Surgical treatment of gastric cancer with special reference to lymph node removal

Factors influencing the prognosis in gastric cancer treated by curative resection include lymph node metastasis and the extent of invasion of the gastric wall. Lymph node metastasis can be removed surgically, but the extent of invasion is not amenable to external measures. Of these two factors, the extent of wall invasion has the greatest influence on prognosis in cases undergoing curative resection. With lymph node removal of equal extent the prognosis worsens in proportion to the depth of invasion. Further, lymph node metastasis increases with increasing depth of invasion. Metastasis was seen in Group 2 and 3 nodes in more than 60% of cancer with invasion beyond the Tunica muscularis propria (pm), indicating that wide lymph node removal is essential in cancers with deep invasion of the wall. The effects of extended radical operation on the host as illustrated by the indices of total serum protein and albumin levels were no different from those of less extensive resections. It was confirmed that extensive radical resection did not delay postoperative recovery.</p

Follow-up study on gastric cancer treated with mitomycin C prior to surgical operation

With the purpose to prevent the dissemination and consequent metastasis of cancer cells at the time of operation we gave 10 mg of Mitomycin C per day for four consecutive days prior to surgical operation of gastric cancer (total of 322 patients), and this so-called adjuvant chemotherapy proved to be effective on the cases with serosal involvement and infiltrating type of cancer, irrespective of histological types. It also gave five-year survival rate of 35 per cent. However, to lymph nodes already metastasized, the adjuvant chemotherapy proved to be not effective.</p

A case of giant cavernous hemangioma of the liver complicated by intravascular coagulopathy.

A case of liver hemangioma complicated by intravascular coagulopathy is presented because of the rarity of the association. Hemangioma of the liver was suspected by palpation of the liver tumor, scintigraphy and x-ray examination, and confirmed by selective hepatic arteriography in combination with exploratory laparotomy. Intravascular coagulopathy was established by demonstrating secondary fibrinolysis and consumption of platelets and coagulation factors. Unconjugated hyperbilirubinemia due to micro-angiopathic hemolytic anemia was also present. The clinical course of the clotting abnormalities was basically a chronic one with an occasional acute or subacute defibrination process associated with further enlargement of the hepatic tumor. These provide sufficient evidence that the intravascular coagulopathy was closely related with the hemangioma in the liver. Neither ligation of a presumed nutritional artery of the hemangioma nor radiation therapy caused any demonstrable reduction in the tumor size.</p

Histological Studies on the Correlation between the Large and Small Alpha Ventral Horn Cells and the White and Red Muscle Fibers Innervated by Them

The correlation between the white and red fibers of the skeletal muscle and the large and small alpha ventral horn cells in peripheral neuromuscular system was studied in cats. In order to damage selectively the small nerve fibers 0.0066% sublimate solution was injected into the cat peripheral nerve (after HIRATA). By this procedure, the degeneration of the small ventral horn cells and of the red muscle fibers was selectively caused, while the large ventral horn cells and white muscle fibers were slightly affected. To damage the large nerve fibers, 80% alcohol was used (after HIRATA). In this case, the large ventral horn cells and the white muscle fibers were selectively degenerated. From the results, the following correlation may be reasonably inferred: large ventral horn cell→large peripheral nerve fiber→white muscle fiber small ventral horn cell→small peripheral nerve fiber→red muscle fiber The peripheral nerve was lesioned at its entering point into the supplying muscle and their regeneration was strained, 10-25 days after the animals were sacrificed, then the spinal cord was examined with NISSL staining and the muscle with Sudan-Black-B. Each number of the degenerated large and small ventral horn cells and that of the red and white muscle fibers were counted. The muscles used were the M. biceps brachii, M. palmaris longus, M. gracilis and median head of M. gastrocunemius, and the innervation ratio of these muscles were 1:195.9, 1:102.7, 1:154.6 and 1:209.3 respectively. The ratio of the number of the large ventral horn cells to that of the white muscle fibers (the innervation ratio to the white muscle fiber) was smaller than that of the small ventral horn cells to the red muscle fibers (the innervation ratio to the red muscle fiber) except for the M. gracilis. The ratio of the number of the degenerated large ventral horn cells to that of the small ventral horn cells was 1.66:1 in M. biceps brachii, 1.88:1 in M. palmaris longus, 1.58:1 in M. gracilis, 1.79:1 in the median head of M. gastrocunemius. The ratio of the number of the white muscle fibers to that of the red muscle fibers was 1.41:1 in M. biceps biachii, 1.51:1 in M. palmaris longus, 1.94:1 in M. gracilis and 1.53:1 in median head of M. gastrocunemius, respectively. It may depend upon that these muscles participate not only phasic movement but also stronger tonic contraction than other muscles. The arrangements of the cells groups in the ventral horn were as follows: M. biceps brachii is mainly supplied by the dorsolateral group, M. palmaris longus by the retrodorsolateral group, M. gracilis by the ventrolateral group, the median head of M. gastrocunemius by the central group, respectively