Search PubMed⌕ Search

Biomedical subjects

S Kitano

Publications and source records attributed to S Kitano.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy.

A clear field of vision during laparoscopic cholecystectomy was attained by using a newly designed retractor which elevates the abdominal wall and does not require high-pressure CO2 infusion into the peritoneal cavity. As the abdominal cavity is continuously ventilated, smoke from the cauterization is suctioned off through openings in the middle part of the retractor. There is no interference with placement of ports.

Cholecystectomy↗
PubMedDate not supplied

A newly designed single dissector useful for laparoscopic cholecystectomy.

We developed a modified dissector capable of carrying out a one-hand operation involving three fundamental functions: grasping, sharp or blunt dissection, and dividing the tissues. With this single dissector, laparoscopic cholecystectomy can be rapidly and safely performed without changing the forceps or instruments through the trocar.

Cholecystectomy↗
PubMedDate not supplied

Long-term palliative treatment of hepatocellular carcinoma extending into the portal vein and bile duct by chemoembolization and metallic stenting.

We present a patient with hepatocellular carcinoma accompanied by portal vein and bile duct tumor thrombi. The patient was treated with a spiral Z-stent covered by a polyethylene sheet placed in the bile duct, a Wallstent placed in the portal vein, chemoembolization, and external radiation therapy. The patient is alive with patency of both endoprostheses 18 months later.

Antibiotics, Antineoplastic↗
PubMedDate not supplied

Endoscopic classification of gastric varices.

Endoscopic observations of gastric varices in 124 patients were classified according to form, location, and color. Form was classified into three types: tortuous (F1), nodular (F2), and tumorous (F3). Location was classified into five types: anterior (La), posterior (Lp), lesser (Ll) and greater curvature (Lg) of the cardia, and fundic area (Lf). Color was white (Cw) or red (Cr). Glossy, thin-walled focal redness on the varix was defined as red color spot (RC spot). Stepwise logistic regression analysis for multivariate adjustments was performed for all of the endoscopic covariates, and four risk factors (La, Lg, F2, RC spot) that affect bleeding from gastric varices were independently identified. This classification should aid in assessing gastric varices observed by fiberoptic endoscopy and help design appropriate treatment.

Adult↗
PubMedDate not supplied

Effects of endoscopic injection sclerotherapy on portal hypertensive gastropathy: a prospective study.

The effect of endoscopic injection sclerotherapy (EIS) for esophageal varices on portal hypertensive gastropathy (PHG) was investigated in 137 patients who underwent EIS from July 1987 to March 1990. Two groups, PHG(+) (N = 35) and PHG(-) (N = 102) were distinguished by endoscopic findings obtained before EIS. PHG was classified into four grades by endoscopy scored as 0, 1, 2, or 3. The PHG score significantly worsened after EIS (p < 0.01), and PHG became worse 6 to 9 months after the eradication of varices followed by gradual improvement. Recurrent small veins, which required additional EIS, appeared more frequently in the PHG(+) group (p < 0.05). New gastric varices appeared or gastric varices enlarged after EIS more frequently in the PHG(+) group (7 patients, 20.0%) than in the PHG(-) group (12 patients, 11.8%), but this was not statistically significant. Thus, frequent endoscopy after EIS is needed with special attention directed to development of PHG and gastric varices, especially for patients with PHG prior to treatment.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Endoscopic ligation of esophageal varices compared with injection sclerotherapy: a prospective randomized trial.

Fifty cirrhotic patients with esophageal varices underwent endoscopic treatment in a prospective randomized trial carried out to compare variceal ligation with injection sclerotherapy, with respect to safety, efficacy, and complications in the initial session. Twenty-five patients each were treated using endoscopic variceal ligation or endoscopic injection sclerotherapy in the initial session and then only endoscopic injection sclerotherapy for all following sessions. Ligations numbered 4.1 at the initial session. The total number of sessions of endoscopic injection sclerotherapy was 4.0 +/- 1.3 in the endoscopic injection sclerotherapy group compared with 3.6 +/- 1.4 in the endoscopic variceal ligation group. The total volume of the sclerosant used by the end of all the sessions was 23.9 +/- 10.3 ml in the endoscopic variceal ligation group and 39.0 +/- 11.5 ml in the endoscopic injection sclerotherapy group (p < 0.0001). In all patients, complete eradication of the varices was achieved, and at 7 to 15 months follow-up no evidence of recurrence was seen. Adverse effects such as pyrexia, chest pain, and pleural effusion after the initial session were significantly lower in the endoscopic variceal ligation group (p < 0.05), and total bilirubin, serum creatinine, lactate dehydrogenase, and urinary beta 2-microglobulin were significantly increased and PaO2 decreased after endoscopic injection sclerotherapy (p < 0.05). This study shows that endoscopic variceal ligation significantly decreased the adverse effects associated with endoscopic injection sclerotherapy in the initial session, and it is recommended as an alternative to sclerotherapy.

Aged↗
PubMedDate not supplied

Formyl-ended heterobifunctional poly(ethylene oxide): synthesis of poly(ethylene oxide) with a formyl group at one end and a hydroxyl group at the other end.

Well-defined poly(ethylene oxide) (PEO) with a formyl group at one end and a hydroxyl group at the other terminus was synthesized by the anionic ring opening polymerization of ethylene oxide (EO) with a new organometallic initiator possessing an acetal moiety, potassium 3,3-diethoxypropyl alkoxide. Hydrolysis of the acetal moiety produced a formyl group-terminated heterobifunctional PEO with a hydroxyl group at the other end.

Chromatography, Gel↗
PubMedDate not supplied

Comparative effects of 5% ethanolamine oleate versus 5% sodium morrhuate for sclerotherapy of oesophageal varices.

Forty-five cirrhotic patients with oesophageal varices were randomized to receive endoscopic injection sclerotherapy with either 5% ethanolamine oleate (EO), or 5% sodium morrhuate (SM). In the EO group, there was a statistically significant higher rate of disappearance of red colour signs on the varices a week after the initial session of sclerotherapy than in the SM group (91.3% vs 45.5%, P less than 0.05). A jet-like bleeding from injection sites at the second session of sclerotherapy occurred in three patients in the SM group and they experienced blurred vision. There was no such occurrence in the EO group. Oesophageal bleeding requiring blood transfusion during the course of repeated sclerotherapy occurred only in the SM group (five patients): bleeding was from a partly thrombosed varix and in four was from oesophageal ulcers. We found that EO administered intravariceally is more efficacious than SM for sclerotherapy of oesophageal varices.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Peritoneoscopic cholecystectomy has opened the door to minimally invasive surgery.

In 1989 a new trend occurred in the surgical treatment of a diseased gall-bladder, laparoscopic cholecystectomy (LC). Laparoscopic surgery is now accepted world-wide as the choice of treatment with the advantages of less pain, good cosmesis, short hospital stay and early recovery. It is also a curative procedure for cholelithiasis as well as a cholecystectomy. The rate of conversion to open surgery is about 5% and the rates of bile duct injury are 0.1-0.6%. This new approach revives controversies concerning cholecystectomy; namely indication, use of intra-operative cholangiography, ductal calculi and pregnancy. There are new issues to consider, including use of a Veress needle for pneumoperitoneum, type of trocars, cardiovascular responses to pneumoperitoneum using carbon dioxide and so on. With increasing use, these difficulties will be overcome. Advances in technology are expected to make even more new types of surgery possible, even perhaps extending into robotic surgery.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

Immunohistochemical study of c-erbB-2 protein in colorectal cancer and the correlation with patient survival.

We related events in immunohistochemical studies on formalin-fixed, paraffin-embedded preparations of 146 colorectal cancer patients. One hundred (68.5%) revealed cytoplasmic staining and only 3 of the 100 showed membranous staining. Western blot analysis revealed proteins with molecular masses of 185 and 155 kD following immunohistochemical membranous and cytoplasmic staining, but only a 155-kD protein following cytoplasmic staining. Amplification of the c-erbB-2 gene was detected in 2 of 44 cases (4.5%). Cytoplasmic c-erbB-2 overexpression correlated with tumor size (p < 0.01), subserosal invasion (p < 0.05), liver metastasis (p < 0.01) and Dukes' classification. Overall survival rates and survival rates for Dukes'B patients were significantly lower in the group with cytoplasmic c-erbB-2 overexpression than in the group without cytoplasmic c-erbB-2 overexpression. Multivariate regression analysis showed cytoplasmic c-erbB-2 overexpression to be an independent prognostic factor for colorectal cancer. These results suggest that overexpression of cytoplasmic c-erbB-2 protein plays an important role in the progression of colorectal cancer and is considered to be an independent prognostic indicator of this lesion.

Adenocarcinoma↗
PubMedDate not supplied

Acceleration of gastric ulcer healing by omeprazole in portal hypertensive rats. Is its action mediated by gastrin release and the stimulation of epithelial proliferation?

BACKGROUND: Gastric ulcer healing is delayed in patients with portal hypertension (PHT) and often responds poorly to histamine H(2) blockers. Although proton pump inhibitors are more effective anti-ulcer agents, there is little information regarding their efficacy for gastric ulcer in cases of PHT. Therefore, we investigated the effects of a proton pump inhibitor, omeprazole, on the healing of acetic-acid-induced gastric ulcer in PHT rats. METHODS: Animals studied were 80 male Sprague-Dawley rats aged 7 weeks, of which half underwent two-staged portal vein ligation (PHT rats) and half underwent a sham operation (SO rats). Gastric ulcers were induced by acetic acid. Starting from day 4 after ulcer induction, rats received omeprazole or vehicle orally (50 mg/kg) for 5 or 10 days. Ulcer area, proliferating cell nuclear antigen labelling index (PCNA LI), and serum gastrin levels were recorded. RESULTS: PHT significantly inhibited epithelial cell proliferation and delayed gastric ulcer healing as indicated by a decreased PCNA LI at the ulcer margin and almost 2-fold larger ulcer area in PHT versus SO rats 14 days after ulcer induction. Ten-day treatment with omeprazole (vs. vehicle) significantly accelerated ulcer healing to a similar extent in both PHT and SO rats. Serum gastrin levels were significantly higher in PHT rats than in SO rats following treatment with omeprazole. Omeprazole (vs. vehicle) restored the decreased PCNA LI at the ulcer margin in PHT rats to that noted in SO rats. CONCLUSIONS: In PHT rats, omeprazole accelerates gastric ulcer healing, stimulates epithelial cell proliferation at the ulcer margin, and increases serum gastrin levels. Since gastrin is a potent stimulator of gastric epithelial cell proliferation, increased serum gastrin levels may be an important factor in omeprazole-induced stimulation of epithelial cell proliferation and acceleration of gastric ulcer healing in conditions of PHT.

Acetic Acid↗
PubMedDate not supplied

Amplification and overexpression of cyclin D1 in aggressive human esophageal cancer.

Cyclin D1 is a cell-cycle regulator essential for G1 phase progression and a candidate proto-oncogene implicated in pathogenesis of several human tumor types including esophageal cancers. Association between cyclin D1 gene amplification and clinical outcome was examined using southern blotting in 45 patients with primary esophageal cancer. In cases showing gene amplification, expression levels of mRNA and gene product were further examined by northern blotting, western blotting and immunohistochemical analyses. Amplification of cyclin D1 gene was found in 14 of 45 patients (31. 1%). There was no association between gene amplification and clinicopathological parameters but the frequency of hematogenous recurrence in cases with gene amplification was significantly higher than that in cases without amplification in 30 patients undergoing curative surgery (70.0% vs 25.0%, p<0.05). Furthermore, cumulative survival rate of cases with gene amplification was significantly lower than that of cases without amplification (p<0.05). Overexpression of cyclin D1 mRNA was observed in 12 of 14 cases (85. 7%) showing gene amplification but overexpression of its protein was found in only four cases (28.6%). Amplification of the cyclin D1 gene is a reliable prognostic factor and post-translational modification of this gene may play a functionally important role in development of primary esophageal cancer.

Aged↗
PubMedDate not supplied

Prognostic significance of c-myc mRNA expression assessed by semi-quantitative RT-PCR in patients with colorectal cancer.

To clarify the prognostic value of the c-myc oncogene mRNA expression levels in human colorectal cancer, samples obtained from 35 surgically resected tissues were examined by the semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Overexpression of c-myc mRNA was detected in 22 cases (63%). Although there was no correlation between c-myc overexpression and the depth of invasion, lymph node metastasis, or Dukes' stage, the patients with c-myc overexpression had metastatic recurrences significantly more frequently than those without it (29% versus 0%, p<0.05). The disease-free survival rate at 5 years was significantly lower in patients with c-myc overexpression than in those without it (70% versus 100%, p<0.05). These results demonstrate that c-myc mRNA overexpression as assessed by semi-quantitative RT-PCR may be a useful prognostic indicator in patients with colorectal cancer.

Adult↗
PubMedDate not supplied

Patterns of lymph node metastasis in carcinoma of the distal bile duct.

BACKGROUND/AIMS: The aim of this study was to clarify the lymphatic spread in distal bile duct carcinoma in relation to local tumor extent (pT category). METHODOLOGY: The distribution and number of involved nodes were examined in 42 patients with distal bile duct cancer. RESULTS: Lymph node metastases were present in 25 of 42 patients (60%); 5 of 12 (42%) with pT2 tumors and 20 of 26 (77%) with pT3 tumors. Nodal involvement was not identified in 4 patients with pT1 tumors. The incidence of node positivity was higher in patients with pT3 tumors than in those with pT1 or pT2 tumors (p<0.01 or p<0.05). The total number of positive nodes was greater in patients with pT3 tumors than in those with pT2 tumors (mean: 3.08 vs. 0.75; p<0.01). All node-positive patients had involved nodes in the hepatoduodenal ligament or posterior pancreaticoduodenal region, or both. The number of positive nodes in the superior mesenteric and para-aortic region was greater in patients with pT3 tumors than in those with pT2 tumors (p<0.05). CONCLUSIONS: As tumor invades the pancreas from the distal bile duct, lymphatic spread extends from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the superior mesenteric and para-aortic nodes.

Adult↗
PubMedDate not supplied

Treatment for extrahepatic metastasis of hepatocellular carcinoma following successful hepatic resection.

BACKGROUND/AIMS: Recent advances in both the diagnosis and treatment of hepatocellular carcinoma (HCC) have improved its prognosis. Intrahepatic recurrence after hepatectomy can be treated with repeated hepatectomy, transhepatic arterial embolization (TAE), percutaneous ethanol injection therapy (PEIT), or microwave coagulo-necrotic therapy. However, treatment for extrahepatic recurrence is also important in prolonging survival in some patients. METHODOLOGY: After radical hepatectomy in 155 patients, extrahepatic recurrences were found in 15 patients that underwent subsequent treatment. The interval between completing treatment for the primary tumor and the discovery of metastasis, the location and mode of treatment of the metastasis, and the outcomes were analyzed. RESULTS: Distant metastasis was detected at a mean of 7 months after radical resection of the primary tumor. Location of the metastasis included lung, bone, and adrenal gland. Four patients had no intrahepatic recurrence and 11 patients had simultaneous intrahepatic recurrence. Six patients with intrahepatic and extrahepatic recurrence that underwent systemic chemotherapy had poor prognoses, and all died within 12 months as a result of progression of the intrahepatic tumor. Five patients with intra- and extrahepatic recurrence that underwent systemic chemotherapy combined with hepatic arterial infusion chemotherapy had relatively good outcomes; all survived for more than 12 months. CONCLUSIONS: These results suggest that to obtain a good prognosis for extrahepatic metastasis coexisting with intrahepatic recurrence, intrahepatic recurrence should be controlled by locoregional therapy, and extrahepatic metastasis should be controlled by systemic chemotherapy and/or irradiation therapy.

Adrenal Gland Neoplasms↗