Biomedical subjects

T Kakegawa

Publications and source records attributed to T Kakegawa.

330 records · Page 19Linked to original sources

PubMedDate not supplied

Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus.

Factors responsible for recurrence of esophageal cancer were investigated in 90 patients who underwent extended radical esophagectomy with three-field dissection for a squamous cell carcinoma in the thoracic esophagus. The initial tumor recurrence was grouped as either locoregional (site of the primary tumor, anastomotic site, or lymph nodes) or as distant (distant organs, pleura, or peritoneum). Nineteen patients (21%) developed a locoregional recurrence, and 19 (21%) developed a distant recurrence. One (1%) developed both recurrences simultaneously and was classified as a distant recurrence. The locoregional recurrence was correlated with the stage factors, particularly the number of metastasis-positive nodes. For the distant recurrence, vascular invasion was found to have been the most important prognostic factor. Our findings suggested that locoregional recurrence was due to tumor progress related to the extent of lymph node metastasis, whereas distant recurrence was due to the oncologic behavior of the tumor. Locoregional recurrence in patients with limited disease may be reduced by extended radical esophagectomy with three-field dissection. Distant recurrence cannot be controlled by surgery. Adopted postoperative adjuvant therapies showed no effect on recurrence.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Direct observation of the portal vein interior by intra-operative angioscopy in the dog and man.

The purpose of this study was to develop the technique of intra-operative portal angioscopy using a portal angioscope, and to demonstrate its potential use in the therapy for patients with hepatocellular carcinoma (HCC) bearing a portal thrombus. Portal angioscopes, Olympus BF3C10 and CHFP10 of a diameter of 3.5 mm and 4.8 mm, respectively, were used during operation in five dogs, two patients with hepatic metastasis from colon cancer and three patients with HCC having a portal tumour thrombus. The portal vein and hepatic artery were ligated simultaneously, and the angioscope was immediately introduced under direct vision through a small portal venotomy. Blood in the portal vein was almost fully diverted by infusion of heparinized saline through a channel of the angioscope at a rate of 3 mL/min in dogs and 5 mL/min in patients with hepatic metastasis. Rates of 6 mL/min and 10 mL/min in dogs and patients, respectively, were adequate to clear completely the portal vein of blood. In patients with HCC, portal tumour thrombectomy was performed with a Fogarty balloon catheter by suctioning thrombi through a channel of the fibrescope after visual study of the portal thrombus. Observation and treatment of portal thrombus by angioscopy may become an important part of surgical treatment of HCC with portal invasion, but further technical improvement is desirable before this technique becomes a routine procedure.

Animals↗

PubMedDate not supplied

Effect of glutamine supplementation on protein metabolism and glutathione in tumor-bearing rats.

BACKGROUND: Since tumor-bearing rats are deficient in glutamine, we investigated whether (1) glutamine and glutathione deficiency occur in tumor-bearing rats, (2) glutamine supplementation caused an increase of glutathione levels in host tissues and tumor, (3) glutamine enhances protein synthesis in host tissues, and (4) glutamine stimulated the tumor to synthesize protein and DNA. METHODS: Male Donryu rats were randomized into four groups: (1) non-tumor-bearing rat (NTB) + standard total parenteral nutrition (STPN); (2) NTB + glutamine-supplemented TPN (GTPN); (3) tumor-bearing rat (TB) + STPN; (4) TB + GTPN. On day 0 AH109A rat hepatoma cells were subcutaneously injected into the backs of rats to induce tumor. The animals were maintained on TPN for 6 days from day 10 through day 15. On day 15, 1-14C-leucine was given by a 5-hour continuous infusion (2.0 microCi/h per rat) to determine the fractional synthesis rate and endogenous leucine production. The levels of glutamine and glutathione were measured by HPLC. the tumor DNA synthesis was estimated by bromodeoxyuridine labeling index. RESULTS: Tumor development led to a significant weight loss, but this weight loss was significantly lessened by glutamine supplementation because of an increase in muscle protein synthesis. Glutamine did not enhance tumor weight, protein, and DNA synthesis in the tumor. Tumor development caused a significant reduction of glutathione in the muscle, jejunum, and liver, but supplemented glutamine increased the levels of glutathione in the jejunum. CONCLUSION: Glutamine supplementation is beneficial in preventing deficiencies of glutamine and glutathione and in improving protein metabolism in tumor-bearing rats.

Animals↗

PubMedDate not supplied

The clinical efficacy of CA 72-4 as serum marker for gastric cancer in comparison with CA19-9 and CEA.

The clinical efficacy in preoperative assessment with CA72-4 for gastric cancer was studied in comparison with CA19-9 and CEA. These three tumor markers were examined simultaneously, preoperatively in 100 cases (44: early cancer, 56: advanced cancer) of gastric cancer. Additionally the efficacy of CA72-4 in follow-up postoperative monitoring for the recurrence was investigated. Positive rate of CA72-4, CA19-9 and CEA for early cancer was 2.3%, 11.4% and 9.1% and that for advanced cancer was 37.5%, 17.9% and 35.7% respectively, thus CA72-4 gave the highest positive rate for advanced cancers. And CA72-4 revealed higher positive findings in stage IV, in infiltrating type, in diffuse type, in cancer invading deeper than p-T3. Further, CA72-4 was positive in 50% for cancer with peritoneal dissemination, whereas CEA was positive in 8.3%, CA19-9 in 16.3%. The most beneficial combination among these three tumor markers was CA72-4 and CEA, and by which, positive rate was 53.6%. Regarding follow-up, CA72-4 showed first elevation prior to other markers in some cases before clinical recurrence was confirmed. CA72-4 appeared to be a useful marker for managing gastric cancer.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

Influence of preoperative performance status on survival time of patients with advanced gastric cancer following noncurative resection.

The relationship between preoperative performance status (PS) and the survival time of 152 patients with gastric cancer was determined following macroscopic noncurative resection and postoperative chemotherapy. There were no preoperative differences in laboratory data between the patients who led a normal life or those with a fully ambulatory performance status (PS 0 or 1) and those who were often bedridden (PS 2 or 3). Neither was there any difference between the groups with regard to clinicopathological factors. The doses of drugs prescribed were lower for patients with PS 2-3. There was no difference in the occurrence of drug toxicity between the groups. The patients with PS 0-1 had a significantly longer survival time than did those with PS 2-3 (P < 0.05). PS, a factor more easily measured than the stage of disease at the time of admission, correlates with survival time. We interpret our findings to mean that for patients with gastric cancer who are symptom-free or who are ambulatory with symptoms, clinical trials of drugs may prolong survival time.

Activities of Daily Living↗

PubMedDate not supplied

Postoperative adjuvant chemotherapy with 1-hexylcarbamoyl-5-fluorouracil in patients with colorectal cancer and at a high risk for recurrence.

We examined the effects of postoperative 5-fluorouracil (5-FU) infusions and oral treatment with 1-hexylcarbamoyl-5-fluorouracil (HCFU) on patients curatively resected for stages II-IV colorectal cancer. The study was prospectively randomized, and 251 (93.3%) of 269 patients were valid candidates for statistical assessment. The inductive regimen for group A included 5-FU 10 mg intravenous (i.v.) injections on days 0, 1, 2, 7, 8 and 9, postoperatively. For maintenance therapy, group A received HCFU 300 mg orally and daily for 52 weeks beginning 2 weeks after surgery. The regimen for group B included only 5-FU injections. The effects of this chemotherapy were also retrospectively analyzed for groups at a high risk for recurrence, stages III-IV, transmural invasion-positive and lymph node metastasis-positive cases. There was no statistical difference in survival time between the groups for 251 eligible cases (p = 0.079). In group A given 5-FU plus HCFU, there was a reduction in the recurrence rate for patients with stages III-IV or lymph node metastasis-positive colorectal cancers (p < 0.05) and prolongation of the survival time for patients with stage III-IV, transmural invasion-positive or lymph node-positive colorectal cancers (p < 0.05). Our findings show that the combination of 5-FU infusion and the continuous administration of HCFU is effective in treating patients with surgically resected colorectal cancer who are at high risk for a recurrence.

Administration, Oral↗