Biomedical subjects
Publications and source records attributed to S Akai.
Thirty one patients with gallbladder cancer (GBC) and 32 healthy controls were typed using antisera against 12 HLA-A, 31 HLA-B, 7 HLA-C and 13 HLA-DR antigens. The DR4 frequency of 61.3% (19/31) in GBC was significantly different from that of 28.1% (9/32) in the control (p = 0.00794 by Fisher's exact test). The relative risk and the etiologic fraction were 4.0 and 0.46, respectively.
We examined the quality of life in the arterial infusion chemotherapy of hepatocellular carcinoma patients using a questionnaire. The questionnaire used a category scale method of five grades. The questions about the quality of life covered ten areas for investigation (appetite, discomfort pain, nausea, daily activities, sleep, fatigue, time with family and friends, thinking about illness and confidence in the treatment). We added up scale points after one week and those after two weeks after the treatment. Patients after one-shot infusion showed aggravated scale points of anorexia and discomfort. Patients after transcatheter arterial embolization showed scale points of abdominal pain, general fatigue and discouragement about illness. Scale points in matters of thinking about illness and confidence in the treatment informed us about confidence in the course of treatment and comprehension of illness by cancer patients. How do we measure the quality of our care? This is difficult, but we thought the rate of being at home in survival might furnish us with much information in respect to the treatment and the quality of our care. In 36 patients with hepatocellular carcinoma treated with transcatheter arterial infusion and embolization, the arithmetic mean survival time after treatment was 412.1 days and time at home was 305.6 days. The rate of being at home doing survival time was 74.2% after the arterial infusion chemotherapy in 39 patients. The rate of being at home in 9 cases with one-shot infusion of Adriamycin was 43.5% (111 days); that in 9 cases with infusion of Mitomycin C microcapsules was 86.6% (716 days); that in 17 cases with transcatheter arterial embolization using spongel was 72.0% (234 days),; and that in 4 cases with infusion using implantable reservoir was 84.6% (220 days). In non-resected patients with chemotherapy, the rate of being at home was 20.3% for 61 cases of gastric cancer patients, 30.7% for 11 cases of colon cancer, 9.6% for 14 cases of gallbladder cancer and 39.8% for 112 cases of lung cancer. The arterial infusion and embolization of hepatocellular carcinoma has made it possible to lengthen the time that patients may stay home and thereby assure good quality of life.
We reviewed 1074 surgically treated patients with biliary tract cancer (gallbladder 564, bile duct 510) in Niigata prefecture in the five-year period from 1982 to 1986. Analyses of regional distributions revealed the incidence of gallbladder cancer to be highest in the Ka-etsu district (northern part of prefecture) and lowest in the Jo-etsu district (south-western part of prefecture). The incidence of bile duct cancer was highest in the district controlled by the most northern public health center and lowest in Chu-etsu district (central part of prefecture). The incidences of gallbladder and bile duct cancers showed regional variations within the prefecture, localization being more pronounced for gallbladder cancer.
A case-control study of biliary tract cancer was conducted in Niigata prefecture where the mortality of the cancer is the highest in Japan. The cases were 109 patients with gallbladder cancer and 84 with bile duct cancer, and the controls were 386 sex- and age-matched neighborhood controls. For gallbladder cancer, a past history of biliary tract disease, a positive family history of cholelithiasis and a taste for oily foods were high risk factors. Intakes of animal proteins and fats such as fish, eggs, meat, etc., ingestion of vegetables and fruits, and taking snacks were low risk factors for gallbladder cancer. For bile duct cancer, a past history of biliary tract disease, a family history of cerebral vascular accident, a thin constitution and taking a small amount of foods were high risk factors, and a family history of heart disease, obesity, intakes of alcohol, animal proteins and fats, or frequent intakes of vegetables and fruits were low risk factors.
Spore rec-assay of human bile was conducted by the Bacillus subtilis test system to examine possible mutagenicity and co-mutagenicity. Of 26 samples examined, 8 (30.8%) showed mutagenic activity and 23 (88.5%) enhanced the mutagenic activity of mitomycin C.
This study was designed to examine the effects of information conflict and complexity on voluntary visual exploration quantitatively. 31 adults viewed each of 16 slides of geometrical figures and places for as long as they wished. The stimuli had two values of information conflict and complexity which had been calculated by means of structural information theory. Free looking times indicated that only when information conflict was low, voluntary visual exploration was positively correlated with complexity. Furthermore, voluntary visual exploration correlated positively with information conflict when complexity was low.
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Patients with advanced gastric cancer were treated with methotrexate-5-fluorouracil sequential therapy. In order to rescue of methotrexate toxicity on the normal proliferating tissue, leucovorin was administered orally to outpatients. As the comparative study, we examined plasma kinetics following oral administration of leucovorin (15 mg) in 6 patients with gastric cancer (received subtotal gastrectomy) and 5 normal subjects. In the patients, peak plasma concentrations of d-1-formyltetrahydrofolate and its main metabolite 5-methyltetrahydrofolate were found after 2 hrs. (7.35 X 10(-7) M, 3.09 X 10(-7) M), and in normal controls also both after 2 hrs. (1.01 X 10(-6) M, 4.89 X 10(-7) M). The active folate metabolite persisted for more than 6 hrs. at over 1 X 10(-7) M that could rescue normal tissue from methotrexate toxicity after leucovorin oral administration in the patients received subtotal gastrectomy.
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Four primary liver tumors and 19 secondary ones (8 gastric, 8 colorectal, 2 esophageal and 1 gall bladder cancer) were treated by intra-arterial infusion chemotherapy intermittently using implantable reservoir. Drugs used in this series were 5-Fluorouracil, Mitomycin C, Adriamycin, and Cis-platinum. They were infused every 2 weeks for outpatients. The antitumor efficacy was evaluated in terms of tumor regression measured by CT scan. The toxicity was slight and temporary. The total response rate was 23.1%, 50% survival period was 7 months, and 1-year survival rate was 24.2%. The response rate was 33.3%, and the 50% survival period was 7 months for 8 gastric cancer patients with liver metastasis. The result was not good, and we must improve the criteria of indication and devise a regimen. But the implantable drug delivery system has made it possible to lengthen the time that patients may stay home and assure good quality of life because of the freedom of movement, normal physical appearance, protection from infection, and reduction of mental burden, due to subcutaneous placement.
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The number of operations, regarded as the incidence, of breast cancer in Niigata Prefecture between 1972 and 1983 was surveyed. The age-adjusted incidence rate of female breast cancer in Niigata Prefecture has increased from 12.2 (per 100,000) to 21.1 (per 100,000) during the past 10 years, although the age-adjusted mortality rate has increased only slightly, from 3.7 to 4.2 (per 100,000) during that time. The age-adjusted incidence rate also increased in the middle-aged (61%) and elderly (41%) group, incidence increased only in the elderly group (74%). It has recently been reported that the aging phenomenon of breast cancer in Japan shows a Western-type tendency. In this paper, however, this phenomenon was considered to be due merely to the increase (24%) in the population of the elderly.
Major molecular species of human alpha-fetoprotein(AFP), which were separated as single components by serial affinity chromatography with concanavalin A(Con-A) and Lens culinaris agglutinin, were further resolved into several bands by affinity electrophoresis with erythroagglutinating phytohemagglutinin of Phaseolus vulgaris lectin(E-PHA). Among the newly separated main molecular species, both Con-A- and E-PHA-reactive AFP(AFP-1X1) was demonstrated, contrary to the known sugar specificity of Con-A and E-PHA, in addition to molecular species of AFP reacting with Con-A but not with E-PHA(AFP-1X0) and of AFP reacting with E-PHA but not with Con-A(AFP-0X1). AFP-0X1 was formed from AFP-0X0, and AFP-1X1 from AFP-1X0 by neuraminidase treatment; thus, AFP-0X1 and AFP-1X1 represent asialylated and AFP-0X0 and AFP-1X0 sialylated molecular species. AFP-1X1' and AFP-0X0' were present as minor components. AFP-0X0' had no affinity for E-PHA, and the affinity increased in the order of AFP's-0X0(or 0X1), -1X1', -1X1 and -0X1. Proportions of those components varied depending on the pathophysiological conditions of AFP production.
The effects of improvements of clinical diagnosis and treatment of gastric cancer on the decline in gastric cancer mortality rate in Niigata Prefecture were evaluated. Analysis of mortality statistics since 1950 and registries of surgical cases with gastric cancer in the 10 years from 1972 provided the following conclusions. (1) The age-adjusted gastric cancer mortality rate (the demography of Japan in 1965 was used for the standard population) began to decline in 1968, and the mean mortality rates were 60.5 per 100,000 population in 1958-1967 and 38.6 in 1981, showing 21.9 decrease in 14 years in Niigata Prefecture. (2) Surgical cases increased from 1,258 to 1,870, and those of early gastric cancer in particular showed a rapid increase from 133 to 421 in 10 years (1972-1981). (3) The age-adjusted early gastric cancer rate in surgical patients increased from 4.6 per 100,000 population to 11.5 within 10 years. Since the 5-year survival rate of patients with early gastric cancer is more than 90%, 30.1% of the decrease in the mortality rate should be attributed to patients with early gastric cancer who are surviving. (4) Improved diagnostic and therapeutic techniques for advanced gastric cancer might account for 16.0% of the decline in the mortality rate. (5) Overall, 46.1% of the decline in the mortality rate can be ascribed to improved diagnostic and therapeutic techniques, and the remaining 53.9% to a decreased incidence of gastric cancer.
Two cases of granular cell tumor of the breast are reported. This disease is uncommon; only 54 cases have been reported so far. Clinically, it resembled breast cancer. Its palpation is solid. It sometimes has a dimpling sign, and, on occasion, the X-ray diagnosis shows a spicule. Pathologically, the tumor has a tendency to infiltration. The tumor cells contain granules of different sizes. Straited muscles, mesenchymal cells and Schwann's cells have been pointed out as possible roigins of the tumor. It has also been explained as histiocytic granuloma. A decisive theory about its organic development, however, has yet to be established.
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