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101.
Manometric Evidence of Improved Early Gastric Stasis by Erythromycin after Pylorus-preserving Pancreatoduodenectomy 总被引:3,自引:0,他引:3
Matsunaga H Tanaka M Takahata S Ogawa Y Naritomi G Yokohata K Yamaguchi K Chijiiwa K 《World journal of surgery》2000,24(10):1236-1242
Gastric stasis is a frequent complication of pylorus-preserving pancreatoduodenectomy (PPPD). We demonstrated that it might be attributable to delayed recovery of phase III activity of the gastric migrating motor complex due to low concentrations of plasma motilin caused by resection of the duodenum. Leucine 13-motilin is effective for treating gastric stasis, but it is not yet available for clinical use. Whether erythromycin would improve early gastric stasis after PPPD was tested clinically and by manometry. A manometric tube assembly and a gastrostomy tube were inserted in the stomach of 10 patients at PPPD for pressure recording from the gastric antrum and jejunum and for gastric juice drainage, respectively. After baseline recording, erythromycin 5 mg/kg was given intravenously on day 14 and saline as a placebo on day 17 every 4 hours four times a day. The daily volume of gastric juice output and the gastric motility index were measured. The mean period until the return of gastric phase III was 31 +/- 1 days. Erythromycin significantly increased the gastric motility index from 7.9 +/- 1.3 mmHg to 15.7 +/- 1.8 mmHg (p = 0.0005), whereas saline did not (7.2 +/- 1.6 mmHg to 6.5 +/- 1.2 mmHg; p = 0.21). Erythromycin significantly decreased the gastric juice output from 1,080 +/- 190 ml to 738 +/- 199 ml (p < 0.0001), but the saline injections did not (1,064 +/- 174 ml to 1,115 +/- 189 ml; p = 0.35). Erythromycin, a universally available motilin agonist, is a safe, effective, potent drug for the treatment of early gastric stasis after PPPD. 相似文献
102.
The human T-cell factor-4 gene splicing isoforms, Wnt signal pathway, and apoptosis in renal cell carcinoma. 总被引:4,自引:0,他引:4
103.
Elevated expression of valosin-containing protein (p97) in hepatocellular carcinoma is correlated with increased incidence of tumor recurrence. 总被引:11,自引:0,他引:11
104.
Takashi Ueno Akira Tangoku Shigefumi Yoshino Toshihiro Abe Hideto Hayashi Hiroaki Toshimitsu Kiichiro Hashimoto Tomomitsu Satoh Atsunori Oga Tomoko Furuya Masaaki Oka Kohsuke Sasaki 《Clinical cancer research》2003,9(14):5137-5141
PURPOSE: Selection of appropriate protocols for treatment of superficial esophageal squamous cell carcinoma (SESCC) is dependent on lymph node metastasis status. Therefore, it is important to know whether lymph node metastasis is present before treatment. EXPERIMENTAL DESIGN: In this study, we examined the relation between DNA sequence copy number aberrations detected by comparative genomic hybridization and lymph node metastasis in 26 surgically resected SESCCs (training samples). We then assessed whether the genetic information is predictive for nodal status in biopsy specimens from eight newly enrolled patients with SESCC (blinded samples). RESULTS: Pathological examination revealed that 17 of 26 training samples (65.4%) did not have associated lymph node metastasis. Gains of 8q24 and/or 20q12-qter were observed in 12, including all (nine of nine) with nodal metastasis. Fourteen training samples did not have gain of either 8q24 or 20q12-qter. Of the blinded samples, two showed no gain of 8q24 or 20q12-qter, and as anticipated the postoperative pathological examination revealed no nodal metastasis. The remaining six blinded samples had gains of 8q24 and/or 20q12-qter, and lymph node metastasis was detected by postoperative examination in four of these tumors. CONCLUSIONS: Absence of gains of 8q24 and/or 20q12-qter appears to be associated with absence of lymph node metastasis in patients with SESCC; therefore, less invasive surgery can be chosen. 相似文献
105.
Identification of HRK as a target of epigenetic inactivation in colorectal and gastric cancer. 总被引:3,自引:0,他引:3
106.
107.
Makoto Okada Junzo Kigawa Yukihisa Minagawa Yasunobu Kanamori Hiroaki Itamochi Xiusi Cheng Tetsuro Ohishi Naoki Terakawa 《International journal of clinical oncology / Japan Society of Clinical Oncology》1998,3(4):240-246
Background A role for theTP53 (alias p53) tumor-suppressor gene in chemoresistance has recently been discussed, but little is known about the clinical
relevance of theTP53 gene to chemoresistance. To elucidate the relevance ofTP53 status to chemoresistance, we investigated theTP53 gene and TP53 protein expression in tumors from the same patients, before and after chemotherapy.
Methods Twenty-one patients with ovarian cancer, who had residual disease after primary surgery, were studied. These patients received
chemotherapy consisting of cisplatin, doxorubicin, and cyclophosphamide, and then underwent a second surgery. Polymerase chain
reaction-single strand conformation polymorphism analysis and cycle sequencing were performed to determineTP53 mutation. TP53 protein was detected by Western blot analysis.
Results Of the 21 patients studied, 9 responded to chemotherapy. Mutation of theTP53 gene was seen in 7 patients (2 responders and 5 nonresponders) before chemotherapy. After chemotherapy, another mutation
of the gene was observed in 5 patients, all of whom were nonresponders. TP53 protein was detected in 10 patients (3 responders
and 7 nonresponders) before chemotherapy. After chemotherapy, the expression of TP53 protein increased in these 3 nonresponders,
and became positive in 2 other nonresponders.
Conclusions This study showed for the first time in clinical investigation that alterations toTP53 could develop in association with chemotherapy, and thatTP53 status may relate to the mechanisms of chemoresistance in patients with epithelial ovarian cancer. 相似文献
108.
Michio Maeta Hiroaki Saito Akira Kondo Hiroshi Yamashiro Syunichi Tsujitani Masahide Ikeguchi Nobuaki Kaibara 《Gastric cancer》1998,1(1):57-63
Background.
In Japan, much attention has recently been paid to super-extended paraaortic lymphadenectomy (PAL) for the treatment of advanced
gastric cancer. However, it has been reported that PAL is associated with increased morbidity and mortality, as compared to
conventional extended lymphadenectomy (D2 or D3). Therefore, an analysis of the effects of PAL on perioperative changes in
the biological responses of patients essential for determining the potential utility of this procedure.
Methods.
The current non-randomized prospective study included evaluations of perioperative changes in parameters of surgical stress
(series I; serum levels of antidiuretic hormone, interleukin-6, trypsin, and phospholipase A
2
) and immunocompetence (series II; phytohemagglutinin- and concanavalin A-induced blastogenesis, activity of natural killer
cells and the ratio of CD4 cells to CD8 cells) in patients with advanced gastric cancer (T3 or T4), comparing groups treated
with D3 plus PAL (
n
= 12) and D3 (
n
= 13), and a control group with early gastric cancer (
n
= 16) treated with D1 lymphadenectomy (perigastric N1 nodes) between April 1995 and April 1997.
Results.
The duration of surgery and the amount of blood lost were longer and greater in the D3 plus PAL group than in the D3 and D1
groups. D3 plus PAL and D3 were associated with significant postoperative increases in parameters of surgical stress, as well
as with significant postoperative immunosuppression, compared to results with D1. However, there were no significant differences
in the respective parameters between the D3 plus PAL and D3 groups.
Conclusions.
Our results indicate that there are no essential differences in patients' biological responses between D3 plus PAL and D3
lymphadenectomy. It appears that PAL-associated morbidity can be minimized by very careful manipulation during the dissection
of paraaortic lymph nodes.
Received for publication on Feb. 10, 1998; accepted on Jun. 3, 1998 相似文献
109.
Yumi Kojima Yoichi Aoki Hiroaki Kase Shoji Kodama Kenichi Tanaka 《International journal of clinical oncology / Japan Society of Clinical Oncology》1998,3(3):143-146
Background The purpose of this study was to assess the accuracy of contrast-enhanced magnetic resonance imaging (dynamic MR imaging)
in the evaluation of preinvasive and early invasive cancer of the cervix.
Methods Twenty-nine women with untreated squamous cell carcinoma of the cervix with either no stromal invasion or early stromal invasion
underwent pretreatment MR imaging and dynamic MR imaging within 4 weeks of surgical evaluation. The images were evaluated
for tumor detection and compared with results of histologic examination of the surgical specimens.
Results The lesions in 17 cases with histologically proven stromal invasion of 4 mm or greater were detected with dynamic MR imaging,
whereas lesions in only 8 of these cases were detected with T2 imaging. In 9 cases with stromal invasion between 4.0 mm and
5.0 mm, lesions were represented as early phase focal enhancement on dynamic MR images, but not detected on T2-weighted images.
In the 12 cases with less than 4 mm stromal invasion, no lesions were visualized on either T2-weighted images or dynamic MR
images, except in 1 case of glandular involvement without stromal invasion that appeared as enhancement on early-phase dynamic
MR imaging.
Conclusion Dynamic MR imaging detected more lesions of early stromal invasion in pretreatment imaging for cervical cancer than nonenhanced
MR imaging. 相似文献
110.
Hiroaki Okamoto Akira Nagatomo Hideo Kunitoh Hiroshi Kunikane Koshiro Watanabe 《Cancer chemotherapy and pharmacology》1998,42(4):307-312
Purpose: Carboplatin doses can be individualized using the formula of Calvert et al. (Calvert formula) dose (mg) = area under the
plasma concentration versus time curve (AUC) · [glomerular filtration rate (GFR) + 25]. Creatinine clearance (Ccr), either
measured by the 24-h method or calculated by the formula of Cockcroft and Gault [Cockcroft-Gault (CG) formula], is often substituted
for the GFR. The CG formula is based on patient weight, age and sex, and the serum creatinine (Cr) concentration. Another
method for predicting carboplatin clearance (CL) using patient characteristics has also been proposed by Chatelut et al. (Chatelut
formula). This study was undertaken to evaluate the performance of the three formulae in predicting standard- and low-dose
carboplatin pharmacokinetics. Methods: A total of 52 patients with advanced lung cancer were enrolled in this pharmacokinetic study; 37 received standard-dose
carboplatin and 25 received low-dose carboplatin. The Cr concentration was measured using an enzymatic assay. The three formulae
were used to predict carboplatin CL. The median absolute percent error (MAPE) for each formula was evaluated by comparing
the calculated and observed CL. For comparison of AUCs, free platinum plasma concentrations were measured at intervals up
to 24 h after carboplatin administration. AUCs were determined and compared with predicted values. Results: In the standard-dose carboplatin group, the MAPEs for the prediction of carboplatin CL from the 24-h Calvert, CG-Calvert
and Chatelut formulae were 13%, 12% and 23%, respectively. In the low-dose carboplatin group, the corresponding MAPEs were
27%, 18% and 44%, respectively. Observed standard-dose carboplatin AUCs after aiming for target AUCs of 5 and 6 mg · min/ml
using the Calvert formula based upon the 24-h Ccr were 5.3 ± 0.8 and 5.9 ± 0.8, respectively, indicating a small and acceptable
bias compared with that predicted from the dosing formula. Conclusions: The pharmacokinetics of standard-dose carboplatin were accurately predicted by the Calvert formula based upon either 24-h
or CG-calculated Ccr, but not by the Chatelut formula. Either CG-calculated or 24-h Ccr can be substituted for the GFR in
the Calvert formula for the determination of individual doses. The poor predictability of the Chatelut formula found in this
study might be the result of a differences in either the Cr assay or the patient population. Therefore, formulae which attempt
to estimate GFR are not necessarily valid if either the Cr assay or the patient population is changed.
Received: 23 July 1997 / Accepted: 16 December 1997 相似文献