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Biomedical subjects

J Ariyama

Publications and source records attributed to J Ariyama.

63 records · Page 4Linked to original sources
PubMed1976

Hyperamylasaemia after duodenoscopy and retrograde cholangiopancreatography.

The salivary and pancreatic isoamylases of serum were determined separately in 234 cases of duodenoscopy and retrograde cholangiopancreatography. Successful pancreatic opacification was associated with pathologically high pancreatic serum amylase activities in 60% of the cases. Extensive opacification was associated with large increases of pancreatic serum isoamylases, the maximal rise recorded was 40 times the initial value. In spite of these striking chemical events only two patients developed clinical acute pancreatitis. There were some variations in pancreatic opacification and in the elevation of pancreatic serum amylase which seemed to depend upon the particular contrast material used. A rise of the salivary serum isoamylases caused pathologically high total serum amylase activities in 7% of the cases. High levels of pancreatic serum isoamylase activity before the time of examination did not result in any different pattern of hyperamylasaemia.

Cholangiography↗
PubMedDate not supplied

The detection and prognosis of small pancreatic carcinoma.

During a period of 16 years, 203 proven pancreatic ductal adenocarcinomas were studied. Tumor size was measured on either the resected or the autopsy specimen. Four tumors were smaller than 1 cm, and 17 tumors were between 1.1 and 2 cm. ERCP has been found to be the most accurate in the diagnosis of small pancreatic carcinoma. Followup of 44 patients in whom the tumor was resected showed that survival depended on tumor size. In four patients with tumors smaller than 1 cm without parenchymal invasion, the postoperative 5-yr cumulative survival rate was 100%. Pancreatic carcinoma smaller than 1 cm limited to duct epithelium is considered as early cancer. Various diagnostic imaging modalities are now available to evaluate patients in whom pancreatic carcinoma is clinically suspected. These include ultrasonography (US), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and angiography. More recently magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), and peroral pancreatic ductal biopsy also have been used. This report compares diagnostic modalities for pancreatic carcinoma in order to provide a data base for their rational use in the diagnosis of small resectable pancreatic carcinomas.

Adult↗
PubMedDate not supplied

Endoscopic ultrasound and intraductal ultrasound in the diagnosis of small pancreatic tumors.

BACKGROUND: The purpose of this study was to assess the diagnostic value of endoscopic ultrasound (EUS) and intraductal ultrasound (IDUS) in the detection of small pancreatic tumors. METHODS: EUS was performed in 166 patients with verified pancreatic disease. IDUS was performed in 46 patients. A microprobe was introduced into the main pancreatic duct through the papilla of Vater using the duodenoscope. RESULTS: EUS was valuable in the detection of small pancreatic tumors. Ductal adenocarcinomas smaller than 1 cm were demonstrated as a hypoechoic mass with a central irregular hyperechoic area. EUS and IDUS were useful in the characterization of intraductal paillary tumors (ductectatic mucinous tumors). EUS demonstrated nodular excrescences, and IDUS depicted papillary proliferation of the duct epithelium, which are characteristic of carcinomas and adenomas but not of hyperplasia. Internal architecture of cystic neoplasms was clearly depicted by EUS, and differentiation of serous and mucinous tumors was readily achieved. A tumor as small as a 5-mm islet cell was demonstrated on EUS because islet cell tumors are very hypoechoic. CONCLUSION: EUS and IDUS are relatively noninvasive procedures and are useful in the detection of small tumors and differentiation of pancreatic diseases.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

5-fluorouracil continuous infusion combined with cisplatin for advanced pancreatic cancer: a Japanese Cooperative Study.

BACKGROUND/AIMS: The prognosis of patients with advanced pancreatic cancer is extremely poor. To improve their prognosis, providing effective chemotherapy is necessary. The aim of this study was to evaluate the anti-tumor activity and toxicity of combined chemotherapy (FP therapy) using 5-fluorouracil and cisplatin in Japanese chemo-naive patients with advanced pancreatic cancer. METHODOLOGY: Thirty-seven previously untreated patients with histologically proven pancreatic adenocarcinoma were treated with FP therapy. 5-fluorouracil was administered at 500 mg/m2/day by continuous intravenous infusion for 5 days and cisplatin was administered at 80 mg/m2 intravenously on the 1st day. Therapy was repeated every 4 weeks until there was evidence of disease progression or unacceptable toxicity. RESULTS: Three patients achieved partial responses, whereas none exhibited a complete response. The overall response rate was 8% (95% confidence interval, 2-22%) and the response durations were 6, 9 and 12 months, respectively. The median survival time of patients was 5 months. Toxicities were generally mild and acceptable, although nausea/vomiting was the most commonly observed toxicity. CONCLUSIONS: FP therapy on this schedule had limited anti-tumor activity for pancreatic cancer, indicating that, practically, it should not be performed in Japanese patients with advanced pancreatic cancer.

Adenocarcinoma↗
PubMedDate not supplied

Integrated approach to the diagnosis of pancreatic carcinoma.

A prospective comparison of sensitivity, specificity and predictive value of ultrasonography (US), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP) and angiography was performed in 112 patients with proven pancreatic carcinoma. ERCP had the highest sensitivity and specificity in evaluation of pancreatic carcinoma. CT was the least sensitive in detecting pancreatic malignancy. Angiography had the highest positive predictive value. US and ERCP had a high negative predictive value. The initial examination of a patient with suspected pancreatic carcinoma is by US. Should this produce an abnormal result, CT is then used to confirm a lesion. A diagnosis of unresectable pancreatic carcinoma could be made by US and CT without the need for additional imaging procedures. If not, ERCP is indicated when there is some distinct reason to suspect pancreatic carcinoma. If ERCP reveals an abnormality, then angiography is performed to determine whether the lesion is benign or malignant, and if malignant whether it is resectable or not.

Adult↗