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Biomedical subjects

S Yamazaki

Publications and source records attributed to S Yamazaki.

At least 433 records · Page 24Linked to original sources

Clinical significance of 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) in the diagnosis of intrahepatic masses.

Hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) was carried out on 48 patients with intrahepatic masses, 44 with hepatocellular carcinoma and one each of hepatocellular adenoma, focal nodular hyperplasia, cholangiocellular carcinoma, and adenoid cystic carcinoma. Scans were performed twice, early scan (30 min post i.v.) and delayed scan (2.5 h post i.v.), and the delayed scan was used for assessing the accumulation of 99mTc-PMT in the intrahepatic masses. In the hepatocellular carcinoma group, based on individual patients, 17 out of 44 (38.6%) showed accumulation of 99mTc-PMT in various degrees; and based on individual masses, accumulation was noted in 21 out of 55 masses (38.2%). However, only the cases which had not received transarterial infusion of anti-cancer drugs (TAI) and/or blocking agents (TAE) were taken into consideration, 9 out of 18 patients (50%) and 12 out of 25 masses (48.0%) were found capable of picking up 99mTc-PMT. A case of hepatocellular adenoma showed a strong accumulation of 99mTc-PMT in the mass which was depicted as a defect on the 99mTc-colloid scan and did not show a significant accumulation of 67Ga. In a case of focal nodular hyperplasia, there were two space-occupying lesions (SOLs), one of which showed a clear-cut defect on the 99mTc-colloid scan and the other which showed only a distorted uptake pattern. However, both masses were strongly positive with 99mTc-PMT. 99mTc-PMT scintigraphy is useful in connection with 99mTc-colloid scan and sometimes with 67Ga-citrate in the diagnosis of intrahepatic masses originating from hepatocytes.

Adenoma, Bile Duct↗

Varicella-zoster virus prevalence in Japan: no significant change in a decade.

A seroepidemiologic time-comparison study was conducted to evaluate changes in IgG antibody to varicella-zoster virus (VZV) and to determine VZV prevalence in Japan with randomly collected serum samples from two healthy Japanese populations: 1973 (n = 670) vs. 1984 (n = 677). Enzyme-linked immunosorbent assay (ELISA) was found to be superior to the immune adherence hemagglutination test (IAHA) especially for detecting seropositivity in adults. Serologic results showed essentially no significant difference between the 1973 and the 1984 age-specific prevalences; with the exception of a slightly lower prevalence in the 5-year-old age group in 1973 than that in 1984. In general, the age-specific prevalence was lowest in the 1-year-old group (mean 11%) and increased in a linear fashion until age 9 (mean 82.9%); prevalence continued to increase slowly after age 9 and plateaued at 100% for ages greater than or equal to 25-29.

Adolescent↗

[A clinicopathological study of early mucinous adenocarcinoma of the stomach].

From 1963 to 1986, 1126 cases (1300 lesions) of early gastric carcinoma were treated at Fukui Prefectural Hospital. Mucinous adenocarcinomas comprised 16 lesions in this series. These cases of mucinous adenocarcinoma were younger than all the other early carcinomas of the stomach and they often were locted in the lower third of the stomach. Macroscopically, most were types "Iia + IIc". Dividing them into 3 grouping: papillary, tubular, and signet ring cell types, depending on the microscopic appearance of the intramucosal carcinoma, the signet ring cell group differed from the other two as to age, macroscopic appearance, and region it occupied. An immunochemical study showed that CA19-9 stained positively in a mucous lake, much like a carcinoma cell, but that CEA stained little.

Adenocarcinoma↗

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↗

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↗

[The role of splenectomy in patients with hepatocellular carcinoma and hypersplenism as an aid to hepatectomy].

To evaluate the clinical value of splenectomy for hepatic resection, a total of 20 patients with hepatocellular carcinoma and hypersplenism were examined focusing on a change of total serum bilirubin values after surgery. Both hepatectomy and splenectomy were simultaneously performed in 12 patients, and in 8 patients as a staged operation. Postoperatively, a significant depression of bilirubin values was observed in a group with the preoperative values between 1.0mg/dl and 2.0mg/ml. Three factors (bilirubin, albumin and prothrombin time) in clinical stage were improved just after splenectomy with a statistical significance (p less than 0.05) in a group received staged operation. In 7 out of 8 patients, clinical stages were getting better as one or two stages prior to the hepatectomies. Therefore, we recommend the addition of splenectomy to hepatectomy in the patients whose hyperbilirubinemia are assumed to be correlated with coexisting hypersplenism.

Adult↗

[Diagnosis and surgical treatment of early esophageal cancer].

144 cases of the superficial esophageal cancer, of which invasion was limited to the submucosa, have been resected for the last 23 years. 94 cases (65%) were early cancer, and 50 cases (35%) were superficial cancer with metastasis. The 5-year survival rate of early cancer cases was 65%, otherwise, that of superficial cancer cases with metastasis was 24%. There was a significant difference between these two groups. As for the depth of cancerous invasion, the 5-year survival rate of mucosal cancer cases was 100%. That of submucosal cancer cases was 70% even in cases without nodal involvement. Analyzing the cancerous depth of the superficial cancer and its nodal involvement and its vascular invasion, the lymph node metastasis and the vascular invasion were not observed in 90% of mucosal cancer cases, otherwise these were negative only in 30% of submucosal cancer cases. So to obtain the remarkable improvement of the long term results of esophageal cancer, the diagnosis and the treatment of mucosal cancer of the esophagus are essential. The endoscopic examination have come to play a large role for the diagnosis of mucosal cancer of the esophagus. Moreover, the endoscopic dyeing with Lugol's solution is important in the diagnosis of flat type of esophageal lesions, that is mucosal cancer and epithelial cancer. At present time, the treatment of early esophageal cancer is in principle surgery. And the operative mortality was low, 1.4%. However, the non-invasive treatments; endoscopic LASER therapy, radiation, endoscopic strip-biopsy etc., will be performed more frequently in minute mucosal cancer.

Aged↗

[Early carcinoma of the gastric remnant: pathological features relating to the interval between the initial and second surgery].

Twenty cases of early carcinoma of the gastric remnant have been treated at our hospital and examined clinico-pathologically. In 11 cases, the interval after the initial gastrectomy, due to the gastric carcinoma, was done was short compared with length of the interval of 9 cases after a gastrectomy for a benign gastric disease. There were two types of gastric remnant carcinomas in cases in which the interval extended 10 years. The first type developed at the site of the gastro-intestinal anastomosis, especially when the anastomosis was found to be joined by the Billroth II method, and the carcinoma was associated with a gastritis cystica polyposa (GCP). The other type showed a polypoid appearance except for the stomal site.

Adenocarcinoma↗

Particle size of airborne mouse crude and defined allergens.

Laboratory animal allergy is a serious occupational diseases of many workers and scientists engaged in animal experimentation. Control measures depend upon characterization of allergens including airborne particles. This study measured the particle size of crude mouse urine and pelt aeroallergens generated in mouse housing rooms and compared them with mouse serum albumin, a defined major allergen. Allergens were detected by specific immunological methods. Most crude and defined allergens (74.5-86.4%) concentrated on a filter with a retention size greater than 7 microns. In distrubed air, allergen concentration increased 1.4 (albumin) to 5 (crude) fold and the proportion of small particles increased from 1.4% in calm air to 4.5% in distrubed air. This information on the generation and size distribution of aeroallergens will be important in the development of effective counter measures.

Air↗

[A rare case of metastasis of the spleen from recurrent cancer of the residual stomach].

In May, 1988, a 75-year-old housewife, who had undergone a subtotal gastrectomy for a carcinoma 12 years earlier, visited our hospital because of vomiting. Biopsy specimens of the residual gastric mucosa revealed malignant cells and an abdominal CT scanning examination showed a solitary nodule in the splenic parenchyma. A non-curative resection of the residual stomach, a splenectomy and a distal pancreatectomy were performed on June 3, 1988. Histological examination of the resected specimens demonstrated a moderately differentiated adenocarcinoma of the stomach, that had invaded the pancreas and retroperitoneal nodes. A nodule of the spleen that was inspected showed a round, greyish solid mass, 0.7 cm in diameter on the cut surface, and microscopically metastatic focus from a gastric cancer. Only a few operated cases manifesting a splenic metastasis of a gastric cancer have been reported and a definitive routing pattern of the metastasis is often difficult to distinguish. However, our case seems to suggest that a hemodynamic route had been taken, since there were no metastatic nodes around the splenic hilus and the metastatic site was only the parenchyma in the spleen.

Adenocarcinoma↗

[Continuous arterial infusion chemotherapy in cancer cases followed as outpatients].

Continuous arterial infusion chemotherapy is associated with a significantly greater tumor response rate, though patients must be hospitalized for a long time. This paper describes techniques and our experience with arterial continuous infusion chemotherapy for outpatients using implantable port and ambulatory pump. Eleven patients (liver metastasis of colorectal cancer, hepatocellular carcinoma and local recurrence of rectal cancer) were treated with continuous arterial infusion chemotherapy at our outpatient clinic. The chemotherapy infusions were carried out repeatedly for 5.7 months on average (10-2 months) with 5-FU or CDDP. Total periods of infusions were 64.8 days on the average (136-24 days). The infusion dose and frequency of drug refilling were limited by pump quality. A major complication occurred only in one patient who developed arterial thrombosis. Minor complications were mainly gastrointestinal symptoms (nausea, vomiting) and abdominal pain, which were easily corrected with drugs. The tumor responses were as follows: PR 1 case, MR 1 case, NC 7 cases and PD 2 cases. Home arterial continuous infusion chemotherapy reduced the hospitalized period and helped patients return to work. Therefore it may well contribute to improve the quality of life of cancer patients.

Ambulatory Care↗

[Family of hereditary elliptocytosis with abnormalities of spectrin function (Sp alpha 1/74)].

We have experienced a case of cytohemolytic hereditary elliptocytosis (HE) in a six-year-old boy. Metabolisms of the erythrocytic membrane were investigated on the members from his pedigree. The results were as follows; 1) The presence or absence of ovalocytic HE were studied in his pedigree. 2) Failure in the process of spectrin dimer to tetramer conversion was found. 3) Although abnormality existed in conversion of D to T by the patient's alpha-chain spectrin and normal beta-chain spectrin, no abnormality was recognized when normal alpha-chain and the patient's beta-chain were combined. 4) Decrease of the alpha-chain (80 kd) domain and appearance of abnormal (74 kd) spot were found by two dimensional peptide mapping of spectrin. 5) In his pedigree, neither patients with hereditary pyropoikilocytosis (HPP) nor carrier states were recognized. In summary, this patient's pedigree was considered to be HE [SP alpha 1/74]. This case appears to be the first case in Japan and only few cases have been reported in the world literature.

Child↗

[Analysis of postoperative thoracic empyema].

We experienced 15 cases of pyothorax after thoracotomy. Six were pyothorax without bronchial fistula and 9 were with fistula. All of former were cured by the closed drainage and/or open window thoracostomy. Two of pyothorax with fistula, who were treated with the tube drainage, died of respiratory insufficiency. Five cases who underwent the open window thoracostomy survived well. Omentopexy was performed in 2 of pyothorax with fistula and results were excellent.

Adult↗

Evaluation of dust respirators for elimination of mouse aeroallergens.

The efficiency of various dust respirators for eliminating mouse allergens [mouse urine proteins (MUP), pelts proteins (MPP) and serum albumin (MSA)] were evaluated with use of low-volume air samplers and immunochemical methods. Three kinds of dust respirators from one manufacturer which have different efficacy in the exclusion of dust particles were put on the fiber glass filter in each air sampler. Then the air in a mouse housing room was sampled. The allergens passed through the respirators, were trapped in the fiber glass filters, and then extracted from the filters. The allergens of MUP and MPP in the extract were measured by an inhibition method of fluorometric enzyme-linked immunosorbent assay (ELISA) for IgE antibody and those of MSA measured by a fluorometric sandwich ELISA. The respirator with the lowest capability of exclusion was found to eliminate 65-86% of respective allergens. The other two respirators with higher powers eliminated 98% of MUP. MPP and MSA were eliminated to undetectable levels through these respirators. This study provided a means for the evaluation of dust respirators for animal aeroallergens.

Air Pollution↗