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Biomedical subjects

Y Kawarada

Publications and source records attributed to Y Kawarada.

At least 145 records · Page 8Linked to original sources
PubMed1990

Diagnosis and treatment of cholangiocellular carcinoma of the liver.

Of the 239 patients with primary liver cancer treated in our department over the last 13 years, 27 had cholangiocellular carcinoma, and 4 cystic adenocarcinoma of the liver. In this paper, the diagnosis and treatment of cholangiocellular carcinoma was reviewed and discussed. Twenty-four (88.9%) of the 27 patients with cholangiocellular carcinoma underwent surgery and 16 (66.7%) had hepatic resection. There were no operative deaths. None with hilar type cancer survived more than 2 years but in the case of the peripheral type the one-year cumulative survival rate after hepatectomy was 63.6%, the 3- and 5-year rates were both 33.9%. Two cases survived more than 5 years. One was a 69-year-old female who died of tumor recurrence 5 years and 6 months after hepatectomy; the other a 61-year-old female who is still alive and well, without recurrence, 10 years and 5 months after right trisegmentectomy. Although the cholangiocellular carcinoma in our series were in the advanced stages, good results were obtained by hepatic resection with multimodal treatment.

Adenocarcinoma↗
PubMed1990

[The significance of subpleural mononuclear cell infiltration in the differential diagnosis of pleurisy showing nonspecific histological findings].

To determine whether or not patients who showed abundant lymphocytes in pleural effusion without any specific findings by pleural biopsy could be histopathologically differentiated between those with tuberculous and nontuberculous origin, we reexamined histology of pleural biopsies of all patients whose pleural effusion showed predominantly lymphocytes and did not contain malignant cells from January, 1984 to March, 1989. A total of 45 patients with a nonspecific histology of pleural biopsy were categorized based on their final diagnosis into three groups; tuberculous (n = 20), carcinomatous (n = 10) and nontuberculous, benign pleurisy (n = 15). Pleural biopsy of patients with nontuberculous, benign pleurisy frequently showed band-like infiltration of mononuclear cells in the subpleural adipose tissue (11 out of 15 patients), while the finding was significantly less frequent in those with tuberculous pleurisy (1 out of 20, p less than 0.01) and pleurisy associated with carcinoma (3 out of 10, p less than 0.05). Based on these findings, the presence of band-like infiltration of mononuclear cells in the subpleural adipose tissue in pleural biopsy of patients with abundant lymphocytes in pleural effusion strongly suggests that the pleurisy is nontuberculous origin.

Adipose Tissue↗
PubMed1990

[The significance of pleural fluid cytology in the differential diagnosis of pleurisy showing lymphocyte-predominant pleural effusion].

We examined the significance of pleural fluid cytology in differentiation between tuberculous and non-tuberculous pleurisy in patients with lymphocyte-predominant pleural effusion. We divided pleural fluid cytologic findings into two patterns, that is "tuberculous" and "non-tuberculous pattern", according to the report by Spieler, and compared the cytologic pattern with the final clinical diagnosis. Thirteen out of 19 cases (68.4%) with tuberculous pleurisy showed "tuberculous pattern" in the pleural fluid cytology, while four (pleurisy associated with collagen-vascular disease, asbestosis and carcinoma, and idiopathic pleurisy) out of 13 (30.8%) with non-tuberculous pleurisy revealed "tuberculous pattern". The pleural fluid cytology could be used as one of the additional means to differentiate between tuberculous and non-tuberculous pleurisy, though it is impossible to differentiate between them with the pleural fluid cytology alone.

Diagnosis, Differential↗
PubMed1988

[Importance of nutritional management for the treatment of carcinoma of the pancreas].

Because the majority of patients with carcinoma of the pancreas are already in a state of malnutrition on admission, various complications can easily occur after surgery and adjuvant therapy such as radiation and chemotherapy. Therefore, the importance of nutritional management in the treatment of pancreatic carcinoma was examined in our department and the following results were obtained: 1) Preoperative nutritional assessment The nutritional state was evaluated using the Prognostic Nutritional Index for Surgery: PNI-S = -0.147 X (ratio of weight loss) + 0.046 X (weight for height) + 0.010 X (% triceps skin fold thickness) + 0.051 X (hepaplastin test), which was calculated from our results. In patients with the PNI-S of over 8, total pancreatectomy was performed safely, and when the PNI-S was more than 6, pancreaticoduodenectomy was done successfully. When the PNI-S was more than 5, it was possible to perform distal pancreatectomy or bypass operation. Depending on the nutritional assessment before surgery, the appropriate operative method could be selected, and the operative results could be improved by preoperative nutritional support. 2) Postoperative nutritional management Administration of a high-calorie by both parenteral and enteral nutrition during the early postoperative period produces good operative results, accompanied by a reduction of postoperative complications, such as fatty liver and so on. This approach also reduces the adverse effects of adjuvant therapy, such as radiation and chemotherapy, with an improvement of prognosis. Thus, it was revealed that nutritional assessment and management was very important for improving the therapeutic results in cases of carcinoma of the pancreas.

Enteral Nutrition↗
PubMed1988

[Pathophysiology during follow-up after extensive pancreatectomy].

In 20 cases of total pancreatectomy and 74 cases of pancreaticoduodenectomy, pancreatic endocrine and exocrine functions in long-term survival after surgery were investigated, particularly in relation to development of fatty liver, metabolic bone disorder and changes of serum zinc. In cases of pancreaticoduodenectomy, although the residual pancreatic endocrine and exocrine functions decreased in 1 or 2 months, they were recovered within a year and these functions were maintained relatively well, but in cases of resection of fibrotic pancreas, they decreased gradually in more than 3 years after surgery. In a long-term survival, fatty liver, metabolic bone disorder and an impaired absorption of zinc developed, and such changes occurred remarkably in cases of resection of fibrotic pancreas or in cases of total pancreatectomy. Hence, after major resection of the pancreas, a long-term sufficient control should be necessary understanding these pathophysiology.

Bone Diseases, Metabolic↗
PubMed1988

[Multimodal treatment of cancer of the biliary tract].

The incidence of cancer of the biliary tract has been recently increasing, but the results of treatment have been unsatisfactory. During the last 10 years and 10 months, 128 cases of carcinoma of the biliary tract, including 64 cases of the gallbladder and the bile duct, respectively, were admitted. Some 98 (86%) out of the 113 cases were resected, with a low curative surgery rate of 32.7%. The curative surgery even resulted in recurrence with a few long-term survivors, so multimodal treatment should be considered for all cases. In non-curative resection, the 2-year cumulative survival rate of gallbladder carcinoma was 25% with radiation and chemotherapy, compared to the group without such treatment, all of whom died within 2 years after surgery. In cancer of the bile duct, similar results were obtained, so multimodal treatment should be administered especially in non-curative resection cases. In 1985 Mizumoto's group reviewed 1614 cases of gallbladder carcinoma and bile duct carcinoma collected from 22 institutions in Japan. The resectability and curative rate have been increasing, and the survival rates of both groups have slightly increased. Multimodal treatment has involved radiation therapy in 13.6% and chemotherapy in 44.1% of the cases. A two-year cumulative survival rate increased in non-curative resection patients treated with multimodal treatment.

Bile Duct Neoplasms↗
PubMed1987

Tenascin is a stromal marker for epithelial malignancy in the mammary gland.

Tenascin is an extracellular matrix glycoprotein that is not present in the normal mature rat mammary gland. The distribution of tenascin was examined by immunohistochemistry in mammary tumors from carcinogen-treated and untreated rats, in virus-induced mammary tumors from mice, and in a variety of mammary gland lesions from humans. Tenascin was detectable in the stroma of the malignant but not of the benign tumors from all species. An inhibition ELISA, testing homogenates of rat tumors, confirmed that tenascin was present in malignant but not in benign tumors. Thus, tenascin was consistently found to be a stromal marker for epithelial malignancy in the mammary gland. It is concluded that tenascin may be involved in the interactions between the epithelial and mesenchyme-derived (stromal) components of the mammary gland, which are known to influence epithelial carcinogenesis in this organ.

Adenocarcinoma↗
PubMed1986

Resectability of the pancreas without producing diabetes, with special reference to pancreatic regeneration.

The exact resectability of the pancreas without producing diabetes was investigated in dogs, with consideration of pancreatic regeneration. Within the first week after major pancreatectomy, acinar cell division occurred, followed by hypertrophy; these changes resulted in an increase in weight of the remnant pancreas. The regeneration rate correlated well with the resection rate, glucose tolerance, and the insulin secretion of the remnant pancreas. Immediately after resection of more than 92% of the pancreas, severe diabetes developed, and the regeneration rate was 29.9 +/- 6.03% three to six weeks after surgery. Twelve weeks after resection of 74-92% of the pancreas, so-called Sandmeyer's diabetes had developed. The regeneration rate was 45.3 +/- 4.22% in the non-diabetic group, but in the diabetic group it proved to be only 15.4 +/- 2.39%. When less than 74% of the pancreas was resected, diabetes did not occur throughout the postoperative observation periods of 3-18 weeks, and the regeneration rate was 5.5 +/- 6.62%. These results suggested that 74% of the pancreas may be removed without producing diabetes.

Animals↗
PubMed1986

Antibodies specific for methylated DNA elicited in rabbits recognize only a single strand region of DNA containing 7-methylguanine.

Immunogenicity of methylated DNA (Me-DNA) was investigated in connection with the changes of the high order structure. Antibodies specific for Me-DNA were elicited in the rabbits with DNA methylated at different extents. When Me-DNA was chromatographed on a hydroxyapatite column and was separated into single and double stranded forms, Me-DNA eluted at single strand position was found to react only with the anti-Me-DNA antibodies. In order to examine the immunogenicity of both single and double stranded forms, each form was injected in rabbits respectively. No specific antibodies were produced for the double stranded form, whereas the single stranded form showed a potent immunogenicity. On the other hand, the antigenicity of the single stranded Me-DNA was decreased or lost in parallel with the extent of the release of 7-methylguanine residues from the molecule on heating under the neutral condition. These results revealed that single stranded structure of Me-DNA is immunogenic or antigenic and that 7-methylguanine residues of Me-DNA play an important role in forming a characteristic structure required for the manifestation of its specific antigenicity.

Animals↗
PubMed1986

[Scintigraphic imaging of autotransplanted splenic grafts by 99mTc-labeled heat-damaged erythrocytes].

Splenectomy is known to increase the risk of bacterial infection. Recently splenic autotransplantation has been suggested as a method of preserving splenic function. In order to demonstrate the viability of transplanted tissue, spleen scintigraphy using 99mTc labeled heat damaged erythrocytes were carried out. So far 21 studies have done in 12 patients. Spleen scans were positive 1 month after surgery, though images showed poor contrast against considerable background of bone marrow and blood pool. The quality of the images much improved five to twelve months after surgery. Functioning splenic autografts could be also shown by scintigraphy using 99mTc sulfur colloid, but the image quality was poorer, particularly within the early stage after operation. Labeling yields were 79.8% on the average, ranging from 45.6-92.3%, that affected little the quality of images. Important techniques in the splenic autotransplantation imaging include a thorough elimination of free 99mTcO4- before injection and to use comparatively small volume of damaged erythrocytes.

Adolescent↗
PubMed1986

Early carcinoma of the gallbladder, noninvasive carcinoma originating in the Rokitansky-Aschoff sinus: a case report.

A patient was reported who underwent cholecystectomy under the diagnosis of chronic cholecystitis with calculi and adenomyomatosis, but it proved to be an early carcinoma of the gallbladder originating in and limited to the Rokitansky-Aschoff sinus (cyst-like structure). Early carcinoma of the gallbladder in this category is rare and this case report may be the first one in the literature.

Aged↗
PubMed1986

Surgical treatment of hilar carcinoma of the bile duct.

The operative results of hilar carcinoma of the bile duct are extremely poor and there are few long term survivors. During the past seven years and six months at our clinic, 26 of 32 patients with hilar carcinoma were operated upon and 24 of these patients underwent resection with a resectability rate of 92.3 per cent. There was one operative death and the mortality was 3.8 per cent in 26 patients operated upon and 4.2 per cent in 24 patients who underwent resection. Seven are still alive postoperatively. The longest survival time is five years and seven months without a recurrence after right trisegmentectomy for carcinoma of the intrahepatic bile duct with hilar invasion. Curative resection was performed upon ten of 26 patients who underwent operation. Of the patients who were operated upon, 12 had invasion of the parenchyma of the liver at the hilum and 11, invasion of the caudate lobe, including direct invasion in three and invasion of the bile ducts in eight. Therefore, the caudate lobe should be resected for radical operation for hilar carcinoma. In this study, the anatomy of the hilar area, including vascular structures of the caudate lobe, was evaluated in 106 cadavers, concerning radical operation for hilar carcinoma.

Bile Duct Neoplasms↗
PubMed1985

Nonhepatocytic malignant mixed tumor primary in the liver. Report of two cases.

Among primary tumors of the liver, the group classified as malignant hepatic mixed tumor or hepatoblastoma in adult is among the least common. In this report, two rare cases of nonhepatocytic malignant mixed tumor primary in the liver are reported. Diagnosis was established after autopsy in one and surgery in the other, who is still alive 2 years and 8 months after removal of the tumor by hepatic resection and may be the longest survivor among the nonhepatocytic malignant mixed tumor primary in the liver.

Adult↗
PubMed1985

The fate of DNA originally existing in the zygote nucleus during achromosomal cleavage of fertilized echinoderm eggs in the presence of aphidicolin: microscopic studies with anti-DNA antibody.

In fertilized echinoderm eggs, the male and female pronuclei fuse to form the diploid nucleus even in the presence of aphidicolin, a specific inhibitor of eukaryotic DNA polymerase-alpha. The subsequent first cleavage is independent of chromosomes but dependent on spindle and amphiaster. The fate of DNA originally existing in the fused nucleus during achromosomal cleavage of fertilized sea urchin and starfish eggs induced by aphidicolin was determined using antidenatured DNA antibody. The nucleus is not formed in the divided daughter cells at the two-cell stage but the nuclear-envelope-free chromatin mass which is unassociated with mitotic apparatus remains in the center region of embryos, especially near the first cleavage furrow. These results indicate that the condensed and nonreplicated chromatin can not be associated with spindle and asters in the presence of aphidicolin.

Animals↗
PubMed1985

[Evaluation of severity in acute pancreatitis].

Recently we reviewed 240 patients with acute pancreatitis admitted to our service and the affiliated hospitals for five years. Clinical symptoms and laboratory data of these cases were analyzed depending on their prognosis. The grades were divided into 3 groups by the mortality rates: Grade I with the mortality rate of less than 10%, Grade II 10-20%, and Grade III with greater than 20%. Clinical symptoms in Grade III were shock and neurological or dermatological symptoms. On the other hand, laboratory findings in Grade III were as follows; blood sugar was more than 200 mg/dl, LDH greater than or equal to 600 IU%, BUN greater than or equal to 40 mg/dl, serum Ca less than or equal to 7.5mg/dl, T.Bil. greater than or equal to 5.0 mg/dl, blood pressure less than or equal to 90 mmHg, and PaO2 less than or equal to 65 mmHg (room air). The degree of severity of acute pancreatitis was divided into 3 types, as follows: Mild; all belong to Grade I, or less than 2 positives of Grade II. Moderate; 3 to 4 positives of Grade II, or one positive of Grade III. Severe; 5 positives or more of Grade II, or 2 positives or more of Grade III. Our criteria with both clinical and laboratory findings are very useful for the evaluation of the severity and choice of treatment in acute pancreatitis.

Acute Disease↗