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Biomedical subjects

J Takeda

Publications and source records attributed to J Takeda.

At least 307 records · Page 17Linked to original sources

Gastric cancer surgery in the elderly.

Although there is a decreasing number of gastric cancer patients in Japan, the number of patients over 80 years of age is increasing. Forty patients over 80 years of age (from 80 to 88 years) with gastric cancer (Group 1) during the 10 years from 1980 to 1989 were retrospectively investigated and compared with those 70-79 years of age (Group 2). The resectability rate was 80% in Group 1 and 89% in Group 2. Early gastric cancer was observed at a rate of only 25% in Group 1 and 39% in Group 2. Pathologically, the differentiated type occurred in 78% of those in Group 1 and 68% of Group 2. Total gastrectomy was performed in only 6% of the resected cases in Group 1 and in 25% of Group 2. A combined resection including such operations as pancreatico-splenectomy or splenectomy (PS) was employed in none of the total gastrectomy cases in Group 1 and in 30% of Group 2. R3 gastrectomy was performed in none of the patients in Group 1 and in 21% of those in Group 2. Postoperative complications occurred in 25% of Group 1 patients and in 12% of Group 2 patients. Anastomotic leakage occurred in 3% of those in Group 1 and in 4% of those in Group 2. The 5-year survival rate was 47% for all the resected cases in Group 1 and 68% for Group 2. The 5-year survival rate was 61% for those who underwent a curative (radical) gastrectomy in Group 1, and 84% for those in Group 2.

Aged↗

The role of endogenous Na+, K(+)-adenosine triphosphatase inhibitory factor in the regulation of membrane fluidity of erythrocytes in essential hypertension.

OBJECTIVE: To investigate the regulatory mechanisms of membrane functions in hypertension, we examined the relationship between endogenous Na+, K(+)-adenosine triphosphatase (ATPase) inhibitor (digitalis-like factor; DLF) and erythrocyte membrane fluidity in essential hypertension by means of an electron spin resonance (ESR) and spin labelling methods. DESIGN AND METHODS: Erythrocytes were obtained from patients with essential hypertension and normotensive subjects, and the ESR spectra for a fatty acid spin label agent (5-nitroxide stearate) incorporated into the erythrocyte membranes were studied. The DLF content in plasma was expressed as the inhibitory potency of dog kidney Na+, K(+)-ATPase activity in vitro. RESULTS: The values of outer hyperfine splitting and of order parameter in ESR spectra were significantly higher in hypertensive patients than in normotensive subjects. This finding shows that the erythrocyte membrane fluidity may be decreased in essential hypertension. The level of plasma DLF content was greater in hypertensive patients than in normotensive subjects and was significantly correlated with the decrease in erythrocyte membrane fluidity. CONCLUSIONS: These results suggest that the decrease in erythrocyte membrane fluidity may be partially dependent upon the increased plasma DLF content.

Blood Proteins↗

[Cell kinetic effect of carcinostatic agents using BrdU and its monoclonal antibody].

We have investigated the cell kinetic effect of four carcinostatic agents (MMC, CDDP, ADR and 5-FU) on the human gastric cancer cell line (KATO-III; signet ring cell carcinoma) by means of flow cytometry (FCM), using bromodeoxyuridine (BrdU) and its monoclonal antibody. Cancer cells in the S phase were first labelled with BrdU and then the bivariate DNA/BrdU distribution was examined to analyze the effect on the cell cycle. Furthermore, cells were reincubated at 24 hours after labelling to evaluate the cell turnover during FCM. MMC, CDDP and ADR assembled the cells into late S phase and G2M phase, while 5-FU assembled them into S phase. after 24 hours, cells with cessation of cell cycle had inhibited their proliferation. We conclude that this technique can be usefully applied as a susceptibility test of carcinostatic agents, since it could define the phase where carcinostatic agents acted on cancer cells.

Adenocarcinoma, Mucinous↗

Review of operative indication and prognosis in gastric cancer with hepatic cirrhosis.

Prognosis following surgery for gastric cancer has markedly improved as a result of early diagnosis, advances in operative techniques, and perioperative management. However, gastrointestinal surgery in patients with hepatic cirrhosis has continued to be associated with a high operative morbidity and mortality. On the basis of a detailed classification of the preoperative hepatic conditions into three risk groups, we have established a preoperative means of assessing surgical indication. Depending on the preoperative assessment, 40 gastric cancer patients with hepatic cirrhosis underwent surgical exploration. Thirty-seven patients (92.5%) received gastric resection, while 3 patients (7.5%) were non-resectable. Postoperative complications occurred in only 8 patients (20%), and no anastomotic leakage occurred; the overall operative mortality was zero. The five-year-survival rate following a curative resection, as calculated by Kaplan-Meier statistical analysis, was 51.4% (n = 30).

Female↗

[Quantitative analysis of electroencephalographic (EEG) activity during sevoflurane anesthesia].

The change in electroencephalographic (EEG) activity during sevoflurane anesthesia was quantitatively evaluated by using zero-crossing analysis in 10 adult patients. The deceleration of EEG activity was significant and dose-dependent. Such change was not significantly different among the regions. Burst suppression appeared at 2-2.5 MAC in all patients. The significant decrease in both alpha and beta activities and the significant increase in delta activity disappeared with 1% or less of sevoflurane. Toward the emergence from anesthesia, EEG activity accelerated and there was no significant difference in its activity between the emergence period and control period. The results demonstrated that the effect of sevoflurane on EEG activity is similar to that of other inhalation anesthetics, but the difference among anesthetics should be clarified in a further study.

Adult↗

[Amrinone reverses cardiac depression by enflurane in the dog].

To evaluate the interaction of amrinone with inhalational anesthetics, cardiovascular effects of amrinone were investigated in nine mongrel dogs anesthetized with enflurane. Each dog received enflurane and amrinone in the following sequence: 1) 2% enflurane alone, 2) continuous infusion of 20 micrograms.kg-1.min-1 during enflurane, 3) 40 micrograms.kg-1.min-1 infusion during enflurane. Amrinone 40 micrograms.kg-1.min-1 during enflurane anesthesia improved the maximum left ventricular dP/dt, stroke volume and decreased effective arterial elastance (Ea) without changes in left ventricular end-diastolic pressure and heart rate. Left ventricular pressure (LVP) and systolic femoral arterial pressure were stable, but diastolic femoral arterial pressure decreased significantly from enflurane anesthesia alone. These parameters at 20 micrograms.kg-1.min-1 of amrinone infusion during enflurane showed the same tendency with 40 micrograms.kg-1.min-1 infusion but not significantly different from enflurane alone. This result suggests that amrinone may be beneficial in the patients with depression of cardiac performance during anesthesia.

Amrinone↗

Remnant-stump gastric cancer following partial gastrectomy.

Between 1970 and 1990, a total of 2,189 patients with gastric cancer underwent resection in the First Department of Surgery, Kurume University Hospital. Of these, 54 patients had previously undergone a partial gastrectomy. The time interval between the initial partial gastrectomy and the resection of the remnant-stump gastric cancer was more than 10 years in 25 patients and less than 10 years in 29 patients. Those with a time interval of more than 10 years we have termed remnant-stump cancer. The original pathology was a gastric ulcer in 13, a duodenal ulcer in 5, a gastric polyp in 1, and a gastric cancer in 6 patients. Of the 19 patients that had undergone an initial operation for benign disease (Group 1), 15 (79%) patients had received initial reconstruction by B-II and 4 (21%) by B-I. On the other hand, of the 6 patients with an initial operation for gastric cancer (Group 2), 3 (50%) had undergone reconstruction by B-I and the other 3 (50%) had received a B-II procedure. Twenty-three of 25 (92%) remnant-stump gastric cancers underwent total gastrectomy, while the other 2 (8%) were early remnant-stump cancers in the stoma and underwent partial gastrectomy. In group 1, only 5 out of 19 (26.3%) patients are alive, while in group 2 all 6 patients are alive, including the 2 (33.3%) early-stage cancers that were found through periodical endoscopic follow-up examinations.

Adult↗

The value of operative ultrasonography in diagnosing tumor extension of carcinoma of the stomach.

Operative ultrasonography was performed during operations to improve the accuracy of diagnosing the extent of the spread of carcinoma of the stomach in the following areas: tumor invasion in the gastric wall (31 patients), para-aortic lymph node metastasis (30 patients) and hepatic metastasis (30 patients). The over-all diagnostic accuracy rates of operative ultrasonography were 81 per cent for determining the depth of tumor invasion, 80 per cent for carcinoma of the mucosa, 70 per cent for carcinoma of the submucosa, 83 per cent for carcinoma of the proper muscle, 80 per cent for carcinoma of the subserosa and 100 per cent for carcinoma of the extraserosa. The over-all accuracy of operative ultrasonography in diagnosing para-aortic lymph node metastasis was 93 per cent. In comparison with the results of preoperative studies, the accuracy (sensitivity) of operative ultrasonography was significantly superior in diagnosing metastasis to the lymph nodes. In three of 30 operations, preoperatively unrecognized and nonpalpable (occult) hepatic metastases were identified by operative ultrasonography. Operative ultrasonography provides more accurate information regarding the spread of carcinoma of the stomach, and thus may be helpful in deciding upon the type of surgical procedure or in avoiding unnecessary tissue dissection.

Carcinoma↗

[Electroencephalographic change during induction of high-dose fentanyl anesthesia--evaluation by LIFESCAN EEG monitor].

The relation between the patient's consciousness level and the change in electroencephalographic (EEG) activity during general anesthesia has not been well understood. In the present study, we evaluated such relationship quantitatively during the induction of high-dose fentanyl anesthesia in adult open-heart cases. There are significant increase in delta activity and significant decrease in alpha and beta activity in response to the induction of anesthesia. The loss of consciousness coincided with the sharp reduction in delta ratio and edge frequency (80%). Such reduction was more prominent in delta ratio than in edge frequency. These findings suggest that delta ratio could indicate the consciousness level during the induction of high-dose fentanyl anesthesia. Further study is needed to clarify the EEG response during inhalation and intravenous anesthesia in relation to EEG activity.

Adult↗

Molecular cloning, structural characterization and functional expression of the human substance P receptor.

A cDNA encoding the human substance P receptor (SPR) was isolated and the primary structure of the protein was deduced by nucleotide sequence analysis. This SPR consists of 407 residues and is a member of the G-protein coupled receptor superfamily. Comparison of rat and human SPR sequences demonstrated a 94.5% identity. The receptor was expressed in a COS-7 cell line and displayed a Kd for Tyr-1-SP binding of 0.24 nM. Ligand displacement by naturally occurring tachykinin peptides was SP much greater than neurokinin A greater than neurokinin B. SP stimulation of transfected cells resulted in a rapid and transient inositol 1,4,5-trisphosphate response. RNA blot hybridization and solution hybridization demonstrated that SPR mRNA was about 4.5 Kb in size, and was expressed in IM-9 lymphoblast and U373-MG astrocytoma cells, as well as in spinal cord and lung but not in liver.

Amino Acid Sequence↗

In vitro effect of additives in benzodiazepine solutions on the superoxide anion-generating system in polymorphonuclear leucocytes.

Inhibitory effects of diazepam and flunitrazepam on the superoxide anion (O2-)-generating system in granulocytes were examined for their clinical relevance. When the effects of commercial solutions and pure preparations were compared using porcine and human polymorphonuclear leucocytes in vitro, the solutions were found to be more inhibitory than the pure drugs by 4-11 times, indicating that inhibition was caused mainly by the additives in the solutions. Concentrations of the additives required for 50% maximal inhibition of the system were 2.3, 7.5 and 0.9 microliters ml-1 for propylene glycol, ethanol and diazepam and flunitrazepam were 220 and 190 micrograms ml-1, respectively, under comparable conditions. However, plasma concentrations of the benzodiazepines and their additives during clinical use were far less than these inhibitory concentrations, indicating that they had no appreciable effect on the O2(-)-generating system in polymorphonuclear leucocytes of patients.

Animals↗

Antihypertensive effects of oral calcium supplementation in spontaneously hypertensive rats.

This study was designed to clarify the mechanisms underlying the antihypertensive action of oral calcium supplementation in SHR. Four-week-old SHR and age-matched WKY were divided into calcium-supplemented and control groups. Calcium supplementation was carried out by giving 1.2% CaCl2 solution as drinking water ad libitum. Distilled water was given to the control group. After 3 weeks of treatment, plasma NE, pressor response to NE in isolated mesenteric artery, platelet cytosolic free calcium concentration and membrane fluidity of erythrocytes were evaluated. The elevation of blood pressure were retarded in calcium supplemented SHR. Calcium supplementation reduced the augmented pressor response to NE and the high level of cytosolic free calcium concentration in SHR. WKY showed no significant changes of these parameters by calcium supplementation. In conclusion, calcium supplementation reduces blood pressure through the reduction of sympathetic and vascular tone in SHR.

Administration, Oral↗

Gastric cancer following gastrectomy for benign gastroduodenal disease.

Twenty-four cases of resected remnant cancers following partial gastrectomy were retrospectively investigated for benign gastroduodenal disease. The time interval between the initial gastrectomy and the remnant gastrectomy was more than 10 years in 19 (79%) patients and less than 10 years in 5 (21%) patients. There were 2 cases with remnant cancer at stage I, 1 at stage II, 3 at stage III and 13 at stage IV for the all cases with a time interval of more than 10 years. Early-type remnant gastric cancer has a frequency of only 5%. The proportion of positive lymph node metastases was high, in 84%.

Aged↗

Zero operative mortality for gastric cancer with hepatic cirrhosis.

Thirty-two cases of gastric cancer associated with hepatic cirrhosis were reviewed, retrospectively. These patients represented 1.3% of 2590 patients with gastric cancer who were treated over the 23 year period from 1966 to 1988. The male to female ratio was 9.7:1 for gastric cancer patients with hepatic cirrhosis (mean age, 63.2 years) and 2:1 for all patients with gastric cancer (mean age, 61.2 years). Among the 32 patients, one was inoperable, and 31 patients underwent surgical exploration. The gastric cancers were resected in 28 patients (90.3%), while the cancers in 3 patients (9.7%) were non-resectable. Twenty-two patients underwent curative resections with a five-year survival rate of 51%. Postoperative complications occurred in 6 patients (20%), but no anastomotic leakage occurred. There were no operative mortalities. On the basis of the present study, different surgical procedures are indicated depending on the preoperative hepatic conditions for patients with gastric cancer accompanied by hepatic cirrhosis.

Female↗

Early gastric cancer following gastrojejunostomy without gastrectomy.

Two rare cases involving distal gastrectomies for gastric cancer after an earlier gastrojejunostomies without gastrectomy for duodenal or gastric stricture due to a duodenal or pre-pyloric ulcer are reported. The time interval between the initial gastrojejunostomy and the resection of the distal stomach with gastrojejunal stoma were 17 and 36 years. One patient underwent reconstruction by Billroth II and the other by Roux-en-Y end-to-side gastrojejunostomies, both retrocolically without any peri or postoperative complications. The histological classification was confirmed for both as type IIc mucosal early gastric cancer. Only 6 other primary early gastric cancers following gastrojejunostomies without gastrectomy have been reported in the Japanese literature.

Duodenal Ulcer↗

Early mucosal gastric cancer with extra-perigastric (n2) lymph node metastasis.

During the 10 years from 1977 to 1986, a total of 314 cases of early gastric cancer were resected. Of these, 43 (14%) had lymph node metastases, with 6 cases of mucosal (m-) cancer and 37 of submucosal (sm-) cancer. Among the patients with positive lymph node metastases, 37 (86%) had metastases in the Group 1 regional lymph nodes. Eight patients had metastases in the Group 2 lymph nodes, and these involved 2 cases of m-cancer and 6 of sm-cancer. Lymph node metastasis is generally believed to occur in only about 3% of m-cancer, and then mainly in the Group 1 lymph nodes. Here, 2 rare cases of early gastric m-cancer with positive extra-gastric lymph node metastasis are reviewed in detail, with special attention to the surgical management.

Aged↗

Early gastric cancer associated with synchronous liver metastasis.

During the 14 years from 1976 to 1989, 1442 gastric cancers were resected in the Department of Surgery at Kurume University. 546 (37.9%) were primary early gastric cancers. One (0.2%) of these was associated with a synchronous liver metastasis. In the advanced gastric cancers, the rate of synchronous liver metastasis was 12.8%. However, synchronous liver metastasis with an early gastric cancer is quite rate. Only 19 cases have been reported in the Japanese literature. A case involving an early cancer, 10 mm in diameter, that was associated with liver metastasis is reported.

Cardia↗

Early gastric cancer with juxta regional lymph node metastases.

During the 12 years from 1977 to 1988, a total of 425 cases of early gastric cancer (EGC) were treated by resection. Of these, 53 (13%) had lymph node metastases, occurring in 6 cases of mucosal cancer (m-cancer) and 47 cases of submucosal cancer (sm-cancer). Among the patients with positive lymph node metastases, 46 (87%) had metastases in the Group 1 perigastric regional nodes, and 8 (2%) had metastases in Group 2 lymph node. These data support the general view that lymph node metastasis occurs in only 2-5% of m-cancers and 15-20% of sm-cancers, and then mainly in Group 1 lymph nodes. A rare case of early cancer with Group 3 juxta regional lymph node metastasis (n3+) is described in this report with special attention to the surgical management and postoperative chemotherapy.

Female↗