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Biomedical subjects

K Hamazaki

Publications and source records attributed to K Hamazaki.

At least 55 records · Page 3Linked to original sources
PubMed1994

Hepatectomy with extracorporeal circulation for liver metastasis from colon carcinoma located at the confluence of the major hepatic vein: a case report.

Liver metastasis located at the confluence of the major hepatic veins developed after an operation for sigmoid colon carcinoma in a 63-year-old patient. Curative resection of the tumor was performed by in situ hypothermic perfusion of the liver and extracorporeal circulation. Intra-abdominal bleeding occurred on the first postoperative day, and ligation of the right inferior phrenic artery was performed via an emergency laparotomy. Only mild elevation of ALT and recovery of the arterial ketone body ratio to the "safety zone" was noted on the second postoperative day. Hepatic function gradually deteriorated after the 4th postoperative day with no distinct cause. Diffuse fatty liver was suspected as a cause of liver failure. The patient died on the 31st postoperative day. The problems encountered in this case are discussed in this paper.

Adenocarcinoma↗
PubMed1993

99mTc-HMDP accumulation in a phyllodes tumor of the breast, a case report.

In a patient with breast tumor, 99mTc-HMDP accumulation in the tumor was recognized in evaluating bone metastasis. Surgery and histopathology revealed that the tumor was a phyllodes tumor. This scintigraphic finding was thought to be rare and phyllodes tumor should be included in differential diagnosis when 99mTc-HMDP accumulation in the breast was recognized.

Breast Neoplasms↗
PubMed1993

An analysis of DNA ploidy pattern of hepatocellular carcinoma.

To determine whether a relationship exists between DNA ploidy and the prognosis of hepatocellular carcinoma (HCC), flow cytometric DNA analysis was performed in paraffin-embedded specimens obtained from 44 patients with HCC who underwent hepatectomy. There were 26 diploid (59%) and 18 aneuploid (41%) tumors. No correlation was shown between DNA ploidy pattern and patient age, sex, liver cirrhosis, hepatitis B virus antigen and serum alpha-fetoprotein level. The ploidy pattern had no significant correlation with the presence of vascular invasion or intrahepatic metastasis. Only Edmondson's grade was well correlated with the ploidy pattern. We noted a significant correlation between survival rates and the presence of vascular invasion or intrahepatic metastasis (p < 0.05). In contrast, no significant correlation was found between DNA ploidy pattern and the prognosis of HCC. The results of this study indicate that DNA ploidy pattern may not be a useful indicator for the prognosis of HCCs after hepatic resection, unlike the results of gastric and colon cancers.

Carcinoma, Hepatocellular↗
PubMed1993

Common bile duct injury during laparoscopic cholecystectomy.

Bile duct injury can occur more frequently during laparoscopic cholecystectomy than in open cholecystectomy. Three cases of common bile or hepatic duct injuries occurred in a series of eighty laparoscopic cholecystectomies; In case 1, the common bile duct was misidentified as the cystic duct. In case 2, bile peritonitis occurred on the fourth postoperative day caused by necrosis of the common hepatic duct involving the cautery surrounding it. In case 3, a bile leak occurred due to an incision at the confluence of the cystic and common duct. Dissection of the cystic duct at the infundibulum of the gallbladder, blunt dissection of the Calot's triangle, the handling of clips with special attention for safety were thought to be necessary in order to lower the risk of bile duct injury. Preoperative endoscopic retrograde cholangiography (ERCP) is recommended to avoid bile duct injury.

Adult↗
PubMed1993

Per-rectal portal scintigraphy with technetium-99m pertechnetate for esophageal varices.

Per-rectal portal scintigraphy is a non-invasive method in which a radioisotope is used for imaging of the portal collaterals. Per-rectal portal scintigraphy with 99m-technetium pertechnetate (99mTcO4-) was performed in 42 subjects to evaluate the portal hemodynamics. Ten healthy controls, 13 cases of liver cirrhosis without esophageal varices, 15 cases of liver cirrhosis with esophageal varices, and 4 cases of portal systemic shunt were included in this study. Moreover, in 4 patients who underwent transabdominal esophageal transection, per-rectal portal scintigraphy was repeated one month postoperatively. Portosystemic shunt index was calculated by the following equation. Shunt Index (%) = (99mTcO4 Counts of Heart/99mTcO4 Counts of Liver and Heart) x 100. The results, expressed as shunt index (SI) were: 8.8 +/- 5.2 in controls, 21.2 +/- 8.0 in cirrhotic patients without esophageal varices, 31.0 +/- 18.5 in cirrhotic patients with esophageal varices, and 49.0 +/- 6.9 in patients with portosystemic shunt. After transabdominal esophageal transection, the shunt indices were decreased in all four cases. Morphological improvements of the esophageal varices were also observed. These results suggest that the shunt index measured by per-rectal portal scintigraphy may be useful for assessment of portal collaterals, especially for patients with esophageal varices.

Adult↗
PubMed1993

[In vivo comparative study of the pharmacokinetics of chemotherapeutic agents infused via hepatic artery or portal vein against hepatic metastases. DRC Group].

Recently, the treatment for hepatic metastasis has been performed by injection of chemotherapeutic agents via hepatic artery. Although this therapeutic procedure has been contributing to a relatively higher response rate, the resulting increased response has not significantly improved prognosis. So, we assessed the infusion of chemotherapeutic agents via portal vein in rabbits and compared the results with those from arterial infusion. Two weeks after inoculation of VX-2 tumor cells into the liver, subcapsularly, injection of chemotherapeutic agents as well as sampling of the livers was started. The rabbits were allocated into two groups, an arterial infusion group and a portal vein infusion group. They received a single shot of mitomycin C (MMC, 1.7 mg/kg), or 5-fluorouracil (5-FU, 9.5 mg/kg) or cisplatin (CDDP, 1.6 mg/kg) injected by infusion pump for 1 h. The drug concentration into the normal liver and intratumorally was measured by HPLC method for 5-FU and MMC, and by flameless atomic absorption spectrometry for CDDP. Either drug concentration in the liver or tumor did not substantially differ between the two groups. This experiment revealed that portal vein infusion can contribute as much drug concentration intratumorally as by arterial infusion.

Animals↗
PubMed1993

The significance of post-hepatectomy changes in polymorphonuclear elastase and endotoxin levels.

We studied the association between polymorphonuclear elastase and endotoxin levels and complications following hepatectomy. The blood concentrations of polymorphonuclear elastase, endotoxin, fibrinogen and C-reactive protein were examined with the aim of clarifying their involvement in postoperative complications in twenty-five patients who underwent hepatectomy. Polymorphonuclear elastase increased significantly (p < 0.01) on the second postoperative day compared with preoperative levels, and decreased on the seventh postoperative day. The difference in the polymorphonuclear elastase level with and without liver cirrhosis was significant (p < 0.05) on the second postoperative day. Endotoxin changed in a manner similar to polymorphonuclear elastase, but no positive correlation was found between endotoxin and polymorphonuclear elastase. Neither parameter showed any significant positive correlation with the volume of hepatic resection. We were unable to find any relationship between the degree of elevation of endotoxin and complication after hepatectomy; further study will be needed.

Endotoxins↗
PubMed1992

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↗
PubMed1992

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↗
PubMed1991

[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↗
PubMed1991

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↗
PubMed1990

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↗
PubMed1989

[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↗
PubMed1989

[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↗