ISSN:0022-4790    

DOI:10.1002/jso.2930590402

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractWe retrospectively examined the extent of invasion of gastric cancer with duodenal involvement in order to design pertinent surgical procedures that may lead to a better prognosis. Examinations were made on excised tissues from 650 patients who underwent gastrectomy for adenocarcinoma in the gastric antrum. In 95 patients, the cancer cells extended to beyond the pyloric ring. Spread into the duodenum was limited to within 2 cm in 76% of the patients and to within 3 cm in 81%. In addition to high rates of metastasis in group 1 and 2 lymph nodes, some group 3 lymph nodes also were involved, and more frequently so in cases with duodenal invasion than in those without such invasion (P<0.01). The 5‐year survival rate for patients with duodenal invasion was 35.4% when a curative resection was done. For patients with advanced adenocarcinoma with duodenal invasion, gastrectomy with resection of 3–4 cm of the duodenum and dissection of group 1, 2, and 3 lymph nodes were recommen

ISSN:0022-4790    

DOI:10.1002/jso.2930590403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractAn increase in gluconeogenesis contributes to the cachexia seen in severe injury, sepsis, and malignancy by converting amino acids from skeletal muscle to glucose. Since tumor necrosis factor α (TNFα) may mediate this cachexia, we examined the effect of this cytokine on gluconeogenesis. Twenty‐eight male Fischer rats were injected intraperitoneally with TNFα (250 μg/kg) or saline, and after 4 hours, isolated hepatocytes were obtained by in situ collagenase liver perfusion. Hepatocytes were incubated with alanine (10 mM), and rates of gluconeogenesis were determined. Plasma lactate, glucose, insulin, glucagon, cortisol, and amino acids were measured. TNFα administration resulted in a 50% increase in gluconeogenesis from alanine (P<0.05) and a three‐fold increase in plasma glucagon (P= 0.01). Total and glucogenic plasma amino acids decreased with TNFα injection (P<0.05). In vivo TNFα causes an increase in hepatic gluconeogenesis associated with increased plasm

ISSN:0022-4790    

DOI:10.1002/jso.2930590404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractPatients with stage T3N0∼2M0 gastric carcinoma (n = 108) were studied for relevant prognostic factors. Peritoneal lavage cytology (PLC) was performed in all. In univariate analysis, 5‐year survival rates were better with smaller serosal invasion (diameter<3.0 cm vs. ≥3.0 cm, 61% vs. 37%,P<0.05) and fewer metastatic nodes (≤5 vs. ≥6, 57% vs. 29%,P<0.05). In multivariate analyses, only these two factors were significant. The predictive value of PLC was not shown in both univariate and multivariate analyses. Peritoneal recurrence occured in 14 (22%) of 77 patients with negative PLC, and in 3 (18%) of 17 with positive PLC, the difference being not significant. Our results indicate that PLC is insensitive in predicting the development of peritoneal recurrence. Its role in the estimation of survival is limited, as many will die of visceral or locoregional recurrence if not of peritoneal diss

ISSN:0022-4790    

DOI:10.1002/jso.2930590405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractOf 478 consecutive patients with intrathoracic esophageal carcinoma, 5% had vocal cord paralysis. In two thirds of the patients with vocal cord paralysis, the paralysis was caused by a metastatic lymph node located along the recurrent laryngeal nerve. These findings indicate that the possibility exists for radical surgery by esophagectomy and resection of the metastatic lymph node infiltrating the recurrent laryngeal nerve, even in patients with vocal cord paralysis. However, in only two patients was radical surgery accomplished. None of the 24 patients with paralysis survived without disease for more than 1 year. Thus, in patients with vocal cord paralysis, the need for combined therapy should be emphasized.

ISSN:0022-4790    

DOI:10.1002/jso.2930590406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractWe studied 148 colorectal adenocarcinomas to clarify any correlation between HLA‐DR antigen expression on tumor cells and histopathological features. Paraffin sections of formalin‐fixed tissues were stained with HLA‐DR antigen using the indirect immunoperoxidase technique. All the tumor tissues were divided into two groups, depending on the incidence of HLA‐DR‐positive cells (greater and lesser than 50%). Carcinoma tissues with a higher incidence showed less mural invasion, lymphoductal invasion, venous invasion, lymphonodular metastasis, and peritoneal metastasis. Tissues with a high HLA‐DR reactivity were more often observed for Dukes' A and B stages, whereas those with a low HLA‐DR positivity were frequently Dukes' C and D stages. As for the cumulative survival rate, the group with high HLA‐DR expression demonstrated significantly better survival. We speculate that HLA‐DR expression by colorectal cancer cells exerts a favorable influence o

ISSN:0022-4790    

DOI:10.1002/jso.2930590407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractThe risk factors for colon cancer recurrence following a curative intent surgery include the presence of metastatic disease, the tumor location and size, number of positive lymph nodes, the presence of adhesions, perforation, bowel obstruction, depth of invasion, histological grade, percentage of S‐phase content, and cell kinetic profile.The DNA content of colon cancers in 20 Dukes' B2 patients in follow‐up evaluation at our center, who relapsed, either locally or systemically following surgical treatment was measured by image analysis. The data were pair‐matched for age, sex, tumor site, and grade with 20 Dukes' B2 patients who had no evidence of disease.Aneuploidy occurred in 16 (80%) patients with recurrence, as compared with only in 8 (40%) in the control group. Aneuploidy was associated with significantly higher tumor recurrence rate (P= 0.024) and shorter overall survival (P0.002).Our data may point out a possible indication for systemic adjuvant chemotherapy in Dukes' B2 colon cancer patients who have aneuploid tumors on image analysis. This warrants further investigation in a prospective controlled randomized

ISSN:0022-4790    

DOI:10.1002/jso.2930590408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractParietal pleurectomy is our preferred procedure for management of malignant pleural effusion. However, the morbidity of a major thoracotomy has precluded all but highly selected patients from the conventional (open) procedure. Recently, we have been able to perform parietal pleurectomy by means of a video‐assisted, thoracoscopic technique. We have retrospectively analyzed the results of this procedure performed on 11 patients between March 1993 and February 1995. These patients ranged in age from 40 to 87 years of age, with a mean age of 61.5 years. Primary tumors were non‐small cell lung cancer (5), breast cancer (4), mesothelioma (1), and unknown (1). There was one operative mortality (9.1%). All were relieved of symptoms of pleural effusion. Median survival was 128 days. Early experience indicates we are accomplishing an operation equivalent to that formerly performed by “open” technique. If continued results are similar to our initial experience, we will be able to offer this superior palliation of malignant pleural effusion to a wider range of p

ISSN:0022-4790    

DOI:10.1002/jso.2930590409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractPrevious studies have suggested that serum prostate‐specific antigen (PSA) levels are under androgenic influence, especially in patients with adenocarcinoma of the prostate. PSMA (prostate‐specific membrane antigen) is thought to reflect hormonal or clonal resistance or an independence with respect to testosterone regulation. The influence of testosterone on serum PSA expression in normal men is not clear. We studied the effect of exogenous testosterone administration on the serum levels of PSA and PSMA in hypogonadal men. Serial serum PSA, serum PSMA by Western blot, and serum total testosterone levels were obtained at intervals of every 2–4 weeks in 10 hypogonadal men undergoing treatment with exogenous testosterone, delivered as testosterone enanthate injection or by testosterone patch. Linear and quadratic orthogonal polynomial scores were calculated for PSMA, PSA, and testosterone. A 2‐tailed, pairedt‐test failed to demonstrate a significant correlation between serum PSA (linearP= 0.432, quadraticP= 0.290) or PSMA (linearP= 0.162, quadraticP= 0.973) and serum testosterone levels. This study suggests that in hypogonadal men, neither PSMA nor PSA expression is testosterone

ISSN:0022-4790    

DOI:10.1002/jso.2930590410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY

摘要:

AbstractWe retrospectively investigated 308 cases of non‐small cell lung cancer of ≥3 cm diameter. There were 204 adenocarcinomas, 78 squamous cell carcinomas, 15 large cell carcinomas, and 11 other carcinomas. According to TNM staging, there were one case stage 0, 208 stage I, 22 stage II, 49 stage IIIA, 15 stage IIIB, and 13 cases stage IV. T1 disease was seen in 262 cases, T2 in 19, T3 in 10, T4 in 16, and Tis in 1. No disease was seen in 217 cases, N1 in 30, N2 in 60, and N3 in 1. The 5‐year survival rate of all case was 63%. There were statistically significant differences amont T status (T1 vs. T3, T4), N status (N0 vs. N1, N2), and M status (M0 vs. M1) (P<0.01). The 5‐year survival rates of cases with adenocarcinoma and squamous cell carcinoma were 60% and 64%, respectively. In 204 cases of adenocarcinoma, T3 disease was found in one case, T4 disease in 15 (7%), and nodal involvement (N1 + N2) was present in 69 (34%). In 78 cases of squamous cell carcinoma T3 was seen in 6 (8%), T4 in 1, and nodal involvement in 14 (18%). The incidence of T3 disease, T4, and N(+) varied significantly according to histology (P<0.05). Our investigation suggested that cases of small‐sized lung cancer were often at an advanced stage at detection, and that the spread of disease differed according to histology. The patient with small‐sized lung cancer should be offered a standard operation regardless o

ISSN:0022-4790    

DOI:10.1002/jso.2930590411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1995

数据来源: WILEY