Biomedical subjects

A Yamanoi

Publications and source records attributed to A Yamanoi.

59 records · Page 4Linked to original sources

PubMedDate not supplied

Comparison of topical hemostatic agents in elective hepatic resection: a clinical prospective randomized trial.

To compare the difference in efficacy of microcrystalline collagen powder (CL) and fibrin glue (FG) in elective hepatic resection, 62 patients (female 14, male 48) with ages ranging from 51 to 75 years were randomly allocated to receive either CL or FG as a topical agent during hepatectomy. There were no significant differences between the patients treated with CL (n = 31) and those treated with FG (n = 31) regarding sex, age, liver function, coagulation function, platelet counts, type of liver resection, and operative duration. A dry cut surface of the liver was obtained during surgery in 27 (87%) patients and 25 (81%) patients treated with CL and FG, respectively. Both CL and FG showed similar hemostatic effects. The CL and FG groups were not different in terms of postoperative rebleeding, bile leakage, or morbidity and mortality rates (6% vs. 6%, 6% vs. 6%, 45% vs. 39%, and 13% vs. 10%, respectively). Of the 52 patients with a dry cut surface of the liver during surgery, 3 patients in the CL group encountered rebleeding (n = 1) or bile leakage (n = 2) from the cut surface postoperatively, while no such complications were noted in the FG group. The results seem to favor FG for reliability in the postoperative period. The application of CL or FG may be better performed with consideration of the characteristics of each agent.

Administration, Topical↗

PubMedDate not supplied

Role of preoperative transcatheter arterial oily chemoembolization for resectable hepatocellular carcinoma.

To clarify the effect of preoperative transcatheter arterial oily chemoembolization (TAOE) for resectable hepatocellular carcinoma (HCC) on long-term survival after curative resection, we retrospectively evaluated 60 patients with and 68 patients without preoperative TAOE. Although there was no substantial difference in the clinical backgrounds between the two groups, the 5-year survival rate was lower for the patients with preoperative TAOE than for those without TAOE: 24% versus 63%, respectively (p < 0.05). A worse survival rate was particularly observed for the cirrhotic patients with TAOE than for those without TAOE: 35% and 72% at 4 years, respectively (p < 0.01). As the cause of death, liver failure and gastrointestinal bleeding were more frequent in the patients with TAOE (13.3% versus 1.5%;p < 0.05). Although the TAOE seemed to retard intrahepatic recurrence during the first 1.5 years after operation (1.7% versus 10.3%;p < 0.05), the overall cancer death rate was similar between the two groups (18.3% versus 11.8%). Therefore we suggest that preoperative TAOE must not be performed for resectable HCC as a routine procedure, particularly in patients with cirrhosis. A prospective randomized trial is warranted to elucidate the merits and demerits of preoperative TAOE for surgically resectable HCC.

Adult↗

PubMedDate not supplied

Growth kinetic study of human hepatocellular carcinoma using proliferating cell nuclear antigen and Lewis Y antigen: their correlation with transforming growth factor-alpha and beta 1.

The factors which control the balance between proliferation and cell death in hepatocellular carcinoma (HCC) remain unclear. The kinetic state of the tumor growth was investigated in the present study with references to transforming growth factor (TGF)-alpha and -beta 1 in 50 resected HCCs without preceding therapies. three-micrometer sections were cut from formalin-fixed, paraffin-embedded tumors. Proliferating cell nuclear antigen (PCNA), Lewis Y antigen (LeY). TGF-alpha, and -beta 1 were immunohistochemically stained and quantitatively assessed with an image analyzer. By means of immunohistochemical staining, a reciprocal correlation was observed between PCNA and LeY. A similar pattern was found between TGF-alpha and -beta 1, although not so strikingly as in the case of PCNA and LeY. The expression of LeY and PCNA labeling index (LI) ranged from 0 to 56.1% and from 0 to 52.8%, respectively. A correlation was observed between LeY and tumor size (r = 0.302, p < 0.04), while there was no significant relationship between PCNA LI and tumor size (r = -0.048, p > 0.05). The positive area ranged from 0 to 61.6% for TGF-alpha, and from 0.6 to 71.5% for TGF-beta 1. Analysis of these data showed a significant correlation between TGF-beta 1 and tumor size (r = -0.327, p < 0.03). Among HCCs < 5 cm, PCNA LI positively correlated with tumor size (r = 0.399, p < 0.04), but negatively with TGF-beta 1 (r = -0.431, p < 0.03). In conclusion, the present investigation indicates that the simultaneous analyses of proliferating and apoptotic activities by means of PCNA and LeY could yield more accurate data to determine the kinetic state of the tumor growth compared with either alone. In addition, TGF-beta 1 might act as a suppressive factor in the growth of HCC < 5 cm.

Adult↗

PubMedDate not supplied

Postoperative adjuvant chemotherapy after radical hepatic resection for hepatocellular carcinoma (HCC).

BACKGROUND/AIMS: This prospective randomized study was aimed to clarify the efficacy of epirubicin after radical hepatic resection for hepatcellular carcinoma (HCC). MATERIALS AND METHODS: One hundred and one patients entered the present study and were randomly allocated to Group A in which UFT (300 mg/day) was given from 5th postoperative week for one year, or Group B in which a bolus injection of epirubicin (40 mg/m2) was given arterially, in addition to the same UFT administration, on day 28. Groups A and B included 40 and 48 eligible cases, respectively. RESULTS: No obvious intergroup differences were observed including prescribed dose of UFT. The 1-, 3- and 5-year survival rates (Groups A vs B) were 82 vs 90%, 50 vs 49% and 35 vs 30% (p = 0.2162). Excluding 4 operative deaths, the recurrence-free survival rates were 65 vs 70%, 32 vs 37% and 14 vs 17% (p = 0.3843). Initial recurrence sites were also similar. CONCLUSIONS: A bolus arterial injection of epirubicin does not change the long term results after radical hepatic resection for HCC.

Aged↗

PubMedDate not supplied

Thoracoscopic limited resection of bronchogenic carcinoma in patients over the age of 80.

Video-assisted thoracoscopic surgery (VATS) has emerged as a minimally invasive therapy of bronchogenic carcinoma, when the diseases occur in patients unable to tolerate open thoracotomy who are 80 years old or older. We report on an 80-year-old man with poor pulmonary function and an 83-year-old man, who were treated with a complete VATS resection of bronchogenic carcinoma. Mean chest tube duration of the two patients was one day and mean postoperative hospital stay was 7 days with an uncomplicated postoperative course. Compared with patients with open thoracotomy, there were early mobility, less morbidity, and less mortality. We believe that when the indication for treatment of bronchogenic carcinoma in patients over the age of 80 with concomitant systemic disorders, a thoracoscopic limited resection should be considered.

Aged↗