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M Oguma

Publications and source records attributed to M Oguma.

At least 19 recordsLinked to original sources
PubMed2000

[Prognostic factors of hepatocellular carcinoma: analysis by the proportional hazard model].

Five hundred fifty patients hospitalized to our hospital during 1990 to 1999 were studied. Subjects consisted of 413 males and 102 females and mean age was 62.1 years. Association with HBV infection, HCV infection and both infection was 11.1%, 78.4% and 2.5% respectively. According to the criteria based in Liver Cancer Study of Japan, 5 year survival rate in clinical stage I, II, III was 42.3%, 38.8% and 17.5%. Tumor morphology was nodular type in 78.9%, massive type in 9.1% and diffuse type in 10.5% of cases. Portal tumor thrombus and distal metastasis were observed in 19.9% and 6.3% of all cases. The 1-, 3- and 5-year survival rate in patients received any therapy was 80.8%, 44.6% and 28.7%, respectively. Analysis by the proportional hazard model showed that HBV infection, advanced clinical stage, multiple tumors, a tumor diameter in excess of 5 cm and AFP positivity were shown as significant factors on poor prognosis.

Carcinoma, Hepatocellular↗
PubMed1999

Immunolocalisation of PIVKA-II in paraffin-embedded specimens of hepatocellular carcinoma.

AIMS/BACKGROUND: Although serum PIVKA-II has been widely used as a tumor marker for hepatocellular carcinoma (HCC), little information is available concerning tissue PIVKA-II, and detection of tissue PIVKA-II in paraffin-embedded tissue specimens of HCC is also considered difficult. METHODS: Paraffin-embedded HCC tissues obtained at autopsy from 22 patients were subjected to immunohistochemical staining using the antibody MU-3 (Eisai Co., Ltd.) after microwave antigen retrieval. RESULTS: PIVKA-II was mainly detected in the cytoplasm of HCC cells. The intensity of tissue PIVKA-II staining was not correlated with serum PIVKA-II levels or with the histotogical differentiation of HCC. However PIVKA-II staining tended to be more intense in tissue from patients with portal tumor thrombus, distant metastases, or a longer duration of HCC. CONCLUSION: This method of immunohistochemical staining is easy and simple to use and may be helpful for detecting tissue PIVKA-II in paraffin-embedded HCC specimens.

Adult↗
PubMed1999

[Positivity rate of TTV-DNA in patients with acute liver injury of undetermined etiology].

To elucidate a role of TTV infection in patients with acute liver injury, TTV-DNA in the sera from 97 patients with acute liver injury of various etiology were determined according to Okamoto's method. Out of 77 patients with acute liver injury of determined etiology, 31 patients(40.3%) showed TTV-DNA positive, and out of 15 patients with acute liver injury of undetermined etiology, 8 patients(53.3%) showed TTV-DNA positive. These results suggested no evident role of TTV in patients with acute liver injury was shown. Further study including genotype and quantitative determination of TTV-DNA and antibody assay is needed.

Acute Disease↗
PubMed1996

[Glucose intolerance after percutaneous ethanol injection therapy (PEI) in liver cirrhosis patients with hepatocellular carcinoma].

We studied the effect of percutaneous ethanol injection therapy (PEI) on glucose tolerance in liver cirrhosis patients with hepatocellular carcinoma. All of 10 patients underwent PEI and aspiration biopsy of the tumor on separate day. Two-time oral glucose tolerance tests (OGTT), before and after PEI, were performed in all patients. There were no significant changes in blood glucose and insulin chronologically measured on aspiration biopsy and PEI. To detect changes in glucose tolerance, we compared the results of OGTT before PEI with those of OGTT after PEI. On the basis of results of OGTT before PEI, patients were classified to impaired glucose tolerance group (4) and diabetes mellitus group (6). Blood glucose at 180 minutes on OGTT after PEI showed significantly higher value than that of OGTT before PEI, but insulin response was not suppressed. From these experiments we speculate that exaggerated insulin resistance due to injected ethanol may be one of the factors influencing glucose tolerance after PEI.

Aged↗
PubMed1995

[Follow-up study of hepatic hemangiomas].

Hepatic hemangioma is the most common benign tumor of the liver, but there are a few reports on chronological changes in size of hepatic hemangioma. To elucidate natural history of hepatic hemangioma, we evaluated consecutive ultrasonograms of 27 hemangiomas in 23 patients. Underlying liver disease in these 23 patients included seven cases with chronic hepatitis, five cases with liver cirrhosis and three cases with fatty liver. The remaining eight cases showed no evidence of liver disease. Follow-up period ranged 12 to 114 months (average 44). During the follow-up, six (22.2%) hemangiomas changed in size on US, which included three lesions with increase in size, one lesion with decrease in size and two lesions with spontaneous regression. Of 12 patients with chronic liver disease, only one patient showed significant change in the hemangioma size, which regressed spontaneously. These results showed that there was no case showing increase in size of hemangioma in patients with chronic liver disease. Thus, if clinically diagnosed hemangioma which tends to increase in size is detected on US or other imaging modalities in patients with chronic liver disease, aimed aspiration biopsy should be preferably performed considering the possibility of hepatocellular carcinoma.

Adult↗
PubMed1994

[Analysis of blood flow in hepatic tumors by color Doppler ultrasonography].

We evaluated the diagnostic significance of blood flow pattern and velocity in hepatic tumors detected by color doppler ultrasonography. Fifty seven patients with hepatocellular carcinoma (HCC) and 12 patients with hepatic hemangioma (HEM) were studied with ultrasonographic apparatus equipped with color doppler system (Toshiba SSA-270A, 3.75MHz sector scanner). Furthermore 12 patients with HCC were studied repeatedly after transcatheter arterial embolization (TAE) and/or percutaneous ethanol injection (PEI). Blood flow was measurable in 2 of 12 patients with HEM (17%). Pulsatile flow with low speed (7 cm/sec) and low amplitude was detected in one patient, and continuous flow with low speed (5 cm/sec) in the other. Blood flow was measurable in 43 of 57 patients with HCC (75%). The detection rate of blood flow in HCC was significantly higher than in HEM. Pulsatile flow was detectable in 42 of 43 patients (98%). Average maximum velocity of pulsatile flow was over 40cm/sec. Analysis of blood flow after treatment provided us useful information on the effect of treatment. In conclusion, analysis of blood flow in hepatic tumors on US with color doppler system may provide useful information on differential diagnosis between HCC and HEM, the assessment of the therapeutic effect of TAE or PEI, whether additional treatment is required or not, and when it should be done if required.

Adult↗
PubMed1991

Significant stenosis of coronary arteries in patients with single and multiple vessel diseases without previous myocardial infarction.

To determine what degree of stenosis should be counted as a significant lesion in each of 3 major coronary arteries in classification of the number of vessels involved, coronary arteriographic percent diameter narrowing (by quantitative angiography) was compared with thallium-201 scinitgraphic redistribution on treadmill exercise in 47 patients with evidence of exercise myocardial ischemia and greater than or equal to 50% diameter narrowing (visual assessment) in at least 1 major coronary artery. Severity of exercise-induced myocardial ischemia for the entire left ventricle (assessed by averaged redistribution index) was separated most sufficiently with definition of 63-64% or greater between patient groups with no- and single-, single- and double-, and double- and triple-vessel diseases. Collaterals and intraventricular contractile interaction are possibly the factors making definition more severe in extensive coronary artery disease. Since the visual method gives an overestimation of stenosis, it was concluded that vessel diameter narrowing of 70% or more should be regarded as significant in patients with single and multiple vessel diseases if the visual method is used.

Adult↗
PubMed1990

Segmental diastolic narrowing of epicardial coronary arteries in aortic regurgitation. Phase analysis by quantitative angiography of coronary artery diameter change during cardiac cycles.

A new finding of a segmental narrowing of the left anterior descending coronary artery in diastole (diastolic narrowing: DN) was reported. DN was found in 6 out of 45 patients (13.3%, 5 males, 1 female) with chronic aortic regurgitation (AR). It is likely that aortic regurgitation was more severe in terms of the history of heart failure, regurgitant fraction, left ventricular end-diastolic volume index and pressure, and aortic diastolic pressure in the patients with DN compared with those without DN. The phasic change of DN in cardiac cycles was analyzed by quantitative angiography, and indicated that DN commences at a point in mid-diastole when coronary vascular driving pressure (the instantaneous aortic and LV pressure difference) becomes abnormally reduced, reaches its maximum at end-diastole, and gradually recovers as aortic pressure increases during systole. In two patients, DN was no longer evident after valve replacement. We concluded that DN, a new coronary arteriographic finding, reflects the integrated severity of AR.

Angina Pectoris↗
PubMed1989

Effect of diltiazem on coronary blood flow distribution in dog heart under ischemia.

Effect of intracoronary infusion of diltiazem (1 microgram/min) on regional myocardial blood flow (RMBF) was studied using 15-microns radioactive microspheres in 11 excised cross-circulated canine left ventricles. With total coronary blood flow (CBF) and heart rate (HR) held constant, regional ischemia was induced by ligating the left anterior descending coronary artery (LAD). Diltiazem at the dose used had no effects on ventricular Emax before and after LAD ligation. RMBF expressed by the counts divided by the counts averaged in all segments in each layer significantly (p less than 0.05) increased under diltiazem only in the low-flow region that had less than 50% RMBF before diltiazem; from 21% (+/- 12%) to 35% (+/- 18%) in the epicardial, from 22% (+/- 12%) to 32% (+/- 18%) in the midwall, and from 24% (+/- 10%) to 31% (+/- 12%) in the endocardial layers. We conclude that the beneficial effect of diltiazem on the ischemic heart involves a direct action on the coronary vascular system and does not necessarily depend on the concomitant changes in hemodynamics.

Animals↗
PubMed1987

[Predictability of stress-induced myocardial ischemia from coronary arteriography in patients with organic coronary artery stenosis].

A quantitative index for describing the severity and extent of coronary artery disease has not been established yet, although it is certain that the stenosis causes myocardial ischemia induced by stress. To establish the most meaningful scoring system, we developed the grading of stenosis which is "critical" or significant in the single-, double-, and triple-vessel method (SDT), and the extent of improvement in the predictive value which may be induced by accounting for the predominance of the three major coronary arteries nourishing the left ventricle. Thirty-three patients (six were women), whose average age was 58.6 years, all having exertional angina pectoris and fixed organic coronary artery stenosis documented by coronary arteriography, but no old myocardial infarction, were the subjects of this study. For these patients the mean redistribution index (RDI) was determined by ergometer stress myocardial perfusion imaging using 201T1. The number (nST) of significant ST segment depressions by body surface ECG mapping after treadmill stress tests was compared with the sigma Pujadas grade, which is the sum of each grade assigned to each of the three major coronary arteries, and with the Pujadas score, which is the weighted sum of grades by dominance in the coronary artery distribution. The SDT method was a better predictor of ischemia if the criterion for critical stenosis is selected at a more severe stenosis (greater than 90% diameter stenosis). Among factors predicting ischemia, the length of the stenosis and the presence of collaterals did not seem to be definitive. However, the distribution of the arteries was an important factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗
PubMed1986

[Severity and extent of coronary artery disease and their relationship to left ventricular functional reserve in the chronic disease state].

Our previous observations showed that left ventricular wall motion abnormality (asynergy) induced by stress was observed in the phase response of radionuclide technique, and the severity and extent of coronary artery disease (CAD) assessed by the Pujadas score (PS) correlated well with the maximal phase delay response (delta MPD) but not with the ejection fraction response (delta EF) in patients with CAD without old myocardial infarction (MI). This study evaluated the usefulness of EF, MPD and the first-third filling fraction (FF, divided by the volume accrued throughout diastole) at rest and during stress, using ergometer and first-pass radionuclide angiocardiography (RNA), to determine the severity of CAD, and to evaluate any abnormalities in the systolic and diastolic coupling in left ventricular function during stress. Seventy-four patients with significant CAD, including 41 with previous transmural MI (MI group) and 33 without MI (angina group) were the subjects of this study. EF at rest and during stress inversely correlated, and MPD on stress linearly correlated with PS in angina group with PS greater than 10, while no such correlations were found in MI group. A normal EF response (delta EF greater than or equal to 5%) was accompanied by a greater-than-normal response in FF (delta FF) in both groups. A lower EF response was accompanied by a smaller delta FF in angina group, but by a larger delta FF in MI group. The difference was statistically significant (p less than 0.03), without significant differences by age, PS, peak heart rate, systolic blood pressure, and ischemia on ECG during stress. Resting EF and FF by the RNA method correlated with those by left ventriculography (LVG), respectively. It was suggested that RNA is an accurate method for determining EF and FF, while phase analysis may provide some additional information different from that provided by LVG. We concluded that EF and MPD during stress are as useful as delta MPD with the exception of a few cases in predicting the severity of CAD, and that scar tissue within the ventricular wall in MI may play an important role in determining the ventricular diastolic mechanical property during stress.

Angina Pectoris↗
PubMed1985

Hyperkinetic contraction of a nonischemic segment of ischemic left ventricle in anesthetized dogs.

Regional myocardial function during acute coronary artery occlusion was studied with ultrasonic dimension gauges in 20 open-chest anesthetized dogs. Two pairs of ultrasonic crystals were implanted in the left ventricular free wall near the epicardium in an ischemic segment and in a control nonischemic segment, and the segment length (SL) and maximum velocity of systolic shortening (max dL/dt) were measured. In six dogs, the wall thickness (WT) was measured simultaneously in the same regions with sonomicrometry. Left ventricular pressure (LVP), aortic pressure (AoP), and plasma norepinephrine concentration in the coronary sinus (NECS) were also measured. The heart rate was kept constant (180 beats/min) with atrial pacing. The left anterior descending coronary artery was occluded at its distal portion without propranolol in 12 dogs (group 1) and 30 min after propranolol in eight dogs (group 2). In the ischemic region, coronary artery occlusion resulted in an increase in end-diastolic SL (50% at 3 min after occlusion in group 1, P less than 0.005), and a decrease in max dL/dt in systole (36% at 5 min after occlusion in group 1, P less than 0.02). In the nonischemic region, end-diastolic SL did not change significantly, but an increase in max dL/dt (29% at 10 min after occlusion in group 1, P less than 0.005) was observed in systole. Under propranolol (group 2), the results were similar to those of group 1. There were no significant changes in LVP, AoP, AoP, and NECS during occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗
PubMed1985

[Functional reserve of the ischemic left ventricle with ventricular aneurysm to afterload stress: digital subtraction angiographic assessments].

Digital subtraction angiography (DSA) has been confirmed to be an accurate method for determining left ventricular function. It is a relatively non-invasive technique without inducing premature ventricular complexes. The response of left ventricular function to afterload stress was assessed using DSA for eight patients with old anterior myocardial infarction and ventricular aneurysm including that of the anterior wall (averaging 30.3 months after the acute episodes). Their ages ranged from 36 to 65 years and one patient was a woman. Prior to the investigation, we confirmed that a single DSA procedure did not alter left ventricular function in a pilot study of one patient (No. 8). After initial DSA in the basal state, methoxamine was infused intravenously (1 to 2 mg/min). When aortic systolic blood pressure increased by 30 to 50 mmHg, a second DSA was performed for each patient. Left ventricular volumes and ejection fractions were calculated by the area-length method, and regional wall motion was assessed by the visual method according to the AHA classification and the curvature radius of the apical ventricular aneurysm was calculated. Methoxamine induced neither acute heart failure nor angina pectoris in the present series. The heart rates decreased, and there were a significant increase in end-systolic volumes (p less than 0.05), end-systolic radii (p less than 0.05), and a significant decrease in ejection fractions (p less than 0.02) after methoxamine infusion. In 32 of 40 segments, regional wall motion was unchanged by methoxamine as assessed by the visual method; whereas, in the other eight, there was a deterioration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗