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K Izawa

Publications and source records attributed to K Izawa.

At least 73 records · Page 4Linked to original sources
PubMed1988

Congenital mesenteric arterio-portal fistula: report of a case.

A male patient with an arterio-portal fistula resulting from a mesenteric arteriovenous malformation, who developed portal hypertension and liver cirrhosis, is presented herein. The malformation was considered to be congenital in origin and its location made any ablative surgical procedure impossible. Such alternative treatments as ligation of the afferent arteries, followed by transarterial embolization were therefore given, but both were unsuccessful. We also present a review of the literatures of mesenteric arteriovenous fistula. Radical surgical approach for this rare entity is proposed. The case reported here as related to mesenteric arteriovenous communications of congenital origin is the seventh such case published, and the first which was ever found to be located in the trunk of the superior mesenteric artery.

Arteriovenous Malformations↗
PubMed1987

The surgical treatment for carcinoma of the gallbladder--rationale of the second-look operation for inapparent carcinoma.

Eighty-seven patients with carcinoma of the gallbladder treated in our hospital over a 15-year period were reviewed. Macroscopic curative resection was performed in 30 cases, 6 of which received second-look operations, and their cumulative five-year survival rate was 42.6 per cent. Histological and clinical analysis of our cases initially diagnosed by postoperative histologic examination revealed that the depth of carcinomatous invasion was the most important criterion for the indication of second-look operation, and that the second-look operation is mandatory for the inapparent carcinoma limited to the muscularis or subserosa. The surgical procedures of the second-look operation were: resection of the anterior inferior and medial inferior areas of the liver and dissection of the regional lymph-nodes. The presence of invasion of carcinoma to the cut end of the cystic duct or severe carcinomatous invasion to the lymphatic vessels were also important histopathologic findings for a second-look operation. Cases in which lymphatic invasions are remarkably observed, should receive an en bloc hepato-cholecystectomy plus a resection of the extrahepatic bile duct with neural tissues and soft fatty tissues in the hepatoduodenal ligament in a two-stage operation.

Carcinoma↗
PubMed1987

[Early determination of the effect of preoperative TAE by observation of serum AFP changes in patients with hepatocellular carcinoma].

Serum Alpha-fetoprotein (AFP) was assessed several times after preoperative TAE on 18 patients with hepatocellular carcinoma, and postoperatively the resected specimens were examined histopathologically. Changes in AFP level after TAE showed five typical patterns: AFP continued to rise in spite of treatment (non-effective type); AFP shows regular and equal increases and decreases (undulating type); AFP showed an increase after initially decreasing (increasing after decreasing type); AFP decreased gradually to normal levels (gradually decreasing type); and AFP decreased along a half-value period line to normal levels (half-value period type). These AFP patterns were intimately related to necrosis rate of tumor and other factors such as tumor size and existence of daughter tumors. Even when the AFP level decreased to 1/2 one week after TAE, the tumor showed only about 70% necrosis. Only when the AFP level fell into 1/4 of the original level after one week we could expect complete necrosis. Immuno-histological findings revealed AFP-producing cells in carcinoma but not in necrotic cells. It seems therefore, that the immuno-histological technique is uneffective in determining the viability of tumor cells.

Carcinoma, Hepatocellular↗
PubMed1986

Collective review of small carcinomas of the pancreas.

To determine problems involved in the treatment and diagnosis of pancreatic cancer, a collective study of small carcinoma of the pancreas (2 cm or less in diameter) was performed. One hundred six cases were collected and analyzed. The results were as follows: In small carcinoma of the pancreas, the resectability rate was 99.0% and the operative mortality rate was 4%. Only 44% of the patients belonged to Stage I, and 14% belonged to Stage III or IV. Lymph node involvement, capsular invasion, retroperitoneal invasion, and vascular invasion were found in 30, 20, 12, and 9% of the patients, respectively. The postoperative cumulative 5-year survival rate was 30.3%, and that of Stage I was 37.0%. A small-sized tumor of the pancreas is not always an early carcinoma, but a tumor in Stage I may be regarded as an early carcinoma. Percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography were the main diagnostic indicators in cases with and without jaundice, respectively. There was no specific single serum test for detecting small pancreatic cancer.

Adult↗
PubMed1985

Long-term results of surgical treatment for intrahepatic stones.

One hundred and nineteen patients with intrahepatic stones treated surgically in Nagasaki University Hospital from 1969 to 1984 were reviewed. The patients were divided into four types according to location of the stones and the presence or absence of stenotic lesions and/or localized dilatation of the intrahepatic bile ducts. Types I and II patients were treated with choledocholithotomy or choledochojejunostomy, while type III patients underwent hepatic resection and type IV patients were treated by partial hepatic resection with bilioenteric anastomosis, including extended hepatico-choledochojejunostomy. The majority of operative or early deaths belonged to type IV and residual stones were present in almost all patients. The long-term results for the 88 patients revealed that the rate of improvement was 100 per cent for type I, 87 per cent for type II, 83 per cent for type III and 84 per cent for type IV. In type IV, the most excellent results (92 per cent) were obtained by extended hepaticocholedochojejunostomy, especially with hepatectomy. It is suggested that extended hepaticocholedochojejunostomy with partial hepatic resection is a reasonable procedure for treating patients with type IV intrahepatic stones.

Adolescent↗
PubMed1985

Immobilization and reproducibility in radiotherapy for cancer of the larynx and pharynx using simplified shell and bite-block.

In this paper we describe the comparative study concerning the immobilization during radiotherapy for cancer of the larynx and pharynx with or without shell and fixing device. Immobilization was continuously monitored by semi-conductor detector. Reproducibility was investigated by means of verification film. The result significantly indicated that better immobilization was obtained in the patients treated with use of the shell (p much less than 0.001). Reproducibility of the field arrangement was also sufficient throughout the course of radiotherapy.

Humans↗
PubMed1984

[Morphological studies on the pathogenesis and treatment of hepatolithiasis].

Review of 108 patients with hepatolithiasis showed a recent increase of primary intrahepatic gallstones. 55 per cent of cases with hepatolithiasis had their gallstones in the left intrahepatic bile ducts. Clinicopathological study on the resected hepatic specimens of 33 patients revealed numerous intrahepatic periductal glandular formations. Periductal glandular formations were classified into the intramural and extramural glands. The mucous substances which might had been released from the periductal glands seemed to play a role in the formation of stones in combination with bilirubin pigments, cholesterin, bacterial organisms, cellular debris and other bile component. Intrahepatic gallstones and extramural glands were seen in the intrahepatic segment and area ducts. The defunctionalized atrophic hepatic lobe or segment should be resected in order to remove the calculi completely and to prevent the recurrence.

Adolescent↗
PubMed1984

[Evaluation of the accuracy in radiotherapy for carcinomas of the hypopharynx and larynx].

Immobility and reproducibility were investigated to evaluate the accuracy in radiotherapy for carcinomas of the hypopharynx and larynx. Based on our comparative study using a semi-conductor detector, a light-cast shell is sufficient to maintain immobility during radiotherapy. In most cases, the range of reproducibility was within 5 mm throughout the course of radiotherapy.

Humans↗
PubMed1982

Reoperative surgery in cholelithiasis.

From 1965 to 1980, reoperations for residual or recurrent stones were performed on 78 out of 962 Japanese patients with cholelithiasis. The majority of patients who required reoperation had intrahepatic stones. Most of the causes of reoperation were residual stones due to incomplete removal or the non-detection of intrahepatic stones at the previous surgery. Very careful examination of the intrahepatic biliary trees should be done in patients with biliary tract diseases, because in many, the first operation was done during their youth. To remove the intrahepatic calculi completely, hepatic lobectomy should be considered as a final procedure. The causes of reoperation of common duct stones were residual in 60 per cent and recurrent in 40 per cent. Definitive surgery should be done at the first or at least the second operation to avoid irreversible hepatic disorders which have untoward effects on the prognosis. It is important not only to remove the stones but also to relieve the bile stasis in the biliary tract.

Aged↗
PubMed1980

[Comparative roentgenographical study on the incidence of ossification of the posterior longitudinal ligament and other degenerative changes of the cervical spine among Japanese, Koreans, Americans and Germans (author's transl)].

Ossification of the posterior longitudinal liagment (OPLL) of the cervical spine which causes narrowing of the spinal canal has been reported to occur in about three percent of adult Japanese, whereas only sporadical cases have been reported outside Japan. Whether this indicates a real ethnic difference of the disease incidence or simply reflects a difference of attention toward this disease has been one of the questions raised by many workers. In order to clarify this, the author reviewed a large number of roentgenograms of the cervical spine in Japan (Juntendo University Hospital), Korea (Sebrance Hospital and Hanko Sacred Heart Hospital), the United States (Mayo Clinic and Dr. Cloward's Office in Hawaii), and West Germany (Mainz University Hospital). The rate of appearance of OPLL was compared between these ethnic groups. In addition to this, the rate of appearance of calcification of the nuchal ligament and other degenerative changes of the cervical spine such as osteophyte formation and narrowing of the intervertebral disc space was also studied and statistically analysed. Results 1. OPLL: The author found OPLL in 143 out of 6,994 (2.06%) Japanese individuals above 20 years of age. The incidence was lower in Koreans being 0.95%. This was much more pronounced and significant in the United States (Mayo Clinic) and in Germany, where only a few cases were found (Table 6). However, it is interesting to note that six cases found at Dr. Cloward's office in Hawaii included two Japanese. The author concludes that the incidence of OPLL is significantly higher in Japanese than in Caucasians, although the reason for this still remains to be studied. 2. Calcification of the nuchal ligament: This calcification (Barsony) was found in 10.2% among Japanese and in 11.3% among Koreans, whereas in 6.1% among Americans and in 4.5% among GErmans (Table 13). The author proposes that this significantly higher incidence of this calcification among Japanese and Koreans may have something to do with the higher incidence of OPLL in these two countries. 3. Osteophyte: In Japanese and Koreans, the most frequent site of the osteophyte formation was at C-5 between the third and the sixth decades, and then moved to C-6 above 60 years of age, whereas in Americans and Germans, C-6 was the most common site throughout the ages. Although severe osteophytes were found even in younger age group in Japanese and Koreans, the severity of the osteophytes tend to increase comparatively more with age in Americans and Germans. 4. Narrowing of the intervertebral disc space: The narrowing was the most frequent in C-5-6 interspace regardless the age and the ethnic background.

Adult↗
PubMed1976

[Clinical studies with amoxicillin (Pasetocin) (author's transl)].

This paper describes briefly the results obtained with AMPC (Pasetocin) administered by oral route to 21 patients with infection of the respiratory tract. 1. There was no difference in therapeutic effect on infection of the respiratory tract between daily dosages of 1,000 mg and 750 mg (the former was orally given in 4 divided doses every 6 hours a day and the latter in 3 divided doses after meal). The response of the patients to AMPC was remarkable or satisfactory. 2. Acute aggravation symptoms associated with chronic infection of the respiratory tract showed similar improvement to single acute infection of the respiratory tract. 3. The patients presenting acute aggravation symptoms received treatment for chronic stage consisting of consecutive oral administration of AMPC (500 approximately 750 mg a day) and their prognosis was favorable. Side effects attributable to prolonged treatment were not noted. 4. The incidence of side effects can be reduced largely by rejecting form AMPC therapy the patients who are hypersensitive to drugs including penicillins.

Adolescent↗