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Biomedical subjects

K Kajiyama

Publications and source records attributed to K Kajiyama.

At least 109 records · Page 6Linked to original sources
PubMed1979

[Pharmacological studies on Zingiber mioga (ZM) (1). General pharmacological effects of water extracts (author's transl)].

In the central nervous system, ZM decreased locomotor activity and potentiated hypnosis of hexobarbital-Na in mice. ZM had little hypothermic action and there were no anticonvulsive effects on chemoconvulsion and electroconvulsion shock. ZM, 3 mg/kg i.v. produced a sleep-like pattern in the spontaneous EEG activity of cat; from 20 to 30 min. after injection, spindle burst-like waves (12-13 Hz) appeared in the cortex and subcortex. These EEG activities were antagonized by atropine sulfate. In the respiratory and cardiovascular system, ZM, 1 mg/kg or over produced a fall in blood pressure and stimulated respiration in dogs. This hypotensive action was antagonized by atropine sulfate and diphenhydramine hydrochloride, and tachyphylaxis was observed in blood pressure. This compound inhibited cardiomotility in isolated toad heart, had little effect on peripheral blood flow, and produced contractions of isolated guinea pig ileum which were inhibited by atropine by sulfate. Regarding inflammatory response, ZM showed inhibitory effects on the acute edema induced serotonin and dextran. These results indicate that water extracts of ZM have cholinergic actions and in peripheral tissues, histaminergic-like actions.

Animals↗
PubMed1979

[Pharmacological studies on Zingiber Mioga (2). Effects of water extracts on the central nervous system (author's transl)].

Effects on the cat central nervous system of water extracts of Zingiber Mioga (ZM) were studied by electroencephalography (EEG). ZM had little effect on the EEG arousal response to electrical stimulation of mid-brain reticular formation. ZM (3 approximately 5 mg/kg, i.v.) suppressed the recruiting response and the augmenting response recorded from the posterior sigmoid gyrus, respectively. ZM (1 approximately 3 mg/kg, i.v.) decreased the photic driving response, while 5 mg/kg, i.v., tended to enhance the response. In the chronic experiments, ZM(1 approximately 3 mg/kg, i.v.) induced a drowsy pattern in the cortex and subcortex, and shortened the lasting time of the EEG arousal response to sonic stimulation. After 5 to 10 minutes, behavior showed a drowsy to light sleeping state, and electromyogram recorded from the platysma showed a decreased amplitude and frequency, but, did not have an inhibitory effect on the motor system, (ataxia). ZM (5 mg/kg, i.v.) induced desynchronization in the cortex and subcortex, arousal wave appeared in hippocampus, midbrain reticular formation, nucl. ventralis postero-lateralis and amygdala, and behavior tended toward the awake stage. After 10 minutes, EEG transferred to a drowsy pattern and behavior showed a drowsy to light sleeping state. The animal could be readily awakened by sonic stimulation, at every time. ZM appears to have an inhibitory effect on the central nervous system.

Animals↗
PubMedDate not supplied

MR signal intensity changes in hepatic parenchyma with ductal dilation caused by intrahepatic cholangiocarcinoma.

MR images of the liver in 13 patients with surgically proven intrahepatic cholangiocarcinoma were reviewed retrospectively and correlated to the histologic analysis of surgical specimens. We paid special attention to the peripheral liver tissue with ductal dilation but without tumorous involvement. High signal intensity was observed in the hepatic parenchyma with ductal dilation on T1-weighted spin-echo images (8 of 12) and spoiled gradient-recalled echo images (seven of seven), as compared with the contralateral hepatic lobe without duct dilation. The high signal intensity was not suppressed with fat saturation and showed enhancement after administration of contrast (11 of 12). Concurrent portal venous obstruction did not have significant effect on these findings (P < .05). Correlation with pathologic specimens suggested that this enhancement was associated with periportal fibrosis. The etiology of the high signal intensity on unenhanced spin echo or gradient-recalled T1-weighted image remains unclear. Radiologists should recognize these findings and should distinguish these from tumor involvement or the arterial buffer response caused by portal venous obstruction.

Bile Duct Neoplasms↗
PubMedDate not supplied

Gastric cancer in a general hospital in Japan.

During 20 years from 1971 to 1990, 605 patients with gastric cancer were treated by gastric resection at a medium-size general hospital by one surgeon. The overall 5-year survival rate was 61.9%. The 5-year survival rates in the first 10 years (n = 261) and the second 10 years (n = 344) were 53.7% and 67.9%, respectively (P < 0.01). In the second 10 years there was a significant increase in the patients with early gastric cancer (P < 0.01). Meanwhile, operative procedure or R2 or R3 lymph node dissection did not show any improvement of the 5-year survival rates. These results indicate that the prognosis for gastric cancer was relatively good at a general hospital which does not specialize in cancer research, and that much of the improvement in the prognosis could be attributed to the increase in the incidence of patients with early gastric cancer.

Female↗
PubMedDate not supplied

Radiologically identifiable intratumoral portal vein in intrahepatic cholangiomas: a diagnostic pitfall.

BACKGROUND: Although intratumoral patent portal vein (ITPV) is one of the characteristic features of benign hepatic lesions, ITPVs can be demonstrated in malignant tumors. We present the spectrum of MR and CT findings of ITPV identified in intrahepatic cholangiomas with pathological correlations. METHODS: The ultrasound, CT and/or MRI findings of pathologically-confirmed intrahepatic cholangiomas were reviewed and correlated with surgical specimen or autopsy findings. RESULTS: Intratumoral patent vessels were radiographically-demonstrated in 5 patients with intrahepatic cholangiomas. All intratumoral vessels were secondary or tertiary order portal vein branches. Some wall thickening was identified on pathological examinations. CONCLUSION: The radiological demonstration of intratumoral portal vein is not a specific sign of benignity. In the case of a hepatic tumor with a patent portal tract, cholangioma should be considered, as well as benign tumors or lymphoma.

Adenoma, Bile Duct↗
PubMedDate not supplied

Temporary spontaneous regression of intrahepatic cholangiocarcinoma.

A 34-yr-old man with a liver mass was referred to the hospital. The mass showed temporary spontaneous regression during the follow-up, however, subsequent regrowth of the tumor prompted surgical resection. The specimen revealed intrahepatic cholangiocarcinoma with two distinct components which had been clearly demonstrated on serial CT. Spontaneous resolution of a lesion does not necessarily suggest the lesion's benign, self-limiting entity. Intrahepatic cholangiocarcinoma should be included in the tumors that could spontaneously regress.

Adult↗
PubMedDate not supplied

CD34 expression in endothelial cells of small hepatocellular carcinoma: its correlation with tumour progression and angiographic findings.

The angiogenic process plays an important role in tumour growth and metastasis during hepatocarcinogenesis, but it is still uncertain when the process begins during tumour formation. Forty-two small hepatocellular carcinomas (HCC) that measured either less than or equal to 2 cm in diameter were studied by comparing the histologic findings with the angiographic findings, and with immunohistochemical expression of endothelial marker QB-end/10 (QB), a new monoclonal antibody raised against CD34, in the sinusoidal wall. Twenty (91%) of 22 moderately or poorly differentiated HCC revealed a positive reaction for QB, while only eight (40%) of 20 well differentiated HCC demonstrated a positive reaction (P < 0.01). In the tumours showing a 'nodule in nodule' appearance, the less differentiated areas were more reactive for QB. Twenty-three (82%) of 28 QB positive tumours were hypervascular, while only three of 14 (21%) QB negative tumours were hypervascular (P < 0.01) by angiography. All six of the poorly differentiated and 13 (81%) of the 16 moderately differentiated tumours were hypervascular, while only seven (35%) of 20 well differentiated HCC were hypervascular (P < 0.01). These results indicate that as the tumour becomes less differentiated, the QB positive areas become wider and angiography demonstrates hypervascularity. We therefore speculate that the HCC sinusoids acquire the characteristics of capillary and precapillary blood vessels during de-differentiation from well to moderate, and thus the tumour begins to reveal hypervascularity on angiography. The above process may be correlated with the stepwise progression of HCC.

Antigens, CD34↗
PubMedDate not supplied

Acute lymphoblastic leukemia of Burkitt's type (L3-ALL) without chromosome abnormality and lacking surface and cytoplasmic immunoglobulins.

A case of heterogeneous acute lymphoblastic leukemia of the Burkitt type (L3-ALL) is reported. A 58-year-old woman was admitted to our hospital with complaints of palpitation and shortness of breath in December 1988. On admission, the peripheral blood showed severe pancytopenia. The bone marrow was hypercellular with abnormal lymphoblasts; the cytoplasm was moderately abundant and intensely basophilic with prominent vacuoles. A diagnosis of L3-ALL was made. Cytogenetic analysis of bone marrow cells revealed a karyotype of 46,XX. The leukemic blasts were HLA-DR+, CD10+, CD19+ and CD20+, but no surface or cytoplasmic immunoglobulins were detected. This is the first report in Japan of a case of L3-ALL without chromosome abnormality and lacking surface and cytoplasmic immunoglobulins.

Antigens, CD↗
PubMedDate not supplied

Cell proliferation and cell loss in nodule-in-nodule hepatocellular carcinoma.

BACKGROUND/AIMS: In order to clarify the significance of the balance between cell proliferation and cell loss during the progression of hepatocellular carcinoma, 16 operative specimens of nodule-in-nodule hepatocellular carcinoma were investigated. METHODOLOGY: In 16 specimens, cell proliferation was evaluated by the expression of Ki-67 nuclear antigen, and cell loss was also examined by the method of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). The expressions of p53 protein, bcl-2 protein and Fas antigen were also investigated to clarify the relationship between their expression and cell kinetics. RESULTS: The Ki-67 labeling index of the inner nodules was higher than that for the outer nodules (18.9% vs. 7.2%; p < 0.05) and the TUNEL labeling index of the inner nodules was also higher than that for the outer nodules (12.8% vs. 6.6%; p < 0.05). The increasing rate of the Ki-67 labeling index from Edmondson's grade I to II was 3.9 +/- 3.0, that from grade II to III was 3.9 +/- 2.4, while the increasing rate of the TUNEL labeling index from grade I to II was 2.7 +/- 0.3 and that from grade II to III was 1.7 +/- 0.2 (p < 0.05). p53 Protein was observed in 5 cases, while bcl-2 protein was found in 4 cases in the border area of the inner nodule. However, Fas antigen was found in none of the examined cases. Regarding the Ki-67 positive rate in the inner nodule, the Ki-67 positive rate in the p53 protein positive cases was significantly higher than that in the negative cases (30.3 +/- 15.4 vs. 11.9 +/- 9.2; p < 0.05). However, the TUNEL labeling index was not affected by the expression of those proteins. CONCLUSIONS: This study suggested that tumor progression depends on a disturbance in the cell kinetic balance caused not by a decrease in the absolute amount of cell loss but in the chaotic balance between cell loss and cell proliferation.

Apoptosis↗
PubMedDate not supplied

Clinicopathological characteristics of surgically resected minute hepatocellular carcinomas.

BACKGROUND/AIMS: The multistep development of overt hepatocellular carcinoma from very well-differentiated early hepatocellular carcinoma, and of early hepatocellular carcinoma from adenomatous hyperplasia has been strongly suggested. The clinicopathologic and immunohistochemical characteristics of solitary minute hepatocellular carcinomas smaller than 1 cm in size have yet to be clarified. METHODOLOGY: Fourteen minute hepatocellular carcinomas were divided into 2 groups consisting of: 1) hepatocellular carcinoma of hepatitis B surface antigen positive patients (B-HCC) (n = 5), and 2) hepatocellular carcinoma of hepatitis C virus antibody positive patients (C-HCC) (n = 9), then they were all analyzed histopathologically and clinicopathologically. Immunohistochemical studies were also performed using the antibodies against p53 protein. RESULTS: Six of the 14 minute hepatocellular carcinoma were demonstrated to be moderately or poorly differentiated tumors. Among the 8 well-differentiated minute hepatocellular carcinomas, 2 tumors already contained less differentiated components. B-HCC tended to be less differentiated than C-HCC (P < 0.05). Adenomatous hyperplasia was detected in only 2 cases of C-HCC. Small cell liver dysplasia was detected significantly more frequently in C-HCC than in B-HCC (P < 0.05). The prognosis of the 14 minute hepatocellular carcinomas varied considerably. Immunohistochemically, some tumor cells were positive for p53 in 3 cases. CONCLUSIONS: Our study suggests that 1) the multistep carcinogenesis through adenomatous hyperplasia may not be so frequent, 2) De novo carcinogenesis from not only well-differentiated hepatocellular carcinoma, but also from less differentiated hepatocellular carcinoma, especially B-HCC, may be present, 3) the carcinogenesis in the B-HCC cases may behave differently from that in C-HCC cases, and 4) minute hepatocellular carcinomas demonstrate varying prognoses after hepatectomy.

Adult↗
PubMedDate not supplied

A resected case of combined hepatocellular carcinoma and cholangiocarcinoma associated with cystic formation.

Combined hepatocellular carcinoma and cholangiocarcinoma is a rare tumor. In addition, both hepatocellular carcinoma and cholangiocarcinoma are rarely associated with cystic lesions. We herein present a 62-year-old Japanese woman with combined hepatocellular carcinoma and cholangiocarcinoma which was associated with a rapidly enlarging cystic lesion. Both abdominal ultrasonography and computed tomography revealed a cyst with a solid portion in the left hepatic lobe. A partial hepatectomy was performed on the basis of a tentative diagnosis of a cystadenocarcinoma of the liver, while the diagnosis based on immunohistochemical studies was combined hepatocellular carcinoma and cholangiocarcinoma with cystic formation. The patient died of tumor recurrence, such as intrahepatic metastases and extensive lymph node metastases, 6 months after the operation. The prognosis of this entity, which has never been reported in the English medical literature and is difficult to preoperatively differentiate from hepatic cystadenocarcinoma, therefore seems to be extremely poor.

Bile Duct Neoplasms↗
PubMedDate not supplied

Characteristics of sarcomatous cholangiocarcinoma of the liver.

BACKGROUND/AIMS: The aim of this study was to clarify the clinicopathological characteristics of intrahepatic cholangiocarcinoma with sarcomatous changes. METHODOLOGY: Four cases of cholangiocarcinoma with sarcomatous change were identified and investigated. The clinicopathological findings, including the results of immunohistochemical staining, were investigated in comparison with those of ordinary cholangiocarcinoma. RESULTS: Two of them exhibited pyrexia as the initial symptom. The serum alkaline phosphatase level in sarcomatous cholangiocarcinoma was significantly lower than that in ordinary cholangiocarcinoma. Both the serum carcinoembryonic antigen and carbohydrate 19-9 level in sarcomatous cholangiocarcinoma also tended to be lower than those in ordinary cholangiocarcinoma. The carcinomatous component of all tumors was mostly poorly differentiated adenocarcinoma. The associated microscopic findings were as follows: lymphocyte infiltration in the tumor, accompanied by both necrosis and extensive lymph node metastases. Three of them predominantly exhibited spindle-shaped sarcomatous changes, whereas the other case predominantly demonstrated pleomorphic-type sarcomatous changes. The sarcomatous area was positive for both vimentin, a mesenchymal marker, and for epithelial markers, furthermore, in 3 of 4 cases, the carcinoma portions were also positive for vimentin. The overall survival curves were not significantly different between the 2 groups, however, no long-term survivor was found in sarcomatous cholangiocarcinoma. CONCLUSIONS: The main characteristics of cholangiocarcinoma with sarcomatous changes are considered to be as follows: 1) often demonstrating pyrexia as a symptom; 2) not always demonstrating remarkable abnormal findings in the laboratory data including tumor markers; 3) histologically showing poorly differentiated adenocarcinoma; and 4) showing a very poor prognosis (especially, in a pleomorphic-type).

Aged↗
PubMedDate not supplied

Small hepatocellular carcinoma with minute satellite nodules.

BACKGROUND/AIMS: To investigate the clinicopathologic characteristics of small hepatocellular carcinoma with minute satellite nodules. METHODOLOGY: We investigated the clinicopathologic characteristics of 131 solitary small (< or = 2.0 cm in diameter) hepatocellular carcinomas including 105 hepatocellular carcinomas without minute satellite nodules and 17 hepatocellular carcinomas with minute satellite nodules smaller than 5 mm, and also discuss the clinical significance. RESULTS: None of the clinical backgrounds of the patients and pathologic features of the main tumor, except for the average of preoperative serum alpha-fetoprotein, were significantly different between the two groups. Firstly, minute satellite nodules demonstrated that the maximum diameter of all minute satellite nodules was 1.5-4.0 mm, secondly, the moderately to poorly differentiated hepatocellular carcinomas had 4 or more minute satellite nodules within 1 cm from the main tumor, while well differentiated hepatocellular carcinomas may have 1 or 2 minute satellite nodules 6 cm or more away, and thirdly, 4 or more minute satellite nodules may present within 1 cm in intrahepatic metastasis cases, while 1 or 2 minute satellite nodules may be present 6 cm or more away from the main tumor in multicentric occurrence cases. CONCLUSIONS: At least 13% of solitary small hepatocellular carcinomas had preoperatively undetectable minute satellite nodules. In case of moderately to poorly differentiated hepatocellular carcinomas, hepatic resection as well as percutaneous ethanol injection should be performed including the surrounding liver tissue at least 1.0 cm from the main nodule. On the other hand, in well-differentiated hepatocellular carcinomas, which may indicate multicentric occurrence, closer observation and careful follow-up after therapy are recommended.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Clinicopathological characteristics of patients with extrahepatic recurrence following a hepatectomy for hepatocellular carcinoma.

BACKGROUND/AIMS: None of the previous studies have compared the prognosis or clinicopathological factors between the patients with extrahepatic recurrence and those with intrahepatic recurrence of hepatocellular carcinoma after a hepatic resection. METHODOLOGY: The clinicopathological features and prognoses of patients with extrahepatic recurrence after a curative hepatectomy for hepatocellular carcinoma were investigated. RESULTS: Twenty-three patients with extrahepatic recurrence had more advanced-stage hepatocellular carcinoma at the primary operation compared to 186 patients with intrahepatic recurrence. After adjusting for tumor size, the prognosis of the 2 groups were comparable. However, among the patients with hepatocellular carcinoma exceeding 5 cm in diameter, the number of patients whose plasma levels of des-gamma-carboxy prothrombin was higher than 2.0 AU/mL in the patients with extrahepatic recurrence (62.5%) was significantly more (P < 0.05) than that in the patients with intrahepatic recurrence (20.0%). On the other hand, the prognosis of the 13 patients with extrahepatic recurrence alone was significantly better than in the 10 patients with both intrahepatic and extrahepatic recurrences. The prognoses of the 3 patients who underwent a surgical resection for isolated extrahepatic recurrence were markedly better than that of the remaining 10 patients only treated palliatively. CONCLUSIONS: If patients have tumors exceeding 5 cm in diameter and their plasma levels of des-gamma-carboxy prothrombin are higher than 2.0 AU/mL, more careful follow-up examinations than usual may thus be necessary in order to detect extrahepatic recurrence as early as possible. Furthermore, a surgical resection for the isolated extrahepatic recurrence of hepatocellular carcinoma is also recommended to produce long-term survivors.

Adult↗
PubMedDate not supplied

Multiple primary gastric and colorectal cancer in Japan.

The features of multiple primary gastric and colorectal cancer (MPGCC) were investigated, using 447 patients with primary gastric cancer and 199 with colorectal cancer during 1981-1992. Thirteen of these patients were found to have adenocarcinoma in both the stomach and colorectum. The increase rate for MPGCC and colorectal cancer was higher than that of primary gastric cancer (p < 0.05). Of the 13 patients with MPGCC, 8 showed synchronous MPGCC, while 5 showed metachronous MPGCC. Five of the 8 patients with synchronous MPGCC showed either Stage I or II in both lesions of the stomach and colorectum, and all 5 patients with metachronous MPGCC showed Stage I or II in the lesion of the second primary cancer. Since patients with MPGCC are expected to have a relatively good prognosis, both a preoperative examination and postoperative follow-up will be needed in order not to overlook lesions of the stomach or colorectum in patients with MPGCC.

Adenocarcinoma↗
PubMedDate not supplied

Cystic neoplasms of the liver: a report of two cases with special reference to cystadenocarcinoma.

We herein present two cases with cystic neoplasms of the liver, both successfully treated by a surgical resection. One patient underwent a tumor enucleation, while the other had a left hepatic lobectomy and left caudate lobectomy. Although the follow-up period is still relatively short, both patients are doing well without any sign of recurrence. The specimens were histopathologically examined including immunohistochemical staining. Both tumors were unilocular-cystic and contained mucus. One tumor was considered to have originated from a cystadenoma with a mesenchymal stroma, which has been espoused by Wheeler and Edmondson, while the other tumor was considered to have originated from the bile duct. Therefore, the diagnosis of one patient was cystadenocarcinoma, while the other was considered to be a mucin-producing papillary adenocarcinoma of the intrahepatic bile duct. No invasive growth to the liver parenchyma or the surrounding tissues was observed in either case. Thus, a surgical resection should be the first choice of treatment for cystic neoplasms of the liver. Furthermore, a malignant transformation of cystadenoma with a mesenchymal stroma should be given a special entity in cystadenocarcinoma.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

A refined method of trans-thoracoabdominal hepatectomy for cirrhotic patients with hepatocellular carcinoma.

A hepatectomy in cirrhotic patients with hepatocellular carcinoma, located in either the posterior or superior part of the right lobe, inevitably requires a forced mobilization of the right lobe. Such a forced procedure causes a decreased hepatic blood flow resulting in postoperative morbidity and mortality, as well as an increased risk of the intrahepatic dissemination of cancer cells during the operation. We have thus refined the method of trans-thoracoabdominal hepatectomy to minimize those demerits of conventional transabdominal hepatectomies. The main characteristics of our refinements are as follows; (1) an optimal incision for the best short-cut to the hepatocellular carcinoma is determined by a three-dimensional imaging of either helical computed tomography and/or magnetic resonance imaging before operation; (2) a complete view of the operative field is obtained by the pertinent use of rotating the operation table, on which the patient is placed in a left semi-lateral position; (3) this method is suitable for resecting a tumor located in the posterior segment such as a posterior segmentectomy. This refined method is considered to decrease the postoperative morbidity including post-operative hepatic dysfunction and is also useful for cirrhotic patients with hepatocellular carcinoma.

Carcinoma, Hepatocellular↗