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Biomedical subjects

S Ueda

Publications and source records attributed to S Ueda.

1,322 records · Page 74Linked to original sources
PubMedDate not supplied

Chemoembolization and percutaneous ethanol injection for intrahepatic recurrence of hepatocellular carcinoma after hepatic resection.

BACKGROUND/AIMS: Management of 36 patients who developed intrahepatic recurrence (IHR) after curative hepatic resection for hepatocellular carcinoma (HCC) was studied. MATERIALS AND METHODS: IHRs were classified into type I with a solitary lesion (n = 16), type II with 2-4 lesions (n = 11), and type III with > or = 5 lesions (n = 11). RESULTS: Periodic angiography and Lipiodol CT first detected IHRs in six patients. Most IHRs in type I and II were smaller than 20 mm. Thirty-three patients underwent regional treatments including transarterial infusion of Lipiodol containing anticancer drugs (TAIL) (n = 19), combined TAIL and percutaneous ethanol injection PEI (n = 12), surgery (n = 3), and PEI (n = 1). Post-recurrence 5-yr survival rate of type I (51%) was higher than that of type II (0%) or III (0%) (p < 0.01). Of the 27 patients with type I and II recurrences, seven became tumor-free for 11-67 months after regional treatments including TAIL + PEI (n = 5), TAIL (n = 1), and surgery (n = 1); 13 developed multiple IHRs. CONCLUSIONS: Postoperative close follow-up with qualified imaging and vigorous treatments prolong the survival of the patients with HCC who developed IHRs. Type I or type II IHR can be curable with the combination of TAIL and PEI or repeated surgery.

Adult↗
PubMedDate not supplied

Laparoscopic hepatic resection: a new and safe procedure by abdominal wall lifting method.

HCC is well known for its high incidence of intrahepatic tumor recurrence and many patients suffering from them, usually undergo further treatments, such as PEI, TAE, MCNT or hepatic resection. However, conventional hepatic resection by large skin incision causes severe intraabdominal adhesions, which disturb US examination and further treatments. The aim of the laparoscopic procedure is to prevent intraabdominal adhesions. This is a study of the feasibility of laparoscopic hepatic resection without CO2 pneumoperitoneum, which is not yet popular, as a safe and effective procedure. The patient in this study had a solitary HCC in the lateral segment. Mobilization of the lateral segment, dissections of the left hepatic artery and portal venous branches, i.e. P2 and P3, were performed under CO2 gas insufflation. However, to avoid CO2 gas embolism, further procedures, including parenchymal compression and hepatic venous dissection, were performed using the abdominal wall lifting method without pneumoperitoneum. The patient could eat on the second postoperative day and had an uneventful postoperative recovery and was discharged from the hospital 13 days after surgery. Hospital stay was shorter than conventional hepatic resections with large skin incisions. The importance of this procedure lies in that it is not only a minimally invasive procedure, but also provides us with the possibilities of further treatments, including PEI and re-hepatic resection.

Abdominal Muscles↗
PubMedDate not supplied

Intrahepatic cholangiocarcinoma associated with hepatolithiasis.

BACKGROUND/AIMS: Despite sporadic reports of cholangiocarcinoma (CC) associated with hepatolithiasis, this entity has not been widely studied. The purpose of this study was to clarify its clinical features and optimal management by studying the 10 patients we have encountered with this condition. METHODOLOGY: There were six women and four men, with a mean age of 61 years. The patients underwent anatomic hepatic resection (n = 5) or biliary drainage (n = 5). The clinical features and results of surgery were studied. RESULTS: The characteristic findings included tumor-related symptoms, irregular ductal stricture or obstruction, and hepatic lobar atrophy with a whitish mass. The tumor and stones were located in the same hepatic lobe. Eight patients had advanced CC with periductal tumor infiltration, while two had in situ carcinoma characterized by intraductal tumor growth, papillary adenocarcinoma, and mucin-hypersecretion. Seven patients died within 6 months after surgery, while the remaining three, including the two with in situ carcinomas and one with an involved node at the dissected hilum, are alive more than 4 years after anatomic hepatic resection. CONCLUSIONS: Recognition of the clinical features of CC associated with hepatolithiasis, which were clarified in this study, is important in treating patients with hepatolithiasis. An anatomic hepatic resection with hilar nodal dissection offers long-term survival in selected patients.

Adult↗
PubMedDate not supplied

6R-L-erythro-5,6,7,8-tetrahydrobiopterin is involved in brain vulnerability of senescence-accelerated mouse during the processes of aging.

The effects of age on the dopamine (DA) turnover and 6R-L-erythro-5,6,7,8-tetrahydrobiopterin (6R-BH4), a cofactor for monooxygenases, were investigated in the striatum and midbrain of the senescence accelerated mouse (SAM) at 6, 12 and 15 months old. 6R-BH4 and DA levels were decreased significantly in the striatum of 15-month-old SAM-P/1 (senescence accelerated prone) mice. At 12 months old, DA level was decreased significantly in the striatum of SAM-P/1 compared with SAM-R/1 (senescence accelerated resistant) mice. The reduction of striatal DA level was shown to be related to the depletion of 6R-BH4 in the striatum during the processes of aging. Age-related decreases in striatal dopamine function occurred in SAM-P/1 mice earlier than in the SAM-R/1 mice. The striatal [DOPAC]/[DA] ratio, as the index of DA turnover, was increased significantly in the 15-month-old SAM-P/1 mice. On the other hand, the DA, 6R-BH4 levels and the ratio of [DOPAC]/[DA] did not show any changes in the midbrain of SAM-P/1 and SAM-R/1 during the processes of aging. It was suggested that brain vulnerability with aging may be associated with the levels of 6R-BH4.

3,4-Dihydroxyphenylacetic Acid↗
PubMedDate not supplied

Metallic stents for low invasive recanalization of the portal veins with cancerous invasion--first case report.

BACKGROUND/AIMS: Portal venous stenosis caused by cancer invasion has been difficult to treat and patients do not have any treatment options. On the other hand, protal venous stents have been applied to patients with variceal haemorrhaging associated with portal vein thrombosis. However, there have not been any reports concerning portal venous stents for malignant portal stenosis. The aim of this report was to apply metallic stent for malignant portal stenosis to reduce portal hypertension and restore portal venous blood flow, which in turn leads to the recovery of liver function. METHODOLOGY: Two patients with portal hypertension caused by malignant portal stenosis were treated by metallic stent implantation. In one case, the stent was applied intraoperatively via the ileal vein and in the other case, it was applied postoperatively via transhepatic portal cannulation. RESULTS: In the first case, portal pressure monitored before and after placement of the stent was 350 mmH2O and 200 mmH2O, respectively. Liver function tests showed normalization after stent placement. In the second case, over 3000 ml of ascites, which were drained through the drainage catheter every day, could be reduced remarkably, and one week later, the catheter could be withdrawn. Portal pressure before and after embedding the stent was 410 and 275 mmH2O, respectively. Both patients were discharged from the hospital and their recovery was uneventfully. CONCLUSION: Both cases had an uneventful postoperative course, with normalization of liver function and cessation of ascites on the next postoperative day in case 2. Thus, portal venous stent should be considered a viable option for the treatment of malignant portal stenosis.

Aged↗
PubMedDate not supplied

Duodenum-preserving resection of the pancreatic head for mucinous ductal ectasia without overt carcinoma.

BACKGROUND/AIMS: The clinical characteristics of mucinous ductal ectasia (MDE) of the pancreas without overt carcinoma have not been clarified. To clarify MDE and assess the optimal treatment procedure, including the technique of duodenum-preserving resection of the pancreatic head (DpRPH), we studied four patients. METHODOLOGY: Our patients consisted of three men and one woman, with a mean age of 71 years. The patients underwent DpRPH (n=3) or the pylorus-preserving Whipple procedure (PpW) (n=1). Clinicopathological features, postoperative pancreatic function, and technique to preserve duodenal blood flow were studied. RESULTS: All patients had intraductal mucin-hypersecretion and multilocular cysts lined by hyperplastic epithelium. The lesions were located in the uncinate process (n=3) or head-body (n=1) of the pancreas. DpRPH totally removed the lesions in the uncinate process. Of the three patients receiving DpRPH, dusky duodenum and a postoperative duodenal ulcer developed in two whose gastroduodenal arteries (GDA) were divided, but did not develop in one with undivided GDA. Postoperative glucose tolerance test and peptide para-aminobenzoic acid test after DpRPH showed better values than those after PpW. All patients are alive and well 22 to 40 months after surgery. CONCLUSIONS: DpRPH is a new standard for MDE. During DpRPH, preservation of the GDA and the superior portion of the pancreatic head is recommended to maintain an adequate duodenal blood flow.

Aged↗
PubMedDate not supplied

Clinicopathological evaluation of long-term survivors treated for cancer of the head of pancreas.

BACKGROUND/AIMS: This is a study of 43 patients with cancer of the pancreatic head treated by resection in the past 13 years; 8 patients survived for 3 years or more and were compared with 17 who died of cancer within 3 years, in terms of histopathological spread. METHODOLOGY: Eight patients with cancer of the pancreatic head who survived for 3 years or more after resection were evaluated clinically. They were compared histologically with 17 patients who died of cancer within 3 years. RESULTS: The long-term survivors had s0 lesion (no frontal invasion of the pancreatic capsule). Lymph node metastasis was absent, or if present, limited to the n1 group. Histological examination showed rpe (positive retroperitoneal invasion) in four of the eight patients (50%). E-ew (-) (no evidence of invasion to the exposed cut surface) was obtained in all patients. They had stage (histological cancer Stage) II or III except for one patient with stage IV. CONCLUSIONS: Based on the results of the evaluation of our patients, the preconditions at present for prolonged survival for patients with cancer of the pancreatic head would appear to be as follows: --no frontal invasion of the pancreatic capsule; --no retropancreatic invasion or no evidence of invasion to the exposed cut surface even if the retroperitoneal tissues are invaded; --no lymph node metastasis or metastasis limited to the first lymph node group.

Adenocarcinoma↗