Biomedical subjects

Shigeki Yamaguchi

Publications and source records attributed to Shigeki Yamaguchi.

46 records · Page 3Linked to original sources

PubMed2002

[Multidisciplinary therapy for peritoneal dissemination using peritonectomy].

An aggressive approach to peritoneal dissemination involves peritonectomy procedures combined with preoperative intraperitoneal chemotherapy, intraoperative chemo-hyperthermia, and postoperative systemic chemotherapy. We have been performing multimodal therapy consisting of peritonectomy plus perioperative chemotherapy for the treatment of patients with peritoneal dissemination. Fifty-seven patients with established peritoneal dissemination from gastric cancer (n = 32), colon cancer (n = 17), ovarian cancer (n = 7), and mesothelioma (n = 1) have been treated with peritonectomy and intraoperative chemo-hyperthermia. Five-year survival rates of patients with gastric and colon cancer were 18% and 38%, respectively. Among various clinical factors, complete tumor resection was the most significant prognostic factor, and the prognosis of patients who underwent complete cytoreduction was significantly better than those who received incomplete cytoreduction. A multimodal therapy consisting of perioperative chemotherapy and peritonectomy with complete cytoreduction may be the most powerful method to treat patients with established peritoneal dissemination.

Colonic Neoplasms↗

PubMedDate not supplied

Addition of dexmedetomidine prolongs duration of vasodilation induced by sympathetic block with mepivacaine in dogs.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the duration of vasodilation induced by sympathetic block with the addition of dexmedetomidine to mepivacaine. METHODS: We measured right and left brachial artery blood flow (BABF) before and after stellate ganglion block used as a sympathetic block in dogs. The experimental protocol was designed as follows: (1) left stellate ganglion block using 1.0 mL 0.5% mepivacaine (n = 8), (2) left stellate ganglion block using the addition of dexmedetomidine 0.5 microg to 1.0 mL 0.5% mepivacaine (n = 8), and (3) left stellate ganglion block using the addition of dexmedetomidine 0.5 microg to 1.0 mL physiological saline solution (n = 8). RESULTS: Left stellate ganglion block with mepivacaine alone increased left BABF significantly from 5 minutes through 50 minutes after the block (baseline, 100%; peak at 10 minutes after SGB, 181 +/- 27%; P <.01). Left stellate ganglion block with the addition of dexmedetomidine to mepivacaine induced a significant increase of left BABF from 5 minutes through 90 minutes after the block (baseline, 100%; peak at 10 minutes after SGB, 174 +/- 36%; P <.01). Left and right BABF did not change significantly after stellate ganglion block with dexmedetomidine only. Right BABF decreased significantly after left stellate ganglion block with mepivacaine alone or the addition of dexmedetomidine to mepivacaine throughout the study. CONCLUSIONS: The addition of dexmedetomidine prolongs the duration of vasodilation induced by stellate ganglion block with mepivacaine used for sympathetic block in dogs.

Analgesics, Non-Narcotic↗

PubMedDate not supplied

Effects of head-up tilt after stellate ganglion block on QT interval and QT dispersion.

BACKGROUND AND OBJECTIVES: The aim of this study is to examine the effects of head-up tilt (70 degrees ) 30 minutes after right or left stellate ganglion block (SGB) on RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD), and the rate-corrected QT dispersion (QTcD) using computerized measurement. METHODS: Ten healthy volunteers underwent both right and left SGBs using 7 mL 1% mepivacaine with a 7-day interval between the two blocks. A 12-lead electrocardiogram was monitored to measure parameters before SGB; 30 minutes after SGB (before head-up tilt); and immediately, 5, 10, and 15 minutes after head-up tilt. RESULTS: Right SGB induced significant increases in QT interval, QTc interval, QTD, and QTcD from 30 minutes after the block through 15 minutes after head-up tilt. There were significant increases of QT interval, QTc interval, and QTcD between before and immediately after head-up tilt in right SGB. Left SGB induced significant decreases of QT interval and QTc interval from 30 minutes after SGB through 15 minutes after head-up tilt. Left SGB also induced a significant decrease of QTD from immediately after through 10 minutes after head-up tilt. CONCLUSIONS: Significant increases of QT interval, QTc interval, and QTcD, which are associated with an increased risk of ventricular arrhythmias and cardiac events, occur immediately after head-up tilt in right SGB. However, head-up tilt does not induce increases of QT interval, QTc interval, QTD, and QTcD in left SGB.

Adult↗

PubMedDate not supplied

Comparison of 0.2% ropivacaine, 0.125% bupivacaine, and 0.25% bupivacaine for duration and magnitude of action in peripheral arterial blood flow induced by sympathetic block in dogs.

BACKGROUND AND OBJECTIVES: The aim of this study is to compare 0.2% ropivacaine with 0.125% bupivacaine or 0.25% bupivacaine for the duration and magnitude of the vasodilation effect induced by sympathetic block. METHODS: We measured mean arterial pressure, heart rate, and right and left brachial artery blood flow (BABF) before and after cervicothoracic sympathetic block in 24 dogs. The experimental protocol was designed as follows: (1) left cervicothoracic sympathetic block with 1.0 mL 0.2% ropivacaine (n =8), (2) left cervicothoracic sympathetic block with 1.0 mL 0.125% bupivacaine (n=8), and (3) left cervicothoracic sympathetic block with 1.0 mL 0.25% bupivacaine (n=8). RESULTS: Mean arterial pressure and heart rate did not change significantly throughout the study in either group. Left cervicothoracic sympathetic block with 0.2% ropivacaine increased left BABF significantly from 5 to 100 minutes after the block (baseline, 100%; peak at 10 minutes after the block, 254 +/- 38%; P <.01). Left cervicothoracic sympathetic block with 0.125% bupivacaine increased left BABF significantly from 5 to 80 minutes after the block (baseline, 100%; peak at 10 minutes after the block, 144 +/- 9%; P <.01). Left cervicothoracic sympathetic block with 0.25% bupivacaine increased left BABF significantly from 5 to 100 minutes after the block (baseline, 100%; peak at 10 minutes after the block, 235 +/- 61%; P <.01). CONCLUSION: Ropivacaine may be equally potent to bupivacaine at equal concentrations in sympathetic block in dogs.

Amides↗

PubMedDate not supplied

Clinical evaluation of granisetron as an inhibitor of nausea and vomiting induced by oral anticancer drugs.

In order to inhibit the nausea and vomiting induced by oral anticancer drugs, granisetron was administered orally at a dose of 2 mg once a day, and its usefulness and safety were evaluated. The subjects were 26 outpatients with gastric or colon cancer receiving chemotherapy with oral anticancer drugs and complaining of gastrointestinal symptoms. A record sheet was handed to the patients. In comparison with the condition before treatment, the patients were instructed to indicate on the record sheet the severity of nausea (4 grades), presence or absence of vomiting, and degree of appetite (4 grades) after treatment, and thereby to evaluate the clinical efficacy or antiemetic effect every day in accordance with clinical efficacy evaluation criteria of 4 grades (very effective, effective, slightly effective, and ineffective). i) Nausea disappeared in 47.8% of the patients on the 1st day of treatment and in 65.2% on the 5th day of treatment. ii) Vomiting was observed in 2 and 3 patients on the 1st and 3rd day, respectively, but not on the 4th day of treatment or thereafter. iii) The efficacy rate, comprising both very effective and effective, was 69.5% on the 1st day of treatment, and increased gradually to reach 78.2% on the 5th day of treatment. iv) There was no adverse reaction or abnormality of laboratory test values attributable to granisetron. Granisetron was safe and effective against nausea and vomiting induced by oral anticancer drugs.

Administration, Oral↗

PubMedDate not supplied

Real-time PCR (TaqMan PCR) quantification of carcinoembryonic antigen (CEA) mRNA in the peripheral blood of colorectal cancer patients.

Reverse transcriptase-polymerase chain reaction (RT-PCR) has been utilized to detect living micrometastases of cancer cells in the lymph node, ascites or circulation system. However, the method was so sensitive that false-positives happened frequently. Therefore we have developed a quantification of CEA mRNA using real-time PCR to detect living cancer cells in the circulating blood and examined its usefulness as a predictive marker for liver metastases of colon cancer. In cell spiking experiments, it was possible to detect CEA mRNA in 10(1) cancer cells diluted in 10(7) normal lymphocytes. In the blood samples of cancer patients, the CEA mRNA level was significantly higher in Dukes' D patients than in the other clinical stages of colorectal cancer. This indicates that quantification of CEA mRNA is useful for the evaluation of colorectal cancer progress and that the post-operative increase of CEA mRNA can be a predictive marker for micrometastasis.

Adenocarcinoma↗

PubMedDate not supplied

Outcome of total pelvic exenteration for locally recurrent rectal cancer.

BACKGROUND/AIMS: Local recurrence occurs in 10 to 30% of patients with rectal cancer following curative resection. However treatment of choice remains controversial. We assessed the results of total pelvic exenteration for locally recurrent cancer of the rectum retrospectively. METHODOLOGY: We reviewed medical charts of 45 patients with rectal cancer who underwent curative total pelvic exenteration for local recurrence. The cause of recurrence was classified into four groups: anastomotic, surgical cut-end, implantation, and lymphatic based on pathologic findings and computed tomography. Long-term survival was correlated with clinicopathologic variables. RESULTS: Postoperative morbidity was 77.8% and in-hospital death occurred in 13.3% of patients. The overall 5-year survival rate was 14.1%. The 5-year survival rates stratified according to the expectation of curability were 31.6% for absolutely curative resection, 7.8% for relatively curative resection, and 0% for non-curative resection. Multivariate analysis revealed that the disease-free interval was the only independent prognostic factor. There was no benefit from perioperative radiation or intraoperative continuous pelvic peritoneal perfusion of the pelvis. CONCLUSIONS: Total pelvic exenteration for local recurrence of rectal cancer can achieve long-term survival when curative resection is possible and the disease-free interval is long.

Adenocarcinoma↗

PubMedDate not supplied

Adjuvant hepatic arterial infusion chemotherapy after curative resection for Dukes C colorectal cancer: a pilot study.

BACKGROUND/AIMS: The aim of this study was to evaluate the effect and the toxicity of prophylactic adjuvant hepatic arterial infusion chemotherapy (HAIC) on liver metastases and on overall survival of Dukes C colorectal cancer patients. METHODOLOGY: Ninety patients in whom Dukes C colorectal cancer was diagnosed and were treated with curative resection between 1993 and 1997 underwent HAIC. The HAIC regimen consisted of a 24-hour continuous infusion of 1500 mg of 5-fluorouracil, administered once a week for 8 weeks, utilizing a portable infusion drug delivery system to ambulatory patients. Patients to whom 7 g or more of 5-fluorouracil could be given were included in the HAIC group, which resulted in 70 of the 90 patients being in this group. The HAIC group overall survival and liver recurrence rates were compared with those of 62 non-treated cases of Dukes C, which formed the non-HAIC control group. RESULTS: There were no serious toxic effects in this study. Significant differences were seen in the cumulative overall 5-year survival (HAIC group, 84.1%; non-HAIC group, 65.2%; p=0.0369). The cumulative 5-year liver metastasis-free rate was 92.7% in the HAIC group and 78.6% in the non-HAIC group (p=0.0649). In cases of distal lymph node metastasis, a risk factor for liver metastasis, the cumulative 5-year liver metastasis-free rate in the HAIC group (91.7%) was significantly higher than that in the non-HAIC group (58.6%; p=0.0268). CONCLUSIONS: HAIC effectively prevents metachronous liver metastasis, especially in patients with pre-existing distal lymph node metastases, and improves the prognosis of advanced colorectal cancer.

Adult↗

PubMedDate not supplied

Laparoscopic reduction of appendicocecal intussusception due to mucinous cystadenoma in an adult.

OBJECTIVE: Laparoscopic reduction of appendicocecal intussusception due to mucinous cystadenoma is herein described. METHODS: A 32-year-old female had intermittent abdominal pain and nonbloody diarrhea. The preoperative diagnosis was intussusception of the colon with a benign tumor by CT-scan findings. RESULTS: Laparoscopic reduction of intussusception and ileocecal resection were successfully performed. Gauze sponge sticks were used to provide compression from the distal colon. This maneuver was very effective to reduce the intussusception. CONCLUSION: Laparoscopic reduction of intussusception due to a benign tumor is feasible and safe even in adults. Mucinous cystadenoma is one of the causes of intussusception in adults and a good indication for the laparoscopic approach.

Adult↗

PubMedDate not supplied

Expression of dihydropyrimidine dehydrogenase, thymidylate synthase, p53 and p21 in metastatic liver tumor from colorectal cancer after 5-fluorouracil-based chemotherapy.

BACKGROUND: The expression of genes thought to be related to 5-FU chemosensitivity has been extensively investigated. However, little data is available on the expression patterns of these genes after chemotherapy. PATIENTS AND METHODS: We investigated the expression of four genes, DPD, TS, p53 and p21, in the metastatic liver lesions obtained from colorectal cancer patients who had been treated with hepatic arterial infusions of 5-fluorouracil(5-FU)-based chemotherapy. RESULTS: Expression of DPD, TS and p53 in the metastatic liver lesions was significantly higher in the chemotherapy-response group than in the no response group. In the response group, viable cancer cell nests were seen in confined spaces surrounded by fibrous tissue. It was of interest that these cancer cells in the response group showed conspicuous immunoreactivity of DPD, TS and p53. CONCLUSION: An analysis of genes involved in 5-FU sensitivity revealed that surviving tumor cells exhibited resistance characteristics, indicating that the chemotherapy regimen should be altered, even in partially responding cases, unless the response is pathologically complete.

Adult↗