Kenjin Kamino

Thallium‐201‐chloride thyroid scintigraphy to evaluate benign and/or malignant nodules usefulness of the delayed scan

The purpose of this study is to evaluate benign and/or malignant thyroid tumors with 201TI thyroid scan. We studied 76 cases of histologically verified thyroid tumors, all seen as cold nodules on the 123I thyroid scan. 201TI thyroid scan was performed 5–15 minutes (early scan) and 3–5 hours (delayed scan) after intrayenous administration of 1.5–2.0 mCi of 201TI. In 35 (94.6%) of 37 malignant tumors (anaplastic carcinoma, six; papillary carcinoma, 23; follicullar carcinoma, five; epidermoid carcinoma, one; malignant lymphoma, 1), 201TI accumulated in the cold nodule of the 123I thyroid scan on both early and delayed scans. On the other hand, the delayed 201TI scan was negative in 35 out of 39 (89.7%) benign tumors. Employing early and delayed 201TI scans, we were able to differentiate most malignant thyroid tumors from those which were benign. False‐negative and ‐positive cases are discussed.

An analysis of the DNA ploidy patterns of gastric cancer

This article deals with DNA measurements by fluorometry of nuclei in 33 freshly obtained specimens and in 109 fixed specimens of gastric cancer in Japanese patients. Histograms of the DNA measurements can be classified into four types (Ia, Ib, II, III). The nuclear DNA patterns had definite, if not significant, correlations with clinical and histologic parameters. For example, 88.2% of the cases classified as Type III were advanced stage disease, whereas early stage cases were predominant in Type Ia. Type II and III were frequently found in hepatic, peritoneal, and lymph node metastasis. The rate of occurrence of polyploid cells was significantly higher in the group with hepatic or lymph node metastasis than in the other group without metastasis. The results of this study show that fluorometric measurement of nuclear DNA is considered one method of determining the biological activity of gastric cancer cells.

Postoperative total parenteral nutrition in patients with liver disorders

Sixty-one patients with liver disorders receiving total parenteral nutrition (TPN) for about 14 postoperative days were divided into three groups based on the parenteral nutritional regimen. The influence of these TPN solutions on the liver function tests and the nutritional assessments, and the availability of the specially formulated amino acid solution were studied. Glucose alone as energy source was infused in Group Ia. The mixture of glucose and fructose was infused in Group Ib. In these patients (Group I), a commercially available amino acid solution was administered simultaneously. A specially formulated amino acid, rich in branched-chain amino acids but poor in aromatic amino acids was infused with the mixture of glucose and fructose in Group II. There was no remarkable elevation of blood glucose and lactate levels in all patients. Blood glucose levels in Group Ib were maintained lower than that in Group Ia. Except for serum alkaline phosphatase, no remarkable abnormality was observed in liver function tests. Body weight changes were less than 5% in each group. Average nitrogen balances were -44.5 mg/kg/day in Group Ia, -5.5 mg/kg/day in Group Ib, -51.5 mg/kg/day in Group II. While the abnormalities in serum amino acid pattern and molar ratio of leucine, isoleucine, and valine to phenylalanine and tyrosine tend to be more enhanced in Group I, these abnormalities returned to near normal in Group II during TPN. By multiple linear regression analyses, 45 kcal/kg/day of energy intake would be required to maintain nitrogen equilibrium and zero body weight change. And when nitrogen intakes were 159 mg/kg/day in Group Ia, 114 mg/kg/day in Group Ib, and 189 mg/kg/day in Group II at 45 kcal/kg/day in energy intake, nitrogen balances were expected to be equivalent. These results suggest that postoperative TPN is good for nutritional support in patients with liver disorders. And also, the combination of glucose and fructose has better effect on nitrogen balance. The postoperative TPN with a specially formulated amino acid solution may be a valuable way of maintaining the nutritional status as well as normal serum amino acid pattern in patients with liver disorders.

Serum fatty acid concentrations in patients on postoperative parenteral nutrition with and without fat

To examine changes in fatty acid composition of serum lipids, sixteen patients with gastric cancer were maintained on total parenteral nutrition (TPN) or intravenous feeding immediately after total gastrectomy. Subjects receiving no fat showed decreases in linoleic acid, linolenic acid and arachidonic acid and increases in palmitoleic acid and oleic acid, whereas those receiving fat emulsion showed no detectable changes. Decrease in the linoleic acid content was greater in subjects on a higher carbohydrate intake, but less in those on a higher fat intake. Multiple regression analysis of the relationships among carbohydrate intake (X1) and fat intake (X2) and changes in the linoelic acid percentage of total serum fatty acids (Y) in each case yielded an equation: Y=−4.75 X1+69.0 X2−27.9 (R=0.885, p<0.05). Approximately 1 g/kg/day of fat provided in 40–50 kcal/kg/day of nonprotein energy intake was estimated to prevent decrease in the linoleic acid content in the serum fatty acid pattern during the postoperative catabolic stage.

A comparative study of experimental and human pancreatic carcinoma with special reference to histochemical findings

This study was undertaken in order to histochemically investigate the mucoid substances (acid mucopolysaccharide and sialic acid) in experimental and human pancreatic carcinoma. The degree of alcian blue staining in the ductal and interstitial portions of the pancreas increased, especially in hamster tubular adenocarcinoma which had been induced by N-nitrobis (2-hydroxypropyl) amine. The pancreatic carcinoma of the rats, induced by di-methyl benz (α) anthracene, was usually poorly differentiated carcinoma, in which alcian blue and toluidine blue staining was high in the interstitial portion when compared with that of the hamster pancreatic carcinoma, which was usually well differentiated. The rates of enzyme digestion of acid mucopolysaccharide and sialic acid showed more prominently in the rat pancreatic carcinoma than in the hamster pancreatic carcinoma. Mucoid substances in the ductal portion of human pancreatic carcinoma revealed properties similar to those of hamster pancreatic carcinoma whereas those in the interstitial portion were similar to those of rat pancreatic carcinoma. These results suggested that mucoid substances, especially acid mucopolysaccharide, both in experimental and human pancreatic carcinomas, may play an important role in tumor growth.

Studies on gastric carcinoma with liver metastasis. With special reference to poorly differentiated adenocarcinoma of the medullary type and DNA polyploid patterns of gastric carcinoma.

開腹時肝転移胃癌138例を検索対象とした.病巣占居部ではA領域が多く, 肉眼形態では1型2型の限局型17例中13例 (76.5%) が, H2, H3症例で, 限局型に肝転移高度例が多かった.組織所見では低分化型が41例 (58.6%) で, そのうち髄様性増殖を示すものが29例 (70.7%) と高率であった.また, 分化型では乳頭腺癌像を示すものが多かった.肝転移胃癌細胞核DNAパターンはII, III型を示し, 4C以上のpolyploid cell出現頻度は50.7%と非肝転移胃癌に比べ差がみられた.H1例の胃切除群の予後は非切除群に比べ良好であったが, H2・H3症例では両者間に差はみられなかった.