Subtrocar for removing a gallbladder from the abdominal cavity.
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Biomedical subjects
Publications and source records attributed to H Kakizoe.
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Rectal expander-assisted transanal endoscopic microsurgery (RE-TEM) was performed for two cases of early rectal cancer and a case of villous tumor under saddle block anesthesia. RE-TEM is the new technique for local excision of rectal tumors with a rectal expander that we developed. The rectal expander expands the rectum after insertion through the anus and provides adequate vision for microsurgery with standard video monitors. Tumors were located 8, 8, and 5 cm from the anal verge, and all of them were excised completely with no difficulty. Minor bleeding was noted in all cases and was controlled by electric coagulation and/or sutures. Average operative time for the three cases was 105 min. We conclude that RE-TEM is useful for rectal tumors and/or early rectal cancer that cannot be removed by endoscopy.
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OBJECTIVES: To identify the endoscopic findings and clinical manifestations of anisakiasis, we studied 87 cases of gastric anisakiasis. METHODS: Patient information was analyzed by means of patient records. The interval between the day of intake of Anisakis and endoscopic examination was determined in 86 cases. Then the endoscopic findings of each interval were elucidated. RESULTS: Moderate to severe gastric mucosal edema tends to occur within 1 or 2 days after Anisakis infection, accompanied by leukocytosis. As to the sites of penetration of Anisakis, 55% of cases were found in the greater curvature with severe mucosal edema. Among 87 cases, four patients experienced anisakiasis twice during the interval examined, and six patients had past histories of anisakiasis before the investigated interval. CONCLUSIONS: Gastric anisakiasis may be caused by an allergic reaction to the Anisakis antigen. There is a classic relationship between clinical and endoscopic findings and the interval after Anisakis administration. Anisakis usually is found in the greater curvature.
A small pedunculated polyp was detected among other polyps in the transverse colon of a 64-year-old man, the resected specimen of which showed an adenomatous polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the submucosa, muscularis, and serosa. This case report stresses the importance of performing careful pathologic examination of resected specimens obtained from endoscopic polypectomy, even for small pedunculated colon polyps.
Percutaneous transhepatic portacaval shunt (PTPS) was performed in a patient with high-risk esophageal varices prior to sclerotherapy. PTPS was accomplished with the aid of two catheters. The first catheter was placed in the right hepatic vein under ultrasonographic guidance, and the second was placed in the portal vein. The two catheters were then connected together. The color of the esophageal varices changed from blue to white, and serum protein levels were increased 8 weeks after PTPS. Sclerotherapy was then performed without any difficulty. PTPS is the easy and quick method of performing a portacaval shunt and may have importance for the management of patients with high-risk esophageal varices prior to the treatment of sclerotherapy or liver transplantation.
It has recently been demonstrated that prostaglandins (PGs) play an important role in the ovulation, the onset of menstruation and labor pain and other reproductive phenomena. The purpose of this study is to develop the enzyme immunoassay (EIA) for PGF2 alpha to estimate the PGF2 alpha level in body fluids. beta-Galactosidase-PGF2 alpha conjugate and bovine serum albumin-PGF2 alpha conjugate were prepared by a mixed anhydride method. PGF2 alpha was extracted with ethylacetate from an acidified sample. EIA was carried out using a double antibody method. As for the conjugation ratio of PGF2 alpha and beta-Galactosidase, 5, 10, 20, 40 and 80 were examined. Recovered enzyme activity and sensitivity of the method were better in the enzyme of conjugation ratio 10 than in the other conjugation ratios, 5, 20, 40, 80. Values measured by RIA and EIA were well correlated. The correlation rate was 0.84. The recovery rate was 102.3%. The sensitivity of the standard curve was 5-100 pg/tube. PGF2 alpha in the menstrual blood of the 18 women was determined with the EIA method. The mean value for PGF2 alpha in menstrual blood is 20.9 ng/ml (S.D. = 11.4).
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Frequent chemolipiodolization and prostaglandin E1 (PGE1) administered through a hepatic arterial infusion port were used for treatment in 2 cases of hepatocellular carcinoma (HCC) with liver cirrhosis. Chemolipiodolization was performed every 4 weeks with 6 ml lipiodol, 3 ml Optilay and 30 mg Epirubicin or 10 mg Mytomycin C. PGE1 (10 ug) was administrated to the hepatic artery once every week after the first 7 days administration. The treatment resulted in a decrease of the AFP level, an arrest of HCC growth and a reduction in ascites with an improvement of clinical and biochemical parameters in both cases. These encouraging preliminary results show that frequent lipiodolization is effective for unresectable HCC and frequent PGE1 administration via the hepatic artery is a safe and efficient treatment for liver cirrhosis.