Search PubMed⌕ Search

Biomedical subjects

K Inokuchi

Publications and source records attributed to K Inokuchi.

At least 217 records · Page 12Linked to original sources
PubMed1985

[Evaluation of splenectomy in total gastrectomy for gastric cancer].

It has been well accepted that extensive prophylactic lymphadenectomy is certainly effective for elevating cure rate after gastric cancer surgery, however, regarding to the prophylactic splenectomy the arguments are controversial. We studied the value of splenectomy in total gastrectomy for gastric cancer by examining the late survival rates, the accuracy of intraoperative judgement of splenic hilar lymph node metastasis and postoperative changes of serum immunosuppressive factors. In curatively resected stage III cases without splenic hilar lymph node metastasis, the nonsplenectomized group showed a significant better late survival rate than the splenectomized group, 5-year survival rate being 59.9% in the former and 30.8% in the latter. In cases with splenic hilar lymph node metastases, 2 of 9 splenectomized patients survived more than 10 years. In cases of noncuratively resection, splenectomy did not enhance the survival rate. Although further clinical randomized study is needed to draw a definitive conclusion, we had better take a splenic reserve operation for the patients without splenic hilar lymph node metastasis. On the other hand, splenectomy should be performed in cases with splenic hilar lymph node metastases.

Gastrectomy↗
PubMed1985

[Preoperative assessment of hepatocellular reserve by discriminant analysis of limited hepatic resection in cirrhotic patients with primary liver cancer].

We analysed various preoperative data of 32 cirrhotic patients with primary liver cancer to predict clinical course after limited hepatic resection. Out of 32 patients, postoperative course was uneventful in 26, however, the remaining 6 developed hepatic failure which led to death. The analysis of the preoperative data including liver function tests and age of patients to discriminate the two groups was carried out. It was shown that indocyanin green (ICG) test, prothrombin time (PT), lecithin cholesterol acyltransferase (LCAT), gamma-globulin, age of patients and total bilirubin appeared to be important factors to discriminate the subjected patients into two groups. An equation for prediction of hepatic failure after hepatectomy obtained in this study was: Y = 0.086726 X ICG(%), -0.054694 X PT(%), +0.102850 X LCAT(microgram/ml/h), +0.059758 X gamma-globulin(%), +0.077260 X age, +1.099958 X total bilirubin (mg/dl), -6.776657. When Y was over 0.5, patients are considered to be at high risk for postoperative liver failure, and satisfactory postoperative course could be expected when Y was less than 0.5. This equation can be used to determine operative indication for minimal hepatic resection in cirrhotic patients with impaired liver function.

Female↗
PubMed1984

The natural history of hepatocellular carcinoma. A study of 100 untreated cases.

The natural course of hepatocellular carcinoma (HCC) was evaluated in 100 untreated patients who were seen during recent 13 years. There were 80 males and 20 females. The macroscopic type of tumor was massive in 58, nodular in 35, and diffuse in 7 cases. Liver cirrhosis was associated with in 80% of patients. The mean survival time of overall patients was 4 months from the onset of initial symptoms to death and 2 months from admission to death. Occult and cirrhotic types of HCC showed a longer survival than frank and febrile types that had a mean survival time of all patients. The prognosis of icteric and metastatic types was poorest. Sex, tumor type, or associated cirrhosis did not substantially affect the natural course of HCC. The tumor stage and clinical stage were grossly correlated to the prognosis. In terms of symptoms, severe jaundice and ascites were the most dismal prognostic signs.

Adult↗
PubMed1984

Characterization by deletion mutagenesis in vitro of the promoter region of ompF, a positively regulated gene of Escherichia coli.

The ompF gene codes for a major outer membrane protein whose expression is positively regulated by the ompR and envZ genes. Two sets of promoter deletions, upstream deletions and downstream deletions, were generated in vitro, and the promoter function was studied by connecting them with the tet genes. One of the hybrid genes thus constructed had a functioning ompF-tet hybrid promoter. The 107 base-pair fragment was found to be functioning as the ompF promoter, 90 nucleotides upstream and 17 nucleotides downstream of the mRNA start site that was also determined in this study. The start site was preceded by a convenient Pribnow box. Although the sequence at the -35 region had a low degree of homology to the consensus sequence, analyses of the hybrid promoter suggested that this region is involved in the promoter function in relation to the Pribnow box. They also indicated that the domain responsible for regulation by the ompR gene is located within the -35 region and its upstream region.

Bacterial Outer Membrane Proteins↗
PubMed1984

Cytophotometric DNA analysis of mucosal and submucosal carcinoma of the esophagus.

Cell nuclear deoxyribonucleic acid (DNA) content was microspectrophotometrically determined in 35 cases of mucosal and submucosal carcinoma of the esophagus. DNA distribution pattern was classified into types I, II, III, and IV, according to the degree of dispersion on the DNA histogram, in the order of wider distribution. Patients with types I and II (relatively regular in DNA distribution) had an uneventful postoperative course and no recurrence, whereas 3 of 15 (20%), and 5 of 9 (55.6%) with type III and type IV, respectively (widely scattered DNA distribution), died following a recurrence. Cytophotometric DNA analysis of the cancer cells reflected well the outcome in patients with esophageal carcinoma. These results suggest the potential usefulness of cytophotometric DNA analysis for assessing the prognosis, even in the early stage of esophageal carcinoma.

Adult↗
PubMed1984

Postoperative adjuvant chemotherapy for gastric carcinoma. Analysis of data on 1805 patients followed for 5 years.

The effectiveness of combination chemotherapy with mitomycin-C (MMC) plus Futraful (N1-(2'-tetrahydrofuryl)-5-fluorouracil) for gastric cancer was investigated in a prospective randomized and controlled study. Two thousand sixty-four Japanese patients in 297 hospitals were entered, and 1805 could be followed. All patients had undergone gastrectomy from May 1975 to July 1976. These patients were grouped into two protocols: protocol I (intermittent intravenous injection of a moderate dose of MMC), and protocol II (bolus intravenous injection of MMC), each of which was allocated to group A (without Futraful) and group B (MMC plus oral administration of Futraful for 3 months). Statistically, this randomized study showed that the 5-year survival rate of patients with advanced cancer was not enhanced. However, with protocol II the Futraful administration seemed to improve the 5-year survival rate for those with Stage III cancer and for those with positive lymph node metastasis plus obvious serosal invasion.

Adult↗
PubMed1984

Selective effects of Lipiodolized antitumor agents.

Lipiodol Ultra-Fluid (Lipiodol) remains selectively in the tumor for an extended time when applied through arteries feeding the tumor. Although lipophilic antitumor drugs are selective when combined with Lipiodol, wide application of common hydrophilic agents is limited, as these compounds are insoluble in oil. We propose "Lipiodolization" of water-soluble agents using as an intermediate Urografin, a water-soluble contrast medium. Thirteen patients with primary hepatocellular carcinoma were treated with this Lipiodol-Urografin system containing antitumor agents. Marked decrease in serum alpha-fetoprotein (AFP) levels, decrease in tumor size in the hepatic imaging, and histologic studies of the resected specimen revealed this mode of therapy to be effective in 10 of 13 patients (77%) with hepatocellular carcinoma. Lipiodolization of antitumor agents is a new approach to selective cancer chemotherapy.

Adult↗
PubMed1984

Preoperative hyperthermo-chemo-radiotherapy effective for carcinoma of the esophagus.

We prescribed hyperthermo-chemo-radiotherapy preoperatively for 13 patients with esophageal carcinoma. Viable cancer cells disappeared in four out of 13 patients, and all of these four patients survive without recurrence 3 to 34 postoperative months, at this writing. In another seven out of the 13, cancer cells were extensively damaged, despite the presence of a small number of viable cancer cells, and three out of these seven died with a recurrence. For two, the treatment was ineffective, and they died of liver metastasis and a local recurrence, respectively. These findings suggest that preoperative hyperthermia combined with chemotherapy and radiation is highly effective for treatment of carcinoma of the esophagus.

Aged↗
PubMed1984

Levamisole in postoperative adjuvant immunochemotherapy for gastric cancer. A randomized controlled study of the MMC + Tegafur regimen with or without levamisole. Report I.

The usefulness of LMS in postoperative immunochemotherapy of gastric cancer was investigated. In compliance with the protocol, MMC was given at a dose of 20 mg on the day of gastrectomy, and an additional 10 mg on the next day IV. The patients receiving 600 mg Tegafur daily were then divided into two groups according to whether LMS was also given or not. LMS was administered for 3 days before the operation in a daily dose of 150 mg and for 1 year or more after operation according to a schedule of 3 days' administration followed by an 11-day interval. The 2-year follow-up demonstrated that in stage III patients, the LMS (+) regimen was superior to the LMS (-) regimen, since the former prolonged the relapse-free interval significantly. The survival rate for stage III disease was also significantly higher in the LMS (+) than in the LMS (-) group. There was no significant difference in the incidence of subjective or objective side-effects between two groups. The incidence of agranulocytosis was comparable in the two groups.

Adult↗
PubMed1984

Effect of free fatty acid on pulmonary transvascular fluid and protein exchange.

We demonstrated the effect of infusion of oleic acid, a common free fatty acid, on pulmonary vascular permeability in anesthetized dogs prepared with a lung lymph fistula. Infusion of oleic acid caused significant increases in lung lymph flow with no change in L/P protein ratio, resulting in significant increases in transvascular protein clearance. Pulmonary arterial and pulmonary arterial wedge pressures increased significantly from baseline but their elevation was slight. Cardiac output decreased significantly after oleic acid infusion. In contrast to the effects of oleic acid, left arterial hypertension caused increases in lung lymph flow that were associated with decreases in the L/P protein ratio. Lung water content was increased after oleic acid infusion, despite little effect on pulmonary vascular pressures. These findings indicate that oleic acid produced endothelial lung injury and increased pulmonary vascular permeability.

Animals↗
PubMed1984

Prolonged survival of gastric cancer patients on a specific adjuvant chemotherapy.

Since 1970, there has been a remarkable improvement in Japan in the outcome of surgery for patients with gastric cancer. Not only the increased rate of detection of early gastric cancer but the standardization of the prophylactic extended lymphadenectomy (ELX) has brought about a remarkable rise in survival rate. In patients with regional lymph node metastasis, we obtained a 5 year survival rate of 39 percent in the ELX group, whereas the rate was only 18 percent in the simple gastrectomy group. The difference was statistically significant (P less than 0.001). As to adjuvant chemotherapy, the Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer found in data on 1,805 patients followed for 5 years that the protocol, intraoperative bolus intravenous injection of Mitomycin C (MMC) plus oral administration of Futraful (Tegafur) for 3 months, concomitantly applied with ELX, proved to be effective for improving the survival of patients with advanced cancer such as stage III and positive lymph node metastasis with obvious serosal invasion. The 5 year survival rate of Japanese patients with gastric cancer after resective surgery was an overall 56 percent, 48 percent when confined to those with stage III cancer.

Adjuvants, Immunologic↗
PubMed1984

Growth patterns of gastric carcinoma detected by mass survey.

Two hundred and sixty-seven cases of gastric carcinoma detected by mass survey included 196 discovered at the first examination (Group A) and 71 noted at the annual sequential examination (Group B) were analyzed in terms of growth pattern and prognosis. The incidence of early carcinoma was 54.9 per cent in Group B higher than 35.7 per cent in Group A. In early carcinoma, the superficially spreading (SUPER) type of carcinoma was more common in Group A than in Group B. On the contrary, the penetrating growth (PEN) type of carcinoma was more frequently found in Group B than in Group A. About eighty per cent of those with an advanced carcinoma, in both groups, was the advanced PEN type. The outcome of the patients in Group B was more favorable. These results support the hypothesis that the majority of advanced carcinoma is derived from the PEN type of early carcinoma. Early detection of the PEN type of carcinoma is mandatory.

Humans↗
PubMed1984

A newly designed clamp facilitates hepatic resection.

We designed a new clamp (Inokuchi liver clamp), mainly used for partial or wedge resection of the liver. This clamp is gently curved and has 9 non-traumatic teeth with double step locking devices at the tips. This clamp proved to be most useful for limited hepatic resection, a common procedure for primary liver cancer associated with cirrhosis, however, it can also be used for major resections. From August 1981 to February 1984, this clamp was used by our surgical team in 45 resections of the liver for primary and secondary malignant tumors and benign hemangiomas.

Constriction↗
PubMed1984

Hormone conditioned cancer chemotherapy for recurrent breast cancer prolongs survival.

Left suprarenal-inferior mesenteric venous shunt (Inokuchi) was prescribed for 80 patients with recurrent breast cancer and the efficacy of hormone conditioned cancer chemotherapy was assessed. The patients were separated into 3 groups according to the historical regimen of combined chemotherapy: Group I; surgical hormone therapy alone, Group II; surgery plus short term chemotherapy, and Group III; surgery plus long term chemotherapy. The 5 year survival rate of the responsive patients to the surgical hormone therapy was as high as 84.6 per cent in Group III, as compared to that of Groups I and II, 41.7 per cent and 16.7, respectively. Survival was not prolonged in non-responsive patients, regardless of the group. These findings indicate that surgical hormone therapy combined with postoperative long term cancer chemotherapy is a valid and effective method for treating recurrence of breast cancer.

Adrenalectomy↗
PubMed1984

Combination of hepatic arterial infusion and systemic chemotherapy for gastric cancer with synchronous hepatic metastases.

Between 1964 and 1981, seventy-two Japanese patients with gastric cancer associated with hepatic metastases, in whom the primary tumor had been resected, were treated in a nonrandomized manner at the Second Department of Surgery, Kyushu University Hospital. Fourteen received hepatic arterial infusion (HAI) of 5-FU and Mitomycin C (MMC) combined with systemic chemotherapy, 26 combination systemic chemotherapy of MMC, Futraful and PSK, 18 single drug (MMC) therapy, and 14 no chemotherapy. The average survival was 264 days in HAI combined with systemic chemotherapy, 208 in the combination systemic chemotherapy, 156 in the single drug therapy and 135 in those given no chemotherapy. One year survival and nine month survival rates were 21.4 per cent and 42.9 per cent in HAI combined with systemic chemotherapy, 11.5 per cent and 19.2 per cent in the combination systemic chemotherapy, 5.6 per cent and 11.1 per cent in the single drug therapy and 7.1 per cent and 14.3 per cent in the no chemotherapy group, respectively (HAI vs single drug therapy and no chemotherapy, p less than 0.01). Five of 14 patients treated with HAI combined with systemic chemotherapy showed a partial response (greater than 50 per cent reduction in tumor size), and the average survival time was 335 days, while that of nonresponders was 224 days. Six of 14 patients treated with combination infusion therapy with MMC and 5-FU survived 314 days, as compared to 201 days for patients with infusion of 5-FU alone.

Adult↗
PubMed1984

Transparent box enables three dimensional viewing of CT imaging of the liver.

We designed a transparent box to reconstruct cross sectional computed tomography (CT) imagings of the liver into a three dimensional form. The objective was to clearly visualize the area of lesion and to facilitate clinical teaching. This box (31.5 X 22.0 X 18.5 cm) is made of acrylic board containing 16 demountable panels layered horizontally at 10-mm intervals. The transparency of the CT film is projected onto these panels at each height of the liver, and findings including location of the tumor, main vessels and adjacent organs are outlined with an erasable marker. After completion of each tracing, the panels are replaced in the box and the total layer forms a completed picture of the CT findings. Since 1981, we have used this tool to assess resectability and/or to select adequate procedures for treating 54 patients with liver tumor. The solid picture gives an definite location of the tumor and its extension. In the clinical work-up, indication for surgery and a procedure of choice can be discussed by the team, using this visual aid.

Humans↗