J Nakamura

Gunma University, Maebashi-shi, Gunma-ken, Japan

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Publications (25)56.26 Total impact

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    ABSTRACT: Extramammary Paget's disease (EPD) is rare. We report a case of double anal canal cancers in a patient with a long history of perianal Paget's disease. The patient, a 68-year-old Japanese woman, refused surgery initially and was treated with electron beam therapy, which achieved remission. However, 6 years later, Paget's disease was found to be progressing again and double anal canal tumors were also detected in the proctos and external skin area. We performed abdominoperineal resection (Miles' operation) and lymph node dissection for the Paget's disease with double anal canal tumors. Immunohistochemical staining revealed cytokeratin (CK)-20 expression in the adenocarcinomas and Paget's disease lesion, but not CK-7 or gross cystic disease fluid protein-15 expression. The lesion was joined to the carcinoma by a stalk. The immunohistochemistry results suggested secondary EPD, although it was originally considered to be Paget's carcinoma (primary EPD) based on the clinical history.
    Surgery Today 04/2012; 42(7):697-702. · 0.96 Impact Factor
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    ABSTRACT: A 63-year-old woman with advanced gastric cancer was referred to our hospital.Upper gastrointestinal endoscopy revealed a type 2 tumor in the lesser curvature of the angle of stomach. Moderately-differentiated adenocarcinoma was found in the biopsy specimens. Lymph node metastases of No.3 and No.7 were suspected by abdominal CT. We diagnosed the tumor as cStage III A (cT2N2H0P0M0) gastric cancer.For better curability, we selected neoadjuvant chemotherapy with TS-1/ CDDP. Two courses were completed without serious side effects. Upper gastrointestinal endoscopy and abdominal CT revealed that the primary tumor and metastatic lymph nodes had become smaller, suggesting that a partial response had been achieved. The patient underwent curative surgery, including distal gastrectomy and D2 lymph node dissection.No cancer cells were found by pathological evaluation of the resected stomach and all the regional lymph nodes, confirming a pathological complete response. It is suggested that the neoadjuvant chemotherapy is a useful therapeutic strategy for advanced gastric cancer.
    Gan to kagaku ryoho. Cancer & chemotherapy 01/2011; 38(1):101-4.
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    ABSTRACT: Entero-related fistulae are often intractable. Recently, growth factors were generally in sight with the development of regenerative medicine. Basic fibroblast growth factor (bFGF) possesses potent angiogenic activity. In Japan, recombinant bFGF, also known as Trafermin, has been administered for intractable skin ulcer for its strong effect on tissue granulation. Here, we report the effect of bFGF for entero-related fistulae. Two intractable cases were treated by applying bFGF in the fistulae after performing the enterostomy. Case 1: Postoperative intractable vesicorectal fistula was treated by bFGF. 82 days later, fistula was closed. Case 2: Colonic perforation due to ischemic colitis was treated. 37 days after treatment, fistula was closed. In conclusion, in the treatment of the intractable entero-related fistulae, Trafermin was useful for healing the fistulae.
    Hepato-gastroenterology 01/2007; 54(75):803-5. · 0.77 Impact Factor
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    ABSTRACT: Both paclitaxel and S-1 are effective against gastric cancer, but the optimal regimen for combined chemotherapy with these drugs remains unclear. This phase I/II study was designed to determine the maximum tolerated dose (MTD), recommended dose (RD), dose-limiting toxicity (DLT), and objective response rate of paclitaxel in combination with S-1. S-1 was administered orally at a fixed dose of 80 mg m-2 day-1 from days 1 to 14 of a 28-day cycle. Paclitaxel was given intravenously on days 1, 8, and 15, starting with a dose of 40 mg m-2 day-1. The dose was increased in a stepwise manner to 70 mg m-2. Treatment was repeated every 4 weeks unless disease progression was confirmed. In the phase I portion, 17 patients were enrolled. The MTD of paclitaxel was estimated to be 70 mg m-2 because 40% of the patients given this dose level (two of five) had DLT. The RD was determined to be 60 mg m-2. In the phase II portion, 24 patients, including five with assessable disease who received the RD in the phase I portion, were evaluated. The median number of treatment courses was six (range: 1-17). The incidence of the worst-grade toxicity in patients given the RD was 28 and 8%, respectively. All toxic effects were manageable. The response rate was 54.1%, and the median survival time was 15.5 months. Our phase I/II trial showed that S-1 combined with paclitaxel is effective and well tolerated in patients with advanced gastric cancer.
    British Journal of Cancer 01/2007; 95(12):1642-7. · 5.08 Impact Factor
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    ABSTRACT: The location of a small lesion must be precisely identified during laparoscopic surgery. A gamma probe that is usually used for navigating sentinel lymph nodes was evaluated for its usefulness in locating small gastrointestinal lesions (14 gastric and 10 colonic). A total of 2 mCi of a Tc(99m)-labeled rhenium colloid was injected endoscopically around a tumor 16 h prior to surgery. During operation, the abdominal cavity was scanned using a handheld gamma probe (Navigator GPS, Tyco HealthCare, Norwalk, CT, USA). In all cases, the injection site was identified as the highest spot in the abdominal cavity, with 2585 counts per second on average (range, 910-8800 counts per second). The highest count in a lymph node was 637 per second on average. The gamma probe is a useful tool for identifying small gastrointestinal lesions during open and laparoscopic operations.
    Surgical Endoscopy 09/2003; 17(8):1216-7. · 3.43 Impact Factor
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    ABSTRACT: To extend the usefulness of laparoscopic operations, a secure and easy method for the ligation of large vessels is needed. Herein we describe a novel ligation forceps that can be used as a ligature carrier and knot pusher. A 2-0 suture thread with a knot already tied near one end is hooked in the upper jaw of a novel ligation forceps. After the lower jaw is passed under the vessel or cystic duct, the forceps is closed. When one end of the thread is withdrawn, the knot is trapped in the indentation built into the lower jaw; the ligature is then passed under the pedicle. An extracorporeal ligation can then be performed continuously by the same forceps. The origins of large vessels were ligated safely and easily with this device during 65 laparoscopic procedures (four total colectomies, 12 colectomies, and 49 gastrectomies). Following temporary hemostasis of accidental bleeding with clamping forceps, ligation hemostasis can also be performed using this instrument. This novel ligation forceps permits the secure ligation of vessels or a cystic duct without the need for another device. The proposed method is both easy and inexpensive.
    Surgical Endoscopy 06/2001; 15(5):524-7. · 3.43 Impact Factor
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    ABSTRACT: Systemic administration of a cholinergic blocking agent or glucagon is used to reduce spasms, but it is inconvenient and sometimes causes side effects. This study is an evaluation of the intracolonic administration of peppermint oil during colonoscopy for the control of colonic spasm. Each patient in the treated group (n = 409) was given approximately 200 mL of the solution (a mixture of 8 mL of peppermint oil and 0.2 mL of Tween 80 per 1 L of water with 0.04% indigo carmine) by using a hand pump attached to the accessory channel of the colonoscope. Changes in patient posture were made to distribute the solution. The patients in the control group (n = 36) were given the solution without peppermint oil. A satisfactory spasmolytic effect was seen in 88.5% of the treated patients and in 33.3% of those in the control group (p<0.0001). No adverse effect was observed. The mean time to onset was 21.6 +/- 15.0 seconds, and the effect continued for at least 20 minutes. In patients with irritable bowel syndrome, efficacy was significantly lower (p < 0.0001). The intraluminal administration of peppermint oil by using a hand pump is a simple, safe, and convenient alternative to the systemic injection of a cholinergic blocking agent or glucagon during colonoscopy.
    Gastrointestinal Endoscopy 02/2001; 53(2):172-7. · 5.21 Impact Factor
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    ABSTRACT: Recent advances have made possible the treatment of small invasive colorectal cancer by means of polypectomy or endoscopic mucosal resection. CD44 expression in cancer cells was identified as an indicator of lymph-node metastasis, which could be evaluated in specimens removed by colonoscopy. The correlation between lymph-node metastasis and the expression of standard-type CD44 in cancer cells was examined immunohistologically using the invaded cancer cells of 61 tissue samples of superficially invasive colorectal cancer. We defined the above as invasive cancer restricted within the colorectal wall. Of the 61 samples, 31 had submucosal invasion and 30 had muscular invasion. Standard-type CD44 expression in the area of invasion in cases with lymph-node metastasis was remarkably down-regulated. In 43 cases with no lymph-node metastasis, 36 (83.7 percent) of patients had CD44 expression in invaded cells, whereas only two of 18 cases (11.1 percent) with lymph-node metastasis had expression of standard-type CD44 in the same area (P < 0.0001). A total of 69.6 percent (16/23) of patients with loss of standard-type CD44 expression in invaded sites were found to have positive metastasis in the lymph nodes. These results suggest that standard-type CD44 in invasive colon cancer cells could suppress metastasis to the regional lymph nodes. In cases of invasive colorectal cancer, the loss of standard-type CD44 expression in the invaded area is a sensitive marker for metastasis to the lymph nodes. Further investigation with larger patient groups is required to clarify the reliability of loss of standard-type CD44 expression as an indicator for additional surgery after endoscopic resection of submucosal invasive colorectal carcinoma.
    Diseases of the Colon & Rectum 09/2000; 43(9):1250-4; discussion 1254-5. · 3.34 Impact Factor
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    ABSTRACT: We have previously reported that the elevated activities of serum alpha 1,3fucosyltransferase reverted to normal levels after curative removal of the tumors. To determine the origin of elevated serum alpha 1,3fucosyltransferase, blood samples were obtained from both the drainage vein and the artery in patients with different stages of colorectal cancer at surgery. The enzyme levels in all samples from the drainage vein were found to be higher than the levels in the artery that fed the tumor. Hence, the origin of elevated alpha1,3fucosyltransferase in serum was thought to be the tumor rather than the liver that is the normal source of serum alpha1,3fucosyltransferase. When serum samples not only from colorectal cancer patients but also from patients with gastric, liver, lung, pancreas, bladder and esophagus cancer were treated with anti-FUTVI antibody, the measured activities of alpha1,3fucosyltransferase were markedly reduced. Further, secretion of alpha1,3fucosyltransferase from human colorectal carcinoma cells was also detected in the culture medium by Western immuno-blot analysis with anti-FUTVI antibody.
    Clinical and Experimental Metastasis 02/2000; 18(7):605-10. · 3.46 Impact Factor
  • Surgical Endoscopy 02/1999; 13(1):91. · 3.43 Impact Factor
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    ABSTRACT: Levels of fucosylated antigens in sera from patients with liver diseases were examined by a newly developed sandwich-type enzyme immuno assay with the aid of anti-fucosylated antigen antibody, YB-2 which reacts simultaneously with Y, Leb and H type 2 antigens. When the cut-off value was set arbitrarily at mean +3 SD values of normal, 30 (69.8%) of the 43 patients with HCC, 14 (53.8%) of the 26 patients with liver cirrhosis (LC) and 24 (45.3%) of the 53 patients with chronic hepatitis (CH) were found to be positive, whereas all of the 30 samples from healthy controls were negative. The levels of alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in HCC were not correlated with those of YB-2 antigens. The positive rates of the combination YB-2 and AFP assay and YB-2 and PIVKA-II assay in HCC were significantly higher (83.7 and 86.0%, respectively) than that of the AFP and PIVKA-II combination (65.1%) which had been reported to be the best combination up to this time.
    Glycoconjugate Journal 02/1997; 14(1):81-7. · 1.88 Impact Factor
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    ABSTRACT: A novel assay method specific for alpha 2-->3sialyltransferase that seems to be responsible for the synthesis of CA 19-9 antigen was developed and the levels of the enzyme in colorectal tumor tissues were measured and compared with the levels of alpha 1-->4fucosyltransferase and the CA 19-9 antigen. Lacto-N-biose I (Gal beta 1-->3GlcNAc beta, Lewis(c) [Le(c)]) and 6-O-methyl-Le(c) (Gal beta 1-->3[6OMe]GlcNAc beta) were synthesized and covalently attached to bovine serum albumin (BSA). These two substrates were incubated with extracts from colorectal tissues in the presence of cytidine 5'-monophospho-N-acetylneuraminic acid (CMP-NeuAc) and their resulting products were detected by a sequential use of anti-BSA monoclonal antibody-coated beads and 125I-labelled anti-sialylated Le(c) antibody. Levels of alpha 2-->3sialyltransferase and alpha 1-->4fucosyltranferase activities and CA 19-9 antigen were measured in the extracts from colorectal tumors and their adjacent normal tissues. 6-O-Methyl-Le(c)-BSA showed a strong acceptor activity compared with Le(c)-BSA and was used as a specific acceptor for alpha 2-->3sialyltransferase. Similar elevation patterns alpha 2-->3sialyltransferase activities and CA 19-9 antigen levels were observed in tumor extracts but no clear correlation was present between the level of alpha 1-->4fucosyltransferase activities and CA 19-9 antigen levels were observed in tumor extracts but no clear correlation was present between the level of alpha 1-->4fucosyltransferase activities and CA 19-9 antigen levels in the same extracts. The accumulation of CA 19-9 antigen in colorectal tumors might be caused mainly by the activation of alpha 2-->3sialyltransferase but not by that of alpha 1-->fucosyltransferase.
    Cancer 04/1996; 77(8 Suppl):1694-700. · 5.20 Impact Factor
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    ABSTRACT: In this study we examined the efficacy of the measurement of IAP (serum ancl peritoneal washings) during the treatment of colorectal cancers, and determined the possible benefits of using the IAP measurements from both serum and peritoneal washings. One hundred and six patients (peritoneal washings: 58, peritoneal fluid: 67) were investigated. Serum IAP levels were significantly higher in patients who underwent complicated surgical procedures which involved greater time and blood loss compared to those patients who underwent less involved surgical procedures with little loss of blood and time. In peritoneal washings, up to 66. 7% of cases with peritoneal dissemination showed elevated levels of IAP in the peritoneal cavity, while 37% of cases with no dissemination at surgery macroscopically had positive IAP levels (8 mg/g protein). The results suggest the value of IAP in determining the need for combined immunochemotherapy for patients in an immunosuppressive environment.
    Anticancer research 01/1996; 16(4B):2269-72. · 1.71 Impact Factor
  • Cancer 01/1996; 77:1694-1700. · 5.20 Impact Factor
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    ABSTRACT: The effectiveness of the combined administration of 5-fluorouracil (5-FU) and Krestin (PSK) on experimentally induced liver cancer has not been established. This study was undertaken to elucidate the effect of the combined administration of these drugs on tumor growth and metastasis. Male inbred WKA/H strain rats were used. The drugs used were 5-FU and PSK, each dissolved in water and fed orally. The drugs were administered separately or concurrently in standardized cycles to the tumor-bearing animals. KDH-8 ascitic liver cancer cells were subcutaneously transplanted into WKA rats. The tumor growth inhibition rates of 5-FU and PSK were then determined. Eighteen days after subcutaneous transplantation, tumor growth in the combined administration group was significantly inhibited, compared to the control group and the single treatment groups (p < .05). In addition, a liver metastatic model was prepared by transplanting KDH-8 cells into the spleen. Then the metastatic inhibitory effects of 5-FU and PSK were analyzed. At 14 days, the mean number of liver metastatic nodules was approximately 63 in the control group. However, the combined-medicated group showed a much lower number of nodules (40), indicating that metastasis was significantly inhibited (p < .05).
    Journal of Investigative Surgery 01/1995; 8(1):1-5. · 1.32 Impact Factor
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    ABSTRACT: In surgery for colorectal cancer, a tendency of immune suppression was noted as seen in surgery for other types of gastro-intestinal cancer. This tendency was also found in the biological response, and it was related to the operative procedures and insults for rectal cancer. The degree of immunosuppression was milder in patients who underwent procedures that preserve the natural sphincter than in those who underwent colostomy. It is important for surgeons to avoid postoperative immunosuppression in order to prevent recurrence and improve prognosis. Given similar degrees of operative insult and stage of cancer, an operative procedure which causes as little immunosuppression as possible should be selected.
    Oncology Reports 09/1994; 1(5):1029-33. · 2.30 Impact Factor
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    ABSTRACT: In this study we investigated the effect of combined administration of UFT and Krestin (PSK) on the growth of intraperitoneal metastasis and temporal changes in the immune-endocrine system under this immunochemotherapy. At 7 days, Plasma ACTH levels of the PSK group were significantly lower than that of the control group (p<0.01). At 14 days, the tumor weight in the combined and the PSK alone group was significantly decreased, compared to the control group (p<0.05). Serum IAP levels of the UFT group were significantly lower than that of the control group (p<0.05). Serum cortisol levels of the combined group were lower than that of the other groups.
    Oncology Reports 07/1994; 1(4):727-30. · 2.30 Impact Factor
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    ABSTRACT: A monoclonal antibody, YB-2, which has a novel epitope for fucosylated antigens and shows cross-reactivity with Y/Leb/H type 2 antigens, was used in an immunohistochemical study of human neoplastic and normal colorectal tissues. Of 64 colorectal cancers, 59 (92.2%) were stained by the YB-2 antibody; however, only 3 (12.0%) of 25 samples of normal colon mucosa and 13 (50.0%) of 26 adenomas expressed the antigens recognized by YB-2. Clinicopathologically, the YB-2-negative colon cancers were exclusively in Dukes stage A. These results indicate that the monoclonal antibody, YB-2, could detect cancer-associated antigens, and the degree of YB-2-reacted antigen expression might be correlated with the progression of colorectal carcinogenesis.
    Surgery Today 02/1994; 24(4):382-4. · 0.96 Impact Factor
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    ABSTRACT: Evidence indicates that the presence of aberrant alpha 1-->2fucosylation pathways is responsible for the accumulation of large quantities of Le(b) and Y antigens in human colorectal carcinoma. Significantly higher activities of alpha 1-->2 as well as alpha 1-->3 and alpha 1-->4fucosyltransferases were found in most of the tissues from carcinoma than in the adjacent normal tissues and in healthy subjects. alpha 1-->2Fucosyltransferases associated with the synthesis of Le(b) (Fuc alpha 1-->2Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta) and Y (Fuc alpha 1-->2Gal beta 1-->4[Fuc alpha 1-->3]GlcNAc beta) structures from Le(a) (Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta) and X (Gal beta 1-->4[Fuc alpha 1-->3]GlcNAc beta) ones, respectively, were demonstrated in colorectal carcinomas and in colorectal carcinoma cell lines (COLO201, LS174T and SW1116). The activation of alpha 1-->2fucosyltransferase with such new substrate specificities in colorectal carcinoma might result in the preferential synthesis of Le(b) and Y structures from Le(a) and X rather than from H type 1 and H type 2 structures.
    Japanese journal of cancer research: Gann 09/1993; 84(9):989-95.
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    ABSTRACT: A novel monoclonal antibody, YB-2 was obtained after immunization of mice with fucosylated antigens isolated from human saliva. The antibody was demonstrated to react with Y (Fuc alpha 1-->2Gal-beta 1-->4[Fuc alpha 1-->3]GlcNAc beta),Leb (Fuc alpha 1-->2Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta) and H type 2 (Fuc alpha 1-->2Gal-beta 1-->4GlcNAc beta) antigens, but not with H type 1 (Fuc alpha 1-->2Gal beta 1-->3GlcNAc beta), Lea (Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta), X (Gal beta 1-->4[Fuc alpha 1-->3]GlcNAc beta) or with non-fucosylated antigens. Inhibition assays of YB-2 antibody with such reactive antigens showed that YB-2 antibody preferentially reacted with Y antigen. Formalin-fixed and paraffin-embedded sections prepared from normal and malignant colorectal tissues were examined immunohistochemically with YB-2. The positive rates of staining with YB-2 antibody were 88.6% in malignant and 12.0% in normal tissues. The expression of fucosylated antigens detected by YB-2 antibody seemed to be correlated with survival among patients with primary colorectal cancer. Therefore, YB-2 antibody could be useful as an immunochemical tool for diagnosis and evaluation of the prognosis of colorectal cancer.
    Japanese journal of cancer research: Gann 07/1993; 84(6):641-8.