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H Yukaya

Publications and source records attributed to H Yukaya.

At least 19 recordsLinked to original sources
PubMed1998

A sweat-gland tumor metastasizing to the axilla: report of a case.

Sclerosing sweat-duct carcinoma is a rare malignancy of the skin. We herein present the case of a 68-year-old Japanese man who developed sclerosing sweat-duct carcinoma 2 years after undergoing local excision of a primary tumor in his right arm. Firm nodules appeared in the right axilla, which were revealed by surgical resection to be metastases. This rare tumor grows slowly but usually metastasizes to the regional lymph nodes, whereupon they are often associated with a poor prognosis. As the effectiveness of chemotherapy and radiotherapy against this neoplasm remains unclear, we recommend that the disease should initially be aggressively treated by surgery, which would also be indicated for any metastatic lesions.

Adenocarcinoma↗
PubMed1998

Pulmonary blastoma in an adult. A case with rapid progression.

A case of biphasic type pulmonary blastoma in a 59-year-old man is reported. Although the tumour was radically resected, there was rapid metastasization to the neck, mediastinum, liver and multiple bones. Despite radiotherapy, the patient died about 14 months postoperatively. Close follow-up and aggressive chemotherapy should be considered for such tumours.

Combined Modality Therapy↗
PubMed1997

Adjuvant chemotherapy with epirubicin and carmofur after radical resection of hepatocellular carcinoma: a prospective randomized study.

The intrahepatic recurrence rate is extremely high, even after radical resection of hepatocellular carcinoma (HCC). One report showed intra-arterial administration of epirubicin to be effective in the treatment of nonresectable HCC. We evaluated the effect of postoperative adjuvant chemotherapy including this drug. Fifty-seven patients who had undergone radical resection of HCC were entered in this study. Using the sealed-envelope method, 27 patients were assigned to a group undergoing resection only and 29 patients to a group also receiving adjuvant chemotherapy after resection. The protocol of the chemotherapy was intra-arterial administration of epirubicin (40 mg/m2) at 1 month after resection followed by intravenous administration of epirubicin (40 mg/m2) every 3 months for 2 years. In addition, 1-hexylcarbamoyl-5-fluorouracil (HCFU; carmofur), 300 mg/d, was administered orally every day, beginning from 1 month after the resection and continuing (in principle) for 24 months. The clinicopathologic backgrounds were well randomized between the two groups. The chemotherapy protocol was performed completely in only five patients (7.2%). Twenty-four (82.8%) patients had to cease the protocol due to various reasons: change to a new therapy after recurrence of HCC in 19 cases (79.2%), severe side effects of the chemotherapy in three cases (12.5%), liver failure in one case (4.2%), and a postoperative complication in one case (4.2%). The mean total doses were 128 +/- 114 mg for epirubicin and 144 +/- 84 g for HCFU. The cumulative overall and disease-free survival rates for 5 years were not significantly different between the two groups. The results of this prospective randomized study suggest that this adjuvant chemotherapy protocol with epirubicin and HCFU after radical resection of HCC was not effective.

Antibiotics, Antineoplastic↗
PubMed1996

Repeat hepatectomy for recurrent hepatocellular carcinoma.

This study evaluated the results of repeat hepatectomy for recurrent hepatocellular carcinoma (HCC) and delineated the limitations of such a treatment strategy. Of 290 patients who had radical hepatic resection, 167 had intrahepatic tumour recurrence. Fifty patients underwent a second hepatectomy. Third and fourth hepatectomies were carried out on six and two patients respectively. There were 36 men and 14 women. Age ranged from 32 to 77 years (mean 59.1 years). Liver cirrhosis was present in 38 and chronic hepatitis in 12 patients. Operative death occurred in four patients (8 per cent) after a second and in one of six after a third hepatectomy, compared with 4.5 per cent after first hepatectomy. The five postoperative deaths were attributed to either Child grade B or C liver disease, or severe intraoperative bleeding. The 5-year survival rate was better in these 50 patients (41 per cent) than in 117 patients who were treated otherwise (7 per cent). The present study indicates that repeat hepatectomy may be useful for recurrent HCC. It is indicated principally for patients with a solitary tumour and Child grade A liver disease.

Adult↗
PubMed1996

Immunohistochemical expression of beta-human chorionic gonadotropin in colorectal carcinoma.

The presence of human beta-chorionic gonadotropin (HCG) was immunohistochemically studied in 123 cases of primary colorectal carcinoma using the avidin-biotin-peroxidase complex method. Positive staining for HCG was recognized in 45 (36.6%) tumors and a statistical difference was observed between the HCG-positive (n = 45) and -negative (n = 78) groups concerning the frequency of blood vessel invasion in the primary tumor (P < 0.01). The prognosis for patients with HCG-positive carcinoma was thus significantly worse than that for patients with HCG-negative carcinoma (P < 0.05). A multivariate analysis using the Cox hazards model demonstrated the positive or negative staining of HCG to be one of the independent prognostic factors. The above findings show that, in addition to various other prognostic factors, the HCG staining status may thus also help in determining the prognosis of patients with primary colorectal carcinoma.

Aged↗
PubMed1995

Androgen and oestrogen receptors in hepatocellular carcinoma and surrounding liver parenchyma: impact on intrahepatic recurrence after hepatic resection.

Seventy-eight patients in whom androgen or oestrogen receptors, or both, were assayed in hepatocellular carcinoma (HCC) and the surrounding liver were discharged from hospital after curative resection of the tumour. Intrahepatic recurrence was evaluated retrospectively after 28-128 months follow-up to determine the association with receptor status. Androgen and oestrogen receptors in HCC significantly influenced the intrahepatic recurrence rate. The recurrence-free 5-year survival rate was 55 per cent for patients who had androgen receptor-negative tumours, 24 per cent for oestrogen receptor-negative, 10 per cent for oestrogen receptor-positive and 0 for androgen receptor-positive (P = 0.0322). Recurrence-free 5-year survival in 57 patients who had both receptor assays was 75 per cent for patients who had androgen receptor-negative, oestrogen receptor-negative tumours, 50 per cent for androgen receptor-negative, oestrogen receptor-positive, but 0 for androgen receptor-positive, oestrogen receptor-positive and androgen receptor-positive, oestrogen receptor-negative (P = 0.0104). The presence or absence of androgen or oestrogen receptor in the liver, however, was not associated with intrahepatic recurrence (P = 0.7534). Thus, androgen receptors are strongly associated with intrahepatic recurrence of HCC, while oestrogen receptors are weakly associated. Receptor status in the normal liver was not related to intrahepatic recurrence.

Aged↗
PubMed1994

A clinicopathologic study of gastric carcinoma with reference to age of patients.

We carried out a clinicopathologic study on gastric carcinomas excised from 36 young (< 40 years), 34 elderly (61 or 62 years), and 34 aged (> or = 80 years) patients. The young group was characterized by long duration (6.9 months) of epigastric pain (64%), tumor location rarely along the lesser curvature (31%), grossly depressed type in early stage (100%), and histologically undifferentiated type (92%). The aged group was characterized by preexisting disorders (85%), limited lymph node dissection (74%), short operative time (136 min), blood transfusion (74%), tumor location in the lower stomach (59%), and noncurative operation (47%), mainly because of locally advanced disease (59%). The 5-year survival rate in the aged (40%) was much lower than that in the young (72%) and elderly (67%). However, the 5-year survival rate for curatively treated patients did not differ among the young (85%), elderly (81%), and the aged (74%). Thus, gastric carcinomas in the young were mostly of the undifferentiated type resembling peptic ulcers, and resection led to a good prognosis. Aged patients with gastric carcinoma often had preexisting clinical disorders and locally advanced diseases; the limited feasibility of surgical excision sometimes led to a less satisfactory outcome.

Adult↗
PubMed1993

Incidence and factors associated with intrahepatic recurrence following resection of hepatocellular carcinoma.

BACKGROUND: The long-term survival rate after liver resection of hepatocellular carcinoma (HCC) is far from satisfactory, mainly because of high intrahepatic recurrence (IHR) rates. This study was aimed to clarify clinicopathologic factors relevant to IHR after resection of HCC. METHODS: The 10-year cumulative intrahepatic recurrence rates were analyzed in terms of seven clinical and eight pathological factors in 201 patients with curative hepatic resection. RESULTS: IHR was found in 121 patients during the follow-up period. The overall IHR rates were 22% at 1 year, 43% at 2 years, 62% at 3 years, 72% at 4 years, 75% at 5 years, and 75% at 10 years. Age, sex, and serum alpha-fetoprotein level, hepatitis B virus markers, and extent of liver resection were not significantly related to the IHR rate. Postoperative chemotherapy mainly with anthracycline tended to suppress IHR (P = 0.0889), but preoperative chemoembolization did not affect IHR. The presence of cirrhosis, satellite nodules, and venous invasion and the absence of capsule formation were associated with higher recurrence rates throughout the observation. Positive surgical margin (< or = 5 mm) was also associated with a higher IHR rate. Although not significant, well-differentiated HCCs showed a higher recurrence rate in comparison with poorly differentiated tumors. Size and number of tumor did not influence the IHR rate. CONCLUSIONS: Accurate patient selection and adequate hepatic reserve are important considerations in the management of HCC by resection.

Aged↗
PubMed1993

Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years.

OBJECTIVE: This study analyzed the results in 229 patients with primary hepatocellular carcinoma (HCC) who were treated by radical hepatic resection in the past 11 years. SUMMARY BACKGROUND DATA: Due to marked advances in diagnostic and therapeutic methods, the therapeutic strategy for HCC has changed significantly. However, there are still many problems to be solved when hepatic resection is to be performed for HCC associated with chronic liver disease. A satisfactory result may be possible only when all of accurate operative indication, skillful surgical technique, and sophisticated postoperative management are met. METHODS: There were 188 men and 41 women. Age ranged from 32 to 79 years averaging 60.8. Underlying cirrhosis of the liver was found in 177 patients, and chronic hepatitis was found in 47 instances. Before surgery, 114 patients had 157 associated conditions; diabetes mellitus in 66, esophageal varices in 42, cholelithiasis in 22, peptic ulcer in 12, and miscellaneous in 15 cases. In addition to various types of hepatic resection, 69 patients underwent concomitant operations such as cholecystectomy, the Warren shunt, splenectomy, partial gastrectomy, and so forth. RESULTS: The 30-day (operative) mortality rate was 7.0%, and there were eight additional late deaths (3.5%). Child's class, bromosulphalein (BSP) test, and the estimated blood loss during surgery were good predictors for operative death. The cumulative 5- and 10-year survival rates for all patients were 26.4% and 19.4%, respectively. At present, 110 patients are alive; 2 more than 10 years and 21 more than 5 years. Younger age, absence of cirrhosis, smaller tumor, and postoperative chemotherapy were associated with increased survival. CONCLUSIONS: The results of hepatic resection in 229 patients with HCC were analyzed. Child's class, BSP test, and blood loss during surgery were good predictors for operative death. The 5- and 10-year survival rates were 26.4% and 19.4%, respectively. Age, liver cirrhosis, tumor size, and postoperative chemotherapy were prognostic factors. Multidisciplinary approach with liver resection, postoperative chemotherapy, and liver transplantation will be a realistic direction for the surgical treatment of HCC in future.

Blood Loss, Surgical↗
PubMed1992

Long-term results after modified distal splenorenal shunt with expanded PTFE interposition.

Forty consecutive patients with esophagogastric varices underwent a modified distal splenorenal shunt with expanded polytetrafluoroethylene (PTFE) interposition and were followed up for 12 to 66 months (mean 44.7). The operations were urgent in 9, elective in 14, and prophylactic in 17 patients. There were 24 males and 16 females. Age ranged from 32 to 76 years with an average of 53.8. The causes of portal hypertension were liver cirrhosis in 32, chronic hepatitis in 4, idiopathic portal hypertension in 3, and primary biliary cirrhosis in 1. Twenty-six patients were in Child's class A, 6 in class B, and 8 in class C. The operative death rate within 1 month was 2.5% and the overall in-hospital mortality rate was 5%. The shunt patency rate was 97.2% at early and 100% at late examinations. Only one patient (2.5%) had upper gastrointestinal bleeding. Hepatic encephalopathy was seen in 8 (20.5%) of 39 surviving patients. Six patients died of liver failure and another six died from various causes during the follow-up period. Twenty-six patients (65%) are alive at present. The 1-, 3-, and 5-year cumulative survival rates were 87.4%, 73.3% and 48.8%, respectively. The current modified shunt can be carried out more safely and easily and yield a similar result to that with the original Warren shunt. In order to avoid hepatic encephalopathy and liver failure, however, it is not wise to persist in this procedure.

Adult↗
PubMed1991

Intraoperative changes in blood coagulation and the effectiveness of ulinastatin during liver resection.

The blood coagulation status of 16 patients undergoing liver resection was monitored by thrombelastograph (TEG). Coagulation test by TEG was performed at three different times: before and one hour after induction of anesthesia and after liver resection. The four variables such as r (reaction time), k (coagulation velocity), ma (maximum amplitude) and me (maximum elasticity) were measured. In 8 patients, Ulinastatin was not administered during the operation and FFP was transfused after the second measurement of TEG (group I). The other 8 patients were administered totally 300,000 units of Ulinastatin after induction until the second measurement of TEG, thereafter FFP was transfused (group II). The TEG showed poor preoperative coagulation state in both groups. In group I, TEG variables showed coagulopathy was exacerbated significantly during liver resection. In group II TEG variables showed no significant changes during operation. Between the two groups there were statistical differences in the TEG variables during the operation. The TEG was useful for monitoring coagulation function during liver resection. It was impossible to improve TEG data by only replacement of FFP. Ulinastatin was useful in normalizing the coagulation function and in preventing the changes in TEG measurements during liver resection.

Journal Article↗
PubMed1990

Clinicopathologic comparisons between estrogen receptor-positive and -negative hepatocellular carcinomas.

During the past 8 years, estrogen receptors (ERs) in the cytosol of hepatocellular carcinoma (HCC) were assayed in 66 unselected patients without preceding treatments on whom radical hepatic resection was performed. Twenty-six patients had ERs of 0.9 to 13.4 fmol/mg protein with a mean dissociation constant of 7.8 x 10(-10) M. The remaining 40 patients had no detectable amount of the receptor. There were no substantial differences between the ER-positive and ER-negative groups in preoperative clinical and laboratory data such as sex, age, alcohol abuse, underlying liver disease, and hepatic functions. Large tumors were more common in the ER-negative group and therefore the incidence of major hepatic resection was significantly higher in this group. Histopathologic studies revealed no substantial differences between the two groups. Operative mortality rate was 11.5% in the ER-positive and 12.5% in the ER-negative group. Excluding eight operative deaths, the rate of tumor recurrence in the residual liver and long-term survival rate were identical for the two study groups. The current results may indicate that the presence or absence of ERs in human HCC does not correlate to either biologic or pathologic characteristics of this tumor, but the true role of ERs in human HCC remains to be elucidated.

Carcinoma, Hepatocellular↗
PubMed1990

Assessment of pattern and treatment of intrahepatic recurrence after resection of hepatocellular carcinoma.

From 1980 to 1988, 161 patients underwent total extirpation of primary hepatocellular carcinoma. There were 18 operative or hospital deaths. Recurrence of tumor was diagnosed in 69 of the remaining 143 patients during follow-up treatment with monthly serum alpha-fetoprotein measurements and imaging studies that were performed every three months. There were 61 men and eight women whose ages ranged from 33 to 78 years. The histologic factors noted were cirrhosis of the liver in 60 patients and chronic hepatitis in nine. There were multiple or diffuse recurrences (Type A) in 34 instances, one to three nodular recurrences (Type B) in 21, marginal recurrences (Type C) in 11 and a mixed form of the latter two in three instances. Two-thirds of the recurrences were found within 1.5 years and the second peak was noted between 2.0 and 2.5 years. Sex of patient, hepatitis B virus, type of tumor, capsule, extent of hepatic resection and postoperative chemotherapy did not influence the rate of recurrence, but cirrhotic livers had a significantly higher recurrence rate. A second hepatic resection was performed upon 20 patients with a five year survival rate of 26.8 per cent. Good results were obtained by chemoembolization of the hepatic artery. Prevention and adequate treatment of intrahepatic recurrence are of paramount importance in achieving better surgical results for hepatocellular carcinoma.

Adult↗
PubMed1989

Androgen and estrogen receptors in hepatocellular carcinoma and the surrounding liver in women.

Androgen receptors (AR) and estrogen receptors (ER) were consecutively assayed for hepatocellular carcinoma (HCC) and the surrounding liver was removed surgically from 19 female patients. Patient age ranged from 43 to 79 years, with an average of 61 +/- 9 years. All patients had underlying liver disease (liver cirrhosis in 16, liver fibrosis in two, and chronic hepatitis in one). Seven (37%) of 19 HCC had AR ranging from 2.3 to 82.6 fmol/mg of cytosol protein. The AR titer was higher in the HCC than in the liver in these cases. Three cases also had ER. ER existed in seven (37%) tumors (range, 2.4 to 25.6 fmol/mg of protein). AR and ER were detected in 11 (65%) and ten (58%) of 17 nonneoplastic liver tissues, respectively. Serum alpha-fetoprotein (AFP) level, hepatitis B virus markers, or histopathologic types of HCC had no correlation with the presence or absence of AR or ER and their titers. Also, there was no correlation between the AR and ER positivities. Further studies are mandatory to determine the genuine role of sex hormone receptors in the development and growth of HCC in humans.

Aged↗
PubMed1989

Liver resection for hepatocellular carcinoma: results from 150 consecutive patients.

During the past 6 years, 150 consecutive hepatic resections were performed for hepatocellular carcinoma on 129 male and 21 female patients. Their ages ranged from 17 years to 78 years, with an average of 57.0 years. All but two patients had an underlying parenchymal disease of the liver; 131 had liver cirrhosis, 16 chronic hepatitis, and one liver fibrosis. The operations performed were extended right lobectomy in 10 cases, right lobectomy in 13, left lobectomy in 5, left lateral segmentectomy in 11, other segmentectomies in 31, and partial wedge resection in 80 instances. The operative and in-hospital mortality rates were 6.0% and 12.0% respectively. In the 122 patients with curative resection, the 1-, 3- and 5-year survival rates were 75.2%, 49.0% and 30.0% respectively. The 1- and 3-year survival rates were 14.3% and 7.1% in the 28 patients with palliative resection. The tumor size and Child's classification generally reflected the survival rate.

Adolescent↗
PubMed1989

Intraoperative ultrasonography in resection of small hepatocellular carcinoma associated with cirrhosis.

Preoperative detectability rates of hepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonography, 93 percent by computed tomography, and 92 percent by selective angiography. The combination of two methods produced detectability rates of 97 to 99 percent. One hundred three patients underwent various types of hepatic resection with the aid of intraoperative ultrasonography. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. The detectability rates were 38 percent for hepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable hepatocellular carcinomas were identified by intraoperative echography. The overall detection rate by this method was 98 percent, which was substantially higher than the preoperative rate. Intraoperative ultrasonography is a useful and indispensable method for performing atypical minor hepatectomy for the treatment of small hepatocellular carcinomas associated with liver cirrhosis.

Carcinoma, Hepatocellular↗