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Biomedical subjects

R Tsuchiya

Publications and source records attributed to R Tsuchiya.

At least 181 records · Page 10Linked to original sources

Size of the tumor and other factors influencing prognosis of carcinoma of the head of the pancreas.

Extent of the tumor in carcinoma of the pancreas seems an important factor in stage classification. The purpose of this report is to present the results of studies on the relationship between the size of the tumor (T) and prognosis, and the correlation between the size and the other factors influencing prognosis such as invasion to the pancreatic capsule, invasion to the retroperitoneal tissue, metastasis to the regional lymph node, and so on. T was divided into four groups: T1, T2, T3, T4. Tumor diameter of 2 cm or less was designated as T1, 2.1-4 cm as T2, 4.1-6 cm as T3, and 6.1 cm or more as T4. Case reports of 163 patients who underwent resection of carcinoma of the pancreatic head were submitted by 10 major institutions and retrospectively analyzed. There was significant differences in 1-year cumulative survival rates between T1 and T3, T1 and T4, and T1 and T2 + T3 + T4, but no significant difference in 3- or 5-year survival rates among the T groups. The incidence of no capsular invasion, no retroperitoneal invasion, and no lymph node metastasis had a tendency to decrease along with increase in tumor size and the incidence of definite capsular invasion, and lymph node metastases increase with increase in the size. Attempts to diagnose tumors of less than 2 cm should be made to ameliorate the poor surgical results. However, it should be stressed that even in the T1 group regional lymph node metastases were seen in about half of the cases.

Adult↗

[Surgical results of severe acute pancreatitis with special consideration of the severity of pancreatitis].

The surgical treatment of acute pancreatitis remains controversial. Since 1975, we have treated 70 patients with acute pancreatitis. In 36 with severe acute pancreatitis who were not responding adequately to medical intensive treatments, mobilization and drainage of pancreatic exudate from pancreatic bed and retroperitoneal cavity (M-D procedure) were carried out. Thirty-six operative cases were classified into 8 edematous, 7 hemorrhagic, and 21 necrotizing. Edematous pancreatitis showed a tendency of early development of severe symptoms such as enzymatic encephalopathy. Eight of 36 patients who underwent M-D procedure died (22.2 percent), but the rate became 13.8 percent after excluding 3 who died of unrelated causes. Postoperative complications were most frequently encountered in the patients with gallstone pancreatitis. Obstruction of the alimentary tract due to pancreatic or peripancreatic abscess was most serious late complication. Six of the eight were required reoperations and three of them died of further complications which were developed after reoperations. The rate of curability of M-D procedure was 84.8 percent. These data suggest that M-D procedure is highly effective in the treatment of early case of severe acute pancreatitis.

Acute Disease↗

A novel combination of K-ras and myc amplification accompanied by point mutational activation of K-ras in a human lung cancer.

Amplifications of two oncogenes, c-K-ras-2 and c-myc, were found in a human lung giant cell carcinoma (LGCC) Lu-65, which is maintained in nude mice. The extent of c-K-ras-2 and myc amplifications were estimated to be 10- and 8-fold, respectively, by means of the Southern hybridization procedure. In addition, NIH3T3 cells were transformed by transfection of Lu-65 DNA and the transforming gene was identified as c-K-ras-2. c-K-ras-2 genes were cloned from a gene library of Lu-65 and a single point mutation causing a substitution of cysteine for glycine in codon 12 was found by DNA sequencing. It was concluded that the amplification of the c-myc and c-K-ras-2 genes are accompanied by point mutational activation of c-K-ras-2 in the human LGCC Lu-65. This is the first report of multiple gene amplification accompanied by a point mutation of oncogenes in human cancer cells, providing further support for the idea that co-operation of at least two activated cellular oncogenes is required for carcinogenesis.

Amino Acid Sequence↗

Large cell carcinoma of the lung associated with marked eosinophilia. A case report.

A case of large cell carcinoma of the lung which produced eosinophil colony stimulating factor and eosinophil chemotactic factor was reported. A 52-year-old Japanese man with a tumor in the left upper lobe of the lung underwent left pneumonectomy. Marked eosinophilia persisted especially after recurrence, with a maximum peripheral leukocyte count of 161,000/mm3, of which 78% consisted of eosinophils. The patient died of pulmonary insufficiency 18 months after surgery. At autopsy, metastatic tumor tissues and almost all organs were markedly infiltrated with eosinophils, especially the spleen, and there was marked proliferation of eosinophils in the bone marrow. Eosinophil colony stimulating factor production by the transplanted tumor in a nude mouse was confirmed by use of a human bone marrow culture assay system. Eosinophil chemotactic factor production by metastatic tumor tissue also was proved by a modified micro-filter technique.

Biological Assay↗

Results of mobilization and drainage of the pancreas for acute pancreatitis.

The surgical treatment of acute pancreatitis remains controversial. Since 1969, we treated 60 patients with acute pancreatitis. In 34 with severe acute pancreatitis who were not responding adequately to intensive medical care, surgical intervention was made by mobilization of the pancreas from retroperitoneal tissue and drainage of the pancreatic bed (M-D procedure). Thirty-four operative cases were classified into 7 edematous, 7 hemorrhagic, and 20 necrotizing. Macroscopic findings of the pancreas did not correlate either to the severity of the acute pancreatitis or to the mortality rate. Eight of 34 who underwent M-D procedure died (23 per cent), but the rate became 14.7 per cent after excluding 3 who died of unrelated causes. These data suggest that the M-D procedure is highly effective in the treatment of early cases of severe acute pancreatitis. There was an associated marked reduction in the mortality rate with the prophylactic use of broad spectrum antibiotics. With M-D procedure, there was a low incidence of late sequelae of pancreatic or peripancreatic abscess.

Acute Disease↗

[Morphological studies on the pathogenesis and treatment of hepatolithiasis].

Review of 108 patients with hepatolithiasis showed a recent increase of primary intrahepatic gallstones. 55 per cent of cases with hepatolithiasis had their gallstones in the left intrahepatic bile ducts. Clinicopathological study on the resected hepatic specimens of 33 patients revealed numerous intrahepatic periductal glandular formations. Periductal glandular formations were classified into the intramural and extramural glands. The mucous substances which might had been released from the periductal glands seemed to play a role in the formation of stones in combination with bilirubin pigments, cholesterin, bacterial organisms, cellular debris and other bile component. Intrahepatic gallstones and extramural glands were seen in the intrahepatic segment and area ducts. The defunctionalized atrophic hepatic lobe or segment should be resected in order to remove the calculi completely and to prevent the recurrence.

Adolescent↗

Preparation of polyamine antibody and its use in enzyme immunoassay of spermine and spermidine with beta-D-galactosidase as a label.

An enzyme immunoassay for polyamines is described which uses beta-galactosidase labeled spermine and antiserum raised in rabbits against spermine-bovine serum albumin synthesized by coupling spermine to mercaptosuccinylated bovine serum albumin with a bifunctional cross-linker, N-(gamma-maleimidobutyryloxy)-succinimide. The lower limit of detection by this assay, which involves a double antibody technique for the separation of antibody-bound and free antigen, was 1 ng of spermine per tube. The anti-spermine serum showed 88% cross-reaction with spermidine but only 0.13% with putrescine, 0.08% with 1,3-diaminopropane, and 0.04% with cadaverine. The method has been used to measure serum polyamine levels in healthy subjects and cancer patients, in whom mean concentrations of 58.1 ng/ml and 94.8 ng/ml (as spermine), were respectively noted. This enzyme immunoassay is specific, accurate and easy to perform, and appears suitable for routine clinical use.

Animals↗

A study on clinical spectrum at acute stage of pancreatitis--a proposal to grade severity in mild cases.

Two hundred patients with pancreatitis were studied in respect to incidence and severity of 26 items of symptoms, signs and laboratory data. Factor and cluster analyses were performed on correlation coefficients between the items and both gave similar results which allowed classification of the items into three groups: the 1st group consisting of symptoms and objective signs, the 2nd group consisting of laboratory test items related to liver function and the 3rd group consisting of test data concerning acute inflammation of the pancreas. The 1st, followed by the 3rd item-group, had a high correlation with the overall severity judgement made by individual physicians and with that by the central committee concerning a CDP-choline trial. Impairment in the 2nd item-group was particularly apparent in patients with biliary-associated pancreatitis. Subsequent scalogram analysis was carried out to investigate the relationship between the incidence of the items and overall severity. Finally, operational criteria for the assessment of overall severity were proposed.

Acute Disease↗

[Evaluation of the lipid and glucose metabolism on the apancreatic status with insulin supplement and with pancreatic autotransplantation].

To evaluate the effect of pancreatic fragments transplantation on glucose and lipid metabolism in the apancreatic status, 22 healthy mongrel dogs were totally pancreatectomized and then divided into three groups, (1) 5 dogs without any supplement , (2) 5 dogs with insulin replacement, and (3) 12 dogs with additional pancreatic fragments transplantation. In these three groups, changes in fasting plasma sugar, triglyceride, total cholesterol, phospholipid and lipoprotein fractions were studied. Stability of serum glucose levels were compared between the dogs with insulin replacement and those with transplantation by using glucose infusion and insulin test. Without insulin replacement or transplantation, apancreatic dogs showed high serum glucose levels immediately after total pancreatectomy. With pancreatic transplantation, serum glucose levels and lipids were well controlled within normal limits for a long time period after the operation. However, in the dogs with insulin replacement, serum glucose levels and lipids were remarkably unstable in fasting period and also showed easily tendencies to become hypoglycemic status by insulin test and diabetic ketoacidosis by glucose infusion test as compared with those in the transplanted dogs.

Animals↗