[The production of spontaneous liver metastasis model from colon carcinoma in nude mice: preliminary report].
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Animals↗
Biomedical subjects
T Kakegawa
Publications and source records attributed to T Kakegawa.
[Prediction of performance status after pneumonectomy].
To predict performance status (P.S.) following pneumonectomy, patients with lung carcinoma underwent pre-surgical pulmonary function tests with spirometry and unilateral pulmonary artery occlusion test (UPAO test). Between 1980 and 1991, twenty-nine patients who had survived more than six months after surgery were selected for the study. These patients were divided into two groups according to P.S. measured at six months after surgery: 16 patients with P.S. 0 to 1 were in Group A, and 13 patients with P.S. 2 to 3 were in Group B. The results of the following tests obtained prior to surgery were compared for the two groups to predict post-surgical P.S.; vital capacity (VC), VC/m2, forced expiratory volume in 1 second (FEV1.0), FEV1.0/m2, predicted VC/m2 and predicted FEV1.0/m2 calculated with residual pulmonary segments, mean pulmonary arterial pressure (PPA) before UPAO and 15 minutes after UPAO, total pulmonary vascular resistance (TPVR) before and during UPAO, and rate of changes in PPA and TPVR. Results obtained were as follows: Group B demonstrated significantly higher TPVR (p < 0.05) before the UPAO, PPA (p < 0.05) and TPVR (p < 0.002) during UPAO, and rate of change in TPVR (p < 0.02) than those in Group A. There were no significant differences between the two groups for other test results. From these results, lowering of post-surgical P.S. might be predicted when the TPVR during UPAO was 350 dyne.sec.cm-5/m2 or more.
Blood Pressure↗
[Preoperative chemotherapy in patients with non-small cell lung cancer].
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Aged↗
[Evaluation of radiotherapy for bone and lymph node metastasis in post-operative hepatocellular carcinoma--three case reports].
Successful radiotherapy was performed for three post-operative hepatocellular carcinoma patients, two with bone metastases and one with lymph node metastasis. One patient had severe high back pain and paraplesia caused by spinal compression with bone metastasis on 5th thoracic vertebra. After a total of 45 Gy irradiations, the back pain was removed, and 9 months later the patient recovered from the paraplesia gradually and could start rehabilitation. A second patient with multiple bone metastases was very concerned about skull metastasis and severe headache. Radiation reduced the headache and the tumor vanished. A third patient with cervical lymph node metastasis was irradiated. The size of the lymph node was decreased but did not disappear. We concluded that radiotherapy for distant metastases (ie, bone, skin) in a hepatocellular carcinoma patient, can be an effective therapeutic procedure for patient complaints.
Bone Neoplasms↗
Production of matrix metalloproteinase-2 and metalloproteinase-3 related to malignant behavior of esophageal carcinoma. A clinicopathologic study.
BACKGROUND: Matrix metalloproteinases (MMP) are a gene family of zinc enzymes capable of degrading almost all of the extracellular matrix macromolecules in vivo. Their enzymic activities are believed to be responsible for tumor invasion and metastasis. METHODS: In this study, using peroxidase-antiperoxidase method, monospecific antisera against MMP-1 (tissue collagenase), MMP-2 (type IV collagenase/72-kilodalton [KD] gelatinase), and MMP-3 (stromelysin) were applied to 29 squamous cell carcinomas and normal epithelium of the esophagus to identify cells synthesizing and secreting these enzymes. RESULTS: Immunoreactivity of MMP-1, -2, and -3 was observed in small cancer nests of the deeply invasive or marginal portion of the tumor. Among the 29 patients studied, the presence of at least one MMP was observed in 17 (58.6%). All three enzymes were observed in six (20.6%) patients, MMP-2 and -3 in five (17.2%) patients, only MMP-2 in three (10.3%) patients, and MMP-3 alone in three (10.3%) patients. There was a good correlation among histologic stage and tumor invasion, lymph node metastasis, and MMP expression. In particular, expression of MMP-2 and -3 was closely related to lymph node metastasis and vascular invasion. CONCLUSIONS: These results suggest that MMP, especially MMP-2 and -3, play an important role in tumor invasion and metastasis and that analysis of MMP-2 and -3 production is useful for evaluation of malignant potential in esophageal carcinoma.
Aged↗
A regulatory cis element and a specific binding factor involved in the mitogenic control of murine ribosomal protein L32 translation.
The mRNA encoding ribosomal protein L32 redistributes from untranslated subribosomal particles into polysomes after mitogenic activation of quiescent T-lymphocytes and fibroblasts. To identify the regions of the L32 mRNA which are important in regulating its cytoplasmic location we constructed a plasmid containing the murine L32 cDNA under the control of the Rous sarcoma virus (RSV) long terminal repeat promoter and introduced this construct into murine 3T3 fibroblasts. The mRNA transcribed from the RSV-L32 construct redistributed from subribosomal particles into polysomes in response to mitogenic activation in a manner similar to endogenous L32 mRNA. A conserved polypyrimidine region present at the 5' terminus of all ribosomal protein mRNAs is required for translational regulation of L32 mRNA since deletion of this sequence resulted in a mRNA that was not sequestered in subribosomal particles in quiescent cells. A radioactive RNA probe containing the first 34 nucleotides of the L32 5'-untranslated region, including the polypyrimidine region, specifically interacted with a protein of about 56 kDa. This protein did not bind detectably to RNA probes lacking the polypyrimidine sequence. Binding activity was similar in protein extracts made from resting and activated cells, suggesting that binding of the 56-kDa protein as measured in this assay is not regulated. This protein is a member of what may be an emerging family of polyribopyrimidine-binding proteins with diverse biochemical functions.
3T3 Cells↗
Suprasellar germinomas; relationship between tumour size and diabetes insipidus.
The clinical and neuro-endocrinological aspects of 17 suprasellar germinoma patients treated between 1972-1991 are reported. Surgical extirpation was not initially attempted, but all patients received irradiation with or without a biopsy. Sixteen of those have led useful lives with appropriate hormonal replacement therapy during a mean follow up of 8 years. Seven tumours at diagnosis were less than 2 cm in diameter (type 1), nine tumours more than 2 cm (type 2), and one double midline tumour was of unknown size. All 7 type 1 patients required 1-deamino-8-D-arginine-vasopressin (DDAVP) to control diabetes insipidus (DI), but only 2 of the 9 type 2 patients have needed DDAVP since completion of the treatment. Patients with smaller tumours required more DDAVP following tumour disappearance, than those with larger tumours. The prognostic indicators for the post-treatment course of DI and retarded growth appeared to be the tumour size and the age at diagnosis. We also emphasize the absence of metastasis in unoperated cases and the use of tumour markers as a diagnostic criterion which obviates surgical acquisition of tissue to make the diagnosis. Possible reasons are discussed and the literature reviewed.
Adolescent↗
Early postoperative chemotherapy following noncurative resection for patients with advanced gastric cancer.
We studied the effect of early postoperative chemotherapy, including 5-fluorouracil (5-FU) for 5 days for patients with gastric cancer following noncurative resection. The study was prospectively randomised and controlled, and 162 (87.1%) of 186 were eligible candidates for statistical assessment. Patients randomised to group A received therapy that is used widely to treat patients with gastric cancer in Japan; mitomycin C (MMC), OK-432, UFT and PSK. Patients randomised to group B received the same drugs given to group A plus 5-FU bolus injections for 5 days, beginning on postoperative day 2. There were no differences in prognostic factors and doses of the drugs prescribed, except for 5-FU. There was no difference in the toxicity rate between the groups. Generalised Wilcoxon test revealed a P value of 0.169, and the 50% survival rate improved 1.4-fold in patients with gastric cancer treated with early postoperative chemotherapy of MMC, OK-432 plus 5-FU injection.
Aged↗
A study on polyethylene glycol electrolyte lavage solution and sodium picosulfate combined pretreatment method for colonoscopy.
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Citrates↗
Massive gastric cancer in a patient with a negative Gregory antigen (Gy (a-)), a rare blood group.
A case of a massive advanced gastric cancer of the Borrmann type III in a patient with the rare blood group of negative Gregory antigen (Gregory (a-)) is reported. On admission, he was found to have a severe anemia (Hb 6.1 g/dl) requiring a direct blood infusion. He had never received a blood infusion, previously. In blood crossmatching tests, his blood was agglutinated by all the antisera for the common antigens, and he was discovered to have a rare blood type of Gregory (a-). There was no appropriate blood donor in his family. Before the operation, only 600 ml (6 i.u.) of frozen red blood cells could be found in storage from only 2 people with Gregory (a-), O blood type and Rh (+) in Japan. To increase the RBC, erythropoietin (3000 i.u.) was administered 6 times; and the Hb increased to 7.4 g/dl. However, the anemia remained and 200 ml (2 i.u.) Gregory (a-) blood was infused, preoperatively. The final preoperative Hb was 7.8 g/dl and the RBC was 283 x 10(4)/mm3. A massive gastric cancer directly infiltrated the pancreas, the transverse colon and the mesocolon. A palliative subtotal gastrectomy with combined resection of the transverse colon was performed. The intraoperative blood loss was 460 ml and the volume of blood infused was 400 ml (4 i.u.). The postoperative Hb was 7.9 g/dl, and more blood was needed. However, there was no more Gregory (a-) donor blood in storage in Japan.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
A retrospective study of resected gastric cancers.
From 1976 to 1989, a total of 1303 patients with gastric cancers underwent gastrectomies in the First Department of Surgery, Kurume University Hospital. Of these, 358 (27.5%) were total gastrectomies, 84 (6.4%) were proximal gastrectomies and 825 (63.1%) were distal gastrectomies. The 5-year survival rate was 44.8% after the total gastrectomies, 38.9% after the proximal and 72.4% after the distal gastrectomies. The 5-year survival rate was 86.2% with the absolute curative resection, 36.3% with the relative curative resection, 29.3% with the relative non-curative resection and 9.4% with the absolute non-curative resection. Macroscopically, the 5-year survival rate was 95.1% for type 0 (early cancers), 61.3% for Borrmann type 1, 58.8% for Borrmann type 2, 37.5% for Borrmann type 3 and 16.5% for Borrmann type 4. According to the pathological cancer stage, the 5-year survival rate was 94.8% for stage I, 79.3% for stage II, 49.2% for stage III and only 11.3% for stage IV.
Gastrectomy↗
Preoperative prediction of mortality following surgery for esophageal cancer.
Ninety-five patients with thoracic esophageal cancer who had undergone radical esophagectomies through right thoracotomies from 1986 to 1989 were statistically analyzed semi-quantitatively to identify the risk factors predicting "operative (within 45 days of operation) or hospital death." Age, pulmonary function (%VC or %FEV1.0), cardiac function (EKG or Master test), renal function (Ccr), hepatic function (R15'ICG), diabetes mellitus (75 OGTT), extent of tumor invasion to the adventitia, and the type of operative procedure were each scored according to severity; 0 (no risk), 1, 2, or 3 (high risk). Patients with no severe postoperative complications had an accumulated score of less than 8 and comprised Group I, while those suffering an an "operative death" had a total score of 8 or more, and comprised Group II. Group III included those suffering a "hospital death." There was a significant difference between Group I and Group II (p < 0.005), but not between Group I and Group III. "Operative deaths" could be preoperatively predicted from the risk factors. However, "hospital deaths" could not be predicted, since they resulted mainly from recurrences of the cancer. In cases with scores of 8 or more the operative procedure should be changed to a simpler one for an improved prognosis.
Adult↗
Cervico-thoraco-abdominal (3-field) lymph node dissection for carcinoma in the thoracic esophagus.
The efficacy of an extended radical lymph node dissection for carcinoma in the thoracic esophagus is controversial. Results of a multivariate analysis using clinical data from 127 cases collected from 1982 to 1988 are reported. Twenty-seven of these patients underwent an extended radical (cervico-thoraco-abdominal: 3 fields) lymph node dissection which was recently developed in Japan, while others underwent a standard (thoraco-abdominal: 2 fields) lymph node dissection. They all had a locally-curative resection of the tumor through a right thoracotomy. In this study, 13 factors commonly affecting prognosis were examined: sex, age, cancer location, tumor length, radiographic type, depth of invasion, lymph node metastasis, tumor differentiation, postoperative radiotherapy, chemotherapy, operative risk, postoperative complications, and 3-field or 2-field dissection. Based on the survival-rate curves using Kaplan-Meier's statistics, the 3-field dissection was superior to the 2-field dissection. Moreover, when other prognostic factors were adjusted using Cox's proportional hazards general linear model, the same result was obtained from survival-rate curves. From this analysis, it can be concluded that a 3-field dissection is a better approach for management of carcinoma in the thoracic esophagus.
Abdomen↗
Preoperative radiation for carcinoma of the thoracic esophagus involving adjacent organs--a comparative and multivariate analysis of prognosis.
Controversy remains over the comparative efficacy and subsequent prognosis for preoperative radiation for carcinoma of the esophagus involving the trachea, bronchus, and/or aorta. Results of a multi-variate analysis are reported using clinical data from 57 cases from 1981 to 1987. Based on both the survival-rate curves using the Kaplan-Meier method and the adjusted survival-rate curves using Cox's proportional hazards linear model, there was no significant difference in prognosis between patients who received preoperative radiation and those who did not. This analysis indicates that preoperative radiation at doses of 30Gy produces no clinical advantage and therefore is not the best treatment for carcinoma of the esophagus involving these adjacent organs.
Aged↗
Questionable resection for carcinoma of the esophagus involving the trachea, bronchus and/or aorta--a comparative and multivariate analysis.
Controversy remains over the comparative efficacy and subsequent prognosis of resections for carcinomas of the esophagus involving the trachea, bronchus, and/or aorta. Results of a multi-variate analysis are reported using clinical data from 103 cases from 1981 to 1987. Based on the survival-rate curves according to the Kaplan-Meier method, resection was superior to non-resection. However, when other prognostic factors were adjusted using Cox's proportional hazards linear model, there was no significant difference between the resection and non-resection groups. This analysis indicates that esophagectomy is not necessarily the best approach for carcinoma of the esophagus involving these adjacent organs, although it must be remembered that resection provides excellent palliation.
Aged↗
Clinicopathologic study of perineural invasion in rectal cancer.
Perineural invasion (PNI) in rectal cancer was studied, prospectively. One-hundred patients (20%) were identified as having tumors with PNI. The incidence of PNI was significantly increased in tumors with moderate or marked venous invasion (30%, 64%), with moderate or marked lymphatic permeation (37%, 72%), with liver metastasis (50%) and with peritoneal dissemination (64%). In cases of curative surgery, the incidence of PNI was significantly increased in MAC stage C2m+g or C3 (28%, 35%). There was no significant difference in the recurrence or survival rates between the patients with PNI and without PNI in MAC stage B2m+g. However, there was a significant increase in local recurrence in the patients with both PNI and lymph node metastasis (p less than 0.05). Also, the patients with PNI in MAC stage C2m+g had a significantly lower 8-year survival rate (29.1%, p less than 0.001). Multivariate analysis using Cox regression models demonstrated that PNI was an independent prognostic factor for survival.
Aged↗
Invisible cardia cancer metastasis to the diaphragm.
The best surgical procedure to treat a carcinoma in the gastric cardia remains a controversy because the carcinoma is often advanced and there are other unknown factors. In this article the incidence of invisible metastasis from cardia cancer to the diaphragm will be analyzed using an experimental cardia cancer model and clinical studies. An experimental cardia cancer was induced by an endoscopic injection of VX2 cancer cells into the submucosal layer of the esophago-gastric junction in rabbits using a 27G needle and an Olympus BF-4B2 bronchofiberscope. A total of 26 cardia cancer models for Borrmann type 2 or 3 were produced. Of these, six (23%) had visible cancer metastases in the diaphragm, including 4 cases with direct invasion and 2 cases with peritoneal dissemination on the surface of the diaphragm. Four (20%) of the remaining 20 were histologically found to have macroscopically-invisible cancer metastases mainly in the lymph vessels of the left hemidiaphragm. From 1985 to 1988, 22 clinical cases of cardia cancer were managed by a combined total gastrectomy with a partial diaphragm resection through a left thoracoabdominal approach. When widely resected, reconstruction was performed using a latissimus dorsi muscle flap. Six (27%) of these 22 were also histologically found to have macroscopically-invisible cancer metastases to the diaphragm, including 1 (11%) of the 9 well-differentiated type and 5 (39%) of 13 poorly-differentiated type adenocarcinomas.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Retrospective studies of gastric subserosal (ss) cancer--in comparison to pm- and se-cancers.
The deepest gastric cancer invasion into the tela subserosa is expressed as the ss-cancer. Subserosal gastric cancers (ss) can be divided into 4 subtypes; ss alpha, ss beta, (ss gamma) and ss gamma, pathologically. These four subtypes were compared to cancerous invasion into the muscularis propria (pm-cancer) and cancerous invasion with serosal exposure (se-cancer). During the 10 years from 1979 to 1988, a total of 938 cases with gastric cancer were resected in the First Department of Surgery, Kurume University Hospital. Of these, 104 (11.1%) cases were ss-cancers, consisting of 28 (27%) cases of ss alpha, 33 (32%) cases of ss beta, 4 (3%) cases of (ss gamma) and 39 (38%) cases of ss gamma. Pm-cancers and ss-cancers were most frequently observed in Borrmann type 2, macroscopically, and in the differentiated type, histologically. On the other hand, se-cancers were frequently observed in Borrmann type 3 and in an undifferentiated type. Positive lymph node metastases were found in 49.1% of pm-cancers, in 50.0% of ss-cancers and in 79.9% of se-cancers (p < 0.01), with no statistical difference in the positive lymph node metastasis rates for the subdivisions of ss-cancer. In ss-cancer, however, there was a statistical difference in prognosis according to the tumor size, and according to the degree of subserosal infiltration. The 5-year survival rate was 82.3% for pm-cancer, 75.0% for ss-cancer and 34.7% for se-cancer (p < 0.01).
Female↗