Biomedical subjects

T Matsumata

Publications and source records attributed to T Matsumata.

At least 19 recordsLinked to original sources

PubMed2002

[A review of Japanese literatures concerning surgery for lung cancer with idiopathic interstitial pneumonia].

OBJECTIVE: The aim of the present study is to investigate the perioperative management of acute exacerbation of idiopathic interstitial pneumonia (IIP) after pulmonary resection for lung cancer. METHODS: We reviewed 5 Japanese literatures published from 1992 through 1998. The present study included 50 lung cancer patients with IIP, of which 3 were our cases and 47 were reported cases. RESULTS: Within 30 days after operation, acute exacerbation of IIP occurred in 12 cases (24.0%). Preoperative profiles (gender, age, smoking status, respiratory function, pathologic stage) of the exacerbated cases did not differ from those of non-exacerbated cases. The mean intraoperative PaO2 of the exacerbated cases was significantly higher than that of non-exacerbated cases (224 +/- 45.6 Torr vs 120 +/- 41.2 Torr, p = 0.005). The rate of acute exacerbation increased with the extent of resection, that is 42.8% in pneumonectomy, 24.3% in lobectomy, and 0% in wedge resection although the difference was not significant. After acute exacerbation of IIP, all 12 cases were given high doses of steroids. However, 11 cases died due to the disease progression (mortality rate = 91.7%). CONCLUSION: In order to establish the perioperative management for prevention of acute exacerbation of IIP, multi-institutional study is warranted on the basis of the present results (intraoperative FiO2, administration schedule of steroids etc).

Aged↗

PubMed2000

Osteoporosis after gastrectomy: bone mineral density of lumbar spine assessed by dual-energy X-ray absorptiometry.

Although osteoporosis is a common clinical disorder associated with gastric surgery, long-term effects of gastrectomy on bone metabolism are still unclear. The purpose of this study was to clarify the incidence and risk factors of osteoporosis after gastrectomy using univariate and multivariate analyses of quantitative measurements. The study included 59 patients who had undergone gastrectomy more than 5 years before. There were 38 men and 21 women, aged 37-81 years, mean 64 years. Bone mineral density (BMD) of L2-L4 spine was measured using dual-energy X-ray absorptiometry (DXA). Absolute value of BMD (g/cm2) and age- and sex-matched BMD (%) were given. The mean BMD was 0.766 g/cm2, and the incidence of osteoporosis (BMD less than 0.70 g/cm2) was 37%: 18% in men and 71% in women. The mean age- and sex-matched BMD was 85.9%: 87.5% in men and 83.1% in women. Univariate and multivariate analyses revealed that BMD was significantly associated with the age and sex of patients, but was not influenced by the type of gastrectomy (partial versus total) and years after operation (< 20 versus 20 <). Our study clarified the fact that postgastrectomy osteoporosis was frequent in the aged or female patients. BMD should be evaluated after gastrectomy, especially in the aged and in women.

Absorptiometry, Photon↗

PubMed2000

Hepatic sclerosing hemangioma mimicking a metastatic liver tumor: report of a case.

We present herein the case of a sclerosing hemangioma of the liver which was extremely difficult to differentiate from liver metastasis of rectal cancer, in a 67-year-old woman. All the radiological findings were compatible with liver metastasis; however, marginal pooling of the tumor revealed by computed tomographic angiography and magnetic resonance imaging scans was inconsistent with a diagnosis of liver metastasis. At laparotomy, the tumor was macroscopically unusual in that it was yellowish elastic-hard with a very clear margin, and thus, it did not have the appearance of a metastatic tumor. Mile's operation and a partial hepatectomy were performed, followed by an uneventful postoperative course and no signs of recurrence. The carcinoembryonic antigen (CEA) level in the peripheral blood was not elevated at any time. The postoperative pathological diagnosis was a rare hepatic tumor, namely, a "sclerosing hemangioma," based on the findings of cellular fibrous stroma containing vascular channels with flattened endothelial cells. Preoperatively differentiating between sclerosing hemangioma and a metastatic liver tumor from colorectal cancer may be very difficult; however, this case demonstrated some interesting characteristics, namely, the serum CEA level was not elevated, marginal pooling of the tumor was found in the enhanced radiological findings, and the tumor was macroscopically unusual. Therefore, the possibility of sclerosing hemangioma should be borne in mind when considering the differential diagnosis of patients suspected of having colorectal liver metastasis. A preoperative biopsy should be carried out and when a laparotomy is performed under the misdiagnosis of colorectal liver metastasis, it is advisable that either an intraoperative needle biopsy or a frozen histological analysis be undertaken to avoid unnecessary extended hepatic resection of this rare benign hepatic tumor.

Aged↗

PubMed2000

Dysphagia after prophylactic endoscopic injection sclerotherapy for oesophageal varices: not fatal but a distressing complication.

BACKGROUND: Although dysphagia resulting from oesophageal strictures induced by endoscopic injection sclerotherapy (EIS) is not a fatal complication, it is often quite distressing for the patients. The aim of the current study was to clarify the relationship between dysphagia resulting from oesophageal stricture following prophylactic EIS and the volume of sclerosant consumed in the EIS series. METHODS: Fifty-two patients with oesophageal varices, who had been treated by prophylactic EIS, were selected as the subjects. RESULTS: Seventeen (32.7%) patients developed dysphagia following prophylactic EIS, and five patients with a severe stricture required bougie dilatation to take meals. The volume of sclerosant used in the initial session of EIS for patients with subsequent dysphagia (24.9 +/- 4.0 mL) was significantly larger than that for patients without dysphagia (18.4 +/- 5.1 mL; P < 0.001). The mean volume of sclerosant consumed per session during the EIS series for patients with dysphagia (16.5 +/- 3.0 mL) was also significantly larger than that for patients without dysphagia (13.1 +/- 3.8 mL; P < 0.01). CONCLUSIONS: The injection of a superfluous amount of sclerosant in prophylactic EIS brings about distressing dysphagia with oesophageal stricture in the patients with oesophageal varices who had no such complaint or symptoms before the therapy.

Adult↗

PubMed2000

The progression of invasiveness regarding the role of transforming growth factor beta receptor type II in gastric cancer.

AIMS: Transforming growth factor beta (TGF beta) is a potent growth inhibitor of epithelial cells. The expression of TGF beta receptors is required for the effect of TGF beta. In this study, we used immunohistochemistry to demonstrate the roles of the expression of TGF beta type I (T beta R-I) and type II (T beta R-II) receptors in the progression of gastric carcinoma. METHODS: To evaluate the potential prognostic value of T beta R-I and T beta R-II, 158 consecutive gastric cancer tissues specimens obtained over a 3-year period were examined. RESULTS: A total of 50 (32%) and 28 (18%) patients had T beta R-I(+) and T beta R-II(+), respectively. The 5-year survival rates of the patients with T beta R-I(+) and those with T beta R-I(-) were 74% and 71%, respectively. In contrast, the 5-year survival rates of the patients with T beta R-II(+) and those with T beta R-II(-) were 57% and 75%, respectively, and the difference was statistically significant (P<0.05). The extent of T beta R-II was closely correlated to the macroscopic types based on the Borrmann classification (P<0.01), and curability (P<0.05). However, a significant difference between the 5-year survival rates of the patients with T beta R-II(+) and those with T beta R-II(-) was only obtained in advanced cases (P<0.05) not in either curative cases, non-curative cases, or early cases. CONCLUSIONS: Our data suggest that when T beta R-II expression correlates with the progression of invasiveness in gastric cancer, it may lead to a non-curative resection and a poor prognosis.

Adult↗

PubMed2000

Preoperative elevation of serum C-reactive protein is related to impaired immunity in patients with colorectal cancer.

The significance of a preoperative elevation of serum C-reactive protein (CRP) as an indicator of the malignant potential and prognosis in colorectal cancer is reported. The reduction of circulating lymphocytes reflects the immunosuppressive conditions of patients with neoplasms. The aim of the current study was to elucidate the significance of a preoperative elevation of serum CRP as an indicator of the impaired immunity of the patients with colorectal cancer. The subjects were 155 consecutive patients with colorectal cancer who were treated with surgical resection. The preoperative serum CRP level and the proportion of circulating lymphocytes in peripheral blood were measured and the relationship between these values was investigated. The mean value of lymphocytes percentages in patients with the preoperative elevation of serum CRP was 25.2 +/- 8.7%, which was significantly lower than that (33.4 +/- 9.3%) in patients without the preoperative elevation of serum CRP (p < 0.01). In summary, preoperative elevation of serum CRP was significantly related to the reduction of lymphocyte percentages in peripheral blood, and it can be an indicator of impaired immunity in the patients with colorectal cancer.

Adult↗

PubMed2000

Usefulness of preoperative colonic lavage using transanal ileus tube for obstructing carcinoma of left colon: device to perform one-stage operation safely.

Surgical treatments for patients with obstructing carcinoma of the left colon still remain controversial, and many devices to perform a one-stage operation for such cases have been reported. The aim of the current study was to demonstrate the usefulness of preoperative colonic lavage using a transanal ileus tube to perform a one-stage operation for patients with obstructing carcinoma of the left colon. Five patients with intestinal obstruction due to advanced carcinoma of the left colon were investigated. An ileus tube was transanally inserted and placed in the colon proximal to the tumor under the guidance of a colonoscope and guidewire. Preoperative colonic lavage was done with oral administration of an irrigating solution over several days. By using a transanal ileus tube, preoperative colonic lavage can be done, which enables us to safely perform a one-stage operation for patients with obstructing carcinoma of the left colon with no increase in complications or anastomotic leakage.

Aged↗

PubMed2000

Primary gastric lymphoma associated with human T-cell leukaemia virus I.

We herein report a case of primary gastric lymphoma with reference to human T-cell leukaemia virus type I. A 65-year-old male was admitted to our hospital for emergency treatment of abdominal pain and haematemesis. Upper gastrointestinal endoscopy on admission revealed a disintegrated tumour with bleeding in the cardia. Total gastrectomy with distal pancreatomy and splenectomy was performed. The patient soon fell into cachexic condition due to early recurrence of abdominal lymph nodes and a rapid increase of the tumour, and died 80 days after operation. The pathological diagnosis was non-Hodgkin's lymphoma with diffuse large cell type and T-cell lineage. The patient was serologically positive for human T-cell leukaemia virus type I (HTLV-I) antibody. Southern blot analysis on the resected tumour tissue showed a monoclonal integration of HTLV-I pro-viral DNA. These results confirmed the current case to be primary adult T-cell leukaemia/lymphoma of the stomach.

Aged↗

PubMed2000

[Colorectal cancer in spouses of colorectal cancer patients].

Married couples share home environments and life style for years. In the case of colorectal cancer, an association with insulin resistance was reported. We determined the presence of the insulin-resistance syndrome (IRS, 1 or more of the following: body mass index of > 25 kg/m2, diabetes, or hyperlipidemia) in 84 colorectal cancer patients, of whom 61 patients (73%) had IRS. The incidence of the distal colorectal cancer, which has been declining in the United States, was significantly higher in the IRS group than in the non-IRS group (75.4 vs 52.2%, p = 0.0400). Some mechanisms may promote the progression of mucosal lesions to invasive cancers in the distal colorectum. There were no significant differences with respect to the age (64.6 +/- 9.4 vs 64.3 +/- 11.3 yr, p = 0.8298), height (159 +/- 9 vs 157 +/- 8 cm, p = 0.1375), and body mass index (22.2 +/- 3.6 vs 22.4 +/- 2.7 kg/m2, p = 0.6364) between the patients and their spouses. In 84 couples in whom colorectal cancer develops at least in one may then not illustrate the nursery rhyme: "Jack Sprat could eat no fat, His wife could eat no lean...". The spouses had been married for an average of 38 years, and in 30 spouses who had been followed in a colorectal cancer screening, 5 developed colorectal cancer. To diminish the incidence of colorectal cancer in Japan, we might advise screening colonoscopy to the spouses of colorectal cancer patients, or déjà vu all over again?

Aged↗

PubMed1999

Rare occurrence of colorectal cancer metastasis in livers infected with hepatitis B or C virus.

BACKGROUND: The rarity of the occurrence of metastatic malignancy in injured liver has been noted by many observers. However, since the clinicopathological features of primary carcinoma and the etiology of liver disease of these patients vary greatly, this phenomenon may not be universal. METHODS: We evaluated the relationship between either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the incidence of colorectal liver metastasis in 438 patients undergoing surgical treatment for advanced colorectal carcinoma. RESULTS: The liver function of the patients in the infection group (n = 37) was significantly worse than that of those in the noninfection group (n = 401). The incidences of tumor recurrence in the lung or peritoneum were comparable between the two groups. However, the percentage of patients with liver metastases in the infection group (3 of 37, 8.1%) was significantly lower (P <0.05) than that of those in the noninfection group (85 of 401, 21.2%). The patients in the infection group tended to survive longer than the patients in the noninfection group. CONCLUSIONS: We herein report an initial finding that colorectal carcinoma rarely metastasizes to livers infected with HBV or HCV.

Aged↗

PubMed1999

Clinical results and prognostic factors of radiologically node-positive gastric carcinoma.

Lymph node metastasis determined by histologic examination is an important prognostic indicator in gastric carcinoma. However, prognostic value of lymph node metastasis detected by computed tomography (CT) is unknown. The aim of this study was to evaluate clinical results and prognostic factors of patients with radiologically node-positive gastric carcinoma. The study included 78 patients with primary gastric carcinoma and lymph node metastasis confirmed by CT. The level of lymph node metastasis was simply graded as follows: level I included perigastric nodes; level II included intermediate nodes along the left gastric, common hepatic, and celiac arteries; and level III included distant nodes along the hepatoduodenal ligament, pancreas, spleen, and abdominal aorta. Sixty patients (79%) had stage IV tumors showing one or more of the following: level III lymph node metastasis in 37, pancreatic invasion in 27, peritoneal dissemination in 23, and liver metastasis in 19. Overall 1- and 5-year survival rates were 29% and 6%, respectively, and the 1-year survival rate was significantly influenced by the level of lymph node metastasis on CT (55% for level I, 27% for level II, 7% for level III, P < 0.01). In patients with gastrectomy, prognostic factors were tumor size (<10 cm versus >10 cm, P < 0.01), gross type (localized versus infiltrative, P < 0.01), histologic type (well differentiated versus poorly differentiated, P < 0.01), and curability of the disease (curative versus noncurative, P < 0.01). Our study indicates that prognosis of patients with radiologically node-positive gastric carcinoma is poor because of high frequency of extensive tumor spreads. Patients having only positive level I nodes on CT are candidates for curative gastrectomy, which may offer long-term survival.

Adenocarcinoma↗

PubMed1999

Carcinoma in villous adenoma of ascending colon associated with sarcoid reaction in the regional lymph nodes.

A 79-year-old woman was admitted to our hospital due to continuous anal bleeding. Colonoscopy showed a huge villous tumor on the middle area of the ascending colon. A typical right colectomy and lymph node dissection were performed. The resected specimen showed a villous type tumor located on the ascending colon. The histopathologic investigation demonstrated a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma and extending to the submucosa. Although there was no evidence of metastatic carcinoma in the dissected lymph nodes, epithelioid cell granulomas with multinucleated giant cells lacking in the central caseous necrosis suggested sarcoid reaction.

Adenocarcinoma↗

PubMed1999

Usefulness of preoperative transvaginal ultrasonography for women with advanced gastric carcinoma.

OBJECTIVE: Transvaginal ultrasonography (TVUS) is widely used to diagnose diseases in obstetrics and gynecology. We performed TVUS for diagnosing peritoneal dissemination preoperatively in cases of advanced gastric carcinoma in women. METHODS: Thirty-six female patients with advanced gastric carcinoma were investigated in the current study. TVUS was performed for 24 patients. Computed tomography (CT) was done for all of the women, and the sensitivity and specificity in detecting the existence of ascites were compared between the two in preoperative examinations. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in detecting ascites were 46.7%, 100%, 100%, 72.4%, and 77.8%, respectively. The results of TVUS were rated as 80%, 100%, 100%, 87.5%, and 91.7%, respectively. CONCLUSIONS: Preoperative TVUS is quite significant for predicting the existence of peritonitis carcinomatosa in women with advanced gastric carcinoma. The aim of the current study was to reduce the use of inappropriate and invasive surgical treatments, including exploratory laparotomy, for women with incurable advanced gastric carcinoma.

Adult↗

PubMed1999

Long tube for obstructing left-sided colon cancer.

BACKGROUND: Obstructing left-sided colon cancer is now managed by immediate resection and primary anastomosis using intraoperative mechanical bowel irrigation. The aim of this study was to describe our new technique using a long tube for preoperative bowel decompression and intraoperative antegrade irrigation. METHODS: A long nasointestinal tube was inserted and a balloon was inflated with distilled water. The tube gradually went forward to the ileum end by peristalsis, and the small intestine became fully decompressed. At operation, antegrade colonic irrigation with warm saline was performed through this long tube without insertion of a Foley catheter. RESULTS: Immediate colonic resection and primary end-to-end anastomosis using layer-to-layer interrupted sutures was successfully performed in 4 patients with obstructing sigmoid colon cancer. CONCLUSIONS: This method avoids opening and closure of the cecum or ileum, and minimizes bacterial contamination. The technique is simple and easy, and useful for immediate resection and primary anastomosis of obstructing left-sided colon cancer.

Colonic Neoplasms↗

PubMed1998

Bone mineral density in patients taking H2-receptor antagonist.

Osteoporosis after gastrectomy is a common clinical disorder. In gastrectomized patients, decreased gastric acidity may be associated with impaired calcium absorption. This study was undertaken to determine whether patients with chronic use of H2-receptor antagonists (HRA) had demonstrable decreases in bone mineral density (BMD). Thirty-three patients taking cimetidine, ranitidine, or famotidine for more than 2 years were analyzed. We measured BMD of L2-L4 using dual energy X-ray absorptiometry (DXA). Osteoporosis (BMD less than 0.70 g/cm2) was found only in three patients (9%). As compared with healthy controls, age- and sex-matched BMD ranged from 74.4% to 132.9%, with a mean of 97.0%, and was not influenced by the period of HRA use (<5 years versus >5 years or more). Although the age- and sex-matched BMD was different among the kinds of HRA (98.6% for cimetidine, 101.3% for ranitidine, and 85.5% for famotidine), the relationship between the BMD and type of drug was not significant by multivariate analysis. These results indicate that chronic use of HRA has little influence on the degree of BMD, and suggest that decreased gastric acidity is not always associated with osteoporosis after gastrectomy.

Adult↗

PubMed1998

Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosis in colorectal cancer.

BACKGROUND: C-reactive protein (CRP) is a product synthesized in hepatocytes and has been reported to be upregulated by such proinflammatory cytokines as interleukin-1, interleukin-6, and tumor necrosis factor. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potential and prognosis in colorectal cancer has not been elucidated. METHOD: One hundred and twenty consecutive patients with colorectal cancer, whose local lesions were resected in our department, were selected. Any patients with inflammatory diseases such as infection or collagen diseases were excluded from the current study. The preoperative serum CRP level was measured, and the relationship between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. RESULTS: The incidences of liver metastases, peritonitis carcinomatosa, histopathologic lymph nodes metastasis, and intravascular invasion in patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum protein level. The survival rates of the patients without a preoperative elevation of the serum CRP proved to be significantly more favorable than that of the patients with such an elevation (P <0.001). CONCLUSIONS: A preoperative serum elevation of CRP was thus found to be an indicator of the malignant potential of the tumor as well as a predictor of the prognosis of patients with colorectal cancer.

Adult↗

PubMed1998

[Spontaneous regression of hepatocellular carcinoma: a case report].

A 65-year-old woman with hepatocellular carcinoma underwent right hepatic lobectomy. Her alpha-fetoprotein levels significantly dropped from 285,000 ng/ml to 3,100 ng/ml for one month without any preoperative treatment. The tumor thrombus in the portal vein showed complete necrosis, and lymphocytes infiltration around the main tumor were present microscopically. However, there was no necrotic area in the main tumor. This patient is living with no evidence of recurrence for 3 years and 6 months following hepatic resection.

Aged↗

PubMed1998

[Necrosis of the hepatocellular carcinoma nodule can aggravate metastasis].

Since the stroma of hepatocellular carcinoma is composed of sinusoid-like structures, cancer cells are readily released from the primary tumor with possible injurious consequences. A 63-year-old woman with hepatocellular carcinoma underwent percutaneous ethanol injection therapy. During this treatment, tumor thrombus developed in the right hepatic vein. Partial hepatic resection was performed. Six months later, multiple nodules appeared in the lung fields. Partial necrosis may have allowed the release of cancer cells from the primary tumor. Perioperative therapy should have an effect on intrahepatic micrometastases, because removal of the main tumor can be done surgically.

Carcinoma, Hepatocellular↗