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Biomedical subjects

H Shimazu

Publications and source records attributed to H Shimazu.

At least 109 records · Page 6Linked to original sources
PubMed1987

Effective chemotherapy for small cell carcinoma of the esophagus.

This article documents the use of chemotherapy in a case of small cell carcinoma of the esophagus with multiple liver and lymph node metastases. A multi-drug regimen was used and included cis-dichlorodiamine platinum (CDDP), VP-16, vincristine (VCR), adriamycin (ADM), and cyclophosphamide (CPA). After chemotherapy, the esophageal tumor disappeared, and liver masses reduced in number and degenerated. Nine months later, however, the patient died of brain metastases. It was concluded that radiotherapy should be given to the brain for the prophylaxis of tumor relapse.

Aged↗
PubMed1987

[Pre-operative staging in advanced gastric cancer by ultrasound; with special reference to para-aortic lymph node metastases].

Extraluminal cancer spreadings such as peritoneal dissemination, liver metastases, lymph node metastases and infiltration to surrounding organs were examined in 236 patients with gastric cancer by ultrasound (US). Peritoneal dissemination was found in 36 of 236 cases. Ascites, nodules in the cul-de-sac and thickened wall of the transverse colon could be detected by US in 24 of 36 cases (sensitivity of 67%). Liver metastases were detected in 18 out of 23 cases (78%). Infiltration to the surrounding organs, mainly to the pancreas, was impossible to demonstrate by US. Sensitivity was 44% (17/39). Lymph node metastases in the region around the celiac axis were indicated in 30 of 40 cases (75%) by US. Para-aortic nodal metastases were also detected in 27 of 34 cases (79%). Ultrasonic images of para-aortic lymph node metastases were classified into four figures: plate type, sandwich type, unilateral multiple type, unilateral solitary type. These types were not necessarily the same in indication of laparotomy, selection of combined or adjuvant therapy, significance of nodal dissection and also prognosis. Solitary involved para-aortic node near the left renal vein should be removed in a case free from peritoneal dissemination or liver metastases. Ultrasound could be very useful in screening patients with gastric cancer for peritoneal dissemination, liver metastases and lymph node metastases.

Aorta↗
PubMed1987

[Comparative study on the macroscopic and histopathological diagnosis of lymph node metastases in cancer patients].

Macroscopic diagnosis for lymph node metastases was compared with histopathological diagnosis in 444 patients with carcinoma of the esophagus, stomach, colon, thyroid and breast. The former indicated lymph node metastases in 181 patients. In all of them, none or less than five node metastases were proven by routine histopathological diagnosis. Detailed histological study revealed lymph node metastases in 25 out of 263 patients with macroscopically negative nodes, the rate of false negative being 9.5 per cent. The study also demonstrated no lymph node metastases in 51 of 181 patients with macroscopically positive nodes. Three additional specimens were obtained from originally examined 693 lymph nodes and reexamined microscopically in these 51 patients. Involvement by cancer cells was detected in 9 nodes (1.3 per cent) in 8 patients. Metastases were found from additional specimens in 7 of 9 nodes, indicating that metastatic carcinoma had been overlooked in the remaining two nodes. Additional specimens or embedding-techniques were recommended in such cases as macroscopic metastases were strongly suspected or lymph vessel invasions were remarkable. In 24 patients with esophageal cancer, one to one correspondence was available in the analysis of macroscopic diagnosis. Seventy-eight out of 108 involved nodes were macroscopically judged as involved (sensitivity; 72.2 per cent), and 1166 out of 1260 nodes without macroscopical metastases were judged as cancer-free (specificity; 92.5 per cent). Overestimation of macroscopic diagnosis was due to thickened capsule, fibrosis, inflammation and enlargement in size more than 10 mm in diameter of the nodes. Underestimation was observed in case of nodes with metastatic area less than one-third and with smaller size less than 5mm in diameter.

Diagnosis, Differential↗
PubMed1987

Lymph drainage originating from the lower esophagus and gastric cardia as measured by radioisotope uptake in the regional lymph nodes following lymphoscintigraphy.

Lymph drainage originating from the lower esophagus and gastric cardia was determined using uptake of radioisotope (RI) in the regional lymph nodes in 19 patients with primary cancer at these sites. On the day prior to operation, 99m Tc colloid solution was injected submucosally in the distal esophagus or gastric cardia during endoscopy. The regional lymph nodes were removed at operation and RI uptake of individual nodes was measured in a well-type scintillation counter. Uptake was expressed as the amount per nodal weight. After radioactive colloid was injected into the lower esophagus, high RI uptake was common in both the mid-mediastinal and abdominal nodes, suggesting that lymph originating from the lower esophagus drains in both a superior and inferior direction. On the other hand, after radioactive colloid was injected into the gastric cardia, high RI uptake was never demonstrated in mediastinal lymph nodes suggesting that direct mediastinal lymph flow from the gastric cardia is rare. These results support clinical observations on the distribution of lymph nodal metastases in patients with lower esophageal and gastric cardia malignancies. As a diagnostic tool for lymph nodal metastases, however, lymphoscintigraphy is unreliable.

Abdomen↗
PubMed1986

Step response analyses of the cardiovascular system and their application to the measurement of systemic and pulmonary vein compliances.

A theoretical analysis of the step response in the closed cardiovascular system induced by a sudden shift of the right cardiac output curve predicted that if the relations of the right heart output (COr) and the total systemic capillary flow (CFs) to the systemic venous pressure (Psv) are linear, then the time course of Psv change will become monoexponential with a time constant T given by T = Csv/(Gr + Gs), where Csv is the systemic vein compliance and Gr and Gs are the conductances of the transient COr-Psv and CFs-Psv relationships. A similar prediction was obtained for the time constant T of the pulmonary vein pressure (Ppv) response to the step change in the left cardiac output (COl) curve, pulmonary vein compliance (Cpv) and the conductances of the COl curve, and the pulmonary capillary flow (CFp) curve against Ppv. The actual Psv or Ppv changes following sudden alteration of the COr or COl curve by inflation and deflation of the balloon in the right or left atrium revealed monoexponential time courses. Semilogarithmic plots of the transient vein pressure changes yielded correlation coefficients of -0.995 +/- 0.006 (means +/- SD) in 11 curves for Psv and 0.977 +/- 0.017 in 16 curves for Ppv (P less than 0.01). The assumed linearity of dynamic COr and COl curves was confirmed by beat by beat COr-Psv and COl-Ppv relationships during the step responses, except for the first few beats immediately after the balloon maneuver. The linearity of the dynamic CFs curve was examined by measuring CFs with a double-step balloon maneuver so as to cause rapid equilibrium between COr and CFs at varied moments of the transient process. The correlation coefficient between CFs and Psv thus obtained was 0.98 +/- 0.04 (P less than 0.01). A similar linearity of the dynamic CFp-Ppv relationship was suggested from their steady-state curves. The values of Csv calculated from the experimental data were 1.70 +/- 0.12 ml/mmHg/kg body wt in 11 curves and those of Cpv were 0.13 +/- 0.03 ml/mmHg/kg in 15 curves. These results are mostly consistent with those previously reported.

Animals↗
PubMed1986

[Thyroid nodules; evaluation of malignancy by ultrasonography].

Preoperative ultrasonic examination was correlated to final pathological diagnosis in 102 cases which underwent thyroidectomy in our clinic from 1979 to May 1985. Preoperative ultrasonic diagnosis was as follows: Sensitivity was 78% (45/58 cases), and specificity was 86% (38/44 cases). Four factors in ultrasonic image were considered: Shape, boundary, internal echo and margin were featured, and correlated to malignancy in 75 cases with mainly solid nodules. Among 34 nodules with irregular shape, 33 (97%) were pathologically malignant and 40 of 42 (95%) with rugged boundary were also malignant. Whether internal echo was even or not could not be used as a diagnostic criteria. Similarly, whether a nodule had well defined margin or not was found not to be a significant criteria in order to differentiate malignant from benign lesions. In 15 of 34 cases with lymph node metastases, metastatic lymph nodes were detected by ultrasonography. Lymph node metastases must be also evaluated by ultrasonography preoperatively in thyroid diseases. Each of these factors must be considered individually in the diagnosis of thyroid nodules. By evaluation of the ultrasonography findings the pathological characteristics may be inferred, and consequently being possible to reach a correct diagnosis.

Adenocarcinoma↗