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Biomedical subjects

K Inokuchi

Publications and source records attributed to K Inokuchi.

At least 343 records · Page 19Linked to original sources
PubMed1980

Thymoma: clinicopathologic features, therapy, and prognosis.

We have treated 40 patients with thymoma. All the 18 with benign thymoma were treated with resection alone and none had a tumor recurrence or died from disease-related causes. Postoperative survival in this group ranged from 2 months to 14 years. Of the 22 patients with malignant thymoma, 2 underwent total resection, 10 partial resection and 10 were non-resectable. Fifteen of the 20 patients with non-resectable and partially excised thymomas were given radiotherapy. The cumulative 5- and 10-year survival rate of irradiation treated patients was 45.6%, and 34.4%, respectively. Of 6 non-irradiated patients, only one who underwent complete excision of tumors survived for more than 10 years, and 5 died within 3 years after treatment. Based on our findings we suggest that all patients with malignant thymoma, irrespective of the extent of surgical treatment, should be given postoperative irradiation.

Adolescent↗
PubMed1980

Long-term results of reconstructive surgery for aorto-iliac arterial occlusive lesions.

We report a review of 215 reconstructions for aorto-iliac arterial occlusive lesions, involving 156 patients. At 13 years, the cumulative patency rate of 158 aorto-femoral or aorto-iliac dacron synthetic bypass prostheses was 71.6 per cent as compared to 52.7 per cent at 5 years for 22 blunt endarterectomies and 47.4 per cent at 6 years for 35 axillo-femoral bypass prostheses. Of the 158 synthetic bypass prostheses, the cumulative patency rate at 13 years was 85.1 per cent in cases with no occlusive involvement of the peripheral arteries, significantly higher (p less than 0.03) than the 39.3 per cent patency rate at 7 years in cases in which associated femoro-popliteal occlusive lesions were not treated. At 12 years, the patency rate was 53.2 per cent in cases in which associated femoro-popliteal occlusive lesions were treated during the same reconstructive intervention, i.e. markedly higher (p less than 0.08) than in patients in whom the degree of outflow in the distal vessels was poor. Our findings indicated that, in order to achieve a satisfactory long-term patency rate, it is important to treat associated occulusive lesions in the femoro-popliteal arteries.

Adolescent↗
PubMed1980

Long-term results of reconstructive surgery for femoro-popliteal arterial occlusive lesions.

A retrospective review of 156 reconstructions performed for femoro-popliteal arterial occlusive lesions in 141 patients was carried out in terms of the reconstructive procedure and the degree of out-flow in the distal vessel. The cumulative patency rate for 95 autogenous vein grafts was 60.7 per cent at 12 years and higher than the 27.4% patency rate for 50 endarterectomies (p less than 0.001). All of 11 synthetic bypass prostheses failed with late thrombosis within 3 years after operation. The cumulative patency rate in cases with good distal run-off vessel and those with fair distal run-off vessel were 77.1% at 11 years and 57.3% at 12 years, respectively, and these values were significantly superior to 10.3% in cases with poor distal run-off vessel. The patency rate for 41 in situ grafts was 72.2%, being superior to 65.5% for 42 free grafts.

Adolescent↗
PubMed1980

Abnormalities in maximum flow volume curve and closing volume in patients with hepatic cirrhosis.

Pulmonary functions were measured in 53 patients with hepatic cirrhosis in whom there was no clinical or radiographic evidence of pulmonary involvement. Spirometric tests such as total lung capacity, vital capacity, functional residual capacity, residual volume and forced expiratory volume during one second were within normal ranges, in all subjects. Flow volume curve and closing volume tests, however, were abnormal in the majority. The maximal expiratory flow at 50 per cent of vital capacity was not altered but the maximal expiratory flow at 25 percent of vital capacity was decreased significantly in patients with hepatic cirrhosis. The closing volume in patients with hepatic cirrhosis was also significantly increased. The abnormalities in flow volume curve and closing volume curve were also demonstrated in non-smokers, and at any age, in cases of hepatic cirrhosis. These results suggested that the narrowing or closure in small airways may occur in patients with hepatic cirrhosis. These changes may be due to mechanical compression of small airways but interstitial edema which was induced by presence in the circulating blood of vasoactive substances and endotoxins.

Adult↗
PubMed1980

Clinicopathological analysis of the intestinal type and diffuse type of gastric carcinoma.

A clinicopathological study of gastric carcinoma was carried out according to Lauren's classification, on 207 patients, who underwent gastric resection at Department of Surgery II, Kyushu University, Faculty of Medicine from 1970 to 1972. Among them 93 cases (44.9%) were of intestinal-type carcinoma, 71 (34.3%) of diffuse carcinoma and 43 (20.8%) of other types. Intestinal-type carcinoma, often showing the protuberant type, was more common in the aged and in men. Most had a low grade of penetration, while in some, the penetration was moderate to high grade and was associated with lymph node metastasis, lymphatic and vascular involvement, or liver metastasis. Hematogenous recurrence was not infrequent. Diffuse carcinoma was more common in younger subjects and women, and was often of the depressed type. The serosa was involved in most cases. High grade penetration was associated with lymphatic permeation. Metastasis via the bloodstream was infrequent. Recurrence was often due to peritoneal dissemination. A better prognosis was indicated in cases of diffuse carcinoma with no serosal involvement, while prognosis in cases of invasion of the serosa was worse for diffuse carcinoma than for intestinal-type carcinoma.

Adenocarcinoma↗
PubMed1980

Venous permeation of colorectal carcinoma.

Two hundred and fifty-six tumors of carcinoma of the colon and rectum which had been surgically removed five or more years previously, and preserved in paraffin blocks, were examined for venous invasion using both routine hematoxylin and eosin (H-E) and by special stain for elastic fibers. In all these samples, 156 (61%) showed histological evidence of venous invasion and such was most frequently seen in the submucosa, followed by the subserosa or the perirectal fat. Since most of the involved veins showed marked destruction of the wall structure and were associated with total obstruction of the lumen, identification was difficult using the routine H-E strain. The frequency of venous invasion varied with the gross type of the tumor, the depth of penetration and the degree of differentiation, although there was no relation to size or to the site of the tumor. The incidence increased in cases of evident lymphatic permeation or lymph node involvement. The number of patients with venous invasion and a 5-year survival rate was significantly decreased, particularly in the Dukes' C cases. Thus, the determination of the extent of venous invasion using the elastic tissue stain is of definite prognostic value.

Adolescent↗
PubMed1980

Comparative study on the fibrinolytic activity of pseudointima in varying types of autovein grafting.

Three types of autovein grafting procedures have been commonly employed for peripheral arterial reconstruction, that is, non-reversed, reversed and in-situ autovein grafting, and these procedures were comparatively studied in dogs to assess the best one for grafting. In the fibrinolytic activity of the internal surface of the grafts, as measured by standard fibrin plate method and Todd's fibrin slide technique, the in-situ autovein graft showed the highest activity, 139.5% in the mean, followed by 18% (mean) in the reversed autovein graft and 5.2% (mean) in the nonreversed autovein graft. The extent of fibrous proliferation of the pseudointima was least in the in-situ graft followed by the reversed and the non-reversed graft. These results suggest that preservation of the vasa vasorum is the most important factor to minimize fibrous proliferation of the graft pseudointima and to maintain high fibrinolytic activity on the internal surface of the graft. Consequently, the in-situ autovein grafting appears to be the most suitable method to ensure peripheral arterial continuity following surgical reconstruction.

Animals↗
PubMed1980

A safer and more reliable operative technique for esophageal reconstruction using a gastric tube.

A safer and more reliable method of esophageal reconstruction, using a gastric tube, is described. Th procedure to create an elongated gastric tube involves separate cutting of the seromuscular and mucosal layer along the line extending parallel to and 4 cm from the greater curvature of the stomach. The end of the cervical esophagus is anastomosed to the posterior wall of the gastric tube in end-to-side fashion. In addition, circumferential cutting of the seromuscular layer of the gastric tube about 5 cm from the anastomotic line is performed to avoid tension resulting from postoperative shrinkage of the gastric tube due to muscle contraction. Combination of these methods resulted in compete elimination of anastomotic leakage.

Esophageal Neoplasms↗
PubMed1980

[Effects of adrenergic beta-receptor blocking drugs on brain catecholamine concentrations in spontaneously hypertensive rats (SHR) (author's transl)].

To acquire data on the mechanism of central effects of adrenergic beta-blockers as antihypertensive agents, experiments were done on spontaneously hypertensive rats (SHR). Each group included 5 animals. Propranolol (5 mg/kg), pindolol (0.3 mg/kg), alprenolol (5 mg/kg) or bupranolol (5 mg/kg) were given subcutaneously to the respective groups, once daily for 7 days, while the control group were given no treatment. All the rats were sacrificed 12 hours after the last injection, and the concentrations of the following materials were measured: noradrenaline (NA), dopamine (DA) and serotonin (5-HT) in the brain; NA in the heart muscle; adrenaline and NA in the adrenal glands. As compared with the control group, all rats on the beta-blockers showed an increase in NA concentration in the brain. Both pindolol and alprenolol, which have an intrinsic sympathomimetic action (ISA), increased DA concentrations in the brain. Both propranolol and bupranolol, which have no ISA, either decreased DA concentrations or showed no effect. No marked change was seen in 5-HT concentration in the brain and of NA in the heart muscle. Catecholamine concentrations in the adrenal glands showed a tendency toward decrease. These results suggest that the mechanism of antihypertensive effects of beta-blockers may be due to depression of the peripheral sympathetic activity, as induced by the central inhibitory effects of beta-blockers.

Adrenal Glands↗
PubMed1980

Adjuvant long-term immunochemotherapy for squamous cell carcinoma of the thoracic esophagus.

Between 1965 and 1978, 131 patients with primary squamous cell carcinoma of the thoracic esophagus underwent subtotal esophagectomy. Since 1972 we hae used active therapy involving pre- and postoperative irradiation and postoperative long-term cancer immunochemotherapy. When the surgical results of the active therapy and the historical control group, in which postoperative radiotherapy was used primarily, were compared, active therapy appeared to be high effective. The one, two, and three-year survival rates were 54.7, 36.3, and 27.1 per cent, respectively, in the former, and 32, 14, and 12 12 per cent, respectively, in the latter group. With respect to noncurative cases, the one-year survival rate was 42.2 per cent in the active therapy group, and 20 per cent in the control group.

Adult↗
PubMed1980

Regression of polyploid carcinoma induced by N-methyl-N'-nitro-N-nitrosoguanidine in the stomach of a dog.

Polyploid carcinoma in the gastric antrum of a Beagle dog induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) was sequentially studied by endoscopy and biopsy. Ulcer appeared on the angulus of the stomach at the 28th week and resulted in ulcer scar at the 42nd week. A new depression with atypical glands arose on the ulcer scar at the 69th week, developed elevated border at the 77th week, and progressed to a polyploid lesion at the 90th week. Well-differentiated adenocarcinoma in situ was found in the polyploid lesion at the 97th week. It gradually grew with nodular change of its surface. However, the carcinoma was ulcerated at the 126th week, became an elevated lesion with central depression at the 138th week, and finally regressed at the 154th week. At necropsy on the 202nd week, no carcinoma was found in the stomach.

Adenocarcinoma↗
PubMed1980

A comparative study of lysosomal enzyme contents in blood and liver of rats following partial hepatectomy.

Lysosomal enzyme contents (acid phosphatase and beta-glucuronidase) in blood and liver were comparatively studied with histochemical methods after 70 per cent hepatectomy in rats. The major source of these enzymes released into the circulation was investigated. The serum lysosomal enzymes were substantially increased immediately after hepatectomy (6 and 12 hours), with the simultaneous peak elevation of serum glutamic oxaloacetic transaminase (SGOT). This increment decreased thereafter. However, the second significant increment was observed between 48 and 72 hours postoperatively, when SGOT activity was almost normalized. Histochemically, lysosomes in regenerating liver were significantly increased at 6 and 12 hours, mainly in the hepatocytes, and at 36 hours exclusively in the Kupffer cells, after hepatectomy, From these observations, the initial significant increment of lysosomal enzymes in the serum, seems to be due to enzymatic leakage following surgical trauma to the remnant liver. The comparative study may indicate that the major source of lysosomal enzymes released substantially into the circulation, from 48 to 72 hours, could be the Kupffer cells which contained numerous amounts of lysosomes at 36 hours following hepatectomy. A possible mechanism for the enzymatic release in our study seems to be "reverse endocytosis".

Acid Phosphatase↗
PubMed1980

Critical evaluation of prophylactic splenectomy in total gastrectomy for the stomach cancer.

In gastric cancer surgery, an extended radical operation is commonly performed, and in cases of total gastrectomy, there is a tendency to perform splenectomy at the same time. However, some surgeons have reservations regarding this treatment in connection with the possible preservation of the host resistance. The question arises, is it reasonable to accept, by simple analogy with prophylactic lymphadenectomy the concept of the prophylactic splenectomy? The present study was designed to cast light on this problem. In order to examine the value of prophylactic splenectomy in gastric cancer surgery, a comparable patient group was followed up, and it was found that the non-splenectomized group showed a significantly better late survival rate than the splenectomized group (P less than 0.005), the 4-year survival rate being 63% in the former group and 36% in the latter group. Although these results do not necessarily contraindicate combined splenectomy, it seems desirable to reappraise the value of prophylactic splenectomy in cases having no metastasis in the splenic hilar and adjacent lymph nodes.

Gastrectomy↗
PubMed1979

Spontaneous and traumatic rupture of hepatoma.

Hepatoma is a common cause of spontaneous rupture of the liver. During recent years, spontaneous rupture was found in 11 (7 per cent) of 157 patients with hepatoma. The rupture occurred spontaneously in 7 patients, traumatically in 1 while in 3 patients trivial trauma seemed to be the precipitating factor. A correct preoperative diagnosis was made in 7 patients, all of whom were known to have a hepatoma. Hepatic resection was performed in 4 patients, 2 of whom were long term survivors. Haemorrhage stopped in 2 of 3 patients who underwent hepatic artery ligation, but only 1 patient was discharged from hospital. The remaining patients, who were treated by packing, suture or laparotomy alone, died within a short time after admission. It is suggested that resection is the preferred management, but if this is not possible hepatic artery ligation should be performed.

Adult↗
PubMed1979

An alternative one layer inverting suture technique for intestinal anastomosis.

An alternative method of anastomosis using a suture one layer inverting was proposed in which the sutures are placed the serosa, proper muscle layer, submucosal layer and muscularis mucosae, but not mucosa. An experimental study using canine intestine revealed that tensile strength as well as bursting pressure at the anastomotic site is significantly superior in our method to the end-on method.

Animals↗
PubMed1979

Remnant liver function during surgery for extensive hepatic resection.

True functional reserve of remnant liver should be determined at the same condition that contemplated hepatectomy has been performed, and this condition can be achieved before resection by temporary clamping of the inflow vessels of hepatic lobes to be removed. Using indocyanine green (ICG), the remnant liver function (RLF) was evaluated whether or not the method can be a useful indicator for or against hepatomy. In the study of healthy dogs, the RLF proved to be a reliable indicator to prospect hepatic failure which may occur after extensive resection of the liver. Then, the method was employed in nine patients who underwent 40 to 70 per cent hepatectomy. The results indicated that the RLF with ICG during surgery, if performed under stable hemodynamics, is a beneficial tool to decide the resectability in equivocal cases.

Adult↗