Biomedical subjects

Daijo Hashimoto

Publications and source records attributed to Daijo Hashimoto.

29 records · Page 2Linked to original sources

PubMed2003

[Results of prophylactic hepatic arterial chemotherapy for liver metastases of Dukes C colorectal cancer--correlation with tumoral expression of dihydropyrimidine dehydrogenase, thymidylate synthase, p53, or orotate phosphoribosyl transferase].

The purpose of this study was (1) to disclose data from a non-randomized trial of prophylactic hepatic arterial chemotherapy for liver metastases from Dukes'C colorectal cancer, (2) to examine the influence of the expression of dihydropyrimidine dehydrogenase (DPD), thymidylate synthase (TS), and p53 in the primary lesion on this chemotherapy, and (3) to examine the expression of orotate phosphoribosyl transferase (OPRT) mRNA levels in the cases of recurrence included in this study. Patients who underwent curative resection of Dukes'C colorectal cancer between November 1996 and April 2000 were examined. After curative resection, patients were non-randomly divided into two groups after obtaining their informed consent: Hepatic arterial infusion (HAI) group patients (n = 28) were given 5-FU (500 mg/body for 1 h per week, repeated 50 times) via the hepatic artery and peroral UFT-E after resection of Dukes'C colorectal cancer. Control group patients (n = 21) received UFT-E alone. Liver metastasis-free survival did not differ between the groups. Immunohistochemical examinations revealed that the expression of tumoral DPD or p53 was unlikely to affect the hepatic recurrence, although patients with a low expression of TS tended to have better survival in both groups. However, multivariate analysis by the Cox proportional hazard model revealed that a significant prognostic factor influencing the hepatic recurrence is extensive venous invasion. Expression levels of OPRT mRNA, measured in tumors of patients with recurrence (n = 6 for the HAI group; and n = 4 for the control group) were not significantly different between the groups. These results suggest that (1) intermittent hepatic arterial infusion of 5-FU in addition to oral UFT-E was not more useful than administration of UFT alone, and (2) the expression of DPD, TS, p53, and OPRT in the primary lesion was unlikely to affect the prognosis of patients included in this study.

Adult↗

PubMed2003

[Relationship between effectiveness of hepatic artery injection chemotherapy and serum VEGF].

Elevated plasma VEGF levels were reported in patients with colorectal cancer. This report presents regarding VEGF in patients who underwent hepatic artery injection chemotherapy (TAI) for liver metastasis of colorectal cancers. Thirty patients who underwent TAI for liver metastases of colorectal cancer during January 2002 to March 2003 were studied. Their serum CEA, CA19-9, and plasma VEGF were measured, and the relationships between these, their doubling times (DT) and therapeutic efficacy were examined. While the detected values and DTs were not considered significant, the tendency for DT to be the same was observed. One case with negative CEA and CA19-9 had high VEGF but negative VEGF-DT, which is compatible with therapeutic effects (PR). It appears that VEGF is a parameter that changes without direct correlation to CEA or CA19-9, and that VEGF may possibly be used as a therapeutic marker for cases with negative CEA or CA19-9.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2003

[Evaluation of liver metastasis of colorectal cancer following hepatic arterial infusion with degradable starch microspheres and adriamycin, mitomycin C as seen in changes in CEA at early stage of therapy].

OBJECTIVE: Recently, for the treatment of unresectable colorectal cancer with liver metastasis, hepatic artery injection of anticancer drugs suspended in degradable starch microspheres (DSM) is being performed. To predict its effectiveness, we did a retrospective study to see whether or not changes in CEA at early stages of therapy are significant. SUBJECTS AND METHOD: The subjects were 16 patients with unresectable colorectal cancer with liver metastasis (H3) who had undergone DSM therapy at least three times (mean age 65, male to female ratio of 10:6, 6 cases of synchronous metastasis and 10 cases of metachronous metastasis). Adriamycin (ADM) 30 mg and mitomycin C (MMC) 10 mg were suspended in 600 mg of DSM and injected into the common hepatic artery until embolization of the vessel was recognized (once/3-4 weeks). We examined the changes in CEA level (doubling time or half time) and the time to progression (TTP) of CEA after the third DSM treatment. RESULTS: Of the 16 patients, 4 (25%) showed rise in CEA, of which 3 died within a year. In the 12 cases with decreased CEA, the half time was 20-526 days (mean of 80 days). When the TTP of CEA was compared for the group with CEA half time less than 80 days (n = 6) to those with more then 80 days (n = 6), the TTP was significantly longer in the group with half time less than 80 days (p = 0.02 logrank test). CONCLUSION: To evaluate the effectiveness of DSM therapy, it is important to examine the changes in CEA at the early stages of treatment.

Aged↗

PubMed2002

Spatially selective laser coagulation of the gastric wall: a new methodology.

BACKGROUND: The incidence of lymph node metastasis is low in early gastric cancer. Early cancer without nodal metastasis may be theoretically eradicated by local treatment alone. However, except for gastrectomy, there exists no reliable treatment for submucosal cancer. We present a new laser system which irradiates the gastric wall from the serosal side combined with synchronous serosal cooling that can produce deep thermal coagulation without transmural damage. METHODS: A laser handpiece with a built-in surface cooling system has been devised, employing a diode laser of 980 nm wavelength. Animal experiments were conducted to ascertain whether this laser system could coagulate the mucosa and submucosa with acceptable injury to the muscular layer and serosa. The gastric wall was irradiated from the serosal side with synchronous serosal cooling at 6.0-10.0 W power output and 50-400 s exposure time. The degree and depth of damage were histologically assessed after 7 days. RESULTS: Ninety-one points were irradiated in 8 dogs. Mucosal coagulation was observed during the treatment while the serosa showed no serious injury. No gastric perforation occurred up to 7 days later. Histologically, the damage did not penetrate the gastric wall except for cases where 10.0 W and 400 s were used. Cauterization of the mucosa and submucosa with acceptable muscle layer damage was achieved in selected settings. CONCLUSIONS: This laser system enables thermal coagulation of the gastric mucosa and submucosa with acceptable muscle layer damage. This makes it a promising, novel, minimally invasive treatment for submucosal cancer.

Animals↗

PubMed2002

APC gene mutations in a jejunal adenoma causing intussusception in a patient with familial adenomatous polyposis.

Adenomatous polyps of the jejunum/ileum in patients with familial adenomatous polyposis (FAP) are usually small (<5 mm) and are considered to be of little clinical importance. Genetic alterations in these polyps have not previously been analyzed. We herein report an extremely rare case of FAP presenting with intussusception caused by jejunal adenomas. Both somatic and germline mutations of the APC gene were detected in one of the polyps. A 40-year-old man with FAP was admitted for closure of an ileostomy that had been created because of an anastomotic leak after subtotal proctocolectomy with ileo-anal-canal anastomosis. During the follow-up after that surgery, he had occasionally complained of colicky abdominal pain, but it had quickly subsided. At the second laparotomy, for closure of the ileostomy, jejuno-jejunal intussusception was incidentally found, and segmental resection of the jejunum, including the leading point of the intussusception, was performed. There were five polyps clustered in the resected jejunum. Histologically, the polyps, ranging from 5 to 26 mm in diameter, were adenomas with moderate to severe atypia. Genetic examinations of one of the largest polyps, using polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP) and direct sequencing methods, revealed somatic (T insertion at codon 1557) and germline mutations (4 base-pair deletion at codons 181-182) of the APC gene. This is the first evidence that the coexistence of somatic and germline alterations in the APC gene is involved in the development of a jejunal adenoma causing small-bowel intussusception.

Adenoma↗

PubMed2002

Risk of missing colorectal cancer during laparoscopic cholecystectomy.

PURPOSE: The increased number of patients undergoing laparoscopic cholecystectomy (LC) is associated with a risk of missing concomitant colorectal cancers; however, the incidence and cause have not yet been well recognized. Our aim, therefore, was to evaluate these factors. METHODS: This retrospective study evaluated data on 473 patients with benign gallbladder diseases, who underwent LC between January 1991 and December 1999. Among these 473 patients, 2 (0.4%) were thought to have had detectable cancer at LC. RESULTS: The first patient was a 59-year-old woman who underwent palliative resection for ascending colon cancer associated with liver and pulmonary metastases 10 months following LC when laboratory data showed a low hemoglobin level (10.0 g/dl). The other patient, a 50-year-old man, underwent resection for Dukes' C sigmoid colon cancer 6 months following LC. At LC, the patient did not present with any symptoms suggesting the existence of colorectal cancer and the laboratory data were normal. CONCLUSIONS: These results indicate that although an extremely low incidence of missed colorectal cancers does not justify routine screening for colorectal cancer before LC in terms of cost-effectiveness, careful attention to preoperative physical findings and laboratory data as well as meticulous techniques and full diagnostic visualization of the large-bowel intraoperatively may reduce the potential risk of missing coexisting colorectal cancers during LC.

Adolescent↗

PubMed2002

Primary thyroid carcinoma found with esophageal stenosis: report of a case.

The typical symptoms of primary thyroid cancer are a cervical mass and cervical lymphadenopathy, while dyspnea, hoarseness, or dysphagia can occur in the presence of extrathyroidal involvement. Esophageal involvement or stenosis causing dysphagia without any influence on the trachea is rare because of the anatomical location of the esophagus and the trachea. We report herein a case of primary thyroid carcinoma advancing behind the esophagus with the trachea intact, which was difficult to diagnose by esophagoscopy or roentgenogram. Thus, thyroid tumors need to be differentiated from other possible causes of esophageal stenosis. Computed tomography, magnetic resonance imaging, and ultrasonography are useful diagnostic modalities to detect thyroid tumors causing esophageal stenosis.

Deglutition Disorders↗

PubMed2002

Hand-assisted laparoscopic distal pancreatectomy in pigs using our original hand device (Lap Disc).

We analyzed the safety and feasibility of a hand-assisted laparoscopic distal pancreatectomy (HALDP) in pigs. We performed HALDP in five cases using our original hand device (Lap Disc). The procedures in all cases were successfully performed. The Lap Disc was very useful for performing HALDP because of its compact design and simple usage. This preliminary experience suggests that this device could be used to perform HALDP as well as other procedures in humans.

Animals↗

PubMed2002

[A case of postoperative liver metastasis of alpha-fetoprotein producing gastric cancer successfully treated with intrahepatic chemotherapy (adriamycin, cisplatin, irinotecan hydrochloride)].

There are only a few reports demonstrating effective regimens for AFP-producing gastric cancer. We report a case of alpha-fetoprotein (AFP)-producing gastric cancer successfully treated with postoperative intrahepatic chemotherapy, together with a review of the literature. A 63-year-old man was diagnosed as having multiple liver metastases 6 months following total gastrectomy for type 2 gastric cancer. Serum AFP level was markedly elevated at 291.4 ng/ml although the level was not determined at the time of gastrectomy. Twenty cycles of intrahepatic arterial infusion with adriamycin, cisplatin, and irinotecan hydrochloride resulted in a 93% decrease in the liver metastases along with normalization of the serum AFP level. These results suggest that this regimen is worth trying for patients with liver metastasis from AFP-producing gastric cancer.

Antineoplastic Agents, Phytogenic↗

PubMed2002

[Hepatic recurrence after prophylactic hepatic arterial infusion of 5-fluorouracil for Dukes' C colorectal cancer--correlation with the expression of dihydropyrimidine dehydrogenase in the primary tumor].

PURPOSE: The purpose of this study was twofold: (1) to disclose the intermediate outcome of a non-randomized trial of prophylactic hepatic arterial infusion chemotherapy (PHAI) for curatively resected Dukes' C colorectal cancer performed between November 1996 and April 2000, and (2) to examine the relationship between the expression of dihydropyrimidine dehydrogenase (DPD) in tumor tissue and the efficacy of this chemotherapy. PATIENTS AND METHODS: The oncological outcomes were compared between patients (n = 28) receiving PHAI (5-FU: 500 mg/body/w x 50 cycles) plus oral administration of UFT-E (400 mg/body/day, for 24 months) and those (n = 21) receiving UFT-E alone. The levels of tumoral DPD were determined in a total of 43 patients (n = 25, PHAI group; n = 18, control group) by an enzyme-linked immunosorbent assay. RESULTS: Seven (25%) in the PHAI group and four (19%) in the control group developed liver metastasis postoperatively. The liver metastasis-free survival was not different between the groups (p = 0.94). When the analysis was restricted to patients who developed liver metastasis, the duration from surgery to detecting liver metastasis tended to be longer in the PHAI group (p = 0.09). In addition, the overall survival tended to be better in the PHAI group (p = 0.12). In the control group, the level of DPD was higher in patients who developed liver metastases (n = 4) than in those who did not (n = 14, p = 0.04). However, in the PHAI group, the level of DPD was not different regardless of the occurrence of liver metastases (p = 0.30). CONCLUSIONS: These results suggest that (1) PHAI is unlikely to improve the prognosis of Dukes' C patients remarkably, and (2) the efficacy of this regimen cannot be predicted by determining the levels of tumoral DPD.

Administration, Oral↗

PubMed2002

[Short-term intraperitoneal infusion of cisplatin and OK-432 for a case of malignant mesothelioma of the peritoneum].

A case of malignant mesothelioma of the peritoneum successfully treated with short-term intraperitoneal chemotherapy is reported. A 67-year-old woman underwent laparotomy for ascending colon cancer. During, laparotomy, numerous mucoid nodules were found on the peritoneal surface, even though the colonic tumor did not invade the serosa. Ileocecal resection (D1) with partial omentectomy was performed. Intraperitoneal infusion with cisplatin (200 mg) was started immediately after surgery and additional cisplatin (150 mg) was administered with OK-432 (30KE). The serum level of CA125 rapidly decreased after the chemotherapy, and was normalized 3 months postoperatively. The histological diagnosis of the peritoneal lesions was malignant mesothelioma of the peritoneum (diffuse type). The patient is living without any evidence of recurrence 10 months postoperatively. These results suggest that this short-term chemotherapy is worth trying in cases of malignant mesothelioma of the peritoneum.

Aged↗