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Biomedical subjects

Y Nakane

Publications and source records attributed to Y Nakane.

240 records · Page 14Linked to original sources
PubMedDate not supplied

Negative effect of transforming growth factor-beta-1 on intestinal anastomotic tissue regeneration.

To examine the involvement of transforming growth factor-beta(1 )(TGF-beta(1)) in intestinal anastomotic repair, we administered a TGF-beta(1)-neutralizing antibody to rats after operation, and then examined its influence on the healing process and interaction with other peptide growth factors. Thirty male Sprague-Dawley rats were subjected to primary anastomosis after transection of the small intestine (n = 30) and treated by intraperitoneal administration of IgG (n = 15) or the TGF-beta(1) neutralizing antibody (n = 15). Treatment with the antibody against TGF-beta(1) resulted in more definite mucosal growth and increased vascularity on day 5 after surgery. Augmented mRNA expression of epidermal growth factor and vascular endothelial growth factor, and an increased number of cells that expressed these peptides in granulation tissue were demonstrated by RT-PCR and immunohistochemical staining. Taken together it was indicated that TGF-beta(1) has negative effects on regeneration of the bowel wall mucosa and angiogenesis in the course of intestinal anastomotic wound healing.

Anastomosis, Surgical↗
PubMedDate not supplied

Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer.

BACKGROUND/AIMS: There have been many reports proposing some advantages of pylorus-preserving gastrectomy for gastric ulcer compared to the conventional distal gastrectomy. However, it is not clear whether similar results will be obtained from the patients with early gastric cancer. METHODOLOGY: Of 50 patients with early gastric cancer, 25 underwent pylorus-preserving gastrectomy under strict criteria and the other 25 underwent distal gastrectomy with Billroth I anastomosis by the same surgeon. The subjects were then interviewed and examined periodically to assess symptoms, food intake, body weight and serum nutritional parameters. Endoscopy and a radioisotope gastric emptying test was performed 1 year after the operation. RESULTS: Many of the patients with pylorus-preserving gastrectomy complained of gastric fullness after meals, resulting in poor food intake; a significant between-group difference was found up to 1 year after the operation. A low incidence of reflux gastritis and slow gastric emptying were confirmed in the patients after pylorus-preserving gastrectomy. CONCLUSIONS: Pylorus-preserving gastrectomy has advantages over distal gastrectomy in terms of the avoidance of dumping syndrome and protection against duodeno-gastric reflux. However, more time was necessary for improved gastric fullness or food intake. Pylorus-preserving gastrectomy should be applied in younger patients with early gastric cancer expecting long survival.

Adult↗
PubMedDate not supplied

A randomized clinical trial of pouch reconstruction after total gastrectomy for cancer: which is the better technique, Roux-en-Y or interposition?

BACKGROUND/AIMS: To determine the optimum pouch reconstruction after total gastrectomy, we conducted a randomized trial to compare the usefulness between PR and PI in terms of quality of life. METHODOLOGY: Thirty patients younger than 70 years of age were selected and randomly classified into the following 2 groups: pouch and Roux-en-Y (PR; n = 15) and pouch and interposition (PI; n = 15). In each subject, the postoperative symptoms, food intake in a single meal, body weight, serum nutritional parameters, endoscopy, emptying time of the gastric substitute, and gallstone formation were evaluated. RESULTS: There were no significant differences in terms of the postprandial symptoms, food intake, body weight, and serum nutritional parameters until 2 years postoperative. Endoscopy showed a tendency of food stasis in the PR group, although this was not significant. The gastric emptying test in the PR group indicated that the retention capacity was slightly superior to that in the PI group. CONCLUSIONS: The impact of the duodenal passage on symptoms and nutrition could not be ascertained.

Adult↗
PubMedDate not supplied

Emptying of the jejunal pouch as a gastric substitute after total gastrectomy for cancer.

BACKGROUND/AIMS: The reservoir and transit capacity of the post-gastrectomy jejunal pouch was evaluated, using a radioisotopic method, to examine the relationship of the gastric emptying to postprandial symptoms and to the food intake status. METHODOLOGY: Thirty-seven patients who had undergone total gastrectomy for cancer (Roux-Y reconstruction, 8; Hunt- Lawrence pouch and Roux-Y, 15; pouch interposition, 5; modified pouch interposition, 9) were retrospectively studied. Based on the percent retention in the gastric substitute, the emptying curves were classed as showing delayed, intermediate, and rapid emptying types. RESULTS: All of the patients with pouch reconstruction showed either delayed or intermediate emptying. High frequency of the sensation of epigastric fullness, nausea, or vomiting was demonstrated in the patients with delayed emptying (p < 0.01). The patients with delayed emptying showed poor food intake compared to those with intermediate emptying (p < 0.05). Given the X-ray video film and endoscopic findings, the delayed emptying was thought to be due to poor drainage of the efferent loop resulting from the post-operative adhesions. CONCLUSIONS: The present study revealed that delayed emptying is associated with postprandial symptoms and with poor food intake. The examination of gastric emptying is useful in evaluating or predicting the postoperative status.

Adult↗
PubMedDate not supplied

Incidence and prognosis of para-aortic lymph node metastasis in gastric cancer.

BACKGROUND/AIMS: We investigated the frequency of para-aortic lymph node involvement and evaluated the effects on survival of dissection of these lymph nodes in patients with N4 node metastasis. METHODOLOGY: One hundred and forty nine gastric cancer patients with N4 node dissection were analyzed. Total gastrectomy with splenectomy or pancreatosplenectomy was performed in 99, distal gastrectomy 48, pancreaticoduodenectomy 3, and proximal gastrectomy with splenectomy 2. RESULTS: N4 nodal involvement was found in about 30-40% of operable patients with Borrmann's type 3 or 4 tumor, with tumor >8 cm in size, with tumor throughout the entire or in the upper third of the stomach, with tumor invasion to the serosa or adjacent structures, with N2 or N3 regional lymph node metastasis, and with undifferentiated histological type. The survival was quite poor. However, in patients without N3 nodal involvement or intraperitoneal free cancer cells, the survival after resection of tumor with N4 nodal involvement was relatively favorable. CONCLUSIONS: The resection of these involved lymph nodes can be expected to be beneficial in patients without extensive serosal invasion and without extensive lymph nodal involvement such as N3 nodes. Patients with tumor in the upper third of the stomach are appropriate candidates for N4 node dissection.

Adenocarcinoma↗