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T Kakegawa

Publications and source records attributed to T Kakegawa.

At least 199 records · Page 11Linked to original sources
PubMed1990

Clinical and pathological evaluation of early cancer in the gastric cardia.

We report 9 rare cases (7 males and 2 females) of early gastric cancer of the esophagogastric junction. From 1976 to 1988, 1308 cases of gastric cancer were resected in our Institute. Of these, 479 (36.6%) cases were early gastric cancer. Among all 479 early gastric cancers, 9 (1.9%) were located within 2 cm of the esophagogastric junction on the lesser curvature and/or posterior wall of the cardia. This represents 11.7% (9/77) of the cases of cancer at the esophagogastric junction. This incidence contrasts with the 39.5% of early cancers elsewhere in the stomach. Overall, 36.6% (479/1308) were early gastric cancer. Eight of these 9 patients were resected through the abdominal approach and one by the thoracoabdominal approach. Seven underwent proximal and 2 underwent total gastrectomy. On microscopic examination, one cancer was m-cancer, and 8 were sm-cancer. Lymphnode metastasis was found to be absent in all 9 cases. The prognosis of cancer of the cardia is generally poorer than that for adenocarcinoma in the corpus or distal stomach. However, cancer recurrence 22-91 months postoperatively was zero in these 9 cases of early gastric cancer at the esophagogastric junction.

Cardia↗
PubMed1990

Retrospective studies of gastric cancer with hepatic metastases.

From 1979 to 1988, a total of 1265 cases of gastric cancer were admitted to our Institute. Of these, 80 cases (6.3%) involved hepatic metastasis. Thirty-eight cases (47.3%) underwent gastrectomy (24 distal, 2 proximal, 11 total and one partial). Of these 38 cases, 7 underwent a combined resection of a simultaneous metastatic hepatic tumor. A total of 19 (67.9%) of the 28 cases in H1, 6 (37.5%) of the 16 cases in H2, and 13 (36.1%) of the 36 cases in H3 underwent gastrectomy. Hepatic metastasis occurred most frequently (18.2%) in Borrmann type 1, 5% in type 2, 14.9% in type 3 and 8.7% in type 4. Of all 593 resected advanced cases, there were 283 differentiated type, with a hepatic metastasis rate of 14.5%, and 310 undifferentiated type with 7.1% rate of hepatic metastasis. In H1 and H2, the prognosis after primary gastric cancer resection was better than for unresected cases. Moreover, there have been reports recently of long-term survival using continuous hepatic arterial infusion of anti-cancer drugs, and of combined resection of the metastatic hepatic tumor after curative gastrectomy. Therefore we should not give up these H1 and H2 patients.

Adult↗
PubMed1990

Survival of rectal carcinoma patients studied with flow cytometric DNA analysis.

The cellular DNA content was measured with flow cytometry from paraffin-embedded materials in 197 patients with primary rectal cancer who had had "curative" resection. All patients were followed clinically for from 2.5 to 7 years. There was a significant difference in recurrent rate between DNA diploid and aneuploid tumors. The cumulative survival rate (Kaplan-Meier) of curative operative rectal carcinomas was worse in DNA aneuploid than in DNA diploid tumors (p less than 0.05). These data suggest that tumor DNA content is an important prognostic indicator for both recurrence and overall survival in patients with primary rectal carcinoma.

DNA, Neoplasm↗
PubMed1990

[Suspected primary tumor in the diaphragm revealing large cell carcinoma in the lung with sarcomatous change].

A 59-year-old female was admitted to our institute with coughing. A primary tumor of the diaphragm was suspected by chest X-ray, CT and angiograms preoperatively. Intraoperative findings also suggested a large primary tumor in the diaphragm with invasion to the lung, pericardium and liver. Therefore, we performed partial resection of the diaphragm, lung, pericardium and liver all together through a right thoraco-abdominal approach and the diaphragm was reconstructed using polyglycolic acid mesh. Histologically, the large tumor located mainly in the diaphragm was sarcomatous, with transposition from the carcinomatous cells to the sarcomatous cells. A large cell tumor of the lung was also confirmed. Immunohistologically, the diaphragm tumor was positively stained by keratin and by epithelial membrane antigen. In addition, desmosomes were demonstrated under electron microscopy studies. The tumor of this case was sarcoma in the diaphragm developed from a minor large cell tumor in the lung. Though commonly thought difficult to prove sarcomatous change development from large cell tumor in the lung, we were able to determine this clearly with immunohistology and electron microscopy.

Carcinoma, Small Cell↗
PubMed1990

Mediastinal tracheostomy using a pectoralis major myocutaneous flap after resection of carcinoma of the esophagus involving the proximal part of the trachea.

An operative procedure of mediastinal tracheostomy using a pectoralis major myocutaneous flap is presented. In this procedure, the terminal portion of the trachea penetrates through the center of a pectoralis major myocutaneous flap and the tracheal wall is completely wrapped with the muscular portion of the flap. Between 1981 and 1988, eight patients with carcinoma in the cervicothoracic segment of the esophagus underwent mediastinal tracheostomy after laryngoesophagectomy and extended resection of the proximal part of the trachea through sternal manubrectomy, because of invasion into the trachea. In five of eight patients, a pectoralis major myocutaneous flap was used to construct a tracheal stoma. A skin flap only, or both a skin flap and a muscle flap, was used in the other three. In four of eight patients, tracheal necrosis occurred, and rupture of the brachiocephalic artery occurred in one patient when the tracheal stoma had been constructed using both a skin flap and a muscle flap. However, neither skin breakdown nor bleeding from the major vessels occurred when using the myocutaneous flap. Therefore, it is concluded that the construction of the tracheal stoma using a pectoralis major myocutaneous flap is recommended for mediastinal tracheostomy after laryngoesophagectomy with extended resection of the proximal part of the trachea.

Aged↗
PubMed1990

[Clinicopathologic study on venous invasion of colo-rectal cancer: a prospective study].

Metachronous liver metastasis developed less than in 5% of v0 and v1 groups, while it developed in 22% of v2 and v3 groups. In addition, it developed in 15% of EF(I) group, in 19% of EF group, in 10% of Intramural greater than Extramural group and in 16% of the Intramural less than or equal to Extramural group. Six-year survival rate of v0, v1, v2 and v3 groups in the cases of curative resection for advanced colo-rectal cancer were 97%, 85%, 57% and 51%, respectively. Also those of E, EF, EI(F), Intramural, Intramural greater than Extramural and Intramural less than or equal to Extramural groups were 83%, 65%, 55%, 86%, 80% and 55%, respectively. Non-hematogenous recurrence developed in 19.4% of v3 group, in 13.6% of EF(I) group and in 15% of Intramural less than or equal to Extramural group. Conclusions were as follows: (1) There was a close relationship between venous invasion and development of liver metastasis (or of non-hematogenous recurrence) and survival of patients. (2) It was proved that the diagnostic criteria of venous invasion established by the authors were good indices to predict survival of colo-rectal cancer patients.

Adult↗
PubMed1990

[The role of surgery in the management of small cell lung carcinoma].

Small cell lung carcinoma is responsive to chemotherapy and radiotherapy, but long-term survival of patients is rarely seen. We analyzed resected 19 patients with small cell lung carcinoma. The overall 5-year survival rate of resected patients was approximately 30% and mean survival time (MST) was 50 months. 2 patients of them survived more than 5 years. The survivors were received chemotherapy and radiotherapy several times after surgery. When we consider the role of resection in the treatment of small cell lung carcinoma, we can realize multimodality therapy including resection is important to obtain long-term survival. Moreover, the surgical resection can identify mixed type with non-small cell elements or residual tumors after chemotherapy and determine optimal treatment methods from their histopathologic findings.

Aged↗
PubMed1989

Effect of OK-432 on large-bowel carcinogenesis in rats.

To examine the carcinogenetic and growth inhibitory effects of OK-432, large-bowel carcinoma was induced experimentally in rats by intrarectal injection of N-methyl-N-nitrosourea (MNU), and OK-432 was administered intradermally. Rats were sacrificed after six months and the large intestine was cut into serial sections. Histopathologic examination and analysis of the infiltrating mononuclear cells, using monoclonal antibodies, were performed. The average rate of carcinogenesis per rat was 15.7 +/- 8.5 in the MNU alone group (n = 10) and 8.3 +/- 3.5 in the MNU and OK-432 group (n = 6). The invasion was deeper than the muscularis propria in 16 out of 157 lesions (10.2 percent) in the MNU alone group and in one out of 50 lesions in the MNU + OK-432 group (2.0 percent) (P less than 0.05). When time of appearance of atypical glands or carcinomas were compared in the MNU alone and MNU + OK-432 group, carcinogenesis was found to be delayed in the MNU + OK-432 group. In the investigation of infiltrating mononuclear cells using monoclonal antibodies, there were increases in helper T cells in both the MNU alone and MNU + OK-432 groups, but there was little difference between the two groups. The results of this study suggest that the suppression of experimental carcinogenesis in the large bowel by the concomitant administration of OK-432 with MNU, may be due to the enhanced activation or prolonged activated state of immunocompetent cells, which appear via antigen recognition, by OK-432.

Adenocarcinoma↗
PubMed1989

Effect of polyamines on mitochondrial F1-ATPase catalyzed reactions.

The effect of polyamines on F1-ATPase catalyzed reactions has been studied through the use of submitochondrial particles and F1-ATPase. ATP degradation catalyzed by submitochondrial particles and F1-ATPase was inhibited by spermine and spermidine. Spermine's inhibition was much greater than spermidine's effect. In contrast, P1-ATP exchange and succinate dependent ATP synthesis catalyzed by submitochondrial particles were both stimulated by spermine. The inhibition of ATPase activity by polyamines probably occurs through polyamine's replacement of Mg2+ on ATP, for the following reasons. (a) The ATPase activity inhibited by spermine was partially recovered when Mg2+ was added. (b) Spermine bound to ATP and phospholipids but not to F1-ATPase; yet spermine inhibited the ATPase reaction catalyzed by F1-ATPase, a protein free of phospholipid. (c) The binding of spermine to ATP was inhibited by Mg2+. The ATP content in polyamine-deficient cells definitely was lower than that in normal cells. On the basis of these results, the possible role of spermine in keeping the ATP concentration at a high level is discussed.

Adenosine Diphosphate↗
PubMed1989

Parameters linked to ten-year survival in Japan of resected esophageal carcinoma. Japanese Committee for Registration of Esophageal Carcinoma Cases.

From January 1969 to December 1980, 8,948 patients with esophageal carcinoma were registered in Japan. Among these patients, 5,506 underwent resection. The ten-year survival rate was 12.3 percent for all registered patients and 18.7 percent for resected cases. Female patients had significantly better survival rates than male patients. Depth of invasion correlated better with ten-year survival than the superficial extent of the tumor. The TNM classification revised in 1987 was examined in relation to the survival, and it was found to have good prognostic value.

Carcinoma, Squamous Cell↗
PubMed1989

Effects of thyroid hormones on cartilage sulphation in sex-linked dwarf chickens.

The present investigation was undertaken to see if exogenous thyroid hormome could stimulate cartilage sulphation in vivo and in vitro in sex-linked dwaft chickens B-thyroxine or 1-3,5,5-triiodothyronine injection for 7 consecutive days stimulated in vivo 35SO2-4 incorporation into trachea cartilages of the dwarf chicken. Both thyroid hormones added to the incubation medium with or without 2.5% dwarf chicken serum also stimulated in vitro 35SO2-4 incorporation into pelvic rudiment from 11-day chick embryos. These data demonstrate that thyroid hormones, like insulin-like growth factor 1, might be responsible for the reduced growth rate of dwarf chickens.

Animals↗
PubMed1989

[Dihydroergotoxine mesylate in the treatment of functioning pituitary adenoma].

Although it is well known that bromocriptine (BC) is effective in the treatment of functioning pituitary adenoma, this agent sometimes causes severe gastrointestinal side effects. In this study, dihydroergotoxine mesylate (EX), which is composed of ergot alkaloids and is similar to BC, was administered to 11 patients with functioning pituitary adenomas who could not tolerate the adverse effects of BC. Three patients (27%) showed clinical improvement with EX treatment alone (1 to 6 mg/day). In another patient, computed tomography demonstrated tumor shrinkage. The remaining seven patients experienced adverse effects while taking EX. These results indicate that EX is a useful alternative to BC in the treatment of functioning pituitary adenoma, particularly in patients who cannot tolerate the side effects of BC. Moreover, pretreatment with EX appears to reduce the incidence of side effects of BC.

Adenoma↗
PubMed1989

Surgical management of residual gastric cancer.

From 1966 to 1985, 2130 patients with gastric cancer were admitted to our surgical department. Among these cancers, gastric cancer following partial gastrectomy for benign gastroduodenal lesion were present in 22 (1%) patients. The original pathology was gastric ulcers in 64% (14 patients), duodenal ulcers in 23% (5 patients), combined gastric and duodenal ulcers in 9% (2 patients), and leiomyoma of the gastric cardia in 4% (1 patient). Fourteen patients were reconstructed by Billroth II, 7 by Billroth I, and one had an esophagogastrostomy after a proximal gastrectomy. The cancer in 19 (86%) patients was resected and 3 (14%) could not be resected. Only 2 (9%) were early cancer, 20 (89%) were advanced cancer including 11 (50%) with Borrmann type 3. A higher proportion of positive lymphnode metastasis was observed for residual gastric cancer (84%) than for primary gastric cancer (49%). The overall 5-year survival rate was 32%, with a 5-year survival rate of 45% for those who underwent curative resection.

Aged↗
PubMed1989

Effects of gastrin releasing peptide and its related peptides on the release of gastrin.

Gastrin release of porcine gastrin releasing peptide (pGRP) and its related peptides were evaluated. The concentration of serum gastrin after intravenous administration of the peptides was measured by a radio immunoassay. Among pGRP and its related peptides, pGRP was found to retain full bombesin potency with respect gastrin release. The carboxy-terminal fragments of pGRP, 14-27, 18-27, and 19-27 were equipotent for gastrin release, though the peak value of serum gastrin caused by each of these three fragments was significantly less than that evoked by pGRP. The pGRP fragment 20-27, despite showing considerably lesser potency, still evoked statistically significant levels of serum gastrin during its infusion. On the other hand, pGRP fragments 21-27 and 1-13 did not exhibit any appreciable activity. It was concluded that the carboxy-terminal octapeptide 20-27 constitutes the vital active core for gastrin releasing activity of the pGRP molecule. The amino-terminal tridecapeptide pGRP (1-13), while itself inactive, appeared to be important for the full active of pGRP.

Amino Acid Sequence↗
PubMed1989

Transgastric vagotomy with selective proximal vagotomy for duodenal ulcer.

To improve surgical results of duodenal ulcer, transgastric myotomy (TGM) was added to the traditional selective proximal vagotomy (SPV) and its efficacy was evaluated clinically in 40 patients. 35 men and 5 women were involved, with a mean age of 33.07 +/- 14.25 years. Pyloroplasty was added in 12 operations for stenosis and perforation. 28 patients in this series underwent TGM with SPV without drainage. In the 36 patients, basal and maximal acid output (BAO and MAO) was compared preoperatively and at 6 months postoperatively. A satisfactory reduction of acid output was achieved, with a mean reduction rate of 71.4% in BAO and of 79.9% in MAO. All 40 patients were negative in Hollander's insulin stimulation test at 6 months postoperatively. The gastric mucosa was injured during myotomy in 2 of the patients (5.0%), and was simply sutured using 3-0 Dexon, without causing any problems. No other early or late postoperative complication was present. In addition, no peptic ulcer recurrence has been noted over a maximal follow-up of 8 years. The present results suggest the completeness of gastric denervation by TGM+SPV, and establish the efficacy of TGM with SPV, and therefore this method is recommended in the surgical treatment of duodenal ulcer.

Adolescent↗