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Biomedical subjects

T Matsushiro

Publications and source records attributed to T Matsushiro.

At least 19 recordsLinked to original sources
PubMed2000

[Home anti-cancer therapy with a venous port].

Home anti-cancer chemotherapy and palliation in the terminal stage were performed for patients with advanced cancer of the digestive system, using a venous port implanted beneath the skin via the subclavian vein. Patients under 75 years of age (5 with esophageal, 61 gastric, 59 colorectal, 5 cholangio, 5 pancreatic, 1 hepatic and 1 ileal cancer) were treated. With two portable balloon pumps, continuous intravenous infusion of 5-FU (300 or 400 mg/body/day) combined low-dose injection of cisplatin (5 mg/body/day) was continued for 10 days, and repeated 3 times for 6 weeks. The response rate was 17.9% in 78 patients according to valuation of the tumor mass. In 119 patients also undergoing a tumor marker evaluation, an effect was seen in 26.1%. No severe side effects such as renal dysfunction or bone marrow suppression were seen, and no special infusion was needed. Therefore, such treatment can be continued for a long time. Use of a venous port should make easy the switchover to HPN and the amelioration of the symptoms of the terminal stage, such as pain, and helps patients cope with the worry. Therefore, the present technique is useful in a series of cancer treatments including surgery, chemotherapy and the amelioration of symptoms.

Aged↗
PubMed1996

[Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].

The efficacy of 1/2 FAM, which consists of 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin C (MMC), was compared with that of palliative treatment in patients with unresectable pancreatic and biliary tract carcinomas in a multicenter randomized trial. The patients assigned to 1/2 FAM group were treated with 5-FU 200 mg/m2/day IV, ADM 15 mg/m2/day IV and MMC 5 mg/m2/day IV. These 3 drugs were given concurrently as the initial dose within a week after palliative operation, and this regimen was repeated for at least 2 whole courses, at 4-week intervals before the next course of therapy. Those randomized to the control group were subjected to palliative treatment alone. Completely eligible for analysis were 42 cases of the 1/2 FAM group and 41 of the control group. There was no significant difference between the groups with respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy. As for the duration of 50% inhibition of tumor progression, a significantly better outcome was obtained in 1/2 FAM group. Tumor progression was most significantly inhibited in patients with gallbladder carcinoma. In 1/2 FAM group, tumor reduction was achieved in 1 CR and 2 PR patients. The most frequent adverse reaction was gastrointestinal manifestations, along with diarrhea and alopecia. 1/2 FAM did not contribute to the life prolongation, but inhibited the tumor progression for a significantly longer duration and, to a lesser extent, reduced the tumor size in unresectable pancreatic and biliary tract carcinomas. This regimen is suggested to be useful particularly in the treatment of the latter carcinoma.

Adult↗
PubMed1995

Undifferentiated carcinoma of the duodenal ampulla.

This report demonstrates a case of undifferentiated carcinoma of the duodenal ampulla. A 74-year male experienced jaundice lasting for 3 weeks. An upper gastrointestinal series demonstrated a polypoid, ovoid filling defect in the second portion of the duodenum, and duodenoscopy disclosed a protruding mass involving the orifice of the papilla of Vater. Cholangiography demonstrated obstruction due to compression in the terminal common bile duct. Pylorus-preserving pancreatoduodenectomy was performed on the diagnosis of ampullary carcinoma. The gross specimen showed a polypoid mass, measuring 3.5 cm in diameter, in the ampulla, located mainly in the duodenal submucosal layer and invading the terminal common bile duct. Histologically, the tumor was small cell type, undifferentiated carcinoma, arising from the duodenal epithelium adjacent to the ampulla.

Aged↗
PubMed1992

[Prospective randomized trial comparing modified FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus 5-FU alone for the treatment of non-resectable pancreatic and biliary tract carcinomas (the 1st trial in non-resectable patients). Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].

The modified FAM (5-fluorouracil (5-FU) + adriamycin (ADR) + mitomycin C (MMC)) therapy (FAM group) was compared with 5-FU mono-therapy (F group) by multi-institutional randomized trial in the patients with cancer of the pancreas or the biliary tract who underwent non-resection. The patients in FAM group received 6 mg/m2 of i.v. MMC during operation, 310 mg/m2 of i.v. 5-FU for 5 days in the 1st and 3rd postoperative weeks and 12 mg/m2 of i.v. ADR in the 2nd postoperative week. Those in F group received only 5-FU course in the administration schedule of FAM group. Among the cases which completed respective whole administration schedules. 35 cases in FAM group and 36 in F group, better effect than partial response (PR) was observed in neither groups, and there was no significant difference between groups with respect to overall/each disease survival duration, progression-suppressed duration and clinical effect. Primary adverse effects were alimentary symptoms and hepatic dysfunction, neither of which was serious, and there was no difference between groups except that hair loss was observed in more cases in FAM group (p less than 0.05). Results in FAM group did not statistically surpass those in F group, but a tendency was observed that FAM group was better than F group in terms of survival duration and clinical effect for cancer of the gall-bladder.

Adult↗
PubMed1991

[Cell kinetic studies on the gallbladder epithelium in patient with anomalous arrangement of pancreatobiliary duct].

It is well known that the patients with anomalous arrangement of pancreatobiliary duct (AAPBD) are combined with biliary tract cancer. To clarify possible carcinogenesis of the gallbladder with AAPBD, DNA analysis of the gallbladder epithelium was performed in control (9 cases), AAPBD (26), gallbladder cancer confined in mucosa (10) and noncancerous epithelium around the gallbladder cancer (21). The mean values of DNA score, as already reported by us as an indicator of cell kinetics, were 12.1 (control), 27.2 (AAPBD, Type a), 13.3 (AAPBD, Type b), 14.8 (noncancerous epithelium around cancer) and 77.2 (gallbladder cancer confined in mucosa). The values of DNA score in the epithelium of AAPBD (Type a) showed significantly high level, which was next to that of cancer. Type a AAPBD may be supposed to have potential malignancy because of its accelerated cell cycle. But as Type b AAPBD without accelerated cell cycle combines cancer at least as often as Type a, further studies should be performed to reveal the relationship between cell cycle and malignancy.

Bile Ducts↗
PubMed1990

Lymphoepithelial cyst in the pancreas: a case report.

A case of lymphoepithelial cyst in the pancreas was reported. A 64-year-old man without any specific complaints was found to have a cystic lesion in the anterior portion of the pancreas, as revealed by ultrasonography of the abdomen at an annual medical examination in 1988. This was dissected easily from the pancreas. Histologically, it was diagnosed to be a benign lymphoepithelial cyst in the pancreas. Cysts of this type are rare, and their histogenesis is also not well understood.

Branchioma↗
PubMed1986

Valvuloplasty plus fundoplasty to prevent esophageal regurgitation in esophagogastrostomy after proximal gastrectomy.

To prevent regurgitation esophagitis in esophagogastrostomy after proximal gastrectomy, valvuloplasty plus fundoplasty was carried out in 17 patients with stomach cancer or cancer of the abdominal esophagus. For this purpose, an equilateral triangular flap of 2.5 cm per side was formed at the upper margin of the remaining stomach along the greater curvature. The flap was inverted into the stomach only to serve as a valve. After the esophagogastrostomy was properly performed, fundoplasty was carried out, lifting and suturing the uppermost edge of the stomach to the esophagus along the greater curvature. To prevent pylorospasm as a result of reduced gastric volume, pyloromyotomy was also performed. The results were excellent in those followed for more than 1 year. The technique is simple and effective and, we believe, deserves further clinical evaluation.

Esophagitis, Peptic↗
PubMed1985

Precancerous lesions of the gallbladder mucosa.

To elucidate the morphological characteristics and the incidence of precancerous lesions of the gallbladder, 200 gallbladders removed for presumed benign diseases were examined histopathologically. Dysplastic epithelia with distinct cellular and structural atypia were graded into either mild or moderate to severe degree. Twenty-nine (14.5%) of 200 cases showed dysplasia; 5 (2.5%) was to moderate to severe degree and 24 (12%) to mild degree. Carcinoma in situ was found in 4 cases (2%) and occult invasive carcinoma in 2 cases (1%). Simple hyperplasia was seen in 54 cases (27%). Abnormal epithelia showed a male preponderance in consistent with the previous report on cancer epidemiology in Japan. Dysplasia and hyperplasia were found to have close association with chronic cholecystitis, but not with gallstones per se. It was postulated that the progression of dysplasia or carcinoma in situ into invasive carcinoma may occur in the sixties to seventies.

Adult↗
PubMed1985

[Pathophysiology of duodenal papillitis in cholelithiasis].

Pathological features of duodenal papillitis relative to cholelithiasis were analyzed in terms of dilatation of the bile duct, intracholedochal pressure, and histopathological pictures of papillitis, and the following conclusions were drawn: The principal causes of bile duct dilatation appeared to be pathological changes in the papilla per se; Papillitis accompanying choledocholithiasis with cholesterol stone were secondary to those gallstones evacuated from the gallbladder; Calcium bilirubinate stones seemed to be formed primarily as the result of papillitis. In some cases, ascariasis in their past history was thought responsible for the papillitis; and 4. It is suggested that as the papillitis advances, papillary incompetence will emerge.

Adult↗
PubMed1984

Exfoliation as a mode of cancer elimination in rectal carcinoma.

A histopathological survey of surgical materials from 143 patients with rectal carcinoma subjected to chemotherapy and low-dose radiotherapy with tegafur and bleomycin was carried out. The chemotherapy combined with radiotherapy brought about better results than chemotherapy alone. In 4 of the 58 patients treated with radiochemotherapy, no cancer cells could be found in surgical specimens. Exfoliation into the rectal lumen of cohorts of cancer cells may occur in some cases of rectal carcinoma thus treated, resulting in cancer cell elimination.

Combined Modality Therapy↗
PubMed1984

Perfusion cholangiomanometry with papillary stimulation by dilute hydrochloric acid.

A modification of cholangiomanometry in which the papilla of Vater was stimulated by hydrochloric acid was devised as a means to evaluate the papillary function. Manometric tracings could be classified into four patterns according to the mode of response to hydrochloric acid of the papilla. Pattern I was the type in which a group of regular, high-amplitude spikes appeared within 60 seconds after the onset of perfusion. This represented a normally functioning papilla. Pattern II was characterized by rhythmic occurrence of low-amplitude waves. This represented a reversible papillitis as evidenced by the fact that postoperatively such cases exhibited pattern I results as examined through T tube. In pattern III the perfusion pressure remained flat, showing no reaction waves. This represented an incompetent papilla. The pattern III patients with conditions which were reversible responded to intravenous pentazocine. In pattern IV the perfusion pressure continued to increase without reaction waves, representing cicatricial stenosis of the papilla or incarcerated stone in the papilla. This method of cholangiomanometry was thus found to be useful for selecting candidates for sphincteroplasty.

Ampulla of Vater↗