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Biomedical subjects

H Kasugai

Publications and source records attributed to H Kasugai.

At least 55 records · Page 3Linked to original sources
PubMed1989

Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil.

The therapeutic effectiveness of transcatheter arterial embolization (TAE) with intraarterial infusion of cisplatin/ethiodized oil mixture in treatment of resectable and unresectable hepatocellular carcinoma was compared with TAE with intraarterial infusion of doxorubicin mixed with and without ethiodized oil. The series included 97 patients with unresectable hepatocellular carcinoma and 40 patients with resectable hepatocellular carcinoma. With TAE using doxorubicin infusion, a partial response of the tumor was seen in only 11%, and the 2-yr survival was calculated to be only 5%. Histologic examination of the specimens obtained by hepatectomy also showed that this treatment was relatively ineffective in daughter tumor and portal tumor thrombi. In contrast, TAE with infusion of cisplatin/ethiodized oil mixture significantly increased the rate of partial response (38%), and significantly prolonged the 2-yr survival (45%). Histologically this treatment gave severe necrosis in daughter tumors (69%) and tumor thrombi (78%) as well as main tumor (75%). This treatment was significantly better than TAE with doxorubicin and ethiodized oil infusion in terms of the tumor regression and histologic responses of main tumor and portal vein tumor thrombi, but not in terms of the 2-yr survival. However, 2 patients (8%) died within 4 wk of the latter treatment, whereas no deaths were reported after the former treatment. Therefore, TAE combined with intraarterial infusion of cisplatin/ethiodized oil mixture may be a safe and useful treatment modality for hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1989

Comparison of delayed imaging with Tc-99m PMT and Tc-99m DEIDA for visualization of hepatoma.

Delayed imaging was performed after the intravenous administration of Tc-99m DEIDA and Tc-99m PMT in 18 patients with hepatocellular carcinoma. Using Tc-99m DEIDA imaging, sharp uptake by liver tumors was observed in four patients (22%), but the uptake was similar to that of the surrounding normal liver in eight patients (44%). Using Tc-99m PMT imaging, the uptake by the tumor was notable in ten patients (56%) and normal in two (11%). Tc-99m PMT and Tc-99m DEIDA were both concentrated in hepatocellular carcinomas, but the former showed intense uptakes more frequently, and thus is suggested to be useful in the diagnosis of hepatocellular carcinoma.

Aged↗
PubMed1989

[A case report of ruptured thymic carcinoid].

A scarce case of a rupture of thymic carcinoid followed by hemothorax and mediastinal enlargement was reported. And the mechanism of rupture of thymic carcinoid was discussed comparing to 38 thymic carcinoid cases reported in Japan. A 61-year-old male who had been pointed out mediastinal tumor by chance in a chest X-ray developed a sudden onset of chest pain and dyspnea during an aortography in a hospital transferred to our center because the rupture of the tumor was suspected. Emergency median sternotomy revealed a rupture of a solid tumor with a lot of clot which originally located in the anterior mediastinum but perforated into the right pleural space. This may be the first report of the ruptured thymic carcinoid, so far as we know in Japan. Reviewing the reported cases, the tumor of carcinoid is generally large in size and poorly differentiated in histological study. In more than half of the cases, it is reported that intraparenchymal necrosis or hemorrhage is found. Therefore, it is considered that a thymic carcinoid is a tumor which may result in the rupture, and it should be emphasized that the rupture of the thymic carcinoid which require an emergency treatment is one of the severe complications of the tumor.

Carcinoid Tumor↗
PubMed1988

Comparison of delayed hepatobiliary imaging using 99mTc-Sn-N-pyridoxyl-5-methyltryptophan and 67Ga-citrate imaging for diagnosis of hepatocellular carcinoma.

Images were obtained both with a biliary agent, 99mTc-Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT), and with 67Ga-citrate in 40 cases of hepatocellular carcinoma and in 43 cases of other hepatic diseases and results were compared. Positive results were obtained by delayed 99mTc-PMT imaging in 25 (63%) of 40 cases of hepatoma: the hepatic tumor showed increased uptake in 18 cases (45%) and equilibrated uptake in 7 cases (18%). Positive 67Ga-citrate imaging was found in 28 (70%) of the 40 cases of hepatoma: increased uptake was seen in 24 cases (60%) and equilibrated uptake in 4 cases (10%). Of 15 cases of hepatoma giving negative results in the 99mTc-PMT study, 7 cases (47%) took up 67Ga-citrate, and 6 of these showed increased 67Ga-citrate uptake by the hepatic tumors. A certain relation existed between the degree of histological differentiation of hepatomas and the intensity of 99mTc-PMT uptake by those tumors, while such a histological correlation was denied for 67Ga-citrate uptake by the tumors. Delayed 99mTc-PMT imaging is preferable to 67Ga-citrate imaging for increasing the specificity of diagnosis of hepatoma. 67Ga-citrate should be used in those cases that do not give positive results with 99mTc-PMT.

Carcinoma, Hepatocellular↗
PubMed1987

A new approach to chemoembolization therapy for hepatoma using ethiodized oil, cisplatin, and gelatin sponge.

This article reports on a new approach to hepatic arterial chemoembolization therapy using ethiodized oil (Lipiodol, Ultra Fluide), cisplatin, and gelatin sponge (Gelfoam, Upjohn, Kalamazoo, MI) for hepatocellular carcinoma (HCC). The anticancer effects of this therapy on 20 patients who underwent subsequent hepatic resection were evaluated mainly by histologic examination. All main tumors were reduced in size following this therapy. It is notable that in 65% of the patients the tumor size was reduced to less than 50% of that before therapy. All the values of serum alpha-fetoprotein (AFP) in the patients who exhibited pretreatment levels exceeding 100 ng/ml dropped by more than 50%, and in 55% of them it fell below 20 ng/ml. The concentration of platinum in the tumor tissue was significantly higher than that in the nontumorous tissue. In 15 of 20 patients (75%), the main nodules were completely necrotic. Thirteen of the patients had daughter nodules and/or small intrahepatic metastases (Group A); nine had tumor emboli in the portal (hepatic) vein (Group B); 17 had intracapsular invasions (Group C); and ten had extracapsular invasions (Group D). The ratios of patients with completely necrotic cancer cells in Group A were nine of 13 (69%); in Group B, seven of nine (78%), in Group C, 11/17 (65%); and in Group D, four of 10 (40%). In eight of the 20 patients (40%) no viable cancer cells were recognized at any foci. Lesions other than those with extracapsular invasion could be considerably eliminated with this form of therapy. It is expected that this method will become the therapy of choice not only for palliative treatment but also for preoperative treatment.

Adult↗
PubMed1987

Glycylproline dipeptidyl aminopeptidase and gamma-glutamyl transpeptidase in human hepatic cancer and embryonal tissues.

Changes of glycylproline dipeptidyl aminopeptidase (GPDA) and gamma-glutamyl transpeptidase (gamma-GTP) activities and their subcellular distributions were compared in human hepatic cancer and embryonal tissues. The activity of GPDA in cancer tissues was significantly higher than that found in healthy liver, though there were no significant differences between fetal and adult livers. The placenta, however, had the highest GPDA activity. The activity of gamma-GTP, on the other hand, was increased significantly not only in cancer tissues but also in live tissues adjacent to the tumor, and it was higher in the fetal liver but much lower in the placenta. Subcellular distribution of GPDA was also different from that of gamma-GTP in cancer tissues, especially after postmortem changes. These results suggest the possibility that GPDA has carcinoembryonic characters similar to gamma-GTP, but the mechanisms, whereby serum activities of these two enzymes were increased in hepatocellular carcinoma patients, are different from each other.

Adult↗
PubMed1987

Regional therapy in the management of intrahepatic recurrence after surgery for hepatoma.

The significance of regional therapy against the intrahepatic recurrence for hepatocellular carcinoma (HCC) was evaluated. During the past 6 years, 101 patients who had radical operations for HCC (liver cirrhosis, 75%; chronic hepatitis, 22%) were followed. Forty-seven patients (47%) had recurrences; the liver was the site of first recurrence in 43 patients and distant site recurrence in four patients. In the patients where the liver was the recurrent site, 33 patients (77%) received regional therapies for an aggregate total of 60 times. Transcatheter arterial chemoembolization was chosen as the first preferred therapy against recurrence in the liver in 30 of 33 patients (91%). Postrecurrence survival of the patients treated with regional therapy was significantly better than disease-free survival (p less than 0.001). Disease-free survival after surgery, postrecurrence survival, and postsurgery survival were compared in the patients treated with regional therapy and untreated patients. Fifty per cent survival after recurrence of the treated patients was 27 months, and that of the untreated patients was 3 months. Postrecurrence survival (p less than 0.001) and postsurgery survival (p less than 0.01) of the treated patients were significantly better than those of the untreated patients. To obtain successful long-term survival after surgery for the cirrhotic patients with HCC, it is necessary to repeat active regional therapies against the recurrent liver.

Adult↗
PubMed1986

Cell features and patterns in fine-needle aspirates of hepatocellular carcinoma.

The values of the cytologic features of individual cells and cellular patterns in aspirated materials in the diagnosis of 49 hepatocellular carcinomas (HCC) were investigated. Excellent cytologic specimens were obtained by percutaneous aspiration biopsy with a heparinized fine 22-gauge needle. In the well-differentiated type of HCC, a correct diagnosis of malignancy was difficult from the cytologic features of individual cells because of their resemblance to normal hepatocytes. In contrast, in moderately differentiated and poorly differentiated types of HCC, a correct diagnosis of malignancy was easily made from the features of individual cells, but there was little or no cytologic evidence of the hepatic origin of the cells. Comparison of histologic and cytologic findings in aspirated materials obtained from the same patients showed that the cellular patterns seen in cytologic specimens faithfully reflected the histologic structures of HCC. Various characteristic cellular patterns were recognized only in specimens obtained from patients with HCC, but not in those from patients with benign liver diseases. These cellular patterns were very useful not only for diagnosis of malignancy, but also for identification of the hepatic origin of cells. A combination of the features of individual cells and of characteristic cellular patterns raised the diagnostic rates for well-, moderately, and poorly differentiated types of HCC to 90.5%, 100%, and 100%, respectively.

Adult↗
PubMed1986

Specific diagnosis of hepatocellular carcinoma by delayed hepatobiliary imaging.

For assessment of the value of delayed hepatobiliary imaging with technetium 99m (99mTc)-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) for specific diagnosis of hepatocellular carcinoma, 88 patients with various malignant and benign liver diseases (49 with hepatocellular carcinoma, 4 with cholangiocellular carcinoma, 10 with metastatic liver carcinoma, 2 with liver cysts, 2 with liver hemangioma, 1 with liver abscess, 2 with intrahepatic lithiasis, 12 with liver cirrhosis, and 6 with chronic hepatitis) were studied. In 20 (41%) of the 49 patients with hepatocellular carcinoma, greater uptake of 99mTc-PMT by the tumor than by the surrounding liver tissue was seen in delayed hepatobiliary images, whereas in eight patients (16%), equilibrated uptake was seen. No increased uptake of the radioisotope by hepatic lesions was seen in 21 patients with localized liver diseases other than hepatoma. Moreover, in 18 patients with diffuse liver diseases, no focal accumulation of the radioisotope was seen in delayed 99mTc-PMT images. In addition, of 28 patients with hepatocellular carcinoma in whom the serum alpha-fetoprotein level showed little or no increase, 12 showed increased uptake of 99mTc-PMT by the tumor. In assessing delayed 99mTc-PMT images, however, it was necessary to consider following complications: accumulation of tracer in obstructed and dilated biliary trees; retention of radioactivity in nonneoplastic liver tissues; difficulties in evaluating 99mTc-PMT uptake by small hepatic tumors; overlapping of radioactivity in the gut and gallbladder in delayed 99mTc-PMT images of tumors. This study indicates that delayed 99mTc-PMT images can be useful in the diagnosis of hepatocellular carcinoma.

Aged↗
PubMed1986

Early diagnosis of hepatocellular carcinoma: usefulness of ultrasonically guided fine-needle aspiration biopsy.

The results of various diagnostic procedures performed on six cases with solitary and minimal (less than 2 cm) hepatocellular carcinoma (HCC) that was later surgically resected were comparatively reviewed. The tumor was detected in 6/6 patients by ultrasonography, 1/6 by scintigraphy, 2/6 by CT, and 4/6 by angiography, and hepatocellular carcinoma was diagnosed in 3/6 by angiography and 6/6 by ultrasonically guided fine-needle aspiration biopsy. Since there are not a few HCCs that can be detected only by ultrasonography, fine-needle aspiration biopsy with ultrasound guidance is strongly recommended to confirm cases with a minimal lesion in the liver visualized only on a sonogram.

Aged↗
PubMed1986

Value of serum alpha-fetoprotein and ferritin in the diagnosis of hepatocellular carcinoma.

Alpha-fetoprotein (AFP) and ferritin in the serum were determined by radioimmunoassay and enzyme immunoassay, respectively, in 224 healthy subjects, 55 patients with benign hepatic disease and 44 patients with hepatocellular carcinoma (HCC). The AFP levels in the serum were significantly higher in patients with HCC than in healthy subjects and in patients with benign hepatic disease, but this level was not a satisfactory indicator of small HCC since it was elevated in only 75.0% of the patients with a tumor of less than 3.0 cm in its greatest diameter. Although serum ferritin was elevated in only 56.8% of the patients with HCC, the combination of these two tests raised the diagnostic rate of HCC from 65.9% by serum AFP measurement alone to 88.6% with no appreciable decrease in the specificity for HCC. In particular, it raised the diagnostic rates of lesions of less than 3.0 cm in the greatest diameter from 75.0% by measuring AFP alone to 100%. Thus the combination of AFP and ferritin measurement in the serum is useful for the early detection of HCC.

Adult↗
PubMed1985

Concentration of 99mTc-Sn-N-pyridoxyl-5-methyltryptophan, a biliary agent, in distant metastases of hepatomas.

During the last 2 years, eight patients with hepatocellular carcinoma who were suspected of having distant metastases have been studied to determine whether a new biliary agent, 99mTc-Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT), is taken up by extrahepatic tumors. In all eight patients, scintigrams showed a clearly increased uptake of 99mTc-PMT radioactivity by the extrahepatic tumors. In contrast, an increased uptake by the tumors of gallium citrate Ga 67 was only detected in four of the seven patients examined. The results obtained in this study suggest that 99mTc-PMT is useful both for characterizing the nature of extrahepatic tumors in patients with hepatoma and for detecting the metastases.

Adult↗
PubMed1985

Histocytologic diagnosis of pancreatic cancer by percutaneous aspiration biopsy under ultrasonic guidance.

Percutaneous aspiration biopsy of the pancreas using a heparinized 22-gauge fine needle was performed under ultrasonic guidance in five patients with benign pancreatic diseases and in 18 patients with pancreatic cancer. Using a heparinized needle and syringe, it was possible to make good smears containing abundant tumor cells and to obtain small tissue specimens. Using egg albumin as binding material, a new cell-block technic was developed to conveniently obtain histologic specimens. In this way, a correct diagnosis was made cytologically in all 23 patients suspected of having a pancreatic malignancy. Histologic specimens were obtained in 22 (95.6%) our of 23 patients. A correct diagnosis was established histologically in all patients from whom histologic materials were obtained. This procedure thus has proved a very reliable method for diagnosing pancreatic cancer.

Adenocarcinoma↗
PubMed1985

Value of heparinized fine-needle aspiration biopsy in liver malignancy.

The accuracy of diagnosis of hepatic malignancy by percutaneous aspiration biopsy was compared using heparinized and nonheparinized 22-gauge needles. When a heparinized instrument was used, it was able to accurately diagnose malignancy and cytologic types of exfoliative cells. Heparinization also made it possible to recover small tissue fragments and make ultrathin sections for histologic examination. In this way, material suitable for cytologic and histologic examination was obtained from 100% and 95%, respectively, of 59 patients suspected of having hepatic malignancy. A correct diagnosis was made cytologically in 92.5% of patients with hepatic malignancy and in 89.5% of those from whom histologic material was obtained. From a combination of histologic and cytologic results, the overall diagnostic rate for hepatic malignancy was increased to 95%. This procedure proved to be a reliable method for diagnosis of hepatic malignancy.

Biopsy, Needle↗
PubMed1984

Cytohistologic diagnosis of neoplasms of the liver by ultrasonically guided fine-needle aspiration biopsy.

A procedure was developed for obtaining both cytologic and histologic specimens from patients suspected of having hepatic malignancy at the time of ultrasonically guided liver aspiration biopsy using a 22-gauge needle of 0.4 mm inner diameter. The fine needle and the syringe used were heparinized before use to avoid blood coagulation in the materials obtained. With heparinized needle and syringe it was possible to centrifuge the materials obtained and make good smears containing abundant tumor cells, and to obtain small tissue specimens. Histologic specimens obtained with the heparinized needle were fixed in 2.5% glutaraldehyde, postfixed in 1.0% osmium tetroxide, and embedded in epoxy Epon resin. Ultrathin sections were made and usually stained with Azan-Mallory stain. In 41 patients suspected of having hepatic malignancy, a correct diagnosis was made by a combination of these examinations. The sensitivity of this procedure for hepatic malignancy was 100%, and the specificity was 95.7%. Therefore, this procedure is a very reliable method for diagnosis of hepatic malignancy.

Aged↗
PubMed1984

The importance of delayed imaging in the study of hepatoma with a new hepatobiliary agent.

Concentration of Tc-99m(Sn)-N-pyridoxyl-5-methyltryptophan (Tc-99m PMT), a biliary agent, in hepatic tumors was studied with delayed hepatobiliary imaging in 23 patients with histologically verified hepatocellular carcinomas. All 23 showed filling defects on liver images obtained with Tc-99m tin colloid. In the images taken 5 hr after Tc-99m PMT injection, ten cases showed increased uptake in the carcinoma, six nearly normal uptake, and seven decreased uptake. In those showing the increased uptake of Tc-99m PMT in the tumor, the ratio of the radioactivity in the lesion to that in the adjacent liver parenchyma (T/L ratio) increased progressively with time for 5 hr after injection. These results indicate that delayed Tc-99m PMT images, obtained 5 hr after injection, are useful in assessment of uptake of the radioactivity by hepatocellular carcinoma.

Biliary Tract↗