Showing papers in "Surgery Today in 1984"
TL;DR: The surgical implications of pancreatectomy for such anatomical abnormalities, especially preduodenal portal vein, and the usefulness of ultrasonography for the preoperative evaluation are given attention.
Abstract: Total pancreatectomy was performed for carcinoma of the head of the pancreas associated with multiple anomalies in the peripancreatic region and of the pancreas. The anomalies were preduodenal portal vein, annular pancreas with agenesis of the dorsal pancreas, left-sided gallbladder, polysplenia and high mobile right colon. The surgical implications of pancreatectomy for such anatomical abnormalities, especially preduodenal portal vein, and the usefulness of ultrasonography for the preoperative evaluation are given attention.
44 citations
TL;DR: Adjuvant immunochemotherapy using schizophyllan (SPG), an extract from the culture broth of Schizophyllum commune Fries, was prescribed at random for 326 Japanese patients with resectable gastric cancer, with little difference in the 3-year survival rates.
Abstract: Adjuvant immunochemotherapy using schizophyllan (SPG), an extract from the culture broth ofSchizophyllum commune Fries, was prescribed at random for 326 Japanese patients with resectable gastric cancer. The overall survival rates for 3 years did not differ between the SPG and control groups. In 62 patients with stage I gastric cancer and 67 with stage II, there was little difference in the 3-year survival rates. The survival rates for 100 patients with stage III were enhanced at p=0.0811 in the SPG group, as compared to the controls. The survival rates in 97 patients with stage IV cancer were much the same. These results warrant further application of this immunopotentiating drug for treating patients with resectable gastric cancer.
38 citations
TL;DR: It is concluded that acute cholangitis was aggravated by endotoximia and that severe cholangaitis was accompanied by DIC induced by a decline in phylaxis, which was closely related to the consumption of complements.
Abstract: We investigated 91 cases of acute cholangitis, including 42 of severe cholangitis and 49 of mild cholangitis. The incidence of endotoxemia was 78.6 percent in 42 and 32.6 percent in the 49 patients. In the 42 with severe cholangitis, remarkable leukocytosis, thrombocytopenia, decrease of serum CH50, C3, plasma fibronectin and phagocytic index were characteristic. Disseminated intravascular coagulation (DIC) was observed in 76.2 percent. Since there was a positive correlation between platelet counts and levels of CH50 and C3, the decrease of platelet count, and the occurrence of DIC in patients with endotoxemia were thought to be closely related to the consumption of complements. There was no difference in mortality rate between nonsurgical treatment (57.8 percent) and the emergency bile drainage treatment (56.5 percent). The results of therapy depended on the degree of complicating DIC. We conclude that acute cholangitis was aggravated by endotoximia and that severe cholangitis was accompanied by DIC induced by a decline in phylaxis.
28 citations
TL;DR: RSPP is a most important factor in the development of the ischemic spinal cord injury during the temporary thoracic aortic occlusion, whereas all the dogs in Group 2 demonstrated complete postoperative recovery without any neurological sequelae.
Abstract: Paraplegia has been a devastating and unpredictable complication following surgical procedures involving temporary occlusion of the thoracic aorta. This study was undertaken to determine the effect of the pressure gradient between the aortic pressure distal to the occluding aortic clamp and cerebrospinal fluid pressure, defined as “Relative spinal cord perfusion pressure” (RSPP) on the development of the ischemic spinal cord injury. In twelve mongrel dogs, the thoracic aorta just distal to the left subclavian artery was cross-clamped. Somatosensory evoked potentials (SEP) were generated by peripheral stimulation of the bilateral peroneal nerves. After complete loss of SEP was evident, six dogs, Group 1, were subjected to occlusion of the descending thoracic aorta for a period of 20 minutes with maintenance of 0 mmHg of RSPP, by an injection of normal saline into the subarachnoid space. Six other dogs, Group 2, likewise underwent 40 minutes of aortic occlusion, keeping the RSPP at 15 mmHg by withdrawal ofcerebrospinal fluid. All the dogs in Group 1 developed paraplegia, whereas all the dogs in Group 2 demonstrated complete postoperative recovery without any neurological sequelae. Thus, RSPP is a most important factor in the development of the ischemic spinal cord injury during the temporary thoracic aortic occlusion.
26 citations
TL;DR: There was a significant difference in the rate of preoperative diagnosis between the minimal and the ordinary cancer groups and the papillary variant of minimal cancer metastasized not only to the central cervical lymph nodes but also to the ipsilateral and even to the contralateral jugular lymph nodes.
Abstract: Clinicopathological studies were carried out on 27 patients with minimal thyroid cancer and 56 with ordinary thyroid cancer at Kanazawa University, from April, 1979 to December, 1982. There was a significant difference in the rate of preoperative diagnosis between the minimal and the ordinary cancer groups. Subtotal thyroidectomy with modified neck dissection was usually performed in both groups. The histological types in minimal cancer group included 16 papillary carcinomas, 7 nonencapsulated sclerosing carcinomas, one follicular carcinoma, one anaplastic carcinoma with squamous cell metaplasia and two multiple mixed carcinomas. There was no significant difference in the rates of intrathyroidal and lymph node metastases between the two groups. While the metastatic lesions of sclerosing carcinoma were localized to the central cervical lymph nodes, the ordinary cancer in general and the papillary variant of minimal cancer metastasized not only to the central cervical lymph nodes but also to the ipsilateral and even to the contralateral jugular lymph nodes.
17 citations
TL;DR: It is concluded that cancer cell proliferation in the remnant liver can be accelerated by the process of liver regeneration, compared with that in the sham-operated liver.
Abstract: Tumor growth of Yoshida sarcoma implanted in the remnant liver was studied in rats subjected to a hepatectomy. After 70 percent hepatectomy, the liver progressively regenerated and the total liver weight was reverted to by 10 days after the operation. Concomitantly with liver regeneration, tumor growth in the remnant liver was stimulated significantly, compared with that in the sham-operated liver. Incorporation of tritiated thymidine into tumor cells in the remnant liver was strikingly high and progressive, while that in the sham-operated liver was low and retained. Mitomycin C given to the hepatectomized rats was more effective against the tumor in the remnant liver than in the sham-operated liver. We conclude from this study that cancer cell proliferation in the remnant liver can be accelerated by the process of liver regeneration.
17 citations
TL;DR: A fifty six-year-old woman with leiomyosarcoma of the breast is well without evidence of metastases or local recurrence of the tumor fifty-five months after radical mastectomy.
Abstract: We treated a fifty six-year-old woman with leiomyosarcoma of the breast. Light microscopy showed typical findings of leiomyosarcoma and electron microscopy confirmed the smooth muscle origin of the tumor. The patient is well without evidence of metastases or local recurrence of the tumor fifty-five months after radical mastectomy.
16 citations
TL;DR: The Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer found in data on 1,805 patients followed for 5 years that the protocol, intraoperative bolus intravenous injection of Mitomycin C (MMC) plus oral administration of Futraful (Tegafur) for 3 months, concomitantly applied with ELX, proved to be effective for improving the survival of patients with advanced cancer.
Abstract: Since 1970, there has been a remarkable improvement in Japan in the outcome of surgery for patients with gastric cancer. Not only the increased rate of detection of early gastric cancer but the standardization of the prophylactic extended lymphadenectomy (ELX) has brought about a remarkable rise in survival rate. In patients with regional lymph node metastasis, we obtained a 5 year survival rate of 39 percent in the ELX group, whereas the rate was only 18 percent in the simple gastrectomy group. The difference was statistically significant (P<0.001). As to adjuvant chemotherapy, the Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer found in data on 1,805 patients followed for 5 years that the protocol, intraoperative bolus intravenous injection of Mitomycin C (MMC) plus oral administration of Futraful (Tegafur) for 3 months, concomitantly applied with ELX, proved to be effective for improving the survival of patients with advanced cancer such as stage III and positive lymph node metastasis with obvious serosal invasion. The 5 year survival rate of Japanese patients with gastric cancer after resective surgery was an overall 56 percent, 48 percent when confined to those with stage III cancer.
15 citations
TL;DR: Improvements in the intubation of a long intestinal decompression tube by use of a new flexible tip guide wire and a new intestinal decomression tube were detailed.
Abstract: This study details improvements in the intubation of a long intestinal decompression tube by use of a new flexible tip guide wire and a new intestinal decompression tube. The intubation route of the endoscope was changed from the oral to the nasal cavity. Although the guide wire formerly used (TGBD-65-345) could be inserted into the descending part of the duodenum by passing it through the biopsy channel of the endoscope, with this new method, the guide wire (TGBD-65-450) could be inserted into the upper jejunum. The endoscope could also be left in the stomach, when this method was used. The long tube was introduced along this guide wire into the upper jejunum. As a result of these improvements, the intubation rate for long intestinal decompression tubes was significantly more rapid and the time reduced. Intubation rate to the jejunum was 96 percent successful, as compared with a former success rate of 75 percent. The intubation time was decreased to 11.3 +/- 5.6 min. to the duodenum and 18.6 +/- 8.6 min. to the upper jejunum. This differs markedly from the former method which required 16.0 +/- 5.3 min. and 39.6 +/- 22.7 min, respectively.
15 citations
TL;DR: From 1962 to 1983, nine patients with minimal carcinoma of the thyroid were referred to Aichi Cancer Center Hospital and Aichi Medical University Hospital for evaluation of enlarged lymph nodes in the neck as discussed by the authors.
Abstract: From 1962 to 1983, nine patients with minimal carcinoma of the thyroid were referred to Aichi Cancer Center Hospital and to Aichi Medical University Hospital for evaluation of enlarged lymph nodes in the neck. The radiographic study and scintigraphy of the thyroid were useful in detection of small thyroid lesions. In two cases, a lymph node biopsy was required for confirmation of the diagnosis. The thyroid lesions were histologically papillary carcinoma, in all the cases. A modified neck dissection with total thyroidectomy was carried out in five patients and modified neck dissection with thyroid lobectomy was done in four cases. Nine patients were followed for 6 months to 20 years and all the patients except one are alive.
14 citations
TL;DR: The results indicate that in case of postoperative adjuvant chemotherapy, great care must be directed to the time when DNA synthesis and mitosis of hepatocytes have not yet reached their peaks, because adjUvant chemotherapy in this period may be life-threatening.
Abstract: Five-fluorouracil (5-FU) was given to rats at various periods following two-thirds hepatectomy and the effects of this drug on the regenerating liver were investigated. In one group of rats, two-thirds hepatectomy was carried out (Group I). In four other groups, 20mg/kg 5-FU was given intravenously three times: 0, 24, 48 hours (Group II); 12, 36, 60 hours (Group III); 24, 48, 72 hours (Group IV); and 3, 4, 5 days (Group V) after the same operation. The peaks of DNA synthesis and mitoses of liver cells were noted on the first postoperative day in Groups I, IV and V. Persistent suppression and delay of DNA synthesis was induced in Groups II and III, while in Group IV, DNA synthesis and liver cell divisions were suppressed temporarily after the drug administration but recovered thereafter. There was no significant suppression in Group V. The serum albumin levels and survival rates paralleled the DNA synthesis. These results indicate that in case of postoperative adjuvant chemotherapy, great care must be directed to the time when DNA synthesis and mitosis of hepatocytes have not yet reached their peaks, because adjuvant chemotherapy in this period may be life-threatening.
TL;DR: The mechanism of the increase of biliary cholesterol secretion in diabetic mice is different from that after cholesterol diet, and the cholesterol mole percent and the lithogenic index increased.
Abstract: Plasma and liver cholesterol levels and biliary cholesterol, phospholipid and bile acid concentrations were examined in normal and alloxan diabetic mice fed ordinary and 0.5 per cent cholesterol diets. The plasma and liver cholesterol levels markedly increased in the diabetic mice, and the cholesterol diet further increased the liver cholesterol level but not that in the plasma. The gallbladder bile weight increased in the diabetic mice, but not after the cholesterol diet. The biliary lipid concentrations markedly increased in the diabetic mice, and the increases of the cholesterol and phospholipids exceeded that of the bile acids, resulting in increases of the cholesterol molar concentration ratio (mole percent) and the lithogenic index. The cholesterol diet increased the biliary cholesterol concentration and slightly the phospholipid, but not the bile acids. Therefore, the cholesterol mole percent and the lithogenic index increased. Among the biliary bile acid composition, cholic and deoxycholic acids increased and β-muricholic acid decreased in the diabetic mice, whereas the cholesterol diet feeding decreased cholic acid and increased chenodeoxycholic and α-muricholic acids. These data suggest that the mechanism of the increase of biliary cholesterol secretion in diabetic mice is different from that after cholesterol diet.
TL;DR: It is held the view that this is the most effective operative procedure for the correction of funnel chest in adults and adolescents.
Abstract: As an operative procedure for the correction of funnel chest in adult and adolescents, a strut method using AO-plates was used. All of the concaved parts of the sternum, costate, and cartilages contributing to the formation of the deformity were osteotomized to mobilize and elevate the deformed part. A vertical plate was used for fixation of the transected sternum, and three transverse plates were used as the portions which are curved appropriately to remodel the reconstructing chest wall. These plates were removed twelve to eighteen months after implantation. To date, thirty-one patients have undergone this repair. For the first eight, a single transverse plate was used, however, re-retraction of the region around the transverse plate became evident in the long term follow-up. Therefore, two or three plates were inserted for an improvement. When three transverse plates were used, retraction at the costal arch was relieved. Although a second operation is required to removal of the plates, we hold the view that this is the most effective operative procedure for the correction of funnel chest in adults and adolescents.
TL;DR: Bowel function after surgery for anorectal malformation was assessed by Kelly's score in 101 children over 3 years of age and the findings placed the “fair” group between the ’good’ and the ‘poor’ groups.
Abstract: Bowel function after surgery for anorectal malformation was assessed by Kelly's score in 101 children over 3 years of age. Seventy-two were examined using anorectal manometry. In the “good” group, resting pressure of the anal canal was as high as in the normal children, and the frequency of contraction waves in the anal canal was the same as in the normal children. Recto-anal reflex was recognized in about three fourths of the “good” group. On the other hand, in the “poor” group resting pressure was low, in only one were contraction waves evident and in none was there a recto-anal reflex. The findings of the anorectal manometry placed the “fair” group between the “good” and the “poor” groups. The clear contraction waves of the anal canal or the clear recto-anal reflex related to a resting pressure in the anal canal of over 20 cmH2O. This high pressure in the anal canal is important for good anal continence, and depends on a precise pull-through of the rectum into the puborectalis muscle.
TL;DR: An improved staining technique for acetylcholinesterase (AChE) activity using rubeanic acid was used to make a clinical diagnosis in 54 children with constipation andeteen were confirmed to have Hirschsprung's disease.
Abstract: An improved staining technique for acetylcholinesterase (AChE) activity using rubeanic acid was used to make a clinical diagnosis in 54 children with constipation Nineteen were thus confirmed to have Hirschsprung's disease False positive or negative reactions were nil The sites of AChE activities were in the form of black deposits and the contrast was sharp This approach should find a wide application for the diagnosis of Hirschsprung's disease
TL;DR: Cytological examination of exfoliated cells in the bile or irrigated fluid from a percutaneous transhepatic choledochal drainage (PTCD) tube and other jaundICE-reducing fistula was performed in 59 patients with obstructive jaundice, and malignant cells were found in 22 of 27 patients with choledchal cancer, 5 of 17 patients with pancreatic cancer, and one of 5 patients with other malignancies.
Abstract: Cytological examination of exfoliated cells in the bile or irrigated fluid from a percutaneous transhepatic choledochal drainage (PTCD) tube and other jaundice-reducing fistula was performed in 59 patients with obstructive jaundice. Malignant cells were found in 22 of 27 patients with choledochal cancer, 5 of 17 patients with pancreatic cancer, 3 of 6 patients with gallbladder cancer, and one of 5 patients with other malignancies. Exfoliated malignant cells were found at a higher rate in the washed fluid of the PTCD tube than in the pure bile aspirated from the PTCD tube. Half of the positive cases were diagnosed as such upon the first cytological examination, and the remaining in second or subsequent cytological examinations. The cytological appearance of cells in the washed fluid or bile reflected the type of cancer cells found by touch-smear of the lesion and also the histological type. This method requires no special technique and facilitates accurate diagnosis in patients with malignant lesion of the choledochal duct.
TL;DR: In a 51-year-old man the middle colic artery ruptured, the patient had abdominal pain for several days, and then suddenly, a considerable intraperitoneal bleeding occurred, and in the postoperative angiogram, numerous aneurysms were detected in the colic arteries.
Abstract: In a 51-year-old man the middle colic artery ruptured. The patient had abdominal pain for several days, and then suddenly, a considerable intraperitoneal bleeding occurred. The aneurysm was extirpated and in the postoperative angiogram, numerous aneurysms were detected in the colic artery. Splanchnic artery aneurysm mainly occurs in renal artery, splenic artery and hepatic artery, but rarely in the mesenteric artery. The pathogenesis of mesenteric artery aneurysms is usually mycotic false aneurysm from prior aortic endoarteritis. In the present case, the etiology of the aneurysm was not confirmed.
TL;DR: TF seems to inhibit postoperative recurrence and appears to be an effective postoperative adjuvant immunotherapeutic for primary resected adenocarcinoma of the lung, especially at the relatively early stages.
Abstract: A total of 102 patients were studied in a randomized controlled trial to evaluate the clinical effect of transfer factor (TF) for primary resected adenocarcinoma of the lung. The TF and Control groups consisted of 50 and 52 randomly chosen patients, respectively. However, 6 and 5 patients were excluded from both groups for various reasons, therefore the total of cases eligible for evaluation were 44 and 47 in the TF and Control groups, respectively. The clinical features of both groups were similar. The survival of the TF group was significantly better than that of Controls in Stage I cases (p<0.05), however, there was no significant difference in patients in Stages II, III and IV. Significant differences were found between the TF and Control groups in curative resection cases (p<0.05), however, no significant difference was seen in either the relatively curative resection or noncurative resection groups. TF seems to inhibit postoperative recurrence and appears to be an effective postoperative adjuvant immunotherapeutic for primary resected adenocarcinoma of the lung, especially at the relatively early stages.
TL;DR: The intra-arterial MMC microsphere treatment, for albino rabbits with implanted VX-2 tumor, increased remarkably the tissue MMC levels, compared to that with conventional MMC, and resulted in conspicuous antitumor efficacy.
Abstract: In an attempt to enhance antitumor effects, we prepared heated albumin microspheres containing mitomycin C (MMC). These MMC microspheres have an average diameter of 45±8 μm and contain about 5 per cent of MMC. The intra-arterial MMC microsphere treatment, for albino rabbits with implanted VX-2 tumor, increased remarkably the tissue MMC levels, compared to that with conventional MMC, and resulted in conspicuous antitumor efficacy. This approach to antitumor chemotherapy should be effective for selected patients with malignant tumor receiving a blood supply from an end-artery.
TL;DR: A 49 year-old women with acute pancreatitis, in whom there was an accessory pancreatic duct which opened into a duodenal duplication cyst, this cyst was diagnosed as one of duodanal duplication and removed by hemigastrectomy and partial resection of the head of the pancreas.
Abstract: We treated a 49 year-old women with acute pancreatitis, in whom there was an accessory pancreatic duct which opened into a duodenal duplication cyst. Epigastric pain associated with vomiting and fever were present. Laboratory data showed leukocytosis and hyperamylasemia. An upper G-I series revealed a stricture at the pyloric region. At operation a spherical mass of 6 cm in diameter was present between the greater curvature of the pyloric region and the head of the pancreas. The cyst was removed by hemigastrectomy and partial resection of the head of the pancreas. The accessory pancreatic duct opened into the cyst. Taking particular note of the communication with the pancreatic duct, this cyst was diagnosed as one of duodenal duplication. A duodenal duplication cyst communicating with the accessory pancreatic duct is rare and is dissimilar to any of the 20 cases of duodenal duplication reported in Japan since 1960.
TL;DR: This is a report of a 63-year-old Japanese woman with a nonfunctioning islet cell carcinoma of the pancreas presenting bleeding gastric varices and splenomegaly.
Abstract: This is a report of a 63-year-old Japanese woman with a nonfunctioning islet cell carcinoma of the pancreas presenting bleeding gastric varices and splenomegaly. These manifestations are extremely rare in patients with nonfunctioning islet cell tumor. The tumor originated in the tail of the pancreas and grew mainly within the spleen. The gastric varices due to increased blood flow to the tumor and arteriovenous fistuals within the tumor were confirmed by angiography and operation. The tumor was resected and she is in a good health for 14-months after the operation.
TL;DR: Findings in this study indicate that a peripapillary duodenal diverticulum is likely to lead to bile stagnation and ascending infection of the biliary tract and thus cause formation of calcium bilirubinate stones.
Abstract: The relationship between peripapillary duodenal diverticulum and benign biliary tract disease was studied. Peripapillary duodenal diverticulum could be classified pathophysiologically into three types. Type I represents the disease not directly affecting the biliary tract. Type II shows the elevation of bile duct pressure directly caused by intraduodenal pressure loading. Type III includes patients in whom the diverticulum is small and is prone to cause papillitis or mechanical stimulation. This, then, may lead to organic changes in Oddi's sphincter and possibly to biliary tract disorders. In our patients, many cases of peripapillary duodenal diverticulum were associated with calcium bilirubinate stones, indicating that a peripapillary duodenal diverticulum is likely to lead to bile stagnation and ascending infection of the biliary tract and thus cause formation of calcium bilirubinate stones. Based on findings in this study, we want to emphasize that Type II peripapillary duodenal diverticulum should be surgically treated.
TL;DR: Both partial spleens and autotransplants gave substantial protection and rats which succumbed to pneumococcal sepsis demonstrated massive fibrin thrombi in renal glomeruli and frank adrenal hemorrhage, strikingly similar to clinical observations.
Abstract: Postsplenectomy septicemia carries an ominous prognosis. Accompanying disseminated intravascular coagulation and adrenal hemorrhage result in a high mortality, despite aggressive treatment by antibiotics. The efficacy of prevention by in situ partial spleen and splenic auto-transplant were evaluated in Sprague-Dawley rats. All totally splenectomized rats died following intravenous challenge of liv pneumococcus. Both partial spleens and autotransplants gave substantial protection. The rats which succumbed to pneumococcal sepsis demonstrated massive fibrin thrombi in renal glomeruli and frank adrenal hemorrhage, strikingly similar to clinical observations.
TL;DR: Normal rectal compliance (reservoir function of the rectum), together with normal resting pressure of the anorectum and rectoanal reflex, is indispensable for an adequate postoperative continence.
Abstract: Clinical assessment of fecal continence and anorectal manometry were carried out in 22 patients with Hirschsprung’s disease who had undergone “Rectoplasty with posterior triangular colonic flap”. Satisfactory postoperative continence was achieved in 18 out of these 22 patients. The result of anorectal manometry disclosed that normal rectal compliance (reservoir function of the rectum), together with normal resting pressure of the anorectum and rectoanal reflex, is indispensable for an adequate postoperative continence.
TL;DR: Results support the hypothesis that the majority of advanced carcinoma is derived from the PEN type of early carcinoma, which is more common in Group A than in Group B.
Abstract: Two hundred and sixty-seven cases of gastric carcinoma detected by mass survey included 196 discovered at the first examination (Group A) and 71 noted at the annual sequential examination (Group B) were analyzed in terms of growth pattern and prognosis. The incidence of early carcinoma was 54.9 per cent in Group B higher than 35.7 per cent in Group A. In early carcinoma, the superficially spreading (SUPER) type of carcinoma was more common in Group A than in Group B. On the contrary, the penetrating growth (PEN) type of carcinoma was more frequently found in Group B than in Group A. About eighty per cent of those with an advanced carcinoma, in both groups, was the advanced PEN type. The outcome of the patients in Group B was more favorable. These results support the hypothesis that the majority of advanced carcinoma is derived from the PEN type of early carcinoma. Early detection of the PEN type of carcinoma is mandatory.
TL;DR: In a sixty-three year old Japanese man with a history of long standing pulmonary tuberculosis, an unusual esophago-cutaneous fistula developed, which may be the first report of a benign esophagopleurocutaneous Fistula.
Abstract: In a sixty-three year old Japanese man with a history of long standing pulmonary tuberculosis, an unusual esophago-cutaneous fistula developed. The possibility of esophago-pleuro-cutaneous fistula was considered, because there was an old tuberculosis causing lung abscess or hilar lymph node adenopathy and which facilitated development of an extensive fistulous tract. The patient was effectively treated by palliative surgical procedure. This may be the first report of a benign esophagopleurocutaneous fistula.
TL;DR: Results suggest that splenectomy in very early and late stages of tumor-bearing host may be effective for tumor treatment.
Abstract: The effect of splenectomy on neoplastic outgrowth was examined prior to and after implantation of methylcholanthrene-induced C3H/He murine tumors. Splenectomy performed 12 days before tumor inoculation did not affect the tumor outgrowth, however, both splenectomy and sham operation performed shortly before tumor inoculation resulted in significant tumor facilitation compared with the non-operated group, suggesting that this accelerated tumor was not related to the presence or absence of splenic tissue, but rather to systemically-induced immunosuppression. While splenectomy performed 6, 9, 12 days after tumor inoculation did not alter the tumor growth, splenectomy performed early (3 days) or late stage (20 days) after tumor cell challenge revealed a retarded neoplastic outgrowth, compared with the sham operated group. These results suggest that splenectomy in very early and late stages of tumor-bearing host may be effective for tumor treatment.
TL;DR: In the presence of 3.5 percent PEG-precipitated IC from sera of gastric cancer patients, the mitogen respones of normal peripheral blood lymphocytes was inhibited; the PHA response revealed a significant negative correlation with the concentration of IC.
Abstract: Immune complexes (IC) were measured in 66 gastric cancer patients, using the 3.5 percent polyethylene glycol (PEG) precipitation method. Preoperatively, the IC values in patients with advanced gastric cancer (stages III and IV) were significantly higher than in normal subjects (p<0.01). In the presence of 3.5 percent PEG-precipitated IC from sera of gastric cancer patients, the mitogen respones of normal peripheral blood lymphocytes was inhibited; the PHA response revealed a significant negative correlation with the concentration of IC (p<0.01). Our data suggest that IC may be a major serum factor exerting immunosuppressive effect in cancer hosts.
TL;DR: The results suggest that this combination chemo-immunotherapy is effective for a selected group of patients with advanced gastric carcinoma, and significantly improved survival rate of patients in Stages III, IV and unresectable or recurrent carcinoma.
Abstract: Eighty-nine patients with advanced gastric carcinoma were treated with a combination chemo-immunotherapy regimen that consisted of active immunotherapy with Vibrio cholerae neuraminidase (VCN) treated autologous tumor cells admixed with BCG and drugs including cyclophosphamide, mitomycin C (MMC) and 5-fluorouracil, followed by long term tegafur (FT) and immunomodulators. This treatment significantly improved survival rate of patients in Stages III, IV and unresectable or recurrent carcinoma, compared to that of historical controls. As compared to controls treated with MMC followed by long term FT and immunodulators concurrently, survival rate of those in Stage III tended to improve (p<0.1) and survival rate at 4.5 years in Stage III was significantly higher (p<0.01), although it was not improved in Stage IV. In patients with unresectable or recurrent tumor, survival time was not significantly lengthened with this therapy when compared with that in patients given BCG alone in the same treatment schedule (CCI-BCG group). However, none of 19 patients in CCI-BCG group survived more than 15 months, although 4 of 28 patients receiving this therapy survived. These results suggest that this combination chemo-immunotherapy is effective for a selected group of patients with advanced gastric carcinoma.
TL;DR: In attempts to obtain complete control of bleeding esophageal varices, terminal esophago-proximal gastrectomy and its modification proximal gastric transection were performed, under endoscopic assistance, in 42 patients with cirrhotic portal hypertension.
Abstract: In attempts to obtain complete control of bleeding esophageal varices, terminal esophago-proximal gastrectomy (TEPG) and its modification proximal gastric transection (PGT) were performed, under endoscopic assistance, in 42 patients with cirrhotic portal hypertension. Complete disappearance of varices was confirmed in all patients at surgery and 4 weeks after surgery, and this condition was maintained for up to 60 months in 15 patients of TEPG and 16 of PGT. Recurrent varices in 3 (17 per cent) TEPG and 8 (34 per cent) PGT were attributed to the advance in the liver cirrhosis in 7, hepatoma in 3 and portal vein thrombosis in 1. In 8 of 11 recurrences, type C variceal blood circulation drained into the cervical veins. Endoscopic assistance during surgical treatment for bleeding esophageal varices plays a decisive role.