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Biomedical subjects

S Tsutsui

Publications and source records attributed to S Tsutsui.

At least 109 records · Page 6Linked to original sources
PubMed1979

Combined therapy of T3, and antidepressants in depression.

Since there are some patient groups whos symptoms do not improve despite the fact that the use of the antidepressants will alleviate the symptoms to some extent, we have conducted a TRH test for depression and found that there are not a few cases who show a low TSH response. We therefore used a small amount of T3 together with the antidepressants in these cases and have found that the therapy is useful for improvement of tye symptoms. When the TRH test is made at the time of improvement of the symptoms due to the combined use of these two drugs and compared with the state at pre-treatment, it has been confirmed that the TSH response will go back to normal. Hence, we would like to present here two markedly improved cases due to the combined use of imipramine and clomipramine plus T, and to refer to the result of the TRH test.

Adolescent↗
PubMedDate not supplied

A long-term survivor of ruptured hepatocellular carcinoma after hepatic resection.

We treated a patient who had previously undergone a hepatic resection for ruptured hepatocellular carcinoma (HCC) but developed a solitary peritoneal recurrence at the site of the incision 8 years and 9 months later. Since no other recurrence was evident, we resected the tumour. The primary tumour was 2.5 cm in size and histological examination revealed HCC without any histological risk factors for intrahepatic recurrence. The peritoneal tumour consisted of less differentiated cancer cells than those found in the primary tumour. The positive rates of Ki-67 were 10% in the primary tumour and 23.3% in the peritoneal recurrence. The DNA indexes in both tumours were considered to be identical. The comparison between the primary and peritoneal tumours suggested that the histological differentiation and proliferation activity can change after recurrence, in spite of consistent DNA ploidy contents. Clinically, a patient who undergoes a hepatic resection for ruptured HCC can survive for a long time, such as 10 years, if they have good liver function and small HCC without any histological risk factors for intrahepatic recurrence. However, since late recurrence is possible, a follow up for as long as 10 years is recommended.

Aneuploidy↗
PubMedDate not supplied

A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia.

Zolpidem (10 mg/day) and zopiclone (7.5 mg/day), administered at night, were compared in a 14-day, double-blind, equivalence trial on 479 chronic primary insomniacs (zolpidem, 231; zopiclone, 248) throughout Japan, with a 1-week follow-up to assess rebound. The primary endpoint was the investigators' rating of global improvement of sleep disorders. A total of 32 patients in the zolpidem group (13.9%) and 45 patients in the zopiclone group (18.1%) withdrew from the study before the end of the treatment. In the zolpidem group, 67.9% (142/209) of patients were rated at least 'moderately improved' versus 61.6% (135/219) with zopiclone, zolpidem being at least as effective as zopiclone (90% confidence interval: -1.7, 14.3). With zolpidem, sleep onset latency improved in significantly more patients (85.8% versus 77.5%) and significantly fewer patients showed aggravated sleep onset latency relative to baseline at follow-up (4.5% versus 15.4%). Significantly fewer patients receiving zolpidem experienced drug-related adverse events (31.3% versus 45.3%), with bitter taste representing 5.8% (six of 104) of such complaints with zolpidem compared with 39.9% (69/173) with zopiclone. In conclusion, zolpidem was at least as effective as zopiclone, showed significantly less rebound on discontinuation and was better tolerated.

Adult↗
PubMedDate not supplied

A complete response of an advanced oesophageal carcinoma treated with hyperthermic chemotherapy: a case report.

A 56-year-old Japanese man with an advanced squamous cell carcinoma in the middle oesophagus was treated with a combination of hyperthermia, intravenous infusion of cisplatin (CDDP) and oral administration of oily bleomycin(BLM)-polyacrylate paste. After performing six sessions of hyperthermia treatment conducted at 42-45 degrees C for 30 min with 150 mg of CDDP and 180 mg of BLM, a subtotal oesophagectomy and lymph node dissection were performed. A histopathological study of the resected specimen showed no residual viable cancer cells either in the oesophagus or in the dissected lymph nodes. There were no side effects or perioperative complications and the patient is now healthy and leading a normal life 10 months after operation without undergoing any further treatment, at the time of writing. The effect of small amounts of CDDP and the oral application of oily BLM were thought to be strongly enhanced by hyperthermia in the treatment of oesophageal squamous carcinoma, and this regimen is therefore recommended as a safe and effective strategy, especially for preoperative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Platelet aggregability and the occurrence of anastomotic leakage after esophageal reconstruction.

In 21 patients who had undergone resection and reconstruction for esophageal carcinoma, the postoperative platelet aggregability was measured and the correlation between the occurrence of anastomotic leakage and platelet aggregability was investigated. There was no statistical difference in the clinical features of the patients between those with (n = 5) and without (n = 16) anastomotic leakage. Platelet aggregability was measured by the turbidimetric method from blood samples taken preoperatively, and at 1, 3, and 7 postoperative days (POD). The average values of platelet aggregability in patients without anastomotic leakage were 81.2, 70.4, 80.1, and 81.8%, while those with leakage were 81.3, 47.6, 52.3, 70.6% preoperatively, and 1, 3, and 7 POD, respectively. Thus, platelet aggregability significantly decreased in patients with anastomotic leakage on the first postoperative day (p < .05), and then gradually recovered postoperatively as time passed. Therefore, the measurement of platelet aggregability is considered to be one of the parameters predicting the occurrence of anastomotic leakage, and a prevention in the decrease of platelet aggregability as well as its activation could become a treatment for preventing anastomotic leakage.

Aged↗
PubMedDate not supplied

Esophageal carcinoma is frequently accompanied with early gastric carcinoma.

A review of data on 360 patients with esophageal squamous cell carcinoma who underwent esophageal resection revealed 14 cases (3.9%) and 16 lesions with synchronous gastric carcinomas. Among the 16 lesions, there were 14 (87.5%) early gastric carcinomas and two advanced carcinomas. Of the 14 early gastric carcinomas, two were minute (less than 5 mm in the largest diameter) early gastric carcinomas and four small (6-10 mm in the largest diameter). These gastric carcinomas were in a relatively early stage. The six early gastric carcinomas were not detected preoperatively. However, a thorough observation of the gastric mucosa could not be done in four of those due to stenosis which had developed as a result of the esophageal carcinoma. Therefore, intraoperative gastric observation should be done in cases in which the findings of the preoperative endoscopic examination of the stomach are inadequate and the upper gastrointestinal series reveal certain gastric abnormalities.

Adenocarcinoma↗
PubMedDate not supplied

Origin and spread of intra-epithelial carcinoma of the esophagus. Histopathologic investigation of the junctions between intraepithelial carcinoma and non-cancerous epithelium.

Scrutinization of data on 56 patients of primary esophageal squamous cell carcinoma and not given preoperative irradiation therapy disclosed 36 areas (64.1%) of intra-epithelial carcinoma contiguous to the main lesion, and in 16 (28.7%) there was a multiple occurrence of squamous cell carcinoma, in which 13 were double and 3 were triple carcinomas. A total of 96 junctions between intra-epithelial carcinoma and non-cancerous epithelium were histologically investigated. These junctions could be grouped into two types: well-demarcated (29 areas, 30.2%) and ill-demarcated (67 areas, 69.8%) types. The latter was separable into 12 (12.5%) of whole layer, 33 (34.4%) of basal layer and 22 (22.9%) of irregular patterns. Epithelial dysplasia occurred in one (3.4%) of well-demarcated and ten (14.9%) of ill-demarcated junctions, and almost all lesions of dysplasia were moderate or severe. Thus, most carcinomatous transformation had occurred at the site of junction (in-situ carcinogenesis) and epithelial dysplasia may be a carcinoma rather than pre-cancerous lesion, per se.

Carcinoma in Situ↗
PubMedDate not supplied

Prognostic significance of immunological parameters in patients with esophageal cancer.

BACKGROUND: The role of immunosurveillance in the fight against cancer is well known. In addition, cancer patients have been reported to have an impaired immune function. In patients with esophageal cancer, however, the relationship between the immunological parameters of the host and their survival has not yet been evaluated fully. MATERIALS AND METHODS: Of 103 patients with esophageal cancer who underwent esophagectomy, lymphocyte subsets (CD4+ and CD8+), the PHA response, and natural killer cell (NK) activity were all assessed in relation to clinicopathological features and the prognostic significance was evaluated using both a univariate and multivariate analysis. RESULTS: The CD4+/CD8+ ratio in 58 (56%) patients was higher than the mean of the control, while the PHA response and NK activity in 74 (72%) and 70 (68%) patients, respectively, were lower than 1 SD below the mean of the control. None of these three parameters demonstrated a low value in 5 patients, while 1, 2 and 3 parameters showed a low value in 28, 49 and 21 patients, respectively. The survival rate of the patients with low values in all of three of these parameters was significantly worse than that for the patients in whom the number of low parameters was less than two. A multivariate analysis revealed that tumor invasion and the number of low values in these parameters were independently significant prognostic factors. CONCLUSIONS: This survival analysis revealed that low values in the CD4+/CD8+ ratio, the PHA response, and the NK activity will help predict a poor prognosis in patients with esophageal cancer.

CD4-CD8 Ratio↗