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Biomedical subjects

K Shirouzu

Publications and source records attributed to K Shirouzu.

At least 145 records · Page 8Linked to original sources
PubMed1996

Pulmonary capacity in lung cancer patients prior to lung resection--comparison of the unilateral pulmonary artery occlusion test with expired gas analysis during exercise testing.

We attempted to determine if expired gas analysis during exercise testing has equal value to the unilateral pulmonary artery occlusion test (UPAO). Sixty-four lung cancer patients were evaluated. We performed UPAO and measured mean pulmonary artery pressure (PPA) and cardiac output (C.O.) 15 min later, and calculated total pulmonary vascular resistance (TPVR). Expired gas analysis during exercise testing was performed, and the maximum oxygen consumption per unit body surface area (VO2max/m2) and the anaerobic threshold (AT/m2) were calculated. The patients were divided into two groups according to the PPA as follows: Group PPA(L) and Group PPA(H), and the TPVR as follows: Group TPVR(L) and Group TPVR(H). Comparative studies of the mean values of VO2max/m2 and AT/m2 were performed between the two groups. VO2max/m2 was significantly higher in Group PPA(L) than in Group PPA(H). VO2max/m2 was significantly higher in Group TPVR(L) than in Group TPVR(H). TPVR and VO2max/m2 showed no significant correlation, but a weak negative quadratic correlation with the equation y = 2276-246.6 logx was found. This result led a minimal acceptable levels for lung resection of Vo2max/m2 of 650 ml/min/m2 corresponding to the TPVR levels of 700 dyne.sec.cm5/m2.

Adult↗
PubMed1996

Mucinous adenocarcinoma of the stomach-clinicopathological studies.

The clinical and morphological features of 58 cases of the rare mucinous adenocarcinoma of the stomach (MUC) were investigated and compared to those of other pathological types. The incidence of MUC was only 2.9% of all cases of resected gastric cancer. Among the 58 cases of MUC, the incidence of early cases was only 19% (Group 1), while among other pathological types of cancer, it was 42% (Group 2) (p < 0.001). The incidence of early mucosal cancer was 0% in Group 1, and 54% in Group 2 of the resected early gastric cancer. The incidence of lymph node metastasis rate was 81% in Group 1, and was 46% in Group 2 (p < 0.001). The presence of peritoneal dissemination was 21% in Group 1, and was 8% in Group 2 (p < 0.001). The incidence of liver metastasis pre- and intraoperatively was 0% in Group 1, and was 3.5% in Group 2. The overall 5-year-survival rate was 45% in Group 1, and was 61% in Group 2 (p < 0.05). In stage III, the 5-year-survival rate was 30% in Group 1, and was 49% in Group 2 (p < 0.05). There was no statistical prognostic difference between the two groups in stage I, II and stage IV. Therefore, to improve the outcome for MUC, more effective radical gastrectomy and aggressive immunochemotherapy should be selected especially for stage III mucinous adenocarcinoma of the stomach.

Adenocarcinoma, Mucinous↗
PubMed1996

A pylorus-retaining pancreatic head-duodenectomy for cancers of the duodenal papilla and the lower bile duct.

With the development of diagnostic technology, the surgical methods of cancer therapy have been expanded, and operations have been performed using a procedure corresponding to the stage of cancer to improve the postoperative QOL. A 79-year-old man with cancer of the duodenal papilla and obstructive jaundice, and a 63-year-old woman with cholangiocarcinoma in the lower region complicated by cholangitis caused by Candida underwent resections of the pancreatic head and duodenum, and pancreaticogastrostomies retaining the pylorus. Satisfactory results were obtained in both cases. The merits of the procedure were that there were few complaints, sufficient food could be ingested and the QCL was maintained. The benefits of pancreaticogastrostomy are that the anastomosis procedure is simple, the gastric wall is thicker than the jejunum and blood flow is plentiful. The dorsal gastric wall is located close to the pancreatic cut-end, therefore tension is not created, and the pancreatic enzymes are not activated because the anastomosis site does not contact the intestinal fluid. These characteristics should decrease the rate of anastomosis failure which can be a fetal complication. A safer operation is desirable, particularly for elderly patients or patients who have complications.

Aged↗
PubMed1996

Hepatic arterial chemotherapy for liver metastases from colorectal cancer.

We have investigated the complications, toxicities, tumor response and survival rate with hepatic arterial (HA) chemotherapy for liver metastases from colorectal cancer. Forty-three patients with measurable liver metastases and 10 patients after the resection of liver metastases were treated with HA bolus mitomycin C (MMC) or continuous fluorouracil (5-FU) infusion between 1986 and 1994. The catheter- or reservoir-related complications such as catheter induced infection, subcutaneous reservoir pocket infection, or catheter or hepatic artery occlusion occurred in 14 patients (26%) mainly in our early cases. Severe gastritis or a gastroduodenal ulcer developed in 12 patients (23%), in particular after treatment with continuous infusion of 5-FU and when the catheter was placed into the gastroduodenal artery during laparotomy. An ulcer often caused a serious complication such as a duodeno-biliary fistula, penetration into the hepatic artery or duodenal perforation. Also noted were upper gastrointestinal symptoms in 26 patients, hepatic toxicities in 3 patients, and bone marrow depression in 4 patients. Because of these complications and toxicities, HA therapy was discontinued in more than 60% of the cases. The overall tumor response rate was 17%. However, in the cases which were treated by 5-FU continuous infusion for longer than 3 months, the response rate was higher than 60%. There was no significant difference in survival rate between HA therapy and systemic palliative chemotherapy. These results suggest that it is important to prevent gastrointestinal toxicities in order to allow continuation of HA continuous 5-FU infusion therapy which could provide a higher response rate and a better survival for colorectal cancer patients with liver metastases.

Colorectal Neoplasms↗
PubMed1996

Superficial spreading-type mucosa-associated lymphoid tissue (MALT) lymphoma in the stomach--a case report.

We presented a case of a 71-year-old woman who presented irregular mucosal folds with tiny depressions and multiple erosions with ulceration in the stomach, on endoscopy and roentgenography. Histological findings from biopsy specimens showed dense and mildly atypical lymphoid-like cells invading the submucosa. Immunohistochemical examinations revealed monoclonal reactivity of Heavy-chain. She was then diagnosed to have low grade malignant lymphoma in the stomach and underwent total gastrectomy. The resected cancer demonstrated the pathological features including small lymphocytic plasmacytoid cells and lymphoepithelial lesions characteristic of a mucosa-associated lymphoid tissue (MALT) lymphoma. The lymphoma cells expressed B cell markers with a phenotype of IgG and lambda type. It is difficult to make a firm diagnosis of a MALT lymphoma from only small biopsy specimens. Accordingly it is necessary to complete the observed clinical process, endoscopic and roentgenographic findings with immunohistochemical characteristics to determine diagnosis. The MALT lymphoma should be treated as a low-grade malignancy and diagnosis sufficiently early can lead to a favorable prognosis.

Aged↗
PubMed1996

[Measurement of serum tissue polypeptide antigen (TPA) in patients with malignant tumor using prolifigen TPA-M "Daiichi" kit].

Serum tissue polypeptide antigen (TPA) was measured using a newly developed Prolifigen TPA-M "Daiichi" kit in 1,236 healthy subjects, 2,867 patients with malignant tumors, and 901 with benign diseases. Because 94.0% of healthy subjects had serum TPA under 70 U/l, the cut-off value was set at 70 U/l. Serum TPA was elevated in more than 50% of patients with head and neck cancer, lung cancer, liver cancer, gallbladder or bile duct cancer, pancreatic cancer, colorectal cancer, ovarian cancer, and prostate cancer. The overall positive rate in malignant tumors was 55.5%. Serum TPA was higher in advanced cancer than in earlier stage cancer, and decreased after the resection of the tumor. The false positive rate in benign diseases was 31.3%. ROC analysis revealed the usefulness of TPA as a tumor marker in many cancers. The correlation coefficient between TPA and CYFRA 21-1, and between TPA and TPSA, was 0.747 and 0.694, respectively. In conclusion, measurement of serum TPA using the new kit is useful in the management of patients with various malignant tumors.

Antigens, Neoplasm↗
PubMed1996

[An experimental study on antitumor effect of MMC-fibrin glue mixture].

In spite of postoperative chemo- and/or radiation therapy, the prognosis of advanced cancer patients undergoing palliative operation is still poor. Therefore, in order to improve the effect of chemotherapy, we made a mixture of MMC and fibrin glue (MMC-FIB) as a local chemotherapy. Using FIB with MMC, we expected to enhance the efficiency of MMC by sustained release of MMC. We examined cytotoxic effects and anti-tumor effects of the MMC-FIB using a gastric cancer cell line (MKN-28) and an esophageal cancer cell line (KE-3). Effects of the MMC-FIB were twice as strong as those of MMC on in vitro and in vivo studies. MMC-FIB is easy to make and apply to residual tumor. These results suggest that MMC-FIB is an effective treatment as a local chemotherapy for postoperative residual cancer.

Animals↗
PubMed1996

[Immunohistochemical analysis of c-erB-2 and nm23 expression in early gastric carcinoma].

The expression of c-erB-2 and nm23 genes product were investigated immunohistochemically in 108 resected cases of early gastric cancer. The expression rate of c-erB-2 was significantly higher in the cases of submucosal cancer or in the cases with lymph node metastasis. The expression rate of c-erB-2 was higher in the metastatic tumor than in the primary tumor. There was no significant correlation between the expression of nm23 and depth of invasion. The expression rate of nm23 was lower in the cases with lymph node metastasis than in the cases without lymph node metastasis. The expression could not be found in the metastatic tumor. These results suggest that there would be correlation between the expression of c-erB-2 and depth of invasion and lymph node metastasis, and the nm23 may suppress metastatic potential in early gastric cancer.

Humans↗
PubMed1995

Distal spread of rectal cancer and optimal distal margin of resection for sphincter-preserving surgery.

BACKGROUND: Ascertaining the optimal distal margin of resection in sphincter-preserving surgery has become an important problem. This study was designed to examine distal rectal spread of rectal carcinoma and to determine the optimal distal margin of resection for sphincter-preserving surgery. METHODS: Six hundred ten consecutive specimens of resected rectal carcinomas were analyzed retrospectively and pathologically. RESULTS: Sixty-one patients (10%) had distal spread. In patients who underwent curative surgery, distal spread was observed in only 3.8% (19/505). Distal spread was not found in patients with Stage I disease (0/150), according to the International Union Against Cancer stage. Only 1.2% (2/162) of patients with Stage II disease and 5.1% (10/195) with Stage III disease had slight spread but this was confined within a 1 cm length. Most patients with distal spread had a lower survival rate and died of distant metastasis rather than local recurrence, even after curative surgery. CONCLUSIONS: Distal spread seems to be an important risk factor for distant metastasis. Distal margin of resection of 1 cm may be appropriate clearance for most rectal cancers.

Female↗
PubMed1995

Surgical treatment for patients with pulmonary metastases after resection of primary colorectal carcinoma.

BACKGROUND: The optimum treatment for patients with pulmonary metastases from colorectal carcinoma is still controversial. METHODS: To evaluate the results of pulmonary resection in 22 patients with pulmonary metastases after resection of primary colorectal carcinoma, patients' characteristics were examined retrospectively. Eighteen patients had a solitary metastatic lesion and four had two lesions. RESULTS: Postthoracotomy recurrence occurred in 17 of the 22 patients (77.3%), and showed no correlation with the type of pulmonary resection. In 11 patients with a solitary lesion of less than 3.0 cm in greatest dimension, the 3- and 5-year postthoracotomy survival rates (PTSR) were 71.6% and 36.8%, respectively. Six of these patients received two or more thoracotomies for pulmonary recurrence. The 3-year PTSR for seven patients with a solitary lesion greater than or equal to 3.0 cm was 19.0%, and for the four patients with two lesions, 25.0%. A significant difference was noted in the survival rate according to both number and size of the metastatic lesions (P < 0.05). CONCLUSIONS: The number and size of metastatic lesions appear to be important prognostic determinants. Repeated thoracotomy can prolong survival for selected patients.

Adenocarcinoma↗
PubMed1995

Carcinomatous lymphatic permeation. Prognostic significance in patients with rectal carcinoma--a long term prospective study.

BACKGROUND: The question of whether lymphatic permeation in rectal carcinoma is an index of prognosis remains controversial. METHODS: A long term prospective study of lymphatic permeation of 288 rectal carcinomas was performed. The degree of lymphatic permeation was divided into four stages (Ly0 through Ly3). The median follow-up for the surviving patients was 84 months (range, 23 to 151 months). RESULTS: In patients with UICC Stage I or II disease, there was no correlation between the Ly0 and Ly1-3 groups' recurrence or survival rates. In patients with Stage IIIa disease, the rate of postoperative recurrence was significantly higher in the Ly1 or Ly2 + Ly3 groups compared with the Ly0 group. The 10-year survival and disease free survival rates in patients with Stage IIIa disease were both 90.0% in the Ly0 group, 63.6% and 62.5% in the Ly1 group, and 52.0% and 45.5% in the Ly2 + Ly3 groups, respectively. A significant difference was noted in the survival rates between the Ly0 and Ly2 + Ly3 groups (P < 0.05), and was noted in the disease free survival rates between the Ly0 and Ly1 (or Ly2 + Ly3) groups (P < 0.05, P < 0.005). In patients with Stage IIIb disease, there were trends toward higher recurrence, lower survival, or disease free survival rates in the Ly2 + Ly3 groups compared with the Ly1 group (P < 0.1). CONCLUSIONS: The degree of lymphatic permeation is an important prognostic factor in patients with Stage III disease, especially in those with Stage IIIa disease. It should be classified as a clinical subgroup.

Aged↗
PubMed1995

Purification of human blood eosinophils by a combination method using anti-CD16 monoclonal antibody, immunobeads, and Nycodenz density gradient.

A simple method is described for the procurement of human blood eosinophil phenotypes by combining an anti-CD16 monoclonal antibody, immunobeads, and a non-toxic and non-ionic density gradient medium, Nycodenz. The purification depends on the removal of mononuclear cells using a 1.076/1.102 g/ml Nycodenz density gradient, partial removal of neutrophils based on different binding to plastic dishes, interaction of residual neutrophils with immunobeads via an anti-CD16 monoclonal antibody and, finally, extraction of eosinophil phenotypes by sifting the immunobeads-loaded neutrophils through an 1.080/1.102 g/ml Nycodenz density gradient. This method permits simultaneous preparation of highly purified normodense (> 1.080 g/ml) and hypodense eosinophils (< 1.080 g/ml) with reasonable chemiluminescence responses to opsonized zymosans and helminthotoxic activity to opsonized schistosomula corresponding to their own immunocytological properties.

Animals↗
PubMed1995

Total pelvic exenteration for locally advanced colorectal carcinoma--postoperative complications.

This study was designed to clarify the postoperative major complications of total pelvic exenteration for locally advanced colorectal cancer. Twenty-six patients (primary disease: 17, recurrent disease: 9) were retrospectively studied. Major complications developed in 30.8% (8 of 26); in 23.5% (4 of 17) for a primary disease and in 44.4% (4 of 9) for a recurrent disease. Only 2 patients (7.7%) died within 30 days after the operation; one patient died of hepatic failure and another of pelvic sepsis. Postoperative ileus developed at a high rate of 11.5% (3 of 26). Ileo-ileal anastomotic leakage developed at a rate of 7.7% (2 of 26) and it commonly occurred following irradiation. The remaining one patient had gastrointestinal bleeding. These 6 patients surviving the operation were successfully managed conservatively. Conclusion was as follows: Total pelvic exenteration should be performed carefully and aggressively regardless of the development of postoperative complications.

Adult↗
PubMed1995

Inhibition of Fc gamma R- and CR-mediated human neutrophil chemiluminescent responses by anti-allergic and anti-histaminergic drugs.

The effects of ketotifen fumarate (KF) and clemastine fumarate (CF) on neutrophil chemiluminescent (CL) responses to zymosan particles coated with either IgG (IgGZ), C3 (C3Z), or both (IC3Z), were examined in vitro. These opsonized zymosans caused not only detectable neutrophil superoxide anion generation evaluated by an MCLA-dependent CL (MDCL) assay, with the order of light emission being IC3Z > IgGZ > C3Z, but also a transient rise of neutrophil [Ca2+]i measured by an aequorin-dependent CL (ADCL) assay. Both KF and CF could suppress all opsonized zymosan-induced neutrophil MDCL in a dose-dependent fashion, but not all ADCL. Similar inhibitory effects of KF and CF were observed on the phorbol myristate acetate-induced MDCL. However, there was no interference by these two drugs with the measurement of MDCL in the hypoxanthine/xanthine oxidase superoxide anion generation system. These results indicate that the inhibitory effects of both KF and CF on Fc gamma R- and/or CR-mediated neutrophil oxidative potential is attributable to effects on an enzymatic reaction after protein kinase C activation in the oxidative signal transduction pathway.

Clemastine↗
PubMed1994

Primary linitis plastica carcinoma of the colon and rectum.

BACKGROUND: Linitis plastica carcinoma (LPC) usually shows a scirrhous growth pattern with a severe stromal desmoplastic reaction. Another growth pattern showing lymphangiosis carcinomatosa rather than scirrhous growth pattern, however, was noted. This study was designed to clarify the clinical and pathologic characteristics of colorectal LPC. METHODS: Linitis plastica carcinoma was reviewed clinicopathologically and classified into two types according to the histologic growth pattern: The first was a scirrhous type (nine patients) and the second, a lymphangiosis type (three patients). RESULTS: Grossly, the mucosal surface of the scirrhous type had a granular, cobblestone, gyriform-like appearance. The cancer cells were composed mainly of poorly differentiated or signet-ring cells and were accompanied by a severe stromal desmoplastic reaction; lymphatic permeation was not so marked. Most patients with this type of cancer died of peritonitis carcinomatosa. The mucosal surface of the lymphangiosis carcinomatosa had a smooth and glossy appearance. The cancer cells were composed mainly of moderately differentiated cells, frequently with a glandular formation. Stromal desmoplastic reaction was not so marked. The growth pattern was characterized by lymphangiosis carcinomatosa and marked venous invasion. All patients who had this type died of distant metastases. CONCLUSION: Perhaps with earlier diagnosis and aggressive treatment, the peritoneal dissemination of scirrhous LPC and distant metastasis of lymphangiosis LPC may be minimized.

Adenocarcinoma, Scirrhous↗
PubMed1994

Clinicopathologic characteristics of large bowel cancer developing after radiotherapy for uterine cervical cancer.

PURPOSE: This study was designed to clarify the characteristics of large bowel cancer developing after radiotherapy for uterine cervical cancer. METHODS: A retrospective chart review was performed. RESULTS: The latent period was a mean of 20.5 years. The most common site was in the rectum (16/32). Mucin-producing carcinoma was observed in 53.1 percent, with an especially high rate of 75 percent in the rectum. Histologic radiation damage was also demonstrated at a high rate of 64.3 percent. CONCLUSIONS: It was difficult to judge from clinicopathologic findings whether large bowel cancer developed with relation to radiation effect. We emphasize, however, that the characteristics are different from ordinary large bowel cancer. Particular consideration should be given to the high incidence of mucin-producing carcinoma.

Adenocarcinoma, Mucinous↗