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Biomedical subjects

S Tamakuma

Publications and source records attributed to S Tamakuma.

At least 37 records · Page 2Linked to original sources
PubMed1993

Clinical and experimental studies on the role of platelet-activating factor (PAF) in the pathogenesis of septic DIC.

Various toxic factors induced by endotoxin (Et) are thought to be deeply involved in the pathogenesis of severe infections. In this study, particular attention was paid to the role of the platelet-activating factor (PAF) in these conditions, and clinical and experimental studies were conducted on the relationship between PAF and the changes observed in the general parameters after surgical infections. In the clinical study, changes in the PAF concentration in the blood of seven patients with disseminated intravascular coagulation (DIC), five of whom were septic and two non-septic, were monitored by gas/mas spectrometry. The mean PAF level in the septic DIC group tended to be higher than that in the non-septic DIC group. Moreover, in the septic DIC group, the relationship between the increase in the PAF level and platelet count was analyzed with the lapse of time and we surmised a negative correlation between these parameters. Experimentally, we also investigated the role of PAF in Et shock and the effect of an anti-PAF agent and protease inhibitor. The Et-induced fall in blood pressure was similarly prevented by both the anti-PAF agent and protease inhibitor. However, the decrease in the platelet count was more significantly inhibited by the anti-PAF agent than by the protease inhibitor, whereas the parameters of the blood coagulation/fibrinolysis system were more affected by the protease inhibitor than by the anti-PAF agent.

Aged↗
PubMed1993

Proposal of a risk score for recurrence in patients with curatively resected gastric cancer.

In this study, 168 patients who underwent curative resection for gastric cancer with prognostic serosal invasion [ps(+)] and 150 without prognostic serosal invasion [ps(-)] were analyzed separately to determine the prognostic importance of clinicopathological factors, and identify which patients were at high risk of recurrence. A multivariate analysis of survival time using Cox's proportional hazard model revealed the important prognostic factors to be: Lymph node involvement, the classification of gross appearance, macroscopic serosal invasion, and interstitial connective tissue in the ps(+) group; and lymph node involvement, macroscopic serosal invasion, and venous invasion in the ps(-) group. We proposed a risk score of recurrence based on the results of a further multivariate analysis called Hayashi's Quantification Analysis II, in which recurrence was chosen as an objective variable and the above prognostic factors were chosen as explanatory variables. Eighty-four percent of the patients with a score of 0 or higher in the ps(+) group and 83% of those with a score of +6 or higher in the ps(-) group showed recurrence. Thus, we believe that this score is useful for identifying those patients at high risk of recurrence, who should receive intensive chemotherapy even after curative resection.

Female↗
PubMed1993

The advantage of primary resection and anastomosis with intraoperative bowel irrigation for obstructing left-sided colorectal carcinoma.

Of a total 712 patients with left-sided colorectal cancer, 79 (11%) required emergency surgery due to severe obstruction by tumors. Of these 79 patients, 55 underwent tumor resection and anastomosis. Primary resection and anastomosis with intraoperative bowel irrigation was performed in 44 patients (primary group), while staged resection and anastomosis was performed in only 11 (staged group). In comparing the two groups, there was no significant difference in the rates of curative resection, being 76% versus 90%. However, the primary group demonstrated significantly lower rates of postoperative wound infection (P < 0.001), anastomotic dehiscence (P not equal to 0.05), and postoperative mortality, at 2% versus 18% (P < 0.05). The cumulative survival curve was also better in the primary group (P < 0.05). These favorable results of the primary group were confirmed by analyses which established that no bias of therapeutic backgrounds existed in either of the two groups. Thus, it was concluded that for left-sided obstructing colorectal carcinoma, intraoperative bowel irrigation, followed by primary resection and anastomosis, produces more advantageous results.

Adult↗
PubMed1993

Assessment of clinicopathologic features of colorectal mucinous adenocarcinoma.

The purpose of this report is to analyze the clinicopathologic features of colorectal mucinous adenocarcinoma (MC), which is generally believed to have a poor prognosis, in an attempt to assess ways in which the surgical outcome can be improved. Clinicopathologic features of 44 patients with MC (6.6%), from among 662 patients with primary colorectal cancers, were compared with those of 545 patients with nonmucinous (non-MC) adenocarcinoma. MC is more likely to invade the adjacent viscera (29% versus 10%, p < 0.005) and show more extensive lymph node involvement beyond the pericolonic region (50% versus 26%, p < 0.005) than non-MC. Based on these findings, a more aggressive attitude toward surgical intervention is recommended, including extensive lymph node dissection and the resection of adjacent organs that seems to be affected macroscopically, to improve the surgical outcome of this clinical entity.

Adenocarcinoma, Mucinous↗
PubMed1993

Comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage based on their location in patients with gastric cancer.

PURPOSE: To determine which is the better prognostic determinant in gastric cancer: number of positive metastatic lymph nodes or current nodal stage. PATIENTS AND METHODS: Seven hundred seventy-seven patients who underwent potentially curative resections for gastric cancer were divided into three groups according to the depth of invasion. The influence of the number of positive nodes on their survival rate was analyzed. A multivariate analysis by the Cox proportional hazards model was used to determine independent prognostic factors. RESULTS: A decreased survival rate was associated with an increased number of positive nodes in all of the subjects and in each of the three groups. Patients with one to three positive nodes had as good a prognosis as those without nodal involvement when each of the three groups was analyzed separately. Using a multivariate analysis in the patients with four or more positive nodes, we found that the number of positive nodes was the most important prognostic determinant (P < .0001), followed by the depth of invasion (P < .02), and that the nodal stage was not significantly prognostic. Further multivariate analysis in the patients with one to three positive nodes showed that nodal stage and number of positive nodes were not significantly prognostic. CONCLUSION: The number of metastatic nodes should be adopted for classification of nodal stage in gastric cancer.

Adenocarcinoma↗
PubMed1993

[Two cases of cancer with bone metastases treated with local therapy].

Two cases with osteolytic bone metastases from cervical cancer and esophageal cancer treated by local therapy were reported. The first case is a 53-year-old female with bone metastases of left ischium developed 1 year after hysterectomy. She was treated by intratumor injection of sizofiran (SPG) 20 mg/w and radiation therapy. After 4 weeks, ischias pain decreased and bone lesion showed remarkable calcification (PR) 8th months later. The second case is a 58-year-old male with bone metastases of the left tibia and fibula developed 1 year after surgery. He was treated by intratumor injection of SPG 20 mg/w x 4 and OK-432 1.0 KE/w x 8 after radiation therapy. After 4 weeks, pain and swelling of left leg decreased and bone lesions showed remarkable calcification (PR) three months later. We suggest that intratumor injection of SPG and OK-432 with radiation therapy was effective for osteolytic bone metastases.

Adult↗
PubMed1992

[Acid-base disturbances in surgical operation].

Metabolic acidosis immediately after surgical operation is followed by metabolic alkalosis. Hormonal change by surgical stress and anaerobic glucolysis due to tissue ischemia cause initial lactic acidosis. Later alkalosis may be caused by secondary aldosteronism and bicarbonate production from lactate and citrate supplied by massive infusion and transfusion. Postoperative complications, such as respiratory insufficiency, renal failure and hypovolemic or septic shock, cause acidosis. In the gastrointestinal surgery, acidosis can be caused by starvation and loss of bicarbonate contained in bile, pancreatic juice or intestinal fluid, and alkalosis can be caused by loss of HCl in gastric juice. Severe acidosis can be caused by extracorporeal circulation, hypothermia, low output syndrome or declamping shock in cardioaortic surgery.

Acid-Base Imbalance↗
PubMed1991

Nuclear p53 immunoreaction associated with poor prognosis of breast cancer.

p53 protein has been frequently detected at high levels in the nuclei of human breast cancer cells. We analyzed immunohistochemically the association between nuclear localization of p53 protein and clinical and histological parameters of breast cancer patients. Surgically resected tissues of 73 primary breast cancers were processed by acetone fixation and paraffin embedding and examined using an anti-p53 monoclonal antibody, PAb1801. p53 immunoreactivity was detected in the nuclei of cancer cells in 17 cases (23%). The nuclear p53 immunoreaction was closely associated with overexpression of c-erbB-2 protein (P less than 0.05), high histologic grade (P less than 0.01), advanced clinical stage (P less than 0.05), and negative estrogen receptor status (P less than 0.01). When 31 cases which had been followed up for more than 50 months were examined, a positive nuclear p53 immunoreaction was found to be significantly associated with shorter overall survival of patients (P less than 0.01). These results suggest that immunohistochemical examination of nuclear p53 protein is clinically useful as an indicator of breast cancer aggressiveness.

Antibodies, Monoclonal↗
PubMed1991

[Effects of syngeneic preserved blood cells on metastatic growth of the Lewis lung carcinoma].

Each of B6C3HF1 mice was infused with stored syngeneic blood cells, fresh syngeneic blood cells, or saline, and then was injected intravenously with 1 x 10(6) Lewis lung carcinoma cells. Survival rate of each group declined in order of the saline group, the fresh-cell group, and the stored-cell group with a significant difference between all paired groups (p less than 0.001). When the number of metastases and 125I-Iododeoxyuridine uptake in the lungs and livers were compared between these groups, there were significant differences with greater number and uptake in the stored-cell group than the fresh-cell group or the saline group on day 15 through 17, and greater in the fresh-cell group than the saline group on day 23 and 24. In the second experiment, each mouse was inoculated subcutaneously with 1 x 10(5) tumor cells. Twenty-one days later, the subcutaneous tumors were removed, and the mice were infused with blood cells or saline immediately. The number of lung metastases of the stored-cell group was significantly larger than that of the fresh-cell group or the saline group on 9 and 11 days following tumor removal. In conclusion, the transfusion of the preserved syngeneic blood cells was considered to enhance both artificial and spontaneous metastasis of the Lewis lung carcinoma.

Animals↗
PubMed1991

[Clinico-experimental analysis of backgrounds of the severe surgical infections].

The purpose of this study was to analyse the clinical course of 410 patients of severe surgical infections (primary 251, postoperative 159) during recent 5 years and to evaluate the important background factors which make these patients serious. As a result, the following patients such as, (1) who have refractory primary infections, for example malignant lymphoma, severe pancreatitis etc. (2) whose infectious foci were uncontrolled. (3) who had finally complicated a septic MOF or DIC, seemed to be especially critical even though recent advanced surgical therapy. To improve these severe conditions, we believe to need a renewed approach like so called "multi-disciplinary therapy", additionally with both conventional antibiotics administration and drainage for infectious foci. Several methods such as, (1) rational nutrition management using indirect calorimetry. (2) plasma exchange for removing toxic substances such as bacterial toxins, chemical mediators etc, from circulating blood. (3) pharmacological block of these toxic substances, were shown. In terms of the harmful chemical mediators, we supposed that both PAF (platelet activating factor) and oxygen free radical were extremely important in septic conditions from previous clinico-experimental studies. Therefore the effects of those pharmacological blockers such as PAF antagonists, SOD, protease inhibitor in experimental endotoxin shock were discussed in detail.

Animals↗
PubMed1991

[Alprazolam for patients with psychotic symptoms or autonomic imbalance symptoms after breast cancer surgery].

Effectiveness of alprazolam in daily dosages of 0.8-1.2 mg was studied in 28 patients who showed psychotic symptoms or autonomic imbalance symptoms after operation for breast cancer. Psychotic symptoms included depression, anxiety, tension, and restlessness, and symptoms of autonomic imbalance included sleep disorder, anorexia, and pains. All of these symptoms were improved at high ratios by alprazolam. The drug was very useful in 16 cases (57.1%), useful in 11 cases (39.3%), and slightly useful in one case (3.6%). The only adverse reaction reported was unsteady gait in one case.

Adult↗
PubMed1990

[Scanning electron microscopic observation of mouse ascitic carcinoma cells after intraperitoneal administration of lentinan].

Direct action of lentinan (LNT) on tumor cells in an in vivo system was observed by scanning electron microscopy. LNT was injected intraperitoneally 7 consecutive days (0.1 mg/mouse/day) in to C3H/He mice along with MM2 ascitic carcinoma cells. MM2 tumor cells adhering to the peritoneal wall were examined every day until the day after the last LNT injection, and compared with cells of non-treated tumor bearing mice. On the day after the first LNT injection, LNT was observed as granulated material both on the tumor cells, which were degenerated and on the mesothelial cells, which were not changed. On the 7th day, almost all tumor cells were seen to be surrounded by many lymphocytes in the LNT-treated mice. Retention of ascitic fluid and fibrin deposition were almost the same as or less than in non-treated mice. From these results, it is suggested that direct action of LNT on tumor cells contributed to enhancement of antitumor immunity, although LNT did not have direct killing activity against tumor cells.

Animals↗