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Biomedical subjects

K Tsukada

Publications and source records attributed to K Tsukada.

At least 145 records · Page 8Linked to original sources
PubMed1996

[Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].

The efficacy of 1/2 FAM, which consists of 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin C (MMC), was compared with that of palliative treatment in patients with unresectable pancreatic and biliary tract carcinomas in a multicenter randomized trial. The patients assigned to 1/2 FAM group were treated with 5-FU 200 mg/m2/day IV, ADM 15 mg/m2/day IV and MMC 5 mg/m2/day IV. These 3 drugs were given concurrently as the initial dose within a week after palliative operation, and this regimen was repeated for at least 2 whole courses, at 4-week intervals before the next course of therapy. Those randomized to the control group were subjected to palliative treatment alone. Completely eligible for analysis were 42 cases of the 1/2 FAM group and 41 of the control group. There was no significant difference between the groups with respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy. As for the duration of 50% inhibition of tumor progression, a significantly better outcome was obtained in 1/2 FAM group. Tumor progression was most significantly inhibited in patients with gallbladder carcinoma. In 1/2 FAM group, tumor reduction was achieved in 1 CR and 2 PR patients. The most frequent adverse reaction was gastrointestinal manifestations, along with diarrhea and alopecia. 1/2 FAM did not contribute to the life prolongation, but inhibited the tumor progression for a significantly longer duration and, to a lesser extent, reduced the tumor size in unresectable pancreatic and biliary tract carcinomas. This regimen is suggested to be useful particularly in the treatment of the latter carcinoma.

Adult↗
PubMed1996

The extracellular matrices and vascularization of the developing corpus luteum in rats.

The extracellular matrices and vascularization of the developing corpus luteum of adult female rats were studied with immunohistochemistry for laminin, type I, III and IV collagen and with electron microscopy. Ovaries were removed from Wistar-Imamichi rats that had a regular 4-day estrous cycle, 6 and 2 h before ovulation, immediately after ovulation, 6, 16 and 24 h after ovulation and at maturity of the corpus luteum and examined. The basement membrane of the follicles and capillaries of the theca interna started to break down around the entire circumference of the Graafian follicle 2 h before ovulation. More than 6 h after ovulation, dot-pattern positive reactions for type IV collagen and laminin were detected in the granulosa layer, and thin basement membrane structures appeared in association with the luteinizing granulosa cells. More than 16 h after ovulation, vascularization with the formation of capillary basement membrane was observed in the granulosa layer, and luteal mesenchymal cells with adjacent interstitial collagen components always appeared in close association with the newly formed capillaries. Our chronological observations revealed that both luteinizing cells and luteal mesenchymal cells are involved in the destruction and reconstruction of the follicular ECM, and that the luteal mesenchymal cells play an essential role in the neovascularization of the developing corpus luteum.

Animals↗
PubMed1996

Junction of the cystic duct with the left hepatic duct: report of a case discovered during laparoscopic cholecystectomy.

We report a case of an anomalous junction of the cystic duct with the left hepatic duct found during laparoscopic cholecystectomy. Only five other patients with this anatomy have been reported. Two of these five patients had left-sided gallbladders, and the remaining patients (including ours) had their gallbladder in its normal location. Although the prevalence of this anomaly associated with left-sided gallbladders is 5.6 to 14.3%, this anomaly appears to be quite rare in patients with gallbladders in the normal position. In four cases, it was accompanied by left-sided gallbladder or low bifurcation of the common hepatic duct. This rare condition may accompany other biliary anomalies and should be kept in mind when performing cholecystectomy.

Bile Duct Diseases↗
PubMed1995

Hepatic metastases from carcinoma of the gallbladder.

BACKGROUND: The optimal hepatic resection margin for gallbladder cancer (GBC) is still debated. To explore this issue, the authors analyzed the mode of hepatic spread of GBC. METHODS: Of 85 patients undergoing radical cholecystectomy, 20 had hepatic metastases. The pattern of hepatic metastasis was examined grossly and histologically in specimens. RESULTS: Twelve patients had evidence of microscopic angiolymphatic portal tract invasion, with or without direct liver invasion. Four had direct invasion alone, and three had distant hepatic metastatic nodules. The distance (y axis) between the farthest angiolymphatic lesion and primary tumor (mm) correlated significantly with the gross depth (x axis) of direct invasion (mm): y = 1.3 + 0.33x (r = 0.88, P < 0.01). Three patients with metastatic nodules died of blood-borne disease within a year. Eight of the others obtained either long-term palliation or cure after potentially curative resection. Lymph node metastases were detected in 90% of patients. CONCLUSIONS: The extent of microscopic angiolymphatic portal tract invasion correlates well with the gross depth of direct invasion of the liver. This correlation may be useful for estimating adequate hepatectomy margins. A hepatectomy with an adequate margin combined with a radical lymphadenectomy provides benefit for selected patients with hepatic metastases.

Aged↗
PubMed1995

Noticeable hyperbilirubinemia following major hepatectomy in patients with biliary tract carcinoma.

Serum bilirubin concentrations were examined in patients who received hepatectomy for biliary tract carcinoma. They were divided into two groups according to the presence or absence of preoperative obstructive jaundice (POJ): the POJ group (n = 14) and non-POJ group (n = 10). The POJ group underwent percutaneous transhepatic drainage to delineate jaundice before definitive surgery. Total bilirubin concentration in the POJ group had increased at 1, 3, 5, 7 and 14 days after operation compared to the non-POJ group; the direct bilirubin level had increased at 1, 3, 5 and 7 days, and the indirect bilirubin level had increased at 1 and 3 days. Liver functional data before and 14 days after the operation were similar for the two groups. The incidence of cholangitis was higher in the POJ group than in the non-POJ group. Blood loss was greater in the POJ group than in the non-POJ group. The morbidity rate in the POJ group was higher than that in the non-POJ group. These results suggest that characteristic hyperbilirubinemia developed after major hepatectomy in patients with biliary tract carcinoma, and the bilirubin response is evoked by underlying preoperative biliary passing disturbance.

Aged↗
PubMed1995

Blunt pancreatic trauma with main pancreatic duct disruption managed successfully with total parenteral nutrition: report of a case.

Although surgery is the usual treatment of choice for pancreatic trauma with disruption of the main pancreatic duct, we report herein the case of a patient in whom blunt pancreatic trauma with disruption of the proximal main pancreatic duct was successfully managed by conservative treatment. An 18-year-old women presented with abdominal pain 22 days after being involved in a car accident in which her upper abdomen was thrust against the steering wheel. Computed tomography revealed a pancreatic pseudocyst and a prevertebral pancreatic fracture, and endoscopic retrograde pancreatography showed complete disruption of the main pancreatic duct at the neck. Considering that the patient had been clinically stable since the accident, we elected to continue with conservative management and placed her on total parenteral nutrition. Rapid recovery followed and 6 years later, the patient remains well without any exocrine or endocrine insufficiency despite atrophy of the distal pancreas. This experience indicates that selected cases of main pancreatic duct disruption following blunt trauma may be amenable to conservative management.

Adolescent↗
PubMed1995

Hepatic functional reserve in patients with obstructive jaundice: an assessment by the redox tolerance test.

PURPOSE: Hepatic mitochondrial response to oral glucose load (redox tolerance test) was evaluated as an indicator of hepatic functional reserve of patients with obstructive jaundice. PATIENTS AND METHODS: The redox tolerance test was performed in 29 patients with obstructive jaundice before percutaneous transhepatic biliary drainage and 2 weeks after the procedure. RESULTS: The redox tolerance index (RTI) before drainage was not related to conventional parameters other than albumin, but was significantly associated with bilirubin half-life (P < 0.01). Of 19 patients with an RTI > or = 0.5 before drainage, all maintained similar values after drainage and experienced satisfactory clinical courses, even after major surgery. Of 10 patients with an RTI < 0.5 before drainage, 5 showed improvement and 5 deteriorated after drainage. Four of the latter 5 died within 60 days after drainage. The hospital mortality was significantly greater in patients with initial RTI < 0.5 than in patients with RTI > or = 0.5 (P < 0.01). CONCLUSION: The redox tolerance test is useful for evaluating hepatic functional reserve and prognosis in patients with obstructive jaundice.

Adult↗
PubMed1995

Expression of deoxyuridine triphosphatase during liver regeneration in rat.

Deoxyuridine triphosphatase (dUTPase) activity increases concomitantly with DNA replication in the course of liver regeneration in rat. We confirmed in this report using Western blot analysis and Northern blot hybridization that the increase of dUTPase activity was derived from expression of the gene. The content of dUTPase protein quantitatively coincided with the activity, they reached to the maximum at about 24 h after partial hepatectomy. We also detected a transcript (1.0 kb) presumed to be a rat spleen dUTPase mRNA by the human dUTPase cDNA probe. This transcript appeared in the liver after a lag of about 16 h, reached to the maximum at 24 h, and could be detected until 48 h after partial hepatectomy. The increase of this transcript nearly coincided with the changes of dUTPase activity and the quantity of enzyme protein. These results indicated that the expression of dUTPase gene is related to the DNA replication.

Animals↗
PubMed1994

Molecular properties, substrate specificity and regulation of DNA-dependent protein kinase from Raji Burkitt's lymphoma cells.

A double-stranded DNA-dependent protein serine/threonine kinase (DNA-PK) was purified from a nuclear extract of Raji Burkitt's lymphoma cells by a three-step column-chromatographic procedure. The main silver-stained band visualized after SDS/PAGE corresponded to an autophosphorylated polypeptide of about 350-kDa that represents the catalytic component. The existence of Ku DNA-binding protein as a regulatory component in the purified enzyme was revealed by Western blot/enzyme immunoassay and direct inhibition test with anti-Ku sera from the autoimmune patients. The DNA-PK catalyzed phosphorylation of synthetic peptides corresponding to Myc and RB proteins in a DNA-dependent manner, indicating that DNA-PK may recognize a second core-sequence motif Pro-Ser/Thr- in addition to the putative consensus sequences of -Ser/Thr-Gln. The level of enzyme activity was significantly higher in DMSO-induced G0/G1-arrested Raji cells as well as in the cells after release from DMSO than in the log-phase cells.

Amino Acid Sequence↗
PubMed1994

Stimulation of DNA-dependent protein kinase activity by high mobility group proteins 1 and 2.

After incubation of high mobility group (HMG) proteins 1 and 2 with DNA-dependent protein kinase (DNA-PK) and [gamma-32P]ATP in the presence of double-stranded DNA, not only phosphorylation of HMG proteins but also enhancement of autophosphorylation of the catalytic polypeptide of 350 kDa in DNA-PK was observed. DNA-PK activity determined with a synthetic peptide and alpha-casein as substrates was stimulated several-fold by HMG1, HMG2, and the DNA-binding domains. The stimulation was decreased at higher concentrations of HMG proteins, and DNA-PK activity was inhibited by histone H1. Electrophoretic mobility shift analysis suggests that HMG proteins facilitate the binding of DNA-PK to DNA.

Adenosine Triphosphate↗
PubMed1994

Major hepatectomy and pancreatoduodenectomy for advanced carcinoma of the biliary tract.

Seven patients with advanced carcinoma of the extrahepatic biliary tract, including two with cancer of the gallbladder, underwent major hepatectomy with concomitant pancreatoduodenectomy. The mean hepatic volume resected was 64 (range 35-81) per cent. Postoperative complications occurred in all patients and accounted for two hospital deaths. Two patients with gallbladder carcinoma survived without recurrence for 22 and 58 months. Three of five patients with bile duct cancer survived operation, although all three subsequently died from recurrent disease at 8, 10 and 27 months. Combined major hepatectomy and pancreatoduodenectomy may be appropriate in selected patients with advanced cancer of the gallbladder. Further evaluation is necessary before this approach can be recommended for those with advanced bile duct carcinoma.

Aged↗