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Biomedical subjects

T Kakegawa

Publications and source records attributed to T Kakegawa.

At least 55 records · Page 3Linked to original sources
PubMed1995

Effect of glutamine supplement and hepatectomy on DNA and protein synthesis in the remnant liver.

One of the physiological roles of glutamine is as a precursor for DNA synthesis. The aims of this study were to determine (1) whether glutamine-supplemented total parenteral nutrition (TPN) enhanced DNA and protein synthesis in the liver and (2) whether glutamine uptake was increased following partial hepatectomy in rats. Male Donryu rats (n = 59; body weight, 250-275 g) were randomized into four groups: (1) sham operation + standard TPN solution (C-STPN); (2) C + glutamine-supplemented TPN (C-GTPN); (3) 70% partial hepatectomy + STPN (H-STPN); (4) partial hepatectomy + GTPN (H-GTPN). On Day 0, rats underwent either a sham operation or 70% partial hepatectomy and concomitantly were catheterized in the jugular vein. TPN was begun immediately after the surgery. GTPN was isocaloric and isonitrogenous with STPN and 25% of total nitrogen was given as glutamine. On Day 2, the animals were sacrificed after either a continuous infusion of 1-14C-leucine or a bolus i.v. injection of bromodeoxyuridine. The rate of hepatic regeneration was enhanced with glutamine supplementation (H-STPN, 60.8 +/- 1.6% vs H-GTPN, 66.3 +/- 2.0, P < 0.05) due to an increase in protein synthesis in the liver (H-STPN, 134.0 +/- 10.3%/day vs H-GTPN, 160.9 +/- 6.9, P < 0.05) and DNA synthesis in hepatocytes (H-STPN, 23.1 +/- 2.5% vs H-GTPN, 31.4 +/- 2.9, P < 0.05). The uptake of glutamine by the liver was increased following hepatectomy with GTPN supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Left partial anomalous pulmonary venous connection found during a lobectomy for lung cancer: report of a case.

We report herein the case of a 68-year-old man in whom a partial anomalous pulmonary venous connection (PAPVC) was found during an operation for primary lung cancer. The preoperative clinical findings did not suggest a vascular shunt, and intraoperatively the anomalous vein was seen to drain only from the left upper lobe into the left innominate vein. The lower pulmonary vein connected normally, and there was no atrial septal defect nor any other anomalous condition. A left upper lobectomy with ligation of the anomalous connected vein was performed uneventfully. This type of PAPVC is extremely rare, and is especially noteworthy because there were no clinical signs.

Aged↗
PubMed1995

Laparoscopy-guided extracorporeal resection of early gastric carcinoma.

BACKGROUND AND STUDY AIMS: Though endoscopic mucosal resection is successful for early gastric carcinoma, the indication for endoscopic mucosal resection appears to exclude larger early gastric carcinomas. We report here on our experience in resecting early gastric carcinoma using laparoscopy-guided partial resection of the stomach extracorporeally. PATIENTS AND METHODS: Seven patients with early gastric carcinoma were treated surgically under laparoscopic guidance. After an inspection of the abdominal cavity by laparoscope through an umbilical port, a gastrofiberscope was then inserted into the stomach perorally, and confirmation of the site of the carcinoma was provided by illuminating the interior gastric wall endoscopically. The gastric wall portion including the carcinoma was then exteriorized through a small upper midline incision, and resected. The gastrotomy was sutured extracorporeally, and then repositioned inside the abdomen. RESULTS: All the carcinomas were successfully resected extracorporeally, with cancer-free margins. Postoperative courses were uneventful, and the average period of hospitalization after the operation was ten days. CONCLUSIONS: This type of laparoscopy-guided partial resection of the stomach is expected to become more widely adopted as a treatment for early gastric carcinoma.

Adenocarcinoma↗
PubMed1995

Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy.

PURPOSE: The authors evaluated the efficacy of extended radical (three-field) lymphadenectomy for esophageal cancer compared with less radical (two-field) lymphadenectomy. STUDY SUBJECTS AND ANALYTIC METHODS: The mortality and morbidity rates, postoperative courses, and survival rates were compared between 63 patients who underwent three-field lymph node dissection and 65 who underwent two-field lymph node dissection at Kurume University Hospital from 1986 to 1991. Long-term quality of life after surgery was compared between 37 patients who underwent three-field dissection and 35 who underwent two-field dissection from 1980 to 1991. RESULTS: Three-field dissection resulted in better survival for patients with positive lymph node metastasis from a carcinoma in the upper thoracic or midthoracic esophagus compared with two-field dissection. The mortality rates, postoperative courses and quality of life were the same for both procedures. CONCLUSIONS: Three-field dissection is preferred for upper thoracic or midthoracic esophageal cancer because of improved survival, acceptable mortality and morbidity rates, and good postoperative course and quality of life.

Aged↗
PubMed1995

Expression of MAGE-1 gene by esophageal carcinomas.

Expression of the MAGE genes encoding tumor-rejection antigens on HLA-A1 and -Cw1601 recognized by cytotoxic T lymphocytes was investigated in esophageal carcinomas at the mRNA level by the semiquantitative reverse transcription-polymerase chain reaction method. MAGE-1 and -2 genes, but not MAGE-3, -3/-6 and -4a/-4b genes, were expressed in substantial proportions of the primary esophageal carcinomas and their metastatic lymph nodes. The proportion of MAGE-positive samples in the primary esophageal carcinomas correlated with the T factor of the TNM classification (pT1: 2 of 12 tumors, pT2: 1 of 6, pT3: 12 of 29, and pT4: 7 of 18). These results have important implications for specific immunotherapy of esophageal carcinomas using MAGE-1 gene product.

Antigens, Neoplasm↗
PubMed1995

Total pelvic exenteration for locally advanced colorectal carcinoma--postoperative complications.

This study was designed to clarify the postoperative major complications of total pelvic exenteration for locally advanced colorectal cancer. Twenty-six patients (primary disease: 17, recurrent disease: 9) were retrospectively studied. Major complications developed in 30.8% (8 of 26); in 23.5% (4 of 17) for a primary disease and in 44.4% (4 of 9) for a recurrent disease. Only 2 patients (7.7%) died within 30 days after the operation; one patient died of hepatic failure and another of pelvic sepsis. Postoperative ileus developed at a high rate of 11.5% (3 of 26). Ileo-ileal anastomotic leakage developed at a rate of 7.7% (2 of 26) and it commonly occurred following irradiation. The remaining one patient had gastrointestinal bleeding. These 6 patients surviving the operation were successfully managed conservatively. Conclusion was as follows: Total pelvic exenteration should be performed carefully and aggressively regardless of the development of postoperative complications.

Adult↗
PubMed1995

Clinicopathologic characteristics of stage I lung adenocarcinoma in women.

A total of 75 cases of surgically resected Stage I lung adenocarcinoma in women were analyzed. The patients were divided into three age groups: less than 50, between 50 and 70, and more than 70 years old. On the basis of the pathological T factor, 45 of 75 (60%) were T1 and 30 of 75 (40%) were T2 tumor. On the basis of pleural involvement, 47 of 75 (63%) cases revealed p0. On the basis of differentiation, all but two cases (97%) were well to moderately differentiated. On the basis of structure, papillary adenocarcinoma were 64 of 75 (85%). There was no difference among the three age groups in the pathological findings. Survival curves of each group indicated no statistically significant difference. We suggest that hormonal factors related to age do not affect the characteristics of lung cancer in women nor the survival of the patients.

Adenocarcinoma↗
PubMed1995

[A case of unresectable advanced gastric cancer responding remarkably to combined chemotherapy with 5-fluorouracil and low-dose cisplatin].

A 62-year-old male patient complaining epigastralgia was diagnosed as having Borrmann type 2 gastric concer (por). The primary lesion was unresectable, so the patient was treated by combined chemotherapy with 5-fluorouracil and low-dose cisplatin for 4 weeks, which resulted in the disappearance of primary tumor and a remarkable reduction of metastatic lymph nodes. The patient has a good quality of life without any sign of recurrence now.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Significance of MMP-9 and TIMP-1 production during liver metastasis in colorectal cancer].

We have investigated the expression of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinases 1 (TIMP-1) in colorectal cancer by the immunostaining (avidin-biotin peroxidase complex method) and in situ hybridization (ISH). Both MMP-9 enzyme and messenger RNA (mRNA) for MMP-9 were located in tumor cells, neutrophils, monocyte-macrophages and fibroblasts in colorectal cancer tissue. The location of TIMP-1 mRNA was similar to that of MMP-9 mRNA in colorectal cancer tissue. There was a strong correlation between the expression of MMP-9 in tumor cells and liver metastasis. The expression of mRNA for TIMP-1 in stromal cells in cases associated with liver metastasis was significantly higher than that in cases without liver metastasis. However, in tumor cells, predominant expression of MMP-9 mRNA was observed in all cases associated with liver metastasis. These results suggest that MMP-9 might play an important role in hematogenous metastasis in colorectal cancer and that the balance between the production of MMP-9 and TIMP-1, in particular in tumor cells, is important as one of the pathogenesis of tumor metastasis.

Collagenases↗
PubMed1995

Two laparoscopic techniques for resection of leiomyoma in the stomach.

We report two surgical treatments by laparoscopic techniques of a leiomyoma in the stomach, each for one patient. The patients, one a 59-year-old man and the other a 28-year-old woman, were found to have an asymptomatic submucosal tumor in the stomach in an annual medical screening. One tumor, 1.5 cm in maximum diameter, was located on the anterior wall of the gastric body and was excised extracorporeally by laparoscopy-guided surgery. The other was 1.9 cm in maximum diameter, on the anterior wall of the antrum, and was excised intracorporeally using only laparoscopic surgery. Their postoperative courses were uneventful. They drank clear liquid after the removal of a nasogastric tube on the first postoperative day and had a solid meal on the second postoperative day. They were discharged from the hospital on the seventh and eighth postoperative days.

Adult↗
PubMed1995

[A controlled study of AO-90, a methionine-free intravenous amino acid solution, in combination with 5-fluorouracil and mitomycin C in advanced gastric cancer patients (surgery group evaluation)].

The results of recent preclinical and clinical studies suggest that AO-90, a methionine-free intravenous amino acid solution (7.43%), potentiates the antitumor effect of 5-fluorouracil (5-FU). In the present multi-center, randomized, controlled study conducted at the surgery departments of 53 institutions between July 1991 and March 1993, patients with advanced gastric cancer were randomly allocated to receive either AO-90 (500-750 mL/day, AO/MF group) or Amiparen, a commercial intravenous amino acid solution (600-800 mL/day, C/MF group) by total parenteral nutrition for 14 days. Both groups received MF therapy which consisted of a continuous infusion of 5-FU at 350 mg/m2/day for 14 days and an i.v. push of mitomycin C 7 mg/m2 on days 7 and 14 (one course). Additional treatment courses were initiated after a withdrawal period when appropriate. Of the 138 subjects enrolled, 129 (93.5%) were eligible and 119 (86.2%) completed the scheduled treatment (AO/MF group: 57, C/MF group: 62). The overall clinical response rates in the completed cases were 26.3% (15/57) in the AO/MF group and 8.1% (5/62) in the C/MF group, and the difference between the groups was significant (p = 0.015). In particular, the response rate in the postoperative recurrent patients with measurable lesions was 42.9% (12/28) in the AO/MF group versus 12.0% (3/25) in the C/MF group (p = 0.016). Further, in the patients who were previously treated with fluoropyrimidine drugs, 29.0% (9/31) responded to the AO/MF therapy versus 8.6% (3/35) in the C/MF group (p = 0.053). The treatment-related adverse reactions observed were mainly hematologic and subjective/objective symptoms, such as decreased leukocyte count and hemoglobin level, nausea/vomiting and stomatitis. The differences in the incidence were not significant between the groups. Based on these results, AO-90 in the MF regimen appears to be effective in the treatment of patients with advanced gastric cancer by significantly potentiating the effects of 5-FU.

Adolescent↗
PubMed1995

[Progress in surgical treatment of carcinoma of the intrathoracic esophagus].

In the past 20 years, 403 patients with thoracic esophageal carcinoma underwent radical surgery. The aim of this study was to determine whether extended lymph node dissection improved the prognosis of these patients. All of the patients were divided into 4 groups every 5 years from group A to group D. Group A (n = 39) underwent radical esophagectomy with lower mediastinal and abdominal lymphadenectomy by the left thoracoabdominal approach. Majority cases in Group B (n = 94) also underwent radical esophagectomy with right upper, lower mediastinal and abdominal lymphadenectomy (incomplete 2-field dissection) by the right thoraco-abdominal approach. About 40% cases in Group C underwent radical esophagectomy with extended cervicothoraco-abdominal lymph node dissection (3-field dissection) and almost all of the others had radical esophagectomy with 2-field dissection. About 60% of the cases in group D underwent radical esophagectomy with 3-field dissection and the majority of the others had complete 2-field dissection (i.e.) radical lymphadenectomy around bilateral upper, lower mediastinal and abdominal lymph nodes. The five-year survival rate was 21% in group A, 23% in group B, 37% in group C and 55% in group D. The survival curve was improved according to the extent of lymph node dissection. Especially significant improvements of survival rate were found in group C and D compared with those in group A and B. Furthermore, group D showed significantly better survival than that of group C. Complete 2-field and 3-field dissection resulted in a better prognosis than incomplete 2-field dissection, while no significant difference in prognosis was found between complete 2-field and 3-field dissection. However, neither 2-field nor 3-field dissection resulted in improved prognosis in cases involving 7 or more positive lymph node metastases. These results suggest that radical esophagectomy and lymph node dissection involving bilateral upper mediastinal area are important factors to improve postoperative prognosis in patients with thoracic esophageal carcinoma. However, more effective adjuvant therapy is needed for the patients with many positive node metastases.

Esophageal Neoplasms↗
PubMed1995

[Postoperative prognostic factors for carcinoma of the thoracic esophagus].

To evaluate significant postoperative prognostic factors for esophageal carcinoma, clinicopathological findings and several markers for biological malignant potential were studied, including cell nuclear DNA contents, EGF receptor, p53 protein, MMP-2, Ki-67 positive cell rate, and tumors infiltrating Leu 7 cells. The subjects of this study were 96 patients with thoracic esophageal carcinoma, who underwent radical surgery with extended lymphadenectomy. In the pathological findings, the postoperative survival rate significantly correlated with depth of invasion (pT1(-2) vs. pT3, p = 0.003), lymph node involvement (pNo vs. pN1, p = 0.0002), vascular invasion (-vs. +, p = 0.0003), stage (pSt. 1-2A vs. 3, p = 0.0018), and the number of node involvements (1-3 vs. more than 4, p = 0.025). Analyzing the markers for the malignancy, a significant difference in postoperative mortality due to the relapse was recognized with p value of 0.0009 between Ki-67 positive (under 1%) and Ki-67 negative (over 1%) tumor. Ki-67 positive tumor significantly correlated with the mortality in both cases with pNo (p = 0.024) and pN1 (p = 0.020). Low-grade tumor infiltrating Leu 7 cells significantly correlated with the mortality (Grade 1+ vs. 2+, p = 0.013; Grade 1+ vs. 3+, p = 0.008). These results suggest that Ki-67 study is a useful prognostic factor after radical surgery for thoracic esophageal carcinoma.

DNA, Neoplasm↗
PubMed1995

[Comparison of CAF plus MPA with CAF plus TAM for advanced or recurrent breast cancer--Kyushu CAFT Study Group of Advanced or Recurrent Breast Cancer].

A multi-center randomized comparison study of CAF + TAM therapy (Arm A) and CAF + MPA therapy (Arm B) in advanced or recurrent breast cancer was conducted at 37 institutions in Kyushu. Out of 119 registered cases, 114 were eligible and 76 were evaluable. The response rate was 42% (15/36) in Arm A and 58% (23/40) in Arm B. In the comparison of side effects, nausea/vomiting and anorexia were significantly less and moon face and body weight gain were significantly more in Arm B. Leucocytopenia was significantly inhibited in Arm B compared with Arm A, which indicated the myeloprotective effect of MPA. These results indicated that CAF + MPA therapy (Arm B) may be more advantageous than CAF + TAM therapy (Arm A) in advanced or recurrent breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Primary linitis plastica carcinoma of the colon and rectum.

BACKGROUND: Linitis plastica carcinoma (LPC) usually shows a scirrhous growth pattern with a severe stromal desmoplastic reaction. Another growth pattern showing lymphangiosis carcinomatosa rather than scirrhous growth pattern, however, was noted. This study was designed to clarify the clinical and pathologic characteristics of colorectal LPC. METHODS: Linitis plastica carcinoma was reviewed clinicopathologically and classified into two types according to the histologic growth pattern: The first was a scirrhous type (nine patients) and the second, a lymphangiosis type (three patients). RESULTS: Grossly, the mucosal surface of the scirrhous type had a granular, cobblestone, gyriform-like appearance. The cancer cells were composed mainly of poorly differentiated or signet-ring cells and were accompanied by a severe stromal desmoplastic reaction; lymphatic permeation was not so marked. Most patients with this type of cancer died of peritonitis carcinomatosa. The mucosal surface of the lymphangiosis carcinomatosa had a smooth and glossy appearance. The cancer cells were composed mainly of moderately differentiated cells, frequently with a glandular formation. Stromal desmoplastic reaction was not so marked. The growth pattern was characterized by lymphangiosis carcinomatosa and marked venous invasion. All patients who had this type died of distant metastases. CONCLUSION: Perhaps with earlier diagnosis and aggressive treatment, the peritoneal dissemination of scirrhous LPC and distant metastasis of lymphangiosis LPC may be minimized.

Adenocarcinoma, Scirrhous↗
PubMed1994

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

Supplemental glutamine prevents gut atrophy and enhances muscle protein synthesis in septic rats. This study investigated the effect of glutamine administration and mitomycin C treatment on protein turnover in tumor-bearing rats. AH109A rat ascites hepatoma cells (2 x 10(6)) were subcutaneously implanted in the back of male Donryu rats (n = 32, body weight 150-200 g) on Day 0. The animals were then fed rat chow ad libitum for 10 days. On Day 10, the rats were catheterized for TPN and randomized into four groups according to diet and treatment. The groups were: (i) standard total parenteral nutrition (STPN) + saline; (ii) glutamine-supplemented TPN (GTPN) + saline; (iii) STPN+mitomycin C (MMC); (iv) GTPN+MMC. GTPN was isocaloric (250 kcal/kg/day) and isonitrogenous (1.5 gN/kg/day) with STPN. The animals were maintained on TPN for 5 days and received mitomycin C (0.5 mg/kg) via the catheter every day. On the fifth day of TPN, [1-14C]leucine was given via a 5-hr continuous infusion (2.0 microCi/hr/rat) to determine the fractional synthesis rate of muscle, gut mucosa, liver, and tumor. Also, endogenous leucine production (not equal to whole body protein breakdown rate) was calculated. Body weight loss during TPN was reduced with GTPN. GTPN enhanced muscle FSR in untreated animals (STPN: 10.8 +/- 8.7%/day vs GTPN: 14.7 +/- 0.6%/day, P < 0.05) and in mitomycin C-treated animals (STPN+MMC: 9.6 +/- 0.9%/day, GTPN+MMC: 12.0 +/- 0.8%/day, P < 0.05). The whole body protein breakdown rate was reduced with GTPN. Mitomycin C reduced the mucosal fractional synthesis rate and GTPN did not prevent this reduction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Long-term follow-up study of conventional irradiation for brain tumours in children: a role for radiosurgery.

21 younger patients (less than 10 years of age) with brain tumours, treated by conventional irradiation, were followed 5 to 20 years (mean 12), using CT scan and/or MR imaging, in order to evaluate adverse effects on the developing brain. Pathological changes such as brain atrophy, lesions in the white matter, calcifications in the brain, and angiopathy were observed in 13 (62%) out of 21 cases. The incidence of abnormalities was related to the age at treatment and the follow-up period. All six cases treated at or under 5 years old and followed more than 10 years showed pathological changes in the brain. In order to minimize the radiation damage, 5 patients with brain tumours less than 5 years old were treated by gamma knife surgery. The early results encourage further trials. Radiosurgery may play a role as an alternative treatment or as a component of future multidisciplinary treatment for brain tumours is children.

Brain↗