1.A Review of Surgical Treatment Cases of Gastric Cancer in the Elderly in a Rural Area of Japan.
Noboru SASAKI ; Sigenobu KADO ; Masaharu KAWAGUCHI ; Kazuto FURUKAWA ; Tatsuya NAKAO ; Shuji KOHATA ; Masafumi SUESHIRO
Journal of the Japanese Association of Rural Medicine 1991;40(1):25-30
A total of 478 resected gastric cancer cases were studied. The male-female ratio was 1.6, -294 males and 184 females. The patients were divided into two groups, namely, the elderly group (patients aged 70 and over) and the non-elderly group (patients aged 69 and below). In the elderly group males were predominant over females. The number of elderly patients accounted for 34.1% of the total number of stomach cancer cases. This percentage is higher than the national average. In the elderly group, cases detected by stomach health screening or health diagnosis tests were a few, but many cases were in stage IV. The number of inoperable cases was somewhat high, radical gastrectomy was performed on a few of the patients, and the resection rate was somewhat low. A tendency was observed for multiple cancer focuses ; in regard to the regions of occupation or spreading and tissue type, the upper region was less likely and the lower region was more likely to be affected, the anterior wall and the circle were likely to be affected. A tendency was observed for the localization of highly differentiated tissue in the patients. Although no difference was observed in the direct surgical mortality rate, the 5 year survival rate was unfavorable, suggesting the patients might have died due to other diseases. In the elderly group, those who suffered from diseases and preoperative complications comprised 92% of the total, and abnormalities during preoperative examinations were detected in 96% of these patients. Postoperative complications developed in 42%. Postoperatively, psychological problems must be taken into consideration. In elderly patients who are operable, although it is desirable to actively perform surgery aiming at radical operations, it is thought necessary to cope carefully with resection of the stomach. If a radical operation is performed after carefully evaluating preoperative risks and with adequate preparations, it is thought possible for elderly patients to achieve favorable therapeutic results and improvement in their QOL differing little from non-elderly patients.
2.Study on Resected Cases of Colon/Rectum Cancer in a Rural Area Adjacent to Hiroshima City.
Noboru SASAKI ; Sigenobu KADO ; Masaharu KAWAGUCHI ; Kazuto FURUKAWA ; Tatsuya NAKAO ; Shuji KOHATA ; Masafumi SUESHIRO
Journal of the Japanese Association of Rural Medicine 1991;40(1):31-35
Study was made on total of 304 cases of cancer of the large intestine resected during the period of 12 years from 1978 to 1989.
Colon cancer accounted for 56.8% of the total and rectal cancer 43.2%. There were no sexual differences. Those people aged 50 and older represented 86.0% of the total number of the cases. By age group, those in their 60s topped the list with 27.3%, followed by those in 70s with 24.4%. Almost all the cases (95.1%) were of the patients who had visited the hospital, having noticed symptoms themselves. A very few cases were detected among the people without subjective symptoms when they received group medical Checkups.
By region, 39.4% of the colon cancer cases were found in S, followed by A. In the cases of rectum cancer, Rb accounted for 50.7%. Of the total caces, 74.5% had cancer on the left side of the large intestine.
Resection rate was 91.5%. The rate of resection leading to cure was 71.8%. Broken down by histological staging, stage I came to 11.7%; stage II, 30.9%; stage III, 21.8%; stage IV, 11.7%; stage V, 23.8%.
The 5-year-survival rete averaged 57.1%. In pre-surgery tests, the positive rate of CEA was as low as 46.6%. The positive rate for early cancer was extremely low. Measurement of CEA levels as an auxiliary diagnosis, therefore, did not prove itself to be useful in searching for cancer.
3.Evaluation of Antiplatelet Therapy with Aspirin and Trapidil in Patients with Prosthetic Heart Valve Replacement.
Noboru MURATA ; Masato KUME ; Satoshi KOBAYASHI ; Koji MORIYASU ; Hideo YOKOKAWA ; Makoto YAMADA ; Makoto FUNAMI ; Tosihiro TAKABA ; Toshitaka FURUKAWA
Japanese Journal of Cardiovascular Surgery 1993;22(2):113-117
Twenty six adult patients who underwent prosthetic heart valve replacement and treated anti-thrombogenic therapy, were divided into 2 groups. One was administered Warfarin alone, another was administered Warfarin plus Aspirin (162mg/day) as antiplatelet therapy. Trapidil (300mg/day) was administered to all of the patients. Platelet aggregation, plasma level of TXB2 (stable metabolite of thromboxane A2), and 6-keto-PGF1 (stable metabolite of PGI2) were measured before and 1, 3, 6 months after Trapidil therapy. Platelet aggregability suppressed in both 2 groups. Plasma TXB2 level, and TXB2/6-keto-PGF1 ratio showed a tendensy to decrease (p<0.05) 6 months after administration. In the Aspirin plus Trapidil group, platelet aggregability, serum TXB2 level, and TXB2/6-keto-PGF1 ratio are significantly lower than that in the Trapidil only. These results suggest that Trapidil is clinically useful for antiplatelet agent, but the combined Aspirin plus Trapidil therapy is more efficacious than the Aspirin or Trapidil single therapy.
4.Twenty years of otsu medical stucents association since 1969.
Michiya Ohtaka ; Tsuyoshi Ikai ; Shinji Fushiki ; Kiyoaki Kitamura ; Yasuyuki Tatsugami ; Junichiro Morikawa ; Yoshio Nakamura ; Takeshi Aoyama ; Tetsuya Yoshikawa ; Akira Matsuda ; Yoshifumi Yokota ; Takuzo Nambu ; Takeshi Moridera ; Nobuki Yamaoka ; Hiroyuki Naito ; Fumikazu Ikeda ; Hiroyuki Furukawa ; Hiroshi Yakushigawa ; Hiroshi Fujimoto ; Kishiko Hayashi ; Tsuyoshi Ohtaka ; Noboru Takano ; Yoshie Ibuki ; Tsutomu Yamanaka ; Akira Matsuda
Medical Education 1991;22(2):115-120