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M Kitamura

Publications and source records attributed to M Kitamura.

783 records · Page 44Linked to original sources

Expression of p53 protein in glandular differentiation admixed with squamous cell carcinoma of the esophagus.

BACKGROUND: Glandular differentiation in squamous cell carcinoma of the esophagus is occasionally recognized by serial histologic investigations. We previously performed histopathologic investigations of such tumors and suggested the possibility of field carcinogenesis in esophageal cancer. MATERIALS AND METHODS: In the current study, we performed an immunohistochemistry analysis for p53 protein in such cases to investigate the mode of carcinogenesis from the view point of genetic changes. p53 protein expression in both ordinary squamous cell carcinoma and glandular differentiation of nine cases to demonstrate the coexistence of these components. RESULTS: The expression of p53 in the areas of squamous cell carcinoma was diffusely detected in three and focally in two (five in all, 55.6%) and, in these five cases, p53 was also positive in the areas of glandular differentiation in four cases. On the other hand, the expression of p53 in the glandular components was negative in all four tumors with p53 negative squamous cell carcinoma. CONCLUSIONS: The process of carcinogenesis within the tumor was thought to be similar in almost all cases even in the different histopathologic components.

Aged↗

The clinical and histopathological contributing factors influencing the effectiveness of preoperative hyperthermo-chemo-radiotherapy for the patients with esophageal cancer.

BACKGROUND/AIMS: The effectiveness of hyperthermic treatment combined with irradiation and chemotherapy for patients with esophageal cancer on local response as well as on long-time survival has been reported. In order to investigate the contributing factors influencing the effectiveness of preoperative hyperthermo-chemo-radiotherapy (HCR therapy), this study was performed. MATERIALS AND METHODS: One hundred nineteen patients with esophageal cancer who underwent preoperative HCR therapy followed by esophagectomy were reviewed in this retrospective study. The rate of effectiveness of preoperative HCR therapy was then compared in resected tissue specimens with regard to such factors as age, sex, the location of the tumor, the longitudinal diameter of the esophagogram, the radiographic type of tumor, the histological type and the histological depth of invasion using univariate and multivariate analyses. RESULTS: Both univariate and multivariate analyses showed that the clinical and histopathological factors which had the greatest effect on preoperative HCR therapy were well differentiated squamous cell carcinoma regarding the histological type and tumorous type regarding the radiographic types. CONCLUSION: We thus conclude that preoperative HCR therapy shows great promise for the treatment of patients with esophageal cancer, especially in instances of well differentiated and radiographic tumorous type squamous cell carcinoma.

Adult↗

Effect of transaortic catheter venting on left ventricular function during venoarterial bypass.

Although venoarterial bypass (VAB) or percutaneous cardiopulmonary support (PCPS) can improve hemodynamics in patients with serious cardiac decompression, some cannot be weaned from circulatory support. Insufficient unloading of the left ventricle (LV) with blood stagnation is a main cause of unsuccessful LV recovery during PCPS. This investigation was undertaken to evaluate the effectiveness of transaortic catheter venting (TACV) for LV unloading. Eight mongrel dogs (mean weight 16.3 kg, range 14-20 kg) underwent VAB with TACV. In addition to monitoring standard hemodynamic parameters, the slope of the LV end systolic pressure-volume relationship (Emax) during transient occlusion of the inferior vena cava, the slope of LV end systolic pressure-stroke-volume (Ea), external stroke work (SW), LV pressure-volume area (PVA), and slope of the SW-end diastolic volume relationship (preload recruitable stroke work: PRSW) were assessed by means of a micro-tip manometer and a conductance catheter. We measured data under the following four conditions; before circulatory support (baseline), during isolated VAB, VAB with TACV, and VAB with TACV plus intra-aortic balloon pumping (IABP). The LV contractility (Emax) and LV elastance (Ea) were equivalent for the four conditions. By comparison with baseline and VAB with TACV, LV energy (PVA) and work (SW, PRSW) were significantly reduced by TACV (1283.9 +/- 197.1 vs. 793.3 +/- 124.8 x 10(-4) J, 897.1 +/- 147.2 vs. 474.2 +/- 83.0 x 10(-4) J and 35.6 +/- 2.7 vs. 25.7 +/- 1.7 x 10(-4) J/ml, respectively), and the PE/PVA increased with TACV (30.4 +/- 2.6 vs. 40.8 +/- 1.8%). In contrast, there was no significant difference in PVA, SW, PRSW, and PE/PVA between baseline and isolated VAB. These results suggest that TACV might be an adjunctive technique to VAB or PCPS for patients with LV failure.

Animals↗

Surgical treatment for biliary lithiasis in patients associated with chronic renal failure on hemodialysis.

BACKGROUND: Incidences of the variety of postoperative complications in surgical treatment for patients with chronic renal failure on hemodialysis is the clinically accepted opinion. The aim of this study was to ascertain the safety of surgical treatment for patients of biliary lithiasis with chronic renal failure on hemodialysis. METHODS: Eleven consecutive patients with biliary lithiasis, who had a history of chronic renal failure treated with hemodialysis, were selected. The peri-operative course in-each of these cases was investigated. RESULTS: There was no incidence of peri-operative problems and postoperative complications in cases treated with laparoscopic cholecystectomy. One case treated with cholecystectomy with laparotomy had a slight degree of postoperative pneumonia, which soon improved after administration of antibiotics. Only one case, treated with choledochotomy, resulted in operative death due to accidental septic shock from an unknown origin. CONCLUSIONS: Surgical treatment of patients with biliary lithiasis and chronic renal failure on hemodialysis can be safely performed with appropriate operative indications and noninvasive surgical techniques.

Aged↗

Successful conservative treatment for esophageal perforation by a fish bone associated with mediastinitis.

A 74 year-old man presenting with esophageal perforation associated with mediastinitis due to the swallowing of a fish bone is reported herein. Conservative treatment, including starvation therapy and the injection of antibiotic drugs, proved to be successful for this patient. Although the optimal treatment for esophageal perforation remains controversial, it is important to choose the appropriate strategies when treating cases of esophageal perforation with mediastinitis.

Aged↗