[Research on liver function before and after surgery by the relation of artery blood ketone body ratio and beta-hydroxybutyrate: preliminary report].
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3-Hydroxybutyric Acid↗
Biomedical subjects
T Aikou
Publications and source records attributed to T Aikou.
[Clinicopathological studies of the recurrence of esophageal squamous cell cancer--with special reference to the mode of recurrence and operative procedure].
In 93 out of 201 patients (46%) with squamous cell carcinoma of the esophagus who underwent radical resection (excluding death within 30 days after operation), the site of recurrence could be identified by means of X-ray, CT, ultrasonography, and biopsy. Recurrence was found in 55% of 93 cases within 12 months after surgery and in 86% of 93 cases within 24 months. Of 93 patients with recurrences, lymph node recurrences were present in 44 cases, visceral recurrences in 32 cases, both lymph node and visceral recurrences in 11 cases and others in 6 cases. Neck and/or upper mediastinal lymph node recurrences were found in 10 out of 15 patients who had recurrences within 3 months after surgery. Careful examination should be made in the left recurrent nerve chain and extended lymph node resection of upper mediastinal region should be performed under the adequate indication. Esophageal squamous cell cancer has a tendency to recur in the lymph nodes initially, and visceral metastases may occur thereafter. The incidence of visceral recurrence increased remarkably, when neck and/or upper mediastinal lymph nodes were involved at the time of operation. Accordingly, both irradiation and chemotherapy should also be applied for improving the prognosis of esophageal carcinoma.
Aged↗
[Pre-operative staging in advanced gastric cancer by ultrasound; with special reference to para-aortic lymph node metastases].
Extraluminal cancer spreadings such as peritoneal dissemination, liver metastases, lymph node metastases and infiltration to surrounding organs were examined in 236 patients with gastric cancer by ultrasound (US). Peritoneal dissemination was found in 36 of 236 cases. Ascites, nodules in the cul-de-sac and thickened wall of the transverse colon could be detected by US in 24 of 36 cases (sensitivity of 67%). Liver metastases were detected in 18 out of 23 cases (78%). Infiltration to the surrounding organs, mainly to the pancreas, was impossible to demonstrate by US. Sensitivity was 44% (17/39). Lymph node metastases in the region around the celiac axis were indicated in 30 of 40 cases (75%) by US. Para-aortic nodal metastases were also detected in 27 of 34 cases (79%). Ultrasonic images of para-aortic lymph node metastases were classified into four figures: plate type, sandwich type, unilateral multiple type, unilateral solitary type. These types were not necessarily the same in indication of laparotomy, selection of combined or adjuvant therapy, significance of nodal dissection and also prognosis. Solitary involved para-aortic node near the left renal vein should be removed in a case free from peritoneal dissemination or liver metastases. Ultrasound could be very useful in screening patients with gastric cancer for peritoneal dissemination, liver metastases and lymph node metastases.
Aorta↗
[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↗
Lymph drainage originating from the lower esophagus and gastric cardia as measured by radioisotope uptake in the regional lymph nodes following lymphoscintigraphy.
Lymph drainage originating from the lower esophagus and gastric cardia was determined using uptake of radioisotope (RI) in the regional lymph nodes in 19 patients with primary cancer at these sites. On the day prior to operation, 99m Tc colloid solution was injected submucosally in the distal esophagus or gastric cardia during endoscopy. The regional lymph nodes were removed at operation and RI uptake of individual nodes was measured in a well-type scintillation counter. Uptake was expressed as the amount per nodal weight. After radioactive colloid was injected into the lower esophagus, high RI uptake was common in both the mid-mediastinal and abdominal nodes, suggesting that lymph originating from the lower esophagus drains in both a superior and inferior direction. On the other hand, after radioactive colloid was injected into the gastric cardia, high RI uptake was never demonstrated in mediastinal lymph nodes suggesting that direct mediastinal lymph flow from the gastric cardia is rare. These results support clinical observations on the distribution of lymph nodal metastases in patients with lower esophageal and gastric cardia malignancies. As a diagnostic tool for lymph nodal metastases, however, lymphoscintigraphy is unreliable.
Abdomen↗
[Clinical evaluation of the esophageal lymph flow system based on RI uptake of dissected regional lymph nodes following lymphoscintigraphy].
For surgical treatment of esophageal cancer, the importance of evaluating lymph node metastasis and the lymph flow of the esophagus can not be overemphasized. In oder to investigate the lymph flow of the esophagus, we preoperatively performed lymphoscintigraphy by endoscopic local injection of 99mTc Rhenium Colloid into the esophageal wall in 42 esophageal cancer cases and 4 gastric cancer cases. Postoperatively, the RI uptake of each dissected regional lymph nodes was examined by a Scintillation Counter. The findings were as follows. From the upper third of the thoracic esophagus, the main lymph flow was ascending to the neck and upper mediastinum. From the middle third, the lymph flow was ascending to the neck and upper mediastinum and descending into the abdomen. From the lower third, the main lymph flow was descending to the abdomen. In some cases, the lymph flow to the tracheal bifurcation nodes or to the lymph nodes around the left renal vein was observed. In 61% of the esophageal cancer cases with a partial bilateral neck dissection, the lymph flow to the bilateral supraclavicular lymph nodes was predominant compared to the upper mediastinum nodes.
Animals↗
[Several problems of a clinical classification system for cardial cancer].
Anatomical features exist in an area between the lower end of esophagus and the cardia portion of the stomach. Clinical features of carcinoma located at the cardia should be differentiated from carcinoma of the stomach or the esophagus. Generally, carcinoma of the cardia has been discussed together esophageal cancer or gastric cancer. However it is better to classify into 3 groups, esophagus, cardia and stomach. And it is necessary to establish the different criteria of cardial cancer. Proper statistical treatment of pertinent data will indicate this problem.
Cardia↗
[Effect of cisplatin (CDDP) against peritonitis carcinomatosa in nude mice inoculated intraperitoneally with human gastric cancer].
Development of effective chemotherapy for patients with peritonitis carcinomatosa is considered to be very important in cancer management. In this study, intraperitoneal injection (ip) of cisdichlorodiammineplatinum (II) (CDDP, cisplatin) together with subcutaneous injection (sc) of sodium thiosulfate (STS), abbreviated as 2-channel chemotherapy, were discussed with regard to its safety and efficacy on peritonitis carcinomatosa using nude mice inoculated intraperitoneally with SCK-8 tumor cells derived from human gastric cancer. A single ip lethal dose (16 mg/kg) of CDDP reproducibly caused weight loss in nude mice and killed 100% of the nude mice by day 5 after injection. However, sc of STS (1,200 mg/kg) protected nude mice against a lethal dose of CDDP, and reduced CDDP-induced weight loss. Two-channel chemotherapy (CDDP 16 mg/kg ip + STS 1200 mg/kg sc) using nude mice with advanced peritonitis carcinomatosa produced a 45% increase of life span with a survival of 74.6 +/- 6.2 days (n = 8), compared with control nude mice with peritonitis carcinomatosa surviving 51.5 +/- 13.3 days (n = 11). Therefore, it is conceivable that 2-channel chemotherapy can be applied to the management of cancer patients with peritonitis carcinomatosa.
Adenocarcinoma↗
[Experimental and clinical study on the radiation therapy for gastric cancer].
In the pre-operative radiation therapy for gastric cancer, radiosensitivity of the tumor, anatomical limit of irradiated field, selection of the patient for this therapy and influence of irradiation to surgical procedures have remained unsolved. For these reasons, this treatment has not been widely used for gastric cancer. We tried to evaluate this therapy by animal experiment and clinical experience. Animal experiment: Radiosensitivity of gastric cancer transplanted to nude mice was measured and compared each other. Higher inhibition of the tumor growth was obtained by 3000 rad irradiation in gastric cancer group. Inhibition of cancer activity was observed on the seventh day after irradiation had started and on the 10th day, all tumor showed remarkable inhibition. Histological destruction of cancer tissue was observed in all cases unrelated to histologic pattern. However, well differentiated adenocarcinoma showed higher sensitivity than poorly differentiated. Clinical aspect: We applied this therapy to the patient with cardiac carcinoma only because of inability of systemic bursectomy and prevention metastasis to the esophagus. Using Linac X-ray, 300rad per day and 4000 rad in total were irradiated. Therapeutical effects and some side effects of this therapy are discussed in this report.
Adenocarcinoma↗
[Esophageal cancer in the elderly].
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Age Factors↗
[Studies on diagnosis for gastric cancer and intestinal metaplasia of gastric mucosa using methylene blue staining method-with special reference to the fresh resected specimen (author's transl)].
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Adenocarcinoma↗
[Clinicopathological study on the significance of combined pancreatosplenectomy for gastric carcinoma -Especially, gross indication on the base of oncological features (author's transl)].
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Adenocarcinoma↗
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↗
Small cystic insulinoma: value of arterial stimulation venous sampling.
Cystic insulinomas are rare, with only three cases having been reported in the literature. It is not difficult to determine the site of such neoplasms, as cystic insulinomas are usually 4-10 cm in diameter. We report a patient with a histologically confirmed cystic insulinoma. This case is unique because of the small size (1.3 cm) of the tumor. Arterial stimulation venous sampling was useful for localizing and distinguishing this tumor from other pancreatic lesions.
Calcium Gluconate↗
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↗
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↗
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↗
Experimental study of bioactive polyurethane sponge as an artificial trachea.
An artificial trachea that has tissue reconstructive activity and elasticity that matches a biologic trachea was fabricated using a polyurethane sponge (PS). The inner surfaces of the PS were modified by immobilizing collagen, fibronectin, RGD peptide, a coating of collagen, and apatite. Two PS pore sizes were prepared, 150 to 350 microns (small pore) and 350 to 710 microns (large pore). When they were implanted in the subcutaneous tissue of rats, study of the implantation showed severe inflammatory cell infiltration with the treated PS, especially with collagen and collagen coating. Infiltration and maturity of fibroblasts inside the PS were noted with fibronectin. Infiltration of inflammatory cells and fibroblasts was noted with small pore PS compared with large pore PS. Partial tracheal defects were patched with PS. Better epithelization of PS patches was observed with fibronectin and apatite compared with the others. The artificial trachea made of PS was transplanted into the tracheas of dogs. No separation of the anastomosis and tissue reconstruction of the artificial trachea wall were observed; however, sputum absorption and tracheal granulation were seen.
Amino Acid Sequence↗