Search PubMed⌕ Search

Biomedical subjects

T Kakegawa

Publications and source records attributed to T Kakegawa.

At least 109 records · Page 6Linked to original sources
PubMed1993

Clinicopathological characteristics of colorectal submucosal carcinoma with lymph node metastasis.

The clinicopathological characteristics of colorectal submucosal carcinoma with lymph node metastasis are described. Lymph node positive metastasis was found in 10 (11%) of 87 cases. The depth of submucosal invasion was classified as sm1, sm2 or sm3. Lymph node positive metastases were found in 18% of the cases at sm2 or more, in 31% of those without adenomatous components, in 39% of those with positive lymphatic permeation, in 41% of those with positive budding, and in 56% of all the moderately differentiated adenocarcinomas. These characteristics are risk factors and are important for the prediction of lymph node metastasis from colorectal submucosal carcinoma. Bowel resection with lymphadenectomy is indicated in the presence of any one or more risk factors.

Adult↗
PubMed1993

Therapeutic rectoscopy for rectal tumors.

A surgical resection in the middle or upper region of the rectum is often technically difficult because of the anatomical inaccessibility of the site. A new rectoscopic operative technique reported by Buess et al. (1985, 1987, 1988) and Kipfmüller et al. (1988) permits microsurgery in the rectum and is less aggressive than other procedures. This technique was used in 7 patients with rectal tumors using an articulated monocular-optical system. The postoperative course in all patients was free from any complications and the patients were discharged at the latest on the eighth day after the operation. A stereoscopic optical system, a new surgical rectoscope, other special surgical instruments, as well as a modification to an insufflation device are necessary for improving the endoscopic operation.

Aged↗
PubMed1993

Stage I adenocarcinomas of the lung: survival of females and males.

Seventy-two cases of Stage I lung adenocarcinomas in females were analyzed and compared with 84 cases in males, all of which were surgically resected at the National Kyushu Cancer Center Hospital in Japan. The females with Stage I adenocarcinomas had a tendency, that was not significant, towards a longer survival than the male patients. When subdivided by age into less than 50, between 50 and 70, and more than 70 years-old, the female patients had a tendency, that was not significant, towards a longer survival in each group. In each age group, the ratio of smokers to non-smokers was higher in the males. The female group of ages 50 to 70 had the best 5-year survival rate. By multiregression analysis, age was found to be the most important factor for improved survival. The results indicate that a hormonal factor in Stage I lung adenocarcinoma does not influence survival.

Adenocarcinoma↗
PubMed1993

Early gastric cancer associated with synchronous multiple liver metastasis--two rare cases.

From 1976 to 1991, 1,640 cases of gastric cancer were resected in our department. Of these, 659 (40.2%) cases were early gastric cancer (EGC). The prognosis after resection of an EGC is generally good, with a 5-year survival rate of 95%. The incidence of an EGC with synchronous liver metastasis is very rare. To our knowledge, only 15 cases of an EGC with synchronous liver metastasis have been reported in the Japanese literature. From 10 cases adequately described the EGC with synchronous liver metastasis derived only from sm-cancers (cancers confined to the submucosa) of medullary type, histologically, more commonly occurring in males than EGC generally, (of elevated type) and with positive lymph node metastasis. Here we report two additional rare cases of EGC with liver metastasis.

Aged↗
PubMed1993

Early gastric cancer with juxta lymph node (n3) metastasis.

From 1976 to 1992, a total of 714 cases of early gastric cancer (EGC) were treated by resection in the First Department of Surgery, Kurume University Hospital. For EGC, the overall lymph node metastasis rate is generally 10%, with the lymph node metastasis observed mainly in the Group 1 perigastric nodes in both mucosal cancer and submucosal cancer. Three rare cases of an early gastric cancer with Group 3 juxta regional lymph node metastasis are described because Group 3 lymph nodes are rarely discovered. To our knowledge, only 14 other cases of EGC with juxta regional lymph node metastasis have been reported in the Japanese literature.

Aged↗
PubMed1993

Retrospective studies of synchronous double early gastric cancer.

From 1984 to 1990, 922 cases of gastric cancer underwent resection in the First Department of Surgery, at Kurume University Hospital. Of these, 381 (41.3%) cases were early gastric cancer (EGC). Among these EGC, synchronous double early gastric cancer (double EGC), according to the diagnostic criteria of Moertel, was found in 49 (12.9%) cases involving 98 foci. In cases of a double EGC, the primary and secondary foci can be distinguished. Double EGC occurred more frequently in males than females (7.1:1). In the elderly, the incidence of a double EGC was higher than the incidence of a single EGC. Double EGC occurred more frequently in the lower third of the stomach than a single EGC. And a macroscopically elevated and histologically differentiated type primary focus was more frequently found in double EGC than in single EGC. Of the 49 secondary foci in the double EGC, 12 (24.5%) foci were a microcarcinoma of less than 5 mm in greatest diameter, and 48 (98%) were limited to the mucosa (m-cancer). Therefore, a preoperative detailed examination of the whole stomach by endoscopy and an intraoperative careful search under gastrotomy must be made in the remnant of the stomach in cases of distal or proximal partial gastrectomy to ensure adequate excision.

Aged↗
PubMed1993

Clinicopathological studies of multiple cancers in the large bowel and other organs.

During the past 17 years, 1,463 cases of cancer of large intestine, there were 117 cases (8.0%) with overlapping cancer in other organs. The male/female ratio was 1.0:1.1 and the mean age was 65.8 years old. The region of existence in other organs was in the order of frequency: stomach 28.3%, uterus 26.3%, and liver 8.1%. The location and histology showed almost similar results to that of single cancer. In comparison with single cancer, overlapping cancer cases showed a high complication rate of adenoma. So it was suggested that a region of cancer development was present but latent. The preceding cases of cancer of the uterus almost all underwent radiotherapy. About 36% of their histology of colon cancer were mucinous carcinoma suggesting at least the development of cancer by radiation.

Age Factors↗
PubMed1993

Mast cells and histamine release in Crohn's disease.

To study the role of intestinal mast cells in Crohn's disease, a sensitive glass-fiber histamine assay was conducted in conjunction with mechanical dispersion of surgical specimens of 80 macroscopically actively inflamed colons, 40 non-inflamed colons, 40 actively inflamed ileums, and 16 non-inflamed ileums from patients with Crohn's disease and 96 control subjects. A strong correlation was found between the number of mast cells and the total histamine content in the controls (r = 0.682) (p < 0.05). The number of mast cells was decreased in Crohn's disease as compared with the controls (p < 0.01). Intestinal mast cells release histamine in a dose-dependent manner after challenges with anti-IgE (1.875-240.0 U/ml). A significant difference was noted in the release by anti-IgE between actively inflamed and non-inflamed colons of patients with Crohn's disease or control subjects (p < 0.01). Mast cells in actively inflamed tissue with Crohn's disease were shown to have different roles in the pathogenesis of inflammation.

Antibodies, Anti-Idiotypic↗
PubMed1993

[Expression of the growth factors (EGF, EGFR, and TGF alpha) and PCNA in superspreading and penetrating types of gastric carcinomas].

Expression of EGF, EGFR, TGF alpha, and PCNA in resected gastric carcinomas (15 cases of superspreading type and 25 cases of penetrating type) was immunohistochemically studied to understand biological features of these two types of gastric carcinomas. EGF, EGFR, and TGF alpha positive cases were preferentially found in the penetrating type rather than in the superspreading type (p < 0.05). Incidence of PCNA high expression cases in the penetrating type was significantly higher than that in superspreading type. Nineteen cases (76%) of the penetrating type and 1 case of the superspreading type (6.7%) were diffusely PCNA (+), and the incidence of in the former type was significantly higher than that of the latter type (p < 0.001). One case of the superspreading type and 13 cases of the penetrating type were either EGF (+) or TGF alpha (+), and EGFR (+), and the incidence in the latter type was significantly higher than that in the former type (p < 0.05), suggesting that growth and invasion of carcinoma cells, especially in the penetrating type, may depend on "autocrine mechanism". Incidence of the growth factors (+) and PCNA (+) cells in classical type of signet ring cells was lower than that in other types of singnet ring cells.

Carcinoma, Signet Ring Cell↗
PubMed1993

Intraoperative ultrasonography during laparoscopic cholecystectomy.

Intraoperative ultrasonography during laparoscopic cholecystectomy is a new procedure for examining the bile duct. The ultrasonic probe used in this study utilized a 7.5-MHz convex array designed for easy insertion through a 10-mm cannula. This probe was 90 cm long, had a 10-mm diameter, and was equipped with an angulation system controlled by levels. Additionally, this ultrasound system could detect the direction of the blood flow using a color Doppler display. Both laparoscopic ultrasound and laparoscopic cholangiography were attempted in 45 patients. In 41 of the 45 patients, laparoscopic ultrasound was successful in visualizing the first-order hepatic branches and the common bile duct. On the other hand, laparoscopic cholangiography was successful only in 38 of the 45 patients. The color Doppler capability helped to distinguish the bile duct from the portal vein and hepatic artery. Visualization of the bile duct was achievable by laparoscopic ultrasound. Also, the color Doppler system easily identified the bile duct. However, further design improvements in the ultrasound probe are required to establish laparoscopic ultrasound as an effective intraoperative routine procedure.

Bile Ducts↗
PubMed1993

Radiosensitive squamous cell craniopharyngioma: clinical and pathological comparison with the adamantinomatous type.

Five patients with the squamous cell type of craniopharyngioma were examined clinically and pathologically, and comparisons were made with the adamantinomatous type of craniopharyngioma. In three patients, the tumor remaining after partial or subtotal resection was treated with conventional radiation therapy, and all three lesions disappeared completely. The squamous cell tumors consisted of basal cubodial cells and polygonal superficial cells with areas of cellular detachment and degeneration. Our findings suggest that these tumors are more radiosensitive than adamantinomatous craniopharyngiomas and represent a distinct clinical entity.

Adult↗
PubMed1993

[Clinicopathologic studies on esophageal carcinoma with basaloid features].

Eight unusual esophageal carcinomas chiefly composed of basaloid cells were defined as "esophageal carcinomas with basaloid features", and analyzed by clinicopathologic findings and immunohistochemical staining with antibodies against S-100, actin, vimentin, and cytokeratin. These tumors were classified into five basaloid-squamous cell carcinomas (BSC), 2 adenoid cystic carcinomas (ACC), and 1 non-small cell type-undifferentiated carcinoma based on the Guidelines for the Clinical and Pathologic Studies on Carcinoma of the Esophagus edited by the Japanese Society for Esophageal Disease. Some histologic patterns of BSC, ACC, or undifferentiated carcinoma were resembled to each others. However, BSC was characterized by solid growth of basaloid cells with microcystic pattern or peripheral palisading arrangement, and it showed simultaneous presence of squamous cell carcinoma or squamous differentiation. In immunohistochemical staining, immunoreactivity for cytokeratin alone was positive in one of five BSCs. On the other hand, ACC showed cribiriform pattern and high mitotic activities, excluding typical cribriform pattern in ACC of the salivary gland. In addition to these features, the presence of foci of squamous cell carcinoma was occasionally found and positive immunoreactivities for S-100 and actin were recognized. Therefore, the immunohistochemical staining was useful for distinction among ACC and other tumors. As to the prognosis, BSC and ACC have been reported that both tumors are aggressive neoplasm with poor prognosis. In our studies, all of 5 patients with BSC were survived more than three years after surgery. In contrast, the patients with ACC or undifferentiated carcinoma died within one year.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Glutamine (Gln) supplementation in septic rats].

The objectives of these experiments were to investigate the effect of Gln supplementation on protein metabolism and immune function in septic rats. (Experiment 1): 73 SD female rats were catheterized for TPN into the jugular vein on day 1. On day 4, the rats were randomized into 4 group: 1) control (C)+Standard TPN (STPN), 2) (C)+Gln TPN (GTPN), 3) sepsis (S)+STPN, 4) S+GTPN. Sepsis was induced by injection of 10(10) C. Coli/kg from the TPN catheter. U-14C-leucine or 15N2-Urea was given before sacrifice on day 5. (Experiment 2): 48 SD male rats were randomized into 3 groups, 1) normal control rat (NC), fed as lib. 2) peritonitis (P)+STPN, 3) P+GTPN. On day 1, 34 rats were catheterized and either STPN or GTPN was begun. On day 3, 6 hours after serum cecum ligation and puncture, resuscitation was done. On day 5, rats were sacrificed. The results were as follows: 1) FSR of ileum, proximal colon, distal colon and muscle were augmented by GTPN, 2) Sepsis caused a significant increase of urea production, but GTPN prevented this increase, 3) lymphocyte blastogenation was decreased with sepsis, but GTPN improved this reduction, 4) Phagocytic index was higher with GTPN than STPN. We concluded that Gln supplementation would prevent from leading the patients with severe infection to the multiple organ failure.

Animals↗
PubMed1993

[Intraoperative real time observation of tumor blood flow in hepatocellular carcinoma by using color Doppler imaging].

To evaluate the tumor blood flow in hepatocellular carcinoma, we have introduced color Doppler imaging during operation. 37 hepatocellular carcinoma patient with 54 nodules were included in this study. Following categories were analyzed, those were detectability of pulsatile blood flow and continuous blood flow signal in the tumor, pulsatile blood flow velocity depend on tumor size and pathological feature. Even the size of the tumor is less than 1 cm in diameter in 70% of those nodules we could detect and analyze the flow signal. This new modality could have a possibility to be a useful diagnostic device for small mass lesions in the liver.

Carcinoma, Hepatocellular↗
PubMed1993

[Surgical adjuvant therapy of carcinoma of the thoracic esophagus].

Between 1981 and 1991, we conducted 3 trials of surgical adjuvant therapy for esophageal carcinoma. The first randomized trial was pre- and post-operative radiotherapy, 30 Gray for preoperative therapy and 50 Gray for postoperative therapy. The 2nd trial was performed with postoperative radiotherapy and postoperative chemotherapy, 30 Gray for radiotherapy and cisplatin (CDDP, 50 mg/m2) plus vindesine (VDS, 3 mg/m2) for chemotherapy. The 3rd trial was postoperative chemotherapy (CDDP+VDS) and surgery alone. In the survival rate of the first trial, no significant difference was noted between the 2 groups (n = 20 and n = 16), while in the 2nd trial, the 5-year survival rate in the chemotherapy group (n = 12) was significantly longer (p = 0.017) than that of the radiotherapy group (n = 12). At the present time, the 3rd trial shows no significant difference in survival between patients with (n = 15) and without (n = 15) postoperative chemotherapy. Therefore, we are now performing a new randomized trial with surgery alone and postoperative chemotherapy using a more effective regimen (CDDP 80 mg/m2 + 5-FU 800 mg/m2). In the near future, the most effective therapy will be selected for individual patients with esophageal carcinoma, thanks to developments in clinical oncology, new anticancer drugs, drug delivery systems and molecular biology.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[A case of advanced gastric cancer with liver and lung metastasis effectively treated by combined chemo-immunotherapy of MMC, 5'-DFUR, OK-432].

A sixty-eight-year-old male patient was diagnosed as having inoperable advanced gastric cancer with liver and lung metastasis. The patient was treated by combined chemo-immunotherapy of MMC 10 mg/M, 5'-DFUR 800 mg/day and OK-432 5 KE/2 W. Six months after commencing chemotherapy, CT-scan and upper GI series revealed that metasized liver tumors and stomach lesion were remarkably decreased in size and no cancer cell was confirmed by endoscopic biopsy. Further, the metastatic lung tumor has disappeared on chest X-ray. The patient had been well without any evidence of tumor re-progression for over one year, but from July the liver tumor began to metastasize again and the patient eventually died of liver metastasis on Jan. 1, 1993.

Adenocarcinoma↗