[Carbohydrate profiles and disease status in human lung carcinomas].
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Antigens, Tumor-Associated, Carbohydrate↗
Biomedical subjects
H Shimazu
Publications and source records attributed to H Shimazu.
[Histopathological features of the lymph node metastases in patients with thoracic esophageal cancer].
Histopathological features of the lymph node involvement were studied in 104 patients with thoracic esophageal cancer who underwent subtotal esophagectomy combined with extended radical lymph adenectomy in cervicothoracoabdominal region. Metastatic involvement was found in a total number of 503 lymph nodes from 73 patients by histologic examination. The mean of long and short diameter was found to be less than 5mm in 125 (24.9%) of these 503 nodes. The involved area on the section was less than one third in 149 nodes (29.6%), and was significantly smaller in mediastinal lymph nodes than those in cervical or abdominal ones. Sixty-seven (13.3%) of 503 nodes were partially invaded by micrometastasis of 1mm or less in diameter. Micrometastasis also more frequently occurred in mediastinal nodes with a statistically significant difference. Extranodal proliferation (ENP) of cancer cells was found in 106 nodes (21.1%), and extranodal lymphatic and/or blood vessel invasion (ENly, v) was also recognized in 60 nodes (11.9%). Micrometastasis and ENP with or without ENly, v were found in 24 (32.9%) and 29 (39.7%) of 73 patients with positive lymph node metastasis, respectively. Postoperative survival rate in patients with micrometastasis and/or ENP with or without ENly, v was inferior to that in patients with neither of them.
Esophageal Neoplasms↗
[A probable relevance of desmosome to lymph node metastasis in esophageal cancer].
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Carcinoma, Squamous Cell↗
[Significance of vitamin K (VK) administration in patients under chemotherapy during postoperative fasting period].
Recently coagulopathy caused by vitamin K (VK) deficiency following antibiotic therapy in malnourished patients has been reported. We studied on the same problem particularly in patients under chemotherapy during postoperative fasting period. For this purpose, prothrombin time (PT), vitamin K-dependent coagulation factors (Factor II (F-II), VII (F-VII) and protein C), PIVKA-II (PK-II) and plasma level of VK in two groups of patients with or without VK administration were measured in esophageal cancer patients. In the group with VK, VK2 were given intravenously everyday. In the group without VK, PT prolonged and F-II decreased from the seventh postoperative day, especially on the 14th day significantly. Although F-VII and protein C decreased on the first day and returned subsequently on the seventh day, no significance was observed between two groups. PK-II increased clearly in the group without VK from the seventh day, whereas no significant changes were observed in the group with VK. The plasma level of VK1 decreased in both groups, but VK2, especially MK-4, was high in the group with VK.
Antineoplastic Agents↗
[A case of pulmonary blastoma].
A 45-year-old male with pulmonary blastoma was described. The patient suffered from headache and gait disturbance, and was diagnosed metastatic brain tumor. The histopathology of the removed tumor indicated metastasis from pulmonary blastoma. The pulmonary tumor, which had been detected on the chest x-ray film but misdiagnosed tuberculous lesion, was subsequently diagnosed pulmonary blastoma by TBLB. The patient underwent left upper lobectomy with mediastinal lymph node dissection, but died 12 months after the operation. To our knowledge, only 54 cases with pulmonary blastoma have hitherto been reported in the Japanese literature.
Brain Neoplasms↗
Significance of lymph nodal metastases in treatment of esophagogastric adenocarcinoma.
Between 1973 and 1990, 104 patients with adenocarcinoma of the esophagogastric junction (EGJ) (i.e., primary tumor within 2-3cm of and including the EGJ) were operated upon. Preoperatively, all were deemed potentially resectable. In 70, the esophagogastrectomy was combined with en-bloc resection, that is, wide excision of the primary mass in conjunction with radical lymph node dissection of the posterior mediastinum and upper abdomen. Postoperative staging was done using the WNM system [i.e., wall penetration (W), lymph node involvement (N), and systemic metastases (M)]. Sixty-four patients or 62% had lymph nodes positive for metastases and these neoplastic nodes were most common in the areas between the lower mediastinum and the celiac axis. Of the 70 patients undergoing radical en-bloc resection, paracardiac lymph nodes had the highest rate of metastatic involvement (40%) while gastric lesser curvature lymph nodes had 29%, and distal splenic/pancreatic lymph nodes 11%. Overall, the frequency of intrathoracic lymph nodal metastases was 7%. Those patients who had intrathoracic lymph nodal metastasis also had intraabdominal lymph nodal secondary tumor involvement. Among postoperative survivors, the percent of 5 year survival with N0 (no positive node) and N1 (1 to 3 positive nodes) stage of disease was 38.6% and 28.9%, respectively, compared to only 11.5% in those with N2 (4 or more positive nodes) staging. Because long-term survival is dismal in patients with multiple lymph nodal metastasis, preoperative and intraoperative staging is desirable to avoid morbidity of radical resection for EGJ adenocarcinomas. With less than 3 positive nodes, en bloc resection is worthwhile.
Adenocarcinoma↗
Tumorigenicity, invasion, and metastasis of human gastric cancer in nude mice.
Tumors derived from 105 patients with gastric cancer were subcutaneously heterotransplanted into nude mice in order to study their tumorigenicity and malignant behavior. Of the 105 gastric cancers, 45 were successfully transplanted (a 42.9% tumorigenesis rate). The tumorigenesis rate of Borrmann type 1 and 2 cancers (77.8%) was significantly higher than that of type 3 and 4 cancers (34.6%). Also, the tumorigenesis rate of differentiated carcinoma (57.1%) was significantly higher than that of undifferentiated carcinoma (30.9%). Spontaneous metastases from the subcutaneous tumors were observed in 5 of the 37 established tumor lines (13.5%), and macroscopic pulmonary metastases were common with one tumor line (SCK-29). Although most of the subcutaneous gastric cancers showed local expansion without distant metastasis, the same tumor cells implanted into the peritoneal cavity exhibited invasive growth and/or metastasis. Thus, the expression of a metastatic phenotype by human gastric cancer was influenced by the host microenvironment. The SCK-29 tumor line with its high metastatic potential may be useful for studies on the mechanism of blood-borne metastasis.
Animals↗
Ambulatory monitoring of indirect beat-to-beat arterial pressure in human fingers by a volume-compensation method.
Using a volume-compensation technique, a portable device has been designed for the indirect measurement of beat-to-beat arterial pressure and its waveforms in the basal phalanx of fingers of ambulatory subjects. The device consists of (1) a transmission infra-red photoelectric plethysmograph (TIPP) to detect the variation of arterial volume, (2) a pneumatic cuff with an actuator, (3) a servosystem to control the cuff pressure, and (4) a stereo cassette tape recorder. Arterial pressure was determined from the cuff pressure which was controlled by the servosystem so as to maintain the arterial volume constant at the 'vascular unloading' state. This device is equipped with a compensator for any hydrostatic pressure difference between the heart and finger. Thus, the blood pressure at heart level can be obtained for any finger height. The total weight of the device was 1.6 kg. Blood pressure changes during walking, jogging, jumping, and exercises such as side-stepping, Master's two-step test and car driving, have been successfully recorded.
Ambulatory Care↗
A detailed histological study on occult metastasis of the lymph nodes.
One representative microsection from each lymph node was carefully surveyed for metastasis in a routine examination. To scrutinize the existence of occult metastasis, three additional sections were then made from half of the remaining lymph node. A total of 1,698 lymph nodes taken from 55 patients with carcinoma of the esophagus, stomach, colon, thyroid or breast were thus reexamined histologically. The initial examination was not able to prove any metastasis in these lymph nodes. Upon reexamination, however, involvement by cancer cells was detected in 10 nodes of 7 patients. The maximum diameter of the metastatic foci varied from 0.2 mm to 1.3 mm and was less than 0.5 mm in more than half of the nodes. The metastatic patterns in the nodes were classified into three types, i.e., marginal sinus type, medullary sinus type and mixed type. The marginal sinus type was the most frequent, with the mixed type being next and the medullary sinus type being found in only one node. Accordingly, surgeons should keep the possibility of occult metastasis in mind and the marginal sinus of the lymph node should be carefully examined in order to detect any small foci of metastasis.
Humans↗
Superficial esophageal carcinoma: a clinicopathological review of 59 cases.
During the period from 1975 to 1989, a total of 59 patients with superficial esophageal carcinoma (SEC) were operated on in our Surgical Clinic. Forty patients of the 59 (68%) had been treated during the previous 5 yr. Although 22 patients (37%) complained of slight esophageal symptoms, 12 patients had only symptoms unrelated to esophageal disease, and 25 patients were asymptomatic. In the latter patients, the lesion was found by chance at the time of screening or follow-up examination of upper gastrointestinal tract disease. Endoscopy was very useful for the diagnosis of SEC, and Lugol's solution staining technique was an effective adjunctive means. The lesions in about half of the patients were initially diagnosed by endoscopy in our series. Radiologic diagnosis of the lesions confined to the mucosal epithelium or lamina propria was particularly difficult. Lymph node metastasis was not observed in patients with intraepithelial or mucosal carcinoma. However, the metastasis was demonstrated in 18 of 38 patients (47%) with submucosal invasion. The 5-yr survival rate of patients with SEC was 73%, which was significantly superior to that of patients with advanced esophageal carcinoma (26%). Since the prognosis for the patients with submucosal invasion and lymph node metastasis was poor, we should be enthusiastic about extended lymph node dissection in the surgical treatment for patients in whom submucosal invasion is suspected.
Adenocarcinoma↗
[A case of local recurrence of rectal cancer successfully treated by UFT combined with two-route CDDP chemotherapy under the AT-II induced hypertension].
A case of local recurrence of rectal cancer was successfully treated by UFT combined with two-route CDDP chemotherapy under the AT-II induced hypertension. UFT (600 mg/day) was orally administered every day. CDDP (75 mg/m2) was infused into the right internal iliac artery via subcutaneously grafted Infuse-a-port under hypertensive state induced by the AT-II (3 micrograms/min). Sodium thiosulfate was intravenously given to protect the CDDP induced nephrotoxicity. The recurrence tumor palpated by digital examination and revealed by MRI disappeared after the fourth two-route CDDP chemotherapy. The serum CEA level elevated before the treatment also normalized. This combined chemotherapy was considered to be an effective measure to cure the local recurrence of rectal cancer.
Adenocarcinoma↗
[Quality of life of patients after esophagectomy for esophageal cancer].
Quality of life of 79 patients who underwent esophagectomy for esophageal cancer and survived more than one year was evaluated by a questionnaire method. About 90% of patients had a good appetite, taking ordinary solid foods, and 69% were satisfied with the daily amount of foods. About 40% of patients complained of passage disturbance on swallowing, abdominal pain or diarrhea after meal. Fifty seven per cent of patients had frequent episodes of cough and sputum, and 20% were not able to go up the stairs to the third floor because of short breath. Thirty two per cent of patients with recurrent nerve paresis and even 5% without paresis had a trouble in daily conversation. These physical distresses were thought to be useful indicators for the doctor to evaluate the quality of life of patients. Additionally, about 30% of patients had a tendency of mental depression postoperatively. Fifty six per cent of patients who had worked before operation returned to work or were doing a lighter work than before. The psychological factor and social rehabilitation were suggested to be very important, when evaluated from the patient's side. Especially in case of aggressive surgery for esophageal cancer, postoperative quality of life of patients should be carefully considered from the viewpoints of both the patient and doctor.
Aged↗
Expression of the MDR1 gene in human gastric and colorectal carcinomas.
We measured expression of the MDR1 gene (also known as the PGY1 gene) in the human gastrointestinal tract. MDR1 messenger RNA (mRNA) levels were elevated in 13 of 15 colorectal carcinoma specimens and in six of 13 gastric carcinoma specimens. Well-differentiated colorectal carcinomas contained significantly higher concentrations of MDR1 mRNA than moderately differentiated colorectal carcinomas. Similarly, moderately differentiated gastric carcinomas contained higher concentrations of MDR1 mRNA than poorly differentiated gastric carcinomas. MDR1 gene expression in normal colorectal and gastric tissues adjacent to carcinomas was similar to that in the carcinomas. MDR1 gene expression in xenografts of colorectal and gastric carcinomas in nude mice was also investigated. Elevated expression of the MDR1 gene was seen in only four of 18 xenografts of colorectal carcinoma and was not seen in any xenografts of gastric carcinoma. P-glycoprotein was distributed over the luminal surface of the colorectal carcinoma. These results imply that the higher levels of MDR1 mRNA found in well-differentiated carcinomas derived from colorectal tissues are the results of increased expression of the MDR1 gene in the luminal surface cells. The level of expression of the MDR1 gene in colorectal and gastric carcinomas appears to correlate with the degree of differentiation and also appears to be affected by transplantation into nude mice.
ATP Binding Cassette Transporter, Subfamily B, Mem↗
Serum carcinoembryonic antigen level increases correlate with tumor progression in patients with differentiated gastric carcinoma following noncurative resection.
Serum carcinoembryonic antigen (CEA) levels were determined serially in 30 preoperative and postoperative patients with differentiated and 47 with undifferentiated gastric cancers. Macroscopic noncurative resection of the stomach was done for those patients. There was no difference between survival curves in the differentiated and undifferentiated cases, and the 50% survival was 13.1 months for the differentiated group and 12.5 months for the undifferentiated group. Preoperative serum CEA levels were 10.4 +/- 5.2 ng/ml for the differentiated and 4.0 +/- 1.6 ng/ml for the undifferentiated cases, and CEA-positive rates were 20.0% for the differentiated and 14.9% for the undifferentiated cases. There was no difference in preoperative CEA values with regard to tissue types. In the course of tumor progression, CEA levels increased during the first postoperative year in the differentiated cases and related reciprocally to decreases in survival rates. Little change was noted in the undifferentiated cases. Therefore, the serial postoperative assay of serum CEA levels has predictability with regard to tumor progression in patients with a differentiated gastric cancer.
Adult↗
Serum Lp(a) lipoprotein concentrations of Japanese patients with coronary heart disease.
The serum Lp(a) lipoprotein concentration in 103 healthy control subjects was determined by ELISA (TintElise Lp(a) kit, Biopool, Umea, Sweden). The distribution of Lp(a) in the controls was highly skewed (mean 132, S.D. 109, median 99 mg/liter), which is similar to the results previously reported. Serum Lp(a) level in 104 subjects who underwent coronary angiography was also measured. These subjects were divided into two groups: 59 cases of stenosis(-) and 45 of stenosis(+) groups. Lp(a) level of the stenosis(+) group (mean 235, S.D. 197, median 159 mg/liter) was significantly higher than that of the stenosis(-) group (mean 156, S.D. 133, median 123 mg/liter) and of the controls (Wilcoxon test, p less than 0.05 and p less than 0.01, respectively). Further, stenosis(+) group was divided into three subgroups: 20 with single vessel disease, 13 with double vessel disease and 12 with triple vessel disease subgroups. Lp(a) level was correlated with the number of stenotic coronary vessels (Spearman's rank correlation coefficient, p less than 0.05). These results suggest that Lp(a) may play an important part as a risk factor for coronary heart disease.
Adult↗
[Studies on 5-FU concentration and thymidine phosphorylase activity in tissues of patients with colorectal cancer after SF-SP administration].
5-fluorouracil (5-FU) concentrations in peripheral blood, portal blood, normal and cancer tissues were evaluated in 26 patients with colorectal cancer after SF-SP administration (800 mg/day for 10 days). Thymidine phosphorylase activity in cancer tissues was also evaluated. 5-FU concentration in cancer tissues was significantly higher than that in other three specimens, and much higher than 0.05 microgram/g which was reported to be the minimum effective concentration. 5-FU concentration in portal blood was lower than MEC (0.05 microgram/ml). As for the relationship with the pathological features of cancer, the protruding lesions showed a higher 5-FU concentration than the ulcerative ones, and the lesions invaded only to submucosa or proper muscle showed a higher concentration than others. 5-FU concentration ratio in cancer tissues per in peripheral blood (T/B ratio) was related to thymidine phosphorylase activity. The higher was the thymidine phosphorylase activity, the greater T/B ratio. The results suggest that the tumor with higher thymidine phosphorylase activity might have a more pronounced anticancer efficacy of 5-FU.
Colorectal Neoplasms↗
Electric impedance cuff for the indirect measurement of blood pressure and volume elastic modulus in human limb and finger arteries.
A new plethysmograph, the electric impedance cuff, was designed for the indirect measurement of blood pressure, volume elastic modulus Ev and compliance Ca in human limb arteries. This comprises a compression chamber filled with electrolyte solution and a tetrapolar electric impedance plethysmograph whose electrodes are placed inside the chamber; the former for controlling transmural arterial pressure Pt, and the latter for detecting total limb volume Vo, mean arterial volume Va and its variation delta Va. Systolic and mean arterial pressure in the upper arms, forearms and fingers were measured by detecting pulsatile impedance variation during the gradual (3-5 mm Hg per heart beat) increase (or decrease) in chamber pressure by the volume oscillometric technique. Diastolic and pulse pressure delta P were calculated from these pressure values. Compliance Ca = delta V/delta P and volume elastic modulus Ev = delta P/(delta Va/Va) were recorded at various Pt levels, controlled by the compression pressure. Although this is a kind of impedance plethysmograph, the volume change in a limb segment can be detected by this method without passing electric current through the limb.
Adult↗
Vibration technique for indirect measurement of diastolic arterial pressure in human fingers.
Diastolic pressure Pd was indirectly measured by vibrating a finger artery with a 10 Hz sinusoidal pressure variation during a gradual increase (or decrease) in occlusive cuff pressure Pc. Pulsatile arterial volume changes on which sinusoidal variations are superimposed were detected by a transmitted infra-red photoelectric plethysmograph (TIPP). It is known that volume change in an artery shows a maximum amplitude at the transmural pressure Pt level equal to 0 mm Hg due to the nonlinear viscoelastic properties of the arterial wall. For the same reason, the amplitude of the sinusoidal volume variation reached its maximum at the end-diastolic phase, when Pc was controlled to be exactly equal to Pd. The indirect Pd values determined from Pc were compared with those simultaneously measured by a direct method in rabbit forelegs and by the volume-compensation method in human fingers. Using the principle of the volume oscillometric method systolic and mean pressures were also determined by this system.
Adult↗