Junji Kasanuki

Heated intraperitoneal mitomycin C infusion treatment for patients with gastric cancer and peritoneal metastasis

The vast majority of peritoneal carcinomatosis occurs in the form of a secondary metastatic lesion. In Japan, the stomach is the most frequent origin of metastatic cancer in the abdominal cavity, while in Western countries the ovary is usually affected. The bile duct, large intestine, and breast are other primary sites. With cancerous invasion of the peritoneoserosal membrane, ascitic fluid frequently accumulates in the abdominal cavity and a terminal state can be thus identified.

Potential utility of a new ulcerative colitis segmental endoscopic index combining disease severity and the extent of inflammation.

Goal: To investigate the potential utility of a new scoring system, the Ulcerative Colitis Segmental Endoscopic Index (UCSEI), which combines measures of disease severity and extent of inflammation. Background: Intestinal mucosal healing (MH) is a new therapeutic goal for ulcerative colitis (UC). Discontinuous lesions are common in UC and endoscopic observation of the entire colon is important. Study: Patients with active mild-to-moderate UC received daily treatment with oral mesalazine (4 g/d) and mesalazine enemas (1 g/d) for 8 weeks. Endoscopic evaluations, using the UCSEI and Mayo Endoscopic Score (MES), were performed in 5 colonic segments at baseline and week 8. The UCSEI criteria included erythema, vascular pattern, friability, and erosion/ulcer. The sum of 5 subscores, determined for each segment, was calculated as the UCSEI. Disease activity was also assessed using the UC Disease Activity Index (UCDAI). MH was defined as MES=0 to 1. Results: Of 58 patients, 51 completed the scheduled endoscopic evaluations. At week 8, the UCDAI score had significantly decreased from 6.63 (baseline) to 2.73 (P<0.001). The remission and MH rates were 35.3% and 55.3%, respectively. Segmental endoscopic evaluation, using UCSEI, showed that baseline inflammation tended to be more severe in the distal colon. The baseline UCSEI increased with the extent of disease, which was not seen in MES. Improvements in UCSEI were observed, even in the patients without decreases in the MES. Conclusions: UCSEI, reflecting disease severity and extent of inflammation, provides useful information for UC management that is not available with MES.

Somatostatin and insulin secretion from pancreatic islets: Studies on the effect of high K+, 9-aminoacridine and valinomycin

We attempted to determine whether a decrease in the potassium permeability of the D cell membrane plays a role in the stimulus-secretion coupling, as it does in the pancreatic B cell. Elevation in the extracellular potassium concentration from 5.5 to 16.5 mM, or 0.2 mM 9-aminoacridine, which decreases potassium permeability in plasma membrane, stimulated the release of somatostatin as well as insulin from the isolated rat pancreatic islets. Valinomycin (1 microM), a potassium ionophore inhibited the secretion in response to high glucose, high extracellular potassium or 9-aminoacridine. These findings indicate that a reduction in potassium permeability in the D cell membrane, as induced by glucose or other stimulants, may be a major step in secretion of somatostatin.

Gastric cancer with synchronous unresectable hepatic metastasis and a positive response to chemotherapy ― report of two cases

We report herein the clinical events seen in two longterm survivors of gastric cancer with unresectable synchronous hepatic metastases. Partial gastrectomy was performed against the primary lesion and continuous intra-arterial infusion of anti-tumor drugs, followed by prolonged systemic antitumor drug treatment, were prescribed. A 43-year-old man with moderately-differentiated tubular adenocarcinoma had an uneventful course during his first 21 postoperative months. However, multiple liver metastases became manifest at 24 months and enlargement of the intrahepatic foci led to death 27 months after gastrectomy. A 51-year-old woman with moderagely-differentiated tubular adenocarcinoma had an uneventful postoperative course and is now well with no signs of recurrence 6 years and 6 months after gastrectomy.

New trends in therapy for gastric malignancy

The incidence of gastric cancer differs much in various countries, and Japan, Chile, and Iceland are high-frequency countries [1]. In Japan, gastric cancer is the first cause of death due to cancer. Surgery is the only treatment that can cure gastric cancer, however, postoperative recurrence is common. Thus, Japanese surgeons have been treating hard gastric cancer. Again, to improve the poor prognosis of gastric cancer, an additional effort has been directed to early and accurate preoperative diagnosis as well as to postoperative adjuvant treatment. In this chapter, clinical classifications of gastric cancer, as well as preoperative diagnosis and surgical treatments for early and advanced gastric cancer, are described.

Effect of caerulein administration on portal plasma somatostatin in dogs.

SummaryThe effect of administration of synthetic caerulein on canine plasma somatostatin concentration in the portal vein was investigated using specific radioimmunoassay of acid-acetone extracted plasma. Gel chromatography revealed that the main component of the plasma somatostatin in the portal vein was identical with somatostatin-14. After administration of caerulein (5ng/kg), the somatostatin level increased significantly while the gastrin level remained unchanged. These results suggested that caerulein affects D cell function but not gastrin secretion.