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Biomedical subjects

M Makuuchi

Publications and source records attributed to M Makuuchi.

At least 433 records · Page 24Linked to original sources
PubMed1989

[Imaging of adenomatous hyperplastic lesions containing and not containing hepatocellular carcinoma in the liver].

In 41 patients with 54 lesions which were resected ans studied histopathologically, there were 14 lesions of adenomatous hyperplasias (AH) in 9 patients, 28 AHs containing hepatocellular carcinoma foci (early HCC, e-HCC) in 22 and 12 borderline lesions which fell between these two lesions in 10. The detectability of these lesions on imagings was evaluated. Detection rates for all lesions and e-HCCs were as follows; intraoperative sonography, 70.0%, 87.5%; Portal-CT, 71.4%; sonography, 44.4%. 64.3%; Arterial-CT, 37.5%, 50.0%; CT, 32.7%, 57.7%; angiography, 17.0%, 30.8%; Lipiodol-CT, 9.1%. 25.0%. On angiography, tumor stain was recognized in only 8 patients with e-HCC. Arterial-CT showed a relatively low density mass compared to non-tumorous area in 2 patients with e-HCC and one with borderline lesion. The median size of 54 lesions was 1.2 +/- 0.4 cm in diameter and that of AHs was 0.8 +/- 0.3 cm, the latter being significantly smaller than the other two lesions (p less than 0.01). Liver cirrhosis coexisted in 35 of 41 patients (85.4%). No complete necrosis occurred in 13 e-HCC lesions following therapeutic embolization or infusion chemotherapy in the hepatic artery.

Aged↗
PubMed1989

A rare case of asynchronous bilateral B-cell lymphoma of the breast.

We report an asynchronous bilateral malignant lymphoma of the breast, in a 56-year-old woman, presenting unusual clinical signs and histological features. The patient, who had a family history of breast cancer, had undergone a standard right radical mastectomy four years previously for a non-epithelial malignant tumor. At that time, the tumor was thought to be a stromal sarcoma, because some of the neoplastic cells were elongated or vacuolated. The patient recently became aware of a rapidly growing tumor of the left nipple without erosion or pain. This tumor underwent biopsy, and the histological examination showed a non-Hodgkin's lymphoma of diffuse mixed type. Staging procedures demonstrated no sign of generalized disease. Following a modified left radical mastectomy for optimal local control and accurate staging, adjuvant chemotherapy consisting of vincristine, cyclophosphamide, prednisolone and doxorubicin was initiated. Immunohistochemical staining for PAN-B and leucocyte common antigen revealed both tumors to be malignant lymphomas of B-cell type, and the first lymphoma of the right breast was thought to be showing 'signet ring' cell change. Since the two tumors were morphologically quite different from each other, it was suggested that they were asynchronous bilateral primary malignant lymphomas; however, the possibility remains that the recent left breast tumor is a recurrence of the malignant lymphoma of the right breast. The patient is currently disease-free, 10 months after surgery.

B-Lymphocytes↗
PubMed1988

Increasing incidence of hepatocellular carcinoma possibly associated with non-A, non-B hepatitis in Japan, disclosed by hepatitis B virus DNA analysis of surgically resected cases.

At the National Cancer Center Hospital in Japan, the total number of surgically treated hepatocellular carcinomas (HCCs) has been increasing steadily and rapidly over the last 10 years, whereas the number of cases positive for hepatitis B surface antigen in sera (HBsAg) has remained almost stable. Thus, the relative percentage of HCC cases with serum HBsAg has shown a marked decrease. In order to examine whether this increased proportion of HBsAg-seronegative patients carries hepatitis B virus (HBV) DNA in the liver, we extracted DNA from the formalin-fixed and paraffin-embedded cancerous and noncancerous liver tissues of 79 patients with HCC. The HCCs examined included 49 specimens resected during a period from 1970 to 1980 and 30 resected in 1986 and 1987. We were able to detect reliably the presence of HBV DNA by dot-blot hybridization. The presence of HBV DNA in liver tissues showed a good correlation with positivity for serum HBsAg in both examined groups. In total, HBV DNA was detected in 81% (21 of 26) of HBsAg-seropositive cases and in only 8% (4 of 53) of HBsAg-seronegative cases, indicating that the increased number of HBsAg-seronegative cases had no HBV involvement. Among these HBsAg-seronegative HCC patients, 89.7% showed a histology of cirrhosis or chronic active hepatitis in the noncancerous liver and 29.1% had a history of blood transfusion. These results suggest an increasing incidence of non-A, non-B hepatitis-associated HCCs in Japan and the possible transmission of factors by means other than blood transfusion.

Carcinoma, Hepatocellular↗
PubMed1988

A case of hepatocellular carcinoma with tumor thrombi in the epiploic vein.

A case of hepatocellular carcinoma (HCC) with tumor thrombi in the vein in the major omentum is reported. A 54-year-old man underwent a second operation for recurrent HCC. Intraoperative ultrasonography revealed a tumor thrombus in the vein of the adhering omentum. Part of the antero-inferior area of the liver adjacent to the tumor was resected with the major omentum. Since it is characteristic of HCC often to form tumor thrombi in the veins, it is not surprising that the tumor budded into the epiploic vein. This is apparently the first report of tumor thrombi of HCC in the epiploic vein.

Carcinoma, Hepatocellular↗
PubMed1988

[A new technic of hepatectomy using peroperative echography and intraparenchymatous guide needles. The geometer technic].

A new technique of hepatectomy is described, using intra operative ultrasound and dental cleaner needle. The needle is inserted in the liver under ultrasonographic guidance, in order to mark the vessel which feed the tumor. Then the trans-section of the liver begins near the needle and the contact of its hip allows an elective ligation of the vessel. Thus the hepatectomy is performed safely along the ischaemic line of the subsegment bearing the tumor. The needle have been also used to mark the adjacent segmental portal vein and the hepatic vein which have to be secured during the operation. We have done 12 hepatectomies in cirrhotic patients with this technic without any complication.

Aged↗
PubMed1988

Treatment of a case of asynchronous bilateral renal cell carcinomas with inferior vena caval thrombus and hepatic metastases.

A 56-year-old man underwent a right radical nephrectomy with removal of a vena caval thrombus and resection of hepatic metastases for right renal cell carcinoma. Twenty-one months after the first operation, a left renal cell carcinoma was detected which was treated with left radical nephrectomy and followed by hemodialysis. The patient then enjoyed an active life for 14 months but died 18 months after his second operation due to lung metastasis. Bilateral radical nephrectomy and hepatic resection may be justified since there is no strongly effective adjuvant therapy for such advanced cases.

Carcinoma, Renal Cell↗
PubMed1988

[Significance of combination therapy involving aggressive resection and arterial infusion in hepatic metastasis from colo-rectal cancer].

During the past 13 years, 125 patients with liver metastasis from colorectal cancer underwent hepatic resection. Among these patients, 90 received potentially curative hepatectomy except for twelve patients who received curative hepatectomy combined with hepatic arterial infusion therapy and 23 patients who received non-curative surgery. The results of surgical treatment, and modes of recurrence following hepatectomy were studied in these 90 patients. The overall 5-year survival rate was 38.6%. Recurrent tumor developed in 59 patients, 42 being found in the remnant liver (47%), 15 in the lung (17%) and 8 at the primary site. The survival rate of the 43 patients who received systemic chemotherapy after hepatectomy was similar to that of the 24 patients who received no chemotherapy. According to this analysis, we have designed a chemotherapy protocol involving infusion through hepatic artery using on Infusaid port, to prevent regrowth in the remnant liver and pulmonary metastasis. In our program, MMC 10mg and 5-FU 750 to 1,000 mg/body were given through the Infusaid port, and HCFU 400 mg orally. Although the follow-up period has been short, no regrowth in the remnant liver has developed in 12 patients who received this treatment.

Adult↗
PubMed1988

[A study of CDDP in the treatment of patients with gastric and esophageal cancers, with special reference to the evaluation of renal functions before and after CDDP administration].

Although CDDP has been widely used for cancer chemotherapy in recent years, the problem is that it causes a renal dysfunction as a side effect. As briefly reported here, we have currently used this drug for the treatment of stomach esophageal cancers as a part of multidepartmental therapy, and obtained a finding on the therapeutic usefulness, particularly for monitoring the renal function before and after administration. The subjects were 6 patients with stomach and 11 with esophageal cancer given CDDP at the dose of 50 mg 2 courses, in principle, a single course per week. Blood transfusion was carried out in an amount of 1,000 ml before administration, 2,500 ml on the day of treatment and 1,000 ml for 3 days after administration. When the effects of CDDP on urinary BUN, Na, K, Cl, Mg, NAG, beta 2 microglobulin, Ccr and FENa levels were measured for the determination of renal functions before and after administration, NAG and beta 2 microglobulin levels were conceivably found to be useful indices.

Adult↗
PubMed1987

Pathology of small hepatocellular carcinoma. A proposal for a new gross classification.

Review of 61 surgically resected small hepatocellular carcinomas (HCC) less than or equal to 3 cm in diameter yielded a simple gross classification system of five types based on tumor shape, which is highly correlated with microscopic and clinical features, including prognosis. Type 1 (single nodular type) tumors (n = 13) are expansile, roughly spheric, and often encapsulated. In Type 2 tumors (single nodular type with extranodular growth) (n = 21), replacing growth is often seen in the area of extranodular growth. Type 3 tumors (contiguous multinodular type) (n = 19) consist of small nodules growing in contiguity, often with replacing growth at the periphery. Type 4 (poorly demarcated nodular type) is a rare tumor showing infiltrating growth at its border. The authors define early HCC (n = 5) as the presence of tumor without destruction of the underlying liver structure. The lesions experienced are tiny (less than or equal to 1.2 cm) and well differentiated. Poorly differentiated histologic characteristics and elevated alpha fetoprotein are more common in Types 2 and 3 than in Type 1. Type 1 has the highest rates of positive serum hepatitis B surface antigen and liver cirrhosis; portal vein tumor thrombus (PT) and/or intrahepatic metastasis (IM) is rare (7.7%), and the effect of transcatheter arterial embolization (TAE) is remarkable. This contrasts with Type 2, which has a high rate of PT and/or IM (71.4%) and multiple local recurrences (40%), and with Type 3, which shows a poor response to TAE.

Adult↗
PubMed1987

Imaging characteristics of large lipoma and angiomyolipoma of the liver. Case reports.

A large lipoma and a large angiomyolipoma of the liver, one case each, are described. In the first case, a 24 X 14-cm homogeneous mass demonstrated a fatty density (-96H) on computed tomography (CT), echogenicity on sonography, and fine neovascular vessels on angiography in the right lobe of the liver. Histopathologic diagnosis of the resected specimen was lipoma. The second case showed a 9-cm fatty mass (-66H) with some enhanced interior nodules in the left lateral area of the liver on CT. Sonography disclosed a large echogenic mass with echolucent nodules, which were seen as stains on the angiogram. Angiomyolipoma was the histopathologic diagnosis. Among these diagnostic modalities, the CT scan provided the most specific and reliable findings. Both patients are doing well more than 2 years and 9 months after resection.

Adult↗
PubMed1987

Hepatocellular carcinoma: treatment with intraarterial iodized oil with and without chemotherapeutic agents.

Thirty-one patients with hepatocellular carcinoma (HCC) were given either an intraarterial injection of iodized poppyseed oil (Lipiodol) alone (group A, n = 6), an emulsion of iodized oil and doxorubicin hydrochloride (Adriamycin) (group B, n = 15), or chemoembolization with the same emulsion followed by gelatin sponge (Gelfoam) particles (group C, n = 10). Hepatic resection was subsequently performed. The frequencies of complete necrosis of tumor in the main lesion, daughter tumors, tumor thrombus, and foci of intracapsular invasion were evaluated in the cut surface of the resected specimen. Group C demonstrated the best therapeutic effects, showing complete necrosis of the main lesion in 83% (P less than .01), daughter tumors in 53% (P less than .01), tumor thrombus in 17%, and foci of intracapsular invasion in 67%. These results are superior to those reported previously for chemoembolization without iodized oil. Group B showed better results than group A, but the difference was not significant. Iodized oil alone (group A) had practically no therapeutic effect but was helpful in differentiating small HCC from regenerative nodules.

Adult↗
PubMed1987

Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein.

Among the accessory hepatic veins, the thickest one is the IRHV and is a significant vessel in 20 to 24 per cent of the patients. In these patients, if the right hepatic vein is totally resected, the right posteroinferior area can be preserved with the IRHV. Four types of hepatectomies n which the IRHV was preserved were proposed and three of the four procedures were performed upon five patients. In these five operations, the hepatectomies were successfully performed and blood losses were from 1,020 to 3,200 milliliters. These operative procedures, which have not been described before, could widen the indication of hepatectomy in patients with reduced liver function and tumor involving the right hepatic vein. In order to perform these operative procedures successfully, intraoperative sonography is indispensable.

Adult↗
PubMed1987

Safety of hemihepatic vascular occlusion during resection of the liver.

To minimize both intraoperative bleeding and circulatory and biochemical disturbances due to the interruption of blood flow to the liver, we developed a technique for selective, mostly unilobar, control of the hilar vessels to the liver called hemihepatic vascular occlusion. One hundred and fifty-three patients who underwent hepatic resection were divided into four groups with and without cirrhosis of the liver and with and without hemihepatic vascular occlusion which was limited to 30 minutes followed by five minutes of perfusion, which was repeated if necessary. This technique reduced the intraoperative blood loss and the postoperative hyperbilirubinemia significantly but did not produce larger postoperative change of transaminases or lactic dehydrogenase serum levels when compared with similar resections without vascular control.

Bilirubin↗
PubMed1986

Clinical and radiologic features of hepatocellular carcinoma originating in the caudate lobe.

Five patients with hepatocellular carcinoma in the caudate lobe were evaluated. Computed tomography (CT) scan and/or angiography clearly demonstrated multiple intrahepatic metastases in four (80%), and tumor thrombi in the portal vein in two (40%), and in the inferior vena cava in one. Even though there was no recognizable lung metastasis, metastases were found in the orbita in one patient, and in the ribs and thoracic vertebrae in two patients. Four patients died after a mean period of 5.5 months from the initial diagnosis. The mechanism for early invasion into the vessels and multiple intrahepatic metastases of hepatocellular carcinoma arising from the caudate lobe is discussed.

Angiography↗
PubMed1986

Hepatic lobar atrophy following obstruction of the ipsilateral portal vein from hilar cholangiocarcinoma.

Gross deformity of the liver associated with hilar carcinoma is rare. In 17 patients with hilar cholangiocarcinoma and intrahepatic bile duct dilatation, the relationships between lobar or segmental atrophy, compensatory hypertrophy, and patency of portal vein branches were evaluated with computed tomography (CT) and angiography. All six patients with obstructed or narrowed portal veins (group A) had lobar or segmental atrophy on CT scans and angiograms. Compensatory hypertrophy was observed in the unaffected lobe with a patent portal vein in five. In contrast, neither hepatic atrophy nor hypertrophy was demonstrated in the other 11 patients with patent portal veins. All group A patients had differences in hepatic attenuation on CT scans or dense opacification during the hepatogram phase of angiography. Biliary decompression was optimized when the bile duct selected for percutaneous drainage paralleled a patent portal vein. Knowledge of radiologic findings will assist in determining the primary site along the bile duct from which carcinoma has arisen.

Adenoma, Bile Duct↗
PubMed1986

Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features.

Three cases of cavernous hemangioma of the liver having atypical imaging features are described. In the first case, an 11 x 10 cm hypervascular mass with a central hypovascular area supplied by many large tortuous vessels was demonstrated on angiography, CT, and sonography. The mass had a central cavity that contained fluid. In the second case there was a 2-cm isoechoic mass with a peripheral halo, despite the presence of typical features of hemangioma on angiography. The halo was shown histologically to be fibrous tissue surrounding the tumor. In the third case, a 6.5 x 4.3 cm mass exhibited slight peripheral enhancement on CT but was not detectable by angiography. Histologically, the tumor was hyalinized with only scattered small foci of hemangioma within it.

Adult↗