[Amino acid solutions, and their features].
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Amino Acids↗
Biomedical subjects
T Kakegawa
Publications and source records attributed to T Kakegawa.
[Combined nutritional management of total parenteral and enteral nutrition].
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Combined Modality Therapy↗
[Immunological examination for assessment of nutrition].
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Antibody Formation↗
[Lymphatic permeation of colorectal cancer--evaluation as a prognostic factor by prospective studies].
To evaluate lymphatic permeation as a prognostic factor in colorectal cancer, long-term prospective studies were conducted and the following results were obtained. 1) The degree of lymphatic permeation increased as the depth of invasion, lymph node metastasis, and stage advanced. 2) Moderate or marked lymphatic permeation (ly2 or ly3) was observed at a high rate in moderately and poorly differentiated adenocarcinoma. 3) Recurrence was more common in the patients with ly2 or ly3. 4) In stage 2 and 3 patients with slight plus no lymphatic permeation (ly0 or ly1), the seven-year survival rates were 89.8% and 85.6%, respectively. In the ly2 + ly3 group, the rates were 67.1% and 66.1%, respectively and a significant difference was noted. In stage 4, however, there was no significant difference between the two groups. Conclusions were as follows. 1) The degree of lymphatic permeation was considered to be extremely closely related to the progression of cancer, histological type and recurrence. 2) In stage 2 and stage 3, the degree of lymphatic permeation was an important prognostic factor, but in stage 4 it was not. 3) It was shown that lymphatic permeation as classified by the authors was a reliable index for survival rates.
Adenocarcinoma↗
[Clinicopathological studies on perineural invasion of rectal cancer with special reference to the prognosis and nerve preserving operation].
Prospective studies on rectal cancer have been continued since 1982 in our department and in the present study, the significance of perineural invasion was investigated clinicopathologically in 432 cases of rectal cancer. (1) Perineural invasion in rectal cancer appeared to be closely related to the degree of progress of the cancer (depth of penetration, lymph node metastasis, liver metastasis and peritoneal dissemination), the degree of malignancy of the cancer (histologic type, lymphatic invasion and venous invasion) and the degree of inflammatory cell infiltration. (2) It was proven to be an important prognostic factor which influences recurrences and the survival rate. (3) If cases indicated for nerve preserving operation are considered to be those with no perineural invasion or with a low frequency of such invasion, it was assumed that such cases are those with well differentiated adenocarcinoma, a penetration depth of ss (a1) or less and no lymph node metastasis.
Humans↗
[An experimental study of ethanol injection on VX2 liver cancer].
Ethanol injection therapy for rabbit VX2 cancer of the liver was performed to measure the extent of ethanol infiltration using normal hepatic tissue as control, to observe the serial histological findings after ethanol injection, and to determine the influence of the ethanol on survival days with VX2 cancer of the liver. The necrotic area caused by ethanol showed a significant dose-dependent correlation in the range of 0.1-1.0ml in the normal liver, and a significant correlation in the range of 0.2-1.0ml also in VX2 cancer of the liver. Further, VX2 cancer of the liver showed a significant extension in the number of survival days in the injection group after ethanol injection; 39.5 +/- 5.7 days in the injection group, against 29.3 +/- 2.9 days in the control group. In the successive observation of histological findings after injection, fibrosis started from the 3rd-5th day after ethanol injection and showed acceleration after the 7th day. Eosinophilic infiltration was seen in the VX2 cancer group but not among the controls. Since ethanol causes direct necrosis of the injected region, it is suggested that ethanol injection therapy is a potentially effective method of treating cancer of the liver.
Animals↗
Phase II evaluation of combined cisplatin and vindesine in advanced squamous cell carcinoma of the esophagus: Japanese Esophageal Oncology Group Trial.
In the present phase II study, 31 patients with advanced measurable esophageal carcinomas were treated with a combination of 30 mg vindesine/m2 and 70 mg cisplatin/m2. The overall response rate was 16.1% (95% confidence limits, 7.1-32.6%). Responses were seen in metastatic sites, including the liver in two patients, a lung in one, neck or mediastinal lymph nodes in two and primary sites in two. The response durations were between one and two months for patients achieving partial response. The average survival time after first administration was 5.5 months for patients who responded to treatment, whereas, for those who did not, it was 7.3 months. The major form of toxicity was myelosuppression, 14 patients developed grade 2-3 toxicity and one sepsis which led to death. No superiority of the combined chemotherapy over either cisplatin or vindesine therapy alone was suggested for cases of advanced squamous cell carcinoma of the esophagus by the present study.
Aged↗
[Surgical infection and its backgrounds].
The backgrounds of surgical infection of esophageal cancer patients are studied for host factors (relation of nutrition and immune response) and parasite factors surgical parts which are easily contaminated, the differences of serum concentration with 3 methods of antibiotics administration, and the relations about the bacteria in mouth and upper esophagus in operation and bacteria which were found in the respiratory system after operation). The results are as follows. The preoperative nutritional support was effective to rapid recovery of cytological immune functions. But in the post-operative infected cases, immunological recovery delayed and they nutritionally needed BCAA, glutamine, and essential fatty acids. For the study of parasite factors, surgical wounds (neck, chest wall, abdominal wall) were more easily contaminated than other parts except digestive tract. Continuous administration of antibiotics, 1g/hr x 4 was most excessive in three methods. The bacteria in the mouth and upper esophagus in operation and those in airway after operation, were not correlated. Furthermore, antibiotics-resistant bacteria which were Pseudomonas, MRSA were found in the airway. These results indicate that nutritional support is important for the host defense system and antibiotics should be administered considering each operative process. And about the postoperative respiratory infection, protection of hospital infection is important.
Bacterial Infections↗
Operative ultrasound: ten years of experience.
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Humans↗
[Serum levels of beta-seminoprotein (beta-Sm) in patients with breast cancer].
Serum levels of beta-Sm (a component of human seminal plasma) were measured in patients with breast cancer or mastopathy by RIA method. 9.4 +/- 9.5 ng/ml in control healthy adult women and 11.7 +/- 15.7 ng/ml in 8 patients with mastopathy were observed. Whereas, in 30 patients with breast cancer including 28 pre-operation and 2 recurrence 64.5 +/- 52.3 ng/ml were observed. Especially, high levels of beta-Sm (135.8 and 182.3 ng/ml) in the recurrence were detected. Each case of 8 post-operation was below 50 ng/ml. Fifty-seven percent of patients with breast cancer including pre-operation and recurrence were showed over 50 ng/ml. In histological typing, the beta-Sm levels of papillotubular carcinoma were higher than that of scirrhous carcinoma. In tubular carcinoma, 45% of stage I, 67% of stage II and 100% of stage III, IV and recurrence cases were over 50 ng/ml. The evidence suggests that serum levels of beta-Sm is useful for the diagnosis of breast cancer.
Adenocarcinoma↗
Serum carcinoembryonic antigen level increases correlate with tumor progression in patients with differentiated gastric carcinoma following noncurative resection.
Serum carcinoembryonic antigen (CEA) levels were determined serially in 30 preoperative and postoperative patients with differentiated and 47 with undifferentiated gastric cancers. Macroscopic noncurative resection of the stomach was done for those patients. There was no difference between survival curves in the differentiated and undifferentiated cases, and the 50% survival was 13.1 months for the differentiated group and 12.5 months for the undifferentiated group. Preoperative serum CEA levels were 10.4 +/- 5.2 ng/ml for the differentiated and 4.0 +/- 1.6 ng/ml for the undifferentiated cases, and CEA-positive rates were 20.0% for the differentiated and 14.9% for the undifferentiated cases. There was no difference in preoperative CEA values with regard to tissue types. In the course of tumor progression, CEA levels increased during the first postoperative year in the differentiated cases and related reciprocally to decreases in survival rates. Little change was noted in the undifferentiated cases. Therefore, the serial postoperative assay of serum CEA levels has predictability with regard to tumor progression in patients with a differentiated gastric cancer.
Adult↗
[Aspects of parasternal lymphnode dissection in radical mastectomy for breast cancer].
In order to clarify the surgical aspects for parasternal lymphnode dissection to improve prognosis in patients with breast cancer, we have retrospectively investigated a total of 319 patients with breast cancer who underwent radical mastectomy with parasternal lymphnode dissection. During the 13 years from 1974 to 1986, 418 patients with breast cancer underwent radical mastectomy. Of these, 319 underwent combined dissection of the parasternal lymphnodes. Among these 319 cases, 36 (11.3%) showed pathologically-confirmed positive lymphnode metastasis. In those cases involving a tumor of diameter greater than 5 cm and more than 4 positive metastatic axillar lymphnodes, then the positive parasternal lymphnode metastasis was higher than 30%. The 5-year survival rate was 88.9% for negative parasternal lymphnode metastasis and 44.7% for positive cases (p less than 0.01 logrank test). The standard adjuvant chemotherapy, chemo-endocrine therapy and radiation therapy, each did not significantly affect or improve prognosis. We conclude that parasternal lymphnode positivity is an important factor in radical mastectomy affecting prognosis and a more powerful adjuvant chemotherapy must be developed to improve prognosis.
Breast Neoplasms↗
The anticancer effect of antineoplaston A-10 on human breast cancer serially transplanted to athymic mice.
We report the effects of Antineoplaston A-10 Injection on the growth curve of human breast cancer (R-27) serially transplanted to athymic mice. The intraperitoneal administration of 1/4 LD-50 (50 mg/mouse) of Antineoplaston A-10 Injection every day and 1/2 LD-50 (100 mg/mouse) every other day for 35 days was found to significantly inhibit the growth curve and also the 3H-TdR uptake was inhibited by 73.7% in those given 1/4 LD-50 and by 77.1% in those given 1/2 LD-50. The tumor histology in both groups showed necrosis but no lymphocyte infiltration.
Animals↗
Transdiaphragmatic liver scanning: a new intraoperative imaging technique for examination of the liver from the thoracic cavity.
In order to examine the liver during thoracotomy, a new intraoperative imaging technique called "transdiaphragmatic liver scanning" was developed. Transdiaphragmatic scanning performed with high-frequency transducers provided clear visualization of the entire liver from the thoracic cavity through the diaphragm. In our study, transdiaphragmatic scanning was used in 27 thoracotomy operations performed for the treatment of malignant diseases, including lung and esophageal cancers. One 5-mm liver cyst, one 3-mm x 4-mm hemangioma, and one 5-mm x 6-mm ill-defined lesion (possible metastasis), all of which were unrecognized preoperatively, were detected. In 3 operations, preoperatively suspected liver metastases were excluded by transdiaphragmatic scanning. Because transdiaphragmatic scanning provides high-resolution images of the liver and is the only method capable of examining the liver during thoracotomy, this intraoperative scanning technique may become a useful tool in the evaluation of liver metastases from thoracic or mediastinal malignancies.
Cysts↗
Experimental and clinical evaluation of the splenic capping method in the treatment of injured spleens.
Polyglycolic acid elastic mesh was tailored and wrapped around the entire surface of experimentally injured spleens in 11 dogs, while carefully avoiding the splenic hilum, like a "hair-net", to achieve complete hemostasis by compression. All 11 dogs survived the experiment with no postoperative bleeding observed. Histological examination, performed 6 weeks postoperatively, revealed histiocytes, fibroblastic proliferation with collagen and cellular collagenized fibrous tissue forming a neocapsule covering the spleen. Hematologically, the platelet count was increased at 2 weeks postoperatively, but subsequently decreased to within the normal levels by 4 weeks. We employed this splenic capping method clinically in four cases to avoid splenectomy and sufficient hemostasis with ultimate splenic recovery was achieved in each case without any abscess formation, postoperative bleeding, or complications related to the use of the mesh. These experimental and clinical results thus indicate the efficacy and safety of the splenic capping method for preserving the injured spleen.
Adult↗
Treatment of rectal carcinoid tumors.
We investigated the treatment of 24 rectal carcinoid tumors from both the clinicopathologic and prognostic viewpoints. All tumors less than 2 cm in diameter had neither muscle layer invasion nor lymph node metastasis, except for an atypical carcinoid tumor that had both lymphatic permeation and intramural metastasis. One typical carcinoid tumor larger than 2 cm had both several lymphatic permeations and urinary bladder invasion. All cases had a good prognosis with no recurrence and no new metastases. For rectal carcinoid tumors less than 2 cm in diameter, local resection is sufficient, whereas radical operation is required for tumors larger than 2 cm in diameter. For atypical rectal carcinoid tumors, radical operation should be considered even if the diameter is less than 2 cm.
Adult↗
Significance and actual status of the dissection of paraaortic lymph nodes in the cases with gastric cancer.
The results of the surgical resection of the paraaortic lymph nodes metastases of the gastric cancer were evaluated in 116 cases. The frequency of the dissection of paraaortic lymph nodes (No. 16 lymph node) was 20%; the metastatic ratio was 24%. When classified by regions, the highest frequency of metastasis was observed in the cases of upper gastric cancer. The effect of the dissection of No. 16 was more conspicuous when No. 16 metastases were absent than when No. 16 metastases were present. Particularly, the prognosis was improved in the case of n1 and n2 population of the cases which were positive with respect to the proximal lymph node metastasis. It appears altogether that the dissection has considerable significance as prophylactic treatment.
Aorta↗
Postoperative subphrenic abscess following gastrectomy for gastric cancer.
From 1985 to 1989, a total of 598 gastric cancer patients underwent gastrectomies in the First Department of Surgery at Kurume University School of Medicine. Of these, 24 patients (4.0%) incurred a subphrenic abscess, postoperatively. Subphrenic abscesses occurred most frequently after total gastrectomies at a rate of 17 of 197 (8.8%) cases. Leaking gastrointestinal anastomoses were responsible for 12 of the 17 (70.5%) abscesses. In 384 cases of distal gastrectomy, only 6 (1.6%) cases with a subphrenic abscess occurred, and only 3 were due to anastomotic leakage. Among the total of 24 cases with subphrenic abscesses, 16 (67%) were related to an anastomotic leakage including a pancreatic fistula, while the other 8 (33%) showed no leakage by contrast roentgenography. When chest roentgenography shows a pleural effusion and an elevation of the diaphragm, then a subphrenic abscess must be suspected. The majority of patients were treated by replacing the intraabdominal drainage catheter inserted during the gastrectomy with a larger catheter. The overall operative mortality rate was 4.1% due to a death in only one (MOF) patient.
Adult↗