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Biomedical subjects

K Inokuchi

Publications and source records attributed to K Inokuchi.

At least 379 records · Page 21Linked to original sources
PubMed1978

Changes in T cell population in patients with bronchogenic carcinoma.

Absolute numbers of T cells were measured in a series of 84 patients with bronchogenic carcinoma and were compared with T cell percent with regard to clinical stage, course, and histologic type. Although T cell percent declined in accordance with the advancement of stage, the differences between the stages were not statistically significant. On the other hand, the absolute number of T cells decreased prominently in Stages III and IV as compared to Stages I and II (p less than 0.05 between Stages I and III, P less than 0.001 between Stages I and IV, and p less than 0.05 between Stages II and IV). Likewise in patients who were followed serially after resection, the absolute number of T cels correlated well with the postoperative course. These results lead us to the conclusion that it is more useful estimate the absolute T cell count rather than T cell percentage in lung cancer.

Carcinoma↗
PubMed1977

Serum alpha-fetoprotein levels after hepatic artery ligation and postoperative chemotherapy: correlation with clinical status in patients with hepatocellular carcinoma.

Eight patients with hepatocellular carcinoma and positive serum alpha-fetoprotein (AFP) levels were treated by hepatic artery legation and postoperative chemotherapy. Three patterns of clinical response were discerned. First, a marked decrease in AFP levels was found in five patients following the treatment. Three of these patients are alive, all with lowered or normal serum AFP levels at 20, 22, and 60 weeks after operation. Second, two patients displayed only a transient decrease in AFP levels followed by a gradual increase. Third, there was a continuous increase in AFP levels in one patient who showed no clinical improvement. The serum AFP levels in each case appeared to correlate with the prognosis of these patients. Thus, serial measurements of AFP levels may provide an index to assess the clinical result of hepatic artery ligation in patients affected with hepatoma.

Adult↗
PubMed1977

Successful treatment of early cancer of the liver and portal hypertension in patients presenting with bleeding oesophageal varices.

A small hepatoma was diagnosed by selective arteriography in 2 patients admitted for treatment of bleeding oesophageal varices. In both cases, hepatoma and variceal lesions were successfully treated. In the first case, left gastric vena caval shunt and local excision of the hepatoma were performed. In the second case, distal splenorenal shunt and local excision of the tumour were carried out. Although a combination of hepatoma and oesophageal varices may be an embarrassing problem, both lesions can be remedied provided that hepatoma is diagnosed at an early stage. It is stressed that arteriography is of value in assessment.

Adult↗
PubMed1977

Mesenteric venous thrombosis occurring late after splenectomy.

Two patients with mesenteric venous thrombosis which occurred late after splenectomy are reported. In the first case the thrombosis was seen, with preceding thrombocytosis, 3 years after splenectomy. In the second case the thrombosis occurred 2 years and 5 months postoperatively. Platelet counts had not been obtained before the mesenteric thrombosis in this case. In both instances persistent severe anaemia for several weeks preceded the symptoms and signs of mesenteric venous thrombosis. Both patients were treated by extended resection of the affected small bowel. Thus, dangerous thrombocytosis may occur in the presence of persistent severe anaemia even late after splenectomy. Thrombocytosis occurring immediately after splenectomy, which is almost inevitable, should be treated with heparin or other anticoagulants. In the late period the avoidance of persistent severe anaemia seems to be important in the prevention of thrombotic complications due to reactive thrombocytosis in splenectomized patients.

Adult↗
PubMed1977

Transthoracic cardiectomy with infraesophago-supragastric devascularization for bleeding esophageal varices.

Based on the thoughts that transthoracic approaches give less load to liver than transabdominal ones, and that effectiveness for bleeding esophageal varices is secured by cardiectomy with complete devascularization of lower esophagus and upper stomach, a new operative procedure for esophageal varices is described which is more safely applicable to the risky patients. Twenty cases with portal hypertension were operated, including eight cirrhotic patients with severe hepatic dysfunction, six cases of emergency bleeding and six reoperated cases. No operative death was encountered, but three cirrhotic patients died during the late follow up period. The remaining 17 patients had uneventful postoperative courses without recurrence esophageal bleeding during 20 months follow up period. Thus this operation may eliminate the shortcoming of previous operative methods for portal hypertension.

Adult↗
PubMed1977

Evaluation of the risk of postoperative pulmonary complications.

Ten of 40 patients who underwent major thoracic or abdominal operations developed postoperative pulmonary complications, consisting of six massive atelectasis, three pneumonias and one edema. They were mostly thoracotomy cases and cigarette smokers. Many of these complications would have been prevented, if reliable pulmonary function tests are available to predict preoperatively such occurrence. Flow-volume curve tracing and closing volume measurement were evaluated in this respect. Both flow at the point of functional residual capacity on flow-volume curve, and the closing capacity subtracted from functional residual capacity were found to be well correlated with the occurrence of postoperative complications and can be used to evaluate the risk of pulmonary complications developing in postoperative period.

Abdomen↗
PubMed1977

Tumor embolism in the right atrium after hepatic artery ligation for hepatoma.

A case of tumor embolism in the right atrium after hepatic artery ligation for hepatoma was reported. Patient was a 55 year old male complaining of upper abdominal pain. Preoperative angiogram and scintigram revealed multinodular hepatomas in the right and middle his condition gradually deteriorated thereafter and sudden hypotension occurred on the 22nd postoperative day with a fatal sequela. At autopsy, the orifice of the right atrium was impacted by a tumor embolus. The cause of death seemed to be attributable to this embolus liberated from the hepatic veins. Accordingly, we emphasize the necessity of careful angiographic evaluation not only of the hepatic inflow but of the outflow tract in performing hepatic artery ligation as a treatment of nonresectable hepatoma.

Carcinoma, Hepatocellular↗
PubMed1977

Early carcinoma in the periampullary region: report of two cases.

Two cases of early carcinoma in the periampullary region detected microscopically are reported. In Case 1, the carcinoma was found in part of an adenomatous polyp resected transduodenally. In Case 2, carcinoma was located within 1 cm from the main pancreatic duct hidden in the surrounding inflammatory tissue of the pancreatic head excised by radical pancreatoduodenectomy. Case 1 survived more than 3 years after the operation and Case 2 more than 5 years without any evidence of recurrence. The practical significance of such early carcinoma is discussed.

Adenocarcinoma↗
PubMed1977

Complete devascularization of hepatic lobe with nonresectable hepatoma.

Complete dearterialization of the entire liver was carried out in three patients with nonresectable liver cell carcinoma in whom the right or left portal vein had already obstructed due to tumor thrombosis or invasion. Although remittent fever ensued for two to three weeks postoperatively in all patients, hepatic infaction never occurred in the devascularized hepatic lobes. The effect of the treatment on tumorous lesions appeared satisfactory. The results indicated that the tumor-bearing liver can tolerate nearly complete deprivation of hepatic arterial and portal blood in at least one lobe of the liver if it is not simultaneous.

Antineoplastic Agents↗
PubMed1977

Enzymatic and hemodynamic changes after short term hepatic outflow occlusion in the dog.

In normal mongrel dogs, outflow occlusion of 15 or 30 minutes duration was produced by clamping both the suprahepatic and suprarenal portions of the vena cava. One dog died immediately after release of occlusion; two dogs died from recurrent hypotension between six and 24 hours postoperatively. The other five dogs survived for three days, at which time an autopsy was done. During outflow occlusion, the blood pressure fell in all dogs, as did the central venous pressure. The pulse rate decreased during, and after, occlusion but toward a tendency of gradual recovery. A significant drop in pH and base excess of arterial blood was seen after occlusion. Although a steady, but not substantial, increase in hemoglobin and hematocrit values was noted, there were no remarkable changes in the blood coagulation system. Significant increases in serum glutamic-oxalacetic transaminase, glutamic-pyruvic-transaminase, lactic dehydrogenase, acid phosphatase and beta-glucuronidase activities were observed from immediately after release of occlusion, but alkaline phosphatase values increased much later than did these. Thus, hepatic outflow occlusion, even if it is short, seems to be dangerous in the dog, since it produces hypotension, metabolic acidosis and diffuse damage as well as disruption of the parenchyma of the liver.

Acid Phosphatase↗
PubMed1977

Hepatoportal arteriovenous fistula in primary carcinoma of the liver.

The correlation between the portal circulation and esophageal varices was evaluated in 80 patients with a primary carcinoma of the liver, with special regard being given to the significance of an hepatoportal arteriovenous fistula. Hepatoportal arteriovenous fistula was found in eight patients. Esophageal varices were observed 32 of all patients with a hepatoma. On the other hand, variceal lesions were found in 17 of 52 patients without compared with all patients with an hepatoportal arteriovenous fistula. A fatal hemorrhage was frequently encountered in the patients with the fistula. It was suggested that a rational treatment for those with the triple lesions--hepatoma, esophageal varices and hepatoportal arteriovenous fistula--may be ligation of the hepatic artery.

Adult↗
PubMed1976

Lysosomal enzyme beta-glucuronidase. Release from regenerating liver after partial hepatectomy.

In 12 dogs, 70% hepatectomy was performed to investigate the changes in serum lysosomal enzyme beta-glucuronidase activities, and to compare them with other liver functions and with the restoration of liver mass. Three dogs died within 24 hours without recovering consciousness from anesthesia, and one died on the fourth postoperative day because of hepatic insufficiency. The other eight dogs were killed at various postoperative times up to eight weeks. Regeneration of the remaining liver occurred rapidly after operation. The peak elevation of serum glutamic oxaloacetic transaminase activity was found on the first postoperative day, with a steady return to normal within two or three weeks. To the contrary, the serum activity of beta-glucuronidase decreased during the first three days, but increased substantially between the seventh and 14th postoperative day, when regeneration was considered to be maximum. The results seem to indicate that serial determinations of lysosomal enzyme activities in the blood can be a beneficial biochemical index for detection of progressing liver regeneration following partial hepatectomy.

Animals↗
PubMed1976

Hemangiosarcoma of liver and spleen treated by hepatic artery ligation, intraportal infusion chemotherapy, and splenectomy.

Hepatic artery ligation is useful as a palliation of irressectable hepatic tumors, but does not always produce a satisfactory result. Hepatic tumor with high vascularity is expected to respond more favorably. In this context, primary liver cell carcinoma and carcinoid tumor or leiomyosarcoma of the liver have been satistfactorily treated by hepatic artery ligation. A case is presented of hemangiosarcoma of theliver and spleen treated effectively by hepatic artery ligation, splenectomy, and postoperative intraportal infusion of 5-fluorouracil, as indicated by the regression of hepatic tumors on postoperative scanning and arteriograpms.

Adult↗