Biomedical subjects

I Takeyoshi

Publications and source records attributed to I Takeyoshi.

131 records · Page 8Linked to original sources

PubMedDate not supplied

The resection of non-hepatic intraabdominal recurrence of gastric cancer.

BACKGROUND/AIMS: Surgical resection of hepatic or pulmonary metastases from gastrointestinal cancer has been recognized as a curative modality in some patients. However, the role and outcome of the surgical management of a non-hepatic intraabdominal recurrence of gastrointestinal cancer have not been clearly delineated. METHODOLOGY: We treated 5 patients for non-hepatic intraabdominal recurrence of gastric carcinoma surgically. All the resected specimens were microscopically identified as recurrent gastric cancer. Three of 5 patients received postoperative chemotherapy. The clinicopathological findings were analyzed according to the general rules for gastric cancer study. RESULTS: The lymph nodes were dissected for lymph node metastases. Surgical resection of the tumors combined with total gastrectomy, esophagectomy, or colectomy was performed for the local and peritoneal recurrences. All of the recurrent tumors were macroscopically resected with curative states. One patient died of sepsis 54 days after surgery. Three patients died of recurrent gastric cancer: 2 within 1 year of surgery and 1 after 3 years. One patient still survives disease free 3 years and 6 months after the 2nd operation. CONCLUSIONS: Surgical resection for non-hepatic intraabdominal recurrence of gastric cancer is the treatment of choice for selected patients. Surgical resection followed by adjuvant chemotherapy may improve the outcome of these patients.

Abdominal Neoplasms↗

PubMedDate not supplied

Skin metastasis from the spindle cell component in rectal carcinosarcoma.

Carcinosarcomas are rare tumors, which are usually composed of carcinomatous areas close to or intermixed with sarcomatous components. Only 6 cases of carcinosarcoma of the colon have been reported in the English literature previously. We describe the 7th case, an 82-year-old man with a skin metastasis from the spindle cell component of a rectal carcinosarcoma. On rectal exploration, a large, firm tumor was palpated 2 cm from the anal verge. Endoscopic examination revealed a tumor projecting into the lumen, and hemorrhage from the tumor surface. We performed a low anterior resection. The resected specimen contained an ulcerative lesion with a round wall in continuity with a papillary tumor. Carcinoma and sarcoma components existed concomitantly along with transitional features. Immunohistochemistry disclosed immunoreactivity for vimentin in most of the spindle cell areas. Carcinoembryonic antigen was positive in the adenocarcinomatous component. One month after surgery, the patient developed a skin metastasis on the back. The skin biopsy specimen contained proliferating spindle cells almost identical to those of the primary lesion. The patient died of carcinosarcoma 6 months after surgery. In this paper, we review 7 cases of colorectal carcinosarcoma, including our patient, who is only the 7th such reported case.

Aged↗

PubMedDate not supplied

FR128998 ameliorates liver injury in extended liver resection with ischemia in dogs.

BACKGROUND/AIMS: Platelet-activating factor is one of the most potent phospholipid mediators associated with inflammatory conditions such as ischemia and reperfusion injury. FR128998 (FR) is a novel platelet-activating factor receptor antagonist. In this study, we evaluated the effect of FR during an extended liver resection with ischemia in a canine model. METHODOLOGY: Animals were divided into two groups: the control group (n = 8), and the FR-treated group (n = 7) in which FR was administered via the portal vein. While the right portal pedicle was clamped for 60 min, the left portal branch remained patent to avoid splanchnic congestion. Following reperfusion, 75% of the liver (including the right central, quadrate, left central, left lateral, and papillary lobes) was resected. Hepatic venous blood was collected to measure GPT, GOT, and LDH levels. Hepatic tissue blood flow was measured by a laser Doppler flow meter. The liver specimen was harvested for histological study. RESULTS: GPT, GOT, and LDH levels after reperfusion were significantly (P < 0.05) lower in the FR-treated group than in the control group. Hepatic tissue blood flow was maintained significantly (P < 0.05) higher in the FR-treated group than in the control group. Histologically, accumulation of polymorphonuclear neutrophils significantly (P < 0.05) decreased in the FR-treated group compared with the control group. The 2-day survival rate was statistically (P < 0.05) better in the FR-treated group than in the control group. CONCLUSIONS: FR128998 provides a protective effect for liver parenchyma and sinusoidal endothelial cells during extended liver resection with ischemia.

Alanine Transaminase↗

PubMedDate not supplied

Double cancer in different hepatic lobes: hepatocellular and cholangiocellular carcinoma.

BACKGROUND/AIM: Hepatic tumors with elements of both hepatocellular and cholangiocellular carcinoma are occasionally encountered; however, the independent and simultaneous occurrence of different epithelial malignant tumors in different lobes is rare. This is a case report of resected double cancer in different lobes of the liver. MATERIALS AND METHODS: A 73 year old Japanese man, with hepatic mass and a history of peritonitis and hepatitis, underwent laparotomy and hepatic resection of the posterior inferior and the left lateral segment, and cholecystectomy for cholecystlithiasis with left-sided gallbladder at our hospital in 1991. RESULTS: The tumor, located in the posterior inferior segment, a yellow-white, round, highly circumscribed mass with a thick capsule, was about 9.0 by 8.0 cm in size. The other tumor located in the left lateral segment, grayish-white on the cut section, was approximately 5.0 by 4.0 cm. CONCLUSION: In our case, it is unlikely the tumor in the right lobe metastasized to the left lobe and transformed into a different type. The two tumors showed clearly different microscopic features. Improved imaging will increase the frequency and number of double cancer diagnosis. This additional data may shed light on the pathogenesis and etiology of double cancer.

Aged↗

PubMedDate not supplied

Hepatic vein reconstruction at inferior vena cava confluence using left renal vein graft.

BACKGROUND/AIMS: To preserve remnant liver function, extended left hepatectomy combined with middle hepatic vein reconstruction using a left renal vein graft was performed in resection of liver metastasis from sigmoid colon cancer, involving the confluence of the middle and left hepatic veins. METHODOLOGY: The tumor, 5 cm in size, occupied the superior part of segment 4, and involved the confluence of the middle and the left hepatic veins. An extended left hepatectomy, including the left lobe, left caudate lobe and part of segment 8, together with the middle hepatic vein trunk, was performed. The left renal vein was resected as a graft from the confluence of the inferior vena cava just distal to the branches of the gonadal vein, renal-azygos, splenorenal communications and vertebral veins. The middle hepatic vein was reconstructed using the left renal vein 3 cm in length. RESULTS: Impaired values of liver function tests were normalized by the third postoperative day. Renal function was good throughout the postoperative period. The patient was discharged two weeks after the surgery. The reconstructed middle hepatic vein was patent, which was evaluated by a color Doppler ultrasonography, computed tomography and magnetic resonance imaging 60 days after the surgery. The patient remained well in the eight months thereafter. CONCLUSIONS: Hepatic vein reconstruction using a left renal vein graft is a new and preferable addition for the selection of an optimal graft.

Female↗