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Biomedical subjects

T Tobe

Publications and source records attributed to T Tobe.

At least 325 records · Page 18Linked to original sources
PubMed1988

[Indications for limited hepatic resection in hepatocellular carcinoma].

Indications for limited hepatic resection in patients with hepatocellular carcinoma were evaluated by retrospective and clinicopathologic analysis of postoperative cases. Particular attention was paid to hepatic functional reserve and long-term prognosis. In our department, in order to estimate the hepatic functional reserve, indocyanine green clearance test (ICG), Child's classification and the oral glucose tolerance test have been applied. For instances, the incidences of hospital deaths were 17% and 19% in cases with an ICG-K value below 0.06 and between 0.06 and 0.08, which were high, compared with 6% and 3% in cases ICG-K values of with 0.08-0.10 and 0.10-0.12. On the other hand, by clinicopathologically analyzing 18 surviving patients or those surviving without recurrence for over 3 years after hepatic resection and 41 cases of small hepatocellular cancer less than 3 cm in diameter, those with capsule formation and without portal tumor invasion, intrahepatic metastasis and capsular invasion had a good long-team prognosis without recurrence even following limited resection. Particularly, patients with a surgical margin of over 1cm between the tumor and cut surface were candidates for long, non-recurrence survival. Form these results, the indications for limited hepatic resection for hepatocellular carcinoma were considered to be on ICG-K value of less than 0.08 in hepatic function and cases without venous invasion and extracapsular tumor invasion. In other cases, it is recommended that limited resection should be followed by multidisciplinary treatment.

Carcinoma, Hepatocellular↗
PubMed1988

Simultaneous measurement of hepatic arterial and portal venous flows by transit time ultrasonic volume flowmetry.

Simultaneous measurement of the hepatic artery and the portal vein was performed successfully upon 15 anesthetized patients during abdominal operations with the use of transit time ultrasonic volume flowmeter. The hepatic arterial flow, portal venous flow and total hepatic flow were 267.3 +/- 21.2, 746.4 +/- 41.3 and 1,010.7 +/- 52.7 milliliters per minute, respectively. The ratio of hepatic arterial flow to portal venous flow was 0.36 +/- 0.03. Temporary occlusion of the portal vein resulted in a significant increase in hepatic arterial flow (23.6 +/- 4.3 per cent, p less than 0.01), whereas temporary occlusion of the hepatic artery did not alter portal venous flow significantly. Occlusion of the common hepatic artery induced a significant decrease in hepatic arterial flow (p less than 0.05), but did not alter portal venous flow significantly. The results of this approach had useful clinical meanings in one patient in whom the Appleby's operation was performed in which sufficient hepatic arterial flow was needed after the common hepatic artery was ligated. Data are presented for hepatic circulation measured by transit time ultrasonic volume flowmeter, which is a good device to use to assess portal venous flow as well as hepatic arterial flow with reproducibility and stability.

Adult↗
PubMed1988

[Study on splanchnic circulation: measurement of the liver blood flow].

In anesthetized patients during abdominal surgery, hepatic artery and portal vein flows were measured simultaneously utilizing an ultrasonic transit-time volume flowmeter. The total hepatic blood flow was 994.6 +/- 52.4 ml/min. The hepatic artery flow and the portal vein flow were 260.0 +/- 23.8 ml/min and 730.8 +/- 41.3 ml/min, respectively. The ratio of hepatic artery flow to portal vein flow was 0.37 +/- 0.04. A significant increase in hepatic artery flow (p less than 0.01) followed portal vein occlusion, whereas no significant change was observed in portal vein flow after hepatic artery occlusion. Common hepatic artery occlusion resulted in a significant decrease in hepatic artery flow (p less than 0.05), but no significant change was observed in portal vein flow. The present study firstly demonstrated that ultrasonic transit-time volume flowmeter is a device to quantitatively assess hepatic artery and portal vein flows with good reproducibility and stability in human subjects. This easy and simple technique seemed to have wide clinical application to abdominal surgery and would have a promising in studying splanchnic blood flows in various situations such as in cases of hepatectomy and portal hypertension.

Adult↗
PubMed1988

[Clinical therapeutic effect of adoptive immunotherapy using IL-2-cultured autologous lymphocytes].

Our method of adoptive immunotherapy (AIT) using autologous IL-2-cultured lymphocytes differs from so-called LAK therapy in several points. We (1) obtain cultured lymphocytes from effusion lymphocytes (EL) or regional lymph-node lymphocytes (RLNL), when possible, rather than peripheral blood lymphocytes (PBL), (2) use crude IL-2 to induce T cell proliferation and to maintain killer activity, (3) use sonicated autologous tumor extract as antigen (Ag) to stimulate proliferation of cytotoxic T cells, and (4) pretreat the patients with local administration of OK-432 before AIT to induce effector cells that act synergistically with transferred killer cells. Surface marker analysis showed that OKT3, IL-2 receptor, Leu 2+15- cells were elevated while Leu 11a and Leu 3+8+ cells were decreased. Culture of RLNL augmented the expression of Leu 3+8- marker. Both of PBL and RLNL responded to Ag, and their auto-tumor killing activities were augmented in about half of the patients while rarely decrease by the addition of Ag. Response rates of patients with pleural effusion due to breast cancer and those with liver metastasis of breast cancer were 94% and 60%, respectively. Moreover, the survival was prolonged in the treated patients with pleural effusion or gastric cancer patients with peritoneal dissemination.

Cells, Cultured↗
PubMed1988

[Diurnal profile of gastrointestinal hormones following pancreatectomy].

A long-term follow-up study revealed that diabetes, diarrhea and dumping syndrome were the major complications after pancreaticoduodenectomy. The PABA recovery rate in PFD test was markedly decreased in patients with pancreaticoduodenectomy, suggesting that impaired exocrine pancreatic function is the main cause of the complications. A 24-hour profile of pancreatic juice secretion more than 1.5 months after operation, showed that pancreatic juice was rich in protein and amylase, and secretion was increased following a meal and early in the morning. Gastrin, CCK and VIP were not detected during these periods; however, secretin and motilin were increased. These results suggest that pancreatic exocrine function recovered in patients with pancreaticoduodenectomy and secretin and motilin played an important role in the regulation of these functions.

Circadian Rhythm↗
PubMed1988

[Immunotherapy of gastric cancer].

Two immunotherapeutic methods were developed as adjuvant therapy for gastrointestinal malignancies, one using oral administration of a streptococcal preparation, OK-432, and the other with adoptive immunotherapy (AIT), local transfer of IL2-cultured and autologous lymphocytes, combined with local preadministration of OK-432. Tsuchitani and Nio in our laboratory have revealed experimentally that oral OK-432 stimulates tumor-specific and non-specific immune mechanisms of gut-associated lymphoid tissues and inhibits the growth of some murine syngeneic tumors that were transplanted into cecal patches. The clinical efficacy of oral OK-432 on gastric cancer patients has been examined by a controlled randomized trial involving a total of about 1000 cases. Oral OK-432 (5KE, once a week) was revealed to be significantly effective in curatively resected group but not effective in non-curatively resected group. Ten consecutive patients with peritoneal dissemination of gastric cancer were treated with intraperitoneal OK-432 and AIT. AIT was performed by transferring autologous lymph node-lymphocytes cultured for 13 days with crude IL2 and tumor-extract. The survival of the treated patients was significantly longer (50% survival period exceeded 1 year) than that of historical control (95 cases, 50% survival period was 5 months). These immunotherapeutic methods are expected to be useful for multidisciplinary therapy of gastric cancer by a combination of each method with other therapeutic methods.

Biological Products↗
PubMed1988

[Development of the surgical therapy of malignant liver tumors].

The development of surgical treatment for malignant liver tumor was reviewed. The developmental process can apparently be divided into four periods. The first period up to 1968 is when surgical trials for liver tumors were started, and much effort was directed toward the establishment of systematic procedures for hepatic resection. The second period starts form 1968, when the Liver Cancer Study Group of Japan was inaugurated to organize investigators participating in the treatment of, and basic research on liver tumors. During this period, the basis for contemporary surgical treatment and sophisticated means of diagnosis such as such as determination of serum AFP level, selective angiography, and liver scintigraphy were established. This period came to an end around 1977 when computed tomography and ultrasonography were developed and popularized. In the third period, a variety of procedures for hepatic resection such as lobectomy, segmentectomy and newly devised echo-guided sub-segmentectomy were performed, based on the close evaluation of hepatic functional reserve. However, analysis of the outcome in patients who had undergone surgery alone suggested the limitations of surgical treatment, leading to the advent of the 4th period two to three years ago. The strategy of therapy in the 4th period has been aimed at multidisciplinary treatment such as transarterial embolization, intratumoral injection of tumoricidal agents, radiotherapy, regional chemotherapy and immunotherapy.

Hepatectomy↗
PubMed1988

[Statistical analysis of pathological factors influencing prognosis of colorectal carcinoma].

The pathological and follow-up data of 503 patients with colorectal carcinoma have been analysed to assess quantitatively prognostic values of 16 pathological factors and their sub-categories with aid of computer. Besides the routine procedure, Cox's proportional hazards model, Hayashi's quantification theory II, III, Akaike's information criteria, Kendall's rank correlation, relative risk, and linear trend test were used. Regardless of methods used, liver metastasis, peritoneal dissemination, lymph nodes metastasis, depth of penetration, venous and lymphatic invasion emerged as powerful prognostic variables. Most of the analyses indicated that venous invasion contained the largest amount of prognostic information including that of long-term survival. When venous invasion is graded not only by the number of veins involved but also by the depth of invasion, its prognostic capability was comparable with that of staging systems. The values of relative risks calculated for the factors' sub-category were more closely associated with prognosis than five-year survival rates or median survival rates, thus permitting detailed comparison of different categories. We conclude the modern statistical methods are indispensable tool for prognostic factor analysis.

Colonic Neoplasms↗
PubMed1987

Effect of synthetic neuromedin U-8 and U-25, novel peptides identified in porcine spinal cord, on splanchnic circulation in dogs.

Two novel peptides which exert a potent stimulant effect on rat uterus smooth muscle have recently been identified in porcine spinal cord. These peptides designated neuromedin U-8 and U-25 have been reported to exert a hypertensive effect in rats. But further biological activities are not known. In the present study, the effect of these peptides on blood flow in portal vein, superior mesenteric artery and pancreatic tissue and on blood pressure were examined in dogs, utilizing recently developed ultrasonic transit time volume flow meter and laser Doppler flow meter. Neuromedin Us potently reduced blood flow in superior mesenteric artery. The minimum reductions could be observed even at very small doses of neuromedin U-25 (32 fmol/kg) and U-8 (90 fmol/kg), while the maximal reductions of 48.4 and 51.0% were attained at the doses of 320 pmol/kg (U-25) and 900 pmol/kg (U-8), respectively. These peptides also reduced portal vein blood flow, and the maximal reductions of 42.1 and 37.2% were attained at the doses of 32 pmol/kg (U-25) and 90 pmol/kg (U-8), respectively. On the other hand, blood flow in pancreatic tissue increased slightly with the maximal increases of 13.8% at 3.2 pmol/kg (U-25) and 11.8% at 9 pmol/kg (U-8), respectively. The maximal increases of blood pressure were 5.2% at 320 pmol/kg (U-25) and 4.3% at 90 pmol/kg (U-8). Furthermore, neither neuromedin U-25 nor U-8 influenced the axillary artery blood flow, suggesting their selective effect on splanchnic blood flow. Because of the potent and probably selective activity on splanchnic circulation, neuromedin U-25 and U-8 may well be recognized as physiologically significant novel neuropeptides or hormones.

Animals↗
PubMed1987

Expression of the c-myc gene in human gastrointestinal malignancies.

We have examined the level of the c-myc transcript in 6 esophageal, 16 gastric, 19 colorectal and 1 anal cancer tissue samples; these included four lymph nodes and six hepatic metastases obtained surgically. The esophageal cancer tissues were without an increase of the c-myc transcript, some of the gastric cancer samples showed a two to three fold increase and most of the colorectal and the one anal cancer samples showed a two to ten fold increase when compared with a normal mucosal layer. Therefore, the level of the c-myc transcript in human gastrointestinal malignancies shows organ dependency. Local, lymphatic, and hepatic metastases showed little difference in the level of c-myc mRNA from that of the primary tumor.

Actins↗
PubMed1987

Plasma levels of secretory IgA in patients with gastric cancer.

The levels of plasma secretory IgA were measured in patients with gastric cancer and found to be slightly higher (9.6 +/- 6.2 micrograms/ml) than those in healthy controls (7.0 +/- 2.6 micrograms/ml, 0.05 less than P less than 0.1). Secretory IgA levels in those with hepatic metastases (19.7 +/- 12.2 micrograms/ml) were significantly higher than those in patients without hepatic metastases (P less than 0.001). In the latter, there was no significant relationship between plasma secretory IgA levels and the deepest layer of cancerous invasion or lymph node metastases. The secretory IgA levels in cases of well differentiated tubular adenocarcinoma were significantly higher than those with poorly differentiated adenocarcinoma (P less than 0.05). Although there is small diagnostic value in the detection of gastric cancer by measuring the levels of secretory IgA, high levels of secretory IgA in gastric cancer patients may be indicative of the presence of hepatic metastases.

Adult↗
PubMed1987

The role of plasma secretin during starvation in dogs.

Plasma secretin levels were measured during a 72-hour starvation period in dogs. Plasma secretin rose significantly and insulin levels fell significantly during starvation. Intravenous glucose loading at the end of the 72-hour starvation period suppressed plasma secretin and free fatty acid levels with a concomitant rise of glucose and insulin levels. These findings suggest that secretin might be regulated by plasma glucose and insulin levels and might play a role in lipolysis during starvation.

Animals↗