Hajime Ikuta

Clinicopathological features of esophageal cancer simultaneously associated with gastric cancer

Background and Objectives: We usually use the stomach for esophageal substitution in the surgical treatment of esophageal cancer, although it is often associated with gastric cancer. In order to improve the likelihood of safe and curative surgery of esophageal cancer, we investigated the clinicopathological characteristics of synchronous esophageal and gastric cancer.

An experimental study of regional chemotherapy using CDDP-loaded microspheres for esophageal cancer.

AbstractPurpose. The purpose of this study was to assess the antitumor effects of cisplatin-loaded microspheres (CDDP-MS) and the efficacy of the administration of CDDP-MS into the mediastinum. Methods. To evaluate the antitumor effect, we first performed a paratumoral injection of CDDP-MS to FF6 tumor-bearing DA rats to compare its effect with that of the intraperitoneal injection of a CDDP solution at different doses. Results. In the CDDP-MS groups the tumor growth was effectively delayed in proportion to the dosage of CDDP-MS. All rats treated with the CDDP solution at a dose of 10 mg/kg died within 1 week, while no rats treated with CDDP-MS even at a CDDP dose of 20 mg/kg were lost. In the second experiment, which was designed to determine the delivery of the microspheres-released CDDP to various organs, CDDP-MS was injected directly into the mediastinum via the diaphragm in male Wistar rats. In the CDDP-MS group, the plasma CDDP concentration stayed significantly lower than that in the CDDP solution (intravenous) group while the tissue CDDP concentration in the paratracheal lymph nodes was higher. Moreover, the lymph node-to-kidney platinum ratio was eight times higher in the rats given CDDP-MS intramediastinally than in those given the CDDP solution intravenously. Conclusion. These results demonstrate that a high dose of CDDP can be administered with less systemic side effects by means of encapsulation in the microspheres, and that the administration of CDDP-MS into the mediastinum is more effective for delivering CDDP to the paratracheal lymph nodes. As a regional chemotherapy after esophageal cancer operation, the injection of CDDP-MS into the mediastinum for targeting of the lymph nodes thus promises to be an effective treatment.

A New Device to Prevent Irregular Adsorption of Fatty Tissue While Using an Irrigation-suction Instrument for Laparoscopic Surgery: Divided Silicone Drain Tip.

Background: While using an irrigation-suction instrument for laparoscopic surgery, irregular adsorption of fatty tissue may damage the tissue or obstruct continuous sucking. A new device made up of a divided silicone drain tip to prevent irregular adsorption was reported. Materials and Methods: A cigarette-type silicone drain was cut 4 cm in length. It was slipped over the instrument to cover the side holes, leaving 1.0 to 1.5 cm free from the end of the instrument. It was fixed by means of 1-0 silk above the side holes. Finally, the free tip was divided vertically into 4 even pieces like octopus arms. Results: This device could prevent the irregular adsorption of fatty tissue (greater and lesser omentum, or epiploic appendices) and could suck saline, fresh, and coagulated blood almost continuously. Conclusions: This simple and easy device facilitated the prevention of irregular adsorption of fatty tissue while using an irrigation-suction instrument for laparoscopic surgery.

Study on local chemotherapy of esophageal cancer in use of microspheres.

Peplomicin-containing poly (lactic acid)microspheres(PEP-MS)were prepared, and its long retention and lymphtropic delivery were studied. PEP-MS released 70% of PEP in saline within 24 hours. PEP and PEP-MS were injected into the esophageal wall of rabbits, and PEP concentration of peripheral venous blood and lymph of thoracic duct were measured from 5 minutes to 6 hours after injection. In group “PEP”, PEP concentration of peripheral venous blood and lymph of thoracic duct were same level, but in group “PEP-MS”, PEP concentration of lymph of thoracic duct was higher than of peripheral venous blood. One day after administration of PEP, PEP was not found in esophagus, lymph nodes, lung and kidney, But one day after administration of PEP-MS, PEP was found to still remain 3.0 μg/g in esophagus.