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Biomedical subjects

H Anai

Publications and source records attributed to H Anai.

At least 55 records · Page 3Linked to original sources
PubMed1995

Clinicopathologic study of patients with Borrmann type IV gastric carcinoma.

Between 1979 and 1993, 665 Japanese patients with advanced gastric cancer underwent surgery at our hospital. These patients were divided into two groups, consisting of 102 patients with Borrmann type IV carcinoma, and the remaining 563 patients with all other types of gastric carcinoma, which were then compared clinicopathologically. In the patients with Borrmann type IV carcinoma, 77.4% of the lesions demonstrated poorly differentiated adenocarcinoma, and 99 patients were classified as Stage III or IV. The resection rate was 87.2% (89/102) with only 39 curative operations despite the fact that 70 total gastrectomies were performed. The incidence of peritoneal dissemination (29.4%) and serosal invasion (97.0%) was significantly higher in these patients. Microscopic lymph node metastasis was positive in 86.5%. The 5-year survival rate was 23.4% in the patients with a curative operation and 5.0% in those with a noncurative operation (p < 0.01). Peritoneal dissemination was most frequently noted in the recurrence patterns. We conclude that early detection and a curative operation are both essential to improve the prognosis of patients with Borrmann type IV gastric cancer. The addition of a potent postoperative chemotherapy regimen is also recommended.

Adenocarcinoma↗
PubMed1995

Successful one-stage operation for completely obstructive colorectal carcinoma.

We describe herein a new and successful method of performing a safe and steady one-stage operation for completely obstructive colorectal carcinoma. First, a long ileus tube is utilized to decompress the dilated proximal bowel preoperatively and irrigate the feces-loaded colon intraoperatively. Following this procedure, a standard resection with radical lymph node dissection is carried out without a diverting colostomy. We performed this procedure successfully in seven patients, none of whom developed any anastomotic leakage.

Colectomy↗
PubMed1995

Hemolysis and heat generation in six different types of centrifugal blood pumps.

What the most causative factor affecting hemolysis is still controversial. To resolve this problem, we investigated the relationship between hemolysis and heat generation in six types of centrifugal blood pumps (Bio-Pump, Delphin, Capiox, Nikkiso, Isoflow, and Toyobo). The analyzed parameters were index of hemolysis in fresh goat blood, pumping performance, and heat generation in a thermally isolated mock circuit. These parameters were analyzed at a flow rate of 5 L/min by changing the pressure head (100 mm Hg and 500 mm Hg). At 500 mm Hg of pressure head, the Bio-Pump needed the highest rotation number and showed the highest hemolytic rate and heat generation. The index of hemolysis is well correlated to heat generation (r2 = 0.721). Heat may originate from the motor by conduction, hydraulic energy loss, and mechanical friction between the shaft and seal. We strongly suspect that hemolysis was caused by a factor such as mechanical friction which generates heat locally.

Animals↗
PubMed1994

Role of intraoperative assessment of lymph node metastasis and serosal invasion in patients with gastric cancer.

The clinical diagnoses of nodal status (N) and tumor invasion (T) were performed intraoperatively during 1499 consecutive operations for gastric carcinoma and compared with subsequent pathologic diagnoses. An accurate macroscopic diagnosis of N stage was difficult; overall accuracy was only 56.6%. Intraoperative assessment of T stage (particularly of serosal invasion) was correct for 93.2% of early stages of the disease with invasion confined to the mucosa or submucosa (pT1) when the pathologist assessed the T stage in the resected specimen, for 95.6% of advanced tumors invading the serosa (pT3), but for tumors of an intermediate stage with invasion involving the muscularis propria or the subserosa (pT2) in only 41.9% of cases. Macroscopic overestimation occurred in 58.1% of cases with pT2 tumors, which were characterized by carcinomas in the upper third of the stomach, tumors larger than 5 cm, carcinomas of the ulcerating type, differentiated adenocarcinomas, tumors invading the subserosa, and those accompanied by lymph node metastasis or liver metastasis. The overestimated group had a significantly poorer prognosis than the correctly assessed cases (P < 0.05). Since multivariate logistic regression analysis showed that the significant risk factor related to the inaccurate intraoperative assessment of T stage was tumor size, the error in diagnosis may correlate with a greater degree of tumor spread. Surgeons should decide their therapeutic approach at the time of surgery on the basis of their intraoperative assessment of tumor spread. We recommend extensive surgery followed by adequate chemotherapy when serosal invasion is suspected at surgery.

Adenocarcinoma↗
PubMed1994

A flow visualization study of the NCVC centrifugal blood pump.

A compact centrifugal pump, NCVC-1, has an open-type impeller with 6 curved vanes, and it is characterized by no shaft and no seal. A tunnel is placed in the center of the impeller-rotor assembly to irrigate the back space behind the rotor. To evaluate the flow, we performed 3 visualization methods: tracer, oil film, and injection streak line method. The flow, observed by the tracer method in NCVC-1, indicated little turbulence along vanes. A volute chamber proved effective to reduce vortex formation in the outlet. Oil film pattern revealed no flow separation on vanes at 5 L/min. Washout flow behind the rotor is essential to prevent thrombus formation and was shown as inward spiral flow without any stagnation. These data suggested that a combination of visualization techniques was useful to analyze various flow conditions, and the NCVC-1 has excellent flow characteristics with little turbulence and little flow stagnation, which must be beneficial to low hemolysis and high antithrombogenicity.

Heart-Assist Devices↗
PubMed1994

Lymph node metastasis and macroscopic features in early gastric cancer.

The relationship between macroscopic features and the frequency and extent of lymph node metastasis was examined retrospectively in 421 patients with early gastric cancer. Nodal involvement was evident in 48 patients (11.4%): 7 out of 204 (3.4%) with mucosal cancer and 41 out of 217 (19.3%) with submucosal lesions. The incidence of metastasis to perigastric nodes and extraperigastric nodes was 2.9% and 0.5% for mucosal cancer, and 13.8% and 5.1% for submucosal cancer, respectively. There was no metastasis in lesions less than 1 cm in diameter, but the incidence of positive nodes increased with the size of the primary lesion. There was a low incidence of lymph node metastasis associated with lesions confined to the mucosa and less than 3 cm in size, elevated types of I and IIa less than 2 cm, and the flat type of IIb, while types consisting of a depressed portion such as IIc, III, IIc + III, and IIa + IIc often had not only perigastric but also extraperigastric nodal involvement, even when the lesion was small. As early gastric cancer can be cured by surgery, this modality is the treatment of choice. Endoscopic therapy in cases with a low involvement of lymph node metastasis can be considered when the patient is in a poor clinical state of health.

Adult↗
PubMed1994

[A case of nonresectable gastric cancer treated by sequential methotrexate and 5-fluorouracil].

An advanced gastric cancer patient with multiple retroperitoneal lymph node metastases and bone metastases was treated with sequential MTX and 5-FU. Complete response was obtained against both gastric primary lesion and retroperitoneal lymph nodes observed endoscopically and by computed tomography. Partial response was obtained against bone metastases observed by bone scintigraphy. Side effects of the chemotherapy were not observed.

Adenocarcinoma, Scirrhous↗
PubMed1993

Diagnostic factors in gastric cardia cancer invading the esophagus.

BACKGROUND: The prognosis of patients with tumors in the upper one-third of the stomach, particularly those with esophageal invasion, is poor. METHODS: This study involved 168 patients with advanced cancer in the upper third of the stomach whose lesion had had invaded the esophagus. Clinical and pathologic studies were performed with respect to diagnostic factors and histologic differentiation of the lesion. RESULTS: Eighty-three patients (49.4%) had differentiated gastric cancer, and 85 (50.6%) had undifferentiated cancer. The survival time was shorter for patients with undifferentiated cancer than for those with differentiated cancer (P < 0.01). Multivariate analysis showed operative curability, liver metastasis, peritoneal dissemination, lymph node metastasis, serosal invasion, and tumor size to be independent prognostic factors. In patients with undifferentiated cancer, tumors were larger, serosal invasion was prominent, lymph node metastasis was present in 85.9% of cases, 64.7% of metastases were noncuratively resected, and survival time was less favorable. CONCLUSIONS: Our analysis shows that a group of patients at increased risk for tumor advancement will benefit from more aggressive therapy.

Adult↗
PubMed1993

Prognosis for patients with carcinoma in the middle third of the stomach.

In 268 of the 1,115 patients (24.0%) with gastric cancer who underwent a curative resection in our clinics, the tumor was located in the middle third of the stomach. The clinicopathological features and prognosis of these patients were divided into two groups, according to site of the tumor: anterior wall (n = 58) vs. other sites (n = 210). Clinicopathological factors did not differ between the two groups. The survival time for patients with a tumor in the anterior group was shorter than that for patients with a tumor in other areas (P < 0.05). The five-year survival rate was 79.3% for patients with an anterior tumor and 91.9% for those with a tumor at a different site. A multivariate analysis indicated lymph node metastasis, serosal invasion, and anterior wall location to be independent prognostic factors indicative of a poor prognosis when the tumor was located in the middle third of the stomach. For such patients, close follow-up is needed to detect possible recurrences.

Female↗
PubMed1993

Gastric cancer with p53 overexpression has high potential for metastasising to lymph nodes.

Overexpression of the tumour suppressor gene p53 was investigated immunohistochemically in 96 primary gastric carcinomas and 26 corresponding metastatic perigastric lymph nodes. Abnormalities in p53 expression were found in 52 (54%) of the 96 primary carcinomas. Tumours stained positively for p53 frequently metastasised to lymph nodes (the metastatic rate: 85%) compared to findings in those with negative p53 staining (64%, P < 0.05). Ninety-two percent (24/26) of the malignant cells in the lymph nodes stained positively for p53. When the DNA ploidy pattern of the tumour was determined by flow cytometry, the aneuploid tumours in p53 positive and negative groups accounted for 69% and 45%, respectively (P < 0.05). Proliferative activity of the tumour, as measured by Ki-67 labelling, was significantly higher (30.6 +/- 12.0%) in the p53 positive group than that (25.1 +/- 10.7%) in the p53 negative group (P < 0.05). Thus, gastric cancer with a mutant p53 has high proliferative activity and metastasis to lymph nodes will probably occur.

DNA, Neoplasm↗
PubMed1993

Early carcinoma of the stomach.

We analyzed data on 423 Japanese patients with early carcinoma of the stomach with respect to clinicopathologic features and prognosis. All patients were treated in the clinics at which we work. The upper one-third of the stomach was less frequently involved. Therefore, partial gastrectomy was performed more often in patients with early carcinoma of the stomach than in those with advanced carcinoma of the stomach. The differentiated type of carcinoma of the stomach was more frequent and grew expansively. Lymph node metastasis was noted in 11.6 percent of the patients, lymphatic vessel involvement was evident in 13.5 percent and extensive lymph node dissection (R2 or R3) was performed in 86.0 percent. The 15 year survival rate for patients with early carcinoma of the stomach was 89.0 percent. Lymph node metastasis, differentiated tumor type and patient age proved to be independent prognostic factors, as determined by multivariate analysis. Increased detection of early carcinoma of the stomach in its curable stages may be achieved through gastrointestinal series and endoscopy for symptomatic patients. A close follow-up evaluation is essential to detect recurrences, even when a curative resection is performed.

Female↗
PubMed1993

[A case of nonresectable esophageal cancer treated by the combination of cisplatin, 5-fluorouracil and THP-adriamycin].

An advanced esophageal cancer patient with multiple liver metastases was treated with a combination of CDDP, 5-FU and THP-ADM. Complete response was obtained against esophageal primary lesion endoscopically, and partial response was obtained against liver metastases observed by computed tomography. Bone marrow suppression of grade 3 was observed, but resolved within 2 weeks.

Antibiotics, Antineoplastic↗
PubMed1993

Development of gastric cancer with special reference to growth and DNA content. Slow and rapid growing types.

We treated two patients with gastric cancer for whom surgery was delayed and the natural course of the tumor could be observed pre and postoperatively. A 70-year-old man with a well differentiated adenocarcinoma in the upper portion of the stomach underwent resection 6 years after the clinical diagnosis. Despite extension upwards towards the lower esophagus during a 6-year period, the tumor could be resected. In a poorly differentiated adenocarcinoma in the lower third of the stomach in a 40-year-old woman, the primary lesion was not distinct on the upper GI series done 6 months before, while at the time of laparotomy, disseminating metastases and pancreas invasion made it impossible to resect the stomach together with the tumor. The tumor in the man had a low DNA ploidy, while the lesion in the woman was characterized by a high ploidy. These findings show the distinct difference in the biological behavior of the tumor in these two patients. The possible correlation between DNA content with speed of growth warrants further attention.

Adenocarcinoma↗
PubMed1993

[A case of aortic dissection (DeBakey-I) occurring 20 months after aortic valve replacement].

Simple aortic valve replacement was performed in a 59-year-old man whose ascending aorta was moderately dilated (45 mm) because he had no characteristics of Marfan's syndrome or other connective tissue diseases. However, about 20 months later, reoperation needed to be performed for aortic dissection of DeBakey type I. The pathological findings of the aortic wall obtained at the initial operation revealed cystic medial necrosis. The occurrence of aortic dissection after aortic valve replacement is uncommon but not rare, especially in patients with cystic medial necrosis and/or dilated aortic root. Therefore, in these patients, wrapping or replacement of the ascending aorta may be required at the same time of aortic valve replacement.

Aortic Dissection↗
PubMed1992

Prognostic factors for noncurative gastric cancer: univariate and multivariate analyses.

We performed univariate and multivariate analyses of possible prognostic factors related to postoperative clinical course of patients with advanced gastric cancer. Noncurative resection was done for 119 patients with hepatic metastasis, peritoneal seeding, extensive lymph node metastasis, or direct invasion to adjacent organs, either alone or in various combinations. In the univariate analysis, 6 of 17 items such as peritoneal seeding, lymphatic invasion, vascular invasion, mode of invasion, extent of lymphadenectomy, and width of serosal invasion significantly correlated to the prognosis. The multivariate analysis indicated that three inherent pathologic factors, mode of invasion, lymph node metastasis, and hepatic metastasis, and one treatment factor, extent of lymphadenectomy, were significant variables predictive of the prognosis and that the prognosis was expected to be very poor in cases of infiltrative type, nodal involvement to tertiary nodes, presence of hepatic metastasis, and lymphadenectomy less than R3. Prognosis in terms of the extent of lymphadenectomy shows that extensive lymphadenectomy (R3) proved to be significantly effective in prolonging survival time, even after noncurative gastrectomy. We recommend extensive lymphadenectomy to prolong survival time for such patients.

Adenocarcinoma↗
PubMed1992

Noncurative resection for advanced gastric cancer.

Between 1965 and 1985, 489 patients with advanced gastric cancer who were treated with gastric resection and in whom tumor cells remained after the operation were defined as cases of a "noncurative resection." The clinicopathological features and prognosis of these patients were examined and two groups were prepared: locally advanced cancer and cancer with a distant metastasis. In locally advanced cancer cases, tumor cells remained in the neighboring organs, lymph nodes, and/or resected margins; in those with distant metastasis, peritoneal dissemination and/or liver metastasis were present regardless of whether or not the metastasis was removed, with or without locally noncurative factors. Serosal invasion was prominent and high rates of lymph node metastasis and lymphatic involvement were evident in both groups. The survival rate for patients with locally advanced gastric cancer was better than that of patients with distant metastasis (P < 0.01). Survival time in patients with locally advanced cancer can be lengthened by resecting all of the primary tumor and as much of the metastatic lesions as possible, even if the surgical management is "noncurative." Aggressive postoperative chemotherapy for patients with distant metastasis from a gastric cancer is to be recommended.

Aged↗