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Biomedical subjects

I Fukuda

Publications and source records attributed to I Fukuda.

At least 127 records · Page 7Linked to original sources
PubMed1989

Non-septic endotoxemia in cirrhotic patients.

We have found that endotoxemia detected by conventional LCT (limulus colorimetric test) in patients with liver diseases could not be detected by endotoxin-specific LCT at all, and proposed that this beta-glucan like activity (BGLA) should be termed as non-septic endotoxemia, distinguishing it from septic endotoxemia seen in gram-negative sepsis. In this study, we investigated non-septic endotoxemia through the clinical course of 8 cirrhotic patients. Non-septic endotoxemia appeared at the onset of DIC but tended to decline in level in the late terminal stage. This phenomenon cannot be consistent with the "spillover" theory which explains the mechanism of endotoxemia without sepsis in liver disease. We think it is an urgent problem to elucidate the nature of BGLA in liver disease, without recourse to the "spillover" theory.

Adult↗
PubMed1989

Multifocal gastric cancer in patients younger than 50 years of age.

To identify the high-risk group having a large number of cancerous lesions in the stomach, the histopathological characteristics of multifocal gastric cancer in 38 young patients (49 years old or younger, group A) were studied and compared with 204 older patients (at least 50 years old, group B). In terms of the number of foci, patients with over 4 foci (high-risk patients) were more frequent in group A (20%) than in group B (5%, p less than 0.05). In 80% of the patients in group A, each focus was near the borderline of both glands (pyloric and fundic glands) and was not always surrounded by intestinal metaplasia, while in 70% of the group B patients the lesions were scattered throughout the stomach and were surrounded by intestinal metaplasia. The carcinogenesis of multifocal cancer in group A, which differs from that in group B, might be stimulated by some strong carcinogenic promoters.

Adenocarcinoma↗
PubMed1989

Quantitative assay of lentinan in human blood with the limulus colorimetric test.

A conventional limulus test detects not only endotoxin but also beta (1----3) glucan. Therefore, using a quantitative limulus test (the limulus colorimetric test) we studied the pharmacokinetics of lentinan, an antitumor beta (1----3) glucan, in the blood of 10 health volunteers and three patients with advanced gastric cancer. The calibration curve of lentinan in the human plasma was linear in the range of 0 to 100 ng/ml. When incubated with human plasma at 37 degrees C in vitro, lentinan had the recovery of almost 100% as compared to the initial concentration even after 60-min incubation, indicating the stability of lentinan in human plasma. When 1 mg of lentinan was intravenously administered over a 2 hr period, lentinan concentration reached the maximum levels (50-80 ng/ml) at the end of the drip infusion and decreased gradually thereafter. In the near future, the more appropriate modes of lentinan administration will be determined by further investigation of its kinetics in the human body.

Colorimetry↗
PubMed1989

[Intra-arterial and intraportal therapy combined with decollateralization in unresectable cholangiocellular carcinoma--a case report].

A 45-year-old man was referred to our hospital due to obstructive jaundice by intrahepatic cholangiocellular carcinoma. At laparotomy, he was assessed as unresectable because of multiple foci in both lobes. Therefore, two catheters connected to implantable access devices were placed in both the hepatic artery and the portal vein following decollateralization using silicone rubber sheeting, in addition to choledochectomy and choledocho-jejunostomy. After the surgical procedure, he underwent chemoembolization twice using Lipiodol, cisplatin, and Gelfoam, and two intraportal infusions of cisplatin at a dose of 50 mg. Moreover, a total dose of 4 g of 5-FU and 20 mg of MMC was administered through the arterial and portal catheters, respectively. Administration of G-CSF was remarkably effective for severe thrombocytopenia, and leukopenia resulted from this active chemotherapy. He is still alive 7 months after the surgical procedure with the regression of the lesions.

Adenoma, Bile Duct↗
PubMed1989

[Stagnation of liver blood and effectiveness of intra-arterial chemotherapy in metastatic colorectal cancer].

From the intraarterial infusion tube in the proper hepatic artery, 5-10 mCi of 133Xe (T1/2 = 5.3 days) was injected. The duration of blood stagnation (T1/2) in the tumor site was obtained from the washout curves in the tumor site and the nontumor site as the duration from the peak to the decrease to half value. The results indicated that the stagnation lasted 110.3 +/- 70.0 seconds in the tumor site, and 80.1 +/- 41.0 seconds in the non-tumor site, showing that the blood was more apt to be stagnant in the tumor site than in the non-tumor site. In the foci in which the stagnation in the tumor site (T1/2) was more than 100 seconds, the response was obtained for 6 (75%) out of 8 foci, which was higher than 3 (60%) out of 5 foci having abundant vascularity. In the foci in which the stagnation in the tumor site did not exceed 80 seconds, no response was obtained irrespective of the vascularity. From the above review, the intraarterial infusion method for the metastases of colorectal cancer was effective for the case which required a long time for washout of the anticancer agent at the tumor site.

Aged↗
PubMed1989

[A long-survival case of hepatocellular carcinoma treated by intra-arterial chemotherapy and immunotherapy].

Hepatic resection is generally considered to be superior to any other therapeutic procedures for hepatocellular carcinoma (H.C.C.). However, the resectability of the patients who have HCC. with liver cirrhosis is still low, and surgery is appropriate in only a minority of patients. Although some successful reports of intra-arterial chemotherapy for HCC. have been documented, most of the therapeutic effects are transient and the survival rate is not satisfactory. This report is of a rare case, that of a long-term survivor with HCC treated by intra-arterial chemotherapy and immunotherapy. A 66-year-old man, with a 10-year history of liver cirrhosis was admitted to The Center for Adult Diseases, Osaka, after detection of a tumor in the right lobe on US. On admission, serum AFP was within normal range, HBs-Ag was negative, and ICG-R 15 was 20.8%. On hepatic angiogram, a hypervascular tumor (6 cm in size) was recognized in the middle of the right lobe. He was assessed as unresectable because of insufficient reserve capacity, and the catheterization of the hepatic artery for intra-arterial chemotherapy and the injection 35 KE of OK-432 into the tumor were carried out under laparotomy. After the procedure, the patient was treated by intra-arterial infusion of doxorubicin (ADR) at a total dose of 150 mg and 5-FU in total dose of 25 g, with a hypodermic injection of OK-432 at a total dose of 161 KE. Hepatic angiography, carried out one year after the procedure, disclosed no foci in the liver. The duration of complete remission continued more than 5 years. The patient eventually died of intrahepatic recurrence, but he lived for 7 years and 3 months after the catheterization.

Aged↗
PubMed1989

[Selective anticancer effects of intra-arterial infusion of 3',5'-dioctanoyl-5-fluoro-2'-deoxyuridine (TT82) in hepatocellular carcinoma].

3'-5'-Dioctanoyl-5-fluoro-2'-deoxyuridine (TT 82), one of the lipophilic prodrugs of 5-fluoro-2'-deoxyuridine mixed with Lipiodol (LPD), was injected into the hepatic artery before hepatic resection in 4 patients with hepatocellular carcinoma. Later, the anti-cancer effects of the drug were evaluated mainly by the examination of resected specimens. The serum alpha-fetoprotein levels of three patients in whom the values were over normal range fell to less than 50% of pretreatment values from 7 to 14 days after the injections. In pathological observation of the specimens, the necrosis rates of main tumors were 100%, 70%, 30% and 0%, respectively. In three patients whose main tumors showed complete or partial necrosis, selective depositions of LPD in the tumors were observed on soft X-ray photographs. The concentrations of TT 82 and its metabolites in the tissues of LPD-depositing areas were markedly higher than those in tissue of the regions without LPD deposits. These findings suggested that TT82-Lipiodol mixture remained selectively in the cancerous tissues and exhibited anticancer effects following injection into the hepatic artery.

Aged↗
PubMed1989

[Rational surgical operations for advanced cancers located in the middle of the stomach].

Before 1982, total gastrectomy with pancreaticosplenectomy was performed for advanced gastric carcinoma which exposed to the serosa and was located in the middle of the stomach (M). The results of that surgical treatment were evaluated, and new surgical approaches were expected to provide a much better prognosis to patients. (1) A radical surgical operation, left upper abdominal evisceration + Appleby's method (LUAE + Apl), was tried for Borrmann type 4 gastric cancers from 1983. The 3-year survival after LUAE + Apl (77.9%) was better than that after total gastrectomy with pancreaticosplenectomy (35.0%) (p less than 0.05). In terms of the postoperative condition, no significant differences were observed between both operations. (2) As a conservative operation, total gastrectomy with resection of the spleen and splenic artery (Group A) was compared with total gastrectomy plus pancreaticosplenectomy (Group B) in patients with advanced gastric carcinoma other than Borrmann type 4. The 5-year survival was similar in both groups. The incidence of postoperative disorders was lower in Group A than in Group B (p less than 0.05). LUAE + Apl for Borrmann type 4 and total gastrectomy with resection of the spleen and splenic artery for the other advanced gastric cancers led to good results. These rational surgical operations will be necessary to achieve a good quality of life for the patients.

Adult↗
PubMed1989

[Surgical treatment of right subclavian aneurysm--a case report].

A case of arteriosclerotic aneurysm of right subclavian artery is reported. The patient was 74 years old male. A huge arteriosclerotic aneurysm was found at the origin of right subclavian artery. Calcification of thoracic aorta and arch vessels was prominent. Under the temporary bypass between brachiocephalic artery and right common carotid artery, replacement of the aneurysm with 8 mm Dacron graft was successfully performed. To avoid the systemic embolism, partial clamp was applied to intact arteries. As the perfusion of the brain was maintained through the temporary bypass during the reconstruction of right common carotid and subclavian arteries, intracranial complication was prevented.

Aged↗
PubMed1989

[Pulmonary embolism as a complication in neurosurgical patients].

The overall incidence of pulmonary embolism (PE) among neurosurgical in-patients, whose ages ranged from 23 to 80, was 0.7%. Our report here is based on five cases of patients with PE. Four of these five patients were over 50 years of age. They had been admitted because of such reasons as brain tumor, spinal cord injury, intracerebral hematoma, and venous sinus thrombosis. Deep vein thrombosis (DVT) was seen in four but none were diagnosed before they had developed PE. Decreased level of consciousness and prolonged bed rest appeared to be common risk factors for PE. Mean duration between admission and onset of PE was 31 days. Although non-specific, tachycardia, tachypnea and hypoxemia were the most common signs and symptoms. As a definitive diagnostic procedure, pulmonary angiography was performed in most of cases. One patient required surgical embolectomy and others were treated with anticoagulation or fibrinolytic agents. In order to prevent recurrent thromboembolic phenomena, ligation of the inferior vena cava was a useful mode of treatment when anticoagulation was not indicated. And this approach seemed to be valid in most neurosurgical patients. We conclude that PE and DVT were not uncommon complications among Japanese neurosurgical patients and they can be treated successfully in collaboration with a cardiovascular surgeon if the diagnosis can be made correctly.

Adult↗
PubMed1989

[Radio-Geometric consideration of basal indentation using phantoms and specimens].

With the aid of colon-polyp phantoms, basal indentation (BI) of polypoid lesions on double-contrast examinations of the colon was studied. Our findings indicated that BI is a function of radio-geometric projections and its morphology (arcuate, angular and trapezoid) depends on size, shape and surface pattern of a polypoid lesion. These findings were also substantiated by specimen and clinical radiography.

Colonic Polyps↗
PubMed1989

[The significance of hormone receptors in hormone therapy of gastric cancers].

The influence of sex hormones on carcinogenesis of the stomach was investigated clinically and experimentally. Thereafter, hormone therapy for Borrmann type 4 gastric cancers was started and achieved good results according to some reports. The presence of hormone receptors (ER and PGR), which are detected in 10-20% of gastric cancers, was one of the bases of that therapy. However, the role of hormone receptors in hormone therapy is not clear because the stomach is not the target organ of sex hormones. The mechanisms of hormone effects on cancer therapy have been described as follows: (a) Hormone receptors play an important role in stimulating the proliferation of cells via hormone-receptor complexes. (b) Hormones play a direct role in stimulating the proliferation of cells without any involvement of receptors. We found evidence that sex hormones might suppress the growth of some stomach cancers. On that basis, we started a trial of a hormone therapy using tamoxifen in females and estriol in males after radical surgery for Borrmann type 4 gastric cancer. We hope to obtain good results in this new trial.

Adult↗
PubMed1989

Deacylation of bacterial lipopolysaccharide in rat hepatocytes in vitro.

The possible role of liver parenchymal cells in the uptake and degradation of bacterial lipopolysaccharide (LPS) was investigated in vitro by employing radiolabelled LPS as substrate. Hepatocytes obtained from Wistar rats by collagenase treatment were found to take up LPS only when it was not linked to the polysaccharide of O-antigen. The amount of LPS taken up increased with time and after 48 h incubation it increased in a dose-dependent manner up to at least 30 micrograms. When incubated with LPS radiolabelled exclusively in the fatty-acid moiety, cultured hepatocytes released lipophilic materials into the culture medium. These were identified as beta-hydroxytetradecanoic acid and triglyceride, in the ratio of 7:I. These results indicate that the R-form of LPS which lacks the O-antigen polysaccharide is taken up and deacylated in hepatocytes, and the derived fatty acids are released into the culture medium either in the free form or after conversion to triglyceride.

Animals↗
PubMed1989

[Coexistence of abdominal aortic aneurysm and intraabdominal malignancy; two case reports].

We experienced two cases of abdominal aortic aneurysm which had intra-abdominal malignancy (early gastric cancer). Case 1 was a 72 year-old man who was treated by two-stage operation of them. Gastrectomy was performed about 7 months prior to the aneurysmectomy. Case 2 was a 70 year-old man who was diagnosed both lethal diseases, renal dysfunction, chronic respiratory failure and multiple ventricular arrhythmia. He was treated by one-stage operation and was discharged with no complications. Coexistence of abdominal aortic aneurysm and intra-abdominal malignancy is rare and it is difficult to decide whether to operate the malignancy first, the aneurysm first or both simultaneously. In Japan, 28 cases were reported and 18 cases could be analyzed in detail. In these cases, most frequent coincidental malignancy was the gastric cancer (13/18, 72.2%) and one-stage operation was performed in 8 (44.4%) cases. In general, the risk of infection during upper gastrointestinal surgery is less than that during lower abdominal surgery. We concluded therefore that concomitant resection of the upper gastrointestinal malignancy, especially early gastric cancer, should be considered.

Aged↗
PubMed1989

[Suppressive effect of sex hormones on spreading of stomach cancer].

The frequency of stomach cancer in females is lower than that in males, but the cancers in females are often Borrmann type 4 or poorly differentiated adenocarcinomas. In young patients, the frequency of gastric cancer in females is higher than that in males, and widely spread cancers are often observed just after pregnancy and delivery. The incidence of stomach cancer in female rats is lower than that in males but the incidence increased slightly after pregnancy and delivery. And it decreased when female sex hormones are injected to male rats. It is surmised that female sex hormones or their analogues play a suppressive role on carcinogenesis or progression of stomach cancer, and that pregnancy and delivery may accelerate the growing of stomach cancer. Hormone therapy was performed to get some effects, and to take much more effects, some other new trials on hormone therapy are necessary.

Adult↗
PubMed1989

Organ distribution of 3H-endotoxin in rats with liver fibrosis and rats with liver cirrhosis.

The organ distribution of 3H-endotoxin was investigated in rats with CCl4-induced liver injury. Wistar male rats were given water containing phenobarbital (Controls), or were treated with water containing phenobarbital and CCl4 inhalation. Rats inhaling CCl4 for 6 weeks developed liver fibrosis (Group LF), while those inhaling it for 10 weeks developed liver cirrhosis (Group LC). Animals were killed and examined 24 hours after an intravenous injection of 3H-endotoxin (12,000 CPM/l g body weight). Compared with the control rats, the measured amount of 3H-endotoxin per unit weight of spleen, lungs, and blood increased, while that of the liver significantly decreased in the rats of groups LF and LC. These results suggest that endotoxemia may be enhanced by a diminished uptake of endotoxin by the liver in liver fibrosis and liver cirrhosis.

Animals↗
PubMed1989

[Change of blood lentinan level in patients with advanced cancers].

A conventional limulus test can detect not only endotoxin but also beta(1----3) glucan. Therefore, with a quantitative limulus test, the limulus colorimetric test, we studied the pharmacokinetics of lentinan, an antitumor beta(1----3) glucan preparation, in the blood of 10 healthy volunteers and 20 patients with advanced cancers. The calibration curve of lentinan in the human plasma was linear in the range of 0 to 100 ng/ml. Two mg of lentinan was administered once a week and blood samplings for the measurement were done immediately before the next lentinan administration to document trough-levels serially at a week interval. Trough-levels tended to rise gradually and showed a rapid elevation between 4 and 8 weeks after beginning of administration. This phenomenon may correlate closely with the antitumor effect of lentinan and, therefore, deserves further investigations.

Antineoplastic Agents↗