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Biomedical subjects

K Inokuchi

Publications and source records attributed to K Inokuchi.

At least 307 records · Page 17Linked to original sources

Liver pathology of idiopathic portal hypertension. Comparison with non-cirrhotic portal fibrosis of India. The Japan idiopathic portal hypertension study.

Morphological changes of the liver were studied in 24 autopsy cases of noncirrhotic portal hypertension of unknown etiology (idiopathic portal hypertension, IPH), and in 123 surgical biopsies from such patients. For comparison, 15 whole-cut liver slices from autopsy cases of noncirrhotic portal fibrosis (NCPF) from India were also studied. Liver pathology was very similar in IPH and NCPF, characterized by phlebosclerotic changes and perivascular fibrosis of the portal vein system, and parenchymal atrophy perhaps secondary to portal circulatory insufficiency. The distribution of lesions was uneven, and despite marked fibrosis and occasional surface nodularity, there was no diffuse pseudonodule formation in the parenchyma. Surgical specimens showed similar changes except for more frequent portal cellular infiltrates, but the changes seen in one biopsy specimen were limited and not always diagnostic. It seems that IPH of Japan and NCPF of India are the same disease, and perhaps hepatoportal sclerosis elsewhere is also the same disease.

Adult↗

Mucosal blood flow and modified vascular responses to norepinephrine in the stomach of rats with liver cirrhosis.

To observe changes in hemodynamics and vascular responses to norepinephrine in cases of liver cirrhosis, male WKA rats were given CCl4 subcutaneously. The portal venous pressure of these so-induced cirrhotic rats was significantly higher than that of the controls. There was an increase of mucosal blood flow and a lowering of peripheral vascular resistance of the stomach. After norepinephrine infusion, the gastric mucosal blood flow increased significantly in cirrhotic rats, whereas there was no significant change in controls. The aorta and the portal vein showed no difference in the vascular response to either norepinephrine or [K+].0. These results suggest that in cirrhotic rats there is an increase in blood flow and a lowering of peripheral vascular resistance in the gastric mucosa and that these hemodynamic changes may be derived from alteration in the vascular response to norepinephrine in gastric microcirculation.

Animals↗

[Phase II study on peplomycin for esophageal cancer].

For the purpose of verifying the effectiveness of peplomycin, one of the derivatives of bleomycin, against carcinoma of the esophagus and the safety of it, the analysis of the data for total 113 cases collected from 25 institutions in Japan was made. The results are as follows. It was effective in 19 out of 74 evaluable cases of carcinoma of the esophagus (25.7%). In case of treatment with peplomycin alone, it was effective in 6 out of 39 cases (15.4%). In case of the combination treatment with peplomycin and some other therapy, it was effective in 13 out of 35 cases (37.1%). As for the side effects, the incidence of fever was the highest in both the cases of peplomycin alone and the combination treatment such as 39.6% and 37.0%, respectively. Anorexia, nausea, vomiting, respiratory symptoms and tiredness were found in relatively many cases. In the clinical laboratory tests, the vital capacity after the treatment tended to be lower than that before the treatment, but there was little change in the hematological tests, pulmonary function test and renal function test.

Adult↗

Intraluminal velocity profile analyzed from flow waveforms.

Normal and abnormal flow waveforms, electromagnetically measured in the reconstructed arteries of patients with peripheral occlusive diseases of the lower extremity, were analyzed in terms of luminal velocity profile, using a newly designed flow wave simulation pump. The blood flow with normal flow wave was characterized by a large fluctuation in the velocity profile in the limited layer adjacent to the wall, where a reversal stream was characteristically noted during the phase of cardiac diastole. In contrast, in the abnormal flow wave, the velocity profile in the limited layer adjacent to the wall was always stagnant with little change in the velocity during each phase of a cardiac cycle. These observations clearly explain why an artery with a normal flow waveform remains patent, while an artery with an abnormal waveform tends to occlude. It was also found that the electromagnetically determined flow waveforms do provide the required information on the luminal velocity distribution.

Adult↗

[Multihospital randomized study on the adjuvant chemotherapy with mitomycin-C and Futraful for gastric cancer V. Estimation of 5-year survival rate].

The addition of Futraful to MMC therapy of gastric carcinoma was evaluated. Nationwide 297 institutions participated in a randomized controlled study and cumulative five-year survival rate was calculated. A total of 1,673 cases was studied. These were divided in two groups: Group A, without Futraful, and Group B, with Futraful. Futraful was administered postoperatively for 3 months. The MMC treatment was done by moderate intermittent administration (Method I) or by large dose administration (Method II). Futraful improved survival rates regardless of the method of MMC treatment. Especially, Group B' (more than 60 g of Futraful) showed significantly better results in patients with metastases and positive serosal invasion in both methods, and beta type infiltration in Method I. Furthermore the Group B' patients had higher survival than Group A patients in Method II for patients in stage III and gamma type infiltration. Method II, a large dose MMC, plus Futraful was suggestive of particular effectiveness in preventing peritoneal metastases in curatively resected cases.

Drug Therapy, Combination↗

[Effect of levamisole in postoperative adjuvant immunochemotherapy of stomach cancer--randomized controlled study of MMC-tegafur combination therapy with or without levamisole. 1].

The effects of levamisole used in combination with Mitomycin C and Tegafur in patients with resectable stomach cancer were investigated in 10 cooperative institutes. The patients were randomly allocated to the treatment with either control or levamisole by envelope method. Levamisole group was treated with Mitomycin C (day 0, 20 mg, day 1, 10 mg, one shot i.v.), Tegafur (600 mg/day, p.o.) and levamisole (150 mg/day, p.o.). Levamisole was administered 3 consecutive days prior to surgery, and 3 consecutive days every fortnight after surgery. The control group was administered Mitomycin C and Tegafur. The both drugs were administered by the same method as above. Two hundred and twenty-two patients were entered in this trial. However, with the exclusion of 67 patients, the eligible patients were 155, consisting of 77 in the control group and 78 in the levamisole group. In stage III patients, the disease-free interval and survival time were significantly prolonged in the levamisole group compared to the control group (generalized Wilcoxon test p less than 0.05). The side effects were observed a little more frequently in the levamisole group. However, there was no significant difference. From this result, it can be considered that levamisole is effective in delaying recurrence and in prolonging survival time of the patients when used in combination with adjuvant chemotherapy after resection of stomach cancer.

Adjuvants, Immunologic↗

[Effect of levamisole in postoperative adjuvant immunochemotherapy of stomach cancer--randomized controlled study of MMC-5-FU combination therapy with or without levamisole. 1].

A randomized controlled study by envelope method was carried out with the purpose of evaluating effects and side effects of levamisole in patients with resectable stomach cancer. The patients were randomly allocated to the treatment either with control or levamisole according to the indication of the envelope opened at least 3 days prior to surgery. The control group was treated with Mitomycin C (day 0, 20 mg day 1, 10 mg, one shot i.v.) and 5-FU(150 mg/day, p.o.). The levamisole group was treated with Mitomycin C, 5-FU and levamisole. Levamisole was administered at a daily dose of 150 mg for 3 consecutive days before surgery, and the 3 consecutive days administration schedule was repeated every fortnight for one year after surgery. Four hundred and forty-six patients were entered in this trial. However, with the exclusion of 104 patients as exceptions and dropouts, the total eligible patients were 342, consisting of 167 in the control group and 175 in the levamisole group. The effects were evaluated by comparing the disease-free interval or the survival time of both groups. There was no significant difference in the disease-free interval and survival. In this study, we have not yet reached the conclusion that levamisole is effective in prolonging disease-free interval and survival time, because high survival rates are still maintained in both groups for 2 years after surgery. The final conclusion would be drawn with the follow-up results in the future.

Adjuvants, Immunologic↗

[Effect of postoperative long-term chemotherapy of stomach cancer using mitomycin C and futraful--the secondary study (1)].

The Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer in Japan with the participation of 334 institutes nation-wide had conducted the secondary study in order to investigate the usefulness of futraful in long term treatment, based on the results obtained by the primary study. The following method was taken for the study and patients were randomly divided into three groups: A group-given a high dose of MMC immediately after operation; B group-given futraful for one year after MMC administration; C group-given futraful alone for long-term. The number of eligible cases for data analysis was 3,o30. Side effects observed during the long term treatment with futraful were considered to be minor. Although the occurrence of hematocytopenia was slightly frequent because of possible increase of influence by the concomitant use of MMC, no tendency of hepatic disorders and any subjective side effects to be strengthened by MMC combination was observed at all. As for 2-year survival, an elevated survival was found in the group of concomitant use of MMC and futraful; Especially, a significantly high survival was found in the cases of stage III and n (+) . ps (+). Furthermore, the survival was elevated in proportion to the increase of total dosage of futraful. This suggested the usefulness of futraful for long term treatment.

Aged↗

Transtracheal mediastinal lymphography for visualization of metastatic lymph nodes in carcinoma of the esophagus.

Mediastinal lymphography was carried out preoperatively upon 15 patients with carcinoma of the thoracic part of the esophagus. The tracheal bifurcation was punctured, and contrast medium was slowly injected. Mediastinal lymphograms were taken within 24 hours and, again, three and seven days after this injection. The paratracheal lymph nodes were demonstrated in almost all of the patients, and a filling defect was observed in three patients, leading to possible metastatic involvement. In seven patients, the right pulmonary hilar lymph nodes were demonstrated, and no node was considered to be metastatic. In three, paraesophageal lymph nodes were preoperatively diagnosed as metastatic. All seven lymph nodes in which metastasis was suspected were confirmed to be metastatic at pathologic examination. The smallest node correctly assessed as metastatic was 6 by 6 millimeters.

Aged↗

Problems in esophageal bypass for unresectable carcinoma of the thoracic esophagus.

The clinical evaluation of esophageal reconstruction in both resectable and unresectable carcinoma of the thoracic esophagus is described. Our operative technique for obtaining a long gastric tube and creating and end-to-side anastomosis has been highly successful, and the anastomotic failure rate was remarkably lowered in patients with resectable carcinoma of the esophagus. However, anastomotic leakage remains a serious problem for those undergoing esophageal bypass for unresectable carcinoma of the esophagus. The most likely cause of anastomotic failure after bypass seems to be the tug on the anastomosis with each swallow.

Esophageal Neoplasms↗

Changes in portal pressure and hepatic blood flow after dearterialization of tumour-bearing livers in man.

Eighteen patients with nonresectable liver cancer were treated by dearterialization of the liver. The changes in portal vein pressure and hepatic blood flow were determined prior to the immediately after dearterialization. Portal pressure decreased by 20% in the complete and 11% in the incomplete dearterialization groups. The degree of portal pressure reduction did not differ between the patient with and without associated cirrhosis of the liver. Retention and disappearance rates of indocyanine green were improved in five, unchanged in six and deteriorated in seven patients by dearterialization. The beneficial effects on hepatic haemodynamics seen in this study were probably produced by interrupting deleterious intrahepatic arteriovenous shuntings in or around the tumors.

Adult↗

[Effect of postoperative long-term cancer chemotherapy (PLCC) on non-curative gastric cancer of stage IV].

We studied the effect of postoperative long-term cancer chemotherapy (PLCC) on the survival of the patients with stage IV gastric cancer, subjected to non-curative resection. The study was carried out with 90 patients receiving the PLCC from 1970 to 1978, and 95 patients received intraoperative one shot I.V. injection of Mitomycin-C from 1964 to 1978, and 106 patients without chemotherapy from 1964 to 1970. The PLCC consisted of the following combination: MMC intermittent intravenous injection (20 mg of MMC during operation followed by 10 mg on the next day, 4th week and every 3 months respectively): postoperative oral administration of FT-207 (600 mg/day) and; PSK (3 g/day) for more than 4 months after operation. The background factors were not significantly different among 3 groups. Two year survival rate was 18.9% in PLCC group, significantly higher than that of 7.4% in MMC group and 2.0% in no chemotherapy group which was respectively (P less than 0.05). The PLCC also demonstrated its be effective mess in prolonging the survival of the patients with hepatic metastasis or peritoneal dissemination.

Antineoplastic Agents↗