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Y Saitoh

Publications and source records attributed to Y Saitoh.

At least 343 records · Page 19Linked to original sources
PubMed1996

[Evaluation of a single catheter technique for percutaneous isolated liver perfusion].

We have established a single catheter technique of percutaneous isolated liver perfusion using a 4-lumen-2-balloon (4L - 2B) catheter for treatment of unresectable malignant liver tumors. Herein reported are the technique, safety and pharmacokinetics of the system in comparison with the original double-balloon technique. This study included 19 patients with malignant liver tumors treated by adriamycin at a dose of 100 mg/m2. Seven patients had the double-balloon technique (group D), in which filtered hepatic effluent and the rest of the inferior vena caval blood were separately drawn and returned to the left axillary vein. The other 12 patients had single catheter technique (group S). In group S, hepatic effluent was solely isolated and directed to CHP filters. All patients except for one in group S showed good hemodynamic stability. The hepatic venous flow rate of group S was significantly higher than in group D (p < 0.05). Although the mean area under the time concentration curve at systemic serum was significantly lower in group S compared to group D, the rate of side effects was similar in both groups. A 4L. 2B single catheter allowed safe and repeated percutaneous isolated liver perfusion for technical simplification of the treatment.

Aged↗
PubMed1996

[A case of advanced hepatoma cured by repeated percutaneous isolated liver perfusion using hepatic venous isolation and charcoal hemoperfusion].

We have reported the treatment results of percutaneous isolated liver perfusion using hepatic venous isolation and charcoal hemoperfusion (HVI.CHP) for unresectable liver cancers. This is a case of multiple advanced hepatoma cured completely by repeated per cutaneous isolated liver perfusion. The patient was a 58-year-old woman who was referred to our hospital for a hepatic tumor detected by abdominal computed tomograpy (CT). On admission, she showed HBs antigen positive, mild anemia and liver dysfunction, and elevation of tumor markers. Abdominal CT demonstrated nodular tumors in segment 4. In addition, hepatic angiography additionally revealed multiple bilobar metastases. We treated this case with high-dose intraarterial adriamycin (150 mg/body) using HVI.CHP. There after, the patient received intermittent intraarterial low-dose epirubicin infusions (30 mg/body, 5 times) via an implantable catheter system. Furthermore, she was given a second high-dose of adriamycin (130 mg/body) under HVI.CHP 7 months after the first treatment. Despite repeated high-dose treatments, she had no severe side effects. The levels of tumor markers, including AFP and PIVKA-II, decreased to normal range, and all tumor nodules have disappeared in abdominal CT studies at present, 20 months after the initial treatment. In conclusion, our experience suggests that advanced hepatoma with multiple bilobar lesions, as in this case, would be cured by repeated percutaneous isolated liver perfusion using HVI.CHP.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

[A case of advanced cholangiocellular carcinoma treated successfully by percutaneous isolated liver perfusion with cisplatin].

Herein reported is a case with unresectable intrahepatic cholangiocellular carcinoma (CCC) treated successfully with high-dose cisplatin infusion under hepatic venous isolation and charcoal hemoperfusion (HVI.CHP). The patient was a 43-year-old woman, who was investigated for liver dysfunction and subsequently referred to our institution with a diagnosis of unresectable intrahepatic CCC. We gave this patient a total of 2 treatments of percutaneous isolated liver perfusion with HVI.CHP (a total dose of cisplatin, 400 mg and adriamycin 30 mg). Although she had a slight elevation of serum GOT levels, leukopenia and renal dysfunction did not occur throughout the posttreatment course. The level of DUPAN-2 after the first treatment showed a marked reduction to 910 U/ml, from a pretreatment level of 2,700 U/ml. Abdominal CT scan also demonstrated a remarkable regression of liver tumors (PR: volume reduction, 76%). In conclusion, in percutaneous isolated liver perfusion using HVI.CHP, we have safely accomplished a dose intensification of intraarterial cisplatin. The treatment resulted in a marked tumor regression. Therefore, we consider that this method offers an effective therapeutic option for unresectable CCC.

Adult↗
PubMed1996

Etiological involvement of Helicobacter pylori in "reflux" gastritis after gastrectomy.

OBJECTIVES: "Reflux" gastritis after gastrectomy is associated with various symptoms that are often detrimental to the patients' quality of life. However, prevention of the reflux does not always bring relief from the symptoms of gastritis. Helicobacter pylori (H. pylori) is now considered one of the most important pathogenetic factors in gastritis. The association between H. pylori infection and reflux gastritis after gastrectomy was investigated in the present study. METHODS: In total, 115 patients who had undergone gastrectomy were entered in this study. Five biopsy specimens from the gastric remnant were taken during upper GI endoscopy. One specimen was examined pathohistologically, and the remaining four were examined for H. pylori infection. The histological degree of gastritis was determined according to the score system of Rauws et al. RESULTS: Forty-six patients (40%) demonstrated H. pylori infection in their stomachs. The prevalence of the infection was significantly higher in patients with conventional gastrectomy than in those with subtotal gastrectomy. The prevalence of H. pylori infection was significantly lower in patients who had undergone gastrectomy more than 4 yr ago. The histological gastritis score in patients with H. pylori infection was significantly higher than in those without H. pylori infection. Furthermore, the eradication of H. pylori in patients with both serious gastritis symptoms and no bile reflux improved the symptoms and significantly decreased the histological gastritis score. CONCLUSIONS: The results suggest that H. pylori is a factor in the pathogenesis of reflux gastritis after gastrectomy.

Amoxicillin↗
PubMed1996

[Surgical treatment of pancreatic cancer and its prognosis-long-term therapeutic results after resection].

A total of 15,731 pancreatic cancer cases were registered by the Pancreatic Cancer Registration Committee of the Japan Pancreas Society (JPS) in a period of over 14 years. Tumor resection was performed in 35.4% of the total. The five-year actuarial survival rate of resected cases was 17.5%. 130 patients histologically confirmed had long-term (over 5 years) survival, among whom were only 7 patients with n3, pv3, ly3, a3 and pl (+) as histological criteria by JPS. The combined use of radiation therapy and chemotherapy after resection for Stage I, Stage II and Stage III disease proved effective. According to the National Cancer Data Base (NCDB), though the resection rate was only 14.2%, the long-term survival rate was similar to that by JPS, because Stage IV disease was only 8% of patients who received resection in NCDB's report. Selected patients seemed to be allowed to undergo resection. We concluded that it was very important to select patients to improve therapeutic results for pancreatic cancer.

Humans↗
PubMed1996

[Effect of superoxide production on nitric oxide release from the pulmonary vascular endothelium during reperfusion after warm ischemia].

It has been reported that reperfusion injury results in the diminished nitric oxide (NO) release from the pulmonary vascular endothelium. However, this mechanism is completely unknown. We examined the effect of superoxide dismutase (SOD) on NO release at reperfusion. A rabbit lung was perfused with Krebs-Henselit buffer in a recirculation system. Cyclic GMP (cGMP) content in the lung effluent from the left ventricle was assayed in a time-dependent manner. In the control group, the lung was immediately perfused without interventing ischemia. In the warm ischemia and reperfusion group, the lung was reperfused after 30 min of warm ischemia. In the SOD group, SOD (60,000 U and 120,000 U) was administered at reperfusion after warm ischemia. The cGMP release in the warm ischemia and reperfusion group significantly decreased compared with the control group. In the SOD group, cGMP release was reversed with increasing doses of SOD, and the cGMP content was significantly reversed at all time points with SOD administration of 120,000 U. The impairement of cGMP release by reperfusion injury was restored by SOD administration. This data suggests that NO release from the endothelium may be quenched by superoxide anion generated at reperfusion. In lung transplantation, efforts must be pursued to preserve the endothelial function such as NO pathway.

Animals↗
PubMed1996

[Long-term survival after treatment of thoracic aneurysms by thromboexclusion operation].

Since 1982, fourteen patients with aortic aneurysms received thromboexclusion operation. This method was performed in 7 patients with dissecting aortic aneurysms, 6 patients with true thoracic aneurysms, and 1 patient with true thoracoabdominal aneurysm. Among them, 12 patients received the operation of ascending aorta-supraceliac abdominal aorta bypass, one patient received descending aorta-descending aorta bypass, and another one received bilateral axillo-iliac artery bypass. Graft sizes in diameter were from 16 mm to 22 mm. 9 patients received permanent paired-clamps at both the proximal and the distal parts of the thoracic aneurysm, and 5 patients received permanent single-clamp only at the proximal part of the thoracic aneurysm. 5 patients (35.7%) died perioperatively because of low output syndrome, cerebral infarction, hepato-renal insufficiency, and aneurysmal rupture, respectively. 4 late deaths (28.6%) occurred after 4 months, 5 months, 26 months, and 5 years of operation, respectively. Among them, three deaths were due to aneurysmal rupture and one due to heart failure. Although paired-clamps at both the proximal and the distal parts of the thoracic aneurysm were performed in 1 to 3 ruptured-cases, thrombo-occlusion of the thoracic aorta did not occur in any of the cases. Long-term survival was 35.7% in 5 patients after 14 years and 4 months of mean follow-up. Although a single-clamp only at the proximal part of the thoracic aneurysm was performed in 2 of these 5 cases, thrombo-occlusion of the thoracic aorta occurred in all cases. For the four survivors of them, we ran a follow-up survey and found left ventricular hypertrophic pattern in ECG, concentric left ventricular hypertrophy in UCG, and hypertension, but those were absent before operation. We conclude that thromboexclusion method for thoracic aneurysm should be limited only to high-risk patients particularly in bad conditions or to cases with severe adhesion to lung which seem to be inaccessible through direct approach.

Adult↗
PubMed1996

[Clinical evaluation of neuromuscular block].

Today many aspects of neuromuscular block should adequately be assessed. Post-tetanic count is applied for evaluating intense neuromuscular block and double burst stimulation for residual neuromuscular block. However, very profound neuromuscular block can not be evaluated using the post-tetanic count, and in addition, adequate level of recovery from neuromuscular block can not be identified using the double burst stimulation. Post-tetanic burst and double burst stimulation are thought to be useful for quantifying intense and residual block, respectively.

Humans↗
PubMed1996

Expression of tissue factor in glioma.

Tissue factor (TF) is a cell surface glycoprotein that initiates the extrinsic coagulation protease cascade and it is expressed in some tumor cells. TF belongs to the interferon receptor family, and it is one of the early immediate genes, suggesting that TF has a biological function other than hemostasis. We investigated the expression of TF in gliomas. Immunocytochemistry showed the expression of TF in 3 glioma cell lines. Immunohistochemical analysis of 44 surgical specimens revealed that all gliomas were positive for TF, and 19 (95%) of 20 glioblastomas, 12 (86%) of 14 anaplastic astrocytomas and 1 (10%) of 10 benign gliomas were moderately or strongly positive for TF. Our study showed that TF is expressed in gliomas, and that the level of TF expression is correlated with the grade of malignancy of the glioma, suggesting that TF may participate in cell growth.

Brain Neoplasms↗
PubMed1996

[A successful case of infrarenal abdominal aortic replacement against acute abdominal organ failures and ischemia of bilateral lower limbs following the operation of DeBakey IIIb-type dissecting aneurysm].

We experienced a successful surgical case, who was a 52-year-old man suffered from acute abdominal organ failures and ischemia of bilateral lower limbs following aortic arch replacement against DeBakey IIIb-type dissecting aneurysm. We investigated the abdominal blood flow by DSA via true lumen, which seemed to be obstructed by the increase in blood flow to false lumen. Therefore, to increase in blood flow to true lumen, we performed an urgent infra-renal abdominal aortic replacement successfully.

Abdomen↗
PubMed1996

The relationship of IL-6 to hormonal mediators, fuel utilization, and systemic hypermetabolism after surgical trauma.

OBJECTIVES: To define the relationship between inflammatory cytokines, hormonal mediators, alteration of energy substrate and hypermetabolism during the early phase after surgical trauma. DESIGN: A prospective case-control study of 13 patients underwent elective surgery for carcinoma between November 1993 and January 1995. MATERIALS AND METHODS: They received parenteral supply of adequate glucose and amino acids through central venous catheter after surgery equally. Inflammatory cytokines such as TNF- alpha, IL-1 and IL-6, stress hormones such as norepinephrine, glucagon and insulin, and fuel utilization and hypermetabolism variables such as resting energy expenditure (REE), CRP, free fatty acid, respiratory quotient, the calculated rates of glucose and fat oxidation using indirect calorimetry were measured serially (the day before operation, the end of surgery, and postoperative day (POD) 1, 2 and 5). MEASUREMENTS AND MAIN RESULTS: TNF- alpha and IL-1 were not detected during the study period. Initial elevation and steady decline of IL-6 concentrations were seen after surgical injury, and this response related significantly to post-operative norepinephrine and glucagon levels throughout the study period, and to insulin levels only at the end of surgery. %REE (REE/BEEHB; basal energy expenditure according to the Harris-Benedict equation) on POD 2 and 5, and all CRP levels after surgery were significantly related to IL-6 levels more than hormone levels. Fuel utilization variables on POD 2 were related to both IL-6 and hormone levels. CONCLUSIONS: Initial elevation of IL-6 concentration might induce stress hormones such as norepinephrine and glucagon, but not insulin after surgical trauma. Moreover not only hormonal mediators but also cytokine such as IL-6 are responsible for the development of the stress response of the alteration of energy substrate and hypermetabolism.

Aged↗
PubMed1996

Clinical significance of telomerase activity in hepatocellular carcinoma.

Telomerase is a ribonucleoprotein enzyme that elongates telomeric DNA. It has been reported that most immortal cell lines express telomerase, whereas in adult normal tissues telomerase activity is not detected. So, in malignant tumors telomerase is thought to be activated to maintain their immortality. In this study, we examined telomerase activity in 12 cases of hepatocellular carcinoma (HCC) with the use of PCR-based assay and analyzed the relationship of telomerase activity to clinicopathological features. In 11 of 12 HCC nodules telomerase activity was detected, of which 9 cases showed strong activity. There was no significant correlation between telomerase activity and clinicopathological features of HCC. Telomerase activity among 6 well-differentiated HCCs was strong in 3 (50%), weak in 2 (33%), and undetected in 1 (17%). All of 6 moderately-differentiated HCCs (100%), however, showed strong activity. As regards tumor size, 4 of 5 HCCs (80%) less than 3 cm in diameter showed strong telomerase activity. On the other hand, weak telomerase activity was detected in only 2 of 12 (17%) noncancerous liver tissues surrounding HCC nodules. The assay of telomerase activity may be a useful diagnostic marker of HCC regardless of tumor size, and the activity may be expressed even at early stage.

Carcinoma, Hepatocellular↗
PubMed1996

[Hypertension and hyperuricemia].

Epidemiological studies show that serum uric acid is positively associated with blood pressure levels and that serum uric acid is also a predictor of the development of hypertension in normotensive adults. Several clinical studies revealed that insulin resistance and/or hyperinsulinaemia is associated with hypertension and higher plasma concentrations of uric acid, triglyceride and plasminogen activator inhibitor 1 and with lower HDL cholesterol concentrations. Abnormalities in membrane transport system of sodium and related ions may be associated with impared urinary excretion of uric acid in hyperuricemic patients with hypertension. Several anti-hypertensive drugs have been shown to increase urinary excretion of uric acid and thereby reduce its serum level. Strict salt restriction and weight loss may cause at least in the short-term, adverse metabolic changes including elevated uric acid levels. In hypertensive patients.

Adolescent↗
PubMed1996

The effect of preservation temperature and period on resuscitation of the ischemically damaged canine pancreas during preservation by the two-layer (University of Wisconsin solution/perfluorochemical) method.

We have shown that 24 to 48 hour-preservation by the two-layer (University of Wisconsin solution (UW)/perfluorochemical (PFC)) method at 4 degrees C resuscitates a canine pancreas subjected to 90 min of warm ischemia. However, it is necessary to shorten preservation period for resuscitation of the ischemically damaged pancreas in a clinical simultaneous pancreas-kidney transplantation. The purpose of this study was to clarify the effect of preservation temperature and period on the resuscitation of the ischemically damaged pancreas during preservation by the two-layer method. First of all, we examined the possibility of resuscitation of the ischemically damaged pancreas during short-term preservation by the two-layer method. After 90 minutes of warm ischemia, canine pancreases were preserved by the two-layer method at 4, 20, or 37 degrees C. In control group, the pancreas graft was autotransplanted without preservation. Graft viability was judged by graft survival after autotransplantation. Pancreas grafts subjected to 90 min of warm ischemia were not viable (0/5). At 4 degrees C, 5 to 12 hr-preservation did not resuscitate the grafts (0/3 and 0/3 respectively). At 20 degrees C, 3 and 5 hr-preservation resuscitated the grafts (3/5 and 5/5 respectively), although 1 and 8 hr-preservation were not successful (0/3 and 0/3 respectively). At 37 degrees C, all the grafts were not resuscitated irrespective of preservation period. It was clear that the ischemically damaged pancreas was resuscitated during shot-term preservation by the two-layer method only at 20 degrees C. Secondly, we measured tissue adenine nucleotide levels by high performance liquid chromatography and pancreatic tissue perfusions using H2 clearance technique on reperfusion and examined the viability of vascular endothelium by nuclear trypan blue staining to make clear the necessary conditions for resuscitation of the ischemically damaged pancreas at 20 degrees C. ATP tissue levels in one hr-preserved grafts were 2.55 +/- 0.38 mumol/g dry weight and were significantly lower compared with the levels in 5 and 8 hr-preserved grafts, 9.40 +/- 2.09 (P < 0.01) and 7.37 +/- 1.06 mumol/g dry weight (P < 0.01) respectively. On the other hand, nuclear trypan blue uptakes of endothelial cells in 8 hr-preserved grafts were 37.6 +/- 11.6% and were significantly higher than 1 hr- and 5 hr-preserved grafts 5.6 +/- 4.5 (P < 0.01) and 5.0 +/- 3.0% (P < 0.01) respectively. As a consequence, pancreatic tissue perfusions in 8 hr-preserved grafts, 31.0 +/- 3.5 ml/min/g, were significantly lower than 1 hr- and 5 hr-preserved graft 72.0 +/- 11.6 (P < 0.01), 63.9 +/- 13.3 ml/min/g (P < 0.01) respectively. However, thromboxane A2 synthesis inhibitor (OKY046 0.1 mM/L) decreased the percentage of trypan blue uptake (8.2 +/- 3.6%) without interfering ATP synthesis (8.44 +/- 0.92 mumol/g dry weight) in 8 hr-preserved pancreas and tissue perfusions after reperfusion were dramatically improved (99.6 +/- 11.8 ml/min/g). As a result the ischemically damaged pancreas was resuscitated (4/5, 80%). It was suggested that 1 hr-preservation was not enough to synthesize ATP, which was essential to repair damaged cells, although vascular endothelial cells were maintained. Eight hr-preservation incurs endothelial cell damage although ATP tissue levels were maintained and consequently microcirculation was disturbed at reperfusion but OKY046 protects endothelial cells against preservation/reperfusion injury. As a consequence, the ischemically damaged pancreas was resuscitated. We conclude that short-term (3 to 8 hr) preservation at 20 degrees C by the two-layer method with OKY046 accelerates ATP synthesis, which is essential for repairing damaged cells and protects microvascular endothelial cells. This makes it possible to resuscitate the canine pancreas graft subjected to 90 min warm ischemia. This method holds promise for pancreas-kidney transplantation from cardiac arrest donors.

Animals↗
PubMed1996

Adenine nucleotide metabolism of canine pancreas graft preserved by the two-layer (euro-collins' solution/perfluorochemical) method after reperfusion.

We have demonstrated that oxygenation of a pancreas during preservation by the two-layer method leads continued ATP production to maintain cellular integrity and produces an extended period of preserved pancreatic viability. In this study, we examined whether the pancreas grafts preserved by the two-layer method maintained adenine nucleotides pool as substrates for ATP synthesis before reperfusion and had the ability to synthesize ATP promptly and to recover energy charge potential (ECP) of the pancreas graft on reperfusion. After preservation by the two-layer cold storage method using EC for 48 hrs (group 1, n = 5), or simple cold storage in EC for 48 hrs (group 2, n = 5), canine pancreas grafts were autotransplanted. In control (group 3, n = 5), canine pancreas grafts were autotransplanted without preservation. Tissue adenine nucleotides concentrations were measured using high performance liquid chromatography (HPLC) before and after preservation, before reperfusion and after 1 hr- and 2 hr-reperfusion. Graft survival rates were 5/5, 0/5, and 5/5, in groups 1, 2 and 3, respectively. Total adenine nucleotides before reperfusion in group 1 was almost same levels as group 2 (7.41 +/- 1.47 vs 6.64 +/- 2.23 mumol/g dry weight, N.S.). Furthermore, ATP tissue levels in group 1 before reperfusion was 2.90 +/- 0.51 mumol/g dry weight and almost same levels as group 2 (2.03 +/- 0.68 mumol/g dry weight, N.S.). However, tissue ATP levels in group 1 after 2 hrs of reperfusion (6.71 +/- 1.19 mumol/g dry weight) were significantly higher than group 2 (4.51 +/- 0.51 mumol/g dry weight, P < 0.05), and almost same levels as control (group 3) (6.32 +/- 1.62 mumol/g dry weight, N.S.). In addition, ECP in group 1 and 3 (0.90 +/- 0.03 and 0.83 +/- 0.09, respectively) after 2 hr-reperfusion, were significantly higher than the value in group 2 (0.73 +/- 0.09, P < 0.01 and P < 0.05, respectively). It was clear that recovery of ATP on reperfusion was not depend on the residual nucleotides pool before reperfusion but the ability of the pancreas graft to recover tissue ATP levels and energy charge potential after reperfusion. We conclude that oxygenation of the pancreas graft during preservation by the two-layer method allows for ATP synthesis which is essential in maintaining cellular integrity and leads to maintain the graft's ability to recover ATP levels and energy charge potential promptly after reperfusion. Consequently the pancreas graft survives.

Adenine Nucleotides↗
PubMed1996

Synthetic lipid A produces antitumor effect in a hamster pancreatic carcinoma model through production of tumor necrosis factor from activated macrophages.

The antitumor effect and biological activities of a newly synthesized lipid A analogue (ONO-4007) were investigated in a hamster pancreatic carcinoma model. Marked and dose-dependent inhibition of tumor growth was achieved by i.p. injection twice a week for 3 weeks of 10, 30 or 50 mg/kg of ONO-4007. Endogenous tumor necrosis factor (TNF) activities induced by ONO-4007 were significantly greater in tumor than in serum, spleen and liver. TNF production by macrophages stimulated with ONO-4007 after culture was much greater when culture was performed in the presence of hamster pancreatic carcinoma cells (no cell-to-cell contact). It was further found that the cytotoxic activity of TNF secreted by macrophages cultured with cancer cells was inhibited in the presence of anti-TNF neutralizing antibodies. These findings suggest that ONO-4007 displays antitumor effects by stimulating production of endogenous TNF in tumor macrophages, possibly through activation by soluble macrophage-stimulating factors in cancer cells.

Animals↗
PubMed1996

A study of patients having survived curative operation for esophageal cancer for five years or more.

In order to analyze the prognostic factors for curatively resected esophageal cancer, 42 patients who had survived their operation more than 5 years (long-term survivors) were compared for clinicopathologic items with 30 recurrent patients who had died within 5 years postoperatively (recurrent cases). Moreover, to estimate the prognosis for the current survivors, we investigated the cause of death of long-term survivors who had died. This comparison showed that the rate of lymphatic invasion was 36.4% and of blood vessel invasion 19.4% for the survivors, much lower than those of the recurrent cases which were respectively 62.1% and 31.0%. It was found that the significantly unfavorable prognosis-determinant factors was lymphatic invasion (p < 0.05). Ten out of 12 n (+) survivors (83.3%) had single metastasing region, one in the neck, three in the mediastinum and six in the abdomen. This was not significantly different from the recurrent cases, of whom, ten out of 14 n (+) cases had a single metastasing region, six in in the mediastinum and four in the abdomen. As for the number of metastatic lymph nodes, nine out of 12 n (+) survivors (75%) had only one matastatic lymph node, and none of them had more than three. On the other hand, two of the recurrent cases had more than three. Of the 42 long-term survivors, 21 patients are still alive (current survivors' average age: 70.1 +/- 7.9) and 21 have died. The cause of death was recurrence in six cases, metachronous primary malignant tumor in three, other disease in six and unknown in six. The average age of death was 62.1 +/- 10.3 in cases of recurrence or double cancer, and 71.8 +/- 9.5 in others. The former were thus significantly younger than the latter (p < 0.05).

Cause of Death↗