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Biomedical subjects

H Saisho

Publications and source records attributed to H Saisho.

At least 127 records · Page 7Linked to original sources
PubMed1994

[Development of hepatocellular carcinoma in the patients with a history of tuberculosis].

Of the patients diagnosed as having hepatocellular carcinoma (HCC) at Chiba University Hospital and affiliated hospitals from 1978 to 1992. 191 patients with histories of having a blood transfusion more than 10 years ago were studied. Histories of having transfusions for tuberculosis were the most common, being documented by 50 patients. Of those patients receiving transfusions for tuberculosis, the average period from transfusion to the detection of HCC was 31.1 years and the average year of transfusion was 1955. Liver dysfunction was found during routine medical examinations of the most patients (38.9%), and HCC was diagnosed in 17% of the patients soon after the detection of liver dysfunction. Of the HCC patients with histories of tuberculosis treatment, anti-hepatitis C virus was frequently tested positive regardless of a history of transfusion. Patients with histories of transfusions for tuberculosis should continually be examined for liver dysfunction, and it must be considered that these patients have a risk of developing HCC.

Adult↗
PubMed1994

[Development and predictive factors of hepatocellular carcinoma in patients with chronic liver disease over a long follow-up period].

We performed periodical examinations by ultrasonography (US) and serum alpha-fetoprotein in 272 patients with liver cirrhosis (male, 167; female, 105) over long follow-up periods (1985. 1-1992.9). The average period was 1934 days, and we prospectively studied the early detection of hepatocellular carcinoma (HCC). HCC was detected in 78 patients during the periods, with the average cumulative incidence rate being per year 7%. Tumor size at detection was 15mm or less in diameter in 37.2% HCC patients and 30mm or less in 89.7%. In spite of frequent ultrasonic examinations, it was difficult to detect small sized HCCs in blind spots of US or in the liver with the rough parenchymal echo pattern. Predictive factors important for development of HCC were analyzed using Cox's proportional hazards model. It showed that significant factors were serum AFP level, liver parenchymal echo pattern and small mass lesions (ultrasonic appearance) of the liver.

Adult↗
PubMed1994

[Diffuse gastric mucosal redness in liver cirrhosis--with special reference to portal hemodynamics].

The clinicopathological characteristics of the diffuse gastric mucosal redness were studied in 235 patients with liver cirrhosis. Moreover, in 96 patients in whom percutaneous transhepatic portal catheterization was carried out, the relationship was studied between gastric mucosal lesions and portal hemodynamic aspect with reference to portal vein pressure and extrahepatic collaterals. Extrahepatic collaterals were divided into three groups, which related either of cephalad, caudal and peri-abdominal as the most prevalent extrahepatic collateral on portographic findings. The frequency of the diffuse gastric mucosal redness was increased with the elevation of portal vein pressure, and it was seen more frequently in patients with cephalad collaterals than in caudal. However, the diffuse gastric mucosal redness was seen less frequently in patients with cephalad collateral accompanied with the development of renal shunts. Multiple logistic model analysis showed significant correlation between the diffuse gastric mucosal redness and the development of cephalad collaterals. These results suggest that the gastric mucosal circulation in liver cirrhosis is strongly affected by the development of portosystemic collaterals in portal hypertension.

Aged↗
PubMed1993

Detection of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreatic adenocarcinoma.

Pancreatic adenocarcinomas are known to have a high incidence of K-ras gene mutations. Differential diagnosis of pancreatic cancer and chronic pancreatitis sometimes presents a clinical dilemma. We recently developed a highly sensitive and specific polymerase chain reaction capable of detecting 3-30 copies of mutant K-ras genes harboring codon 12 single base changes in the presence of 300,000 normal copies. Mutant ras genes were detected in DNA purified from pancreatic juice from all 6 cases of pancreatic adenocarcinoma and 1 case of intraductal papillary neoplasms of the pancreas. In 2 of 6 other cases with pancreatic adenocarcinoma, circulating metastatic cells were detected in DNA purified from peripheral blood. Activated ras genes were not found in pancreatic juice of three control cases (chronic pancreatitis and choledocholithiasis) or in the peripheral blood of two patients with insulinomas. Notable conclusions of this study are that there can be significant levels of shed tumor cells in peripheral blood and an even higher number in pancreatic juice. In addition, two different K-ras mutations were found in some patients.

Adenocarcinoma↗
PubMed1993

[Treatment of common bile duct stones by peroral cholangioscopy].

Endoscopic papillotomy (EPT) has become a popular form of treatment in managing common bile duct stones. But it may fail in difficult cases such as large stones of over 20 mm, confluence stones, and impacted stones. Over the past 5 years, our success rate in clearing the bile duct by conventional endoscopic techniques (mechanical lithotripsy) was about 90 per cent. Recently, we have performed electrohydraulic lithotripsy or laser lithotripsy with peroral cholangioscopy in these difficult cases. Complete clearance of the duct was obtained in all 23 patients who underwent peroral cholangioscopic lithotripsy. No complication occurred. In conclusion, peroral endoscopic treatment of common bile duct stones should be safe and effective.

Aged↗
PubMed1992

Diagnosis of portal vein tumor thrombus by pulsed Doppler ultrasonography.

The blood flow of portal vein thrombus was studied by pulsed Doppler ultrasonography in 21 patients with tumor thrombus and 14 with blood clot thrombus. Pulsatile waves were observed in 19 of the 21 with tumor thrombus, with backward continuous waves in 3, and forward/backward continuous waves in 2. In contrast, forward continuous waves were observed in 2 of the 14 with blood clot thrombus. By color imaging, the blood flow could be observed in 9 of 14 with tumor thrombus, but in 1 of 7 with blood clot thrombus. Pulsatile and backward continuous waves were characteristic of tumor thrombus.

Adult↗
PubMed1992

[The diagnostic process in carcinoma of the pancreas].

Early diagnosis of carcinoma of the pancreas is considerably difficult because the disease is often in the advanced stage at the time of clinical manifestation. We have, however, no choice for improving the prognosis of the disease but to make an early diagnosis by detecting small tumors. Ultrasonography (US) is the most useful diagnostic technique in detecting the initial sign of carcinoma of the pancreas. The patient suspected of having this disease should first undergo US combined with measurement of serum pancreatic enzymes (amylase or elastase-1) and the tumor marker (CA 19-9). Those patients with positive results on the first examinations should undergo dynamic CT, ERCP or endoscopic US (EUS) to corroborate suspicions of the disease. Percutaneous fine needle biopsy of the pancreas may be recommended as a reliable method for making a definite diagnosis, when these diagnostic modalities fail to elucidate the disease. In conclusion, appropriate combined use of these diagnostic techniques can facilitate the early diagnosis of carcinoma of the pancreas.

Aged↗
PubMed1992

[Diagnostic significance of angiography for small hepatocellular carcinoma--comparison with other examinations].

The diagnostic value of angiography for small hepatocellular carcinoma was evaluated in comparison with histology, contrast-enhanced computed tomography, and ultrasonography. A total of 120 patients with small hepatocellular carcinoma (less than 3 cm in size) were examined. The definitive detection rate for primary tumors less than 2 cm in size was 44.9% by angiography, while it was 68.6% for primary tumors between 2 cm and 3 cm in size. When the primary tumor was less than 2 cm in size and without tumor vessels on angiography, it tended to be of Edmondson's grade 1 and to show fatty change. When the primary tumor was less than 2 cm in size and without tumor stain while non-cancerous parenchyma showed irregular stain, it tended to be of Edmondson's grade 1 and normotrabecular type. Angiography was found to be of particular value in detecting satellite tumors with a nodular parenchymal echo pattern in non-cancerous areas, because ultrasonography often fails to differentiate these satellite tumors from non-affected parenchyma.

Adult↗
PubMed1992

[Ultrasonographic findings of abdominal tuberculous lymphadenitis].

Five patients with abdominal tuberculous lymphadenitis were studied by ultrasound. The final diagnosis of tuberculosis was based on open biopsy in 2 patients, neck lymph node biopsy in 1, needle biopsy under ultrasound control in 2. Low-echoic and iso-echoic abdominal lymph nodes were seen in all patients and a mixed echoic lymph node was found in one of them. Enlarged, round or oval, lymph nodes were conglomeratically observed along the common hepatic artery, in the hepatoduodenal ligament and along the abdominal aorta. The size of the lymph node was found to be 20-70 mm. In one case, compression of the portal trunk and the common bile duct due to a large lymph node was observed, and arterioportography showed hepatopetal collateral veins. In the other case, multiple mass lesions in the liver and the spleen were observed. In the 4 patients who were observed by ultrasound at 2 months after anti-tuberculosis therapy, enlarged lymph nodes decreased and 3 of them changed from low-echo to iso-echo in the echo pattern. Of the 4 patients who were followed for more than 4 months, lymph nodes disappeared in 2 at 4 months and in one at 12 months. The remaining patient showed residual nodes which decreased in half at 8 months. Ultrasound is now used commonly in the examination of the abdomen, and there are cases of abdominal lymph nodes swelling due to varied diseases. In this study, there were no characteristic ultrasonographic findings in abdominal tuberculous lymphadenitis. So, it is difficult to diagnose the cause of abdominal lymph node swelling by only ultrasound.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1992

[Hemodynamics of intrahepatic portal vein studied in healthy subjects and liver cirrhosis by pulsed Doppler method].

The hemodynamics of the intrahepatic portal vein in 35 healthy subjects and 74 patients with liver cirrhosis was studied by measuring blood flow velocity with pulsed Doppler ultrasound technique. The flow velocity of portal vein decreased from the portal trunk to the first branches and to the second branches in the right and left lobes. Especially, an abrupt decrease of the flow velocity in the umbilical part of the left portal vein was characteristic of hemodynamics in the intrahepatic portal vein. The flow velocity in the third branches decreased more than that of the second branch in the right portal vein, but did not exist in the left. And the velocity was almost equal in all the subsegments. Blood clots of the left portal vein in 25 of 36 lesions were found in 31 patients with intrahepatic portal vein thrombus. This characteristic hemodynamics of the left portal vein was thought to be the main cause for the formation of blood clots. In the group with liver cirrhosis, the flow velocity was lower than in healthy subjects in the portal trunk, bilateral first branches and right second branches, but did not exist in the left second branch and bilateral third branches. No interrelationship between the intrahepatic portal flow velocity and the severity of liver cirrhosis and portal hypertension was observed.

Blood Flow Velocity↗
PubMed1990

[Diagnostic capability and clinical usefulness of percutaneous histological biopsy of the pancreas under control on ultrasound image using 21 gauge needle].

We evaluated diagnostic capability and clinical usefulness of histological diagnosis of the pancreas by percutaneous biopsy controlled on ultrasound image. Thirty seven patients with pancreas carcinoma and 11 with chronic pancreatitis underwent the procedure using 21 guage-Sonopsy C1 needle (Hakko co. Ltd.). Specimens of the tissue obtained were adequate for histological interpretation in 95.8% of all the 48 patients. The histological judgement referring to the nature of the lesion corresponded in 91.3% with the final diagnosis established surgical exploration, autopsy or long follow up more than one year. In cases of pancreas carcinoma with a successful procedure of the biopsy, histological type of carcinoma was confirmed in 91.4% of the tumors. It proved accordant pathologically with the conclusion based on the resected tumors in 5 of 8 patients operated on after the biopsy. Chronic pancreatitis was histologically diagnosed in 9 of the 11 patients with the biopsy. A confident diagnosis could not be obtained by imaging modalities including ultrasound, X-ray CT, ERCP and angiography in 7 of 37 patients with pancreas carcinoma and 3 of 11 with chronic pancreatitis. Biopsy by this method was so useful as to obtain the correct diagnosis in all these cases but one. Abdominal pain happened most frequently as a adverse effect during the procedure, but disappeared soon after that. There were no serious complications requiring intensive care. In conclusion, percutaneous histological biopsy controlled on ultrasound image may be recommended as a reliable method for making a definite diagnosis providing more valuable information than cytological biopsy, when diagnostic imaging modalities are unsuccessful in elucidating pathology of the pancreas.

Adult↗
PubMed1990

[Long-term follow-up results in nonoperated patients with intrahepatic and predominant intrahepatic type of hepatolithiasis].

In order to clarify therapeutic principles of hepatolithiasis associated with a variety of pathological conditions, we studied follow-up results in a term of 5 years after diagnosis in 29 nonoperated patients with intrahepatic gallstones. The patients including 14 males and 15 females underwent direct cholangiography for making diagnosis of the disease consisting of the intrahepatic type (I) and the predominant intrahepatic (IE). Out of the patients, 21 had good results in the follow-up and no one died from the disease or cholangiocarcinoma incidentally occurred. The follow-up results were closely related with the distribution and the location of gallstones in the liver and the grade of severity in clinical symptoms at the diagnosis. The unilateral lober type of the stone distribution had better follow-up results than the bilateral (P less than 0.01), and the peripheral intrahepatic bile duct type of the stone location did better follow-up results than the major (P less than 0.01). The pathological state of mild clinical symptoms showed better follow-up results than that of severe ones (P less than 0.05). The removal of coexisted extrahepatic bile duct stones by endoscopic papillotomy was effective for improving clinical symptoms. The conservative treatment in hepatolithiasis with the type I or IE was generally good in the follow-up results. The follow-up results were various, depending on the pathological conditions at the diagnosis. Accordingly, the treatment of hepatolithiasis must be selected in consideration of pathological conditions.

Adolescent↗
PubMed1989

ESR dating of elephant teeth and radiation dose rate estimation in soil.

Chemical analysis of 238U, 232Th and 40K in the dentine as well as enamel of elephant tooth fossil has been carried out in order to estimate the internal absorbed dose rate of the specimens, which was estimated to be (39 +/- 4) mrad/y on the assumption of early uptake model of radionuclides. The external radiation dose rate in the soil including the contribution from cosmic rays was also estimated to be (175 +/- 18) mrad/y with the help of gamma-ray spectroscopic techniques of the soil samples in which the specimens were buried. The 60Co gamma-ray equivalent accumulated dose of (2 +/- 0.2) x 10(4) rad for the tooth enamel gave "ESR age" of (9 +/- 2) x 10(4) y, which falls in the geologically estimated range between 3 x 10(4) and 30 x 10(4) y before the present.

Animals↗
PubMed1989

[Early diagnosis of carcinoma of the pancreas with emphasis on utility of ultrasonography].

Early diagnosis by detecting small tumors is essential for improving therapeutic effects on carcinoma of the pancreas. Recently, diagnostic modalities of the carcinoma have greatly advanced, but the clinical usefulness of them has not been elucidated clearly in the early diagnosis. So, we assessed the diagnostic capability of such modalities as ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), X-ray computed tomography (XCT) and angiography in 59 patients with carcinoma of the pancreas surgically resected. Gross- and micro-pathological findings of the resected tumors were studied in all the patients. The tumors were divided into two groups according to the size; the one consisted of 19 tumors sized 2 cm or less and the other did of 40 tumors larger than 2 cm. All the tumors in the small size group were located in the pancreatic head. The detection rate of abnormality about the carcinoma in these modalities was so various in the small size group, while it was almost similar each other in the large size group. Above all, US exhibited the highest capability in detecting small tumors of the pancreas and making the early diagnosis. In conclusion, it may be said that the use of US in combination with laboratory tests of pancreatic enzymes, followed by ERCP when necessary, is the most effective for early diagnosis of pancreatic carcinoma.

Adenocarcinoma↗
PubMed1988

Pulsed Doppler in the diagnosis of small liver tumours.

Doppler ultrasound detection of the blood flow associated with liver tumours was studied in primary hepatocellular carcinoma as well as in metastatic liver cancer and haemangioma. Doppler signals were detected from 48 of 55 hepatocellular carcinomas (87.3%), seven of 25 metastatic liver cancers (28.0%) and four of 30 haemangiomas (13.3%). The waveforms of Doppler signals were divided into two types: the pulsatile wave, which was detected from hepatocellular carcinoma (in 35 of the 48 with Doppler signals) and metastatic liver cancer (in all seven with positive signals), and the continuous wave, which was seen from hepatocellular carcinoma (41 out of 48) and haemangioma (in all four with signals). In six patients with hepatocellular carcinoma who underwent transcatheter arterial embolization, the pulsatile wave detected before therapy disappeared immediately thereafter and it is possible that this type of wave originates from tumour vessels. In the study of small, hypoechoic, mass lesions appearing in liver cirrhosis, such signals were also demonstrated, even in eight of 10 small hepatocellular carcinomas less than 2 cm in diameter, whilst they were not detected from nine regenerative nodules related to cirrhotic change. In conclusion, the Doppler ultrasound method may be a useful technique in detecting blood flow within liver tumours and may offer the possibility of a differential diagnosis of small tumours.

Adult↗