Search PubMed⌕ Search

Biomedical subjects

K Okajima

Publications and source records attributed to K Okajima.

321 records · Page 18Linked to original sources
PubMedDate not supplied

Transcatheter arterial embolization for malignant osseous and soft-tissue sarcomas. I. A rabbit experimental model.

PURPOSE: To evaluate the effect of transcatheter arterial embolization (TAE) on metastatic bone tumors in an experimental study. METHODS: Fifteen Japanese white rabbits were transplanted with VX2 sarcoma cells into the iliac crest. In 10 rabbits, the arterial supply to the iliac bone tumors, internal iliac artery and iliolumbar artery were then embolized with particles of gelatin sponge. The therapeutic effect was evaluated by comparison with the natural course of control tumors in the other five rabbits. RESULTS: After TAE, extensive necrosis, fibrosis, and vacuolization within the tumors were confirmed histologically. In the control rabbits, 19% +/- 7% of the entire tumor was found to be spontaneous tumor necrosis; in contrast, the tumors of the TAE group showed necrosis as 62% +/- 22% of the entire tumor. In one TAE group rabbit, no active tumor cell could be detected in the residual tumor. CONCLUSION: TAE was found to be an effective treatment for bone tumors in an experimental model.

Animals↗
PubMedDate not supplied

Transcatheter arterial embolization for malignant osseous and soft tissue sarcomas. II. Clinical results.

PURPOSE: To evaluate the clinical effects of transcatheter arterial embolization (TAE) on malignant bone and soft tissue tumors. METHODS: TAE was performed in 10 patients with primary bone and soft tissue sarcomas and in 31 patients with metastatic bone tumors. The embolized arteries were the internal iliac artery in 30 cases, the intercostal artery in six cases, the lumbar artery in five cases, the suprascapular artery in three cases, and the iliolumbar artery, the internal pudendal artery, and the lateral sacral artery in one case each. The embolized material was gelatin sponge particles. The chemotherapeutic drugs were usually 20-40 mg of doxorubicin for primary and metastatic tumors and 50-100 mg of cisplatin only for primary tumors. In addition, 50-60 Gy of 10-MV radiotherapy with or without radiofrequency (RF)-capacitive hyperthermia in four sessions was administered before TAE for primary tumors only. RESULTS: Even though the pain score increased immediately after TAE, 30 of 38 (79%) patients with pain (8 of 9 with primary tumors, and 22 of 29 with metastases) achieved pain control after TAE. A necrotic low-density area shown by computed tomography (CT) after TAE was found in 31 of 41 (76%) tumors [8 of 10 (80%) with primary tumors, and 23 of 31 (74%) with metastatic tumors]. The tumor size decreased in 14 of 25 (56%) primary and metastatic tumors after 3 months. Osteosclerotic changes appeared in two cases of metastatic tumors after 6 months. In five tumors resected after TAE, large areas of necrosis within the tumor were confirmed histologically. Transient local pain and numbness appeared after TAE, but were relieved by drug treatment within 1 week. No severe complications except a case of gluteal muscle necrosis were encountered after TAE. The 1-year survival rate of the patients with primary tumors was 38.1%, and the median survival was 18 months. The longest survival was 84 months. The 1-year survival rate of the patients with metastatic bone tumors was 38.9%; the median survival was 12 months. The longest survival was 24 months. CONCLUSION: TAE could be an effective treatment for pain control and local control of malignant bone and soft-tissue tumors.

Adolescent↗
PubMedDate not supplied

Transcatheter arterial infusion therapy in the treatment of advanced pancreatic cancer: a feasibility study.

PURPOSE: To evaluate the effects of transcatheter arterial infusion (TAI) therapy in 18 patients with advanced pancreatic cancer. METHODS: The drugs infused were epirubicin 60 mg, mitomycin C 20 mg, and 5-fluorouracil 500 mg. The efficacy of TAI was evaluated by a tumor marker (CA19-9), computed tomography (CT) findings, and postoperative histopathological specimens. RESULTS: In 10 of 15 cases, the tumor marker level was decreased after TAI therapy. In 6 of 14 cases, CT showed a decrease in the tumor size, and in 1 case, the tumor disappeared completely. In 6 cases the tumor could be resected. Necrosis, fibrosis, and degeneration of cancer cells were seen in 3 of 4 cases for whom a histopathological evaluation was done. The median survival was 11 months. In 17 patients back pain was the chief complaint, and was reduced to a self-controlled level in 10 patients following TAI therapy. No major complications were encountered. CONCLUSION: TAI appears to be an effective palliative treatment for advanced pancreatic cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Present status and performance of PACS at Kyoto University Hospital.

A pilot PACS project, named KIDS, has been running in Kyoto University Hospital. The purpose of the system is to establish a small PACS that includes all digital imaging modalities and to evaluate it. The project has been continued from the first phase (KIDS-1) to the second phase (KIDS-2). In the first phase, a small-scale PACS was developed. In the second phase, the expansion of coverage of modalities and completion of the image database was intended. At present, the database contains image data of 16264 patients amounting to 150 Gbytes. Simulation of the retrieval process to the database shows that 154.3 s per patient is required for retrieving his/her entire image data. This calculated value is close to the actual time.

Computer Communication Networks↗
PubMedDate not supplied

CT manifestations of a ruptured hepatic tumor after transcatheter arterial embolization.

There are few reports of the radiologic diagnosis of ruptured hepatic tumors. In a patient with right upper abdominal pain and impending shock, angiography demonstrated a hypervascular hepatic tumor, and CT imaged an extrahepatic mass suggestive of a hematoma. Following transcatheter arterial embolization with Lipiodol Ultrafluide and gelatin-sponge, multiple contiguous CT sections revealed numerous lipiodol droplets adjacent to a lipiodol-containing hepatic tumor, clearly outside the liver. These findings were indicative of a ruptured hepatic tumor. After embolization, the patient's condition improved and he was discharged.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Laser projection system for radiotherapy and CT-guided biopsy.

We devised a laser projection system combined with a CT scanner and radiotherapy treatment planning computer (CT stimulator). The irradiation field can be projected over a range of 180 degrees on the skin of a patient lying on the CT couch. For CT-guided biopsy, the system can project the skin entry point and needle direction.

Biopsy, Needle↗
PubMedDate not supplied

Does amniotomy influence the prognosis of babies in cases with severe chorioamnionitis? Report of a twin pregnancy with varying outcome.

We report our experience in a woman with a twin pregnancy. The patient suffered severe Escherichia coli chorioamnionitis and the outcomes were different between the two babies after birth. The first baby had only a mild infection, but the second suffered sepsis and subsequent perinatal death. These differences in outcome appeared to be due to amniotomy performed for the first baby after late labor stage I to augment uterus contractions. Removal of infectious amniotic fluid from the amniotic cavity might thus have prevented the spread of the chorioamnionitis. E. coli sometimes causes severe infection during pregnancy and the perinatal period. In this case, a large number of enteropathogenic E. coli (serotype O-6) was cultured from blood, stool, pharyngeal swab, gastric juice and puncture fluid from the thoracic cavity of the second baby. O-6 is classified an enterotoxigenic strain mainly causing diarrhea because of endotoxin released from bacteria. O-6 has not hitherto been reported as a cause of severe infection in chorioamnionitis and perinatal sepsis.

Adult↗
PubMedDate not supplied

Fatty acid oxidizing activity in a red marine alga, Porphyra sp.

A crude enzyme solution prepared from fronds of Porphyra sp. showed remarkable oxygen uptake activity when linoleic acid was added as a substrate. Fatty acid oxidizing activity was mainly present in the soluble fraction of the crude homogenate. The activity was purified 769-fold from mature fronds by ammonium sulfate fractionation, ion-exchange and hydrophobic chromatography. SDS-PAGE analysis of the purified proteins indicated that its subunit size was about 13 kDa. Gel filtration chromatography equipped with a photodiode array detector revealed that the activity was associated with a protein having a molecular weight of 12,500-13,000. It eluted with a chromophore having the maximum absorbance at 417 nm, thus, the protein was suggested to be a heme protein. The spectrophotometric property of the protein was highly similar to that of cytochrome c suggesting that it has heme c as a prosthetic group. The protein showed highest oxygenation activity against linoleic acid, and alpha-linolenic acid and arachidonic acid followed, but oleic acid could not be oxidized. From linoleic acid the protein formed 9- and 13-hydroperoxides to the same extent, and both were shown to be racemic. These results showed that the oxidizing activity is accountable to a cytochrome, but not to a typical lipoxygenase.

Chromatography, DEAE-Cellulose↗
PubMedDate not supplied

Development of intra-arterial hyperthermia using a dextran-magnetite complex.

Dextran-magnetite complex (DM) is a colloidal sol of subdomain magnetite particles (i.e. a 'magnetic fluid'). The specific absorption rate of DM in an AC magnetic field is much higher than those of multidomain ferrite particles due to its different mechanism of heat generation. We designed two DM-containing embolic materials (a DM/Lipiodol emulsion and a DM/degradable starch microsphere suspension) to heat target tissues with the use of an external AC magnetic field. In vitro experiments showed that the heat-generating capacity of DM was not reduced in these mixtures. When these materials were injected into the renal arteries of Japanese white rabbits, they both achieved embolization of the artery and selective heating of the embolized kidney by exposure to a 100 kHz AC magnetic field of approximately 15,000 A/m. Histological examination showed a homogeneous distribution of DM in the embolized kidney. These results suggest the possibility of using DM-containing embolic materials for inductive hyperthermia.

Animals↗
PubMedDate not supplied

Effectiveness of paraaortic lymph node dissection for advanced gastric cancer.

BACKGROUND/AIMS: To evaluate the effectiveness of paraaortic lymph node dissection (D4) for gastric cancer from the viewpoint of long-term results. METHODOLOGY: Among 879 patients who underwent gastrectomy for advanced gastric cancer, 130 patients who underwent D4 lymphadenectomy were evaluated in relation to clinicopathological findings and long-term results. RESULTS: The frequency of histological paraaortic lymph node metastasis (n4) was 23.1% (30/130). The cumulative 5-year survival rate of 30 n4 patients with D4 lymphadenectomy was 16.7%, which was higher than that (4.2%) of n4 patients without D4 (sampling of paraaortic lymph nodes). Among n4 patients with D4 lymphadenectomy, the cumulative survival rate in 8 patients with 1-2 paraaortic lymph nodes involved (5-year survival rate: 50%) was significantly higher than that in 21 patients with 3 or more paraaortic lymph nodes involved (5-year survival rate: 4.6%). According to the intra-operative macroscopic extent of lymph node metastasis, the cumulative survival rate of patients who were judged as N2 was higher than that of patients judged as N4. CONCLUSIONS: Paraaortic lymph node dissection for advanced gastric cancer was effective, especially when it was done prophylactically and when the number of paraaortic lymph node metastases were 2 or less.

Aorta↗
PubMedDate not supplied

General and specific prognostic factors of early gastric carcinoma treated with curative surgery.

BACKGROUND/AIMS: In Western countries as well as in Japan, the percentages of early gastric cancer (EGC) have been increasing. This study was performed to clarify the general and specific prognostic factors of EGC. METHODOLOGY: General prognostic factors were evaluated in 601 EGC patients treated with curative surgery, including those who died of unrelated causes, and specific prognostic factors were evaluated in 471 EGC patients, excluding those dying of unrelated causes, using univariate and multivariate analysis. RESULTS: The overall 5- and 10-year survival rates in the EGC patients were 86.7% and 76.6% respectively. In all 601 patients, including those who died of other causes, general prognostic factors, according to multivariate analysis, were sex, age, primary malignant diseases other than the original EGC, depth of invasion, and lymph node metastasis. The specific prognostic factor was lymph node metastasis with a risk ratio of 18.6-fold against patients without lymph node metastasis, according to multivariate analysis. CONCLUSIONS: The worst prognostic factors in all EGC patients were male sex, age 60 years and over, presence of primary malignant disease other than original EGC, submucosal cancer, and lymph node metastasis. Lymph node metastasis was specifically related to EGC recurrence. Thus, lymph node dissection is indispensable for the treatment of early gastric cancer, and the surveillance of other organs or the residual stomach for primary malignancy is particularly important after surgery.

Adenocarcinoma↗
PubMedDate not supplied

Improvement of the prognosis of gastric cancer with extensive serosal invasion using left upper abdominal evisceration.

BACKGROUND/AIMS: The prognosis of gastric cancer patients with serosal invasion is very poor. In this study, the effectiveness of the LUAE (left upper abdominal evisceration) procedure for these patients was evaluated retrospectively. METHODOLOGY: Thirty-seven gastric cancer patients who had serosal invasion but no massive peritoneal metastasis or hepatic metastasis, and underwent LUAE, were enrolled in this study (LUAE group). As a control, 66 gastric cancer patients who had the same disease conditions as the LUAE group, and underwent conventional total gastrectomy with the combined resection of the pancreatic body and tail and spleen (TPS group), were also investigated. RESULTS: The survival rate (5-year, 42.2%) of the LUAE group was significantly better than that (5-year, 21.2%) of the TPS group (P = 0.009). Although D4 super-extended lymphadenectomy and intraperitoneal chemotherapy during surgery was performed more frequently in the LUAE group than those in the TPS group, multivariate analysis demonstrated that the LUAE procedure was a better independent prognostic factor. CONCLUSIONS: The LUAE procedure in combination with D4 super-extended lymphadenectomy and intraperitoneal chemotherapy improved the prognosis of gastric cancer patients with extensive serosal invasion.

Aged↗
PubMedDate not supplied

Histological evaluation of lymph node metastasis on serial sectioning in gastric cancer with radical lymphadenectomy.

BACKGROUND/AIMS: Lymph node metastasis is one of the most important prognostic factors in gastric cancer patients. To evaluate the real extent of lymph node metastasis from gastric cancer, histological examination by serial sectioning was performed. METHODOLOGY: Histological examination of serial sections of lymph nodes was performed in 111 gastric cancer patients who underwent radical gastrectomy, to evaluate methods of examining lymph node metastasis. A total of 58430 cross-sections of 3449 lymph nodes were examined. The extent of lymph node metastasis was evaluated by the routine one-section method, the 3-section method and the serial sectioning method for lymph node examination. RESULTS: The frequency of lymph node metastasis was 81.1% (90/111) and metastatic foci were detected in 23.0% of all lymph nodes by serial sectioning. Serial sectioning of distant lymph nodes showed metastasis in 23.8% by the 1 section method, and 8.4% by the 3-section method. Micrometastasis was detected in 10.5% of metastatic lymph nodes, and distant lymph nodes had a higher rate of micrometastasis. CONCLUSION: Serial sectioning resulted in more accurate evaluation of the extent of lymph node metastasis, and it was also shown that distant lymph nodes had a higher rate of micrometastasis.

Gastrectomy↗
PubMedDate not supplied

Risk factors of esophagojejunal anastomotic leakage after total gastrectomy for gastric cancer.

BACKGROUND/AIMS: The purpose of this study was to investigate the incidence of esophagojejunal anastomotic leakage (EJAL) after total gastrectomy. METHODOLOGY: Four hundred and four consecutive gastrectomy cases were reviewed to determine the incidence of esophagojejunal anastomotic leakage. RESULTS: EJAL developed in 33 patients (8.2%). The rate of leakage was found to be significantly related to the preoperative lymphocyte count and serum albumin level. Cases of para-aortic lymph node dissection (D4) had a significantly higher rate (16.1%) of EJAL than in conventional lymph node dissection (D2,3: 5.3%). The left upper abdominal evisceration group demonstrated a significantly higher EJAL rate (20.0%) than the cases without combined resection (4.8%). CONCLUSION: Aggressive surgery for advanced gastric cancer increases the risk of esophagojejunal anastomotic leakage. When aggressive surgery is necessary for curative purposes, meticulous preoperative, intraoperative and postoperative care are indispensable.

Anastomosis, Surgical↗