To formulate a rational approach for the surgical treatment of patients with superficial esophageal cancer (SEC), tumor spread was clinicopathologically studied in 89 patients with SEC. There were 31 mucosal and 58 submucosal tumors. Lymph node metastases were not found in any of those with a mucosal tumor, while one or more lymph nodes were positive for cancer in 41.4% of those with a submucosal tumor. Furthermore, cancer metastasized to extramediastinal nodes, including cervical and abdominal nodes, in 14 patients, accounting for 58.3% of those with nodal metastasis. The 5-year survival rate was 100% and there were no recurrences after esophagectomy in those with a mucosal tumor, whereas the survival rate of those with a submucosal tumor was 64.3% at 5 years (p < 0.01). Based on the different biological behavior of mucosal and submucosal esophageal cancer, we conclude that mucosal tumors may be adequately treated by any type of local resection but submucosal tumors require a subtotal esophagectomy with systematic lymphadenectomy involving the cervical, mediastinal, and abdominal nodes for cure.

Adult↗

PubMedDate not supplied

In vitro keratinization of normal human salivary gland cells.

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Antibodies, Monoclonal↗

PubMedDate not supplied

Effects of prostaglandin E1 on the cardiovascular response to tracheal intubation.

STUDY OBJECTIVE: To evaluate the efficacy of prostaglandin E1 in attenuating the hypertensive response to laryngoscopy and intubation. DESIGN: Controlled, comparative, and randomized study. SETTING: Induction of anesthesia for elective surgery at a university hospital. PATIENTS: Thirty normotensive patients (ASA physical status I) undergoing elective surgery divided into three groups. Each group consisted of ten patients. INTERVENTIONS: Anesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. Either 0.3 micrograms/kg of prostaglandin E1, 0.6 micrograms/kg of prostaglandin E1, or saline (control) was injected 15 seconds before starting direct laryngoscopy (within 30 seconds), which was attempted 2 minutes after administration of thiopental sodium and vecuronium. MEASUREMENTS AND MAIN RESULTS: Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increases following tracheal intubation were significantly less in prostaglandin E1-treated patients than in the control group (p less than 0.05). CONCLUSIONS: A single rapid intravenous administration of prostaglandin E1 is a practical pharmacologic and safe method to attenuate the hypertensive response to tracheal intubation. The use of 0.6 micrograms/kg of prostaglandin E1 as a supplement during induction is recommended for reducing the pressor response to intubation on the basis of rate-pressure product and mean arterial pressure following intubation as an index.

Alprostadil↗

PubMedDate not supplied

Pathomechanism of atlantoaxial rotatory fixation in children.

The pathomechanism of atlantoaxial rotatory fixation (AARF) was studied using roentgenography and computerized tomography in affected children as well as cadaver studies of upper cervical spine anatomy. The increased incidence of AARF in children may be related to certain anatomical differences between children and adults. The dens-facet angle of the axis was steeper in children than in adults. Meniscus-like synovial folds were found in the C0/1 and C1/2 facet joints of the spines of children but not in those of adults.

Adolescent↗

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Inhibitory effect of barbiturates and local anaesthetics on protein kinase C activation.

A calcium- and phospholipid-dependent protein kinase C subspecies purified from rat brain was inhibited by thiamylal, thiopentone, pentobarbitone, mepivacaine and bupivacaine. This was attributed to the inhibition of the activation process rather than to direct interaction with the active site of the enzyme. It is well established that unsaturated diacylglycerol markedly increases the affinity of protein kinase C for calcium ions. Kinetic analysis suggested that pentobarbitone brought about the inhibition by competing with the diacylglycerol diolein and that mepivacaine and bupivacaine competed with the phospholipid phosphatidylserine used in the assay. The possibility exists that the effects of local anaesthetics on the function of various tissues are due, in part, to an inhibitory action on protein kinase C.

Anesthetics, Local↗

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Carcinomas involving the esophagogastric junction.

In order to avoid confusion in categorizing malignant lesions for surgical treatment, a definition and criteria of carcinomas significantly involving the esophagogastric junction (ECJ-Ca) and those of gastric cardia less significantly involving the esophagogastric junction (eC-Ca) are proposed, devised as this study was from a practical viewpoint. A comparative analysis of carcinomas of these groups was carried out, the control group being those carcinomas situated mainly in the upper third segment of the stomach but not involving the esophagogastric junction (C-Ca). Carcinomas of these regions can be determined by the EGJ-Index (EGJ-I) calculated through the following formula: EGJ-Index = [( Length of the esophageal portion of the lesions)/(length of the of the esophageal portion + gastric portion of the lesion])x1,000. Thus lesions of these regions are easily and practically classified as follows: [I]: EGJ-Ca 250 less than or equal to EGJ-I less than or equal to 750, 59 cases; ( II]: eC-Ca 0 less than or equal to EGJ-I less than 250, 88 cases; [III]: C-Ca 0 = EGJ-I, 208 cases. We found these categories quite suitable for practical use.

Carcinoma↗

PubMedDate not supplied

[Lung transplantation in dogs. I. Autotransplantation].

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Animals↗