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Biomedical subjects

Y Fujimori

Publications and source records attributed to Y Fujimori.

143 records · Page 8Linked to original sources

Admittance plethysmographic evaluation of undulatory massage for the edematous limb.

A new apparatus, called Hadomer has been developed for the treatment of peripheral lymphedema and venous disorder. It has cuffs with 5 rooms, through which the air pressure moves from periphery to proximal point, just like surging waves. The peripheral stagnant lymph and venous blood are displaced toward the heart by this pneumatic massage. Hadomer has been applied to more than 400 patients with the edematous limbs, with satisfactory results, such as decrease of swelling, pain and induration. These clinical results have been also confirmed by electrical admittance plethysmography which is useful to measure noninvasively the edematous volume and the blood flow. The admittance of the edematous limbs is high and after massaging with Hadomer it approaches normal range. The blood flow in the diseased limbs is less than the healthy one and it is observed better after pneumatically massaging.

Edema↗

Scrotal ulcer occurring in patients with acute promyelocytic leukemia during treatment with all-trans retinoic acid.

Although all-trans retinoic acid (ATRA) has been shown to improve the outcome of patients with acute promyelocytic leukemia (APL) compared with chemotherapy alone, various adverse effects have been reported. We report here the development of scrotal ulcer in four patients with APL during ATRA treatment. ATRA 45 mg/m2 was administered orally to four patients with newly diagnosed APL, two of whom also received chemotherapy. Scrotal ulcers appeared in all four patients after a median of 22 days (range: 17-29 days) of ATRA treatment. ATRA was discontinued in only one patient, who was then treated with methylprednisolone pulse therapy. The fever resolved, and scrotal ulcer improved after this treatment. The other three patients were treated with steroid or antibiotic ointment for scrotal ulcers. ATRA was re-administered 2 years later in one patient who had relapse of APL. Ulcers appeared again on the scrotal and lower abdominal skin on day 27 of ATRA treatment. These findings strongly suggest that scrotal ulcer is a potential adverse effect of ATRA.

Abdomen↗

A case of Zollinger-Ellison syndrome produced by gastrinoma in the duodenum accompanied with multiple endocrine neoplasia type 1.

A case of Zollinger-Ellison syndrome produced by gastrinoma in the duodenum accompanied by multiple endocrine neoplasia type-1 (MEN-1) is reported. A 46 year-old female underwent distal gastrectomy due to gastric ulcer 5 years ago. As ulceration of the residual stomach recurred, further examination was performed. Hyperprolactinemia, hypergastrinemia, primary hyperparathyroidism, pancreatic tumor, and duodenal carcinoid were evident, and the diagnoses of Zollinger-Ellison syndrome and MEN-1 were established. The origin of the gastrin secretion was suspected to be from the pancreatic tumor, so sampling of the portal blood was performed. As lesion on the gastrinoma in the pancreas could not be identified, total parathyroidectomy was performed for primary hyperparathyroidism. The level of the gastrin secretion, however, remained high. Partial resection of the duodenum for the duodenal carcinoid and a distal pancreatectomy were carried out concurrently. Immunohistochemical study of the anti-gastrin antibody revealed duodenal tumor cells. Initially, the gastrinoma was thought to be in the pancreas, however, the lesion accompanied with MEN-1 and the Zollinger-Ellison syndrome had occurred in the duodenum.

Duodenal Neoplasms↗

Synchronous gastric cancer associated with hepatocellular carcinoma: a study of 10 patients.

BACKGROUND/AIMS: Little information regarding synchronous gastric cancer (GC) associated with hepatocellular carcinoma (HCC) is available. The aim of this study was to clarify the clinicopathologic features of synchronous GC associated with HCC, and we also discuss the diagnostic and therapeutic issues regarding them. METHODOLOGY: In a series of 396 patients with GC and 340 patients with HCC, we investigated the clinicopathologic features of the patients with synchronous GC associated with HCC (HCC group; n=10). They were compared to the patients with resected GC without HCC (non-HCC group) which was divided into 2 groups: with chronic hepatic disease (CHD: CHD group; n=15) and without CHD (Control group; n=345). RESULTS: The HCC group consisted of 10 of the 396 patients with GC (2.6%), and of 340 with HCC (2.9%). Eight node-negative early GC and 2 advanced GC cases were observed in the HCC group. Nine of these GC (90%) were well-differentiated adenocarcinoma. The tumor sizes of the HCC group were significantly smaller than those of the control group (p<0.05). The incidences of intestinal type and early GC in the HCC group were significantly higher than those in the control group, (p<0.05). However, there were no significant differences in any parameters between the HCC group and CHD group. With regard to early GC, there were no significant differences in any parameters, excluding the site of GC in the CHD group, between the HCC group and non-HCC group. Eight in the HCC group were surgically resected, and the post-operative period of these patients was uneventful. Although there were no significant differences in survival after surgery among the 3 groups, the survival of the patients with early GC in the HCC group was significantly worse than that in the control group (p<0.01). CONCLUSIONS: The clinicopathologic features of synchronous GC associated with HCC are not very aggressive in most patients probably because of the early detection, and those of early GC with HCC appeared to resemble that of GC with CHD. Since early GC may not influence the clinical outcome of HCC patients, limited gastric resection can be recommended even when curative surgery for HCC is performed. By contrast, when advanced GC is present, curative gastrectomy with lymphadenectomy would be advisable to improve the long-term survival.

Adenocarcinoma↗

Effects of prostaglandin E1 administration during hepatectomy for cirrhotic hepatocellular carcinoma.

BACKGROUND/AIMS: Prostaglandin E1 has been used in hepatectomy based on a few limited clinical studies suggesting that PGE1 improves liver function. The aim of this study was to evaluate the effects of PGE1 administration during hepatectomy for cirrhotic hepatocellular carcinoma. METHODOLOGY: Forty-three patients undergoing hepatectomy for cirrhotic hepatocellular carcinoma were divided into 2 groups: hepatectomy with Prostaglandin E1 treatment (PG group; n = 19) and without Prostaglandin E1 treatment (control group; n = 24). Prostaglandin E1 (0.02-0.07 microgram/kg/min) was administered intravenously from beginning to end of surgery in the PG group. RESULTS: There were no significant differences between groups with respect to age, gender, preoperative liver and renal function, or intraoperative variables such as blood loss, weight of resected liver and total clamping time by the Pringle maneuver. No patient had severe postoperative complications. Initial postoperative maximum concentrations of serum total bilirubin, creatinine, and blood urea nitrogen in the PG group were significantly lower than those in the control group. CONCLUSIONS: Prostaglandin E1 administration during hepatectomy for cirrhotic heptocellular carcinoma resulted in improved renal and hepatic function.

Aged↗

Immunohistochemical demonstration of calcium-dependent cysteine proteinase (calpain) in collagen-induced arthritis in mice.

The mechanisms whereby destructive changes in joints develop in rheumatoid arthritis (RA) are not fully understood, but cartilage degradation is considered one of the most important factors. Calpain, a calcium-dependent cysteine proteinase that degrades a variety of substrate proteins in various tissues, may be among the proteolytic enzymes that mediate cartilage degradation associated with RA and other inflammatory arthritides. The object of this study is to ascertain immunohistochemically whether calpain is present in the inflamed joints of mice with collagen-induced arthritis (CIA), as an experimental animal model of inflammatory arthritis such as RA. Murine hindpaws with CIA were decalcified, frozen-sectioned, and stained by immunoperoxidase method (PAP) using a polyclonal antibody against calpain II. Calpain was present in the articular tissues affected by CIA: positive staining was observed in 1) proliferating synovia, and 2) surface, matrix, and chondrocyte lacunae of articular cartilage. It was postulated that calpain functions as one of the enzymes responsible for the cartilage degradation associated with CIA.

Animals↗

Mixed hepatocellular carcinoma and cholangiocarcinoma treated by extended left hepatic lobectomy with resection of the right hepatic vein and preservation of the inferior right hepatic vein after hepatic arterial infusion chemotherapy.

We herein describe a patient with a giant mixed hepatocellular carcinoma and cholangiocarcinoma (MHC) surrounding the inferior vena cava (IVC). The patient was treated by extended left hepatic lobectomy with resection of the main right, left and middle hepatic veins and preservation of the inferior right hepatic vein (IRHV) after hepatic arterial infusion (HAI) chemotherapy. The patient died of distant metastases 4 years after initial HAI chemotherapy. As there is no hope of cure with HAI alone in the patients with MHC, this operative procedure even after HAI is recommended for patients with reduced liver function, tumor involving the RHV and surrounding the IVC.

Adult↗