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Biomedical subjects

A Yamaguchi

Publications and source records attributed to A Yamaguchi.

897 records · Page 50Linked to original sources
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Successful transcatheter embolization of a pancreaticoduodenal artery aneurysm in association with celiac axis occlusion: a case report.

We report a case of a pancreaticoduodenal artery (PDA) aneurysm in association with celiac axis occlusion. A 54 year-old female complaining of abrupt onset of abdominal pain was admitted to our hospital. On admission, abdominal CT examination revealed a hematoma in the retroperitoneal space. Selective superior mesenteric artery (SMA) angiography disclosed an aneurysm in the anterior inferior pancreaticoduodenal artery (AIPDA). The celiac axis was occluded and blood was flowing to the liver and spleen via the enlarged pancreaticoduodenal arcade from the SMA. Transcatheter embolization of the aneurysm was performed successfully. Up to 1996, there have been 37 reported cases of PDA aneurysm in association with celiac axis stenosis or occlusion, including this one. Transcatheter embolization was performed successfully in only 5 of these cases. The formation of this type of PDA aneurysm is thought to be a result of the increased blood flow in the pancreaticoduodenal arcade due to celiac axis stenosis or occlusion. The transcatheter embolization performed in our report produced a far greater blood flow, which may lead to further aneurysmal formation. Careful follow-up is therefore necessary.

Aneurysm↗
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Optimum duration of oral adjuvant chemotherapy of HCFU for colorectal cancer; review of 5-year follow-up.

PURPOSE: To investigate the optimal duration of oral HCFU administration for minimization of side effects induced by long-term administration. PATIENTS AND METHODS: In total, 155 patients allocated to two groups of different duration of the therapy were reviewed: twice or three times per day doses of oral HCFU (8 mg/Kg body weight/day) for 3 months vs. 12 months. RESULTS: Though statistically significant difference was not found in cumulative survival and disease-free rates between the groups due to so many violations of duration of therapy, when reanalyzing the variables in order of real duration of therapy, those rates were significantly higher in patients treated for 300 and more days than less than 300 days (g-Wilcoxon test: p < 0.04). No significant difference was observed in the background factors between the groups. CONCLUSION: At least 300 days is suggested to be necessary to obtain the optimal effectiveness of adjuvant chemotherapy for curatively resected colorectal cancer.

Administration, Oral↗
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Safety and utility of autologous blood transfusion for resection of metastatic liver tumor.

BACKGROUND/AIMS: The purpose of this study was to evaluate the safety and efficacy of predeposit autologous blood transfusion for resection of hepatic metastases. METHODOLOGY: We examined stored blood from 25 patients with advanced colorectal or gastric cancer for carcinoembryonic antigen mRNA using reverse-transcriptase-polymerase chain reaction assay to detect cancer cell in the autologous blood. We also retrospectively evaluated no transfusion (A, n = 44), autologous transfusion (B, n = 15), and homologous transfusion groups (C, n = 26) for perioperative liver function and long-term outcome after undergoing resection of liver metastases. RESULTS: In 5 of 25 patients, carcinoembryonic antigen mRNA was detected immediately after blood donation and after 7 days of storage, but not after 14-21 days of storage. The cumulative 5-year survival rates for groups A, B, and C were not different. However, disease-free survival with colorectal liver metastases was significantly higher in group A than in group C (P = 0.019). Total bilirubin concentrations in group C on the first postoperative day were also significantly higher than group A (P = 0.025). CONCLUSIONS: Stored autologous blood may contain cancer cells, but these decrease or disappear after storage for more than 7 days. For hepatic resection of metastases, transfusion avoidance yields the optimal outcome.

Aged↗
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Safety and advantage of perioperative autologous blood transfusion in hepatic resection for hepatocellular carcinoma.

BACKGROUND: The safety and advantages of perioperative autologous blood transfusion (ABT) were evaluated on hepatectomy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Blood samples were obtained and stored from 30 patients with HCC. HCC cells were investigated by the presence of AFPmRNA using RT-PCR after storage. We also reviewed postoperative liver function and the long-term outcomes of 138 patients who underwent hepatectomy receiving ABT compared with patients receiving homologous blood transfusion (HBT) and patients without blood transfusion. RESULTS: AFPmRNA was not detected in all samples stored for more than 14 days. Postoperative ALT, AST and total bilirubin in the HBT group were significantly higher than those of other groups. Patients in the HBT group had significantly lower survival rates than patients in the ABT group. CONCLUSION: ABT was safe after storage and it had advantages compared with HBT with regard to postoperative liver function and survival rate after the hepatectomy for HCC.

Blood Transfusion, Autologous↗
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Are both PIVKA-II and alpha-fetoprotein necessary in follow-up management after hepatic resection for hepatocellular carcinoma?

BACKGROUND/AIMS: The aim of this study was to clarify the need for measuring of PIVKA-II (protein induced by vitamin K absence or antagonist-II) and alpha-fetoprotein as the prognostic indicator for patients after hepatic resection for hepatocellular carcinoma, and as the monitoring modality for early detection of recurrence after hepatic resection. METHODOLOGY: One hundred and thirty-one patients who underwent planned liver resections for hepatocellular carcinoma were studied. RESULTS: The survival rates in patients positive for preoperative tumor markers were significantly lower than in those in the negative patients. The first modality leading to the diagnosis of recurrence was measurement of alpha-fetoprotein and/or PIVKA-II in 25 cases (55.6%). Almost all patients (96.6%) with positive preoperative alpha-fetoprotein and recurrence had elevated alpha-fetoprotein again when recurrence was found. CONCLUSIONS: Preoperative PIVKA-II and/or alpha-fetoprotein levels can predict postoperative prognosis. Measurement of these markers is useful in monitoring recurrence. For following up patients with alpha-fetoprotein-producing tumors, alpha-fetoprotein monitoring only is sufficient to detect recurrence.

Adult↗
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Follistatin-related protein gene (FRP) is expressed in the synovial tissues of rheumatoid arthritis, but its polymorphisms are not associated with genetic susceptibility.

OBJECTIVE: To examine the expression level and function of follistatin-related protein gene (FRP, also referred to as FSTL1) in rheumatoid arthritis (RA), and possible association of its polymorphisms with genetic susceptibility to RA. METHODS: FRP mRNA expression levels in the synovial tissues from 10 patients with RA and 5 patients with OA were measured using real-time RT-PCR. Effects on the growth of synovial cells were evaluated by stably introducing FRP cDNA into a rheumatoid synovial cell line, E11. Screening of genomic DNA variations was done using DNA from 12 patients with RA and 12 healthy individuals by direct sequencing. Genotypes at the detected polymorphic sites were determined in 224 patients with RA and 220 healthy individuals using PCR-single strand conformation polymorphism. RESULTS: FRP mRNA was overexpressed in synovial tissues from RA patients by 2.3-fold as compared with those from OA. A rheumatoid synovial cell line (E11) transfected with FRP exhibited reduced proliferation, probably mediated by secreted FRP molecule. 16 genomic variations were identified, among which 4 were polymorphisms within the promoter region and exons, and the remainder were either rare variations or intronic polymorphisms. Genotyping of 4 polymorphic sites did not reveal statistically significant association with the susceptibility to RA. CONCLUSION: FRP mRNA is overexpressed in RA synovium, the product of which exerts inhibitory activity on synovial cell growth. Although new polymorphic sites were identified, they were not associated with susceptibility to RA, suggesting that overexpression of FRP is secondarily caused by synovial environment of RA.

Adult↗
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Pancreaticoduodenectomy in combination with right hemicolectomy for surgical treatment of advanced gastric carcinoma located in the lower half of the stomach.

The results of surgical treatment of patients with gastric carcinoma infiltrating into the duodenum and the pancreas head and with N3 metastases are very poor. We have employed pancreaticoduodenectomy in combination with right hemicolectomy (PD + LH) with the aim of leaving no remnant of cancer cells in the vicinity of the primary lesion, in patients with carcinomas of the distal third of the stomach, associated with duodenal invasion, presence of fixity to the pancreas head or N3 metastases, in the last ten years. Twenty-six cases were treated with this technique (Group A). These cases were compared with 63 patients who underwent subtotal gastrectomy (Group B) in the same period. The operation time, amount of blood loss and numbers of operative complications were greater in Group A than in Group B. Operating mortality was found in 2 cases in Group B but was 0 for Group A. When the survival rates were compared, PD + LH can provide better long-term results than subtotal gastrectomy, especially in the patients with tumors infiltrating into the pancreas head or metastasizing to N3. The PD + LH is a rational and safe method for the treatment of gastric carcinoma infiltrating into the pancreas head or metastasizing to N3.

Carcinoma↗
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Analysis of hepatic recurrence of colorectal cancer after resection of hepatic metastases.

Forty patients with history of resected hepatic metastases of colorectal cancer were examined for pattern of recurrence. The 5-year survival rate was 41.3% for 40 patients. Recurrences of the malignancy were seen in 25 of the patients, with hepatic recurrence in 42.5% of them. The hepatic recurrence rate did not correlate with the lobar distribution of metastases or surgical methods. The pathological margins of less than 1 cm, 3 or more liver metastatic lesions, and the metastatic lesions of greater than 5 cm were at increased risk of hepatic recurrence. The recurrence rate was high, or 56% for aneuploid tumors, while it was 18.5% for diploid tumors.

Aneuploidy↗
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Proinflammatory cytokine levels in patients undergoing cardiopulmonary bypass. Does lung reperfusion influence the release of cytokines?

Proinflammatory cytokines have been implicated in mediating tissue injury after cardiopulmonary bypass. Causative factors of inflammatory response after cardiopulmonary bypass include contact of the blood with the extracorporeal circuit and heart-lung reperfusion injury when discontinuing bypass. To evaluate proinflammatory cytokine release during cardiopulmonary bypass, plasma levels of interleukin-6, 8, and monocyte chemoattractant factor were measured in the radial artery (for systemic blood) and left atrium before and after cardiopulmonary bypass. A total of 13 patients were studied, with no deaths or complications. In both radial artery and left atrium, interleukin-6, 8, and monocyte chemoattractant factor rose significantly after cardiopulmonary bypass (p < 0.05 versus before cardiopulmonary bypass). These changes may have been caused by removal of the aortic cross clamp and recommencement of artificial ventilation, which result in reperfusion of the pulmonary capillary beds. There were no differences in cytokine levels after cardiopulmonary bypass in the radial artery and left atrium. This result suggested that lung reperfusion injury after cardiopulmonary bypass may not be the major causative factor of the release of proinflammatory cytokines.

Aged↗
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Duplication of the gallbladder with advanced adenocarcinoma: diagnostic value of MRI and angiography.

We present a very rare case of duplicated gallbladder in which the accessory gallbladder was involved by advanced adenocarcinoma with stones. In this case, MRI was the most useful modality in revealing the cystic formation of the accessory gallbladder with packed stones beside the main gallbladder. Additionally, celiac angiography demonstrated the unusual form of the intrahepatic artery which enveloped the cystic tumor, that might be a diagnostic characteristic of accessory gallbladder.

Adenocarcinoma↗
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Comparison in survival between hepatic metastases of gastric and colorectal cancers.

BACKGROUND/AIM: The outcome after hepatectomy and non-surgical treatment of liver metastases from gastric and colorectal malignancies are reported. METHODOLOGY: Between April 1988 and March 1994, 176 patients with metastatic liver cancer were treated at the First Department of Surgery, Kyoto Prefectural University of Medicine Hospital. RESULTS: All patients received multi-disciplinary treatment, and 51 underwent hepatectomy. The survival after hepatectomy for metastatic liver cancer from a colorectal primary was better than that for gastric cancer. The survival after hepatic arterial infusion (HAI) therapy for metastases from gastric cancer was better than that for colorectal cancer. CONCLUSION: Surgical resection may be the best treatment for liver metastases from colorectal cancer. HAI may be a better option for liver metastases from gastric cancer.

Adult↗
PubMedDate not supplied

A case of obstructive colitis caused by possible colostomy dysfunction.

A case of obstructive colitis caused by possible stricture of colostomy is herein reported. A 58 year old female with an obstructive sigmoid colon cancer underwent an emergency descending decompression colostomy. At laparotomy, the colon proximal to the carcinoma was markedly distended and the bowel wall was thin, but the serosa appeared normal. Postoperatively, however, abdominal pain and distension persisted and low grade fever developed. Diarrhea through the colostomy continued. Nine days after the initial surgery, she underwent a left hemicolectomy. An abnormally thickened segment was identified in the resected specimen; normal mucosa was lost and several pseudopolyps were scattered. Histopathological findings of the abnormal segment were consistent with obstructive colitis. A preserved segment of normal mucosa intervened between the site of colostomy and the abnormal segment of obstructive colitis. A possible stenosis of the colostomy was considered to have caused colostomy dysfunction and subsequent obstructive colitis. She was complicated with anastomotic leakage due to the diseased colon being used for anastomosis. Obstructive colitis should be kept in mind in patients with obstructive colonic carcinomas who complain of persistent abdominal pain, distension and diarrhea in the early postoperative period after colostomy.

Colitis↗
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[Propionic acidemia in the neonatal period].

Propionic Acidemia is an inherited disorder of organic acid metabolism characterized by a wide spectrum of clinical and biochemical findings. Many times is present in the neonatal period, when mortality is high and neurologic residua in survivors is severe. The present case concerns to a healthy male newborn who started with a picture of refusing to feed, lethargy and hypothermia at 49 hours of life. He developed a severe neurotoxicity state with metabolic acidosis. The laboratory evaluation showed high levels of 3-hidroxi-propionic, 2-metil-hidroxibutiric and metil-citric in urine, confirming the diagnosis of proprionic acidemia.

Acidosis↗