We report here the outcome of surgical treatment for gastric cancer in 54 patients over 80 years of age presenting from 1967 to 1989. The mean observation interval of the postoperative period was 24 days. In most cases, preoperative examinations revealed pulmonary, renal or cardiac disturbances. The postoperative morbidity rate was 40.7%, most commonly as a result of pulmonary complications. In the 2 patients with multiple organ disturbances, 1 died 1 day after operation following myocardial infarction and the other died of pneumonia 12 days postoperatively. Intensive care treatments were needed in the early postoperative period. The increased morbidity rate proved to be related to wide resectional procedures such as total gastrectomy, operative time in excess of 3 hours, and intraoperative blood loss greater than 300 ml (p less than 0.05). When adjustment for confounding variables was made in the multivariate discriminant analysis, the type of surgery proved to be a major independent risk factor related to postoperative complications. The majority of tumors (92.6%) could be removed by standard resectional procedures and curative operation was feasible for 36 (66.7%) patients. There were 24 deaths due to progression of the cancer. The crude overall 5-year actuarial survival rate was 23.8%, while the rate was 36.9% when correction was made for sex and age. The probability of long-term survival for patients in a relatively early stage of disease (T1-2, N0-1) was statistically better than for those with a more advanced disease (T3-4, N2, M1). Thus, even for patients in the 8th decade of life, gastric surgery can be considered, for carefully selected patients.

Aged↗

PubMedDate not supplied

Functional and numerical alterations induced by ethanol in the cellular immune system.

Ethanol was found to alter functioning and numbers of lymphoid cells of the cellular immune system in humans and rats. In in-vitro studies on human lymphocytes, a higher than 0.1% concentration of ethanol and acetaldehyde and acetic acid, the metabolites of ethanol, caused a decrease in the formation of E-rosettes. Methanol and propanol also resulted in a decrease in E-rosette formation. The natural killer (NK) cells varied in their ability to lyse tumor cells. In vitro, the NK-cell activity declined at higher than 0.2% concentration of ethanol. The NK activity in cells isolated from spleen and thymus of rats fed 1 g/dl or 7 g/dl ethanol did not differ significantly from the controls. Sprague Dawley rats fed 1 g/dl or 7 g/dl ethanol for 12 weeks had a significantly smaller thymus compared to the controls. Alveolar macrophages isolated from the rats exhibited impaired phagocytic activity. In agreement with other investigators, ethanol was found to result in a loss of T-cell population in the spleens of rats fed ethanol for 13 months. On the other hand, the T-helper cells and the proportion of T-helper to T-suppressor cells were found to increase in the splenocytes from these rats. This latter occurrence, apparently, is to compensate for the general loss of T-cell population observed in the body that occurs with ethanol ingestion. It is hypothesized that immunosuppression and the transient imbalances in the components of the cellular immunity induced by ethanol lead to an increased risk of pathogenesis associated with alcohol consumption.

Animals↗

PubMedDate not supplied

Evaluation of the effect of arginine-enriched amino acid solution on tumor growth.

To investigate the effect of arginine-enriched solution on tumor growth and metastasis, rats were infused with solutions containing 5.5 and 0.66% arginine for 8 days. Infusions were started at the same time of subcutaneous transplant of Yoshida sarcoma. Arginine-rich solution suppressed tumor growth at an early stage and prevented metastases to the liver and kidney. In addition, arginine supplements enhanced the phagocytic activity of alveolar macrophages. It also resulted in maintenance of a positive nitrogen balance and prevented the increases in the levels of several amino acids observed in the control group. The suppressive effect of arginine-enriched solution on tumor growth may be due to its activation of the immunologic system, in which the phagocytic activity of macrophages probably participates.

Adjuvants, Immunologic↗

PubMedDate not supplied

A personal computer network system for equitable allocation of cadaver organs.

We developed a personal computer network system for the equitable allocation of cadaveric organs. This network consists of a host computer (IBM PS55 model 5570 T) and various kinds of personal computers manufactured by many different computer makers in Japan. The merits of our personal computer network include lower cost and an easy access to the host computer from all the centres participating in this network while using their own favourite personal computers. Among the programs made for allocating cadaveric organs, we present in this paper the program for livers. This program was developed with a modified version of the logic developed by Starzl et al. The grade modification for the United Network for Organ Sharing (UNOS) in the United States was used as the basis for classification of medical urgency. Our program weighed the factors of medical urgency, compatibility of blood group and waiting time. Distance factors were omitted because of the smaller area of the network compared to that of UNOS. This computer network would be linked to other computer networks in creating a national organ procurement and transplant network in Japan, in order to help them to catch up with other advanced transplant countries. Such an equal and objective computer system should allow organ transplantation to become more widely accepted.

Computer Communication Networks↗

PubMedDate not supplied

Interactive statistical analysis system for clinical investigators.

We have developed an interactive statistical analysis system (ISAS-Q) with which clinical investigators with little experience in computers and programming can easily perform statistical analyses. ISAS-Q can perform most of the frequently used statistical methods, including multivariate analysis, in an interactive mode. Furthermore, ISAS-Q has self-consistent and extensive help functions.

Data Interpretation, Statistical↗