (W), lymph node involvement (N), and systemic metastases (M)]. Sixty-four patients or 62% had lymph nodes positive for metastases and these neoplastic nodes were most common in the areas between the lower mediastinum and the celiac axis. Of the 70 patients undergoing radical en-bloc resection, paracardiac lymph nodes had the highest rate of metastatic involvement (40%) while gastric lesser curvature lymph nodes had 29%, and distal splenic/pancreatic lymph nodes 11%. Overall, the frequency of intrathoracic lymph nodal metastases was 7%. Those patients who had intrathoracic lymph nodal metastasis also had intraabdominal lymph nodal secondary tumor involvement. Among postoperative survivors, the percent of 5 year survival with N0 (no positive node) and N1 (1 to 3 positive nodes) stage of disease was 38.6% and 28.9%, respectively, compared to only 11.5% in those with N2 (4 or more positive nodes) staging. Because long-term survival is dismal in patients with multiple lymph nodal metastasis, preoperative and intraoperative staging is desirable to avoid morbidity of radical resection for EGJ adenocarcinomas. With less than 3 positive nodes, en bloc resection is worthwhile.

Adenocarcinoma↗
PubMed1991

A detailed histological study on occult metastasis of the lymph nodes.

One representative microsection from each lymph node was carefully surveyed for metastasis in a routine examination. To scrutinize the existence of occult metastasis, three additional sections were then made from half of the remaining lymph node. A total of 1,698 lymph nodes taken from 55 patients with carcinoma of the esophagus, stomach, colon, thyroid or breast were thus reexamined histologically. The initial examination was not able to prove any metastasis in these lymph nodes. Upon reexamination, however, involvement by cancer cells was detected in 10 nodes of 7 patients. The maximum diameter of the metastatic foci varied from 0.2 mm to 1.3 mm and was less than 0.5 mm in more than half of the nodes. The metastatic patterns in the nodes were classified into three types, i.e., marginal sinus type, medullary sinus type and mixed type. The marginal sinus type was the most frequent, with the mixed type being next and the medullary sinus type being found in only one node. Accordingly, surgeons should keep the possibility of occult metastasis in mind and the marginal sinus of the lymph node should be carefully examined in order to detect any small foci of metastasis.

Humans↗
PubMed1989

[Lymph node metastases in the thoraco-cervical transitional region in thoracic esophageal cancer--with ultrasonic detection and a comment on the guide lines].

Lymph node metastases in the thoraco-cervical transitional region (TCTR) and its ultrasonic detection were evaluated in 64 patients with thoracic esophageal cancer, who received radical esophagectomy with modified neck dissection. Lymph node metastases in TCTR were found in 19 of 64 cases (29.7%). Nodal metastases in the supraclavicular region were found in similar incidence of 23.4% (15 of 64 cases). Lymph nodes in both regions were infiltrated in 8 cases. Direct metastases to supraclavicular region and metastases in single region of TCTR were indicated in 4 cases equally. The degree of lymph node metastases of 11 patients suffered from middle intra-thoracic esophageal (Im) cancer with nodal involvement in TCTR were divided into three groups, two cases of n2, one of n3 and eight of n4, according to the Guide Lines. Convex type probe excelled in description of TCTR. Swollen lymph nodes were detected in 12 out of 19 cases with metastases by preoperative ultrasound using this probe (sensitivity of 63.2%). Forty-four of 45 cases without metastases were diagnosed as such (specificity of 97.8%). The partition of TCTR in the Guide Lines should be reconsidered for better evaluation of the results on lymph node metastases in this region.

Esophageal Neoplasms↗
PubMed1989

[Experimental and clinical study on the lymphatic pathway draining from the distal esophagus and gastric cardia].

The intramural and extramural lymphatics draining from the distal esophagus and gastric cardia were studied in 140 mongrel dogs by dye injection technique. A clinical study was also performed on the lymphatic pathway in these regions by radio isotope uptake (RIU). The results were compared with that of lymph node metastases in 113 patients with carcinoma of the distal esophagus and 103 patients with carcinoma of the gastric cardia. The intramural lymphatics between the distal esophagus and gastric cardia were communicated at the central part of the muscularis mucosae. This finding coincided with the results of intramural RIU. The extramural lymphatics from the distal esophagus flowed both upward and downward. Those from the cardia entered the intraabdominal regional lymph nodes, but none was visualized either in the mediastinum or in the thoracic cavity. Similarly, few RIUs were detected in the mediastinal nodes. As the result of partial or total blockade at the cardiac portion of the stomach in dogs, ascending lymphatics reaching the thoracic cavity was observed in 6 of 27 cases. Clinically, the incidence of the mediastinal lymph node metastases were 17.0%. These results indicate that upward lymphatic spreads may occur in cases with cardiac cancer when the descending lymphatic pathway is blocked by the tumor invasion.

Adult↗
PubMed1988

Antrum preserving double tract method for reconstruction following proximal gastrectomy.

The antrum preserving double tract method was originally designed in order to gain the smooth transfer of larger foods through the duodenal route. Surgical improvement was then made at a few points when carrying out the anastomosis between the residual stomach and the jejunum. In the clinical field, this method is characterized by a better transfer of large foods into the duodenum than the conventional double tract method. The clinical investigation revealed that gastrin release remained after the operation due to both the good passage and the presence of food in the residual stomach. The antrum preserving double tract method is a reasonable and simple method which can maintain physiological pancreaticocibal synchronism.

Anastomosis, Surgical↗
PubMed1987

[Comparative study on the macroscopic and histopathological diagnosis of lymph node metastases in cancer patients].

Macroscopic diagnosis for lymph node metastases was compared with histopathological diagnosis in 444 patients with carcinoma of the esophagus, stomach, colon, thyroid and breast. The former indicated lymph node metastases in 181 patients. In all of them, none or less than five node metastases were proven by routine histopathological diagnosis. Detailed histological study revealed lymph node metastases in 25 out of 263 patients with macroscopically negative nodes, the rate of false negative being 9.5 per cent. The study also demonstrated no lymph node metastases in 51 of 181 patients with macroscopically positive nodes. Three additional specimens were obtained from originally examined 693 lymph nodes and reexamined microscopically in these 51 patients. Involvement by cancer cells was detected in 9 nodes (1.3 per cent) in 8 patients. Metastases were found from additional specimens in 7 of 9 nodes, indicating that metastatic carcinoma had been overlooked in the remaining two nodes. Additional specimens or embedding-techniques were recommended in such cases as macroscopic metastases were strongly suspected or lymph vessel invasions were remarkable. In 24 patients with esophageal cancer, one to one correspondence was available in the analysis of macroscopic diagnosis. Seventy-eight out of 108 involved nodes were macroscopically judged as involved (sensitivity; 72.2 per cent), and 1166 out of 1260 nodes without macroscopical metastases were judged as cancer-free (specificity; 92.5 per cent). Overestimation of macroscopic diagnosis was due to thickened capsule, fibrosis, inflammation and enlargement in size more than 10 mm in diameter of the nodes. Underestimation was observed in case of nodes with metastatic area less than one-third and with smaller size less than 5mm in diameter.

Diagnosis, Differential↗
PubMedDate not supplied

Angiogenesis as an unfavorable factor related to lymph node metastasis in early gastric cancer.

BACKGROUND: Recent studies suggest that angiogenesis enhances tumor growth and metastasis. Lymph node metastasis influences the prognosis and selection of treatment modalities in cancers. In this study, the authors investigated the correlation between angiogenesis and clinicopathologic features to determine whether angiogenesis correlated with lymph node metastasis in early-stage gastric cancer. METHODS: A total of 97 specimens from patients with early gastric cancer were studied by immunohistochemical methods using anti-Factor VIII-related antigen antibody. RESULTS: Tumor size was significantly correlated with microvessel count, which increased as tumor size increased. Microvessel counts from tumors with lymphatic vessel invasion, lymph node metastasis, and submucosal invasion were significantly higher than those without. Furthermore, microvessel count was an independent factor that influenced lymph node metastasis (P = .0016) by multivariate logistic regression analysis. CONCLUSION: In the early stage of gastric carcinoma, angiogenesis is an independent factor that impacts on lymph node metastasis.

Adult↗
PubMedDate not supplied

Appraisal of ten-year survival following esophagectomy for carcinoma of the esophagus with emphasis on quality of life.

Characteristics of 10-year survival after esophagectomy for carcinoma were studied retrospectively in 161 patients who underwent curative operation between 1973 and 1984. Of the 161 patients, 44 (27.3%) survived for 10 years after operation (right transthoracic approach with cervical anastomosis in 36 patients and left thoracoabdominal approach with jejunoesophagostomy in 8 patients). Females survived significantly longer than males; 10-year survival was observed in 10 (50%) of 20 females and 34 (24.1%) of 141 males. TNM factors were significantly linked to the 10-year survival for 25 patients (56.8%) whose tumors invaded the adventitia and 20 patients (45.5%) who had lymph node metastases, where the total number of involved nodes was less than eight. A questionnaire mailed 10 years after operation revealed that about one-fifth of the 10-year survivors could not go up one flight of stairs without taking a rest, and that the daily activity significantly deteriorated if the patient's age at the time of surgery was more than 66 years. One-third of the 10-year survivors were not satisfied with the daily quantity of food intake, resulting in no gain of body weight after discharge from the hospital. This complaint was significantly correlated with either weekly reflux or heartburn, resulting in the increasing number of nonmalignancy deaths. Of 13 ten-year survivors who were alive at 10 years but died after that, 11 (84.6%) died of pneumonia or malnutrition. Duodenogastroesophageal reflux may eventually cause nonmalignancy death 10 years after esophagectomy for carcinoma.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Carcinomatous lymphatic invasion in early gastric cancer invading into the submucosa.

BACKGROUND: Lymphatic invasion is a risk factor for lymph node metastases in patients with gastric cancer. No studies have been reported, however, on the correlation between lymphatic invasion and lymph node metastasis in early gastric cancer invading into the submucosa. METHODS: We performed a retrospective analysis of lymphatic invasion in 170 patients with early gastric cancer invading into the submucosa. RESULTS: Lymphatic invasion was found in 76 patients. Lymphatic invasion correlated significantly with the presence of lymph node metastasis and vascular invasion (P < .05) and with the degree of cancerous submucosal involvement (P < .05). The presence of lymph node metastasis also correlated with the grade of submucosal invasion and lymphatic invasion. The 5-year survival of patients with lymphatic invasion was poorer than that of patients without lymphatic invasion (P < .05). Node-negative patients had similar survival, regardless of the presence of lymphatic invasion. All patients with severe lymphatic invasion had sm3 invasion and lymph node metastases. CONCLUSION: Although lymphatic invasion is the first stage of lymph node metastasis, lymphatic invasion in itself does not have clinical importance except for severe invasion in early gastric cancer. It is possible to predict lymph node metastases from the combined evaluation of degree of lymphatic invasion and submucosal involvement of the tumor in patients with early gastric cancer invading into the submucosa.

Aged↗
PubMedDate not supplied

Intraoperative pleural lavage in esophageal carcinoma.

BACKGROUND: Cytological examination of intraoperative pleural or peritoneal lavage specimens is useful for predicting outcomes for patients with various carcinomas. There have been few reports regarding cytological examination of pleural lavage fluid in esophageal carcinoma. METHODS: Intraoperative pleural lavage fluid was collected before and after esophagectomy and was examined by Papanicolaou and Giemsa staining for 78 patients with esophageal carcinoma. RESULTS: Although epithelial cells were found for 29 patients, only blood cells were detected for 48. The remaining one patient exhibited no cells in the specimen. For 4 of 78 (5.2%) patients, tumor cells were detected in the pleural lavage fluid after esophagectomy. Three of these four patients had T4 tumors. CONCLUSIONS: Positive cytological findings for pleural lavage fluid, using Papanicolaou and Giemsa staining, is correlated with regrowth of residual tumor and poor prognosis in esophageal carcinoma.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Prognostic value of HLA-DR expression and dendritic cell infiltration in gastric cancer.

We attempted to correlate the expression of human leukocyte antigen DR (HLA-DR) and tumor infiltration by S-100-protein-positive dendritic cells with clinicopathologic features in 165 patients with gastric cancer. The expression of HLA-DR was correlated with the histologic type. Infiltration of dendritic cells correlated negatively with distant lymph node metastases, clinical stage, and peritoneal invasion. There was no correlation between the expression of HLA-DR and infiltration by dendritic cells. In patients with resectable gastric cancer, the grade of infiltrating dendritic cells may be a suitable predictor of prognosis.

Adult↗
PubMedDate not supplied

Mucosal squamous cell carcinoma of the esophagus: a clinicopathologic study of 30 cases.

A clinicopathologic study was carried out on 30 patients with mucosal esophageal cancer (MEC). The depth of cancer invasion was subdivided histologically into three categories: m1 = carcinoma in situ (intraepithelial carcinoma) or carcinoma with questionable invasion beyond the basal membrane; m2 = cancer invasion confined to the lamina propria, and m3 = cancer reaching to or infiltrating into the muscularis mucosae. Lymph node metastases and lymphatic invasion were found only in the tumors reaching or infiltrating the muscularis mucosae (m3). The maximum histologic vertical extent of the tumors was more than 1 mm in 4 of 5 patients with lymph node metastasis or lymphatic invasion. None of the patients died of recurrent esophageal disease, and 3 of the 6 patients who had a second primary tumor died of this other malignancy. It is critical to distinguish between m1, m2 and m3 tumors to plan a treatment strategy, including an endoscopic mucosal resection.

Adult↗
PubMedDate not supplied

Clinical and biological features of t1 ductal adenocarcinoma of the pancreas.

BACKGROUND/AIMS: The impact of tumor size on tumor development and long-term prognosis is still controversial for patients with ductal adenocarcinoma of the pancreas. We investigated the clinicopathological and biological features of ductal adenocarcinoma limited to the pancreas without direct histological extrapancreatic invasion (t1 tumor). METHODOLOGY: The clinical records of 86 patients who underwent surgery for ductal adenocarcinoma of the pancreas were reviewed to determine clinical features, histopathological findings, operative management and outcomes. Immunohistochemical staining of the p53 tumor suppressor gene (p53) was performed for the resected specimens. RESULTS: Only 10 (12%) of the 86 resected ductal adenocarcinomas of the pancreas were t1 tumors. Six of the 10 patients with t1 tumors survived for more than 5 years. The rates of nodal metastasis (10%) and neural plexus invasion (0%) in t1 tumors were significantly lower than those in non-t1 tumors, although the rates of blood-borne metastasis (30%) and p53 expression (50%) in t1 tumors were the same as those in non-t1 tumors. CONCLUSIONS: Curative resection contributes to a satisfactory long-term prognosis of patients with t1 tumor of the pancreas as a result of the low rates of both nodal metastasis and neural plexus invasion associated with this procedure. In patients with t1 tumor of the pancreas, a satisfactory long-term prognosis can be assured as a result of the low rates of both nodal metastasis and neural plexus invasion associated with curative resection.

Aged↗