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Biomedical subjects

N Okazaki

Publications and source records attributed to N Okazaki.

At least 145 records · Page 8Linked to original sources
PubMed1985

Bone metastasis in hepatocellular carcinoma.

Bone metastasis was observed in 16.1% or in 14 of 87 male autopsy cases of hepatocellular carcinoma. The primary tumor within the liver was located in the right lobe in all but one case. There were six patients who first presented with signs attributable to bone metastasis, and lung metastasis subsequently became evident in five of them. These 6 patients lived significantly longer as compared with 8 other patients with bone metastases and 73 patients without. The possible route by which hepatocellular carcinoma cells were carried to the bone is discussed.

Adult↗
PubMed1985

Variability of breath-by-breath tidal volume and its characteristics in normal and diseased subjects. Ventilatory monitoring with electrical impedance pneumography.

To assess clinical significance of breath-by-breath variation of tidal volume and its distribution pattern displayed as a histogram, continuous measurement of tidal volume was made with electrical impedance pneumography for about 60 minutes. Subjects were composed of 26 normal male and 46 patients including 17 patients with restrictive lung disease and 29 patients with obstructive lung disease. To evaluate variation of tidal volume quantitatively, coefficient of variance (C.V.) was used. In comparison to the normal pattern of distribution (C.V. = 26.0 +/- 7.5%, mean +/- S.D.), patients with restrictive lung disease showed extremely narrow pattern of the distribution and significantly smaller C.V. (17.5 +/- 4.6% in old pulmonary tuberculosis, P less than 0.005 and 18.9 +/- 9.3% in pneumonitis, P less than 0.025). Whereas, patients with obstructive lung disease showed widespread pattern of the distribution and significantly greater C.V. (43.2 +/- 13.0% in pulmonary emphysema with hypercapnia, 33.0 +/- 7.5% in normocapnia and 35.8 +/- 9.4% in asthmatic attack, P less than 0.005). In all the patients with bronchial asthma after the treatment, the extremely widespread pattern of histogram was returned toward the normal one and the C.V. was decreased (22.4 +/- 6.4%). It was suggested that the distribution pattern of tidal volume was affected by the change of clinical condition, and was well correlated to the pathophysiological process related to restrictive or obstructive lung disease. We conclude that analysis of tidal volume distribution by the histogram is one of the useful approach to manage patients with respiratory diseases.

Adult↗
PubMed1985

A case of diffuse type of combined hepatocellular and cholangiocellular carcinoma initially presented as a localized small nodule.

A combined hepatocellular and cholangiocellular carcinoma of diffuse type in a Japanese man is described. A small localized solitary tumor apparently grew rapidly into a diffuse-type carcinoma, and the liver weight increased about 4-fold during the last two months. The clinical course of this case was as expected for a diffuse type of hepatocellular carcinoma except that unusually high levels of serum carcinoembryonic antigen were found. The patient died of hepatic failure with systemic bleeding five months later. At autopsy, multiple small nodules were suspected to be intrahepatic metastatic foci because portal tumor thrombus was observed in the right antero-superior segment where the initial tumor was localized. Histologically, the tumor had components of both hepatocellular and mucin-producing cholangiocellular carcinoma. This is believed to be the first report on a diffuse type of combined hepatocellular and cholangiocellular carcinoma initially presented as a localized small nodule.

Adenoma, Bile Duct↗
PubMed1985

A case of alpha-fetoprotein-producing rectal carcinoma.

A rare case of rectal carcinoma with a high serum alpha-fetoprotein (AFP) level (maximum, 6,983 ng/ml) is reported. The histology of the primary tumor was adenosquamous carcinoma, the major component being moderately to poorly differentiated adenocarcinoma. Immunohistochemically, a few AFP-positive cells were identified in the primary tumor. However, numerous AFP-positive cells were observed in metastatic tumors in the liver and lungs at autopsy, which were histologically undifferentiated carcinoma with marked pleomorphism. Furthermore, components of adenocarcinoma were present in the metastatic tumors at various sites, and components of squamous cell carcinoma were seen only in the pelvic cavity. To our knowledge, this is the first case of rectal carcinoma with verified AFP production by the tumor cells.

Autopsy↗
PubMed1984

Segmental assessment on ordinary scintigrams and SPECT images of the liver.

By examining the area of defect elucidated on the scintigrams and SPECT (single photon emission computed tomography) images, the extension of the tumor into segments was assessed in cases where the SOL (space-occupying lesion) was determined by other methods. In this study, we followed the Couinaud 's segmentation. As a result, it was found that the segment with a SOL could be diagnosed fairly well on radionuclide images. Some incorrect assumptions were also found about the segments on ordinary scintigrams in previously published articles. These incorrect assumptions have been accepted for a long time. Although we do not deny that TCT (transmission X-ray computed tomography), echography, angiography, etc. are necessary for a precise judgment on liver segment and also that there are some cases in which the segmental assessment of these radionuclide images is impossible, we do believe that this kind of effort will improve the diagnostic capability of the radionuclide images.

Adult↗
PubMed1984

Hepatic arterial embolization for hepatocellular carcinoma. Comparison of CT scans and resected specimens.

Transcatheter hepatic arterial embolization (THAE) was performed in 18 patients with hepatocellular carcinoma (HCC) and the final CT scans (with and without contrast enhancement) compared with the resected specimen after a short interval (9.8 days +/- 9.9 S.D.). The necrotic area observed histologically corresponded closely to the constant low-density area seen on the CT scan (r = 0.959) in all but 2 cases. The authors conclude that CT closely reflects gross anatomical changes and is useful in assessing THAE as well as deciding if and when embolization should be repeated, especially in patients with negative serum alpha-fetoprotein.

Aged↗
PubMed1984

Screening of patients with chronic liver disease for hepatocellular carcinoma by ultrasonography.

The accuracy of real-time ultrasonography in screening for hepatocellular carcinoma at the out-patient Liver Clinic was prospectively evaluated in 245 patients with chronic liver disease. There were 14 patients with hepatocellular carcinoma who had no specific symptoms related to it. Tumour was detected by ultrasonography in 12 patients, but it missed the tumour in two patients. There were also three false positive results. The sensitivity and specificity of ultrasonography in the diagnosis of hepatocellular carcinoma were 85.7% and 98.8%, respectively. These are superior to alpha-fetoprotein (AFP) measurement, especially in specificity (p less than 0.01) at 19 ng/ml cut-off. False negative results were compensated for by AFP and computed tomography. A decision on treatment schedule was easily made on an anatomical basis by ultrasonographic examination.

Adolescent↗
PubMed1984

Phase II study of orally and rectally administered Tegafur in liver metastases from gastric carcinoma.

Twenty-four eligible and evaluable patients with measurable liver metastases from gastric cancer were treated with oral or rectal Tegafur. Objective responses were seen in 8 of the patients (33.3%), lasting between 1.5 and 15 months. The median survival period was 10 months for the responders and 2.6 months for non-responders. No complete response was observed. The survival of responders was significantly longer than that of non-responders (p less than 0.01). Toxicity was mild and consisted principally of gastrointestinal and hematological side effects. No central nervous system toxicity was seen.

Administration, Oral↗
PubMed1984

A clinicopathologic study of carcinoma of the papilla of Vater.

With a view to clarify the concept of early carcinoma of the papilla Vateri, we examined the records of 26 patients who were treated at the National Cancer Center Hospital in the past 22 years. The following three factors were considered prognostically important for the identification of carcinomas at early stages: Histologically, 1: cancerous infiltration should not reach the proper muscle layer of the duodenum (d-factor); 2: no infiltration into the pancreas should be observed; 3: no metastasis to lymph nodes should be found. Factor-1 (d-factor) is the most important of these. Therefore early carcinoma of the papilla Vateri should be defined at present as that in which cancerous infiltration is limited to within the sphincter of Oddi. For the early diagnosis of carcinoma of the papilla Vateri, screening should be performed by ultrasonography, and when abnormalities are detected, endoscopic inspection of the duodenum and endoscopic retrograde cholangiopancreatography should be performed. Moreover, it is very important to read carefully the radiograms of the areas near the papillary regions of the duodenum in routine upper-digestive tract X-rays.

Aged↗