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Biomedical subjects

T Kakegawa

Publications and source records attributed to T Kakegawa.

At least 217 records · Page 12Linked to original sources
PubMed1989

Esophageal invasion by an upper gastric cancer: retrospective evaluation and prognosis.

From 1975 to 1984, 894 patients with gastric cancer were operated on in the Department of Surgery at Kurume University School of Medicine. Of these, 86 (10%) had upper gastric cancer invading the esophagus. The 86 resected tumors were divided into two groups according to the surgical approach, thoraco-abdominal or abdominal. Twenty-three (27%) were resected through the abdominal approach and 63 (73%) were resected by the thoraco-abdominal approach. The overall positive mediastinal lymphnode metastasis rates for the 55 patients who underwent mediastinal lymphnode dissection by the thoraco-abdominal approach were 22% for differentiated type and 37% for undifferentiated type. The positive mediastinal lymphnode metastasis and the correlation to the extent of esophageal cancer invasion were observed at a minimal 7 mm distance from the esophago-gastric (E-G) junction for the undifferentiated type, and 2.2 cm for the differentiated type. Sixteen patients with cancer invading the esophagus were radically resected by the abdominal approach with an overall survival rate of 39%, while 48 were resected by the thoraco-abdominal approach with a 5 year survival rate of 40%. The 86 resected tumors were further subdivided into two groups according to the year of surgery. From 1975 to 1979, the abdominal approach was employed in 36% and the thoraco-abdominal approach in 64% of the surgeries, with an overall curative resection rate of 47%. However, from 1980 to 1984, the abdominal approach was employed in only 17% and the thoraco-abdominal approach in 83% of the surgeries and the curative resection rate increased to 59%.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1989

Gastric operations in patients with hepatic cirrhosis following endoscopic sclerotherapy.

Three patients with hepatic cirrhosis who had undergone gastric operations following endoscopic sclerotherapy were retrospectively reviewed. One patient had undergone total gastrectomy for gastric cancer and two had Hassab and Tanner operations for gastric and esophageal varices. All patients were recovering with no complications related to the operations and were free of disease for 2 years, postoperatively. When esophageal varices are found in combination with an upper gastric cancer that requires total gastrectomy, endoscopic sclerotherapy for esophageal varices is contraindicated because severe esophageal injuries may be induced by the sclerosing agent. The Hassab and Tanner method is useful for esophageal and gastric varices after sclerotherapy. A repeat endoscopic sclerotherapy should be performed after this operation.

Esophageal and Gastric Varices↗
PubMed1989

[Intra-arterial infusion chemotherapy of liver metastases in colorectal cancer].

We report the complications and the results of intra-arterial infusion chemotherapy (IAIC) for liver metastases in colorectal cancer. Fifteen synchronous liver metastases and 11 metachronous liver metastases were treated from September 1986 to February 1989. Eight cases had H1 (metastases in one lobe only), 11 cases H2 (a few scattered metastases in both lobes) and 7 cases had H3 (numerous metastases in both lobes). Eight cases underwent hepatic resection and 20 cases were treated by IAIC with implantable reservoir. Incidence of complication was decreased from 75% to 17% by the improved technique of hepatic arterial catheter intubation. Median survival was 12 months, 20 months and 8 months, respectively. When used with MMC, the IAIC showed unsatisfactory results. We should therefore investigate possible use of alternative drugs, their optimum dosages, and the regimens for improved chemotherapy.

Adult↗
PubMed1989

Effect of polyamine related tetraamines on anti-ulcerogenic activity and anti-H+,K+-ATPase activity.

The relationship between the structure of polyamine related tetraamines and their anti-ulcerogenic activity in rats was studied. Among the tetraamines tested, linear tetraamines had stronger anti-ulcerogenic activity in both restraint stress-induced gastric ulceration and ulceration in pylorus-ligated rats. Macrocyclic tetraamines and polycyclotetraamines had less anti-ulcerogenic activity. Correlation was detected between the inhibitory effect of tetraamines on gastric secretion in pylorus-ligated rats and their inhibitory effect on H+,K+-ATPase activity in rat gastric mucosa. Thermine and spermine were the most effective in these two inhibitions. Thus, it is suggested that primary aminogroups are important in both anti-ulcerogenic activity and anti-H+,K+-ATPase activity.

Adenosine Triphosphatases↗
PubMed1989

[Cervico-thoracic-abdominal lymph node dissection for carcinoma of the thoracic esophagus].

Over the period from 1982 to 1988, 127 cases with carcinoma in the thoracic esophagus underwent curative resection through a right thoracotomy. Cervicothoracic-abdominal lymph node dissection was performed in twenty-seven cases. No operative death occurred and only one hospital death (4%) was recorded. The only postoperative complication was recurrent laryngeal nerve palsy. Based on the adjusted survival-rate curves using Cox's method, there was significant difference in prognosis in favor of these 27 cases that received cervicothoracic-abdominal lymph node dissection over those that did not. The survival rate of all curatively operated cases was noticeably improved by using this procedure. Of those that underwent dissection only, or dissection with postoperative radiotherapy or chemotherapy, the best prognosis could be reached by a combination of the cervicothoracic-abdominal lymph node dissection and postoperative chemotherapy. From follow-up data regarding recurrence rates, a more extended dissection and complete removal of lymph nodes in the left upper mediastinum and retroperitoneum should further improve the long-term prognosis.

Abdomen↗
PubMed1989

A phase II study of vindesine in the treatment of esophageal carcinoma. Japanese Esophageal Oncology Group.

A phase II study of Vindesine for esophageal carcinoma was carried out cooperatively by 10 Japanese institutions. Fifty patients were enrolled in the study over a year and ten months. Four patients could not be evaluated because less than 4 weeks had elapsed since their preceding therapy. There were one complete remission and five partial remissions among the 46 remaining patients, a response rate of 13.0%. The patient experiencing the complete remission is still alive more than 24 months after treatment. The main side effects were depilation, anorexia, stomatitis and leukopenia. Thrombocytopenia and elevations of blood urea nitrogen and creatinine were not marked. There was no mortality connected with the administration of Vindesine. It was concluded that Vindesine is useful in the treatment of esophageal carcinoma as a single agent.

Aged↗
PubMed1989

Operative ultrasonography for lung cancer surgery.

During 60 operations for lung cancer, high-resolution (7.5 MHz) operative ultrasonography was performed to evaluate direct cardiovascular invasion of tumor (24 operations), lymph node metastasis (30 operations), liver metastasis (13 operations). Immediately after thoracotomy or sternotomy but before tissue dissection, operative scanning enabled delineation and evaluation of the evaluation of the vessels and heart (atrium) behind or within the tumor and detection of regional lymph nodes. The accuracy of operative ultrasound in diagnosing the presence or the extent of cardiovascular invasion was 91.7% (22 of 24 operations), which was significantly (p less than 0.02) higher than preoperative studies (62.5%), including computed tomography and angiography. Of the 24 surgical procedures, 23 were consistent with operations proposed on the basis of operative ultrasound findings, whereas only 16 were consistent with preoperatively proposed (p less than 0.01). Operative ultrasound provided the capability of depicting lymph nodes as small as 3 mm. More lymph nodes (8.0 +/- 1.84 nodes per cancer) were detected with operative ultrasound than with computed tomography (4.8 +/- 1.56 nodes) (p less than 0.001); however, the sensitivity and specificity of operative ultrasound in determining lymph node metastasis were 82.4% and 67.3%, respectively. No liver metastasis was identified. The information provided by operative ultrasound regarding cardiovascular invasion and lymph node and liver metastasis was considered helpful in selecting the type of surgical procedure an in avoiding unnecessary tissue dissection.

Adult↗
PubMed1989

[A case report of thoracic duct cyst].

A case of mediastinal thoracic duct is described. A 27-year-old female patient was referred to our hospital for abnormal finding of her chest X-ray film, which revealed a mediastinal mass. CT scan, endoscopic ultrasonography, MRI showed that the mass was cystic in the posterior mediastinum. Intra operative ultrasonography demonstrated a thin-walled ovoid cyst containing some high echoic parts inside, which suggested condensed milky fluid. The small pedicle entered the upper pole of cyst was found at surgery and the cyst contained chyle about 300 ml. Histopathological specimen of resected cyst showed a structure of thoracic duct with some lymphoid tissue. Postoperative course was smooth. The characteristic finding of ultrasonography seemed to be valuable in the diagnosis of thoracic duct cyst.

Adult↗
PubMed1989

[A retrospective study of recurrent breast cancer following radical mastectomy].

During 10 years from 1974 to 1986, 390 patients with breast cancer underwent radical mastectomy in our consisting of 12 local lymph node, 26 bone metastasis and 20 lung metastasis. A total of 63 (69%) were found within 3 years. The time internal between radical mastectomy and cancer recurrence was significantly correlated with three year and five year survival rates. Radiation therapy was a adequate chemo-endocrine therapy was required in the control of bone metastasis.

Bone Neoplasms↗
PubMed1988

A latissimus dorsi muscle flap used for repair of the esophagus after enucleation of a giant leiomyoma--a case report.

A giant leiomyoma of the esophagus, 11.5 X 5.0 cm in size, which occupied half of the esophageal circumference, was surgically enucleated. A small epithelial defect caused by the enucleation of the tumor was directly closed, and a large muscular defect was covered with a latissimus dorsi muscle flap, introduced into the thoracic cavity through the space where the second rib had been resected. Postoperatively, a leakage at the epithelial suture line was noted, however, it was localized by the muscle flap coverage and spontaneously healed two weeks postoperatively. During the follow-up period of 1.5 years, no diverticle formation or stenosis occurred, and the patient had no complaints. The present clinical experience indicates that this procedure may be a useful method of grafting after excision of giant leiomyoma of the esophagus.

Adult↗
PubMed1988

Evaluation of endorectal ultrasound for the assessment of wall invasion of rectal cancer. Report of a case.

To accurately assess the depth of cancer invasion, endorectal ultrasound was performed using a radial scanner (Aloka, 7.5 MHz) in 145 patients with rectal cancer. High-resolution ultrasound clearly depicted five- or seven-layer echographic structures in the normal rectal wall, and demonstrated cancer as a hypoechoic lesion. These layer structures provided an important feature in determining the depth of cancer invasion. Rectal cancers of 122 patients were examined thoroughly by endorectal ultrasound. In 95 of these patients (77.9 percent), ultrasonic assessment of the depth of cancer invasion as classified in four groups was correct, corresponding accurately to the microscopic findings. Ultrasonography overestimated the depth of cancer invasion in 21 patients, however, and underestimated it in six patients. This study indicated that a cause of the overestimation was inflammatory cell infiltration around cancer, and that one possible cause of underestimation was microscopically minimal invasion of cancer. Although there are certain limitations of endorectal ultrasound, this ultrasound technique will provide valuable information to determine the preoperative staging of rectal cancer.

Female↗
PubMed1988

Effect of various polyamine analogs on in vitro polypeptide synthesis.

Various polyamine analogs were examined for their ability to stimulate and to function as sparing agents for the Mg2+ requirement in polypeptide synthesis at various temperatures in Escherichia coli (37 and 47 degrees C) and the extremely thermophilic Thermus thermophilus (60 and 70 degrees C) cell-free systems. The optimal concentration of each polyamine analog increased as the incubation temperature was elevated. At a fixed temperature, the optimal concentration of polyamine analogs was in the order diamines greater than triamines greater than tetraamines greater than pentaamines. All diamines tested stimulated polypeptide synthesis almost equally but lowered the optimal Mg2+ concentration in the order diaminopropane greater than putrescine greater than cadaverine. The degree of diamine stimulation was maximal at 37 degrees C. The effects of three triamines were very similar in the E. coli system but in the T. thermophilus system spermidine was most effective in stimulation of polypeptide synthesis. From the results of experiments using tetraamines and pentaamines, it was deduced that the presence of both aminobutyl and aminopropyl groups in polyamine analogs is important for stimulation of polypeptide synthesis. In the E. coli system, triamines were the most effective polyamines for stimulation of polyphenylalanine synthesis at both 37 and 47 degrees C, while, in the T. thermophilus system, thermospermine, a tetraamine, was most effective at 60 degrees C and 3,4,4,3-pentaamine was most effective at 70 degrees C.

Cell-Free System↗
PubMed1988

Effects of propylthiouracil (PTU) on the immunological status of the chicken.

Effects of propylthiouracil (PTU) using different treatment schedules on immune functions in young male chicken were studied. Antibody productions to sheep red blood cells (SRBC) and Brucella abortus (BA) were found to rise in the chicks treated with 0.1% and 1% PTU. Furthermore, the chicks treated with 1% PTU exhibited a significantly greater reaction to phytohemagglutinin (PHA) in skin test using the wing web than the control did. Treatment of 5% PTU, however, inhibited the antibody productions to SRBC and BA and the reaction for the skin test to PHA. Antibody titers to both antigens and serum IgG level were lower in the chicks after cessation of PTU treatment. The most conspicuous histology was the lymphatic depletion of the lymphoid organs in chicks treated with 5% PTU. The bursa of Fabricius, thymus and spleen were severely atrophied. The total WBC and the number of lymphocytes and monocytes were significantly reduced in the presence of 0.1% and 1% PTU at 8 weeks of age. Although, concentrations of serum thyroxin (T4) and 3,5,3'-triiodothyronine (T3) were significantly lower in the chicks treated with all doses of PTU, the cessation of the treatment was followed by an increase in the concentrations of serum T4 and T3 to levels not different from in the untreated control chicks. These data showed that PTU at 0.1% and 1% concentrations did not suppress immune responses in chickens unlike the case reported in mammals.

Animals↗
PubMed1988

Changes in plasma thyroid hormones, luteinizing hormone (LH), estradiol, progesterone and corticosterone of laying hens during a forced molt.

1. Circulating concentrations of iodothyronines, luteinizing hormone(LH), estradiol(E2), progesterone and corticosterone were measured in hens before, during, and after a forced molt induced by fasting. 2. Corticosterone increased at the onset of molt, peaked at the maximal molt and returned to pre- and post-molt levels. LH, E2 and progesterone declined during the molt, and the decline was coincident with the cessation of egg production. 3. Thyroxine(T4), triiodothyronine (T3) and reverse triiodothyronine(rT3) increased during the molt. The increases of T4 and T3 were not abolished even if the forced molt was conducted in mild weather.

Animals↗
PubMed1988

Suppression of human growth hormone (GH)-releasing hormone-induced GH secretion in pentobarbital-anesthetized rats after electrical stimulation of the midbrain central gray and several raphe nuclei.

To investigate the neural mechanism involved in suppression of GH secretion, we examined the effect of electrical stimulation of the midbrain central gray (CG) and several raphe nuclei on human (h) GRF-induced GH secretion in pentobarbital-anesthetized rats. A concentric bipolar stimulating electrode was implanted stereotaxically into each nucleus under pentobarbital anesthesia 1 week before stimulation. Blood samples were taken through a cannula placed in the right atrium via the right external jugular vein. Under pentobarbital anesthesia, 5 micrograms hGRF dissolved in 0.3 ml saline were systemically applied through this cannula. Ten minutes after the infusion, plasma GH was increased from the resting value of 28.5 +/- 7.1 ng/ml (mean +/- SE) to 686.1 +/- 62.0 ng/ml. Biphasic electrical stimulation was delivered for the first 10 min. When the CG was stimulated with a current of 500 microA, hGRF-induced GH secretion was markedly suppressed. However, even when the stimulation site was outside the CG, hGRF-induced GH secretion was suppressed. But with a smaller current (100 microA) the suppressive effect was observed only when the medial portion of the CG was stimulated. This suppression was abolished by prior lesioning of the hypothalamic periventricular nucleus (Pe), in which most of the somatostatin-immunoreactive fibers in the median eminence originate. The stimulation of the dorsal raphe with a current of 500 microA suppressed the GH increment at 10 min, but no suppression occurred with a current of 100 microA. This suppression was abolished by prior lesioning of the Pe. Electrical stimulation of the rest of the raphe nuclei had no effect on hGRF-induced GH secretion. These results suggest that electrical stimulation of the CG suppresses hGRF-induced GH secretion, and the most effective area is the ventromedial portion of the CG. These suppressive actions may be achieved by activation of the somatostatin neurons in the Pe.

Animals↗