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Biomedical subjects

H Shimazu

Publications and source records attributed to H Shimazu.

At least 91 records · Page 5Linked to original sources
PubMed1989

Difference in main lymphatic pathways from the lower esophagus and gastric cardia.

Lymphatic pathways draining the lower esophago-cardiac region were studied in 17 patients with carcinoma of the lower esophagus or gastric cardia, by measuring radioisotope uptakes in the regional lymph nodes. The uptakes were most remarkable in lower mediastinal and upper gastric lymph nodes, when the radioactive colloid was injected at the lower esophagus. A lesser degree of uptakes were observed both in other mediastinal and abdominal lymph nodes. On the contrary, a high degree of uptakes were detected only in abdominal lymph nodes, when the colloid was injected at the gastric cardia. The results indicated that main lymphatic pathways originating from the lower esophagus advance both upward and downward, and that those from the gastric cardia make their way downward to upper gastric, para-celiac and para-aortic lymph nodes. The actual incidences of lymph node metastases were also studied in 108 patients with carcinoma of the lower esophagus and 93 patients with carcinoma of the gastric cardia. In the former group, very high incidences were observed in lower esophageal and upper gastric lymph nodes. In the latter group, the incidence was most remarkable in upper gastric lymph nodes and far less significant in lower mediastinal lymph nodes. The results confirmed those of the radioisotope study. The importance of dissection of para-aortic lymph nodes near the left renal vein was also stressed.

Adult↗
PubMed1989

[A case of localized pleural mesothelioma].

A 68-year-old male with localized pleural mesothelioma was described. The tumor was removed surgically in association with left upper pulmonary lobe and regional lymph nodes, since low grade malignancy had been suggested by preoperative needle biopsy. The operative and macroscopic findings revealed that the tumor was well encapsulated and arise from visceral pleura of S3 segment of left upper lobe, projecting into pleural cavity as a pedunculated mass. The tumor measured 9 X 6 X 4 cm in diameter. Based on electron microscopic and immunohistochemical findings of the tumor, the origin of tumor cells was discussed.

Aged↗
PubMed1989

[A study on the changes in the tracheo-bronchial mucosa after esophagectomy for esophageal cancer; with special reference to the influence of neck and upper mediastinal lymph node dissections].

The tracheo-bronchial mucosa of 27 surgical patients with esophageal cancer was examined by bronchofiberscope postoperatively, and the changes of the mucosa were divided into four grades, i.e., GI: no change or slight redness only (7 cases), GII: Severe redness or erosion (7 cases), GIII: Ulcer formation (11 cases) and GIV: Necrosis of the mucosa (2 cases). All the GI-III changes were reversible. However, GIV change was irreversible. The biopsy specimens were taken from the mucosa of the tracheal bifurcation on the 7th postoperative day, showing squamous metaplasia in 9 of 13 patients. Bilateral modified neck and upper mediastinal lymph node dissections were performed in 18 of 27 patients. The change of the mucosa was judged as GIII or IV in 12 of 18 patients (67%), whereas the change was less significant in the remaining 6 patients. Namely, the degree of mucosal change did not necessarily correspond with the extent of lymph node dissection. The changes of the mucosa were considered to be brought about not only by tracheo-bronchial ischemia but also by injurious effects on the pulmonary parenchyma following aggressive lymph node dissection. The assessment of the degree of the mucosal change might be a useful indicator for postoperative management of esophageal cancer patients.

Aged↗
PubMed1989

[Lymph node metastases in the thoraco-cervical transitional region in thoracic esophageal cancer--with ultrasonic detection and a comment on the guide lines].

Lymph node metastases in the thoraco-cervical transitional region (TCTR) and its ultrasonic detection were evaluated in 64 patients with thoracic esophageal cancer, who received radical esophagectomy with modified neck dissection. Lymph node metastases in TCTR were found in 19 of 64 cases (29.7%). Nodal metastases in the supraclavicular region were found in similar incidence of 23.4% (15 of 64 cases). Lymph nodes in both regions were infiltrated in 8 cases. Direct metastases to supraclavicular region and metastases in single region of TCTR were indicated in 4 cases equally. The degree of lymph node metastases of 11 patients suffered from middle intra-thoracic esophageal (Im) cancer with nodal involvement in TCTR were divided into three groups, two cases of n2, one of n3 and eight of n4, according to the Guide Lines. Convex type probe excelled in description of TCTR. Swollen lymph nodes were detected in 12 out of 19 cases with metastases by preoperative ultrasound using this probe (sensitivity of 63.2%). Forty-four of 45 cases without metastases were diagnosed as such (specificity of 97.8%). The partition of TCTR in the Guide Lines should be reconsidered for better evaluation of the results on lymph node metastases in this region.

Esophageal Neoplasms↗
PubMed1989

[A resected case of triple cancer in the uterus, lung and thyroid].

A 62 year-old woman was admitted to our clinic for the treatment of lung cancer. Right middle and lower lobectomy was performed. Histological diagnosis was well differentiated adenocarcinoma in the right lower lobe (yp-T2N1M0, stage II). Forty-seven months before the pulmonary resection (at the age of 57 year-old), she had undergone hysterectomy for squamous cell carcinoma of the uterus (carcinoma in situ). Forty-three months after the pulmonary resection (at the age of 65 year-old), two minute thyroid cancer were resected. Twenty-one resected cases of triple cancer including lung cancer have been reported in Japanese literature.

Adenocarcinoma↗
PubMed1989

[Intraperitoneal chemotherapy in gastric cancer with peritoneal metastasis using totally implantable peritoneal access system].

Fifteen patients with peritoneal metastasis of gastric cancer were treated with mainly ip-ETP (Etoposide: i.p., THP-ADM: i.v. and CDDP: i.p.) or other drugs by the use of a totally implantable peritoneal access system. In principle, intraperitoneal drug delivery was carried out every two weeks. CDDP was administered into the intraperitoneal cavity with intravenous sodium thiosulfate delivered simultaneously to protect against cisplatin-induced nephrotoxicity. RI-scintigram showed that the intraperitoneal catheter was fully useful even six months after the operation. As a result, performance status has been improved in 12 out of 15 cases, and ascites disappeared in 3 out of 6 cases with same. Ten cases have been alive for more than 6 months after operation. There have been no severe complications (e.g., nephrotoxicity or myelosuppression) even in the cases treated at frequent intervals for more than 8 months. The findings in this study indicated that ip-ETP using totally implantable peritoneal access system is beneficial for advanced gastric cancer with peritoneal metastasis.

Adult↗
PubMed1989

[Two-route chemotherapy under AT-II induced hypertension using totally implanted injection port system in liver metastases derived from digestive cancers].

Two-route chemotherapy (TRC) with intraarterial infusion of cis-diamminedichloroplatinum and intravenous infusion of sodium thiosulfate was carried out on 8 cases of digestive cancer with liver metastases, using totally implanted injection port system. The metastases occurred from gastric cancer in 3 cases and from colonic cancer in 5 cases. Computed tomography and/or ultra-sonography revealed an overall response rate of 50% (4/8). Complete response (CR) was obtained in two cases. The therapy was repeated 12 times in one case of gastric cancer with multiple liver metastases and 5 times in another rectal cancer with a solid metastatic tumor. In the latter case, a right hepatic lobectomy was performed thereafter. The histology of the hepatic tumor showed mucin lakes and necrotic lesions, and no viable cancer cells were observed. This mode of chemotherapy was therefore considered a useful measure for the treatment of liver metastases derived from digestive cancers. Furthermore, no serious side effects occurred.

Adult↗
PubMed1988

Excitatory input to burst neurons from the labyrinth and its mediating pathway in the cat: location and functional characteristics of burster-driving neurons.

1. Spikes of single neurons were recorded extracellularly in the cat prepositus hypoglossi nucleus and the underlying reticular formation and were identified as type II neurons by horizontal rotation. Among these neurons, those activated by contralateral vestibular nerve stimulation with short latencies (1.5-3.0 ms) were selected for further study. 2. A class of these identified neurons was antidromically activated from the contralateral excitatory burst neuron (EBN) area immediately rostral to the abducens nucleus. Systematic tracking for antidromic stimulation revealed a wide distribution of effective spots in and near the EBN area, with varied latencies and thresholds, suggesting terminal branching in that area. The same neurons were also antidromically activated from the contralateral inhibitory burst neuron (IBN) area, the region near the midline, and the nucleus reticularis tegmenti pontis. 3. These neurons exhibited a characteristic firing pattern related to nystagmus: with contralateral rotation the firing rate gradually increased during the slow phase (type II response) and further steeply increased in a burst fashion before and during the contraversive quick phase. Since the time of occurrence of burst activity in these neurons was similar to that of contralateral ENBs and IBNs that received their axonal projection, it is suggested that they send excitatory input to burst neurons, and can thus be called burster-driving neurons (BDNs). 4. Intracellular study revealed that stimulation of the BDN area produced monosynaptic EPSPs in contralateral EBNs. The monosynaptic connection of BDNs with EBNs was confirmed by detecting unitary extracellular synaptic currents of EBNs with the spike-triggered averaging technique. 5. In contrast to BDNs, another class of nystagmus-related type II neurons in the prepositus hypoglossi and medullary reticular formation showed a discharge pattern similar to that of abducens motoneurons on the same side. None of them was antidromically activated from the contralateral pontine reticular formation including the EBN area. Some neurons responded antidromically to stimulation of the ipsilateral dorsomedial pontine reticular formation. 6. In conclusion, the input from the horizontal canal during rotation reaches the contralateral prepositus hypoglossi nucleus and the underlying reticular formation through the vestibular nuclei, and a class of neurons in these structures (BDNs) responds to the canal input in a burst fashion following a tonic type II activity. The axons of BDNs cross the midline and monosynaptically excite EBNs on the side of the canal stimulated.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Antrum preserving double tract method for reconstruction following proximal gastrectomy.

The antrum preserving double tract method was originally designed in order to gain the smooth transfer of larger foods through the duodenal route. Surgical improvement was then made at a few points when carrying out the anastomosis between the residual stomach and the jejunum. In the clinical field, this method is characterized by a better transfer of large foods into the duodenum than the conventional double tract method. The clinical investigation revealed that gastrin release remained after the operation due to both the good passage and the presence of food in the residual stomach. The antrum preserving double tract method is a reasonable and simple method which can maintain physiological pancreaticocibal synchronism.

Anastomosis, Surgical↗
PubMed1988

Computerized morphometry of liver cells in diffuse hepatic diseases.

Computerized morphometrical measurements were made of liver cells and their nuclei taken from livers of healthy persons and from patients with acute hepatitis (AH), chronic hepatitis (CH), and liver cirrhosis (LC). Liver biopsies were performed on 127 people (24 convalescing from acute hepatitis, 20 with chronic inactive hepatitis (CIH), 24 with chronic active hepatitis (CAH), 38 with liver cirrhosis (LC) and 21 who were healthy controls (HC]. The specimens were stained with hematoxylin-eosin, then light microscopic pictures were obtained. The original cells were magnified 1000 times. The sizes of the cells and of their nuclei were calculated using a computer. Correlative variation was noted in cell and nuclear sizes resulting in an consistently constant nucleus-cytoplasm ratio. Average sizes of both cells and nuclei were maximal in livers with LC, followed in decreasing order by those in livers with CAH, CIH, HC and convalescent AH. The smallest cells and nuclei were found in convalescent AH cases. It might be possible to some degree to obtain gross impressions of the histopathological type of the liver lesion by measuring the sizes of cells and nuclei of the liver.

Biopsy↗
PubMed1988

Acute cytogenetic effects of potassium bromate on rat bone marrow cells in vivo.

The acute cytogenetic effects of potassium bromate (KBrO3) on rat bone marrow cells in vivo were studied. The incidence of chromosome aberrations in bone marrow cells increased rapidly, reaching a maximum level 12 h after intraperitoneal injection and decreased within 24 h. Dose-response relationships were obtained for both intraperitoneal and oral administrations.

Administration, Oral↗
PubMed1988

[Antitumor effect of intermittent oral administration of UFT against human rectal cancer xenografted in nude mice].

Effect and toxicities of oral administration of UFT were examined with tumor xenografts (COK-7LiM) in nude mice. Special attention was paid to the differences between daily (Q1D X 9) and intermittent (Q4D X 3) treatments with this agent. The optimal doses of UFT were determined on the basis of the maximal tolerated dose of the agent in nude mice. It was remarkable that the chemotherapeutic effect by intermittent administration of UFT showed a significantly better result than that by daily administration. No difference was seen in the toxicities between the two methods of administration of UFT. Moreover, the concentration of 5-FU in the tumor tissue treated with UFT intermittently was significantly higher than that by daily administration method.

Administration, Oral↗
PubMed1988

[The significance and the indication to dissect para-aortic lymph nodes in esophageal and cardiac cancers].

Recently, now that the para-aortic lymph nodes have become a focus of attention, there has been a tendency to dissect the para-aortic lymph nodes of the abdomen for cases of esophago-cardiac cancers. One of the reasons why R4 procedures are being performed is due to the development of a clear analysis of the lymphatic pathways. In view of the importance of para-aortic lymph nodes, particularly focusing on the lymph nodes adjacent to left renal vein, we also are performing extended systemic lymph node dissections in certain cases. In determining the indication, a preoperative diagnosis by echogram of the neck region is important, and also a diagnosis of the para-aortic region as well. The significant benefit of para-aortic dissection is to be able to carry out a complete R3 procedure.

Aged↗
PubMed1988

[Clinicopathological studies of the recurrence of esophageal squamous cell cancer--with special reference to the mode of recurrence and operative procedure].

In 93 out of 201 patients (46%) with squamous cell carcinoma of the esophagus who underwent radical resection (excluding death within 30 days after operation), the site of recurrence could be identified by means of X-ray, CT, ultrasonography, and biopsy. Recurrence was found in 55% of 93 cases within 12 months after surgery and in 86% of 93 cases within 24 months. Of 93 patients with recurrences, lymph node recurrences were present in 44 cases, visceral recurrences in 32 cases, both lymph node and visceral recurrences in 11 cases and others in 6 cases. Neck and/or upper mediastinal lymph node recurrences were found in 10 out of 15 patients who had recurrences within 3 months after surgery. Careful examination should be made in the left recurrent nerve chain and extended lymph node resection of upper mediastinal region should be performed under the adequate indication. Esophageal squamous cell cancer has a tendency to recur in the lymph nodes initially, and visceral metastases may occur thereafter. The incidence of visceral recurrence increased remarkably, when neck and/or upper mediastinal lymph nodes were involved at the time of operation. Accordingly, both irradiation and chemotherapy should also be applied for improving the prognosis of esophageal carcinoma.

Aged↗