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Biomedical subjects

J Furuse

Publications and source records attributed to J Furuse.

34 records · Page 2Linked to original sources
PubMed1993

Hemodynamics of the left gastric vein in portal hypertension.

BACKGROUND: Esophageal varices reflect the hemodynamics of the left gastric vein, which can now be studied by Doppler ultrasonography. The purpose of this study was to elucidate the hemodynamic features of the left gastric vein in portal hypertension. METHODS: Flow direction and velocity in the left gastric vein were examined by the pulsed Doppler flowmeter in 53 healthy adults and 216 patients with liver cirrhosis. RESULTS: Flow direction was hepatopetal in all healthy controls, whereas it was hepatofugal in 72% of the patients with esophageal varices. In the early stage of mild esophageal varices, flow direction was still hepatopetal. However, in portal pressure > 250 mm H2O, hepatofugal flow was highly frequent (56 of 59 patients, 95%). Hepatofugal flow velocity in patients with varices was 8.5 +/- 2.5 cm/s in mild varices, 11.6 +/- 2.4 cm/s in intermediate varices, and 13.8 +/- 3.4 cm/s in marked varices. Variceal bleeding was frequent in patients with a flow velocity > 15 cm/s (7 of 14 patients, 50%). Flow velocity in the left gastric vein increased after ingestion of glucose in 43 of 56 patients with esophageal varices. CONCLUSIONS: In portal hypertension, as the size of varices enlarged, hepatofugal blood flow in the left gastric vein increased in parallel. High flow velocity in the left gastric vein was strongly associated with variceal bleeding. Increase of blood flow after ingestion of glucose suggests postprandial increase in variceal flow.

Administration, Oral↗
PubMed1992

Diagnosis of portal vein tumor thrombus by pulsed Doppler ultrasonography.

The blood flow of portal vein thrombus was studied by pulsed Doppler ultrasonography in 21 patients with tumor thrombus and 14 with blood clot thrombus. Pulsatile waves were observed in 19 of the 21 with tumor thrombus, with backward continuous waves in 3, and forward/backward continuous waves in 2. In contrast, forward continuous waves were observed in 2 of the 14 with blood clot thrombus. By color imaging, the blood flow could be observed in 9 of 14 with tumor thrombus, but in 1 of 7 with blood clot thrombus. Pulsatile and backward continuous waves were characteristic of tumor thrombus.

Adult↗
PubMed1992

[Hemodynamics of intrahepatic portal vein studied in healthy subjects and liver cirrhosis by pulsed Doppler method].

The hemodynamics of the intrahepatic portal vein in 35 healthy subjects and 74 patients with liver cirrhosis was studied by measuring blood flow velocity with pulsed Doppler ultrasound technique. The flow velocity of portal vein decreased from the portal trunk to the first branches and to the second branches in the right and left lobes. Especially, an abrupt decrease of the flow velocity in the umbilical part of the left portal vein was characteristic of hemodynamics in the intrahepatic portal vein. The flow velocity in the third branches decreased more than that of the second branch in the right portal vein, but did not exist in the left. And the velocity was almost equal in all the subsegments. Blood clots of the left portal vein in 25 of 36 lesions were found in 31 patients with intrahepatic portal vein thrombus. This characteristic hemodynamics of the left portal vein was thought to be the main cause for the formation of blood clots. In the group with liver cirrhosis, the flow velocity was lower than in healthy subjects in the portal trunk, bilateral first branches and right second branches, but did not exist in the left second branch and bilateral third branches. No interrelationship between the intrahepatic portal flow velocity and the severity of liver cirrhosis and portal hypertension was observed.

Blood Flow Velocity↗
PubMed1990

Relative frequencies of portosystemic pathways and renal shunt formation through the "posterior" gastric vein: portographic study in 460 patients.

Percutaneous transhepatic portography was carried out in 460 patients with portal hypertension to study various collateral routes. Besides the left gastric vein, which was the most frequent collateral route and feeder of esophageal varices, a distinct vein located between the left gastric vein and the short gastric vein constituted a major collateral route in 191 patients (42%). In terms of frequency, this vein was more significant than the short gastric (34%) and the paraumbilical vein (24%) as a collateral route. We propose that this previously anonymous vein be called the "posterior gastric" vein because it runs posterior to the stomach. This vein also formed a renal shunt, a common cause of encephalopathy, in 43 (23%) of the 191 patients; the relative frequency of renal shunt formation by this vein was significantly greater than that by the left gastric vein (12%) and the short gastric vein (18%).

Collateral Circulation↗
PubMedDate not supplied

Sonographic appearances of small hepatic nodules without tumor stain on contrast-enhanced computed tomography and angiography.

PURPOSE: We report the sonographic appearances and pathologic findings for hepatic nodules 2 cm or smaller that were detected by sonography but that did not produce a tumor stain on constrast-enhanced helical CT or digital subtraction angiography. METHODS: Sixty-six nodules 2 cm or less were found by sonography in 39 patients. Sonographically guided needle biopsies were done on all lesions. RESULTS: Twenty-seven nodules were benign nodules, 9 were borderline lesions, and 30 were hepatocellular carcinomas. Benign nodules were significantly smaller than hepatocellular carcinomas (mean size, 1.0 cm versus 1.4 cm, respectively; p <0.00001). Nodules 1 cm or smaller were more likely to be diagnosed as benign nodules (68%) than as either of the other types (32%; p = 0.01). A significantly greater percentage of hepatocellular carcinomas showed a heterogeneous pattern (64%) on sonography compared with benign nodules (25%) and borderline lesions (11%; p = 0.04). In nodules 1 cm or smaller, a homogeneous pattern (68%) was more common than a heterogeneous pattern (32%; p = 0.01). CONCLUSIONS: The nature of small hepatic nodules cannot be determined with sonography. Thus, biopsy remains the only technique for obtaining a definitive diagnosis.

Aged↗
PubMedDate not supplied

A phase II study of cisplatin in patients with biliary tract carcinoma.

A phase II study of cisplatin was performed in 13 previously untreated patients with unresectable biliary tract carcinoma. The drug was given intravenously at a dose of 80 mg/m2/day once every 4 weeks. Of 13 patients evaluated, 1 showed partial response lasting 3 months, while no patients showed complete response. Of 9 patients, whose serum level of carcinoembryonic antigen (CEA) was high (> or = 10 ng/ml) before treatment, 4 showed > or = 50% reduction in serum CEA level after treatment. The current study indicates that cisplatin does not have significant antitumor activity against biliary tract carcinoma.

Adolescent↗
PubMedDate not supplied

Detection of bile duct cancer by autofluorescence cholangioscopy: a pilot study.

BACKGROUND/AIMS: There is increasing interest in the detection of malignancy by autofluorescence endoscopy. This is the first report on autofluorescence endoscopy in bile duct cancer. METHODOLOGY: Nine patients with bile duct cancer underwent percutaneous transhepatic autofluorescence cholangioscopy using light-induced fluorescence endoscopy in the gastrointestinal tract (LIFE-GI) system. RESULTS: The cancerous lesion had quite a different color in comparison with normal mucosa, which was seen as light blue, by the autofluorescence endoscopy. In all patients, cancerous legions were observed as dark red. Additionally, in 7 of the 9 cases a white fluorescence was also seen in the cancerous lesion. CONCLUSIONS: In previous reports on the gastrointestinal tract and bronchial tree, cancerous lesions appeared dark red when examined by autofluorescence endoscopy. In our study, it is suggested that a white fluorescence is also an important finding for making diagnosis of bile duct cancer by the autofluorescence endoscopy.

Bile Duct Neoplasms↗
PubMedDate not supplied

Drainage area of the head of the pancreas by computed tomography under endoscopic retrograde pancreatography (ERP-CT).

BACKGROUND/AIMS: This study evaluated the drainage area of the capitular branches of the pancreas head by computed tomography under endoscopic retrograde pancreatography (ERP-CT). METHODOLOGY: ERP-CT was performed in 43 patients. The drainage area of the capitular branches of Wirsung's and Santorini's ducts were evaluated by dividing the pancreatic head into two areas, the anterior area and the posterior area. RESULTS: The pancreatic duct pattern was classified in 4 types; normal type, ansa type, loop type, and embryonic type. In normal type duct pattern, all inferior capitular branches of Wirsung's duct drained the posterior area and all inferior capitular branches of Santorini's duct drained the anterior area. In ansa type duct pattern, all inferior branches from Wirsung's duct drained the posterior area and inferior branches from Santorini's duct drained the anterior area and the posterior area. In loop type duct pattern, all inferior branches from Santorini's duct drained the posterior area and inferior branches from Wirsung's duct drained the anterior area and the posterior area. Middle capitular branches were detected only in normal B, normal C, and loop type. CONCLUSIONS: ERP-CT is a useful procedure that provided three-dimensional morphology of the capitular branch of the pancreas head.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

5-fluorouracil continuous infusion combined with cisplatin for advanced pancreatic cancer: a Japanese Cooperative Study.

BACKGROUND/AIMS: The prognosis of patients with advanced pancreatic cancer is extremely poor. To improve their prognosis, providing effective chemotherapy is necessary. The aim of this study was to evaluate the anti-tumor activity and toxicity of combined chemotherapy (FP therapy) using 5-fluorouracil and cisplatin in Japanese chemo-naive patients with advanced pancreatic cancer. METHODOLOGY: Thirty-seven previously untreated patients with histologically proven pancreatic adenocarcinoma were treated with FP therapy. 5-fluorouracil was administered at 500 mg/m2/day by continuous intravenous infusion for 5 days and cisplatin was administered at 80 mg/m2 intravenously on the 1st day. Therapy was repeated every 4 weeks until there was evidence of disease progression or unacceptable toxicity. RESULTS: Three patients achieved partial responses, whereas none exhibited a complete response. The overall response rate was 8% (95% confidence interval, 2-22%) and the response durations were 6, 9 and 12 months, respectively. The median survival time of patients was 5 months. Toxicities were generally mild and acceptable, although nausea/vomiting was the most commonly observed toxicity. CONCLUSIONS: FP therapy on this schedule had limited anti-tumor activity for pancreatic cancer, indicating that, practically, it should not be performed in Japanese patients with advanced pancreatic cancer.

Adenocarcinoma↗
PubMedDate not supplied

Intraoperative and conformal external-beam radiation therapy in patients with locally advanced pancreatic carcinoma; results from a feasibility phase II study.

BACKGROUND/AIMS: Chemoradiation therapy is widely indicated to patients with locally advanced pancreatic carcinoma, though the capability of radiotherapy alone is not assessed enough. The purpose of this study is to clarify the efficacy and safety of a more intensive radiotherapy for those patients. METHODOLOGY: Fifteen patients were enrolled in a feasible phase II study of treatment with intraoperative radiation therapy (25 Gy), followed by conformal external-beam radiation therapy (40 Gy in 20 fractions, 5 times/week). The antitumor effect was evaluated on the early phase of dynamic computed tomography image. RESULTS: The full irradiation dose was feasible in 12 of 15 patients. The overall response rate was 40% (1 complete and 5 partial responses). Grade 3 toxicity was observed in 2 patients (13%) with nausea/vomiting or anorexia. One patient developed gastric ulcer and died of gastrointestinal bleeding 12 months after intraoperative radiation therapy. The median survival time was 11.1 months, and the 2-year survival rates were 13%. Survival for more than 2 years was observed in 2 of the 6 responders. CONCLUSIONS: The above radiotherapy is considered to be active for the locally advanced pancreatic cancer with acceptable toxicity, when the gastrointestinal tract is excluded from the radiation field. This should be further assessed in late phase II studies involving a large number of patients.

Adenocarcinoma↗
PubMedDate not supplied

Hepatic arterial infusion of 5-fluorouracil for liver metastases from pancreatic carcinoma: results from a pilot study.

BACKGROUND/AIMS: Liver metastasis is a common progression of pancreatic carcinoma, but an effective chemotherapy has not been established. The purpose of this study was to examine the efficacy and safety of a hepatic arterial infusion of 5-FU in patients with liver metastasis from pancreatic carcinoma. METHODOLOGY: Thirteen patients were enrolled in a pilot study of a hepatic arterial infusion of 5-FU therapy. They received 5-FU for 5 days at a dose of 500 mg/m2/day by continuous hepatic arterial infusion every 4 weeks. RESULTS: One patient showed a partial response, while 6 showed no change. Of these 6 patients, 2 showed a minor response. The overall response rate was 8% (95% confidence interval: 0-22%). Nausea and vomiting were the most common types of toxicity. Three patients (23%) had hepatic arterial occlusion. There were no life-threatening toxicities or complications. The overall median survival time was 15.9 weeks. CONCLUSIONS: Hepatic arterial infusion of 5-FU in patients with liver metastasis from pancreatic carcinoma is tolerable but is minimally effective at this dose and schedule. The schedule of administration should be modified.

Adenocarcinoma↗
PubMedDate not supplied

CA 19-9 in evaluating the response to chemotherapy in advanced pancreatic cancer.

BACKGROUND/AIMS: The determination of serum carbohydrate antigen 19-9 (CA 19-9) level is useful in managing pancreatic cancer. However, the usefulness of this marker in evaluating the response to chemotherapy has not been fully established. MATERIALS AND METHODS: Serial changes of serum CA 19-9 levels were studied during chemotherapy in 66 pancreatic cancer patients who showed CA 19-9 level of 100 U/ml or greater before treatment. We investigated the relationship between patient survival and reduction in serum CA 19-9 level after treatment. RESULTS: When a responder was defined as a patient whose serum CA 19-9 level was reduced by more than 50% of the pre-treatment level within 2 months after treatment, CA 19-9 response was observed in 9 (13%) of the 66 patients. Median survival times of CA 19-9 responders and non-responders were 141 and 88 days, respectively. Based on Cox regression analysis, the relative risk of cancer death in CA 19-9 responders for non-responders was 0.47 (95% confidence interval, 0.21 to 1.05). CONCLUSIONS: CA 19-9 reduction may be useful for assessing the efficacy of chemotherapy for advanced pancreatic cancer.

Adult↗
PubMedDate not supplied

Tumor markers in evaluating the response to radiotherapy in unresectable pancreatic cancer.

BACKGROUND/AIMS: Serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) are useful tumor markers in the diagnosis of pancreatic cancer. However, little research has shown their value for evaluating the response to radiotherapy in patients with advanced pancreatic cancer. METHODOLOGY: Serial changes of serum CA 19-9 levels were studied in 34 patients with unresectable pancreatic cancer. All patients had a CA 19-9 level of 100 U/ml or greater before treatment and received radiotherapy as an initial treatment. A CA 19-9 responder was defined as a patient whose serum CA 19-9 level was reduced by more than 50% of the pre-treatment level after treatment. We investigated the relationship between CA 19-9 response and survival. We also studied serial changes of serum CEA levels in 20 patients with the level of 5 ng/ml or greater before radiotherapy, and investigated the relationship between CEA response and survival. RESULTS: CA 19-9 response and CEA response were observed in seven (21%) of 34 patients and four (20%) of 20 patients, respectively. Median survival times of CA 19-9 responders and non-responders were 318 and 122 days, respectively, and median survival times of CEA responders and non-responders were 281 and 151 days, respectively. Based on results of the Cox regression analysis, the relative rates of cancer death between responders and non-responders were 0.24 (95% confidence interval, 0.08 to 0.72) in the CA 19-9 analysis and 0.19 (95% confidence interval, 0.04 to 0.84) in the CEA analysis. CONCLUSION: Serum CA 19-9 may be useful tumor markers for assessing the effectiveness of radiotherapy for pancreatic cancer. Further investigations are necessary to determine the value of CEA.

Adult↗