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Biomedical subjects

N Moriyama

Publications and source records attributed to N Moriyama.

At least 199 records · Page 11Linked to original sources
PubMed1990

Early diagnosis of hepatocellular carcinoma.

We describe the results of our study on the early detection of the development of hepatocellular carcinoma among patients with chronic liver disease. Over a period of 18 years, 33 patients were diagnosed as having hepatocellular carcinoma. From 1970 to 1978, we used serum alpha-fetoprotein determination, liver palpation, and radionuclide liver scans. In addition to alpha-fetoprotein determination, computed tomography and ultrasonography were introduced in 1979. However, we did not have any general guidelines for the use of these imaging modalities. From 1984 onwards, ultrasonography and serum alpha-fetoprotein determination have been performed every three months and computed tomography every year in patients whose right hepatic lobe had atrophied due to liver cirrhosis. On the basis of this screening program, 50% of the detected hepatocellular carcinoma (9/18) were found to be smaller than 1.9 cm in diameter, and tumor resection was performed in 11 out of 18 patients (61%).

Adult↗
PubMed1990

[Qualitative analysis of tissue plasminogen activator in plasma obtained from various liver diseases by gel filtration and affinity chromatography].

Tissue plasminogen activator (t-PA) in plasma obtained from patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, drug-induced intrahepatic cholestasis, obstructive jaundice, fulminant hepatitis or disseminated intravascular coagulation (DIC), was analysed chromatographically. Liver disease cases showed a new peak (peak C) on HPLC fractionation. The protein of peak C had a lower molecular weight than ovalbumin. Lysine- and zinc- chelating affinity chromatography revealed that the peak C consist with the light chain (L-chain) of t-PA. The L-chain was also found in patients with DIC, but disappeared after improvement of DIC. Therefore, it was suggested that appearance of the L-chain would be related to acceleration of secondary fibrinolysis in plasma. The L-chain was especially high in plasma obtained from patients with decompensated liver cirrhosis. These results indicated that high increase of the L-chain in cases of severe liver disease may be due to either impaired clearance of t-PA in the liver or secondary hyperfibrinolysis accompanied by DIC. We concluded that determination of the L-chain of t-PA may contribute to clarify the mechanism of hyperfibrinolysis in liver diseases.

Chromatography, Affinity↗
PubMed1990

[Evaluation of the efficacy of oil chemoembolization for hepatocellular carcinoma by computed tomography: a proposal for altering the criteria to indicate the efficacy].

To evaluate the efficacy of oil chemoembolization for hepatocellular carcinoma (HCC), the authors have investigated computed tomography (CT) and pathological findings of 29 resected HCCs from 24 patients and have reached the following conclusions: (1) HCCs that showed a dense retention of Lipiodol within the whole tumor or showed no enhancement on contrast enhanced CT had a significantly higher necrosis rate (p less than 0.01) but were not always easy to evaluate; and (2) in 18 of the 29 tumors that had been observed by CT for 4 to 8 weeks after oil chemoembolization, 91% of those tumors which had a high necrosis rate (greater than or equal to 90%) showed a significant reduction rate that was 20% or greater (p less than 0.05). Based on these results, we propose altering the criteria to allow for the indication of 'partial response', that is, a decrease of 20% or greater in the size of the tumor, confirmed by CT measurement within 8 weeks after oil chemoembolization, and no new lesions or signs of progression in any existing lesion.

Adult↗
PubMed1989

Clinical and radiologic assessments of the results of hepatectomy for small hepatocellular carcinoma and therapeutic arterial embolization for postoperative recurrence.

To study the prognostic significance of the state of the residual liver after hepatectomy for small hepatocellular carcinoma (s-HCC) no larger than 5 cm in diameter, 123 patients were followed for periods from 9 months to 9 years and 1 month. The following results were obtained: (1) recurrence occurred in the residual liver in 58 patients (54.2%) after an average of 14.9 months from hepatectomy; (2) at recurrence diagnosed by imaging, 12 of 48 recurrent patients showed negative alpha-fetoprotein; (3) computed tomography (CT) had a high sensitivity (71.4%) in detecting recurrence; (4) 5-year survivals for all patients (n = 123) who had hepatectomy, and for those without recurrence (n = 49) or with recurrence (n = 58) were 19.1%, 48.9%, and 11.0%, respectively; and (5) survivals for the patients who developed recurrence and who did and did not receive embolization treatment (n = 32, 23, respectively) were 70.3% and 37.1% at 1 year, 45.0% and 0% at 3 years, and 14.9% and 0% at 5 years, respectively. It is important to recognize that the patient who has undergone surgery even for s-HCC should be followed as a super high-risk patient at regular intervals using CT. Therapeutic embolization for recurrent patients improved the survival after recurrence.

Adult↗
PubMed1989

[On the assessment of the diagnostic accuracy of imaging diagnosis by ROC and BVC analyses--in reference to X-ray CT and ultrasound examination of liver disease].

To achieve an effective assessment of diagnostic accuracies of currently used imaging methods on liver diseases, X-ray CT (CT) and realtime ultrasound (US), ROC analysis and a new analysis method, "the bias to variance characteristics (BVC)" were applied in parallel. The survey has been carried out to assess an image interpretation accuracy on cases with established diagnosis collected on the multi-institutional basis. The images, CT and US of liver diseases including localized and diffuse lesions were selected for image reading sessions and the interpretative difficulties were geared to an appropriate grade so that it does fit to the basic requirement of ROC analysis. Consequently, 91 cases were selected from a total of 258 cases which were collected from 16 institutions. Two image reading sessions were scheduled and a total of 28 radiologists and sonologists undertook the first session. The final analysis covered 8 radiologists for CT and 9 sonologists who carried out both sessions. The image interpretation results were fed to the computer and analyses were made accordingly. Analysis of the first image reading session gave true positive ratios (TPR) of CT and US as 92.5% and 97.4%, and true negative ratios (TNR) of 50.5% and 46.8%, respectively. The second reading session, in which both CT and US images were interpreted simultaneously, gave the similar values of TPRs, 96-97% and TNRs, 44-47%. The ROC analysis of existence of liver mass and diagnosis of malignancy resulted in the higher values in US compared to CT in the first separate reading, however, the 2nd session gave almost identical values in each modality. The diagnostic accuracy for the benign tumors, mostly consisted of hemangioma, CT reading gave higher accuracy rates compared to the US. The entirely new interpretations scheme, arbitrarily named as BVC was carried ou on matrix data obtained in the same experiment. The scatterograms plotted according to the BV values, the mean and the standard deviation inherent to individual cases have demonstrated marked variations among individual cases most likely reflecting the interpretative difficulty of respective images, thus indicating the method to be well in adjunct to the ROC analysis.

Adult↗
PubMed1989

Evaluation of the prognosis for small hepatocellular carcinoma based on tumor volume doubling time. A preliminary report.

The relationship of tumor volume doubling time to length of patient survival was investigated for 15 patients with small hepatocellular carcinoma smaller than 4.5 cm in diameter. The mean tumor volume doubling time of these 15 nodules was 102 +/- 77 days (mean +/- SD; range 41 to 305 days) before the initiation of a specific treatment for cancer. These doubling times tended to correlate with mitotic indexes of the tumors and the patients could be divided into two groups according to the therapeutic modalities used. Patients in Group A received systemic chemotherapy without response or nonspecific treatments for cancer. In this group, there was a positive correlation between tumor volume doubling time and survival length (r = 0.8812; P less than 0.025). Patients in Group B either received hepatectomy after transarterial embolization or systemic chemotherapy or received hepatectomy alone. In this group, early death occurred in patients who had shorter tumor volume doubling times. Three surgically treated patients in Group B were evaluated as having survived for a significantly long period as assessed from their tumor volume doubling times. These results indicate that tumor volume doubling time is one of the determining factors of survival length in patients with hepatocellular carcinoma, and, therefore, can be used in the evaluation of therapeutic efficacy.

Aged↗
PubMed1989

Hepatic artery embolization for inoperable hepatocellular carcinoma; prognosis and risk factors.

During a 7-year period in our hospital, 69 patients with inoperable hepatocellular carcinoma (HCC) underwent 111 courses of transcatheter hepatic artery embolization (TAE) and/or chemoinfusion with lipiodol. Patient survival was 0.5-37 months following therapy and the factors affecting prognosis were evaluated. Survival rates at 1, 2 and 3 years after TAE were 53%, 24% and 15%, respectively. Survival rates at 1, 2 and 3 years in relation to tumor size were 100%, 100% and 100% in 5 patients (tumor size less than 2 cm in diameter), 81%, 33% and 16% in 23 patients (2.1-5.0 cm), and 35%, 9% and 0% in 41 patients (greater than 5.1 cm). An analysis of prognostic factors showed that the size of the main tumor significantly influenced the prognosis following TAE (P less than 0.01), whereas the frequency of TAE, intrahepatic metastasis and the degree of liver dysfunction showed a slight correlation (P less than 0.1). These results suggest that TAE has a significant potential for becoming the first choice of treatment for patients with small multiple HCCs (less than 2 cm), provided that neither severe hepatic dysfunction nor a tumor thrombus in the main portal vein is present.

Adult↗
PubMed1989

Transient perihilar attenuation difference in the liver on dynamic CT secondary to portal vein thrombosis: report of two cases.

In two patients with portal vein thrombosis (PVT) accompanied by cavernous transformation, transient perihilar attenuation difference (TPAD) was demonstrated in the liver in the arterial phase of dynamic CT. It changed to an isodense shadow in the late phase. In one case, the area demonstrated as TPAD was well enhanced by postarterial portal CT, and in the other case, perihilar region was also densely opacified as contrasted by the peripheral area which was enhanced slightly with postarterial portography. It suggested that the TPAD area well supplied by portal blood flow via cavernous transformation and that the peripheral area surrounding TPAD was mainly supplied by increased hepatic arterial blood compensating for reduced portal flow. When the TPAD is found in the early phase of dynamic CT scan, attention should be paid to the existence of portal vein thrombosis (PVT). Chronic pancreatitis was the likely cause in one patient, and in the other it was idiopathic.

Female↗
PubMed1989

Schizophrenic neologism versus aphasic neologism: characteristics in writings of Japanese schizophrenic patients.

Three cases of schizophrenia with ideographic neologisms in Japanese are presented and compared with aphasic neologisms reported in Japanese literature. Schizophrenic neologisms are different from aphasic neologisms in nature. The contrast becomes obvious when both are compared in Japanese writing based on the dual writing system of kanji (Chinese characters, ideogram) and kana (phonetic characters, syllabogram).

Adult↗
PubMed1989

Synchronous early gastric cancer.

Synchronous early gastric cancer (EGC) has a prevalence of approximately 9%. The barium study findings of 73 patients with 163 synchronous EGC tumors were retrospectively reviewed, and the size, location, and morphologic type of each lesion considered malignant were analyzed and correlated with the endoscopic and final pathologic findings. Barium studies and endoscopy each correctly demonstrated 116 of the 163 synchronous EGC lesions. Those lesions not demonstrated by either technique were small, shallow, or flat and confined to the mucosa. Our results indicate that a careful preoperative evaluation with radiography and endoscopy currently can depict about 70% of these lesions.

Barium Sulfate↗
PubMed1989

Expression of ras p21 oncogene product on human bladder tumors.

The immunohistochemical localization of ras p21 oncogene product was examined in human bladder cancer. These bladder cancers consist of 52 superficial bladder tumors and 10 cases of invasive tumor. Five (9.6%) of 52 superficial tumors were demonstrated to be positive for ras p21 product. Two (20%) of 10 cases which showed deep tumor infiltration were demonstrated to be positive for ras p21 oncogene product. When we analyzed the incidence of positive staining for ras p21 with regard to histological grade of bladder cancer, 2 of 30 (7%) patients with G1, 4 of 26 (15%) with G2, and 1 of 6 (17%) with G3 had positive staining for the ras p21 oncogene product. One of five patients who showed positive staining on tumors had tumor recurrence 3 months later. The remaining 4 patients positive for the ras p21 oncogene product had no tendency for recurrence in 11-19 months' follow-up. Therefore, the incidence of detection of ras p21 oncogene product on superficial and deep infiltrating bladder tumor was similar and there was no significant correlation between the incidence of positive ras p21 staining and depth of invasion of bladder tumors or histological grade.

Adult↗
PubMed1989

[Bladder carcinoma in situ which harbored human papilloma virus. A case report].

Last year, we reported that human papilloma virus type 16 genome (HPV 16 genome) was detected in a case (S.Y.) of bladder carcinoma in situ (bladder CIS) (Cancer Res., 1988). Since then, a number of bladder tumors other than CIS were searched for HPV genome. However, no HPV genome was detected in the bladder tumors. From the results, we consider that HPV may not have a relation with all types of bladder tumor but with only a part of it. In the current report, the case (S.Y.) is presented more precisely than before, in particular on the characteristic bladder lesion. The patient was a 40-year-old female with immunodeficiency and anemia who was referred from a hospital with a complaint of asymptomatic pyuria. Cystoscopic examination revealed a bladder tumor, well-demarcated, white and velvety lesion with slight elevation. On November 25, 1987, she underwent total cystectomy, resection of the anterior vaginal wall and of a part of vulval skin, and ileal conduit formation. Postoperative course was stormy because of bleeding from the wounds and thrombophlebitis in the right femoral vein. In spite of the episodes, she eventually recovered and was discharged 2 months later. However she was readmitted 9 months later due to severe anemia which was ascribed to acute myelogenous leukemia. She is now on cancer chemotherapy for leukemia.

Adult↗
PubMed1989

[Urinary calcium and phosphorus excretion and their relationship in calcium-containing urinary stone formers].

Calcium-containing upper urinary stone formers (group SF-A, n = 116) and normal controls (group Normals, n = 10) were examined for urinary calcium (Ca) and phosphorus (P) excretion (mg/mg creatinine) on usual diet, on Ca-restricted diet and in basal period. As a result, urinary Ca and P excretion decreased significantly both in group SF-A and in normal controls, as the dietary intake was reduced. As compared with normal controls, group SF-A exhibited significant elevation in urinary Ca excretion and showed a slight, though not significant increase, in urinary P excretion. A significant positive correlation between urinary Ca and P excretion was observed in either mode of diet in group SF-A, while no correlation was seen in normal controls. To examine the legitimacy of the result above obtained, another 40 Ca-containing upper urinary stone formers (group SF-B) were studied on usual diet. Thus, better correlation was obtained between urinary Ca and P excretion. In conclusion, urinary Ca and P excretion will be strongly influenced by their dietary intake. Stone formers excrete more Ca and P than normal controls. Finally, a tendency was noted that stone formers excreted the more Ca, the more P.

Adult↗
PubMed1989

[A case of malakoplakia of the testis and epididymis].

A forty-two year-old man with left epididymo-testicular malakoplakia was reported. Thirty-two cases of testicular malakoplakia with (5 cases) and without (27 cases) epididymal malakoplakia were reviewed. The mean age was 48. 2 year-old. Two-thirds of the cases suffered from right side involvement. All cases except a few cases received orchiectomy within 2.6 months on average from the onset of the symptoms. Diabetes mellitus, malignant diseases, or chronic renal failure seem to have a causal relation to the development of testicular malakoplakia. Six cases of epididymal malakoplakia were also reviewed.

Adult↗
PubMed1989

Surgical treatment of adrenal metastasis following hepatectomy for hepatocellular carcinoma.

In three patients who underwent hepatectomy for solitary hepatocellular carcinoma (HCC), adrenal metastases, on the right sides of two patients and the left side of the third were subsequently detected by ultrasonography (US) and/or computed tomography (CT), and successfully resected after an average interval of 16 months from hepatectomy. There were no metastatic lesions in the lung, lymph node or bone. Two patients, however, who were found to have metastasis in the right adrenal also had multiple small recurrent foci in the residual liver. The latter were controlled by arterial embolization therapy and the patients are alive at 12 and three months post-adrenalectomy. In the other patient, with left adrenal metastasis, the serum alphafetoprotein level of 3,000 ng/ml returned to normal and he is doing well three and a half years after adrenalectomy. Since there is no effective therapy for metastatic adrenal HCC after hepatectomy, surgery would appear to be indicated, should no other distant metastasis be recognized clinically.

Adrenal Gland Neoplasms↗
PubMed1989

Hepatocellular and cholangiocellular carcinoma, double cancer of the liver: report of two cases resected synchronously and metachronously.

Double primary liver cancer, i.e., hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC), was detected by ultrasound (US) during the follow-up of chronic liver disease, and was safely resected in two patients, one synchronously and the other metachronously. On admission, laboratory data were normal except for slightly abnormal liver function tests. One patient (case 1) had a 5.1-cm white firm CCC with several small daughter lesions around it which was enhanced late in computed tomography, and a 2.1-cm well-circumscribed HCC with a pseudocapsule; the two were situated very close to one another in the right posterior segment of the liver. Another patient (case 2) had a small 1.5-cm CCC in the anterior superior area, and 6 yr after the first resection, alpha-fetoprotein gradually increased and a 4-cm HCC was detected anew and resected; the preoperative diagnosis made by US and ethiadol-computed tomography was correct. The histopathological diagnosis of the noncancerous portion was chronic active hepatitis in both cases. However, it changed to precirrhosis in case 2 during the follow-up.

Adenoma, Bile Duct↗
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↗