Biomedical subjects

T Shimomatsuya

Publications and source records attributed to T Shimomatsuya.

At least 19 recordsLinked to original sources

PubMed2000

Laparoscopically assisted pylorus-preserving gastrectomy.

BACKGROUND: The aim of this study was to describe the procedure of laparoscopically assisted pylorus-preserving gastrectomy (LAPPG), and to evaluate intra- and postoperative conditions of the patients. METHODS: We performed pylorus-preserving gastrectomy under laparoscopic observation, including regional lymph node dissection in early gastric cancer of the lower body. Seven patients were treated (two women and five men) using this procedure between April 1996 and April 1999. RESULTS: All the patients showed good postoperative recovery, and no signs of recurrence were recognized. There were no intraoperative or postoperative complications. Less pain, a rapid recovery, and good cosmetic results were noted. The patients exhibited little weight loss after surgery, and none demonstrated the dumping syndrome. Endoscopic examinations performed postoperatively did not indicate the presence of reflux gastritis or esophagitis. CONCLUSIONS: Our procedure of LAPPG may be useful for early gastric cancer, especially intramucosal cancer.

Aged↗

PubMed2000

Retroperitoneoscopic excision of a mesenteric cyst.

Mesenteric cysts are rare intra-abdominal lesions. We present a case of a mesenteric cyst that was discovered by abdominal computed tomography (CT) and excised by retroperitoneoscopic surgery. There have been 10 reports of excision of mesenteric cysts by laparoscopy in the literature, but retroperitoneoscopic resection of such cysts has not been reported. This case suggests that when a mesenteric cyst arises from the ascending or descending colon, the retroperitoneal approach has a lower risk of traumatizing the bowel than does the laparoscopic intra-abdominal approach, and it does not have to compress other intra-abdominal organs.

Adult↗

PubMed2000

[A case of head metastases of breast cancer successfully treated with radiation therapy and docetaxel].

A 68-year-old female underwent radical mastectomy for left breast cancer in April, 1995. She was treated with conventional combination chemotherapy (CEF) before and after surgery as an adjuvant therapy. She was treated with oral tamoxifen (TAM) and/or medroxyprogesterone (MPA) and doxifluridine daily after surgery. In May, 1998, she was found to have developed a subcutaneous tumor of the head and skull-bone, and a meningeal metastasis. We treated her with 80 mg docetaxel (TXT) one time with radiation (total dose 50 Gy), and with 70 mg two times. After the combination therapy, she achieved partial remissions of the metastases and a decrease in serum CEA. Adverse reactions to TXT were grade 3 alopecia, grade 3 to 4 neutropenia, grade 2 to 3 stomatitis, and grade 2 diarrhea. All were tolerable and reversible. The combination therapy of radiation and TXT may be a good strategy for recurrent breast cancer.

Aged↗

PubMed1999

Laparoscopic splenectomy for treatment of patients with idiopathic thrombocytopenic purpura. Comparison with open splenectomy.

BACKGROUND: Laparoscopic splenectomy (LS) is one of the advanced laparoscopic procedures that benefit most from minimally invasive surgery. This study was undertaken to compare the operating time, blood loss, length of hospital stay, and platelet count response for patients with idiopathic thrombocytopenic purpura (ITP) undergoing open splenectomy (OS) versus LS. METHODS: We performed OS in 20 cases before 1992 and LS in 14 cases after 1993 for the treatment of ITP. RESULTS: The operating time was significantly shorter for OS than for LS (126 +/- 52 min versus 203 +/- 83 min, p < 0.01). Blood loss was less for OS than for LS (321 +/- 264 ml versus 524 +/- 648 ml, p = 0.287). None of the patients who underwent LS were converted to open surgery. Accessory spleens were found in four OS patients (20.0%) and four LS patients (28.6%). The postoperative hospital stay was significantly longer for OS patients than for LS patients (15.2 +/- 5.8 days versus 8.9 +/- 2.9 days, p < 0.0005). No significant difference was noted in the long-term results of splenectomy. CONCLUSIONS: Compared with OS, LS required more operating time, had the potential to cause greater blood loss, had a comparable incidence of accessory spleen and response rate, and appeared to shorten the postoperative stay.

Adult↗

PubMed1999

Laparoscopic excision of an omental cyst.

An omental cyst is a rare intra-abdominal tumor. The authors describe a case of omental cyst that was diagnosed correctly with abdominal magnetic resonance imaging (MRI) and successfully resected completely by use of minimal-access surgical techniques. A sagittal or coronal MRI view may precisely reveal the tumor position. The authors consider MRI to be very useful in the diagnosis of abdominal cystic masses. Laparoscopic surgical techniques are replacing or complementing open abdominal surgical procedures.

Adult↗

PubMed1998

Platelet-derived endothelial cell growth factor/thymidine phosphorylase expression correlated with tumor angiogenesis and macrophage infiltration in colorectal cancer.

To clarify whether platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) expression in both tumor cells and stromal cells has independent or synergistic effects on tumor angiogenesis and progression and to explore a possible regulator for PD-ECGF/TP expression, immunohistochemical staining was conducted on 148 specimens of colorectal cancer. The microvessel count was significantly correlated with the extent of PD-ECGF/TP expression. Macrophage infiltration in tumors with positive TP was significantly higher than in tumors with negative TP (P < 0.001). The Cox model showed that PD-ECGF/TP expression was an independent prognostic factor, although the microvessel count had a stronger value in determining the patient prognosis.

Adenocarcinoma↗

PubMed1997

Association of vascular endothelial growth factor expression with tumor angiogenesis, survival and thymidine phosphorylase/platelet-derived endothelial cell growth factor expression in human colorectal cancer.

To examine the association of vascular endothelial growth factor (VEGF) expression with tumor angiogenesis, survival and thymidine phosphorylase/platelet-derived endothelial cell growth factor (dThdPase/PD-ECGF) expression in human colorectal cancer, immunohistochemical studies were performed on 136 cases of resected colorectal cancer specimens using antibodies for VEGF, KDR, CD34 and dThdPase/PD-ECGF. Fifty-nine cases (43%) were evaluated as positive for VEGF staining and 71 cases (52%) were evaluated as positive for dThdPase/PD-ECGF staining. The expression of VEGF correlated significantly with vessel counts and the expression of dThdPase/PD-ECGF (P = 0.01 and 0.01, respectively). Cox proportional hazards model analysis showed that vessel counts and VEGF expression were significant and independent prognostic factors, but that KDR expression was not.

Adult↗

PubMed1997

Tumor vascularity correlates with the prognosis of patients with esophageal squamous cell carcinoma.

BACKGROUND: Angiogenesis is essential for the growth of solid tumors. Intratumoral microvessel count, which represents a measure of tumor angiogenesis, has been associated with the overall survival of patients with a variety of malignancies. However, little is known about the significance of neovascularization in esophageal squamous cell carcinoma. METHODS: In this study, the role of tumor angiogenesis as a prognostic indicator was examined in esophageal squamous cell carcinomas from 43 patients. Vascular endothelial cells were stained with anti-CD34 and anti-von Willebrand factor monoclonal antibodies before being quantitated by light microscopy (x 200). RESULTS: Significant correlation between vessel counts for two antibodies was observed, although counts for CD34 were approximately three times higher. Intratumoral vessel counts were significantly higher in tumors with deeper penetration. Multivariate analyses indicated that vessel counts determined by either CD34 or von Willebrand factor staining, as well as lymph node metastasis, were identified as significant and independent prognostic factors in patients with esophageal squamous cell carcinoma. CONCLUSIONS: These findings support the hypothesis that tumor angiogenesis is closely related to the overall survival of patients with esophageal squamous cell carcinoma. The extent of tumor vascularity may serve as a reliable prognostic marker with which patients at risk for recurrence can be identified.

Aged↗

PubMed1997

Association of tumour vasculature with tumour progression and overall survival of patients with non-early gastric carcinomas.

In order to investigate the relationship between intratumoral vasculature and progression of gastric carcinomas and between vessel counts and survival of patients with non-early gastric carcinoma, we counted the intratumoral microvessels and compared their numbers with clinicopathological parameters, as well as with the patients' survival. Microvessels were stained with anti-CD34 monoclonal antibody before counting by microscopy (x200). In a group of 181 patients who had undergone tumour resection and were followed for more than 24 months the vessel counts for 83 patients with stage IV disease were significantly higher than those for patients with any other stage of disease. Among various clinicopathological variables, haematogenous metastasis, lymph node metastasis, peritoneal metastasis, stage IV disease and non-curative resection were more frequent in the patients with highly vascularized tumours (intratumoral vessel count > 155) than in those with less vascularized tumours. As a classification of stage IV disease such as haematogenous or peritoneal metastasis generally indicates non-curative resection, it can be considered that the development of stage IV disease is associated with the increase in tumour angiogenesis. Both univariate and multivariate analyses showed that the intratumoral vessel count was significantly predictive of overall survival, when tested as either a continuous or dichotomous variable. Cox hazards model analysis showed that the vessel count was one of the significant and independent prognostic variables. Patients with highly vascularized tumours were significantly more likely to die than those with less vascularized tumours. Assessment of tumour vasculature may therefore be important, not only for its prognostic value, but also as it may help to predict responses to angiogenesis-inhibiting agents.

Adult↗

PubMed1997

Correlation between expression of vascular endothelial growth factor and tumor vascularity, and patient outcome in human gastric carcinoma.

PURPOSE: The relationship between the expression of vascular endothelial growth factor (VEGF) and its receptor, KDR, in human gastric carcinoma tissues and tumor angiogenesis, as well as patient outcome, were investigated. MATERIALS AND METHODS: One hundred sixty-three primary tumor specimens were investigated by immunohistochemical studies with anti-VEGF, anti-KDR, and anti-CD34 antibodies and by monitoring patients for at least 2 years after surgery. RESULTS: For intensity of VEGF staining, 48 tumors were graded as 0, 36 as 1+, 63 as 2+, and 16 as 3+. Tumors with strong VEGF staining, assessed as 2+ and 3+, had significantly higher vascularity than those with weak VEGF. Eighty-eight tumors (54%) were positive for KDR. There was no association between KDR expression and tumor vascularity. No close correlation was found between VEGF and KDR expressions. The Cox proportional hazards model identified intratumoral vessel count as the most significant and independent prognostic factor among various clinicopathologic factors. In contrast, overall survival rates for 84 patients with weak VEGF staining tumors and 79 with strong VEGF staining tumors were not significantly different. Patients with tumors of either localized Borrmann types or well-differentiated histologies, which are found more frequently in tumors with strong VEGF staining, survived significantly longer than those with tumors of either infiltrative Borrmann types or poorly differentiated histologies. CONCLUSION: We suggest that expression of VEGF is more frequently found in tumors with well-differentiated histology and plays a role in the promotion of angiogenesis in human gastric carcinomas.

Aged↗

PubMed1996

Tumor angiogenesis and expression of thymidine phosphorylase/platelet derived endothelial cell growth factor in human gastric carcinoma.

To investigate the relationship between tumor angiogenesis and the expression of platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/dThdPase) and between patients' survival and the expression of PD-ECGF/ dThdPase in human gastric carcinoma tissues, we performed immunohistochemical studies with anti-PD-ECGF/dThdPase and anti-CD34 monoclonal antibodies. Out of 154 gastric carcinoma tissue samples, 61 (40%) were evaluated as PD-ECGF/ dThdPase-positive. The expression of PD-ECGF/dThdPase was significantly associated with the intratumoral microvessel counts (P < 0.0001) and the incidence of hematogenous metastasis (P < 0.05). Intratumoral vessel counts were significantly correlated with overall survival of 154 patients (P < 0.000001). Cox proportional hazards model showed that tumor vasculature was an independent and strong prognostic variable. However, the prevalence of the expression of PD-ECGF did not associate the overall survival. We suggest that expression of PD-ECGF/dThdPase plays a role in the promotion of angiogenesis in human gastric carcinomas, without any definite influence on patient's survival.

Adenocarcinoma↗

PubMed1996

Extent of tumor vascularization correlates with prognosis and hematogenous metastasis in gastric carcinomas.

To determine whether tumor angiogenesis correlates with prognosis and metastasis of patients with gastric carcinoma, we counted the microvessels within the primary carcinoma and compared their numbers with the patient's prognosis and mode of metastasis. Tumor specimens from 110 patients with gastric carcinoma, who had undergone curative resection more than 24 months before, were investigated. Intratumoral microvessels were stained with anti-CD34 and anti-von Willebrand factor monoclonal antibodies before being quantitated by light microscopy (x200). The antibody against von Willebrand factor often showed variability and stromal background staining, providing misleading low vessel counts. The data from three patients who died from nongastric carcinoma within 24 months after surgery were deleted. A total of 107 patients took part in the analysis examining the association between intratumoral microvessels and clinical outcomes. Vessel counts derived from CD34 expression were significantly higher in patients who experienced hematogenous or peritoneal metastasis after surgery than in patients with nonmetastatic tumors. No correlation between vessel counts and lymph node metastasis was found. The prevalence of hematogenous metastasis. but not peritoneal metastasis, increased as the vessel counts increased. Multivariate logistic regression and Cox hazards model analyses showed that the vessel counts obtained with CD34 staining correlated with the development of hematogenous recurrence but not peritoneal recurrence. It was the most important factor for predicting overall survival. These findings support the hypothesis that tumor angiogenesis is closely related to the development of hematogenous metastasis in human gastric carcinomas. Assessment of tumor vascularization may, therefore, prove valuable in identifying patients with gastric carcinoma at high risk for recurrence who would benefit from adjuvant therapy.

Adenocarcinoma↗

PubMed1995

Clinical significance of multidrug resistance and P-glycoprotein expression in patients with gastric carcinoma.

Twenty-four fresh tumors of gastric carcinoma were assessed by flow cytometric detection of P-glycoprotein (P-gp) using monoclonal antibody C219. Eight patients were P-gp positive. Differentiated gastric carcinomas contained significantly higher concentrations of P-gp positive. Incidence of P-gp positive was high in advanced stage. In 16 cases estimated chemosensitivity was test assessed by thymidine incorporation assay (TIA). Seven of nine multidrug-resistant cases according to TIA were P-gp positive and all of seven nonmultidrug resistant cases were P-gp negative. Expression of P-gp and multidrug resistance were closely correlated (P < 0.01). Also, in 89 patients with operable gastric carcinoma, the relation between in vitro chemosensitivity test (TIA) and their clinicopathologic features as well as their survival lengths were studied. Thirty-one of 89 specimens from gastric carcinoma patients were multidrug resistant according to TIA. Patients in the multidrug-resistant group had a significantly poorer cumulative survival rate than those who were not multidrug resistant (P < .05). The multivariate analysis showed that multidrug resistance is a useful indicator of prognosis (P < 0.1). We suggest that multidrug-resistant cases or P-gp-positive cases of gastric carcinoma are highly malignant, and these determinations are clinically useful.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1995

[Potential and limitation of scintillation assay (TIA) for clinical chemotherapy].

The clinical significance of the scintillation assay (thymidine incorporation assay) which we developed was summarized as follows; 1)thymidine uptake by tumor cells which can be evaluated in each assay functioned as a significant predictor of prognosis of patients with gastric or colorectal cancer, 2)the tumor cell compartment in this assay system significantly increased more than did those in other culture systems, 3)evaluable rates were increased to more than 80% by introduction of the preculture system with collagen coated flasks, and 4)it can be considered that chemosensitivity testings may benefit for some types of human tumor, but not for all.

Animals↗

PubMed1994

[Clinical significance of P-glycoprotein expression and multidrug resistance assessed by in vitro thymidine incorporation assay in patients with gastric carcinoma].

Drug resistance in chemotherapy is a significant problem in the treatment of gastric carcinomas as well as other malignant tumors. Multidrug resistant cells frequently overexpress the 170 kDa P-glycoprotein (P-gp). Twenty-four fresh tumor specimens of gastric carcinoma were assessed by flow cytometric detection of P-gp using monoclonal antibody C219. Eight patients were P-gp positive. Differentiated gastric carcinomas contained significantly higher concentrations of P-gp positive. Incidence of P-gp positive case was high in advanced stage. Sixteen cases received in vitro chemosensitivity test assessed by thymidine incorporation assay (TIA). Seven of 9 multidrug resistant cases by TIA were P-gp positive, and all of 7 non-multidrug resistance were negative. Expression of P-gp and multidrug resistance were closely correlated (p < 0.01). Also, in 89 patients with operable gastric carcinoma, the relationship between multidrug resistance by TIA and their clinicopathologic features as well as their survival lengths were examined. Thirty-one of 89 specimens from gastric carcinoma patients were multidrug resistant by TIA. Patients with multidrug resistant group had a significantly poorer cumulative survival rate than non-multidrug resistant cases (p < 0.01). The multivariated analyses showed that multidrug resistance analyzed is useful indicator for prognosis (p < 0.1). We suggest that multidrug resistance cases or P-gp-positive cases of gastric carcinoma are highly malignant, and these determinations are clinically useful.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1994

[Prediction of prognosis of patients with gastrointestinal cancer based on thymidine uptake].

In 173 patients with operable gastric cancer and in 127 patients with colorectal cancer, the relations between thymidine uptake by cancer cells in semi-solid media, their clinico-pathologic features and survival times, were studied. Multivariate analysis using Cox proportional hazard model showed that thymidine uptake is one of the variables most highly correlated with the probability of patient death. Thus, the availability of thymidine uptake information in the perioperative period may be useful for selecting patients who would benefit from more intensive therapy. Thymidine kinase (TK) is the only enzyme by which thymidine is introduced into the DNA metabolism. In 64 specimens, including gastric and colorectal cancers, TK levels in the serum and tumors were measured accordingly. However, there was no correlation between thymidine uptake and the TK levels, suggesting the necessity of measuring thymidine phosphorylase activity as well.

Aged↗

PubMed1993

Thymidine uptake in vitro as a prognostic indicator for primary gastric cancer.

BACKGROUND: Prognostic significance of in vitro thymidine uptake by cancer cells remains unclear in patients with gastric cancer. METHODS: In 173 patients with operable gastric cancer, the relations between thymidine uptake by gastric cancer cells in semi-solid media and their clinicopathologic features as well as their survival lengths were studied. RESULTS: There were significant correlations between in vitro thymidine uptake and such clinicopathologic features as lymph node metastasis (P = 0.00002), lymphatic invasion (P = 0.003), vessel invasion (P = 0.006), peritoneal metastasis (P = 0.010), depth of invasion (P = 0.011), and hepatic metastasis (P = 0.032). Ninety-five of 173 cancers (54.9%) that incorporated 1000 or more cpm in a single well were designated as being a high uptake group. Other gastric cancers (78 of 173; 45.1%) were designated as being a low uptake group. The overall survival rate of the patients was demonstrated to be significantly longer in the group with a low thymidine uptake than with a high uptake (P < 0.00001). The multivariate analysis showed that thymidine is one of the two variables that are the most highly correlated with the probability of patient death (P = 0.00044). CONCLUSIONS: These results indicated that in vitro thymidine uptake is an independent prognostic parameter for gastric cancer and may be useful for selecting patients who would benefit from more intensive therapy.

Aged↗

PubMed1993

En bloc resection for cancer of the gastric cardia without thoracotomy.

Thirty-five consecutive patients underwent en bloc resection of cardia cancer without thoracotomy. All tumors were adenocarcinoma. The operative procedure involved wide resection of the peri-hiatal diaphragm, dissection of the upper abdominal and lower mediastinal lymph nodes, and resection of the stomach including a portion of the lower thoracic esophagus without thoracotomy. The resection area of the diaphragm included not only the crural muscle as in other methods, but also the diaphragmatic tissue surrounding the esophageal hiatus. Through the enlarged hiatus, dissection of the mediastinum was possible up to the carina from the abdominal cavity. The mediastinal node stations were affected in 25% of patients whose tumor invaded to the serosa. Hypotension with or without atrial arrhythmias and pleural tears occurred during surgery in 20 patients (57%) and in 18 patients (51%), respectively. Postoperatively, hypoxia requiring reintubation developed in 7 patients (19%), pleural effusions needed tube drainage in 16 patients (46%), atelectasis in 5 patients (14%), and anastomotic leaks in 3 patients (9%). They were all successfully treated. The cumulative 5-year survival rate for 21 patients with stages I (2 patients), II (9), and III (10) diseases was 62%, whereas none of the patients with stage IV disease lived for more than 2 years after surgery. Because thoracotomy is avoided, the procedure is better tolerated by debilitated patients. We believe this technique is a reasonable and safe alternative to the left thoracotomy approach for resection of cancer of the gastric cardia.

Adenocarcinoma↗