[Trend and problems of chemotherapy of stomach neoplasms with metastasis].
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Biomedical subjects
Publications and source records attributed to Y Oguro.
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We report the effective clinical use of endoscopic laser in Japan using the results of a nationwide survey and our own experience with more than 100 cases. The Nd:YAG laser and argon dye laser with hematoporphyrin derivative (photodynamic therapy) were most commonly used in digestive endoscopy and were investigated as new modalities of cancer therapy. Photodynamic therapy was fairly effective, especially in superficial esophageal cancer and the ill-defined lesions of early gastric cancer. Endoscopic laser treatment was carried out on 80 patients with 86 lesions of early gastric cancer at our hospital, and the following tumor types were proven highly curable by this means: focal cancer, IIa and so-called "gastritis-like" tumors less than 2 cm in size. The Nd:YAG laser provides a new approach to palliative treatment, such as recanalization of neoplastic obstruction in the advanced stage of gastrointestinal cancers.
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A comparative study of local interstitial hyperthermia induced by low power Nd:YAG laser (laser hyperthermia) and microwave hyperthermia was carried out in vivo and in vitro in an attempt to clarify the therapeutic effect and the mechanism. Both therapies, after seven days, caused marked amounts of coagulated necroses in the transplanted tumors of human pancreatic carcinoma. Immediately after those therapies, electron microscopic examination of the tumor tissues showed membranous, cytoplasmic, nuclear and mitochondrial damage; however, this damage was much more extensive in laser hyperthermia compared to microwave hyperthermia. The cytocidal effects of heating alone, laser hyperthermia and microwave hyperthermia were also studied in vitro. Of the three, laser hyperthermia demonstrated the most notable decrease in viability. Thus, in the mechanism of laser hyperthermia, it seems that the immediate effect is cellular damage caused by both heat energy and Nd:YAG laser light followed by subsequent damage of tumor vessels.
In Caucasians, there is close correlation between acute anterior uveitis and histocompatibility antigen HLA-B27. But in Japanese, this is not clear. Therefore, we examined 58 patients with non-granulomatous anterior uveitis (NGAU) about HLA typing in our uveitis clinic at Tokyo Women's Medical College Hospital. HLA-B27 was identified in 20 out of 58 patients (34.5%) with NGAU and it was statistically significant. We also studied the clinical features of patients with HLA-B27 positive NGAU. We found that in HLA-B27-positive NGAU, the visual acuity was more strongly affected during the attack and the duration of inflammation was longer than HLA-B27 negative NGAU patients. The duration of the first attack was longer than re-attack, and the duration of the first attack was longer than HLA-B27 negative NGAU patients. It was less commonly associated with systemic disorders in Japanese HLA-B27 positive anterior uveitis than in Caucasian. However, in Japanese NGAU patients without systemic disorders, there was the same tendency concerning the HLA-B27 positive rate as in Caucasians.
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