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Biomedical subjects

T Iwanaga

Publications and source records attributed to T Iwanaga.

At least 307 records · Page 17Linked to original sources
PubMed1988

A prospective randomized study comparing the effects of large and small volumes of the sclerosant 5% ethanolamine oleate injected into esophageal varices.

The safety efficacy and complications of injections of large and small volumes of 5% ethanolamine oleate (EO) were examined prospectively in the sclerotherapy of esophageal varices in 39 consecutive cirrhotic patients. Twenty patients were randomly allocated to the large-volume group (LVG) injected with up to 30 ml per session, and 19 to the small-volume group (SVG) injected with up to 15 ml per session. The two groups were comparable with regard to age, etiology and severity of liver disease. Post-injection bleeding occurred in 15.8% (3/19) after 1-3 sessions in the SVG and in 0% in the LVG. The LVG showed a significantly higher rate of decrease in variceal size (95.0% vs 53.2%, p less than 0.05) and disappearance of red color signs (RCS) on the variceal surface (95.0% vs 52.6%, p less than 0.01) one week after the initial session. The treatment period and number of sessions of endoscopic injection sclerotherapy (EIS) for eradication of varices were significantly (p less than 0.01) smaller in LVG than in SVG (LVG: 2.7 +/- 0.6 sessions over 4.2 +/- 0.7 weeks vs SVG: 5.4 +/- 0.9 sessions over 6.0 +/- 1.6 weeks). There were no life-threatening complications, and the incidence of minor complications did not differ between the two groups. The persistence of RCS and the occurrence of post-injection bleeding may imply that esophageal varices are not always completely obliterated despite 1-3 sessions in the SVG. We conclude that the large volume of EO is superior to the small volume for repeated EIS to eradicate esophageal varices.

Adult↗
PubMed1988

Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head.

We performed a retrospective review of 59 pancreatic resections for ductal carcinoma of the pancreas head performed between 1971 and 1983. In addition to pancreaticoduodenectomy, 37 consecutive patients (from 1971 to 1981) received lymphatic dissection adjacent to the pancreatic head (Group R1), whereas another 22 patients (from 1981 to 1983) received a wider range of lymphatic and soft tissue dissection, including the para-aortic region (Group R2). These groups did not differ with regard to operative mortality rate or background factors in the patients who tolerated operation. The 3-year cumulative survival rate was 13% in the R1 group vs. 38% in the R2 group (p less than 0.05). Almost all of the deaths from cancer recurrence occurred within 3 years after operation; the cumulative rate of death from local recurrence decreased from 67 to 16% (p less than 0.05) at 3 years. Among the patients with nodal involvement, there was no 3-year survivor in the R1 group, but four (27%) in the R2 group (p less than 0.05) survived. Among the patients whose tumor size exceeded 4 cm with retroperitoneal invasion, there was no 3-year survivor in either group and most patients died of distant metastasis. Extended clearance of regional lymph nodes and soft tissue appears to benefit patients with ductal carcinoma of the pancreatic head whose tumor size is less than 4 cm without severe invasion to the retroperitoneal space.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1988

Depletion of gastrin-releasing peptide (GRP) from nerves in the gastric body of rats with experimental ulcers. An immunohistochemical study.

A predominant population of mucosal nerves in the mammalian gastric body has been known to contain large amounts of gastrin-releasing peptide (GRP). The present immunohistochemical study demonstrates the depletion of GRP immunoreactivity from nerves in the oxyntic mucosa of rats with ulcers induced by restraint plus water immersion. Depletion of GRP occurred in a major part of the nerves after 3 h exposure to the stress, and after 6 h exposure only a few nerve fibers could be recognized. In contrast, GRP fibers in the pyloric mucosa did not decrease significantly in number in any of the stressed rats. Since the depletion of GRP immunoreactivity preceded mucosal erosion in the gastric body, the possibility is proposed that GRP released from the nerves may be related to stress-related ulceration in the stomach.

Animals↗
PubMed1988

Immunocytochemical localizations of neuron-specific proteins in the taste bud of the guinea pig.

The taste buds and their nerves in the guinea pig were immunocytochemically investigated with regard to the localization of spot 35 protein, neuron-specific enolase (NSE), neurofilament protein (NFP), and S-100 protein. The spot 35 protein-like immunoreactivity was confined to slender cells comprising half the number of taste bud cells. NSE-like immunoreactivity was recognized in some taste bud cells as well as nerve fibers both within the taste bud and in the subepithelial connective tissue. The NSE-immunoreactive cells were divided into two cell populations: one weakly and the other intensely immunoreactive. The former cells proved to be spot 35 protein-immunoreactive. Moreover, the cells immunoreactive for both spot 35 protein and NSE were frequently associated with nerve fibers immunostained intensely for NSE. The NFP- and S-100 protein-like immunoreactivities were found in none of cells in the taste bud, but exclusively in the subepithelial neural elements.

Animals↗
PubMed1988

[A case report of long-term survival in advanced gastric cancer with multiple liver metastases treated with mitomycin C and tegafur therapy after palliative gastrectomy].

A 64-year-old male with advanced gastric cancer with multiple liver metastasis was treated with intensive chemotherapy including mitomycin C and tegafur after palliative gastrectomy. The patient was medicated with 30 mg iv of mitomycin C after surgery and 1,000 mg ir or 1,200 mg po of tegafur for one year for induction therapy and 400-600 mg po of tegafur for long-term maintenance therapy. All metastatic lesions in liver were completely eliminated three years after the start of treatment. As to acute and chronic toxicity, slight leukopenia was noted in the treatment, but the patient was found to show a good quality of life because of less toxicity. The patient has been healthy with no evidence of malignancy at nine years and nine months after the surgery. The total cumulative dose of tegafur in this treatment was 1,141.0 g, which is probably the largest dose ever reported in Japan, suggesting that the combination of mitomycin C and tegafur is indicated as a modality for advanced gastric cancer with liver metastasis.

Adenocarcinoma, Papillary↗
PubMed1988

[Anticancer effect of UFT in intrahepatic recurrence with tumor embolus in the left portal vein after hepatectomy of hepatoma--a case report].

A 65-year-old man was diagnosed as having hepatoma (HCC) in the area of S5 and S8. Anterior segmentectomy was performed on September, 1984. TAE (Sandwich therapy) via r. hepatic artery was performed for the intrahepatic recurrence one and half years after hepatectomy. However, the tumor embolus in the l. portal vein with intrahepatic recurrence occurred, and intraarterial infusion chemotherapy (IAC) using CDDP 150 mg was performed via proper hepatic artery. The decrement of AFP value was observed for a short time after IAC therapy. Therefore, UFT 300 mg daily, was administered. For two and half months after UFT administration, the elevation of AFP value continued from 665 ng/ml to 4150 ng/ml, and decreased rapidly below 20 ng/ml in the following 2 months. The tumor embolus in the l. portal vein was remarkably reduced on computed tomogram examination. This case suggests the usefulness of UFT for the intrahepatic recurrence with tumor embolus in the portal vein after hepatectomy for HCC.

Aged↗
PubMed1988

[Transarterial chemoembolization in metastatic liver tumor after curative resection of pancreatic cancer].

Transarterial chemoembolization was done for 6 cases with metastatic liver tumor after curative resection of pancreatic cancer. Three cases underwent pancreatoduodenectomy and another 3 caudal pancreatectomy. Anticancer effect, which was determined from the survival period and the changes in tumor size and tumor markers (CEA and NSE), was remarkable in a case of adenosquamous carcinoma and one of islet cell carcinoma. However, in another 4 cases with adenocarcinoma, it was not sufficient. With regard to the adverse effect, liver abscess was seen in two cases after pancreatoduodenectomy. Laboratory data before TACE showed that both of these 4 cases had cholangitis. This is in contrast to the fact 2 of the 3 caudal pancreatectomies had cholangitis, too. Therefore, it is concluded that careful selection is necessary, especially for the case after pancreatic head resection.

Adenocarcinoma↗
PubMed1988

[Transcatheter arterial chemoembolization in liver metastases of colorectal cancer (lipiodol cisplatin sandwich therapy].

The transcatheter arterial chemoembolization (LPD-CDDP Sandwich Therapy) developed by us was applied to 15 patients with unresectable liver metastases (H2-H3) of colorectal cancer. Computed tomography or ultra-sonography revealed an overall response rate of 27%. Serum CEA values decreased to lower than the pre-TACE value in 11 (78%) of 14 patients excluding one showing the normal range before TACE. The post-TACE CEA values were completely normalized in 2 of the 11 patients. One-year cumulative survival rate was 72% and median survival was 18 months, showing a prolongation compared with intraarterial or systemic chemo-immunotherapy. The histological antitumor effect of LPD-CDDP Sandwich Therapy was examined in the hepatic specimens from 6 patients who underwent hepatectomy after this therapy for liver metastases (H1-H2) of colo-rectal cancer. The necrotic area in the main tumor was 95-100% in 3 patients, 75-94% in 2 patients and 50-74% in one patient. LPD-CDDP sandwich therapy was considered an effective treatment without any serious side effects for liver metastases of colo-rectal cancer.

Cisplatin↗
PubMed1988

[A case of colorectal cancer showing complete response to UFT].

A 33-year-old male patient underwent a low anterior resection for sigmoid colon cancer. Bloody stool developed about one month after discharge and a small, circumscribed, ulcerated adenocarcinoma was found about 1 cm anal to the site of anastomosis. After oral administration of FT 0.6 g/day for 42 days, UFT 0.6 g/day was administered successively. As a result, complete tumor response was observed within about four months. UFT 0.3 approximately 0.6 g/day has been administered daily since then. The patient has been in good health without any sign of relapse for three years after achievement of the complete response.

Adenocarcinoma↗
PubMed1988

[A clinicopathological study on conservative surgery and extended surgery for gastric cancer].

There are two problems in conservative surgery for early gastric cancer. 1) To resect the stomach at a sufficient surgical margin, brushing cytodiagnosis of the gastric mucosa and frozen section examination at the stump are performed during operation. After all these examinations, the stomach is resected at a sufficient margin because of the possibility of multifocal cancer. 2) Regarding lymph node dissection, only N1 lymph nodes are to be removed in minute cancer (less than 5mm in diameter) which have no lymph node metastasis (0%). Thirty-one cases of Borrmann type 4 gastric cancer which underwent left upper abdominal evisceration plus Appleby's method (LUAE + Apl) were compared with 31 patients who had undergone total gastrectomy with pancreatico-splenectomy (TG) before LUAE + Apl series. The 3-year survival rate in stage II-III cases was higher with LUAE + Apl (77.8%) than with TG (35.0%). There was no difference between the two groups in the incidence of postoperative complications or the function after operation. Angiography must be performed before conducting operations by LUAE + Apl preventing liver necrosis. And for patients aged over 70, we propose to reduce the procedure of LUAE + Apl.

Humans↗
PubMed1988

An ultrasonic duplex system facilitates detection of portal hemodynamic changes following selective shunts for esophageal varices.

We used an ultrasonic duplex system (US system) to assess portal hemodynamics in 52 patients with liver cirrhosis and esophageal varices, who underwent 2 types of distal splenorenal shunt (DSRS), conventional DSRS (group A, 8 patients) or DSRS with splenopancreatic disconnection (group B, 44 patients). The portal blood flow rate (PBF) was determined in 64 out of 70 patients (91.4%) and the shunt flow rate (SVF) in 39 out of 42 patients (92.9%) who had angiographically confirmed patent portal vein and shunt vein, during the peri- and postoperative period. In group A, a remarkably small amount of postoperative PBF (193 ml/min) and a concomitant increase in SVF (1039 ml/min) were evident. Such ultrasonic findings were compatible with a reduction in portal vein diameter, in accordance with the poor portal perfusion grade of the liver, and a transpancreatic stealing of the portal blood flow to the shunt, as evidenced by postoperative angiography. In contrast, the reduction in PBF was minimal, that is 663 ml/min preoperatively to 562 ml/min at discharge, and 536 ml/min at late follow-up, in group B patients. Significant alterations in portal circulation of the group B patients were not evident angiographically. This US system is most useful to assess portal hemodynamics in patients with a selective shunt.

Adult↗
PubMed1988

[Occurrence of a heterochronous cancer in the remnant stomach following partial gastrectomy in gastric cancer].

Thirty-six cases of a heterochronous cancer in the remnant stomach following a partial gastrectomy for gastric cancer have been compared with 12 cases of gastric cancer following a gastrectomy for benign diseases. Lesions of a heterochronous cancer are characteristically similar to those of a synchronous multiple gastric cancer. Patients with a heterochronous cancer were found to have high rates of synchronous multiple cancers in the resected stomach as compared with none found in gastric cancer patients following surgical operation for a benign disease. Lesions of cancer after surgery for a benign disease when found were mostly in the anastomosis of the remnant stomach. These findings suggest that a heterochronous gastric cancer may develop into lesions of multiple cancers.

Female↗
PubMed1988

[Local chemo-hyperthermotherapy of recurrent rectal cancer].

Local radiofrequency hyperthermia combined with chemotherapy was performed on five patients with pelvic recurrence of rectal cancer. Relief of pain was obtained in all four patients with uncontrolled pelvic pain due to recurrent rectal cancer. In some patients, CEA levels of peripheral blood were decreased and tumor necrosis was proved histologically. These results suggest that this combined therapy may be useful for patients with pelvic recurrence of rectal cancer.

Adenocarcinoma↗
PubMed1987

Selective inhibition of 5-lipoxygenase pathway in rat pulmonary alveolar macrophages by cigarette smoking.

Pulmonary alveolar macrophages from sham or cigarette-smoke-exposed rats were examined for their ability to transform exogenously added arachidonate to metabolites of lipoxygenase and cyclooxygenase pathways. Synthesis of 5-HETE and leukotriene B4 was selectively inhibited by cigarette smoke exposure, whereas the formation of prostaglandin E2 and thromboxane B2 remained unchanged. Selective inhibition of the lipoxygenase pathway was further reflected by the reduced content of leukotriene B4 in bronchoalveolar fluid of smoke-exposed rats. These results suggest that lipoxygenase-derived products may play a unique role in smoking-induced pulmonary diseases.

Animals↗
PubMed1987

Distribution of serotonin-immunoreactive paraneurons in the lower urinary tract of dogs.

Morphological and quantitative studies were made on serotonin-containing paraneurons throughout the lower urinary tract in male and female dogs. Using an anti-serotonin antiserum, the cells were consistently demonstrated to be dispersed in the epithelium from the vesico-urethral junction to the external urethral ostium. They occurred most frequently in the urethra proximal to the urogenital diaphragm in both sexes. The total number of the serotonin-immunoreactive cells in the urethra was estimated to be 36.2 X 10(4) (SD 9.9 X 10(4] in the male (n = 3) and 15.6 X 10(4) (SD 2.1 X 10(4] in the female (n = 3). Besides the urethra, the prostate and vaginal vestibule contained several serotonin-immunoreactive cells. The urethral serotonin cells were basically bipolar basal-granulated cells that extended the basal cytoplasm to the basement membrane and reached the lumen with an apical process. Modified cell shapes were, however, also frequent, and included bifurcated apical and/or basal processes or a laterally directed basal process. Occasional serotonin cells possessed a threadlike basal process with varicosities and a terminal bouton, reminiscent of a neuronal process. Immunoreactivity for chromogranin A, a carrier protein common to endocrine paraneurons, was demonstrated in all of the urethral serotonin cells. The chromogranin A-immunoreactive granules accumulated more densely in the basal and perinuclear regions of the cell. It is hypothesized that the serotonin-immunopositive paraneurons may receive chemical and/or physical information from urine and, in response to it, secrete serotonin which presumably causes the contraction of the musculature of the urethra.

Animals↗
PubMed1987

Prospective randomized trial comparing two injection techniques for sclerosing oesophageal varices: over-tube and free-hand.

The safety, efficacy and complications of two techniques of endoscopic injection sclerotherapy were examined in 102 consecutive patients, using either a totally transparent over-tube or the free-hand technique. The choice of treatment was at random. There was a significantly higher control of variceal bleeding when the over-tube technique was used (100 per cent versus 77 per cent, P less than 0.05). The frequency of re-bleeding before the eradication of oesophageal varices was significantly less in the over-tube group than in the free-hand group (P less than 0.01), although all re-bleedings were well controlled with additional injections of 5 per cent ethanolamine oleate. There was no significant difference between the two techniques with regard to the frequency of endoscopic injection sclerotherapy for eradication of oesophageal varices. The over-tube technique is safer than the free-hand technique and takes less time to accomplish; at the initial session of treatment, time and bleeding during these techniques were 11.5 +/- 2.3 min (mean +/- s.d.) and 7.3 +/- 5.9 ml in the over-tube technique, and 20.4 +/- 4.1 min and 45.1 +/- 30.0 ml in the free-hand technique (P less than 0.001, in both time and bleeding).

Esophageal and Gastric Varices↗
PubMed1987

Tissue-specific and developmental expression of human transthyretin gene in transgenic mice.

To analyze the regulation of transthyretin gene expression we have produced transgenic mice by microinjecting cloned human transthyretin genes into fertilized eggs of C57BL/6 mice. The 7.6-kilobase (kb) human transthyretin gene containing about 500 base pairs (bp) in the upstream region was used for microinjection. Seven out of nine transgenic mice had detectable amounts of human transthyretin in serum when analyzed by enzyme-linked immunosorbent assay. Transthyretin mRNA was detected in liver and yolk sac but not in other tissues including brain. The amount of mRNA was variable among transgenic mice and was about one-tenth of mouse endogenous transthyretin mRNA. Human and mouse transthyretin mRNAs were detected in liver of fetus and yolk sac at 13 days of gestation and unlike yolk sac the level of mRNA in liver increased gradually during development and reached the maximum at around 17 days of gestation. Human transthyretin was associated with mouse transthyretin to form tetramers as judged from the dilution curve of enzyme-linked immunosorbent assay and the spur formation in Ouchterlony assay.

Animals↗