Search PubMedSearch

Biomedical subjects

K Hamazaki

Publications and source records attributed to K Hamazaki.

At least 19 recordsLinked to original sources

Hepatectomy under extracorporeal circulation.

BACKGROUND: Resection of hepatic tumors located near the confluence of the hepatic vein or invading the inferior vena cava has become technically feasible and relatively safe by using venovenous bypass. However, some technical problems remain to be solved. METHODS: We performed three cases of hepatic resection under extracorporeal circulation combined with hypothermic perfusion. RESULTS: An unexpected hemorrhage was observed in all three cases for different causes. The patient of case 2 died of liver failure developed from fatty liver. Bile duct stenosis was observed in cases 1 and 3. CONCLUSIONS: Although hepatectomy under total vascular exclusion by use of Biopump is now considered a safe procedure, attention should be paid when this procedure is performed because some technical problems still remain.

Blood Loss, Surgical

Expression of Fas antigen and Bcl-2 protein in hepatocellular carcinoma.

Fas antigen (ag) is a cell surface protein known to trigger apoptosis in a variety of cells upon specific antibody binding. On the other hand, Bcl-2 protein, an oncogene product located at the mitochondrial inner surface, prolongs cell survival by blocking apoptosis. In this study we examined the expression of Fas ag and bcl-2 protein in 17 cases of hepatocellular carcinoma (HCC) to determine their role on HCC. By flow cytometric analysis, mean (SD) value of the expression of Fas ag on hepatocytes derived from normal liver, diseased liver (chronic hepatitis or liver cirrhosis) and HCC was 5.8 (4.7)%, 10.3 (6.9)%, and 24.0 (18.2)%, respectively. Fas ag expression on hepatoma cells was significantly greater than normal and diseased liver cells. The expression of Bcl-2 protein in normal liver, diseased liver and HCC was 4.3 (8.5)%, 0.8 (2.5)% and 2.1 (3.4)%, respectively, and the difference was not significant. These results suggest that induction of apoptosis may be a possible therapy against HCC.

Adult

Effect of Picibanil (OK-432) on the scavenging effect of free radicals produced during liver regeneration in the rat.

We administered a biological response modifier Picibanil (OK-432), attenuated Streptococcus pyogenes, via the dorsal vein of the penis after 70% hepatectomy in rats, and clarified the scavenging effect of Picibanil on free radicals generated in the regenerating liver. A group of 5 rats was intravenously administered with 25 KE/kg of OK-432 after hepatectomy, while the control group was given saline after hepatectomy. Serum levels of aspartate aminotransferase and alanine aminotransferase and the value of thiobarbituric acid-reactive substances in serum and hepatic tissue after hepatectomy were serially measured, and these values were significantly lower in Picibanil treated animals than in control animals. Free radical production in the regenerating liver was also measured by electron spin resonance spectrometry, and OK-432 injection significantly reduced free radical production. These results suggested that OK-432 reduced hepatocellular damage in regenerating liver by inhibiting lipid peroxidation.

Alanine Transaminase

Measurement of hepatic blood flow using 111In colloid.

The reduced hepatic blood flow calculated from hepatic scintigram with 198Au colloid was elucidated as the primary responsible factor for postoperative hepatic insufficiency. However 198Au colloid is no longer in use because of the high levels of radiation. Although 99mTc-phytate behaves similarly to 198Au on imaging, there were discrepancies between the hepatic blood flow index (KL) value and the severity of cirrhosis determined by laboratory data or by histology. In the measurement of hepatic blood flow using a radioactive colloid, factors like organ distribution, stability and uniformity of the colloid particles influence the values. In the present study, a 111In colloid was prepared and administered to rats to investigate the usefulness: as much as 95.4 (0.8) [Mean (+/- SD)]% of the colloid accumulated in the liver at pH 6.8. The distribution of particle diameter was within a relatively narrow range with the peak at 0.2 to 0.4 microns. Moreover, the KL values were not affected by condition of the reticuloendothelial system. The values showed a significant correlation with the measurements of the hepatic tissue blood flow obtained by the hydrogen gas clearance method (gamma = 0.83, P < 0.001). Thus, the 111In colloid can be clinically used as a substitute for 198Au colloid in the preoperative examination for estimation of the limit of resection.

Animals

Extracorporeal circulation and hypothermic perfusion for caval tumor thrombus complicating hepatocellular carcinoma: a case report.

A tumor thrombus complicating hepatocellular carcinoma developed in a 61-year-old male patient. Embolization of the right branch of portal vein was performed 2 weeks before operation. Curative resection of the tumor was performed on by extended hepatectomy plus in situ hypothermic perfusion of the liver and extracorporeal circulation. Postoperative course was uneventful until bile leakage occurred on the 11th postoperative day. A bile duct stenosis was diagnosed by cholangiogram, and hepaticojejunostomy was carried out. The patient recovered well without further complications. The pitfalls and technical problems encountered in this case are herein discussed.

Carcinoma, Hepatocellular

Laparoscopic cholecystectomy report of 30 cases.

Laparoscopic cholecystectomy (LSC) was attempted in 30 patients and was accomplished in 29 during the nine months between March and November 1991. Twenty eight patients had cholelithiasis with or without adenomyosis, and two had adenomyosis of the gall-bladder. Mean operative time was 219 min and postoperative pain was slight. Two complications (6.9%), including necrosis of the common hepatic duct and subcutaneous emphysema, were encountered. Patients with subacute and severe chronic cholecystitis were included in the cases. Thus this technique is recommended for almost all patients who require the removal of the gall-bladder for benign diseases.

Adolescent

Surgical treatment for hepatocellular carcinoma (HCC) 3 cm or less than 3 cm in diameter.

The efficacy of surgical treatment of small hepatocellular carcinoma (3 cm less in diameter) was studied in 30 patients with solitary tumors. The survival of the patients surviving at least three months after resection was 95% at 1 year, 69% at 2 years, 50% at 3 and 4 years. With regard to the range of resection in cases of partial resection the survival rate was 94% after 1 year, 64% after 2 years, and 47% after 3 and 4 years, while in the case of more than subsegmental resection the 4-year survival rate was 100% and a significant difference was noted. Recurrence was noted after 47% of the partial resections and 25% of the subsegmental or larger resections, and 6 of the 8 recurrent site especially in lesions of less than 2 cm were within the same segmental region. Thus, in the surgical treatment of solitary cancers smaller than 3 cm in size, resection of the segmental resection seems to be preferred whenever the functional reserves of the liver permits.

Carcinoma, Hepatocellular

[Effects of gabexate mesilate (FOY) on the gallbladder, sphincter of Oddi and duodenum of the normal and gastrectomized dogs].

FOY induced a dose-dependent inhibitory response on the gallbladder, sphincter of Oddi and duodenum of normal and gastrectomized dogs, although it induced an excitatory response in some dogs. The inhibitory response was not reduced or terminated by pretreatment with atropine, guanethidine, hexamethonium or/and proglumide. The FOY-induced inhibitory response reversed to the excitatory response in the sphincter of Oddi and duodenum by pretreatment with tetrodotoxin, but not in the gallbladder. These results suggested that the FOY-induced inhibitory response of the sphincter of Oddi and duodenum was caused by stimulation of nonadrenergic noncholinergic inhibitory neurons, not by FOY-induced cholecystokinin secretion. The excitatory response was induced by direct stimulation of their smooth muscles. The inhibitory response of the gallbladder to FOY was induced by direct stimulation of the smooth muscles.

Animals

Block resection of the hepatoduodenal ligament for carcinoma of the bile duct and gallbladder. Surgical technique and a report of 11 cases.

Carcinoma of the bile duct and gallbladder often infiltrates the entire hepatoduodenal ligament. Therefore radical resection should include block resection of the hepatoduodenal ligament. Over the last two years, block resection of the hepatoduodenal ligament for carcinoma of the bile duct and gallbladder was performed in 11 patients. When the carcinoma was located in the hilar bile duct, a combination of hemihepatectomy including the caudate lobe and ligamentetomy, "hepato-ligamentectomy", was performed (six cases). When the carcinoma was in the lower bile duct, a combination of pancreatico-duodenectomy and ligamentectomy, "ligamento-pancreatectomy", was performed (three cases). In two extremely advanced cases a combination of both hepatectomy and pancreatectomy with ligamentectomy, "hepato-ligamento-pancreatectomy", was performed. To accomplish these procedures safely, double catheter bypass of the portal circulation, devised by the authors in 1986, proved very effective in maintaining sufficient hepatic circulation and preventing portal congestion during block resection of the hepatoduodenal ligament. Histological evidence of invasion of the carcinoma cells into the hepatoduodenal ligament was detected in 10 cases, and in half of them the hepatic artery or portal vein was involved. As of April 1988, five cases in whom curative resection was performed are still alive, the longest survival period being 18 months. Four cases died in the early postoperative period, three of the deaths being due to sepsis and one to respirator malfunction.

Adenoma, Bile Duct

A case of necrosis of hepatocellular carcinoma and tumor thrombus in the portal vein induced by transcatheter arterial lipiodol chemoembolization.

A case of hepatocellular carcinoma is reported in which the main tumor, intrahepatic metastases and a tumor thrombus in the portal vein were necrotized completely after Lipiodol chemoembolization. In this case, the tumor thrombus seemed to act as a portal embolus. This phenomenon is interesting because Lipiodol chemoembolization alone usually can not necrotize intra- or extra-capsular invasion, intrahepatic metastasis or tumor thrombus in the portal vein. This case is considered to be suggestive of a possible therapy for hepatocellular carcinoma.

Carcinoma, Hepatocellular

[Estrogen and androgen receptors in hepatocellular carcinoma and in noncancerous liver tissue].

We have assayed both estrogen and androgen receptors in hepatocellular carcinomas, in the surrounding noncancerous liver tissue, and in normal liver tissue. Estrogen receptors (ERs) were detected in 5 out of 22 HCC tissues, 14 out of 22 surrounding noncancerous tissues, and in 5 out of 6 normal liver tissues. Androgen receptors (Ars) were detected in 4 out of 21 HCC tissues, in 7 out of 21 surrounding noncancerous tissues, and in 2 out of 5 normal liver tissues. These results suggest that the pathogenesis of some HCC may be dependent on estrogen or androgen. Hence, it may be beneficial to provide hormonal therapy for HCC, especially in cases that show high concentrations of ER and/or AR.

Adult

[HCFU and 5-fluorouracil levels in the blood and tissue of hepatocellular carcinoma after oral administration of HCFU].

HCFU was orally administered to 14 patients with hepatocellular-carcinoma, (including 11 patients with liver cirrhosis) and evaluated of HCFU and 5 fluorouracil (5-FU) levels. Blood and tissue 6-8 hr. after oral administration. The concentration of 5-FU in tissue was almost in the effective levels. In addition, the 5-FU level in the tissue of hepatocellular carcinoma tended to be higher than in non cancerous portion of the liver. 5-FU tissue concentration was not correlated with various laboratory data for the liver function (K-ICG, T. bil, GOT, GPT, etc.) From these results, it is suggested that HCFU is a useful anticancer agent for hepatocellular carcinoma especially for the cases accompanied liver cirrhosis.

Administration, Oral

Radical block resection of hepatoduodenal ligament for carcinoma of the bile duct with double catheter bypass for portal circulation.

A new concept of radical block resection of the hepatoduodenal ligament for carcinoma of the bile duct and new double bypass technique of portal circulation for the procedure were introduced. Clinical experiences of six patients were reported. By combined use of radical block resection of the hepatoduodenal ligament and double bypass technique, the radical resectability of carcinoma of the bile duct became a reality, and improvement of postoperative survival rate is expected.

Biliary Tract Neoplasms

[A case of alpha-fetoprotein, carcinoembryonic antigen and human chorionic gonadotropin producing renal cell carcinoma].

A 51-year-old woman was admitted with a complaint of a left hypochondralgia and an abdominal mass. Laboratory testing showed a markedly increased alpha-fetoprotein (AFP) level (234,700 ng/ml). The enlargement of the left kidney and the adrenal gland was noted by CT scan and a tumorous thrombus was shown by inferior caval venography. The patient underwent a left nephrectomy, a combined resection of the spleen, tail of the pancreas and the removal of a tumorous caval thrombus. The patients AFP level gradually decreased after surgery. In a histological study, the tumor was diagnosed as a renal cell carcinoma and the presence of AFP, CEA, and HCG in the cancer cells was demonstrate by means of the "PAP" method.

Biomarkers, Tumor