Biomedical subjects

H Katoh

Publications and source records attributed to H Katoh.

529 records · Page 30Linked to original sources

PubMedDate not supplied

Surgical treatment of carcinoma of the esophagogastric junction.

Forty-seven patients with carcinomas of the esophagogastric junction were operated. In acquiring complete dissection of lymph nodes located at the splenic hilus and along the splenic artery, splenectomy with or without caudal hemipancreatectomy was performed in 29 of 47 patients. To avoid leaving carcinoma cells behind in the remaining esophagus margin of resection, 20 patients underwent left thoracophrenicolaparotomy and 14 patients received blunt dissection of the intrathoracic esophagus. Five-year survival of 55.6% was observed in curative groups of the present study. No operative mortality was present.

Adenocarcinoma↗

PubMedDate not supplied

Duodenum-preserving resection of the head of the pancreas--modified procedures and long-term results-.

BACKGROUND/AIMS: Relief of chronic pancreatitis can be accomplished surgically or with medication. Surgical treatment of pancreatitis should preserve the endocrine and exocrine function of the pancreas. This paper details the results of our modified procedure for resecting the head of the pancreas. The advantage of this procedure is small resection, preservation of endocrine and exocrine function, complete relief of pain by the pancreatic duct drainage and maintenance of function of the duodenum and bile duct. PATIENTS AND METHODS: Duodenum-preserving resection of the pancreatic head with denervation of the body and tail of the pancreas was performed in 41 patients with severe chronic pancreatitis. RESULTS: Mortality after a median follow-up period of 36 months was 2.4%. Complete relief or alleviation of pain were found in 92% of patients and any other patients of recurrent pain due to postoperative pancreatitis was not found. Eighty-seven percent of patients had maintained more than preoperative body weight. Postoperative glucose tolerance was unchanged in 88% of patients. After long-term follow-up postoperative exocrine function had been maintained at preoperative condition. CONCLUSIONS: Our procedure can maintain endocrine and exocrine function of the pancreas, relieve pain well and prevent pain due to recurrent pancreatitis.

Adult↗

PubMedDate not supplied

Differences in metabolic and morphological reactions after radiation therapy: proton NMR spectroscopy and imaging of patients with intracranial tumors.

PURPOSE: The purpose of the present study was to detect tumor cell viability, the diagnosis of which is the most important point in clinical therapy for malignant tumors. The advent of localized proton spectroscopy has made this detection possible. The spectral peak intensities were found to be very different depending on tumor tissue pathology. METHODS: The tumor cell reaction after radiation therapy was examined with proton localized spectroscopy in addition to enhanced MR imaging using a 1.5 Tesla MR system (Philips, Gyroscan S15-HP). Plain MR images (short spin echo) were used for localization pilot images, and after the MRS study, contrast enhanced MRI was carried out. Studies were performed pre-radiation, mid-radiation, and post-radiation if possible. MATERIALS: Sixteen patients (total 27 examinations) with intracranial tumors and three normal volunteers underwent proton NMR localized spectroscopy. The brain tumors were diagnosed before the MR study, and nine patients had metastatic brain tumors, such as adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, and seven other patients were diagnosed with glioma-type tumors. RESULTS: The reaction patterns of proton NMR spectroscopy of brain tumors after radiation therapy were very different and depended on tumor histology. CONCLUSION: Proton NMR spectroscopy is an excellent means of determining tumor cell viability.

Adult↗

PubMedDate not supplied

A giant hepatic hemangioma with secondary portal hypertension: a case report of successful surgical treatment.

A case of a giant cavernous hemangioma of the liver is presented. Selective angiograms revealed secondary portal hypertension, probably caused by a temporal obstruction of the extra-hepatic portal vein due to the physical pressure of the tumor, and a marked dislocation of the hepatic artery. The patient also had consumption coagulopathy. Both the portal obstruction and hematological disorders improved after excision of the tumor. Since surgery the patient has been in good health with no complaints or recurrence.

Angiography↗

PubMedDate not supplied

Predictive factors for long-term survival in patients with pancreatic carcinoma.

BACKGROUND/AIMS: Although numerous clinico-pathological parameters have been demonstrated to predict the prognosis in patients with pancreatic carcinoma after surgical resection, the factor most significant for their post-operative survival is still controversial. Herein, the authors have performed histopathological studies on patients with pancreatic adenocarcinoma and reviewed their clinical records to detect the most significant factor influencing their long term survival. METHODOLOGY: We reviewed clinical records and histological findings retrospectively. Then we performed univariate and multivariate analyses to find a correlation between the factors and the survival of the patients. RESULTS: The overall postoperative morbidity and mortality rates were 30.0% and 5.6%, respectively. The overall 5-year survival was 9.0%. Univariate analysis resulted in the detection of 14 factors which correlated with patient prognosis. Multivariate analysis resulted in the detection of histologic differentiation as an independent predictor for longterm survival. CONCLUSION: Histological differentiation is recommended as the most reliable predictor for the prognosis of patients with pancreatic carcinoma after surgical removal.

Adenocarcinoma↗

PubMedDate not supplied

Prospective randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C for non-resectable pancreatic and biliary carcinoma: multicenter randomized trial.

BACKGROUND/AIMS: The efficacy of combination chemotherapy, which consists of fluorouracil, doxorubicin and mitomycin, was compared with that of palliative surgery-only in patients (control) having non-resectable pancreatic and biliary carcinomas in a multicenter randomized trial. METHODOLOGY: The patients were assigned to combination chemotherapy consisting of concomitant 5-fluorouracil 200 mg/m2, doxorubicin 15 mg/m2, and mitomycin 5 mg/m2 by intravenous administration. This combination chemotherapy was given concurrently as the initial dose within 1 week after palliative operation, and this regimen was repeated for at least 2 whole courses at 4-week intervals before the next course of therapy. Forty-two cases of this combination chemotherapy group and 41 of the control group were completely eligible for analysis. RESULTS: Regarding the overall 50% inhibition of tumor progression and that of gallbladder carcinoma, there were significantly better outcomes in the modified FAM therapy group. In this group, tumor reduction was achieved in 1 complete response (CR) and 2 partial response (PR) patients. With respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy, there was no difference between the groups. The most frequent adverse reactions were gastrointestinal manifestations such as anorexia, nausea, vomiting, and diarrhea; also noted was alopecia. CONCLUSIONS: Since this combination chemotherapy inhibited the tumor progression for significantly longer duration and, to a lesser extent, reduced the tumor size in non-resectable gallbladder carcinomas compared to a non-administrated chemotherapy group, this study will function as the basis for pursuing a more effective chemotherapy.

Adult↗

PubMedDate not supplied

Pre-operative predictors of short-term survival after pancreatic cancer resection.

BACKGROUND/AIMS: The aim of the present study is to investigate the pre-operative factors that affect short-term survival after pancreatic cancer resection and to evaluate their prognostic value. METHODOLOGY: Fifty-nine patients with ductal adenocarcinoma of the pancreas operated on in the Second Department of Surgery, Hokkaido University Hospital between 1989 and 1996 were reviewed. RESULTS: The patients had a mean age of 62.6 years. The difference of survival between patients aged 62 years or younger and older patients was significant (p=0.0053). Primary tumor size was evaluated with enhanced CT examination; 36 patients had tumors larger than 3 cm in diameter. The 1-year survival rate of patients with tumors 3 cm or less in diameter was significantly better than that of patients with primary tumors greater than 3 cm in diameter (p=0.0258). Analysis of carcinoembryonic antigen (CEA) showed a significant difference in 1-year survival rates between patients with a pre-operative value below twice the diagnostic cutoff level (cutoff index; C.I.) and patients with a value above this level (p=0.0006). The 1-year survival rate for the subset of younger patients (= or < 62 years) with smaller tumors (3 cm or less) and a lower pre-operative serum CEA level (= or < two times of C.I.), was 72.7% (n=11). Multivariate analysis indicated that age and the pre-operative serum CEA level were both independent prognostic factors of 1-year survival (p=0.0077, and 0.003, respectively), although the statistical significance of tumor size was weak (p=0.107). CONCLUSIONS: It was suggested that age and serum CEA level were independent prognostic factors of short-term survival after pancreatic cancer resection.

Adenocarcinoma↗