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Biomedical subjects

I Ohashi

Publications and source records attributed to I Ohashi.

At least 37 records · Page 2Linked to original sources

Effect of granulocyte-macrophage colony-stimulating factor on sepsis-induced organ injury in rats.

The administration of granulocyte-macrophage colony-stimulating factor (GM-CSF) to patients with severe active infections has been questioned because activation of neutrophils may cause tissue injury. To identify the effect of GM-CSF administration on severe sepsis, we examined the survival rate and pathologic changes in vital organs using the rat lethal sepsis model. Rats received 20 micrograms of recombinant murine GM-CSF (rmGM-CSF) 3 hours after the onset of peritonitis induced by cecal ligation and puncture. After 48 hours, the survival rate did not improve, and earlier deaths than in the control group were observed. In addition, the inhibition of early leuko-sequestration in the peritoneal cavity was seen in animals treated with GM-CSF. These results suggested that the administration of rmGM-CSF after the onset of sepsis was not beneficial; thus, we concluded that care should be taken in the clinical use of GM-CSF in severe infection.

Animals↗

The frequency of a concomitant early esophageal cancer in male patients with oral and oropharyngeal cancer. Screening results using Lugol dye endoscopy.

BACKGROUND: Male patients with oral and oropharyngeal cancer are known to have high risk of concomitant esophageal cancer developing. Thus, mass screening programs are pursued to detect such esophageal cancer early, and in a mass screening trial of patients with early oral and oropharyngeal cancer, the efficacy of Lugol dye endoscopy for detecting concomitant esophageal cancers has been evaluated. METHODS: Lugol dye was used in an endoscopic screening of 101 patients with oral cancer and 26 with oropharyngeal cancer; all of the patients were men. RESULTS: Among these 127 patients, eight (6.3%) clinical asymptomatic concomitant esophageal cancers were detected, and four of these eight cancers were found in the patients with oropharyngeal cancer. Five of these eight superficial lesions could not be detected by ordinary endoscopy or barium study. CONCLUSION: Our results show that Lugol dye endoscopy is indispensable for monitoring male patients with oral or oropharyngeal cancer to detect an early concomitant esophageal cancer. In addition, a higher frequency of concomitant esophageal cancer was seen in the patients with oropharyngeal cancer than in the patients with oral cancer.

Adult↗

The prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

OBJECTIVE: To evaluate the prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma. DESIGN: Retrospective study. SETTING: The Center for Adult Diseases, Osaka, Japan, between 1980 and 1989. PATIENTS: One hundred eighty-five patients with hepatocellular carcinoma who underwent liver resection with complete extirpation. MAIN OUTCOME MEASURE: Cumulative survival rate. RESULTS: The patients were divided into a wide surgical margin group, in which the lesion was excised with a margin of 1.0 cm or more, and a narrow surgical margin group, in which the margin was less than 1.0 cm. No significant differences could be detected in survival rates for 3 years or longer. Mean +/- SE tumor sizes were 3.4 +/- 0.4 cm and 4.4 +/- 0.3 cm, respectively, in the wide and narrow surgical margin groups. The patients were divided into three groups according to tumor size: group 1, 2.0 cm or less in diameter; group 2, greater than 2.0 cm but 5.0 cm or less in diameter; and group 3, greater than 5.0 cm in diameter. In groups 2 and 3, no significant differences in survival rates were found between the wide and narrow surgical margin groups. In group 1, the survival rate was significantly higher in the wide surgical margin group than in the narrow surgical margin group (P < .05). CONCLUSIONS: Small hepatocellular carcinomas of 2.0 cm or less in diameter should be resected with an adequate surgical margin. However, surgical margin was not a significant factor in the resection of hepatocellular carcinomas larger than 2.0 cm.

Adult↗

Asymptomatic arteriovenous malformation of the pancreas. Demonstration by Doppler ultrasonography and magnetic resonance imaging.

We reported a case of asymptomatic pancreatic AVM, incidentally found on routine ultrasonography and diagnosed noninvasively by means of Doppler ultrasonography and MRI. The diagnosis was confirmed by angiography. This is the first report to demonstrate the characteristics of pancreatic AVM by these two imaging techniques. They proved to be useful in identifying the vascular nature of AVM without the use of a contrast material, which is a definite advantage over DSA and CT. The quality of the image obtained was equivalent or superior to that obtained by DSA and contrast-enhanced CT. Doppler ultrasonography and MRI may serve as the primary imaging techniques of choice in suspected cases of AVM.

Angiography, Digital Subtraction↗

Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation.

PURPOSE: To compare dynamic incremental computed tomography (CT) with other techniques in detecting and evaluating small hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: Two-phase (early vascular and parenchymal) dynamic incremental CT of the entire liver and ultrasonography (US) were performed in 184 patients with chronic liver disease. Thirty patients had 36 small HCCs (less than 30 mm in diameter); 27 of these 30 patients also underwent CT after intraarterial injection of iodized oil, and the results were compared. RESULTS: The HCC detection rate was 92% with dynamic incremental CT, 69% with US, and 81% with iodized oil-enhanced CT. Of six well-differentiated HCCs, two were detected with the first dynamic incremental CT series and two with iodized oil-enhanced CT, whereas all were detected with the second dynamic incremental CT series and five with US. CONCLUSION: Two-phase dynamic incremental CT was superior to the other techniques and is a useful and easy procedure for routine follow-up of patients with chronic liver disease.

Carcinoma, Hepatocellular↗

Acute lymphoblastic leukemia associated with a t(1;19)(q23;p13) in an adult.

A cytogenetic study of a 38-year-old patient with acute lymphoblastic leukemia (ALL) revealed a t(1;19)(q23;p13), which is a characteristic translocation of childhood ALL. The leukemic cells were positive for the CD10, CD19, HLA-DR, TdT and cytoplasmic mu-chain. Both of the immunoglobulin heavy chain gene loci were rearranged and the RNA-based polymerase chain reaction demonstrated the E2A/PBX1 fusion transcript which is the result of the t(1;19). This finding suggests that the t(1;19) is implicated not only in childhood ALL but also in adult ALL patients.

Adult↗

[Changes of serum interleukin 6 (IL6) and acute phase protein after hepatectomy in patients with chronic liver disease].

We examined the changes in serum levels of interleukin 6 (s-IL6) and acute phase protein (APP) during perioperative periods in patients with or without chronic liver disease (CLD) who underwent hepatectomy or other surgeries. The elevation of s-IL6 on the first postoperative day was only correlated with preoperative values of indocyanine green retention test (ICG-R15) (r = 0.56, p < 0.01), and not concerned with any operative factors. We divided the patients into the following three groups; the patients with CLD undergoing hepatectomy (n = 21, group A), the patients without CLD undergoing hepatectomy (n = 7, group B), and the patients without CLD undergoing surgeries other than hepatectomy (n = 7, group C). The values of s-IL6 on preoperative day, 1st, 4th, and 7th days after surgery in group A were significantly higher than the corresponding values in group C (p < 0.05). Among the hepatectomy groups, the serum levels of APP on the 4th day after surgery were significantly higher than those on preoperative day. We concluded that the changes in s-IL6 after hepatectomy were strongly concerned with preoperative liver function, especially with values of ICG-R15. However, it seemed that the induction of APP was negatively correlated with the preoperative liver function.

Acute-Phase Proteins↗

[Fundamental study of helical scanning CT--evaluation of spatial resolution in the longitudinal axis].

We evaluated spatial resolution in the longitudinal axis with helical scanning CT using a fourth-generation fast CT scanner. We made a phantom by stringing acrylic balls (65 mm phi x 8 and 9 mm phi x 6). The acquired images were processed by MPR and assessed visually to evaluate axis resolution. With the conventional scanning method, the partial volume effect varied with the starting position, but helical scanning was able to reconstruct high-resolution images using continuous raw data. During helical scanning, axis resolution varied depending on the slice width and sliding speed of the couch top. Even if the sliding speed was kept constant at 4 mm/sec, axis resolution was superior with a slice width of 2 mm than with one of 5 mm.

Microcomputers↗

Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma.

BACKGROUND: As one of the reasons for the poor prognosis of patients with hepatocellular carcinoma (HCC) and cirrhosis, the influence of cirrhosis itself has not been clarified. METHODS: We compared the postoperative long-term courses of patients with HCC and cirrhosis with the courses of patients with HCC and without cirrhosis to determine how the coexisting cirrhosis affected the prognosis after surgery. The patients with HCC who underwent curative hepatic resection consisted of 142 with associated histologically confirmed cirrhosis and 48 without cirrhosis. RESULTS: The 5-, 7-, and 9-year survival rates were 44%, 32%, and 26%, respectively, in the patients with cirrhosis and 68%, 57%, and 57%, respectively, in the patients without cirrhosis. The prognosis of the group with cirrhosis was significantly worse than that of the group without cirrhosis. The main cause of death in both groups was cancer recurrence. The patients with cirrhosis had significantly lower recurrence-free survival rates at 3 years and later than had the patients without cirrhosis. A comparison of the background factors revealed no substantive disadvantages with regard to tumor-related and surgical factors in the patients with cirrhosis compared with the patients without cirrhosis. The recurrence-free survival rates after minor and major resection indicated fewer disadvantages of limited hepatectomy in the group with cirrhosis than in the group without cirrhosis. Moreover, the recurrence-free survival of the group with cirrhosis was shorter at less advanced stages than at more advanced stages when compared with that of the group without cirrhosis. CONCLUSIONS: The higher carcinogenic potential in cirrhosis could be presumed to be the most likely reason for the poorer prognosis after surgery in the patients with HCC and cirrhosis.

Carcinoma, Hepatocellular↗

["Wrapping therapy" for advanced hepatic cancer with arterial and intraportal infusion chemotherapy].

A new treatment method to intercept collaterals using silicone rubber sheeting was used for 5 patients with advanced hepatic cancer. The therapy was carried out to prevent new collaterals. This procedure was followed by arterial chemoembolization, arterial infusion chemotherapy and intraportal infusion chemotherapy. The results were complete response in 2 patients, partial response in 2 patients, and no change in 1 patient. The overall survival time was 7-54 months after wrapping. Although a randomized control study is necessary to assess the true value of this method, the new therapy is considered worth using as an adjuvant treatment for advanced hepatic malignancies uncontrolled by arterial chemotherapy or chemoembolization.

Antineoplastic Agents↗

[Regional therapy to prevent recurrence after surgery in hepatocellular carcinoma].

The significance of regional therapy to prevent recurrence after surgery for hepatocellular carcinoma (HCC) was evaluated. In 275 patients who underwent hepatic resection for HCC, 143 (52%) had recurrences. Post-recurrence survival of the patients with regional therapy for recurrent foci was significantly better than that of patients without such therapy. Five-year post-recurrence survival of the patients treated with second surgery (77%) was significantly better than that of patients treated with chemoembolization (17%). The difference in 5-year survival between the former and the latter seemed to be caused by the difference in the degree of tumor progression at the recurrence. A second hepatic resection was the treatment of choice for a solitary intrahepatic recurrent tumor. However, chemoembolization was recommended for two or more recurrent foci.

Carcinoma, Hepatocellular↗

The effectiveness of a combination of etoposide/adriamycin/cisplatin (EAP) against inoperable gastric cancer--report of a histologically proven case.

We report herein, the histological observations taken at initial laparotomy from a 55 year old man with unresectable gastric cancer who responded almost completely to chemotherapy with Etoposide/Adriamycin/Cisplatin (EAP). The patient underwent a second operation after 2 cycles of EAP therapy and the stomach and adjacent lymph nodes were successfully resected. Histologic findings showed that cancer cells in the main tumor including the site of direct invasion had completely disappeared and been replaced by regenerated mucosa. The metastatic lymph node tumor was also partially killed, as indicated by a cluster of viable cancer cells which was divided by a strip of necrotic tissue. These findings led us to conclude that EAP therapy was remarkably effective for the patient.

Adenocarcinoma↗

CT findings in primary osteosarcoma of the jaw.

Findings of computed tomography (CT) in five patients with osteosarcoma of the jaw are presented. CT played an important role in the assessment of the tumour extent before the planning of treatment for both primary and recurrent jaw osteosarcoma. Plain CT was capable of demonstrating subtle bony change (cortical reaction and calcification) and medullary tumour extension without interference from other superimposed bones. Tumour vasculature was well represented by thin-slice CT scan with intravenous bolus injection of contrast medium. We emphasize the importance of preoperative CT scanning from both a radiological and surgical point of view when confronted with a tumour of the maxilla or mandible.

Adult↗

[Percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE) for recurrent hepatocellular carcinoma--report of 2 cases].

Two patients with recurrent hepatocellular carcinoma underwent reoperation following percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE). In the first case, although the nodules where the accumulation of Lipiodol (LpD) was seen showed complete necrosis, viable cancer cells were seen in the areas with slight accumulation of LpD. One nodule with no accumulation of LpD where PEIT seemed to have been performed, developed necrosis. In the second case, the nodules with LpI) accumulation also showed almost complete necrosis. The area where PEIT was performed was mixed with necrosis and bleeding, where a small viable cancer nodule existed. The reason for incomplete anticancer effects by PEIT seemed to be the too small ethanol injection.

Aged↗

[The assessment of preoperative transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC)--the comparison between "whole-liver" TAE and "lobar or segmental" TAE].

In 180 patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy, 52 patients were received preoperative arterial chemoembolization (TAE) for the whole liver (whole-liver TAE group: group A), 39 for the limited area of the liver (lobar or segmental TAE group: group B) and the remaining 89 had no treatments before surgery (control group: group C). In order to evaluate the significance of preoperative TAE, long-term prognoses were compared among the three groups. Although there were no significant differences in survivals between A and C, the 2- and 6-year survivals in group B were significantly better than those in group C (P less than 0.05). With regard to reduction rates of tumors and necrotizing effect for daughter nodules after TAE, the lobar or segmental TAE was significantly superior to the whole-liver TAE. Moreover, the lobar or segmental TAE deteriorated the liver function significantly less than the whole-liver TAE. These findings suggest that the lobar or segmental TAE is more advantageous than the whole-liver TAE as a preoperative adjuvant therapy.

Carcinoma, Hepatocellular↗

[Postoperative change of serum protease inhibitor and C-reactive protein level--with special reference to surgical resection of liver cirrhosis].

Changes in the activities of blood protease inhibitors and acute-phase reactive substances during surgical resection of liver cirrhosis were investigated by measuring the pre- and postoperative blood concentrations of alpha 1-antitrypsin (alpha 1AT), alpha 2-macroglobulin (alpha 2MG), pancreatic secretory trypsin inhibitor (PSTI), urinary trypsin inhibitor (UTI) and C-reactive protein (CRP), in patients with liver cirrhosis who underwent hepatectomy (Group A, n = 19), those without liver cirrhosis who underwent hepatectomy (Group B, n = 6) and those without liver cirrhosis who underwent surgeries other than hepatectomy (Group C, n = 5). On examining the preoperative blood levels of protease inhibitors, Group A had an increased level of alpha 2MG and a decreased level of UTI compared to Groups B and C. alpha 1AT and CRP began to increase on the first day following hepatectomy and formed peaks on the third postoperative day. The increases were significantly higher in Group B than Group A (p less than 0.01). To investigate factors causative of these differences, alpha 1AT and CRP on the third postoperative day were compared in relation to the time of operation, amount of intraoperative bleeding, weight of the resected liver and preoperative ICGR15. alpha 1AT and CRP were significantly correlated to only preoperative ICGR15. PSTI was increased postoperatively but showed no difference between Groups A and B.

Aprotinin↗

Diffuse intrasinusoidal metastasis of gastric carcinoma to the liver leading to fulminant hepatic failure. A case report.

An unusual case of gastric carcinoma with diffuse intrasinusoidal metastasis to the liver (DIML) presenting as fulminant hepatic failure is reported. The patient was a 59-year-old man admitted to the hospital complaining of dysphagia. Seven weeks after performance of total gastrectomy, he developed jaundice and consciousness disturbance and died 4 days later. The surgical material was diagnosed as advanced cancer (poorly differentiated adenocarcinoma) of the stomach and postmortem examination disclosed massive and diffuse infiltration of the tumor cells into the hepatic sinusoids with no grossly detectable metastatic nodules. It is important to be aware that, although uncommon, gastric carcinomas may cause fulminant hepatic failure attributable to DIML. The clinicopathologic features of such cases are detailed and a review of the relevant literature included.

Carcinoma↗