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Biomedical subjects

T Amano

Publications and source records attributed to T Amano.

498 records · Page 28Linked to original sources

Helicobacter pylori of the remnant stomach and its eradication.

BACKGROUND/AIMS: Many authors have reported that Helicobacter pylori (H. pylori) is one of the major causes of gastritis and peptic ulcer. This study was conducted to evaluate the incidence of H. pylori infection and the curative effects of amoxicillin and omeprazole on H. pylori in the remnant stomach. METHODOLOGY: Biopsy specimens were obtained from 70 patients who underwent gastrectomy for gastric cancer. H. pylori was subsequently diagnosed by CLO test and culture of H. pylori. Gastritis was assessed by the scoring of four characteristic pathological parameters. Patients with positive H. pylori were eligible for the eradication study. Amoxicillin, 750 mg per day for 2 weeks, and omeprazole, 20 mg per day for 8 weeks, were administered to them. Endoscopic reexamination was performed 12 weeks after the initiation of treatment. RESULTS: The overall positive rate of H. pylori was 37.1%; 39.6% in Billroth I reconstruction, 0% in Billroth II reconstruction, and 55.6% in pylorus preserving gastrectomy, respectively. The positive H. pylori rate of Billroth II reconstruction was significantly low. However, there was no association of positive rate of H. pylori with time. There was no significant difference of gastritis scores between H. pylori infected patients and non-infected patients. The eradication rate was 70.0%. CONCLUSIONS: H. pylori was present in 37.1% of patients who underwent gastrectomy. Gastritis was not significantly severe in H. pylori infected patients. The treatment with amoxicillin and omeprazole was effective for these patients.

Aged↗

Serum CA 19-9, SLX, STN and CEA levels of the peripheral and the draining venous blood in gastric cancer.

BACKGROUND/AIMS: This study was conducted to elucidate the relationship between the seropositive rates of Carcinoembryonic antigen (CEA), Sialyl Le(a) (CA 19-9), Sialyl Le(x) (SLX) and Sialyl Tn (STN) and the clinicopathological variables. The correlation of serum levels of these antigens between the peripheral venous blood and the venous blood draining from the tumor was also evaluated. METHODOLOGY: The subjects were 113 patients with gastric cancer, who underwent gastrectomy at the First Department of Surgery, Yokohama City University, between 1991 and 1996. Serum levels of CA 19-9, SLX, STN and CEA in the peripheral blood and the draining venous blood were measured. RESULTS: The positive rates for CA 19-9, SLX, STN and CEA were closely correlated with tumor stage, lymph node metastasis, and depth of invasion. Although the seropositive rates for CA 19-9, SLX, STN, and CEA in the draining venous blood were lower than those in the peripheral blood, a close correlation for serum levels of 4 antigens between the peripheral venous blood and the draining venous blood was observed in advanced cancer. CONCLUSIONS: These results suggest that these antigens may be drained by the lymphatic route as well as the hematogenous route. Further studies must be performed to elucidate the mechanism of these antigens entering into the peripheral blood by devising a technique for collecting the lymph.

Adult↗

Helicobacter pylori of remnant stomach and optimal dose of amoxicillin for eradicating Helicobacter pylori.

BACKGROUND/AIMS: The optimal dose of antibiotics for Helicobacter pylori eradication is not known. The aim of this study was to evaluate optimal dose of antibiotics (amoxicillin) for eradication of H. pylori in the remnant stomach. METHODOLOGY: Biopsy specimens were obtained from 77 patients who underwent gastrectomy for gastric cancer. H. pylori was subsequently diagnosed by rapid urease test and culture. Gastritis was assessed by scoring. Patients with positive H. pylori were eligible for the eradication study. Amoxicillin 750 mg per day for 2 weeks and omeprazole 20 mg per day for 8 weeks were administered to them. Endoscopic reexamination and 13C-urea breath test were performed 12 weeks after the initiation of treatment. RESULTS: The positive rate of H. pylori was 38.9% in the remnant stomach. Eradication rate was 50.0%. Mean dose of amoxicillin in effective cases was 14.1 +/- 1.5 mg/kg/day. This was significantly higher than that in non-effective cases (12.5 +/- 1.5 mg/kg/day). Remnant gastritis was significantly improved after complete eradication. CONCLUSIONS: H. pylori was present in 38.9% of patients who underwent gastrectomy for gastric cancer. The optimal dose of amoxicillin was 15.6 mg/kg/day for 14 days with omeprazole-amoxicillin therapy.

Amoxicillin↗

Clinicopathologic differences between early gastric remnant cancer and early primary gastric cancer in the upper third of the stomach.

BACKGROUND/AIMS: This study was designed to clarify the clinicopathologic characteristics and survival in early gastric remnant cancer and compare with early primary cancer in the upper third of the stomach. METHODOLOGY: Twenty-five patients with early gastric remnant cancer, who underwent resection at Kanagawa Cancer Center and First Department of Surgery, Yokohama City University between 1974 and 1996 were evaluated in this study. Various clinicopathologic characteristics, such as age, sex, symptoms, size of tumor, depth of invasion, lymph node metastasis, cell differentiation, and survival were investigated and early gastric remnant cancer was compared with early primary cancer in the upper third of the stomach. RESULTS: According to the macroscopic type, protruded type such as I or II type accounted for a great majority in early gastric remnant cancer, while II c depressed type was common in early primary cancer in the upper third of the stomach, comprising 64.2% of all cases. Pathological examination disclosed that well-differentiated carcinoma and mucosal carcinoma were more frequently observed in early gastric remnant cancer than in early primary cancer in the upper-third of the stomach. The 5-year survival rate was 83.5% for early primary cancer in the upper-third of the stomach. In contrast, no patients experienced recurrence after operation for early gastric remnant cancer. CONCLUSIONS: From the view point of clinicopathological evaluation, gastric remnant cancer is a special from of gastric cancer. A follow-up program is important in order to detect early gastric remnant cancer. A low incidence of lymph node metastasis suggests that endoscopic mucosal resection of the tumor or limited operation could be performed under strict indication.

Aged↗

The efficacy of 1 alpha hydroxy vitamin D3 treatment of the metabolic bone disorder in patients who underwent gastrectomy for gastric cancer.

BACKGROUND/AIMS: The aim of this study was to elucidate the efficacy of 1 alpha hydroxy vitamin D3 for treatment of metabolic bone disorder after gastrectomy. METHODOLOGY: MD-MS method was performed in 16 patients who underwent gastrectomy to evaluate the metabolic bone disorder and compared before and after 1 alpha hydroxy vitamin D3 treatment. The symp-toms related to the metabolic bone disorder were also analyzed through patient interview. RESULTS: The severity of the metabolic bone disorder analyzed by the MD-MS method improved after 1 alpha hydroxy vitamin D3 treatment in 56.3% of patients. The deviation degree of the cortical bone density was also significantly improved. The symptoms related to metabolic bone disorder disappeared in 80% of patients after treatment. CONCLUSIONS: The administration of 1 alpha hydroxy vitamin D3 may be useful for the metabolic bone disorder in the treatment of patients after gastrectomy.

Aged↗

Predictive value of c-erbB-2 and DNA ploidy patterns in gastric carcinoma recurrence.

This study was conducted to see whether the accuracy in predicting liver metastases in gastric cancer patients increased when DNA aneuploidy and c-erbB-2 gene products were analyzed besides other clinicopathologic features. Aneuploidy was observed in 32 out of 74 tumors (43%); these included 62% of those tumors in patients with liver metastases, 43% of those with peritoneal dissemination and 26% of those in the 5-year survival group. Aneuploidy was positively correlated with the prognosis and degree of blood vessel invasion but not with lymph node metastases or lymphatic permeation. Positive staining for the c-erbB-2 gene product was detected in 19 out of 89 tumors (21%). This staining was not related to any of the clinicopathologic features examined. Multivariate analysis revealed that the degree of blood vessel invasion was the factor that most strongly correlated with liver metastases. The prognostic value of aneuploidy was significant (p < 0.05) but much smaller than that of blood vessel invasion (p < 0.0001), interstitial tissue reaction (p = 0.02), Borrmann type classification (p = 0.03). Analyses of DNA aneuploidy and c-erbB-2 gene expression in the primary tumor of gastric carcinoma to improve the accuracy of predicting liver metastasis seem to be of limited clinical value at present.

Aneuploidy↗

Low density lipoprotein apheresis during cardiopulmonary bypass of hypercholesterolemic patients.

Ischemia-reperfusion injury in open heart surgery can cause atherosclerotic changes in both bypass grafts and native coronary arteries by increasing endothelial permeability and allowing excessive influx of LDL into the subendothelium. The authors used LDL apheresis during cardiopulmonary bypass (CPB) to actively remove serum LDL before reperfusion, minimizing LDL influx. They evaluated the efficacy and safety of this new procedure in eight hypercholesterolemic patients. The control group consisted of 41 patients. Mean LDL cholesterol (LDL-C) level on admission was 180 +/- 41 (SD) in the LA group and 139 +/- 32 mg/dl in the control group (p = 0.02). After 105 +/- 27 min of apheresis, the LDL-C level in the LA group decreased to 62 +/- 25 mg/dl (reduction rate: 59 +/- 18%). In contrast, in the control group, the LDL-C level was reduced to 117 +/- 41 mg/dl (reduction rate: 16 +/- 9.5% [P = 0.0001]) after CPB. No significant difference was observed in intraoperative blood loss, postoperative blood loss, platelet count, prothrombin time, activated partial thromboplastin time, incidence of wound complications, or early patency rate of bypass graft between groups. Low density lipoprotein apheresis during CPB is a safe and effective method for lowering serum LDL level sufficiently before reperfusion, and can adequately reduce LDL influx into the vessel wall.

Aged↗

Enhancement of CDDP cytotoxicity by caffeine is characterized by apoptotic cell death.

Through the use of STKM-1 human stomach cancer cells, we investigated the enhancement of the anti-tumor effect and the apoptosis induction of the CDDP and caffeine combination. Even when the concentration of CDDP was low, CDDP significantly decreased the proliferation of STKM-1 human stomach cancer cells, thus confirming the synergistic effect of the CDDP and caffeine group. The apoptotic labeling index of the CDDP plus caffeine combination was significantly higher than that of the CDDP group. In conclusion, caffeine enhanced the effect of CDDP by not only inhibiting DNA repairs but also inducing apoptosis.

Apoptosis↗

Clinicopathologic differences between gastric remnant cancer and primary cancer in the upper third of the stomach.

BACKGROUND: The prognosis of gastric remnant cancer is considered to be poor compared with that of primary cancer. MATERIALS AND METHODS: This study was conducted to elucidate the differences of clinicopathologic findings and treatment results between 59 patients with gastric remnant cancer (GRC) and 579 patients with primary proximal gastric cancer (PGC). RESULTS: There was no significant difference in the incidence of lymph node metastasis between GRC and PGC. However, changes in the metastatic pattern to lymph nodes were observed in GRC. In GRC, the tumor easily invaded the neighboring organs due to the adhesions around the remnant stomach, resulting in a low resectability with curative intent. The 5-year survival rate after curative resection for advanced GRC was 50.9%. GRC patients without serosal invasion had a good prognosis. CONCLUSION: Although the survival rate after curative resection for GRC patients was similar to that of PGC, GRC patients without serosal invasion had a better prognosis. Therefore, early detection is an important way to improve overall survival in GRC.

Adult↗

Combined effect of CDDP and caffeine against human gastric cell line in vivo.

This study was conducted to clarify the enhancement of the anti-tumor effect of CDDP by caffeine using a tumor-bearing peritoneal disseminated metastasis model in vivo. To evaluate the combined effect of CDDP and caffeine on the survival in vivo, nude mice bearing STKM-1 gastric cancer cells were administered CDDP alone, caffeine alone, or in both combination intraperitoneally. Treatment was started from 8 days after tumor inoculation. The combination of CDDP and caffeine more markedly prolonged the survival time than CDDP alone or caffeine alone. In conclusion, the results of the present in vivo study suggest that clinical application of caffeine in combination with CDDP might be effective against peritoneal disseminated metastasis in gastric cancer patients.

Adenocarcinoma↗

Carcinosarcoma of the esophagus: three cases with immunohistological examination.

Carcinosarcoma of the esophagus is a rare malignant tumor with both carcinomatous and sarcomatous components. We present 3 cases of carcinosarcoma of the esophagus and discuss the histogenesis of the tumors. We performed immunohistochemical studies using various antibodies: anti-cytokeratin, anti-vimentin, anti-smooth muscle actin, anti-p53, and MIB 1 reacting with Ki-67 nuclear antigen.

Biomarkers, Tumor↗

Gastric emptying after gastric interposition for esophageal carcinoma: comparison between the anterior and posterior mediastinal approaches.

BACKGROUND/AIMS: Close observation and evaluation of the function of the transposed stomach after esophagectomy is essential. The present study uses the sulfamethizole capsule meal test to evaluate differences in gastric emptying between the anterior and posterior mediastinal approaches in patients undergoing esophagectomy. METHODOLOGY: Thirty-eight patients who underwent the esophagectomy and esophagogastrostomy for esophageal cancer were randomly divided into 2 groups: Group 1: anterior mediastinal approach, and Group 2: posterior mediastinal approach. Gastric emptying was studied using the sulfamethizole capsule meal test. Patients received sulfamethizole food capsules, 65 g of bread, and 150 ml of water. Plasma sulfamethizole levels were determined by high performance liquid chromatography (HPLC). RESULTS: Gastric emptying in both groups was significantly accelerated compared to healthy volunteers. Gastric emptying did not differ significantly between groups 1 and 2. CONCLUSIONS: The present data show that the sulfamethizole capsule meal test is an effective means of evaluating the emptying of the transposed stomach. Furthermore, when the stomach is used as an esophageal substitute following esophagectomy, gastric emptying does not differ according to the access route.

Aged↗