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Biomedical subjects

Y Ichiyoshi

Publications and source records attributed to Y Ichiyoshi.

50 records · Page 3Linked to original sources
PubMed1990

Recurrence in early gastric cancer.

In a retrospective study of 503 cases of early gastric cancer, 17 of the patients had died of a recurrence of the gastric cancer and 72 had died of unrelated causes. The cumulative recurrence mortality rates were 2.2% at 9 years for mucosal cancer and 8.4% at 8 years for submucosal cancer. The recurrence patterns of early gastric cancer were hematogenic metastasis to the liver, lung, or bone (nine cases), recurrence from lymph nodes (three cases), and recurrence in the residual stomach (five cases). Submucosal cancers with a macroscopically elevated appearance, lymph node metastasis, and evidence of vessel invasion were the high-risk cancers for hematogenic recurrence, and adjuvant chemotherapy should be prescribed. Two cases of lymph node recurrence were attributed to inadequacy of lymph node dissection. Because metastasis to the group 2 lymph nodes was noted in 1.5% of cases of early gastric cancer and a macroscopic diagnosis of nodal status was inaccurate, complete dissection should be performed regardless of identification of metastasis. Five cases of recurrence in the residual stomach were attributed to overlooked lesions of multiple carcinoma and were detected at an advanced stage. Careful and regular postoperative follow-up is required to detect these recurrences at an early stage.

Blood Vessels↗
PubMed1989

A LINE 1 sequence interrupts the rat alpha 2u globulin gene.

The rat alpha 2u globulin gene family is composed of about 25 members with closely related structure. Several of these genes are transcriptionally active in the liver of adult males. We isolated about 50 independent genomic clones from the library and determined complete nucleotide sequences of two. Although they were alike and revealed structural features prerequisite for active genes, one cloned gene was interrupted in the 6th intron with about 900 bp 5' truncated and 3'-terminal triplicated form of LINE 1 sequence flanked by 16 bp complete direct repeat originating from the 6th intron. Within the inserted LINE 1 an excellent splicing acceptor homologue with a precedent lariat junction motif and multiple polyadenylation signals was identified. Thus, the possible production of a chimeric RNA, the last exon of which would be replaced by a part of LINE 1, has to be considered.

Alpha-Globulins↗
PubMed1987

Length polymorphism in the 3' noncoding region of rat hepatic alpha 2u-globulin mRNAs.

We detected two size classes in rat liver alpha 2u-globulin mRNAs when analyzing cDNA clones, and named the mRNAs corresponding to the cDNA clones having longer and shorter sizes as L-type and S-type, respectively. When sequencing these cDNA clones, a 25 base insertion was present in the L-type at the 6th exon-intron junction. The extra sequence coincided with the 5' part of the reported 6th intronic sequence that is directly contiguous to the 3' part of the 6th exon. The relative abundance of L- and S-type mRNAs in the steady-state liver was determined by a sensitive S1 nuclease analysis using the probe prepared from the L-type cDNA. The same method was also applied for the determination of the L/S ratios during the course of postnatal development and estrogen treatment, all resulting in similar values, of about 0.03. These findings indicated that L-type and S-type mRNAs are generated by an alternative splicing mechanism in the 3' noncoding region of alpha 2u-globulin transcripts. Sequence analysis also elucidated the presence of at least two active genes showing exactly the same pattern of alternative splicing.

Alpha-Globulins↗
PubMedDate not supplied

Clinicopathological features of patients who died with second primary cancer after curative resection for gastric cancer.

The appearance of a second cancer in patients who had undergone curative operation for the first gastric cancer is one of the crucial problems for the clinician. We analysed data on 910 patients with gastric cancer treated with curative resection, with respect to the risk factors for second primary cancer and the prognosis. Of 910 patients, 69 (7.6%) died with a second primary cancer. In patients with a second primary cancer, there were more men and age was more advanced, compared to the survivors. The gastric tumor was larger, the serosal invasion was more prominent and lymphatic involvement was more frequent. The postoperative 5-year survival for patients with a second primary cancer was 60.9%, the 10-year rate was 31.9% and the 15-year was 19.6%. Multivariate analysis revealed that risk factors for a second primary cancer was advanced age, male sex and a larger tumor. Our findings suggest that during the follow-up of patients with gastric cancer treated by curative resection and risk factors, a second primary cancer may occur in other organs, in addition to a recurrence of the first cancer.

Age Factors↗
PubMedDate not supplied

Recurrent pattern of digestive tract carcinoma in the Japanese: comparison of gastric cancer to colon cancer.

Six hundred and two consecutive cases of gastric cancer and 204 of colorectal cancer in recent decades were investigated for recurrence. Recurrence occurred in 103 cases of gastric cancer and 31 cases of colorectal cancer. We classified three categories of recurrent patterns; A: local, B: peritoneal dissemination, and C: distant metastasis. In gastric cancer, 11 cases (11%) were grouped A, 50 (48%) were B, and 42 (41%) were C. Similarly, 12 (39%) were grouped A, 5 (16%) were B, and 14 (45%) were C in colorectal cancer. The incidence of local recurrence was more increased in colorectal cancer than in gastric cancer (p < 0.01). On the contrary, that of peritoneal dissemination was more increased in gastric cancer than in colorectal cancer (p < 0.01). In gastric cancer, 8 cases of 103 survived more than 5 years after operation, furthermore 7 cases obtained more than 5 years of tumor-free interval. At the time of diagnosis of recurrence, data of serum CEA was available in 77 for gastric cancer and 29 for colon cancer. CEA positive cases were revealed 32 (42%) for gastric cancer and 24 (83%) for colorectal cancer (p < 0.01). Our data clarified the different recurrence patterns between gastric cancer and colorectal cancer. And suggest that more than 5 years follow-up should be needed in patients with gastric cancer.

Adult↗
PubMedDate not supplied

Surgical approaches in primary gastric lymphoma and carcinoma.

Data on 29 patients with primary gastric lymphoma and on 1655 with gastric carcinoma were compared with respect to the local extension and the results of surgery. More than two-thirds of the gastric area was involved due to multiple or widespread lesion in 25.9% and 7.0% of the patients with gastric lymphoma and carcinoma, respectively. Maximum tumor dimension exceeded 10 cm in 33.3% and 9.5% of gastric lymphomas and carcinomas respectively. Involvement of the extra-perigastric lymph nodes was evident in 51.8% and 26.2% of the patients with gastric lymphoma and carcinoma respectively. Therefore, wide and extended resection, including total gastrectomy, would be required more often for the surgical excision of gastric lymphoma. Peritoneal dissemination and liver metastasis were much less common in those patients with gastric lymphoma and hence, benefiting most from surgery. The five year survival rate after curative resection was somewhat better in patients with a gastric lymphoma (79.3% as compared to 65.6%), whereas the prognosis after non-curative surgery was equally unfavorable. Aggressive surgical excision is thus recommended for the treatment of patients with a primary gastric lymphoma.

Carcinoma↗
PubMedDate not supplied

Lymphatic advancement to peritoneal dissemination and liver metastasis in gastric cancer patients.

Lymph node metastasis is a risk factor for the occurrence of peritoneal dissemination and liver metastasis in patients with gastric cancer. We analysed data on 893 Japanese patients with serosally invasive gastric cancer, with respect to the relation between lymph node metastasis and peritoneal dissemination or liver metastasis. All these patients were treated in our clinics. Lymph node metastasis was evident in 746 patients, and in these patients the tumors were larger, lymphatic and vascular involvement were prominent and rates of peritoneal dissemination and liver metastasis were higher. In 147 patients with no evidence of lymph node metastasis, peritoneal dissemination was seen in 3.4% of cases and there was no liver metastasis. In cases of peritoneal dissemination and in those with liver metastasis, the rate of lymphatic involvement was higher than when there was vascular involvement. Peritoneal dissemination and liver metastasis are likely to be concomitant with lymph node metastasis in cases of serosally invasive gastric cancer. It seems apparent that lymphatic spread leads to peritoneal dissemination and liver metastasis in patients with gastric cancer.

Female↗
PubMedDate not supplied

Epidermal growth factor in gastric carcinoma as a risk factor of postoperative recurrence.

The expression of epidermal growth factor (EGF) was immuno-histochemically examined in the primary lesions of 201 patients with advanced gastric cancer who underwent curative resection. EGF-positive tumor cells were detected in the specimens of 75 patients (37.3%). A significant correlation was observed between the extent of lymph node metastasis and EGF expression (p < 0.01), indicating that EGF-positive cancer has a tendency to lymph node metastasis. The 2-year and 5-year survival rates of the patients with EGF-negative tumors were 77.2% and 63.0%, respectively, while those with EGF-positive tumors were 59.1% and 47.5% respectively. The difference in survival rates reached a maximum 2 years after surgery, indicating that the patients with EGF-positive gastric cancer had a higher risk of early recurrence. Therefore, the amount of EGF produced by a tumor may play some role in the growth of metastatic tumors and residual tumor cells after surgery, and thus be a potential risk factor in recurrence.

Adenocarcinoma↗
PubMedDate not supplied

Solitary Peutz-Jeghers type polyp of the duodenum containing a focus of adenocarcinoma.

The case of an 84-year-old woman with evidence of continuous gastrointestinal bleeding is presented. A barium study and endoscopy showed a 25 x 20 mm sized semipedunculated polyp in the second portion of the duodenum. No other lesion was found throughout the entire gastrointestinal tract, and endoscopic resection of the duodenal polyp was performed. The resected polyp showed typical histologic features of a Peutz-Jeghers type hamartomatous polyp, although the patient lacked any familial history and signs related to the Peutz-Jeghers syndrome. A focus of adenocarcinoma was also found within the polyp. The present case would appear to be the first demonstration of a solitary Peutz-Jeghers type hamartomatous polyp of the duodenum containing a focus of adenocarcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Macroscopic appearance and biological character of gastric cancer invading the muscularis propria.

BACKGROUND/AIMS: The natural history of gastric cancer, as to how an early gastric cancer develops into an advanced lesion, is still an open question. In this study, we focused on the gastric cancer invading the muscularis propria, and analyzed the relationship between gross appearance and the biological characteristics of gastric cancer. MATERIALS AND METHODS: One hundred and forty six patients with gastric cancer invading the muscularis propria (pm) were studied with special reference to the macroscopic appearance of the primary tumor; Borrmann type vs. EGC type (advanced gastric cancer simulating early gastric cancer), and to the biologic characteristics such as p53 expression and mitotic activity. RESULTS: Borrmann type comprised 59.6% (87/146) and EGC type comprised 40.4% (59/146) of the cases. Borrmann type cancer was located more commonly in the antral region (71.3%), tended to grow expansively, and had higher rate of vascular vessel invasion and lymph node metastasis. The type of recurrence varied, and the prognosis was poor in patients with Borrmann type cancer. Incidence of p53 overexpression in Borrmann type cancer was 44.1% (15/34), and significantly higher than 25.8% (8/31) in EGC type cancer. Proliferating activity measured by MIB-1 labeling percentage was also higher in Borrmann type (49.8 +/- 11.6 vs. 38.9 +/- 10.9). CONCLUSIONS: These results suggest that Borrmann type and EGC type pm gastric cancers are distinct in their inherent biological nature, and possibly represent the advanced form of penetrating growth (Pen) type and superficially-spreading growth (Super) type, respectively, of early gastric cancers.

Cell Division↗
PubMedDate not supplied

Surgical treatment for gastric carcinomas with concomitant hepatic metastasis.

BACKGROUND/AIMS: We have reviewed our experience with gastric cancer patients having synchronous liver metastasis in an attempt to clarify how to treat such patients. PATIENTS AND METHODS: In 116 patients with gastric cancer metastatic to the liver, evaluations were executed to find an effective treatment. Fourteen received gastrectomy plus hepatic resection (Group A), 68 gastrectomy alone (Group B), and 34 non-resected (Group C). RESULTS: The average survival time was 15.0 months in Group A, 7.2 months in Group B and 3.6 months in Group C, with a statistical difference between Group B and Group C (p < 0.05). In Group A patients, the mean survival time was 21.5 months in those undergoing potentially curative surgery for the carcinoma without incurable factors other than liver metastasis. The survival time was 6.3 months in those undergoing noncurative gastrectomy and hepatectomy because of evidence of incurable metastatic spread, the value being similar to that following gastrectomy alone in Group B patients. In Group B, adjuvant chemotherapy led to a significant increase in survival (p < 0.05). CONCLUSIONS: Hepatectomy combined with gastrectomy seems to be effective as an active measure to lengthen survival for patients of gastric carcinoma and concomitant liver metastasis only when other incurable factors were not evident at operation. Noncurative gastrectomy followed by adjuvant chemotherapy is recommended in the presence of various incurable factors.

Case-Control Studies↗
PubMedDate not supplied

Overexpression of p53 is associated with growth pattern and prognosis in advanced gastric cancer.

BACKGROUND/AIMS: The growth pattern of advanced gastric carcinoma, based on volumetric analysis, is closely associated with the biological characteristics of tumors, including DNA ploidy, and is an important prognostic factor. Abnormality of the p53 tumor suppressor gene plays an important role in alteration of cells and possibly leads to cancer development. MATERIALS AND METHODS: Expression of tumor suppressor gene p53 was investigated immunohistochemically in the primary lesion of 196 patients with advanced gastric cancers, and the relationship of p53 immunopositivity with the growth pattern and prognosis was analyzed. RESULTS: Positive p53 staining was found in 94 (48%) of the 196 primary carcinomas. Vessel invasions were more frequent and lymph node metastasis was more extensive in p53-positive tumors (p < 0.05), whereas p53 immunopositivity was not associated with depth of cancer invasion nor with the stage of cancer. In the column and mountain type tumors, characterized by vertical or penetrative growth, positive p53 staining was found in 53.8% and 52.9%, respectively. In the funnel type tumor, characterized by superficially spreading growth, positive p53 staining was found in significantly lower incidence (28.9%, p < 0.05). The 5-year survival rates were 44.2% and 25.4% for patients with p53 negative and positive gastric carcinomas, respectively (p < 0.01). Multivariate analysis showed that p53 overexpression was an independent prognostic factor of patients with advanced gastric cancer. CONCLUSIONS: These findings suggest that p53 gene alteration is associated with less favorable prognosis of advanced gastric cancer, possibly by providing tumors with a potential of vertical growth into the gastric wall.

Carcinoma↗
PubMedDate not supplied

Mesenteric neurofibroma with von Recklinghausen's disease: a case report.

Mesenteric neurofibroma associated with von Recklinghausen's disease is rare. Herein, we present one such case. A 15-year-old mentally retarded Japanese boy presented with destruction of the right 2nd and 3rd ribs on a routine chest roentgenogram. Physical examination revealed a funnel chest and multiple cafe-au-lait spots, but no cutaneous nodules. Although the patient had no symptoms, a computed tomography (CT) and angiogram were performed. There were no definitive findings of malignancy in the tumors. However, since there were two risk factors for malignancy, specifically, a young age at the time of diagnosis and multiple tumors, and coupled with the size of the abdominal tumor which was large, the abdominal mesenteric tumor was removed. Pathological examination showed a neurofibroma with no evidence of malignancy.

Adolescent↗