Biomedical subjects

M Nishi

Publications and source records attributed to M Nishi.

At least 181 records · Page 10Linked to original sources

PubMed1994

A trial to discriminate spontaneous regression from non-regression cases during mass screening for neuroblastoma.

We tried to discriminate between cases of spontaneous regression and non-regression during mass screening for neuroblastoma, taking advantage of differences in respect to the urinary homoranillic acid/vanillyl mandelic acid (HVA/VMA) ratio and the original tumor site among true positive, false negative and natural occurrence cases. After classifying them into a total of six groups depending on the two factors, ratio: < 1, 1-2 or > or = 2 and tumor site: adrenal or extra-adrenal in origin, we calculated the mathematical probability of a given true positive case being one of spontaneous regression. A tumor of extra-adrenal origin was likely to regress spontaneously, especially one with an HVA/VMA ratio < 1 or > or = 2 (82.2-100%). A tumor of adrenal origin with an HVA/VMA ratio < 1 seemed unlikely to regress spontaneously (0-4%). The present method, employing simple preoperative information, would be useful in future for the selection of true positive cases which should be observed without treatment.

Adrenal Gland Neoplasms↗

PubMed1994

[The molecular mechanism of insulin biosynthesis and mutant insulin gene syndrome].

The biosynthetic process of insulin in pancreatic beta cells consists of many steps including transcription of insulin gene to mRNA, translation of mRNA to preproinsulin, production of proinsulin by cleavage of signal peptide, and conversion of proinsulin to insulin and C-peptide. This process also includes intra-cellular trafficking (nucleus, cytoplasm, endoplasmic reticulum, Golgi apparatus, secretary granule, and extra-cellular secretion). The factors concerning and regulating these steps are discussed, although some of these have not been fully understood. The possible influences of insulin gene mutations (mutant insulin gene syndrome) to these steps are also discussed. Understanding of the molecular mechanism of insulin biosynthesis might be usefull to explain the defective insulin production of NIDDM.

Animals↗

PubMed1994

[Role of IAPP in the pathogenesis and development of NIDDM].

Islet amyloid deposits are the characteristic lesions of the pancreas of the patients with non-insulin-dependent diabetes mellitus (NIDDM). Islet amyloid polypeptide (IAPP or amylin) is a 37 amino acid peptide, which was extracted and characterized from islet amyloid deposits in patients with NIDDM. Recent studies and characterization of IAPP cDNA suggest that IAPP is a normal islet hormone and is co-secreted with insulin from islet beta cells of the pancreas. In this paper, we review recent advance of the research for IAPP including our results, and discuss the role of IAPP in the development of NIDDM, and we propose a new type of diabetes, "amyloid diabetes".

Amino Acid Sequence↗

PubMed1994

[Past and future of gastric cancer treatment in Japan].

History of gastric cancer treatment in Japan during about 100 years was described. Not only development of surgery, but also influence of European medicine and improvement of diagnosis were studied. History and activity of Cancer Institute Hospital (C.I. H.) and Japanese Research Society for Gastric Cancer (J.R.S.G.C.) were also described.

Forecasting↗

PubMed1994

[Progress of the treatment of gastric cancer in Cancer Institute Hospital, Tokyo].

From 1946 to 1990, a total of 10,485 cases of gastric cancer patients were treated at the Cancer Institute Hospital (CIH), Tokyo. During the past 46 years, CIH contributed to various aspects of surgical treatment of gastric cancer; extensive radical surgery for advanced cancer, safe reconstruction methods after total gastrectomy, modified surgery for early stage cancer, and multimodality therapy for moderately advanced cancer. Five-year survival rate was 20% for all cases in 1940s, and 66.5% for 1980s. Improvement in the treatment results could be attributed to the relative increase in the number of early stage cancers, the increase in the rate of curative surgery (R0), and incorporation of multi-modality therapy before or after curative surgery. Stage-oriented therapy is mandatory for further improvement in the treatment results and the patient's quality of life after surgery.

Adult↗

PubMed1994

[A case report of 16-year-old gastric cancer patient with a rapid recurrence after curative gastrectomy].

A 16-year-old female patient with gastric cancer was recently treated at our institute. She had macroscopically curative surgery, but relapsed to die 7 months after surgery due to peritoneal dissemination. We experienced three teen-agers over past 45 years, who were 0.019% of all cases treated in our institute. Histological type of these cases was undifferentiated adenocarcinoma, exposing to serosa. Though they had suffered abdominal discomfort for long time, proper diagnosis was not done due to their young age. Even the teen-ager who has abdominal complaints should be subjected to a thorough examination of gastrointestinal tract. Oncogene analysis should be done for the familial strain of gastric cancer.

Adenocarcinoma↗

PubMed1994

[Indication for the lymph node dissection of gastric cancer based on the pattern analysis small of lymphatic spread].

A total of 8,230 cases of gastric cancer treated at CIH were subjected to the analysis of the pattern of lymphatic spread with an aim of getting indication for the lymph node dissection of Small gastric cancer. Modified dissection (D1-alpha) is indicated for the patients with following conditions: 1) every elevated or flat type mucosal cancer, 2) excavated (IIc) type mucosal cancer less than 10mm in diameter, 3) elevated or flat type submucosal cancer less than 10mm in diameter, 4) excavated submucosal cancer less than 5mm in diameter. Extended dissection (D2 + alpha) is indicated for small cancer which exposed to serosa. Cancer in the upper thirds needs total gastrectomy or cardiectomy according to the state of #5 and 6 nodes, with complete dissection of #1 to 11 nodes associated with sampling of #16 nodes. Total gastrectomy with complete dissection of #1 to 11 nodes and sampling of #16 nodes is indicated for the advanced small cancer in the middle thirds, and total gastrectomy with complete dissection of #1 to 13 nodes and sampling of #14, 16 nodes is indicated for cancer in the lower thirds.

Humans↗

PubMed1994

[The analysis of prognosis of patients with gastric cancer with the nodal stage(N, n) and the number of involved lymph nodes].

Now we use the nodal grade (N, n) as a prognostic indicator in patients with gastric cancer according to the general rules for the gastric cancer study. But there are both of patients with good and poor prognosis in the same nodal grade. Then we analyzed the survival of patients with gastric cancer based on the nodal grade and the number involved lymph nodes, and discussed the new prognostic indicator with both of them. We classified the three groups based on the number of involved nodes as follows: 0.1-4.5-. There is the differences in survival between each pair of groups statistically. The relationship between the nodal grade (N, n) and the number of lymph node metastasis is that the survival of patients with involved nodes more than five is equal to the survival of the patients with high nodal grade and involved nodes 1-4. Therefore it suggest that the new grading consisting of them will be more better prognostic indicator.

Humans↗

PubMed1994

[Prognostic factors of the gastric cancer patients without distant metastasis].

From 1946 to 1990, 10,485 patients with gastric cancer were been surgically treated in the Cancer Institute Hospital, Tokyo. Retrospectively, we analyzed prognostic factors, especially in those without distant metastasis. Prognosis of the patients with tumors which invaded the proper muscle layer improved dramatically (from 70% to 90%). However, patients who had advanced tumors with serosal invasion did not show good survived (from 20% to 40%). To improve the prognosis of patients with serosal positive gastric cancer, a new and effective prophylactic therapy for peritoneal recurrence is needed.

Humans↗

PubMed1994

[Multi-variate analysis of prognostic factors in gastric cancer with Cox' proportional hazard model].

A total of 8,993 cases of gastric cancer which were undergone gastrectomy at Cancer Institute Hospital, Tokyo were subjected to the multi-variate analysis of prognostic factors in gastric cancer. Relative ratio of hazard risk indicated the rank of importance in prognostic factors as the following order: Hepatic metastasis, radicality of surgery, macroscopic tumor type, serosal involvement, number of involved lymph node, and grade of lymph node metastasis. Difference in the results of analysis was observed between mono- and multi-variate analysis in the following categories: site of primary lesion, type of resection, and chemotherapy. These results suggested the importance of multimodality therapy to achieve the absolute curative surgery for advanced cancer, and also the importance of multi-variate analysis for the proper evaluation of prognostic factors.

Aged↗

PubMed1994

[The accuracy and clinical issue of preoperative diagnosis of gastric cancer].

We discussed the accuracy and clinical issue of preoperative diagnosis for 764 patients with gastric cancer from 1987 to 1990. The accuracy of diagnosis, location, tumor size, wall invasion, involved lymph node were 81.8, 80.5, 62.2, 82.5% respectively. The clinicopathological characteristics of the regions which we missed preoperative diagnosis are infiltrating type and scirrhous type in diagnosis of tumor size, and large tumor in diagnosis of wall invasion. Especially in the case of early gastric cancer, we missed diagnosis of wall invasion of the regions with clinicopathological characteristics as follows: depressed type, undifferentiated type and ulceration in lesions. Now it is difficult to diagnosis wall invasion before surgery, so we have to be careful to determine the indication of endoscopic resection or limited operation for early gastric cancer, especially with clinicopathologic characteristics stated as above.

Diagnosis, Differential↗

PubMed1994

[Left upper abdominal evisceration for advanced gastric cancer].

To evaluate the clinical significance of the surgical procedure of left upper abdominal evisceration (LUAE), we analysed the prognosis of patients who received LUAE in the Cancer Institute Hospital from 1980 to 1990 using pair matching analysis. Survival benefits were observed in the patients with the tumor located in the upper or middle part of the stomach, and especially in those with Borrmann type 4 gastric cancer. Even in cases of peritoneal dissemination, patients who received LUAE survived longer than those with conventional total gastrectomy. These results indicated that LUAE should be a standard surgical approach for Bormann type 4 gastric cancer.

Aged↗

PubMed1994

[The changes in the treatment of early gastric cancer--endoscopic mucosal resection and limited (nerve preserving) operation].

We have been trying to perform endoscopic mucosal resection (ER) since 1987, and limited operation since 1985 (nerve preserving operation since 1991) for early gastric cancer. 205 patients were performed ER from 1978 to 1990, 78 patients were performed limited operation from 1985 to 1993. We perform ER according to the indication as follows: 1) differentiated IIa type, size approximately 2 cm, 2) differentiated IIc type, size approximately 1cm, Ul(-), 3) undifferentiated IIc type, size approximately 5mm, Ul(-). And the indication of limited operation is the patients with intramucosal cancer and tumor size approximately 2cm. Up to date, we have never experienced recurrence of these patients undergone ER or limited operation. As to QOL, these therapy will be expected to improve QOL of early gastric cancer patients, especially per os and body weight loss after surgery.

Gastrectomy↗

PubMed1994

[The treatment and clinical issue of gastric cancer with infiltrating the adjacent organs].

We discussed the advances and clinical issue including complications in the treatment of gastric cancer infiltrating the adjacent organs. Recent years, the proportion of the patients with gastric cancer infiltrating the adjacent organs are decreasing, but there isn't remarkable advances in the treatment result of them. That is due to the fact that about one half of them has distant metastasis, such as peritoneal dissemination or liver metastasis. Whatever the survival rate of the patients who was performed combined resection is better than unresected cases. The postoperative complications of the combined resection cases is two times as much as the uncombined resected cases. Therefore we should perform combined radical resection for the patients without distant metastasis, and for the patients with distant metastasis, we should perform palliative surgery for the purpose of improving QOL.

Adult↗

PubMed1994

[Meta-analysis of 10 postoperative adjuvant chemotherapies for gastric cancer in CIH].

Six adjuvant chemotherapy protocols with 10 chemotherapy regimens were subjected to meta-analysis with an aim to clarify the survival benefits of adjuvant chemotherapy in gastric cancer. All adjuvant chemotherapies were compared with surgery alone, in cases from 1959 to 1982 in the Cancer Institute Hospital, Tokyo in the setting of controlled randomized study; and 1,177 gastric cancer patients with curative surgery were entered the studies. Pooled odds ratio and its 95% confidence interval was 0.63(0.51-0.78). The results suggested the survival benefits of adjuvant chemotherapy with mitomycin C and/or 5-fluorouracil in gastric cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1994

[Treatment of recurrent gastric cancer].

The recurrence rate of resected gastric cancer was 31.9%. The rate was in creasingly higher in proportion to the lack of radicality. The most common type of recurrence was peritoneal dissemination, followed by hematogeneous metastasis, local recurrence, and distant lymph node metastasis. The treatments for recurrence were surgery (9.3%) and chemotherapy (16.1%). Systemic chemotherapy (intravenous iv) was common, and local chemotherapy (intraarterial ia, intraperitoneal ip) was rate. The efficacy of systemic chemotherapy (iv) for recurrent gastric cancer without local recurrence was suggested. The efficacy of local chemotherapy (ia) was suggested for peritoneal dissemination and local recurrence.

Adult↗

PubMed1994

How extensive should lymph node dissection be for cancer of the thoracic esophagus?

From 1985 to 1992, 171 patients with cancer of the thoracic esophagus underwent esophagectomy with systematic dissection of regional lymph nodes including cervical nodes. The hospital mortality rate was 5.3%. The dissected nodes were classified into four groups: the deep cervical (C), upper mediastinal and cervical paratracheal (U), middle and lower mediastinal (L), and upper perigastric (G) groups. The U group mainly consisted of nodes beside the recurrent laryngeal nerves. The phase of cancer infiltration of lymph nodes was evaluated by the total number and the distribution of involved nodes. Of cases with nodal involvement, only 37% were in the late phase, in which more than seven nodes or in which the U, L, and G groups were all involved. Of cases in the earliest phase in which only one node was involved, 93% had either the U or G group involved. The C group of nodes was infrequently involved until the late phase. Cancer had metastasized to the U and G groups across a considerable anatomic distance even in earlier phases. Outcomes of the cases with nodal involvement not in the late phase were satisfactory; the cumulative survival was 60% at 3 years and 54% at 5 years. Systematic nodal dissection would benefit even cases with nodal involvement, unless the disease is in the late phase. Nodes beside the recurrent nerves and upper perigastric nodes should be dissected with higher priority, though they are located anatomically distant.

Carcinoma, Squamous Cell↗

PubMed1993

Psychological stress increases serotonin release in the rat amygdala and prefrontal cortex assessed by in vivo microdialysis.

The effects of psychological stress on serotonin (5-HT) release were studied in the basolateral amygdaloid nucleus and the prefrontal cortex in conscious rats with in vivo microdialysis. Psychological stress, wherein emotional factors were predominantly involved, significantly increased extracellular 5-HT levels in these two areas. These findings suggest that activation of serotonergic neurons in these brain regions is involved in the emotional and/or cognitive states in animals.

Acoustic Stimulation↗