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Biomedical subjects

E Okamoto

Publications and source records attributed to E Okamoto.

At least 199 records · Page 11Linked to original sources
PubMed1989

The simultaneous use of autologous blood transfusion and hypotensive anesthesia to the radical hysterectomy for uterine carcinomas.

A homologous blood transfusion is often required to replace intraoperative blood loss in a radical hysterectomy. Recently, we have tried the simultaneous use of autotransfusion (predonation and transfusion of autologous blood) and hypotensive anesthesia to eliminate the homologous blood transfusion. Radical hysterectomy was done in 27 cases with uterine cancer from June 1986 to March 1987 at the Kure National Hospital. A homologous blood transfusion was required in 1 of 5 cases with only autotransfusion, none of 5 cases with a simultaneous use of autotransfusion and hypotensive anesthesia, and 6 of 17 cases with neither autotransfusion nor hypotensive anesthesia. The simultaneous use of autotransfusion and hypotensive anesthesia seemed to be effective in reducing the need for homologous blood transfusions.

Adult↗
PubMed1989

[Diurnal changes in colonic motility in conscious dogs].

Daily profile of colonic motor activity was observed in 10 conscious dogs by means of extraluminal force transducers. Each dog was implanted with a set of seven strain, gauges, one on the terminal ileum and the remaining six on the colon equidistantly. The colonic motor activity was basically composed of migrating and non-migrating motor complexes at all six recording sites. Each motor complex was characterized by a tonic contraction superimposed by rhythmic bursts of phasic contractions. During fasted period these motor complexes recurred at a mean interval of 36 min, and a mean duration was 7 to 12 min. Those motor complexes which migrated over at least three recording sites were defined as "migrating", 72% of those observed at the most proximal sites (n = 2680) were migrating, and the remaining 28% were non-migrating. Of those migrating motor complexes 90.4% migrated caudad (iso-peristalsis), while only 9.4% migrated orad (antiperistalsis). During postprandial period the colonic motor complexes at all recording sites uniformly increased their frequency with shorter intervals. Different from the small intestine, the contractile patterns were essentially the same as those of fasted period. The postprandial acceleration of the colonic motor complexes seems to be compatible with gastrocolic response.

Animals↗
PubMed1989

[Surgical treatment of hepatocellular carcinoma].

The surgical treatment for hepatocellular carcinoma must be chosen by considering some factors such as liver function, position and involved area of the tumor. This article reports our guide line for surgical treatment based on liver function and long term survival. In severe cirrhotic patient with ICG retention rate ranging 30 to 40%, hepatectomy can be indicated only when they mach several conditions as follows; KICG from 0.06 to 0.08, superficially located tumor removal by resection of small area with curability. In patients with ICG retention rate lower then 30%, resection range is determined by the multiple regression equation indicating safety limit of hepatectomy. The predictability of the equation has been as high as 93%, the long term survival depends on following factor, i.e.; tumor size, VP factor, and IM factor. Hepatectomy should be first option when the tumor is less than 5 cm in size, VPO, IMO, and can be safely removable with segmentectomy or larger resection.

Aged↗
PubMed1989

[Improving early and late results of hepatectomy for HCC].

The present study reports how we indicate safe and beneficial hepatectomy for hepatocellular carcinomas from the experiences of the consecutive 335 patients treated during 1973 and Dec. 1988. The first question was to appreciate the preoperative prediction of a safe limit of hepatectomy. We established a multiple regression formula consisting of several factors such as CT estimated resection rate, ICG retention rate and patient's age at the end of 1980. Since the beginning of 1981, we have been employing the formula as a major indicator guiding treatment option, leading to a significant drop of postoperative, liver failure. The influencing prognostic factors have been determined to be vascular invasion, intrahepatic metastasis, extent of resection regulated by hepatic reserve and tumor size in the decreasing order. From the viewpoint of the biological aspect, the tumors with DNA diploid pattern showed significantly better prognosis than those with non-diploid ones. The current surgical techniques of hepatectomies with en-bloc ligation of Glisson's vessels or with vascular exclusion supported by veno-venous bypass have greatly encouraged the recent surgical results achieving 56% of 4-year survival rate (1985-1988).

Carcinoma, Hepatocellular↗
PubMed1989

[Nuclear DNA analysis of hepatocellular carcinoma].

Retrospective DNA ploidy studies of paraffin-embedded blocks were performed by flow cytometry on 212 surgically resected hepatocellular carcinoma. One hundred and sixty-four of 212 specimens yielded evaluable DNA histograms. Eighty-three cases showed a DNA diploid pattern and 81 a DNA non-diploid pattern. The incidence of non-diploid pattern increased with the tumor size. (2cm; 15.4%, 2-5; 42.3%, 5-10; 70.8% greater than 10; 73.3%). The DNA pattern correlated with the backgrounds, the degree of vascular invasion, intrahepatic metastasis and serum AFP levels. Survival of patients with non-diploid pattern was significantly less than those with diploid patients in any different stage. Of thirty who survived three years with disease free condition, 20 patients showed diploid patterns. Though remaining 10 patients were non-diploid patterns, 9 were high DNA index more than 1.5. It is concluded that flow cytometric DNA ploidy study had prognostic value for patients with surgically resected hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1989

[Characteristic ultrasonographic findings of the Krukenberg tumor].

Researching into the possibility of ultrasonographic differential diagnosis between the Krukenberg tumor and primary ovarian cancer, we investigated ultrasonograms of 14 Krukenberg tumors, 14 primary ovarian cancers and 5 rare ovarian tumors. Specifically we examined in each the echo pattern of the tumor wall, solid part and cystic part. The results were as follows. 1) Thirteen of the 14 cases of Krukenberg tumor demonstrated a clear tumor margin, irregular hyperechoic solid pattern and moth-eaten cyst formation. These characteristic ultrasonographic features might reflect the specific pathological findings of the Krukenberg tumor. In only one case was there a clear tumor margin, large central cyst formation and diffuse thick solid part around the cysts. 2) The primary ovarian cancers had an indistinct tumor margin, irregular low echoic solid pattern, clear small cyst formation, papillary proliferation and irregular thickness of the septum. Taking the ultrasonographic characteristic findings of the Krukenberg tumors into consideration, eleven of 14 primary ovarian cancers (78.6%) could be distinguished ultrasonographically from the Krukenberg tumor. 3) In rare cases, only a carcinosarcoma was unable to be distinguished ultrasonographically from the Krukenberg tumor. that make it possible to distinguished it ultrasonographically from primary ovarian cancer.

Adult↗
PubMed1989

[A case of reexpansion pulmonary edema during fenestration of a giant hepatic cyst].

We experienced a case of reexpansion pulmonary edema during the fenestration of giant hepatic cyst. The patient was a 56 year-old female who had been suffering from dyspnea due to a large abdominal mass for 3 months. The preoperative chest X-ray revealed remarkable elevation of diaphragm (right third and left fifth intercostal spaces). The result of blood gas analysis showed hypoxemia and respiratory compensation for metabolic acidosis. By the drainage of 12L of the cyst fluid for 30 minutes during operation, bloody and foamy bronchial secretion spurted out. Vigorous respiratory management using PEEP was promptly started and continued postoperatively in ICU. The endotrachial tube was withdrawn on the 2nd postoperative day. The ratio of protein in airway secretion in to plasma protein was 0.78, and it appeared that the pulmonary edema was mainly caused by increased permeability of pulmonary capillary vessels.

Cysts↗
PubMed1989

[Late complications after successful Kasai's operation for biliary atresia].

The late complications in 25 patients more than 3 years after successful Kasai's operation for biliary atresia were presented. Nine (36%) of these 25 patients had episodes of variceal hemorrhage with portal hypertension, and biliary reobstruction in 3 (12%), bleeding from duodenal ulcer in 2, bleeding from gastric erosion in one, and diffuse pulmonary arterio-venous shunt in one were observed. Recently esophageal varices have been well controlled by endoscopic sclerotherapy, and the surgical treatment may be indicated in older children complicated with severe hypersplenism and marked splenomegaly, which are resistant for sclerotherapy. As a surgical procedure, splenectomy with periesophago-gastric devascularization (Hassab's operation) seems to be very useful for portal hypertension by biliary cirrhosis. The reoperation, hepaticoenterostomy, was performed in 3 patients with biliary reobstruction. All three patients are alive and well, and two of them are at 19 years (university student) and 24 years (married life) of age. Hepatic Rehepaticoenterostomy is well indicated rather than liver transplantation, if biliary reobstruction is incurable with conservative therapy. Many of the patients with complications were able to carry on an almost normal life, if suitable treatments for complications were taken.

Adolescent↗
PubMed1989

[A comparative study of the treatment of vulvar carcinomas].

The results of treatment in our department of 24 patients with various vulvar carcinomas between 1969 and 1987 are described. There were 8 patients in stage I, 3 patients in stage II, 10 patients in stage III, 2 patients in stage IV and one patient in recurrence. Eighteen patients could be followed for more than 5 years. Particular attention was given to stage and treatments. The 5-year survival rate was 87% for stage I patients, 28% for stage III patients, 0% for stage IV patient and 0% for a recurrent patient. The 5-year survival rate was 80% (4/5) for operation group, 60% (3/5) for radiation group and 20% (1/5) for radiation and chemotherapy group.

Adenocarcinoma↗
PubMed1988

[Cooperative study of postoperative long-term adjuvant therapy of breast cancer. First study of a series--comparative study between postoperative tegafur administration and no adjuvant chemotherapy].

A prospective randomized study was performed in 22 institutions from July 1978, to evaluate the efficiency of long-term adjuvant chemotherapy with tegafur alone for primary breast cancer. Five hundred and eighty-seven eligible patients, classified into T1a, T2a, T3a, N0, N1a, N1b, and M0 were divided into two groups: Group A, radical mastectomy receiving no adjuvant chemotherapy; and Group B, radical mastectomy followed by 4 courses of adjuvant chemotherapy, each one consisting of daily administration of tegafur 600 mg p.o. for 8 weeks and 4 weeks rest. At the 66th month of median follow up time, there were no differences between the two groups on 5 year cumulative survival and disease free survival rate. In subgroup patients who have histologically 1-3 axillary involvements, there seemed to be a more meaningful prolongation of the disease-free interval in group B than in group A (logrank test; p = 0.11 generalized Wilcoxon test; p = 0.13).

Adenocarcinoma, Scirrhous↗
PubMed1988

[Metastatic renal tumor originating from esophageal carcinoma: a case report].

A 46-year-old woman with a past history of esophageal carcinoma was hospitalized with the chief complaint of right abdominal pain. Enhanced computed tomography (CT) and selective renal angiography suggested a metastatic renal tumor. Right nephrectomy was performed. Histological examination revealed a renal tumor originated from esophageal squamous cell carcinoma. Metastatic renal tumors are frequently observed at autopsy, but clinically they are extremely uncommon. Thirty-four clinical cases of metastatic renal tumors reported in the Japanese literature during these 20 years are discussed including the present case.

Esophageal Neoplasms↗
PubMed1988

[The application of autologous blood transfusion and hypotensive anesthesia for radical hysterectomy in uterine cancer].

The homologous blood transfusion is often required for the replacement of intraoperative blood loss in the radical hysterectomy. Recently, we have tried elective autologous blood transfusion and hypotensive anesthesia to eliminate the complications caused by homologous blood transfusion. This study reports our experience at Kure National Hospital. Radical hysterectomy has been done in 27 cases with uterine cancer from June, 1985 to March, 1987. Homologous blood transfusion was required to one of 5 cases with autologous blood transfusion, none of 5 cases with autologous blood transfusion and hypotensive anesthesia, and 6 of 17 cases without either procedures. Autologous transfusion and hypotensive anesthesia seemed to be effective in reducing homologous blood transfusion.

Adult↗
PubMed1988

[Hepato-portal-splenic dynamics after hepatectomies].

The present study was performed to clarify the regeneration and splenic changes following hepatectomy. The processes were compared between the three classes (L greater than 50%, 30 less than M less than 50%, S less than 30%) categorized by the resection rate (%) calculated by CT scan in the 26 cirrhotics (LC) and 22 non-cirrhotics (N). Hepato-splenic volumes were serially measured by CT scan. The regenerative speed (cm3/day) of the remaining liver were significantly higher in the N group than LC and in the larger resection class. Liver functions tended to return to the initial levels behind the time of restoration of the liver volumes. The delay was partially caused by the posttransfusion hepatitis (PTH), which developed more frequently with an increase of fresh frozen plasma transfusion given. The changing pattern of splenic size was strongly regulated by the massiveness of hepatectomy. Newly developed posthepatectomy esophageal variceal ruptures were endoscopically determined in the 10% of the 129 late deaths after hepatectomies for hepatomas (1973-1987) with or without recurrences and its occurrence was found to be enhanced in the massive resection in the LC group ended with the poor regeneration of the liver and persistent postoperative splenic enlargement.

Esophageal and Gastric Varices↗