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Biomedical subjects

S Koga

Publications and source records attributed to S Koga.

At least 271 records · Page 15Linked to original sources

Proximal gastrectomy as the surgical procedure of choice for upper gastric carcinoma.

To assess the efficacy of proximal gastrectomy in the treatment of upper gastric carcinoma, we analyzed clinical data from patients with lesions confined to the upper third of the stomach (group 1) and from patients with lesions which, while primarily located in the upper portion of the stomach, showed spread to the body of the stomach (group 2). Patients in group 2 showed more metastatic lymph node involvement, particularly of the infrapyloric lymph nodes, which were not included in lymphadenectomy accompanying proximal gastrectomy. None of the group 1 patients demonstrated metastasis to the infrapyloric lymph nodes. The postoperative 5-year survival rate in curatively operated group 1 patients was not significantly different between those treated by proximal gastrectomy and those subjected to total gastrectomy. We conclude that proximal gastrectomy is indicated in patients with upper gastric carcinoma when it is confined to the upper third of the stomach.

Gastrectomy↗

Pathological characteristics of gastric cancer that develop hematogenous recurrence, with special reference to the site of recurrence.

The pathologic characteristics of gastric cancer in 57 patients with hematogenous recurrence were pathologically analyzed by the site of recurrence. In recurrence of gastric cancer that developed in the liver, macroscopic observation revealed that cancers of Borrmann type 2 and 3 were most frequent. Microscopic examination revealed that the rate of occurrence of the medullary type of differentiated or poorly differentiated adenocarcinoma were high and that there were relatively frequent invasion by cancerous cells of the blood vessel that were closely related to the hematogenous metastasis. On the other hand, with respect to recurrence of gastric cancer that had developed in the lung or bone, Borrmann type 3 and 4, respectively, were more frequently observed. In these cases, microscopic analysis revealed that these cancers were poorly differentiated adenocarcinomas. In gastric cancer with bone recurrence, the rate of recurrence of the scirrhous type of tumor were higher than that of other types. It is important, for the management of patients after gastric cancer surgery, to predict possible hematogenous recurrence and its site by evaluation of the pathologic characteristics of the gastric cancer.

Adenocarcinoma↗

Immunological evaluation after splenectomy for hairy cell leukemia--a case report.

Immunocompetence is generally reduced in patients with hairy cell leukemia (HCL), and splenectomy is advocated by many authorities as being the initial treatment of choice for HCL. A 46-year-old Japanese man with HCL underwent a splenectomy and was studied, with respect to immunological parameters, pre- and post-operatively. Preoperative analysis of the T cell subsets showed decreases in the proportions of OKT3 positive cells, OKT4 positive cells and OKT8 positive cells; a decrease in the OKT4/OKT8 ratio; and a markedly reduced lymphocyte blastic response in peripheral blood. After splenectomy, the increase in the proportion of OKT4 positive cells was greater than in that of OKT8 cells and the lymphocyte blastic response was also improved. The patient's post-operative course has been uneventful and immunological improvement is still recognizable now, 1 year after splenectomy.

B-Lymphocytes↗

Alpha-fetoprotein-producing pancreatic carcinoma: case report and review of the Japanese literature.

An autopsy was performed of a patient who succumbed to pancreatic carcinoma and in whom an unusually high level of serum alpha-fetoprotein (AFP) (84,000 ng/ml) was obtained. An immunohistochemical approach, utilizing the peroxidase-antiperoxidase method, proved that AFP was confined within pancreatic carcinomatous cells of the primary lesion and liver metastases. No AFP-positive cells were ever observed in the hepatocytes adjacent to the metastatic lesions in the liver. It may be inferred that, in this particular case, the carcinomatous cells themselves synthesize AFP. The sites of production of AFP in AFP-positive pancreatic carcinoma were discussed in a review of the literature.

Adenocarcinoma↗

Induction of diffuse necrotizing enterocolitis by anticancer chemotherapy.

Fulminant, necrotizing colitis is a frequent, and generally fatal, complication of severe granulocytopenia, occurring during the treatment of hematological malignancies. In these cases, the patient complains of severe peritonitis, including nausea, vomiting, abdominal pain, diarrhea or melena, and a high temperature. Here, a rare case of anticancer chemotherapy-induced diffuse necrotizing enterocolitis throughout the entire intestinal tract is presented, which developed in a patient who did not have a hematologic malignancy but who had colon cancer, the only clinical symptom of which was watery stools, without any evidence of peritoneal irritation. Full attention should be paid to progressive diarrhea in patients with malignancies during anticancer chemotherapy.

Cisplatin↗

Prediction of the prognosis of liver cirrhosis in Japanese using Cox's proportional hazard model.

Data on 155 patients with liver cirrhosis were analyzed, using Cox's proportional hazard model. Twenty variables were screened, using a multiple linear regression analysis in a stepwise manner and 6 were considered to reflect the prognosis of cirrhotics. Three of the 6 variables were significantly prognostic, i.e. ascites, atrophy of the right lobe of the liver seen on liver scintigram and the concentration of serum albumin. The prognostic index (PI) for each patient was calculated by adding all the products of scores of these three variables with the corresponding coefficient: PI = 0.895 X ascites (absent = 0, present = 1) + 0.983 X atrophy of right lobe of the liver on the liver scintigram (absent = 0, present = 1) + (-0.561) X serum albumin (g/dl). According to the PI, the subjects were separated into three groups; group 1: PI less than -1.9, group 2: -1.9 less than or equal to PI less than -0.6, group 3: PI greater than or equal to -0.6. The global 5- and 10-year survival rates of each group were 80% and 65% in group 1, 50% and 30% in group 2 and 12% and 0% in group 3, respectively. Four of the 14 deaths in group 1, 8 of 47 in groups 2 and 10 of 24 in group 3 were caused by hepatocellular carcinoma. Our observations suggest that advanced stage cases of cirrhosis are at a high risk concerning development of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

Experimental study of antitumor effect of methyl-B12.

We examined the antitumor effect of vitamin B12 (methyl-B12) using C3H/He, C57BL/6 and BALB/C mice for animals and MH134 hepatoma ascites cells, Lewis lung cancer cells and Ehrlich ascites tumor cells for tumor cells. At 1.0-10 micrograms/ml, methyl-B12 enhanced PHA- and Con-A-induced lymphocyte blastoformation of C3H/He mice. The growth of MH134 tumors on the backs of C3H/He mice were suppressed by the 7-day administration of 50 or 100 micrograms/day i.p. and their survival was longer than that of untreated mice. However, methyl-B12 administration did not positively affect the survival of C3H/He mice that had been irradiated with 60Co 300 R on the day before tumor cell inoculation. The growth of Ehrlich ascites tumor cells inoculated into BALB/C mice was also reduced at 17 and 19 days after tumor inoculation by administration of methyl-B12 50 micrograms/day i.p. and the mice survived longer than the untreated mice.

Animals↗

Carcinoembryonic antigen in gastric cancer patients.

Carcinoembryonic antigen (CEA) levels were determined in 252 gastric cancer patients. In patients with resectable cancer, the preoperative CEA values and CEA positivity rates were 2.4 +/- 1.5 ng/ml and 7.7% for stage I, 24.9 +/- 72.0 ng/ml and 10.0% for stage II, 21.6 +/- 84.1 ng/ml and 17.9% for stage III, and 6.3 +/- 8.4 ng/ml and 27.1% for stage IV cancers, respectively. In patients with nonresectable cancers, the CEA value was 83.0 +/- 235.5 ng/ml, the CEA positivity rate was 47.8%. Overall, of 252 patients with primary gastric cancer, 47(18.7%) were positive for CEA. In patients with cancer recurrence, the CEA value averaged 41.8 +/- 101.8 ng/ml, the positivity rate was 63%. This rate increased as the cancer stage increased; it was highest in gastric cancer patients with liver metastasis. In 4 of 13 patients with recurrence, an elevation in CEA was observed about 4.8 months before the clinical detection of cancer recurrence. Our results suggest that in gastric cancer patients, the preoperative and periodic postoperative assay of CEA levels has predictive value in determining cancer stage, progression and recurrence.

Carcinoembryonic Antigen↗

Decreased interleukin 1 activity in culture supernatant of lipopolysaccharide stimulated monocytes from patients with liver cirrhosis and hepatocellular carcinoma.

Immunoregulatory function of peripheral blood monocytes was studied in patients with hepatocellular carcinoma (HCC) and liver cirrhosis (LC), by assaying interleukin 1 (IL-1) and prostaglandin E2 (PGE2) in the culture supernatant of lipopolysaccharide-stimulated monocytes. IL-1 activity of the monocyte culture supernatant without indomethacin was decreased in patients with HCC and LC, compared with that of controls. The activity was lower in patients with HCC than that in those with LC. The PGE2 content of the culture supernatant of monocytes from patients with LC and HCC was increased, compared to normal controls. To avoid the effect of PGE2 on the IL-1 assay, we cultured the monocytes with addition of indomethacin and assayed IL-1 activity in the culture supernatant. As a result, monocyte IL-1 production was increased in patients with HCC and LC, compared with normal controls. The decrease in IL-1 activity of the supernatant without indomethacin of patients with LC and HCC was considered to be due to increased secretion of PGE2 by the monocytes. Therefore, monocytes from patients with HCC and LC had an increased capacity of secreting both IL-1 and PGE2 over normal controls, but the effect of the suppressor function (PGE2 secretion) dominated in these patients.

Adult↗

Effects of long-term parenteral nutrition on gastrin release in dogs.

The effects of long-term total parenteral nutrition (TPN) on gastrin release were evaluated in dogs. The antral mucosal gastrin level was also measured before and after TPN. Longterm TPN reduced the mucosal gastrin levels, so that the serum gastrin release was depressed depending on time. However, the reduced levels gradually recovered after resumption of oral feeding. Diminished values had almost returned to pre-TPN levels by the 7th day.

Animals↗

[Positron emission computed tomography].

Positron emission computed tomography (PET) provides high quality tomographic images of the heart with accurate attenuation correction. The use of various compounds labeled with ultra-short lived positron-emitting radionuclides, such as 11C, 13N, 15O and 18F, allows physiological and biochemical measurements in vivo. Recently, a few institutions in Japan have introduced this technique into cardiology. Although it requires an enormous cost both for the equipment and for running the system, it is expected to play a major role in nuclear cardiology in the near future.

Carbon Radioisotopes↗

[Bone disorder in long-term survival after gastrectomy with reference to bone mineral content].

To investigate post-gastrectomy metabolic bone disorder, the radial bone mineral content (BMC) was measured with 125I-photon absorptiometry in 131 long-term survivors, the postoperative periods ranged 3 to 30 years. Sixty-eight patients (52 per cent) showed abnormally low BMC levels compared with healthy controls. The 43 patients with total gastrectomy manifested a higher incidence of decreased BMC levels than did the other 88 patients with partial gastrectomy. In females, patients subjected to the Billroth II procedure manifested low BMC values. The extent of the decline in BMC was much higher in females than in males, and higher in totally gastrectomized patients than in partial gastrectomy group. At more than 10 years postoperatively many patients manifested markedly low BMC levels; in totally gastrectomized patients this finding was made at less than 5 years postoperatively. A significant correlation was found between the extent of the decreased BMC levels and the postoperative periods. Of the patients with decreased BMC values, 30 per cent of them gave histories of osseous symptom after gastrectomy, however, 70 per cent of patients were asymptomatic. Based on the results, in long-term survival treated by total or partial gastrectomy, many patients present an osteopenic status, however, the number of those with clinically manifested bone disease such as osteomalacia may be low.

Age Factors↗