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Biomedical subjects

H Miyake

Publications and source records attributed to H Miyake.

At least 721 records · Page 40Linked to original sources
PubMedDate not supplied

A case of carcinoma associated with the remained intrapancreatic biliary tract 17 years after the primary excision of a choledochal cyst.

Although the incidence of biliary carcinoma associated with choledochal cyst is high, there are extremely rare reports about cancer development in the remaining intrapancreatic biliary tract in patients who underwent primary excision of the choledochal cyst. The authors present a case of carcinoma associated with the remnant intrapancreatic biliary tract in a 39 year-old woman, 17 years after the initial excision of a choledochal cyst with Roux-en-Y hepaticojejunostomy. Long-term follow-up may be recommended even in patients who have undergone excisional surgery for choledochal cyst, because it is possible that cancer associated with the intrapancreatic biliary tract may develop.

Adenocarcinoma↗
PubMedDate not supplied

Leiomyoma of the parapharyngeal space.

A rare case of leiomyoma of the prestyloid parapharyngeal space is reported together with computed tomographic and magnetic resonance imaging findings. The tumor appeared as a well-circumscribed ovoid mass with some calcifications and lobulations. Because the attenuation, signal intensity, and shape of the mass were not specific and were similar to those of a pleomorhic adenoma, the most common tumor of the prestyloid parapharyngeal space, radiological differentiation of leiomyoma from pleomorphic adenoma of the prestyloid parapharyngeal space was difficult.

Adult↗
PubMedDate not supplied

Influence of the extent of hepatectomy on the portal hypertensive state in patients with hepatoma.

BACKGROUND/AIMS: Portal hypertensive symptoms, such as esophageal varices and hypersplenism, are frequently observed in patients with hepatocellular carcinoma (HCC). We investigated whether or not the extent of hepatectomy for HCC has an influence on the deterioration of the portal hypertensive state. METHODOLOGY: Fifty-four patients who underwent curative hepatectomy for HCC at our institute were retrospectively studied. The 54 patients were classified in two groups according to the extent of hepatectomy: Group A patients (n = 38) underwent minor hepatectomy (subsegmentectomy or less) and Group B patients (n = 16) underwent major hepatectomy (segmentectomy or more). On the basis of the endoscopic findings for the esophageal varices and the blood platelet counts, the alterations of portal hypertensive state were evaluated before and after hepatectomy. RESULTS: The number of patients whose esophageal varices deteriorated post-operatively, amounted to 9 (23.7%) in Group A and 1 (6.3%) in Group B (not significant). No significant differences were found in the platelet counts between pre- and post-operative states in each Group (A and B). In all of the 6 patients whose esophageal varices first came about after hepatectomy, the advent of the varices occurred more than 1 year after surgery. CONCLUSIONS: These results suggest that in the patients undergoing hepatectomy for HCC, the clinical deterioration of the portal hypertensive state in not caused by the extent of hepatectomy, but by the advance of the coexisting chronic hepatic diseases or tumor recurrence.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Experimental and clinical studies on liver regeneration following transcatheter portal embolization.

BACKGROUND/AIMS: We studied compensatory hypertrophy following transcatheter portal embolization experimentally in dogs and clinically under the condition of cholestasis. METHODOLOGY: Experimental study: Sixteen dogs were used for this study. Transcatheter portal embolization was performed in the left lobes (70% of the total liver) using Gelfoam powder in dogs with 2-week obstructive jaundice. Liver weight, liver blood flow and the intracellular adenosine triphosphate content of isolated hepatocytes were measured after transcatheter portal embolization. Clinical Study: transcatheter portal embolization of the right portal branch was performed in 13 patients with cancer of the biliary tract and 3 patients with hepatocellular carcinoma before (extended) right lobectomy, using Gelfoam powder and thrombin. Six patients who had a total bilirubin level > 5 mg/dLunderwent a percutaneous transhepatic biliary drainage before transcatheter portal embolization. Liver function tests, a volumetric study with computed tomography and immunohistochemical staining for profilerating cell nuclear antigen and apoptosis in the resected livers were performed. RESULTS: Experimental study: The weight ratio of the non-embolized lobes to the total liver, 2 weeks after transcatheter portal embolization in the dogs with jaundice, was significantly lower than that of the normal dogs with transcatheter portal embolization (40.5 +/- 4.5% vs. 47.6 +/- 3.2%), but significantly larger than that of the dogs without transcatheter portal embolization. The cellular adenosine triphosphate content and tissue blood flow in the embolized lobes were significantly lower than those in the nonembolized lobes in the normal and cholestatic livers. Clinical study: The postoperative course in all patients was uneventful, with no serious complication or liver dysfunction. Extended right lobectomy with caudate lobectomy was equivalent to 65% before transcatheter portal embolization and to 56% after, transcatheter portal embolization owing to compensatory hypertrophy of the left lobe. However, there was no significant difference in liver volume in the patients with or without obstructive jaundice. Apoptosis was observed in the embolized lobe. CONCLUSIONS: Preoperative transcatheter portal embolization with percutaneous transhepatic biliary drainage for the purpose of liver regeneration would be useful for treating extended hepatectomy with obstructive jaundice.

Animals↗
PubMedDate not supplied

Fertility and uterine size among Asian women undergoing hysterectomy for leiomyomas.

OBJECTIVE: To ascertain whether an epidemiological relationship exists between fertility and uterine leiomyomas, and whether uterine size is associated with fertility among Asian women undergoing hysterectomy for leiomyomas. METHODS: The study was conducted in Sapporo, Japan. 91 women undergoing hysterectomy for myomas were compared with age-matched controls with respect to reproductive factors. Further comparisons were made of these factors in women with large myomas and those with small ones. RESULTS: Women with leiomyomas were more likely to be nulliparous than controls (P < .01), and the risk of leiomyoma increased as the number of births decreased (P < .01). Time since last birth was associated with increased risk in women with large myomas (P < .05). Women with fewer births undergoing hysterectomy for leiomyomas tended to have greater uterine weight. CONCLUSION: Fewer births may be a cause of larger leiomyomas.

Adult↗
PubMedDate not supplied

Differential diagnosis of small hepatocellular carcinoma and borderline lesions and therapeutic strategy.

BACKGROUND/AIMS: To investigate imaging characteristics and surgical results of adenomatous hyperplasia and early-stage hepatocellular carcinoma. METHODOLOGY: A retrospective study set in the First Department of Surgery, University of Tokushima, Japan. From 1994 to 1997, 33 patients with 55 small hepatocellular carcinomas (< or = 3 cm) and 10 borderline lesions (3 adenomatous hyperplasia, 5 atypical adenomatous hyperplasia, 2 atypical adenomatous hyperplasia with focal malignancy) were enrolled for this study. The detectability of these lesions on imaging was evaluated. Cumulative survival and disease-free survival rates were also calculated. RESULTS: Twenty-eight patients were incidentally diagnosed on ultrasonography during follow-up study for chronic disease. In the conventional studies, detection rates of ultrasonography, computed tomography and angiography for small hepatocellular carcinomas and borderline lesions were 76% 80%, 33% 10% and 36% 20%, respectively. Magnetic resonance imaging, intraoperative ultrasonography, helical computed tomography and portal angiographic computed tomography showed better results of 67% 20%, 100% 90%, 70% 50% and 74% 56%, respectively. On differential diagnosis, the ratio of echo level in small hepatocellular carcinomas was significantly higher than that in borderline lesions. The 3-year and 5-year survival rates for all patients were 61% and 41%, while disease-free survival rates at the corresponding times were 15% and 7%, respectively. A total of 25 patients (76%) developed intrahepatic recurrence during a mean follow-up of 33.8 months, although there was no recurrent lesion in 4 adenomatous hyperplasia patients treated with microwave coagulation therapy and ethanol injection intraoperatively. CONCLUSIONS: For tumors larger than 1 cm in diameter, the detection rates with various diagnostic modalities were rather high. However, the differential diagnosis of borderline lesions from small hepatocellular carcinomas could be based on pathologic studies only. Early detection of small hepatic lesions and treatment by methods such as resection or ethanol injection are of critical importance in improving long-term survival.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Clarification of risk factors for hepatectomy in patients with hepatocellular carcinoma.

BACKGROUND/AIMS: Hepatic resection is still associated with a higher morbidity than other major abdominal surgery. The aim of this study was to define risk factors for postoperative morbidity, and to evaluate the plasma cytokine pattern to detect early postoperative infection in patients with hepatocellular carcinoma. METHODOLOGY: One hundred and thirty-nine hepatic resections for hepatocellular carcinoma over a 10-year period from 1987 to 1997 were performed. Preoperative and intraoperative predictors of morbid outcomes were analyzed using multiple regression in a stepwise, logistic model. The postoperative concentrations of interleukin-6, interleukin-8, granulocytecolony stimulating factor, endotoxin and hepatocyte growth factor were measured in 32 patients following hepatic resection. RESULTS: Mortality rate within 30 postoperative days was 2.2%, with morbidity occurring in 40.2%. Significant pre- and intraoperative predictors for morbidity were ICGR15 and the presence of liver cirrhosis. Changes of interleukin-6, interleukin-8, granulocytecolony stimulating factor and endotoxin levels were not consistent with the occurrence of postoperative complications. However, the postoperative peak hepatocyte growth factor levels were positively correlated with morbidity. CONCLUSIONS: ICGR15 and presence of liver cirrhosis had a marked effect on the incidence of postoperative complications after hepatectomy for hepatocellular carcinoma. An increase of serum hepatocyte growth factor level could be used to detect complications in the early postoperative period, but the inflammatory cytokine response after hepatectomy did not relate to an increased complication rate.

Adult↗
PubMedDate not supplied

Slow learning in rats due to long-term inhalation of toluene.

Rats were exposed to toluene at the concentrations of 1,000, 4,000 and 7,000 ppm for 1 hr a day, 6 days a week for 6 months and a half; 154 days' exposure. Behavioral tests on a test battery were carried out after the termination of 154 days' exposure. The performance level of FR 1, extinction of the FR 30 schedule, wheel running activity, scores of open field test and body weight were not influenced. Slow acquisition of the timing behavior of the DRL 12 sec schedule in toluene-exposed rats was revealed: higher responses from the 1st session onwards, lower percent reinforced responses from the 1st session onwards and higher relative frequency of shorter interresponse-time (IRT) from the 9th to 12th sessions, respectively than those of the control rats. At the 33rd session onwards, the highest relative frequency of IRT of the DRL 12 sec schedule was at around 12 sec in all groups except one exposed group (7,000 ppm).

Animals↗
PubMedDate not supplied

A case of cerebral air embolism predominant in the left cerebral hemisphere following subclavian catheterization.

We report a case of cerebral air embolism caused by right subclavian vein catheterization. A large amount of air was seen only over the left cerebral hemisphere on computed tomographic (CT) scans. Although neurological deficit was observed bilaterally at the onset, the degree of ischemic brain damage was far greater in the left cerebral hemisphere than in the right. This unusual left-sided predominancy of cerebral air embolism was presumably due to the tortuosity of the ascending aorta.

Aged↗
PubMedDate not supplied

Persistent common bile duct hematoma caused by a small cancer: case report.

We report a case in which an intrabiliary duct hematoma secondary to a coexisting smaller choledochal cancer was observed for more than a month. Initial noncontrast enhanced X-ray computed tomography (CT) showed the hematoma as a high-attenuation mass, leading to the preoperative diagnosis of choledochal stone or calcified tumor.

Aged↗
PubMedDate not supplied

[Surgical treatment of telangiectasis].

The surgical treatment of telangiectasis synchronous to sclerotherapy is presented in this paper. Two female patients with extensive telangiectasis of the lower limbs comprise our report. They were considered typical cases for application of the proposed technique: abolishing venous reflux. The adjacent veins were resected through skin incisions of about 2 mm with crochet hooks, under local anesthesia, immobilized with adhesive tape. Sclerotherapy was performed simultaneously. The cosmetic result was excellent in both cases, with complete removal of the telangiectasis. This procedure should be considered the method of choice in the treatment of telangiectasis resulting from obvious venous reflux.

Drainage↗
PubMedDate not supplied

Interaction of some drugs on the pharmacokinetics or pharmacodynamics of MPC-1304, a dihydropyridine Ca2+ antagonist.

The aim of this study was to assess the pharmacokinetics and subsequent pharmacodynamic interaction of MPC-1304, a dihydropyridine Ca2+ antagonist, with other drugs in animal experiments. We measured the systolic blood pressure and heart rate of conscious spontaneously hypertensive rats implanted with battery-operated biotelemetry devices after combined administration of various drugs. Cimetidine (10 mg/kg) did not affect the reduction in systolic blood pressure and the increase in heart rate induced by MPC-1304, whereas it significantly increased the plasma concentration of a metabolite of MPC-1304 (M-1) compared to that detected when MPC-1304 was administered alone. When MPC-1304 was consecutively administered in combination with rifampicin (400 mg/kg) for 9 days, the plasma concentrations of MPC-1304 and of M-1 significantly decreased compared to those found when MPC-1304 alone was given. In spite of these reductions in plasma concentrations, rifampicin did not attenuate the hypotensive action induced by MPC-1304. When prazosin, reserpine, or methyldopa was administered in combination with MPC-1304, the hypotensive action was enhanced as compared to that by MPC-1304 alone or to that by the co-administered drug used alone (prazosin, reserpine, or methyldopa). Quinidine (10 mg/kg) affected neither the hypotensive action induced by MPC-1304 nor the plasma concentrations of MPC-1304 and M-1. These results indicate that cimetidine and rifampicin interact with MPC-1304 pharmacokinetically, without apparently changing the hypotensive action of MPC-1304, whereas quinidine does not affect the metabolism of MPC-1304, and that other hypotensive drugs, such as prazosin, reserpine, and methyldopa, potentiate the hypotensive action of MPC-1304.

Administration, Oral↗
PubMedDate not supplied

Beneficial effect of MET-88, a gamma-butyrobetaine hydroxylase inhibitor, on energy metabolism in ischemic dog hearts.

The effect of MET-88 [3-(2, 2, 2-trimethylhydrazinium) propionate], a gamma-butyrobetaine hydroxylase inhibitor, on the ischemic changes of energy metabolism was studied in the anesthetized dog. In the dog pretreated orally with MET-88 (50, 100 or 200 mg/kg/day) or placebo for 10 days, the left anterior descending coronary artery was occluded for 60 min, and the myocardium was taken from the left anterior descending coronary area (ischemic area) and left circumflex area (nonischemic area) for metabolic analysis. In the ischemic area, occlusion of the left anterior descending coronary artery decreased the tissue levels of adenosine triphosphate, adenosine diphosphate and creatine phosphate, increased the tissue levels of adenosine monophosphate and lactate, and decreased the value of the energy charge potential. These metabolic alterations, induced by occlusion of the left anterior descending coronary artery, were dose-dependently attenuated by MET-88. In the nonischemic area, MET-88 did not markedly change either the tissue levels of energy metabolites or the value of the energy charge potential. These results indicate that MET-88 attenuates the derangement of the energy metabolism in the ischemic myocardium, without affecting the energy metabolism in the nonischemic myocardium.

Adenosine Diphosphate↗