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Biomedical subjects

K Hojo

Publications and source records attributed to K Hojo.

At least 91 records · Page 5Linked to original sources
PubMed1988

Multidisciplinary treatment for resectable pancreatic cancer.

Since November 1983, a multidisciplinary protocol for the treatment of pancreatic carcinoma has been used for eight patients at the National Cancer Center Hospital. This therapy includes an extended pancreatic resection, intra-operative irradiation with 3,000 rad of electrons using a microton, and an intra-operative hepatic arterial or portal infusion of mitomycin C, 10 mg. Furthermore, post-operative chemotherapy with mitomycin C (10 mg to 10 mg x 3) is added by Seldinger's method or intravenously (i.v.). The post-operative course was uneventful in all eight patients. Although the number of patients treated is small, the one-year survival rate was 86%. This rate is markedly better than the 28% after conventional radical pancreatectomy from 1962 to 1983. According to our experience, pancreatic carcinoma is unlikely to be cured by only radical operative procedures. A multidisciplinary treatment protocol as an adjunct to radical surgery appears necessary for a good prognosis of this disease.

Aged↗
PubMed1988

Distinct antitumor mechanisms of recombinant murine interferon-gamma against two murine tumor models.

The antitumor activity of recombinant murine interferon-gamma (rMuIFN-gamma) against B16 melanoma and EL4 thymoma, which display different sensitivities in in vitro tests, was studied. In antiproliferation tests, B16 cells were highly sensitive to rMuIFN-gamma and growth was markedly inhibited at as low as 10 U/ml, whereas EL4 cells resisted treatment even at concentration as high as 10(4) U/ml. One of these two tumors was inoculated i.d. into C57BL/6 mice and then rMuIFN-gamma (10(4) units) was repeatedly injected s.c. starting 1 day after the tumor inoculation. For the B16-bearing mice, tumor growth was markedly suppressed and the mean survival period was prolonged, but cured mice were not observed. For mice bearing EL4 cells, the therapeutic effects were more pronounced and cured mice were observed. The EL4-cured mice showed in vivo protective immunity against EL4 tumors but not against P815 tumors, indicating tumor specificity. Histologically, a large number of lymphocytes had infiltrated the necrotic tumor mass. These results indicated that rMuIFN-gamma may have not only a direct effect but also an indirect effect in host-mediated murine response on the growth of murine tumor cells under in vivo conditions.

Animals↗
PubMed1988

Differential efficacies of recombinant murine interferon-gamma and recombinant human interleukin 2 against EL4-bearing mice.

The effects of treating tumor-bearing mice with recombinant murine interferon-gamma (rMuIFN-gamma) and recombinant human interleukin-2 (rIL2) were compared using EL4 thymoma with the same mouse model. Successive administration of rMuIFN-gamma (10(4) units) starting 1 day after tumor inoculation was highly effective, while rIL2 (5 x 10(4) Jurkat units) starting 7 days later produced potent suppression of tumor growth leading to complete cure in about 50% of the mice treated with either of two agents. These results showed that the effectiveness of these lymphokines differed depending on the time of their administration. Furthermore, the therapeutic effect of rIL2 against tumor-bearing mouse was poorer in T-cell-deficient nude mice than in B6 mice and NK-cell-deficient beige mice, whereas the effect of rMuIFN-gamma was poorer in beige mice than in B6 and nude mice. These results suggest that the role of NK cells in the tumor regression caused by the treatment of rMuIFN-gamma is much more important than that of other activated lymphocytes, and that the antitumor activity of rIL2 may be due to the generation of T-cell-related lymphocytes. Our results reveal that combination therapy with rMuIFN-gamma and rIL2 can induce a synergistic effect on EL4-bearing mice.

Animals↗
PubMed1988

[Results of intra-arterial infusion chemotherapy in colorectal cancer patients with metastatic liver cancer].

Thirty-eight colorectal cancer patients (pts) with metastatic liver cancer who underwent intra-arterial infusion chemotherapy (IAIC) at the National Cancer Center Hospital from May 1986 to April 1988 were reviewed. Excisions of metastatic liver cancer were performed in 23 pts and 15 pts had nonresectable metastatic liver cancer. Catheter troubles including infections and obstructions occurred in 7 pts, and 4 pts (10.5%) were unable to receive IAIC. Fifteen resectable cases and 12 nonresectable cases were discussed. 5-Fluorouracil (5-FU) (700 mg/m2) and mitomycin C (MMC) (7 mg/m2) were infused through implantable pumps every week. Total infused doses of 5-FU and MMC were 0.5-12.2 g (mean, 5.3 +/- 3.8 g) and 4-144 mg (mean, 51.1 +/- 41.9 mg) in pts with 15 resectable cases, whereas 1.5-20.7 g (mean, 7.8 +/- 3.8 g) and 18-128 mg (mean, 49.7 +/- 29.2 mg) in 12 nonresectable cases. Four of 34 pts (11.8%) with IAIC had major complications; 2 obstructive jaundice, 1 gastric perforation, 1 toxic dermatitis. Four pts (26.7%) had recurrent liver cancer during 6-20 months follow-up after hepatic resection. Three of 12 nonresectable pts were responders (25.0%). Two completely and another partially responded. Another study is needed to clarify the effect of IAIC in survival. IAIC should be done not only for the treatment of nonresectable metastatic liver cancer, but also for resectable metastatic liver cancer in pts with colorectal advanced cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Abnormal distribution of T cell subsets in the thymus of cyclosporin A (CsA)-treated mice.

Cyclosporin A (CsA) administration to normal, unprimed BALB/c mice at the dose of 20 mg/kg every other day for 3 weeks markedly reduced the thymus weight as well as the size and cellularity of the thymic medulla with relative preservation of the cortex. Area of the medullary compartment (the ratio of the area of medulla to area of cortex) of the CsA-treated mice decreased to about one half of that of the solvent alone-treated mice. Through the use of monoclonal anti-L3T4 and anti-Lyt-2 antibodies together with two-color flow cytofluorometry, we demonstrated that CsA caused a remarkable reduction of L3T4+ Lyt-2- subset and only a slight increase in L3T4+ Lyt-2+ subset in the thymus. There was no significant difference in the percentage of L3T4- Lyt-2+ subset between the CsA-treated and solvent-treated groups. Additionally, thymocytes from CsA-treated mice showed a marked reduction of in vitro proliferative responses to concanavalin A and phytohemagglutinin. The above mentioned results imply that in normal, unprimed mice CsA may preferentially impair L3T4+ Lyt-2- subset (helper T cells and their precursors) residing in the thymic medulla whereas is much less effective against L3T4+ Lyt-2+ subset present in the cortex and L3T4- Lyt-2+ subset.

Animals↗
PubMed1988

[Significance of combination therapy involving aggressive resection and arterial infusion in hepatic metastasis from colo-rectal cancer].

During the past 13 years, 125 patients with liver metastasis from colorectal cancer underwent hepatic resection. Among these patients, 90 received potentially curative hepatectomy except for twelve patients who received curative hepatectomy combined with hepatic arterial infusion therapy and 23 patients who received non-curative surgery. The results of surgical treatment, and modes of recurrence following hepatectomy were studied in these 90 patients. The overall 5-year survival rate was 38.6%. Recurrent tumor developed in 59 patients, 42 being found in the remnant liver (47%), 15 in the lung (17%) and 8 at the primary site. The survival rate of the 43 patients who received systemic chemotherapy after hepatectomy was similar to that of the 24 patients who received no chemotherapy. According to this analysis, we have designed a chemotherapy protocol involving infusion through hepatic artery using on Infusaid port, to prevent regrowth in the remnant liver and pulmonary metastasis. In our program, MMC 10mg and 5-FU 750 to 1,000 mg/body were given through the Infusaid port, and HCFU 400 mg orally. Although the follow-up period has been short, no regrowth in the remnant liver has developed in 12 patients who received this treatment.

Adult↗
PubMed1987

Neutralizing monoclonal antibodies against recombinant human interleukin-2.

A series of hybridoma cell lines which produce monoclonal antibodies (MAbs) against recombinant human interleukin-2 (rIL-2) have been established by fusion of murine myeloma cell line P3-NS1-1-AG4-1 and spleen cells of BALB/c mice which had been immunized with rIL-2. 48 hybridoma strains were selected by a solid-phase screening method which produced MAbs reacting with IL-2: four MAbs, L-15, L-20, L-34, and L-61, exhibited strong inhibition of the proliferating effect of rIL-2 on IL-2-dependent cell lines, NK7 and CTLL-2. L-61, the most potent MAb among them, also neutralized natural human IL-2, while the other three MAbs were unreactive. All the four MAbs were specific to human IL-2: they did not cross-react with mouse or rat IL-2. These MAbs are expected to be useful tools in the investigation of IL-2 function.

Antibodies, Monoclonal↗
PubMed1987

[Pelvic exenteration in advanced and or recurrent rectal cancer].

Operative procedures of pelvic exenteration which were performed on a 54 yrs male patient with irradiated rectal cancer involving the prostatic gland, perineal skin and gluteal muscles were demonstrated by cinema. Perianal fistula formation and hard fibrotic adhesion between the distal rectum and the sacrum were also seen. As a result, combined resection of the perianal skin, gluteal muscles and distal sacral bone (fourth and fifth sacral and coccygeal vertebrae) was carried out. Fifty four total pelvic exenteration were performed at National Cancer Center Hospital from 1962 to 1985. The procedures were performed as a definitive treatment for the primary tumors in 35 cases (31 males and 4 females) which corresponds to 2.7% of operated primary rectal cancer at the same period and for the locally recurrent cancer in 19 cases (13 males and 6 females). By post operative histopathological examination 35 operations, 28 of 35 primary and 7 of 19 recurrent cases, were assessed as potentially curative. Hospital death rate was 13%; i.e. 7 cases (1 of 35 primary and 6 of 19 recurrent cases). Postoperative survival rates of the 54 patients were calculated by Kaplan-Meier's method. There were 17 survivors among 35 curatively operated patients and 5 yr survival rate was 34%. On the other hand, though 6 patients are surviving, there is no long term survivor (more than 35 months) among 21 patients who were treated by palliative resection.

Female↗
PubMed1987

[Recovery in aphasia (Part 3)--Study by multivariate analysis].

In order to elucidate the factors which have influence on the prognosis of aphasia, correlation between recovery rate of aphasia and the five factors, i.e. initial evaluation of speech test, age, educational level, time between onset and institution of therapy and size of abnormal findings in CT (computed tomography), was studied in 76 right-handed aphasic patients, using multivariate analysis. Cluster analysis and factor analysis were used for analysis of five factors and multiple regression analysis was used for estimation of recovery rate of aphasia. The method of calculation of recovery rate of aphasia is the same to our previous report. The results obtained were as follows: As to analysis of factors, first similarity group among initial evaluation of speech test, recovery rate of aphasia and educational level and second similarity group among time between onset and institution of therapy, size of abnormal findings in CT and age were observed. As to the estimation of recovery rate of aphasia, multiple correlation coefficient of regression analysis using five factors were 0.758, 0.444, 0.627, 0.620, 0.810 and 0.375 respectively in total score, hearing, speaking, reading, writing and calculation on standard language test of aphasia. As to the weight or partial correlation coefficient of regression analysis to the five factors, initial evaluation of speech test, time between onset and institution of therapy and educational level were 129.46, -49.93 and 45.65 respectively and the one of the size of abnormal findings in CT was not high. Stepwise multiple regression analysis of five factors were made.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1986

Anastomotic recurrence after sphincter-saving resection for rectal cancer. Length of distal clearance of the bowel.

A retrospective study of anastomotic recurrence after sphincter-saving resection for rectal cancer is presented. During the 21 years from 1962 to 1982, 273 patients with rectal cancer underwent sphincter-saving resection and 30 (11 percent) of them had anastomotic recurrences. Computer analysis of 69 variables was undertaken to identify factors contributing to the anastomotic recurrence, with special reference to the length of distal clearance of the bowel. There was no significant correlation between the incidence of recurrence and the length of distal clearance of the bowel, if the latter was over 2 cm. There appears to be justification for carrying out a curative sphincter-saving operation for cases in which more than a 2-cm distal margin can be afforded. However, for cancers of the infiltrating type, annular growths, invasion to adjacent organs or mucinous features, a more extensive distal clearance of the bowel is necessary, and the Miles operation should be performed.

Anal Canal↗
PubMed1986

[Immunohistochemical study of oncogene-related products in human gastrointestinal malignancies--expression of ras p 21, fes p 85 and EGF receptor].

An immunohistochemical examination by the avidin-biotin-peroxidase complex method was carried out to assess the expression of oncogene-related products, i.e., ras p 21 protein, fes p 85 protein and epidermal-growth-factor (EGF) receptors, in human gastrointestinal malignancies. The presence of ras p 21, fes p 85 and EGF receptors was detected in 48%, 62%, and 62% of 29 colorectal carcinomas and in 65%, 65% and 40% of 20 gastric cancers, respectively. More than one oncogene protein was demonstrated in 18 of 29 colorectal carcinomas and in 10 of 20 gastric cancers. These results suggest that multiple oncogenes are important in the occurrence and progress of gastrointestinal malignancies.

Colonic Neoplasms↗
PubMed1986

[Adjuvant chemotherapy of colorectal cancer--results of prospective randomized trials].

The group of research for colorectal cancer treatments-Kajitani-group (chief T. Kajitani) has carried out the co-operative study for the evaluation of adjuvant chemotherapy after curative resection of colorectal cancer. During the period 1975 and 1978, a series of 1,156 cases of cancer of colon and rectum were entered into the prospective randomized controlled study which consisted of three treatment programs. There included chemotherapy of 2 modes of regimen combining MMC with Tegaful and non adjuvant treatment as control. In colon cancer, adjuvant chemotherapy combining MMC with Tegaful was effective on the increasing of survival rates, especially significantly (p = 0.017) in the cases of Dukes B stage (85-88% vs 69.2% in survival rates of 8 year). In rectal cancer, systemic intravenous administration of MMC 4 mg, two times a week for immediately postoperative three weeks, combined with postoperatively prolonged oral administration of Tegaful 800 mg/day more than three months was also significantly effective, especially in the cases of Dukes C stage (52.3% vs 40% in survival rates of 8 year). However, the analysis of recurrence did not prove that the intra-operative local intra vessel administration of MMC 10 mg was useful for the prevention of liver metastasis in colon cancer or pelvic recurrence in rectal cancer respectively.

Administration, Rectal↗
PubMed1986

[Surgery of far-advanced colorectal cancer--extension of surgical indications and its results].

As there has been much progress in pre- and post-operative management, the safety of aggressive surgery has been improved, making this approach more widely available. Total pelvic eviscerations were performed for fifty-one patients with far-advanced rectal cancer which involved adjacent organs. The results were a 33% 5-year survival rate and 2 operative deaths. Even for patients with distant metastasis elsewhere, total pelvic evisceration may be acceptable for the good control of local pelvic symptoms (severe pain, infections, etc.). This operation is not, however, indicated for cases in which complete removal of the cancerous mass seem to be impossible. For advanced rectal cancer with a high degree of lymph-node metastasis, extension of lymph-node dissection up to the para-aortic region or ileo-pelvic lateral dissection en bloc with the internal iliac vessels were effective for decreasing the incidence of local recurrence. For forty-nine patients with liver metastasis, radical surgery with removal of liver metastatic lesions was carried out and the resulting 5-year survival rate was 30%. Removal of pulmonary metastatic lesions was also performed in thirty-four patients and the 5-year survival rate was 45%. The surgical results were poor in cases of multiple metastatic lesions in the liver or lung or of peritoneal dissemination. Extended surgery for far-advanced colorectal cancer may thus be actively undertaken unless multiple metastatic lesions are present.

Aged↗
PubMed1986

[TNM staging of cancer of the colon].

There are several kinds of proposals for the staging of colon cancer with TNM factors in the world. By comparisons with each survival rates on these staging groups, based on 698 curative resected colon cancer at our hospital between 1962 and 1985, we have evaluated the usefulness of their staging systems. There were no significant differences of survival rates between 3rd and 4th stage groups of J.J.C. classification II and III stage groups of I.C.C. -p-TNM, and Ib and II stage groups of A.J.C. -p-TNM. As far as the resected cases, the degree of spreading of serosal involvement is more affective factor influencing to the prognosis than the one of lymph nodes involvement. Extent of the area of resection and clearance of regional lymph nodes, curative or non curative, is also important prognostic factor. There seems to be still, much room for discussion and revision on the staging of the colon cancer.

Colonic Neoplasms↗
PubMed1986

[Treatment of colorectal cancer].

The large majority of colorectal cancers are well or moderately differentiated adenocarcinomas. Their biological behavior is not as malignant as that of stomach cancer, with a tendency of slow growth and limited spread. Surgery is therefore the first choice for management of these cancers even in cases where complete removal of the tumor is not expected, surgery is useful for the prolongation or improvement of the quality of life. However, the correct choice of operation for such cases is very important. The extent of resection and dissection must be decided based upon the degree of cancer spread. Both must be sufficient, but not excessive. In cases in the early stage where cancerous growth has not spread beyond the submucosal layer, local or segmental excision may be a good enough treatment. On the other hand, for far advanced rectal cancer involving adjacent organs, combined resection and pelvic evisceration is curatively effective. Several pathological findings of resected specimens influencing prognosis were investigated in the present study. In cases which appeared to be diffuse infiltrative spreading type in macroscopic appearance or poorly differentiated, undifferentiated, or mucinous types of cancer in their histological features, survival rates were low. However, these were uncommon and over half of them were much too far advanced to receive curative resection. Irradiation combined with hyperthermia or heavy chemotherapy were applied, but were mostly ineffective. For these uncommon types of cases as well as far advanced cases, we have no effective treatment other than surgery at this time.

Adenocarcinoma↗
PubMed1985

Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava.

When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (accessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals.

Collateral Circulation↗