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Biomedical subjects

Y Adachi

Publications and source records attributed to Y Adachi.

At least 433 records · Page 24Linked to original sources
PubMed1997

Morbidity after D2 and D3 gastrectomy for node-positive gastric carcinoma.

BACKGROUND: Several studies show various rates of morbidity and mortality after radical operation for gastric carcinoma. Whether or not extended lymph node dissection should be done is still controversial. STUDY DESIGN: The medical records of 214 patients with node-positive gastric carcinoma who underwent radical gastrectomy and extended lymph node dissection (D2, D3) from 1975 to 1990 were analyzed with reference to the type and cause of postoperative complications. RESULTS: The overall morbidity rate was 36 percent and was significantly different between patients with distal gastrectomy (19 percent) and total gastrectomy (53 percent) (p < .01). Morbidity after distal gastrectomy correlated with blood loss (593 g compared with 438 g; p < .05) and transfusion (43 percent compared with 21 percent; p < .05), whereas morbidity after total gastrectomy was closely linked to splenectomy (64 percent compared with 40 percent; p < .05) and duration of the operation (227 minutes compared with 204 minutes; p < .05). The morbidity rate was not different, however, between D2 dissection (33 percent) and D3 dissection (40 percent) groups. CONCLUSIONS: Radical gastrectomy and extended lymph node dissection can be performed with an acceptable morbidity, but total gastrectomy with splenectomy was associated with high morbidity in patients with node-positive gastric carcinoma.

Adenocarcinoma↗
PubMed1997

Surgical results of perforated gastric carcinoma: an analysis of 155 Japanese patients.

OBJECTIVES: Free perforation of gastric carcinoma accounts for less than 1% incidence of acute abdominal crisis in Japan, and this problem occurs much less frequently in Western countries. To clarify the characteristics of patients with perforated gastric carcinoma (PGC) and to investigate a treatment of choice, we reviewed the data of Japanese patients with PGC. METHODS: A total of 155 cases of PGC reported in the Japanese literature from 1985 to 1994, including one patient of our own experience, were studied. The clinicopathologic features, including tumor stage and patient survival, were analyzed. RESULTS: There were 27 stage I tumors (19%), 16 stage II tumors (12%), 42 stage III tumors (30%), and 55 stage IV tumors (39%). Emergency gastrectomy was done in 128 patients (83%), with the mortality and 5-yr survival rate was 7 and 40%, respectively. The survival of patients was influenced by the gross type of tumor, serosal invasion, lymph node metastasis, stage of the disease, and operative curability. The 5-yr survival rate of stage I and II patients was 76% and that of curatively treated patients was 74%. CONCLUSIONS: Recent Japanese results of emergency gastrectomy for PGC are satisfactory. Long-term survival is expected in curatively treated patients with stage I and II tumors.

Abdomen, Acute↗
PubMed1997

Prognostic factors of node-negative gastric carcinoma: univariate and multivariate analyses.

BACKGROUND: The presence or absence of lymph node metastasis closely correlates with survival of patients with gastric carcinoma. Although prognostic significance of the number and level of lymph node metastasis has been clarified, clinicopathologic features and prognostic indicators of node-negative gastric carcinoma have not yet been studied. STUDY DESIGN: The records of 435 patients who underwent curative D2 or D3 gastrectomy for gastric carcinoma between 1977 and 1987 were analyzed retrospectively. Clinicopathologic data of 252 patients having no lymph node metastasis were compared with those of 183 patients with lymph node metastasis. Prognostic factors were investigated by univariate and multivariate analyses. RESULTS: Compared with node-positive cases, node-negative cases were characterized by frequent location in the lower two thirds of the stomach (85 percent), tumor size less than 4 cm (54 percent), grossly superficial type (69 percent), and tumor invasion not beyond the muscularis propria (77 percent). The 10-year-survival rate for patients with node-negative tumors was 93.4 percent. Multivariate analysis demonstrated that depth of wall invasion and age of patient were independent prognostic factors. CONCLUSIONS: Node-negative gastric carcinoma is associated with a favorable outcome because of small progression of the disease. The depth of wall invasion and patient age were the most important prognostic factors.

Female↗
PubMed1997

Preoperative assessment of advanced gastric carcinoma using computed tomography.

OBJECTIVES: The role of computed tomography (CT) for the staging of gastric carcinoma is controversial. The purpose of this study was to evaluate the utility of CT in assessing the perigastric spread of advanced gastric carcinoma. METHODS: The study included 56 patients who underwent dynamic CT and laparotomy for the treatment of node-positive gastric adenocarcinoma. Preoperative CT findings were compared with surgical findings, and diagnostic accuracy was estimated. RESULTS: Sensitivity, specificity, and accuracy of preoperative CT in determining the perigastric tumor spreads were 33, 97, and 73% in pancreatic invasion, 36, 97, and 70% in level III lymph node involvement, and 89, 98, and 96% in liver metastasis. Peritoneal dissemination was not detected in 15 of 56 patients (27%), and stage IV disease was not diagnosed correctly in 18 of 40 patients (45%). CONCLUSIONS: Radiologists and surgeons must remember that pancreatic invasion, extended lymph node metastasis, and peritoneal dissemination are sometimes overlooked in CT examination in patients with advanced gastric carcinoma.

Adenocarcinoma↗
PubMed1997

Destruction of hematopoietic microenvironment by cytotoxic T cells.

Coculture of cytotoxic T cells (STIL-3 C5) derived from L8313 leukemic mice with hematopoietic supportive stromal cells (MS-5) resulted in the detachment of MS-5 cells from the culture dish, whereas helper T cells (STIL-3 DF) did not induce this detachment. The response of bone marrow (BM) adherent cells to the same treatment was similar to that of MS-5 cells. The detached cells were unable to proliferate further, and genomic DNA of these cells showed fragmentation, suggesting that hematopoietic stromal cells died of apoptosis. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis revealed that STIL-3 C5 cells, but not STIL-3 DF cells expressed perforin, granzyme A & B, and Fas ligand. Fas was expressed in MS-5, BM adherent cells, MS-K and NIH/3T3 cells, which do not support hematopoiesis. These data suggest that the aforementioned factors mediate induction of apoptosis in MS-5 cells induced by direct cell-to-cell interaction with STIL-3 C5. This may explain the mechanism responsible for the destruction of the hematopoietic microenvironment by cytotoxic T cells in L8313 leukemia, from which STIL-3 cells are derived; it also suggests that destruction of hematopoietic tissue may be caused by leukemic cytotoxic T cells in some cases of leukemia.

Animals↗
PubMed1997

[Continuous hepatic arterial infusion of fluorouracil with leucovorin for liver metastases from colorectal cancer].

Sixteen patients with liver metastases from colorectal cancer were treated by continuous intraarterial chemotherapy of 5-FU and leucovorin. The regimen was that 500 mg/body of 5-FU with 30 mg/ body of leucovorin was administered continuously for 5 days followed by no medication for 16 days. The effect of this therapy was evaluated, and the relationship between this therapy and p53 overexpression was also studied. A complete response was obtained in 3 patients and a partial response in 3 patients; the overall response rate was 38%. The response rate was 56% in patients of more than 6 courses, 57% in patients with positive p53, and 20% in patients with negative p53. The three-year survival rate was 31%, and median survival was 18 months. Duodenal ulcer occurred in 2 patients due to extravascular dislocation of catheter. A high response rate and favorable prognosis were obtained by this therapy. Maintenance of catheter and a short administration period are current issues.

Aged↗
PubMed1997

[Relationship between the presence of side-holes in bone marrow aspiration needle and the number of harvested bone marrow mononuclear cells].

The aim of this study was to evaluate the yield of nucleated cells in bone marrow harvested by means of Downs' Islam aspiration needles with or without side-holes. Twenty marrow donors for HLA identical sibling transplants were studied. Bone marrow nucleated cells were harvested 50 ml in the right iliac bone with a Downs' Islam aspiration needle with or without side-holes and 50 ml in the left with another kind of needle by means of 5 ml aspirations in each donor. There were no significant difference between the number of nucleated cells by means of Downs' Islam aspiration needles with and without side-holes by cross-over analysis. All nucleated cell counts were 33.06 +/- 12.93 x 10(3)/microliter (mean +/- standard deviation) by means of the needle with side-holes and 32.90 +/- 15.25 x 10(3)/microliter by means of the needle without side-holes. The Downs' Islam aspiration needle without side-holes seems to be better in bone marrow harvest from normal volunteers than that with side-holes, because the former may be stronger than the latter.

Adolescent↗
PubMed1997

[A case of amyloidosis of the tracheobronchial tree and inferior nasal concha].

A 50-year-old man resented at a local medical clinic with nasal obstruction. He was treated but did not improve. He then consulted our institution. Chest X-ray disclosed infiltrative shadows in the basal region of the left lung. A computed tomography scan of the lung showed marked thickening of the airway walls extending from the trachea to both bronchial trees and obstructive changes in the left lower lobe of the lung. On bronchoscopic examination the bronchial mucosa was reddened and edematous with a pinhole bronchial obstruction in one region. Congo red staining of biopsy samples taken from the bronchial mucosa showed deposition of an amorphous substance. Tracheobronchial amyloidosis was diagnosed. The amyloid material was resistant to potassium permanganate and tested positive for lambda-chain of L immunoglobulin. Otorrhinolaryngological examination disclosed a tumor in the inferior nasal concha as the cause of his nasal obstruction. The nasal tumor was resected and AL lambda-type amyloidosis was diagnosed pathologically. Tracheobronchial and inferior nasal concha amyloidosis is an extremely rare pathological condition. The patient was followed for one year and remain asymptomatic without treatment.

Amyloidosis↗
PubMed1996

Midkine as a novel target gene for the Wilms' tumor suppressor gene (WT1).

Midkine (MK) is a heparin-binding growth factor which is strongly expressed during the midgestation period of mouse embryogenesis. Wilms' tumor is an embryonal kidney malignancy in infants, and WT1 has been identified as its tumor suppressor gene. The high expression level of MK in all Wilms' tumor specimens so far examined and the presence of two WT1 elements (5'-GCGGGGGCG-3') in the human MK promoter region led us to examine the possible role of the WT1 gene product in the regulation of MK gene expression. A gel shift assay verified the complex formation between the WT1 gene product and WT1 consensus sequence of MK gene. DNase1 footprint analysis also demonstrated that the downstream WT1 element was protected from DNase1 cleavage by the addition of the WT1 protein. The human MK promoter fused with the chloramphenicol acetyltransferase gene (phMK2.3kCAT) was co-transfected with an effector plasmid containing the WT1 gene into several cell lines. Transient transfection assays showed suppression of the MK promoter by WT1 co-transfection in recipient cells; deletion of the WT1 binding site abolished the suppression. The evidence reported in this study indicates that MK gene is a newly identified WT1 target gene.

3T3 Cells↗
PubMed1996

IL-2 rescues in vitro lymphocyte apoptosis in patients with HIV infection: correlation with its ability to block culture-induced down-modulation of Bcl-2.

IL-2 administration in vivo has been shown to increase CD4+ T cell counts in HIV+ patients. We have previously reported that PBMC from HIV-infected patients undergo marked spontaneous apoptosis in vitro. In this study, we examined the effect of IL-2 added in vitro upon culture-induced apoptosis in PBMC from 80 HIV-infected patients by flow cytometry. IL-2 at concentrations of > or = 10 U/ml significantly reduced spontaneous apoptosis in CD3+ T lymphocytes in patients but not in healthy volunteers. Interestingly, we observed that Bcl-2 expression in patient lymphocytes decreased rapidly upon in vitro culture while that in cells of healthy volunteers was relatively unaffected. The most significant decrease in Bcl-2 expression was noted in the apoptotic cell population. The IL-2-mediated reduction in lymphocyte apoptosis was found to be associated with the blocking of this culture-induced down-modulation of Bcl-2 expression. IL-2 did not induce significant expansion of lymphocytes during the culture period nor did it affect Fas Ag expression in patient cells, which were already expressing Fas maximally. These findings strongly suggest that IL-2 mediates its apoptosis-blocking effects via suppressing down-modulation of Bcl-2. Our findings also provide an experimental basis for the ongoing therapies utilizing this cytokine for slowing HIV disease progression.

Adult↗
PubMed1996

Presence of elevated carcinoembryonic antigen on absorbent disks applied to nipple area of breast carcinoma patients.

BACKGROUND: Carcinoembryonic antigen (CEA) is used as a serum marker to detect and monitor the status of various kinds of malignant tumors. To determine whether CEA might be detected in secretions collected topically from around the nipple area, and whether its secretion might differ in a cancerous versus a noncancerous breast, we developed a simple method for collecting and measuring CEA, using a small cellulose membrane disk and an enzyme immunoassay. METHODS: We measured the amount of CEA excreted from the nipple area of 22 healthy control women and 32 women with unilateral breast carcinoma confirmed histologically. Secretions were collected from the nipple area by affixing a small (20 mm diameter) absorbent disk made of nitrocellulose membrane backed with filter paper to that area for 24 hours. Substances absorbed by the membrane were then subjected to an immunoassay for CEA using anti-CEA antibodies. RESULTS: In the 22 healthy subjects, a small amount of CEA (0.6 +/- 0.9 units) was secreted from each nipple, which was equally low regardless of the phase of the menstrual cycle. In contrast, 30 of the 32 women with breast carcinoma secreted significantly greater amounts of CEA from the cancerous (16.1 +/- 8.2) than the noncancerous (2.0 +/- 2.2) breast. Such a difference (14.1 +/- 8.0) in CEA excretion was not observed in the healthy controls (0 +/- 0). CONCLUSIONS: These findings suggest that such disks may provide a simple and noninvasive method of collecting trace molecules, including CEA, in skin secretions around the nipple to evaluate functional disorders of the mammary glands, particularly breast carcinoma. Additional studies are indicated in larger groups of women with various stages of breast carcinoma as well as with benign breast diseases.

Absorption↗
PubMed1996

Angiotensin II-induced renal responses in anesthetized rabbits: effects of N omega-nitro-L-arginine methyl ester and losartan.

Intrarenal arterial infusion of angiotensin II (4 ng/kg/min) reduced renal blood flow, glomerular filtration rate and urinary Na+ excretion (UNaV) without affecting fractional Na+ excretion (FENa) in anesthetized rabbits. Losartan (10 micrograms/kg/min) abolished these angiotensin II-induced renal responses. The renal blood flow, glomerular filtration rate and UNaV responses were potentiated during intrarenal arterial infusion of N omega-nitro-L-arginine methyl ester (L-NAME, 10 micrograms/kg/min). A high dose of L-NAME (50 micrograms/kg/min) also potentiated the renal blood flow and UNaV responses but not the glomerular filtration rate response. Angiotensin II reduced FENa during L-NAME infusion at either dose. In L-NAME-pretreated rabbits, losartan abolished the angiotensin II-induced renal blood flow and glomerular filtration rate responses, but the reduction in FENa still remained. The present study suggests that in the rabbit kidney (1) nitric oxide attenuates the angiotensin II-induced (angiotensin AT1 receptor-mediated) vasoconstriction and (2) angiotensin II can evoke losartan-resistant tubular Na+ reabsorption, but the tubular action is concealed by nitric oxide.

Angiotensin II↗
PubMed1996

Prediction of early and late recurrence after curative resection for gastric carcinoma.

BACKGROUND: Although several prognostic factors for patients with gastric carcinoma have been demonstrated, those predictive of early and late recurrences after surgery are still unclear. METHODS: Of 479 patients who underwent curative resection for gastric carcinoma from 1977 to 1987, 115 patients who died of recurrence were studied. RESULTS: The patients were divided into 2 groups: an early recurrence group that included 80 patients who died within 3 years after surgery, and a late recurrence group, that included 35 patients who died more than 3 years after surgery. Early recurrence was characterized by a large tumor (8.1 cm vs. 6.7 cm; P<0.05) and many involved lymph nodes (7.7 vs 4.4; P<0.01). However, the depth of invasion, as well as the level of positive lymph nodes were not different between the two groups. Multivariate analysis showed that tumor size and the number of positive lymph nodes independently influenced the survival period. CONCLUSIONS: Tumor size and the number of positive lymph nodes are the most important factors predicting the timing of recurrence after curative resection for gastric carcinoma.

Female↗
PubMed1996

Amelioration by Kupffer cell blockade in hepatic damage induced by cold preservation with subsequent plasma-supplemented perfusion.

The effects of Kupffer cell blockade with gadolinium chloride (GdCl3) on hepatic injury in the cold preservation with subsequent perfusion was investigated. The condition of the liver grafts which were cold-preserved in University of Wisconsin solution was evaluated by measuring the uptake rates of indocyanine green and hyaluronic acid (IUR and HUR), two indices of liver damage. Perfusion injuries after cold storage occurred in 24-hr-preserved liver and progressed further in 36-hr-preserved liver. GdCl3 prevented the decrease in IUR and ameliorated perfusion injuries in the 36-hr-preserved liver, although GdCl3 did not inhibit the decrease in HUR. The HURs were remarkably decreased in the livers stored even for 6 hr, for which the cold-preserved livers were quite viable, whereas IURs were significantly decreased in livers stored for 24 hr or more when perfusion injury was apparently developed. These results suggest that the IUR is an indicator of hepatic perfusion injury in preserved livers and that Kupffer cell blockade may be a promising strategy for the prevention of hepatic injury after cold preservation with subsequent perfusion.

Animals↗