Biomedical subjects

T Tajiri

Publications and source records attributed to T Tajiri.

135 records · Page 8Linked to original sources

PubMedDate not supplied

Long-term results of modified distal splenorenal shunts for the treatment of esophageal varices.

BACKGROUND/AIMS: Long-term results were compared for 3 types of distal splenorenal shunt for the treatment of esophageal varices. METHODOLOGY: Between July 1983 and December 1997, 45 patients with esophageal varices underwent distal splenorenal shunt. Group 1 underwent standard distal splenorenal shunt (n = 11). Group 2 underwent distal splenorenal shunt with splenopancreatic disconnection (n = 11). Group 3 underwent distal splenorenal shunt with splenopancreatic disconnection and gastric transection (n = 23). RESULTS: Additional treatment for recurrent varices was required in group 1, (n = 1, 9.1%), group 2 (n = 2, 18.2%), and group 3 (n = 1, 4.3%). All of the patients with recurrent varices developed a shunt stenosis within the 1st year after distal splenorenal shunt. The prevalence of hyperammonemia in group 1 was 40.0% at 1, 5, and 10 years. In group 2, the prevalence was 14.3% at 1 year, 31.4% at 5 years, and 54.3% at 10 years. In group 3, the prevalence was 0% at 1 year, and 9.1% at 5 and 10 years. The differences between group 3 and groups 1 and 2 were significant (P < 0.01). The cumulative survival rates at 1 year were 90.9%, 63.6%, and 95.7% for groups 1, 2, and 3, respectively. At 10 years, the cumulative survivals rates were 70.7%, 63.6%, and 69.4% for groups 1, 2, and 3, respectively. There were no significant differences in survival between the 3 groups. CONCLUSIONS: Distal splenorenal shunt with splenopancreatic disconnection and gastric transection may reduce the incidence of postoperative hyperammonemia.

Adult↗

PubMedDate not supplied

Hepatocellular carcinoma responding to chemotherapy with 5-FU.

A 69-year-old man with unresectable hepatocellular carcinoma and portal vein tumor thrombus was treated by chemotherapy with 5-fluorouracil. A dose of 500 mg/day of 5-fluorouracil was continuously administered via a central venous catheter. After 4 months, the alpha-fetoprotein level was decreased from 50,000 ng/mL to 4,760 ng/mL. Computed tomography revealed disappearance of the low-density area in the liver parenchyma, but the portal vein tumor thrombus was not changed. After 6 months, pancytopenia appeared and continuous infusion of 5-fluorouracil was stopped. After 8 months, the patient died of pneumonia, at which time the alpha-fetoprotein level was 12,000 ng/mL. Continuous intravenous infusion of 5-Fluorouracil was effective against unresectable primary hepatocellular carcinoma, but had little influence on portal vein tumor thrombus.

Aged↗

PubMedDate not supplied

Establishment and characterization of malignant rhabdoid tumor of the kidney.

Malignant rhabdoid tumor of the kidney (MRTK) is a highly aggressive tumor which occurs in childhood and which is histologically characterized by the existence of eosinophilic intracytoplasmic inclusions. We established and characterized a cell line from this tumor with histological, immunohistochemical and cytogenetical analysis. Histologically, the tumor cells demonstrate typical eosinophilic inclusions, while immunohistochemically the cells demonstrate common mesenchymal and epithelial differentiation. Although the conventional karyotyping of this tumor lacked the abnormalities of 22q chromosome, Southern blot analysis and microsatellite analysis verified abnormalities of the BCR gene and of the hSNF5/INI1 gene. Despite the variety of locations, these common genetic abnormalities appear to contribute to distinguish rhabdoid tumor from such other small round cell tumors as primitive neuroectodermal tumor, rhabdomyosarcoma, poorly differentiated synovial sarcoma and desmoplastic small round cell tumor.

Animals↗

PubMedDate not supplied

Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.

BACKGROUND/AIMS: This study was undertaken to evaluate the comparison of long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices. METHODOLOGY: Twenty-four cirrhotic patients underwent distal splenorenal shunt, and 19 cirrhotic patients underwent esophageal transection with complete variceal eradication and follow-up for at least 3 years. RESULTS: No recurrent varix was observed in the distal splenorenal shunt group. The cumulative recurrence rates of varices in the esophageal transection group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulative rates of hyperammonemia at 5 and 10 years were significantly higher in the distal splenorenal shunt group (30.4%, 30.4%) than in the esophageal transection group (0%, 5.6%) (P = 0.009). The cumulative survival rates in the distal splenorenal shunt group versus the esophageal transection group were 90.9% versus 94.7%, and 85.2% versus 81.7% at 5 and 10 years (NS). CONCLUSIONS: These results suggest that distal splenorenal shunt is more effective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.

Esophageal and Gastric Varices↗

PubMedDate not supplied

A new method of functional scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin.

BACKGROUND/AIMS: We investigated whether a new method for scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin could visualize the portal venous system and simultaneously assess hepatic function. METHODOLOGY: Thirty-two patients underwent scintiphotosplenoportography, including 4 with metastatic tumor in an otherwise normal liver, 5 with chronic hepatitis, 9 with cirrhosis, and 14 with both hepatocellular carcinoma and cirrhosis. The tracer (3 mg, 185 MBq) was injected into the spleen under ultrasonic guidance. Hepatic function was evaluated using the receptor index and the index of blood clearance, both calculated by regions of interest for liver and for heart. Spleen-to-liver times were calculated by subtracting peak activity times over the spleen from those over the portal vein. RESULTS: Correlations of blood clearance and receptor indices with plasma retention rate of indocyanine green at 15 min (respectively, r = 0.616, P < 0.0005 and r = -0.669, P < 0.0001), prothrombin time (r = -0.605, P < 0.0005 and r = 0.710, P < 0.0001), the hepaplastin test (r = -0.526, P < 0.005 and r = 0.605, P < 0.0005), serum albumin (r = -0.488, P < 0.005 and r = 0.640, P < 0.0001), and serum cholinesterase (r = -0.600, P < 0.0005 and r = 0.671, P < 0.0001) were significant. Blood clearance and receptor indices also were significantly related to clinical stage, underlying liver disease, features of radioisotopic images, and presence of esophagogastric varices (P < 0.01). Additionally spleen-to-liver time reflected progressive hepatic damage. CONCLUSIONS: Our new method of scintiphotosplenoportography using technetium-99m-DTPA-galactosylated human serum albumin can assess hepatic function and portal hemodynamics simultaneously. Results correlate with accepted, conventional diagnostic techniques. This method represents a potent new method for evaluating the hepatic system.

Adult↗

PubMedDate not supplied

Interventional radiology and endoscopic therapy for recurrent esophageal varices.

BACKGROUND/AIMS: We investigated the impact long-term prognosis of combined interventional radiology and endoscopic therapy in patients with esophageal varices. METHODOLOGY: Patients with recurrent esophageal varices underwent treatment as follows: 54 were treated with endoscopic therapy alone and 32 underwent endoscopic therapy plus interventional radiologic procedures. Primary endpoints during 5-year follow-up included recurrent bleeding, second retreatment, and death. RESULTS: The bleeding rates were 11.1% in the endoscopy group, and 9.4% in the combined therapy group. Second retreatment rates at 1 year, 3 years, and 5 years in the endoscopy group and combined therapy group were 25.4% and 17.2%, 70.2% and 39.3%, and 85.0% and 69.6%, respectively. The second retreatment rates in the combined therapy group were significantly reduced compared to the endoscopy alone group (P = 0.05). Cumulative retreatment rates in Child's class C cases were significantly lower in the combined therapy group than in the endoscopy group (P = 0.01). Survival at 3 years was 97.1% in the endoscopy group and 92.0% in the combined therapy group, and 5-year survival was 79.1% and 83.6%, respectively. CONCLUSIONS: The combination of interventional radiologic and endoscopic therapy is highly effective and improves long-term prognosis in patients with recurrent esophageal varices.

Embolization, Therapeutic↗

PubMedDate not supplied

Hypersplenism induced by hepatectomy.

BACKGROUND/AIMS: We encountered a case of posthepatectomy splenic enlargement and hypersplenism followed by disseminated intravascular coagulopathy with airway hemorrhage causing death. METHODOLOGY: We, therefore, retrospectively investigated postoperative splenic enlargement, hypersplenism and disseminated intravascular coagulopathy by computed tomography and laboratory data in 57 hepatectomized patients with a malignant or benign disease in the postoperative period. RESULTS: Of 32 patients with hepatocellular carcinoma or biliary tract carcinoma (group A), 12 with metastatic hepatic lesions (group B), and 13 with benign liver disease (group C); remarkable (20%) splenic enlargement was noted in 8 patients in group A, 2 in group B, and 2 in group C. Seven of the 12 patients were associated with liver cirrhosis, 5 with preoperative splenomegaly, and 8 had undergone major hepatectomy. Postoperative hypersplenism developed in 5 patients in group A, and one patient in group C. All of them were associated with liver cirrhosis or chronic hepatitis and preoperative splenomegaly, and five had undergone hepatic lobectomy or more extensive resections. All except for the disseminated intravascular coagulopathy case recovered. Statistically, splenic enlargement was significantly related to the extent of hepatectomy; lobectomy versus segmentectomy = 28.3 +/- 28.5% (n = 14) versus 12.4 +/- 13.8% (n = 20), (unpaired Student's t test, P = 0.037). Platelet counts of the patients with liver cirrhosis or chronic hepatitis is lower than those without the diseases, both pre- and postoperatively (14.0 +/- 6.0 x 10(4)/mm3 vs. 21.5 +/- 6.2 x 10(4)/mm3, P = 0.0001). CONCLUSIONS: Postoperative hypersplenism was noted only in the patients with liver cirrhosis or chronic hepatitis and preoperative splenomegaly, and developed more frequently after larger hepatectomies than after smaller hepatectomies; 5 (45%) of 11 versus 1 (7%) of 14, chi 2 test, P = 0.026).

Aged↗

PubMedDate not supplied

Combined endoscopic and radiologic intervention to treat esophageal varices.

BACKGROUND/AIMS: In patients with esophageal varices, we investigated the impact on long-term outcome of combining interventional radiologic procedures with endoscopic therapy. METHODOLOGY: Of 133 patients with esophageal varices, 86 were treated with endoscopic therapy alone and 47 underwent endoscopic therapy in addition to interventional radiologic procedures. End-points considered during 5-years of follow-up included recurrent bleeding and retreatment. RESULTS: Bleeding rates were 24.4% in the endoscopy group and 25.4% in the combined therapy group. Retreatment rates at 1, 3, and 5 years for the endoscopy group versus the combined therapy group were 40.7% versus 30.3%, 72.0% versus 67.5%, and 88.2% versus 80.5%, respectively, representing no significant difference between two groups. However, cumulative retreatment rates in Child's class C cases were significantly lower in the combined therapy group than in the endoscopy group (P = 0.025). Patients who had combined therapy which included all embolizing techniques showed significantly lower retreatment rates than patients treated with endoscopy alone (P = 0.05). CONCLUSIONS: In combination, interventional radiologic and endoscopic therapies are highly effective and can improve long-term outcome in patients with esophageal varices, especially those with poor liver function and those who undergo embolization by all techniques.

Adult↗

PubMedDate not supplied

Questionable role of glucose-insulin in cardioplegic solution.

To evaluate the myocardial protective effect of glucose-insulin (GI) in a cold cardioplegic solution, we compared the effect of a solution not containing GI (solution I) with that of an identical solution containing GI (solution II) under cardiopulmonary bypass in mongrel dogs. After 120 minutes of ischemic arrest, defibrillation was necessary to restore cardiac activity in 12.5% of the solution I group and 42.8% of the solution II group, respectively. No distinct intergroup differences were noted in recovery of left ventricular function, oxygen and lactate extraction of the myocardium during the post-arrest period, the myocardial ultrastructure, and myocardial ATP levels. Although creatine phosphate was less well preserved, glucose-6-phosphate and lactate were more accumulated in the solution II group than in the solution I group. Thus, significant advantages of substrate enhancement by addition of GI to cold cardioplegic solution were not found in spite of multidose cardioplegia and presence of noncoronary collateral blood flow.

Adenosine Triphosphate↗