Biomedical subjects

H Kuwano

Publications and source records attributed to H Kuwano.

341 records · Page 19Linked to original sources

PubMedDate not supplied

Healing of the resected liver stump: its process and the significance of portal blood flow.

In an effort to investigate the healing process of resected liver stump and the significance of portal and hepatic arterial flow. In addition to hepatectomy in the first group, an arterial and a portal branch were ligated in the second and third groups, respectively. It was demonstrated that portal branch ligation influenced a delay in healing of resected liver stump rather than hepatic arterial branch ligation. It is assumed that portal blood flow is more responsible for liver stump healing as well as hepatic regeneration than is hepatic arterial flow.

Animals↗

PubMedDate not supplied

Experimental study of morphological changes after gastroplasty.

Twelve rabbits were sacrificed one and three days, one, two, four and eight weeks after horizontal gastroplasty in order to investigate morphological changes after operation. Histology of the proximal pouch of the stomach showed various degrees of mucosal damage and a close relationship between its severity and high pH of the pouch. This suggested the usefulness of pH measurement of the gastric juice in the proximal pouch as an indicator of mucosal damage after gastroplasty.

Animals↗

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The preventative effect of pyridine on stress ulcers: a microvascular and morphological study.

The effect of pyridine in the prevention of cold restraint-induced stress ulcers in rats was investigated. After fasting, rats were administered the appropriate dosage of pyridine and were promptly placed into stress cages for cold room stress. The rats were sacrificed and bleeding, ulceration and vascular patency were examined. At doses of 0.01 mg/kg and 0.20 mg/kg, pyridine significantly decreased the amount of gastric hemorrhage and ulceration (p less than 0.01), as compared with the controls. In addition, microvascular dye, injected after stress, revealed perfused mucosal capillaries in the pyridine group, and occlusion of mucosal capillaries in the control group. These results suggest that the antiplatelet effect of pyridine reduced thrombus formation in the mucosal capillaries with subsequent reduction in mucosal ulceration.

Animals↗

PubMedDate not supplied

Gastric syphilis: case report and review of the literature.

A 35-year-old Japanese woman consulted our clinic with a one-month history of epigastric pain. Although a superficial depressed type of early gastric carcinoma was highly suspected from the results of upper gastrointestinal barium studies and gastroscopy, there was no evidence of malignancy in the biopsy specimen. Gastric syphilis was then considered based on skin lesions and serological studies. Diagnostic antisyphilitic therapy improved the symptoms and gastric lesion promptly. A review of the recent reports indicated that most cases of early phase gastric syphilis seem to present morphologically either as a narrowing lesion or shallow ulcero-nodular lesion at the pyloric antrum. Therefore, whenever such findings are recognized either radiologically or gastroscopically and no malignant cells are found in biopsy specimens, gastric syphilis and diagnostic antisyphilitic therapy should be considered.

Adult↗

PubMedDate not supplied

Origin and spread of intra-epithelial carcinoma of the esophagus. Histopathologic investigation of the junctions between intraepithelial carcinoma and non-cancerous epithelium.

Scrutinization of data on 56 patients of primary esophageal squamous cell carcinoma and not given preoperative irradiation therapy disclosed 36 areas (64.1%) of intra-epithelial carcinoma contiguous to the main lesion, and in 16 (28.7%) there was a multiple occurrence of squamous cell carcinoma, in which 13 were double and 3 were triple carcinomas. A total of 96 junctions between intra-epithelial carcinoma and non-cancerous epithelium were histologically investigated. These junctions could be grouped into two types: well-demarcated (29 areas, 30.2%) and ill-demarcated (67 areas, 69.8%) types. The latter was separable into 12 (12.5%) of whole layer, 33 (34.4%) of basal layer and 22 (22.9%) of irregular patterns. Epithelial dysplasia occurred in one (3.4%) of well-demarcated and ten (14.9%) of ill-demarcated junctions, and almost all lesions of dysplasia were moderate or severe. Thus, most carcinomatous transformation had occurred at the site of junction (in-situ carcinogenesis) and epithelial dysplasia may be a carcinoma rather than pre-cancerous lesion, per se.

Carcinoma in Situ↗

PubMedDate not supplied

Curative local excision for mucosal esophageal carcinoma.

We performed a curative local excision for mucosal esophageal carcinoma through a thoracotomy with the help of intraoperative endoscopy and Lugol's staining. The mucosa and submucosa containing the lesion is completely resected, with neither narrowing nor shortening of the esophagus left remaining.

Carcinoma↗

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Surgical treatment for advanced gastric cancer.

BACKGROUND/AIMS: We herein report on the clinicopathological factors related to the unresectability of far advanced gastric cancer and the prognostic effect of gastrectomy on these cases. MATERIAL AND METHODS: There are four main prognostic factors for advanced gastric cancer including 1) peritoneal dissemination, 2) hepatic metastasis, 3) lymph node involvement and 4) invasion to adjacent organs. RESULTS: The rate of unresectability was high in the cases demonstrating both histologically undifferentiated type cancer and cancers located in the lower third of the stomach. It was difficult to resect the main tumor based on an increase in the factors regulating the macroscopical stage. The rate of unresectability tended to be higher in cancers with peritoneal dissemination or invasion to adjacent organs. The pancreas was the most frequently invaded organ. accounting for the unresectability of the disease. The prognosis for cases with unresected gastric cancers was poor and all died within 2 years of the operation. In addition, the prognosis for cases with Stage IV gastric cancer, demonstrating either 1 or 2 factors, improved after gastrectomy while no such improvement was seen in cases with 3 or 4 factors. CONCLUSIONS: To improve prognosis, gastrectomy should be performed when a patient has far advanced gastric cancer but only demonstrates 1 or 2 of the above 4 factors.

Adult↗

PubMedDate not supplied

Prognostic significance of immunological parameters in patients with esophageal cancer.

BACKGROUND: The role of immunosurveillance in the fight against cancer is well known. In addition, cancer patients have been reported to have an impaired immune function. In patients with esophageal cancer, however, the relationship between the immunological parameters of the host and their survival has not yet been evaluated fully. MATERIALS AND METHODS: Of 103 patients with esophageal cancer who underwent esophagectomy, lymphocyte subsets (CD4+ and CD8+), the PHA response, and natural killer cell (NK) activity were all assessed in relation to clinicopathological features and the prognostic significance was evaluated using both a univariate and multivariate analysis. RESULTS: The CD4+/CD8+ ratio in 58 (56%) patients was higher than the mean of the control, while the PHA response and NK activity in 74 (72%) and 70 (68%) patients, respectively, were lower than 1 SD below the mean of the control. None of these three parameters demonstrated a low value in 5 patients, while 1, 2 and 3 parameters showed a low value in 28, 49 and 21 patients, respectively. The survival rate of the patients with low values in all of three of these parameters was significantly worse than that for the patients in whom the number of low parameters was less than two. A multivariate analysis revealed that tumor invasion and the number of low values in these parameters were independently significant prognostic factors. CONCLUSIONS: This survival analysis revealed that low values in the CD4+/CD8+ ratio, the PHA response, and the NK activity will help predict a poor prognosis in patients with esophageal cancer.

CD4-CD8 Ratio↗

PubMedDate not supplied

Hyperthermia combined with chemotherapy and irradiation for the prolongation of the postoperative prognosis in the patients with esophageal carcinoma invading neighbouring structures.

Preoperative hyperthermo-chemo-radiotherapy (HCR) has been performed on patients with esophageal carcinoma, especially in advanced cases with invasion to the neighbouring structures (a3 carcinoma), and is considered to have contributed to the favorable postoperative prognosis. 163 patients with operated locally advanced esophageal carcinoma with invasion to the neighbouring structures (a3 carcinoma) were analyzed. 40 cases were treated with preoperative HCR (HCR group), while 85 cases were treated with other preoperative adjuvant therapies including 35 with chemo-radiotherapy (CR group) and 42 with radiotherapy (R group), and the remaining 38 were operated on without any preoperative treatments. The effectiveness of the therapies and the prognosis were investigated. The survival rates of the HCR group were significantly better than those of the CR group (p < 0.05). The prognosis of cases with Grade 3 effectiveness was significantly better than those of others, moreover, in 5 cases with Grade 3 effectiveness in the HCR group, there was no case of early recurrence or metastasis after resection, while in addition, three patients have since survived for 4, 5, and 7 years, respectively. Our data showed that for the patients with locally advanced esophageal carcinoma with invasion to the neighbouring structures (a3 carcinoma), hyperthermia combined with chemotherapy and irradiation has demonstrated a favorable influence on the prognosis.

Aged↗

PubMedDate not supplied

A long-term surviving patient with hepatocellular carcinoma including lymphocytes infiltration--a clinicopathological study.

In patients with hepatocellular carcinoma, a diffuse lymphocyte infiltration into the tumor has been reported to be a favorable prognostic factor. Nevertheless, the mechanism of the lymphocyte infiltration is still unknown and HLA-DR antigen expression, which is the cause of lymphocyte infiltration, has never to our knowledge been previously reported in such cases. The patient in this case had hepatocellular carcinoma with a diffuse lymphocytes infiltration into the tumor and was able to survive for 6 yrs and 11 months without any cancer recurrence. The tissue was studied using histologic and immunohistologic methods. Microscopically, lymphocytes infiltrate along the trabeculae of cancer cells. Immunohistochemically, such infiltrated lymphocytes are mainly T lymphocytes. No lysozyme positive cells were seen in the tumor. HLA-DR antigen was diffusely and strongly expressed on the endothelial cells in the tumor, however its expression was minimal on the endothelial cells in the non-cancerous parenchyma. T lymphocytes infiltrated selectively towards the HLA-DR antigen of the endothelial cells in the tumor and the inflammatory infiltrate may thus be related to a distinct category of patients with a favorable prognosis.

Carcinoma, Hepatocellular↗

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Leiomyoma of the esophagus with special reference to the characteristics of this tumor in teenagers.

BACKGROUND/AIMS: Leiomyoma, the most common benign esophageal tumor, occurs rarely in youths. We herein reported our experiences with this tumor, paying particular attention to two cases in teenagers. MATERIALS AND METHODS: We have surgically treated 12 patients with leiomyoma of the esophagus from 1978 to 1995. Ten of them occurred in adult and two occurred in teenagers aged 17 and 18. We evaluated the characteristics, diagnosis and treatment of these cases, particularly in young patients. RESULTS: The age range was from 17 to 55, and the mean was 40.5 years. The mean longitudinal size of 12 tumors in 10 adult cases was 4.9 cm, while both tumors in the teenagers were larger in size, over 10 cm. Endoscopic ultrasonography was useful in the diagnosis of the tumors. All tumors were enucleated without any complication. In young cases, in spite of the large size of the tumors, an enucleation was also possible and the long-term result was satisfactory. CONCLUSION: Regarding the young cases, in spite of the large size of the tumor, an enucleation of the tumor should be tried whenever possible, in consideration of the patient's postoperative quality of life.

Adolescent↗

PubMedDate not supplied

Expression of p53 protein in glandular differentiation admixed with squamous cell carcinoma of the esophagus.

BACKGROUND: Glandular differentiation in squamous cell carcinoma of the esophagus is occasionally recognized by serial histologic investigations. We previously performed histopathologic investigations of such tumors and suggested the possibility of field carcinogenesis in esophageal cancer. MATERIALS AND METHODS: In the current study, we performed an immunohistochemistry analysis for p53 protein in such cases to investigate the mode of carcinogenesis from the view point of genetic changes. p53 protein expression in both ordinary squamous cell carcinoma and glandular differentiation of nine cases to demonstrate the coexistence of these components. RESULTS: The expression of p53 in the areas of squamous cell carcinoma was diffusely detected in three and focally in two (five in all, 55.6%) and, in these five cases, p53 was also positive in the areas of glandular differentiation in four cases. On the other hand, the expression of p53 in the glandular components was negative in all four tumors with p53 negative squamous cell carcinoma. CONCLUSIONS: The process of carcinogenesis within the tumor was thought to be similar in almost all cases even in the different histopathologic components.

Aged↗

PubMedDate not supplied

The clinical and histopathological contributing factors influencing the effectiveness of preoperative hyperthermo-chemo-radiotherapy for the patients with esophageal cancer.

BACKGROUND/AIMS: The effectiveness of hyperthermic treatment combined with irradiation and chemotherapy for patients with esophageal cancer on local response as well as on long-time survival has been reported. In order to investigate the contributing factors influencing the effectiveness of preoperative hyperthermo-chemo-radiotherapy (HCR therapy), this study was performed. MATERIALS AND METHODS: One hundred nineteen patients with esophageal cancer who underwent preoperative HCR therapy followed by esophagectomy were reviewed in this retrospective study. The rate of effectiveness of preoperative HCR therapy was then compared in resected tissue specimens with regard to such factors as age, sex, the location of the tumor, the longitudinal diameter of the esophagogram, the radiographic type of tumor, the histological type and the histological depth of invasion using univariate and multivariate analyses. RESULTS: Both univariate and multivariate analyses showed that the clinical and histopathological factors which had the greatest effect on preoperative HCR therapy were well differentiated squamous cell carcinoma regarding the histological type and tumorous type regarding the radiographic types. CONCLUSION: We thus conclude that preoperative HCR therapy shows great promise for the treatment of patients with esophageal cancer, especially in instances of well differentiated and radiographic tumorous type squamous cell carcinoma.

Adult↗

PubMedDate not supplied

Simultaneous combination therapy of carboplatin and radiation for patients with carcinoma of the esophagus.

BACKGROUND/AIMS: Carboplatin is a less nephrotoxic analog of cisplatin with a significant effect against a variety of malignancies including carcinoma of the esophagus. Furthermore, the supra-additive effect between carboplatin and radiation has been reported in both clinical and experimental studies. METHODS AND MATERIALS: Seven patients with carcinoma of the esophagus underwent a combined therapy of carboplatin (30 mg/m2, total 1500-2000 mg) and radiation (1.6 Gy/day, five days/week, total 50-70 Gy). RESULTS: Six patients had a complete tumor remission while in the remaining patient a partial response was observed. In five of these six cases, no evidence of recurrence has been recognized at 9-13 months after the treatment. Two patients survived without any evidence of recurrent disease 43 and 57 months after the initiation of the treatment. The major side effects were leukopenia and thrombocytopenia, which were grade II to IV but not fatal. However, no significant renal toxicity, gastrointestinal disorders nor liver toxicity were recognized. CONCLUSIONS: These data thus indicate the clinical utility of the combined therapy of radiation and carboplatin for patients with carcinoma of the esophagus.

Aged↗

PubMedDate not supplied

Significance of routine annual esophagram for early detection of carcinoma of the esophagus.

BACKGROUND/AIMS: In order to achieve increased survival rates for patients with carcinoma of the esophagus, early detection of the disease is vital. Serial esophagrams were evaluated to clarify which interval would be effective for early detection of carcinoma of the esophagus during routine examination. MATERIALS AND METHODS: One hundred eighty-nine patients with carcinoma of the esophagus were grouped into three, according to the experience and the time of the previous roentgenograms before the definite diagnosis. RESULTS: Five patients were in Group 1, in which roentgenographic examination had been done within 12 months prior to the diagnosis. Retrospective observation revealed a slight but certain abnormal shadow at the same location as the esophageal tumor seen on the second films. In Group 2, seven had received an esophagram between 12 and 24 months before the diagnosis. In contrast to Group 1, neither abnormality nor findings indicating esophageal tumors were detected on the former x-ray films, in all seven cases. Group 2 was characterized by relatively small tumors and low stage of the disease. Mean tumor length was 4.1 +/- 2.9 cm, and three of seven were classified as Stage I and two as Stage IIA. On the other hand, most of the 177 patients in Group 3, with no previous examination of the esophagus within 24 months before the diagnosis, had far advanced disease. Mean tumor length was 6.3 +/- 2.6 cm. Only nine (5.1%) were classified as Stage I, whereas 115 (65.0%) were classified as Stage III or IV. CONCLUSION: In light of these data, for populations in which esophageal cancer frequently occurs, esophageal examination every 12 months will no doubt contribute towards the early detection of lesions.

Adult↗

PubMedDate not supplied

Effectiveness of hyperthermia and radiation treatments for patients with esophageal cancer predicted by the succinate dehydrogenase inhibition test.

We used in vitro succinate dehydrogenase inhibition test (SDI test) to predict the combined effects of hyperthermia and irradiation on specimens of esophageal cancer obtained at endoscopy. The mean activity of succinate dehydrogenase (SD) after combined treatment of 6 Gy of irradiation and 43.0 degrees C for 20 hours of hyperthermia was significantly decreased compared to findings with each single treatment (to irradiation; p < 0.01, to hyperthermia; p < 0.05). A correlation between the SD activity and the clinical remedial value was also examined in tissues from 47 patients with esophageal cancer, and treated with hyperthermia and irradiation, in combination. The clinical effect, determined radiographically, showed a correlation of 76.6%. Thus, hyperthermia plus irradiation is effective clinical treatment and the SDI test facilitates prediction of the outcome of this combined treatment.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Laparoscopic repair of a paraesophageal hiatal hernia with gastric volvulus.

We report the case of a massive paraesophageal hiatal hernia with gastric volvulus which presented with the symptom of a precordial sense of pressure for over two years, which was successfully treated with laparoscopic surgery. The patient is presently in good condition, without any recurrence of either the hiatal hernia or other symptoms one year after surgery. This approach is considered to be a safe and effective procedure, and it also provides for rapid recovery from the operation.

Aged↗