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Biomedical subjects

H Nagami

Publications and source records attributed to H Nagami.

30 records · Page 2Linked to original sources
PubMed1990

[Factors affecting activity of daily living (ADL) in stroke patients at home].

To examine the effects of housing conditions, health care, age, functional status and other demographic factors on the Activity of Daily Living (ADL), an interview survey of the caregivers of 68 cerebral stroke patients was performed. All patients received care at home for 6-128 (mean 40) months after discharge from hospitals and were 56-91 (mean 79) years old at the time of the survey. During the home care, ADL improved in 28 patients (improved ADL group), and did not change or deteriorated in 26 patients (unchanged/deteriorated ADL group). Three variables, i.e. reconstruction of bathroom (bathing facility and not toilet) in the patient's house after starting the home care, the patient whose main caregiver was his or her spouse, and consultation with a physician at a hospital (not a clinic), were significantly more frequent in the improved ADL group than in the unchanged/deteriorated ADL group. Similarly, the ADL level at the start of home care and age at the time of survey were significantly lower in the improved ADL group. The results of multiple logistic regression analysis indicates that the level of ADL when home care was started (p less than 0.01) and reconstruction of the bathroom (p less than 0.05) were major factors affecting the improvement in ADL.

Activities of Daily Living↗
PubMed1989

[Operative results in cancer of the pancreas, especially complicated with large vascular involvement].

Surgical treatment has been performed in 25 cases of cancer of the pancreas. Localized large vascular involvements of portal vein, celiac axis, common hepatic artery and/or superior mesenteric artery by the pancreatic cancer were observed in 11 cases, which necessitated total or subtotal pancreatectomy associated with segmental resection of the vessels with vascular reconstruction in 7 cases but in remaining 4 cases resectional procedure was not performed. Curative pancreaticoduodenectomy was carried out in 5 cases without large vascular involvement and non-curative pancreatectomy in one case. Exploratory laparotomy or only anastomosis for the bile duct or the intestine was done in 8 cases. The operative resectability rate was 52% and the curative one was 44%. The regional pancreatectomy seemed to contribute to improvement of resectability. However, one year survival rate was only 42% (2 year, 0%) in the curatively resected cases with large vascular involvement, while 5 year survival rate was 67% in those without vascular involvement. The quality of life after extended total pancreatectomy was distressful. On the other hand, two extended totally pancreatectomized cases with successful autotransplantation of distal pancreas are living at one year and 3 months after operation respectively, and enjoying the common social life at present.

Aged↗
PubMed1988

[A case of two patients with primary lung cancer secreting CA19-9].

We experienced two primary lung cancer patients who showed high levels of CA19-9 (Carbohydrate Antigen 19-9). One case was small cell carcinoma and the other was adenocarcinoma. In contrast to malignancies of digestive organ origin, rare CA19-9 positive cases are reported in lung cancer. To get evidences that these lung cancer tissues were producing CA19-9, PAP stain (Peroxidase anti peroxidase method: Sternberger) was performed, and positive stains were obtained in tumors surgically removed from these two patients. Especially in a patient who showed very high level of CA19-9 (27,369 U/ml), almost every tumor cell was positively stained. From these findings, we suggest the importance of checking CA19-9 in patients with lung cancer.

Adenocarcinoma↗
PubMed1988

[A case of unusual total anomalous pulmonary venous drainage (supra cardiac type)].

Here we report a case of total anomalous pulmonary venous drainage (TAPVD) appearing in an unusual way with Ib type of Darling's classification. The patient was a five-month old male baby. We found that the left pulmonary vein traveled down and then horizontally behind the heart and flowed into SVC together with right middle, lower pulmonary and right superior anterior pulmonary veins. On the other hand the right superior posterior pulmonary vein flowed into SVC directly. We performed a radical operation on this patient by making an internal conduit using a Gore-Tex patch, but he died of LOS on the 2nd postoperative day. We have reviewed and discussed the preoperative diagnosis, the type of surgical procedures and the prognosis of TAPVD in this paper in the light of our case.

Humans↗
PubMed1988

[A case of abdominal aneurysm accompanied by an aneurysm of left subclavian artery].

The case was a 62-year-old man. Two years ago under a diagnosis of aneurysm of the left subclavian artery he received: Ligation of aneurysm, aneurysmorrhaphy and extra anatomic bypass grafting from right axillary artery to left axillary artery. This time we palpated a pulsatile mass on his abdomen and performed replacement of abdominal aorta by Y shaped prosthesis following a diagnosis of abdominal aneurysm. In recent years population of advanced age have been increasing and arteriosclerotic diseases including aneurysm are also remarkably increasing. In the future we think that cases of multiple aneurysms such as this one will increase. In Japan we collected fifty cases of aneurysm of the subclavian artery including our case. In this paper we reviewed those cases and discussed the diagnosis and treatment of aneurysm of subclavian artery and multiple aneurysms.

Aneurysm↗
PubMedDate not supplied

Second malignancies after a gastrectomy for gastric cancers: the effects of adjuvant therapies.

Second malignancy after gastrectomy has become one of the important issues in the management of gastric cancer patients. However, the effect of adjuvant therapies has never been surveyed, although there have been many reports on second malignancy after chemotherapy of other malignancies. Between 1979 and 1995, 574 patients with gastric cancer underwent gastrectomies in our department. 563 patients (98.1%) were completely followed-up, and the incidence of second malignancy after gastrectomy was assessed with special emphasis on the effect of adjuvant therapies, namely benefits versus carcinogenesis. The overall postsurgical survival rate was 62.5%, and the survival rate of patients with stage 2-4 cancer was significantly higher in the adjuvant therapy groups than in the surgery alone group. The overall incidence rate of a second malignancy was 3.20% (18/563), including 4 colorectal, 3 liver, 3 head and neck, and 8 other malignancies, and 3.90% (9/231) for the surgery alone group, 1.94% (3/155) for the chemotherapy group, 3.68% (6/163) for the chemoimmunotherapy group, and 0% (0/14) for the immunotherapy alone group. There were no statistical differences in the incidence rates between these 4 groups. The mean duration until the occurrence of second malignancy was 5.1 years for the surgery alone group, 8.6 years for the adjuvant therapy group (9.3 years for chemotherapy and 8.1 years for chemoimmunotherapy; p < 0.1, surgery alone vs. adjuvant therapy). The overall mean actuarial risk of developing a second malignancy was 6% at 5 years and 18% at 10 years. Multivariate analysis demonstrated that chemotherapy decreased the risk of death due to gastric cancer (risk ratio = 0.67, p = 0.017) and the risk of a second malignancy (risk ratio = 0.52, p = 0.261). Oral fluoropyrimidines were found to be particularly effective at decreasing the risk of death due to gastric cancer (risk ratio = 0.66, p = 0.012) and a second malignancy (risk ratio = 0.38, p = 0.136). However, intravenous chemotherapy was demonstrated to have no influence on survival (risk ratio = 0.93, p = 0.692) or a second malignancy (risk ratio = 0.58, p = 0.500). There was no evidence of an increased risk for a second malignancy following adjuvant chemotherapy. Adjuvant chemotherapy with oral fluoropyrimidines was suggested to contribute to the improved survival of patients with stage 2-4 gastric cancer, and to have a decreased the risk of a second malignancy.

Adult↗
PubMedDate not supplied

Beneficial effect of thromboxane A2 synthetase inhibitor (OKY-046) on 24-hr simple hypothermic preservation of the canine pancreas graft.

This study was performed to investigate the potential protective effect of OKY-046, an inhibitor of thromboxane A2 synthetase, on the viability of 24-hr preserved canine segmental pancreas graft. Each graft was preserved in either cold Euro-Collins (E-C) solution (control group; n = 5) or E C+OKY-046(10(-4)M) solution (OKY-046 group; n = 5). In both groups, grafts were preserved for 24 hr and calculated the total levels of 6keto-prostaglandin F1 alpha (6ket-PGF1 alpha) and thromboxane B2(TxB2) in the preservation solution per pancreas graft weight at the time point of 0,3,7,12,24 hr after preservation. The efficacy of OKY-046 in protecting ischemically stressed grafts was examined by histological findings of the grafts before transplantation and blood flow of the transplanted pancreas graft. During 24-hr preservation time, increased production of 6ket-PGF1 alpha and decreased production of TxB2 were found in OKY-046 group. Histologically ischemic damage of the acinar cells was observed in the control group, but it was milder in the OKY-046 group. The blood flow of the transplanted pancreas in the OKY-046 group were higher than that in control group. In the OKY-046 group, all dogs survived with functioning grafts, although some grafts were lost in the control group. These results suggest that there is a possibility that OKY-046 may contribute to the improvement of the survival rate in segmental pancreas transplantation.

Animals↗
PubMedDate not supplied

A splenic-inferior mesenteric venous anastomosis prevents gastric congestion following pylorus preserving pancreatoduodenectomy with extensive portal vein resection for cancer of the head of the pancreas.

BACKGROUND: In order to prevent gastric congestion after both of the splenic and coronary veins were taken as part of extensive portal vein resection in pylorus preserving (PP) pancreatoduodenectomy (PD), we made a splenic-inferior mesenteric venous (SpIMV) anastomosis. MATERIALS AND METHODS: Four patients underwent PP subtotal PD with such extensive portal vein resection under the diagnosis of pancreas head cancer. The portal vein was reconstructed by end-to-end anastomosis, and the coronary vein was ligated. Since the stump of the splenic vein could not be approximated to the portal or superior mesenteric vein, shunting the splenic venous flow to the inferior mesenteric vein was attempted by making a SpIMV anastomosis in 3 patients and by preserving the SpIMV confluence in a patient. Postoperative celiac angiography showed that venous outflow from the stomach, spleen and remnant pancreas collected into the splenic vein and passed through the SpIMV anastomosis or confluence, and finally drained into the portal vein by inferior mesenteric to superior mesenteric collateral. RESULTS: No remarkable congestion of the stomach was observed. CONCLUSIONS: In conclusion making a SpIMV anastomosis or preserving the SKpIMV confluence is beneficial for preventing gastric congestion following PP PD with extensive portal vein resection for cancer of the head of the pancreas.

Aged↗
PubMedDate not supplied

Neoadjuvant chemotherapy of gastric cancer with oral UFT (a mixture of uracil and fturafur) during the waiting period for surgery.

Our previous experience has demonstrated that growth of gastric cancer during the waiting period for surgery cannot be neglected, and some patients hope to receive prophylactic treatment to inhibit the growth of tumor until surgery. The present study was designed to assess the clinical benefits of preoperative chemotherapy with oral UFT for gastric cancer during the waiting period for surgery. Fifty patients with gastric cancer (24 early, 25 advanced and 1 recurrent cancers) were treated with oral UFT at 300-600 mg/day for 7-36 days before surgery and the objective responses and the postsurgical survivals were evaluated. In 42 of 50 patients objective responses of primary lesions were assessed by endoscopy or upper gastrointestinal series examination, and 2 CRs, 15 PRs and 25 NCs were seen (40% response). The histological effect was evaluated in 50 patients and the following classifications were made: grade 3 (complete disappearance or necrosis of tumor cells), 2; grade 2 (necrotic changes > 2/3 area), 4; grade 1b (> 1/3 area), 7; grade 1a (< 1/3 area), 15; and grade 0 (no histological changes), 22. A longer period of UFT administration was associated with CR or PR. All the patients underwent gastrectomy (38 curative and 12 palliative gastrectomies): all patients with Stage I-III primary gastric cancer are alive after surgery, and the 50% survival period of the patients with Stage IV cancer was 20 months. The side effects were not serious, including slight myelotoxicity, liver dysfunction and anorexia. It is concluded that preoperative chemotherapy for gastric cancer with oral UFT on outpatient basis may result in down-staging as well as the prevention of tumor growth during the waiting period for surgery without serious side effects.

Administration, Oral↗