[Comparison of the clinical outcome of gastric cancer in aged and younger patients in relation to treatment].
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Biomedical subjects
Publications and source records attributed to K Okamura.
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The concentration of Cefbuperazone (CBPZ) was determined in the prostatic tissue and serum of 23 patients with benign prostatic hypertrophy. One or 2 of CBPZ was injected intravenously prior to transurethral prostatectomy. The mean CBPZ level in prostatic tissue and tissue/serum ratio at 1 hour was 17.4 +/- 7.2 micrograms/g (28.9 +/- 9.1%) in 10 patients administered 1 g of CBPZ, and 34.7 +/- 1C.2 micrograms/g (35.7 +/- 13.2%) in 13 patients administered 2 g of CBPZ. Serum and prostatic tissue CBPZ levels responded satisfactorily to the dose of CBPZ. Weights of resected prostatic tissue were not correlated to the tissue CBPZ level. Judging from the inhibitory concentration of CBPZ (minimum inhibitory concentration 80), the prostatic tissue CBPZ level was sufficient against pathogenic bacteria, particularly E. coli, K. pneumoiae and P. mirabilis for a relatively long time. For this reason CBPZ is a very useful drug for treatment of bacterial prostatitis and postoperative infection of prostate.
Urethral carcinoma in 2 females has been treated with irradiation together with adjunct chemotherapy. In case 1, a 73-year-old female with squamous cell carcinoma was successfully treated with irradiation of 4,000 rad and peplomycin of 60 mg intravenously given. She has been free from the disease for the past 43 months. In case 2, a 61-year-old female with transitional cell carcinoma was initially treated with irradiation of 5,000 rad together with peplomycin 90 mg, which was followed by another 5,000 rad irradiation. The tumor recurred and the patient was operated on for cystourethrectomy and partial resection of the vagina. A further chemotherapy of cisplatin, peplomycin, and mitomycin C was instituted. She died of the tumor recurrence 23 months after the first visit to our clinic. Diagnosis and treatment modalities on the female urethral carcinoma are briefly discussed.
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Fourteen cases of urogenital tumors (9 prostatic carcinomas, 4 renal cell carcinomas and 1 bladder carcinoma) which had bone metastases were treated with eel-calcitonin, Elcitonin injections for relief of bony pain. Forty mgs. of Elcitonin was injected intramuscularly, 2 to 3 times a week, to out-patients. Forty to 80 mgs. of Elcitonin was injected intramuscularly, daily to hospitalized patients. Relief of the pain was obtained in 71.4% of all patients (71.4% of out-patients and 71.4% of hospitalized patients) and especially in 88.9% of prostatic carcinoma patients. Hypercalcemia was seen in only one patient of renal cell carcinoma. It is considered that Elcitonin treatment is useful for relief of bony pain in the patients with bone metastases, with or without hypercalcemia.
We report a rare case of advanced renal cell carcinoma which showed complete resolution of multiple metastases following nephrectomy, partial metastatectomy and interferon therapy. A 55-year-old male patient underwent right nephrectomy for the renal cell carcinoma with metastases to the right lung and the left femur. In 45 days from the nephrectomy, metastasis to the right humerus was discovered. Immediately after this, the patient suffered occlusive ileus. Laparotomy revealed multiple intestinal tumors, and a temporary partial jejunotomy was performed for the detectable lesions proved to be metastases later. After this operation the pulmonary lesion revealed regression. Then, the patient was treated with daily intramuscular administration of human lymphoblastic interferon (3 X 10(6) units). In consequence, the pulmonary lesion showed complete resolution in two months and the humeral lesion in five months. The left femur which remained osteolytic was replaced by an artificial bone, and revealed no cancer cells histologically. No evidence of metastatic lesion has been found with following intestinal examinations. More than a year has passed since the detection of disease and complete response has persisted for three months under the interferon therapy.
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Thirteen cases (20 ureters) of vesicoureteral reflux (VUR) associated with neurogenic bladder, treated with anti-reflux operation are reviewed. Twelve of the 13 cases had meningomyelocele and 1 had spina bifida occulta as an underlying disease. The type of neurogenic bladder was hypoactive detrusor-active sphincter in 11 patients and hypoactive detrusor-hypoactive sphincter in 2 patients. They were treated with an anti-reflux operation, 2 ureters by Politano-Leadbetter method and 18 ureters by Cohen method. The results were successful (success rate 85.0%). Therefore, we concluded that in neurogenic bladder patients especially with the hypoactive detrusor-active sphincter, the cause of their renal deterioration is mostly VUR. Thus we should examine such patients for VUR. On the other hand, when the renal deterioration of VUR patients cannot be improved by conservative treatment for example clean intermittent catheterization or indwelling catheter, we should perform an anti-reflux operation.
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In order to investigate changes in FHR when a fetus suffers acidemia, we produced progressively advanced acidemia in lamb fetus by intermittently repeated cord compression. FHR was monitored throughout the study. FHR patterns were classified into five characteristic types as fetal arterial pH fell from around 7.35 to below 6.90. It was confirmed by studies involving catecholamine release and the administration of drugs such as atropine sulfate, alpha or beta adrenergic antagonists that sympathetic and parasympathetic regulation was deeply involved in the changes. Among the patterns, type 4, in which decreased amplitude of the initial drop and hypoxia-induced deceleration was followed by overshoot acceleration, took place during acidemia at arterial pH below 7.15. In conclusion, the appearance of type 4 FHR indicates a deteriorating state in human fetus as well, induced by repeated cord compression, and obliges us to deliver the fetus as soon as possible.
An unusual case of a coexistence of pancreas divisum and intestinal malrotation in a patient with cholecystolithiasis is described herein. The diagnosis of pancreas divisum was established by endoscopic retrograde pancreatography, and the intestinal malrotation was diagnosed by duodenography and barium enema. An operation was performed for the cholecystolithiasis. The pancreas was soft, and its shape was almost normal. Cholecystectomy and prophylactic appendectomy were performed, however nothing was done to the pancreas.
Thyroid function was investigated in 123 yusho patients who were exposed to toxic levels of polychlorinated biphenyls (PCBs) 16 years ago. In yusho patients, compared with the patients without evidence of yusho or normal controls, the serum triiodothyronine (T3) and thyroxine (T4) levels were significantly higher, while thyroid stimulating hormone (TSH) levels measured by sensitive assay were normal. There was no difference in serum levels of albumin, alkaline phosphatase, total cholesterol, and thyroxine binding globulin (TBG) between the two groups and the prevalence of positive antithyroid autoantibodies was almost the same, suggesting that hyperthyroxinemia in yusho patients was not due to increased TBG binding or abnormal autoimmune mechanism. Serum free T4 levels, however, were not elevated, although T4/TBG ratio was significantly higher. The thyroid hormone levels were higher than normal value in 4 of 123 yusho patients but only 1 case had clinical symptoms such as excessive perspiration. Despite higher serum PCBs in yusho patients, there was no correlation between PCB levels and levels of T3, T4, or TSH. The present results suggest hyperthyroxinemia without obvious clinical symptoms in yusho patients long after exposure to PCBs.
Human external urethral sphincter muscle was isolated for biochemical research. Myosin samples were prepared and pyrophosphate gel electrophoresis and two-dimensional electrophoresis were performed. Assignment in pyrophosphate gel of myosin isozymes of human external urethral sphincter was carried out by making comparisons with those from human rectus abdominis muscle. Myosin light chains in human external urethral sphincter were identified using two-dimensional electrophoresis. Human external urethral sphincter, similar to other voluntary muscles, is composed of fast and slow twitch muscle fibers, since fast and slow myosin components were shown in both pyrophosphate gel and two-dimensional electrophoretograms.
Serum triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) and thyroid autoantibodies (TAA) to either microsome or thyroglobulin were measured in 1251 samples from the general population, 546 males and 705 females, aged 40 or over in Hisayama, a Japanese rural town. TAA was positive in 7.7% of men and 15.0% of women, and the male/female ratio was 1:2. This ratio was markedly different from those in hospital patients with thyroid disorders where ratios such as 1:8 for chronic thyroiditis and 1:4 for Graves' disease were found. Among the study subjects, definite hyperthyroidism was found in 0.2%, borderline hyperthyroidism in 0.7%, overt hypothyroidism in 0.3%, latent hypothyroidism in 4.2%, and non-thyroid illness in 2.4%. Overt thyroid dysfunction was more evident in women, while latent thyroid dysfunction or non-thyroidal illness was equally prevalent in men and women. These results indicate that the incidence of immunologically or functionally latent thyroid disorders is rather higher than expected, in both women and men. Some unknown factor(s) might act as a trigger to manifest thyroid dysfunction, mainly in females.
The complete amino acid sequence of cytochrome c551 isolated from an aerobic photosynthetic bacterium, Erythrobacter sp. strain OCh 114, was determined. The cytochrome molecule was composed of a total of 119 amino acid residues and its molecular weight including heme was calculated to be 13,235. The sequence was (Sequence: see text). Its molecular weight indicates that this cytochrome is of the L-type. Sequence alignment with other bacterial cytochromes c shows that this cytochrome is similar to cytochromes c of Rhodobacter capsulatus, Rhodobacter sphaeroides, and Paracoccus denitrificans, which were grouped into the alpha-3 subcluster from the 16S rRNA sequence analysis.