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Biomedical subjects

Tomoo Tajima

Publications and source records attributed to Tomoo Tajima.

26 records · Page 2Linked to original sources
PubMed2002

[Endoscopic surgery for breast diseases: the present state of art and outlook for the future].

Endoscopic breast surgery (EBS) is still not in common use today, mainly because of the lack of intracavitary operative maneuvers in breast surgery. It has been shown, however, that in experienced hands, the therapeutic benefits of EBS include not only improved natural esthetic outcomes but also less morbidity with faster recovery. Endoscopic partial/total mastectomy, axillary dissection, and breast reconstruction can be performed through an axillary incision with an additional periareolar incision depending on the situation, as safe alternatives to conventional operative procedures for early breast cancer. Furthermore, EBS is particularly effective when performing axillary dissection and mobilizing tissue flaps for immediate reconstruction. Since EBS requires the creation of a dissecting working passage and space, which tends to increase operative invasiveness, operating time, and blood loss, in less experienced hands an initial period of learning curve adjustment appears to be mandatory. Safety in terms of adequate local control must be further evaluated and long-term results need to be followed up before EBS can be applied in more advanced-stage breast cancer. Instead of being regarded as a competing technology. EBS should be welcomed and accepted in combination with conventional methods to nurture and further improve the technical aspects of breast cancer surgery. EBS is expected to become an indispensable and integral part of breast surgery in the near future, especially in an era when informed consent is sought with broader patient choice and empowerment models.

Breast↗
PubMed2002

Tracheal agenesis: a case report.

Tracheal agenesis is a rare congenital anomaly which results inevitably in immediate respiratory distress after delivery. Since the first report of the case in 1900, more than 150 cases reported in the Japanese and world literature. Attempts to save these children have failed to permit survival although a slight prolongation of life was achieved in some. We treated a baby girl with tracheal agenesis associated with other multiple anomalies and surgical intervention was attempted but without success due to incorrectable anatomy. Herein we describe her clinical picture and autopsy findings. Along with a review of the Japanese literature, we discuss this rare anomaly in terms of its anatomy, associated anomalies, pathogenesis, and clinical management.

Abnormalities, Multiple↗
PubMed2002

[Current surgical treatment of breast cancer in Japan and its rationale: foreword].

This is a foreword to a collection of articles specially dedicated to describing the present status of local treatment of breast cancer patients in Japan, which continues to be a source of controversy in the midst of collaborative efforts between surgeons, pathologists, and medical and radiation oncologists. Surgical treatment of breast cancer consisting of procedures on the breast parenchyma and on lymph nodes do not appear to have reached the expected technical perfection. A variety of surgical procedures are performed under the name of breast-conserving surgery with widely varied rates of application ranging from 20-85% depending upon the institution. With regard to sentinel node biopsy/dissection, diversified techniques such as different types of tracers and injection sites are currently being utilized, and furthermore long-term analysis may be necessary to determine the superiority as compared with other approaches such as lower axillary sampling/dissection and 4-node biopsy. Since all efforts should be made to prevent locoregional tumor recurrence, surgeons must be alert and attuned to all the details of surgery. Continued efforts of surgeons with a broadened perspective will lead to the improvement of local treatment of breast cancer with the ultimate goal of obtaining better local control and consequently better long-term survival outcomes.

Axilla↗
PubMedDate not supplied

Gastric tube cancer after esophagectomy for esophageal squamous cell cancer and its relevance to Helicobacter pylori.

BACKGROUND/AIMS: Improvement of surgical skills and postoperative management has allowed longer postoperative survival for patients with esophageal cancer, among those some develop gastric tube cancer. We analyzed the characteristics of such patients we encountered as well as of reported cases of Japan. Furthermore, we investigated if Helicobacter pylori plays a role in carcinogenesis of the gastric tube in our cases. METHODOLOGY: We analyzed the clinicopathological features of our 8 patients with gastric tube cancer from 1991 to 2000 as well as the status of H. pylori on the gastric tube biopsy. Moreover the features of gastric tube cancer from domestic reported cases up to the year 2000 were also summarized. RESULTS: According to the review of our cases, the frequent tumor location was the distal portion of the gastric tube. Seventy-eight percent were detected in early stage during postoperative follow-up, 71% of those were treated endoscopically. No cases showed H. pylori positivity. From the previous domestic reports, early cancer is increasing as the screening becomes popular. Type 0-IIa and 0-IIc were the most popular images for early cancer, while type 2 and 3 were for advanced cancer. CONCLUSIONS: The carcinogenesis of the gastric tube seemed not to be related to H. pylori. Subdermal route of reconstruction at esophagectomy seemed superior regarding early recognition of gastric tube cancer and easiness of its treatment.

Aged↗
PubMedDate not supplied

The stability of dihydropyrimidine dehydrogenase activity in colorectal cancer tissue after resection.

Dihydropyrimidine dehydrogenase (DPD) is the first and rate-limiting enzyme in the catabolism of 5-fluorouracil (5-FU). DPD activity in tumor tissue may consequently serve as a predictive factor for sensitivity to 5-FU. The purpose of this study was to elucidate the stability of DPD activity over time in resected colorectal cancer tissue. DPD activity was measured in samples frozen immediately after the tumor was resected and in samples that had been allowed to stand at room temperature for 15, 30, 60, 120, and 180 min before being frozen. Surgical specimens obtained from 15 cases with advanced colorectal cancer were analyzed. The effects of differences among individuals and differences in time between collection and freezing were assessed by two-way analysis of variance (ANOVA). Significant differences in DPD activity were found among tumors (p=0.001), but there were no significant differences in the same tumor depending on the time between collection and freezing (p=0.496). Based on these results, it appears possible to make comparative assessments of DPD activity in colorectal cancer tissue without strictly stipulating the time between resection and freezing.

Adult↗
PubMedDate not supplied

Proliferative, infiltrative, and metastatic activities in colorectal tumors assessed by MIB-1 antibody.

MIB-1 antibody staining discriminates the cells in phases other than G0 of the cell cycle. The current study examined the proliferative activity assessed by MIB-1 antibody in colorectal adenoma, primary lesions of colorectal carcinoma (CRC) to investigate the relation between the histologic atypia, the proliferative, infiltrative, and metastatic activities. The MIB-1 antibody positive rate was immunohistologically determined in primary lesions in 311 patients, 22 having adenoma or carcinoma in situ, 207 invasive CRC without distant metastasis, and 82 invasive CRC with distant metastasis. The MIB-1 antibody positive rate was significantly higher in cases of adenoma with severe atypia and carcinoma in situ, showing a close relation between histologic atypia and proliferative activity. Among invasive CRC, the positive rate in poorly differentiated adenocarcinoma and mucinous carcinoma is significantly lower than in well differentiated and moderately differentiated adenocarcinomas. The positive rate was significantly lower in carcinomas with subserosa or deeper invasion than in carcinomas with submucosa or muscularis propria invasion, showing no distinct relation between the proliferative activity and the infiltrative activity. The positive rate of primary lesion was significantly lower in cases with metachronous liver or lung metastasis than in synchronous cases, indicating that metachronous hematogenous metastasis occurs even in cancers with low proliferative activity. The MIB-1 antibody positive rate showed a close relation between histologic atypia and proliferative activity in mucosal colorectal tumors although its relation with infiltrative activity was unclear in invasive CRC. It was apparent that metachronous hematogenous cancer metastasis might take place even in cases with low proliferative activity.

Adenocarcinoma↗
PubMedDate not supplied

Recurrence patterns after curative resection of colorectal cancer in patients followed for a minimum of ten years.

BACKGROUND/AIMS: To investigate the recurrence patterns and interval from initial surgery in patients with curatively resected colorectal cancer followed for a minimum of 10 years. METHODOLOGY: We retrospectively reviewed 418 patients who had undergone curative resection for colon cancer (n = 246) or rectal cancer (n = 169). Follow-up periods ranged from 10 to 23 years. Main outcome measures were interval until recurrence, site of first recurrence, and influence of adjuvant chemotherapy. RESULTS: 26 (6%) had been lost to follow-up by 10 years and 143 (34%) had died. The most common site of recurrence was liver in colon cancer and locoregional in rectal cancer. The cumulative recurrence rate in colon cancer was 100% at 4 years. In rectal cancer, it was 89% at 5 years, 98% at 7 years and 100% at 10 years. The interval until recurrence was longer in rectal cancer (26.0 +/- 24.2 months) than in colon cancer (17.1 +/- 11.0 months) (p = 0.03). It was also longer in patients receiving than in those not receiving adjuvant chemotherapy (p < 0.01). The interval until lung metastasis was longer than that until liver metastasis in colon cancer (p = 0.04), and longer than that until locoregional recurrence in rectal cancer (p = 0.03). The interval until recurrence in the colon cancer was shorter for stage III than for stage II (p = 0.02). CONCLUSIONS: Surveillance for recurrences, particularly for relapses in the liver and lung, should be performed for at least 4 years in colon cancer patients. Patients with rectal cancer should be followed for a longer period than those with colon cancer, focusing on locoregional, liver and lung recurrence. It is particularly noteworthy that adjuvant chemotherapy may prolong the interval until recurrence and the interval until lung metastasis is relatively longer.

Chemotherapy, Adjuvant↗