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J Urata

Publications and source records attributed to J Urata.

45 records · Page 3Linked to original sources
PubMed1991

Prognostic factors in the treatment of hepatocellular carcinoma with transcatheter arterial embolization and arterial infusion.

From January 1986 to December 1988, a prospective trial of transcatheter arterial treatment was carried out for hepatocellular carcinoma (HCC). Two hundred seventy-five patients were included. Okuda's staging system was employed. Patients with Stage I and II HCC were treated by transcatheter arterial embolization (TAE) with a gelatin sponge containing an anti-cancer agent (protocol 1a); a gelatin sponge and iodized oil mixed with an anti-cancer agent (protocol 1b); or iodized oil mixed with an anti-cancer agent (protocol 2). Patients with Stage III HCC were treated with iodized oil with anti-cancer agent (protocol 2). As an exception, patients with an unsuccessful superselective catheterization into the proper hepatic artery by Seldinger technique or obstruction of the main trunk of the portal vein were treated with percutaneous transcatheter arterial infusion into the common hepatic artery regardless of stage (protocol 3). Tumor type and extension, area of tumor involvement, portal vein involvement, method of treatment, and presence of ascites and icterus were found to be the significant factors for an initial response to therapy. Treatment method was the most important factor. Respective survival rates at 1 and 2 years were 70.9% and 55.3% for protocol 1a; 62.3% and 43.8% for protocol 1b; 37.8% and 18.3% for protocol 2; and 16.5% and 0% for protocol 3. Many factors proved to significantly influenced prognosis; however, tumor type had the most important prognostic significance followed by AFP value, ascites, treatment protocol, and area of tumor involvement.

Adult↗
PubMed1991

Differential diagnosis of gastric adenoma and type IIa early gastric cancer.

The endoscopic and radiographic findings of 45 gastric adenomas in 39 patients were followed for 6 months to 13 years and compared with type IIa early gastric cancer observed in 9 patients. Difficulties in the differential diagnosis of these disorders were evaluated. The following features were suggestive of gastric adenomas: clustered lesion; protuberance with gentle slope; smooth surface; and relatively young patients. Discrimination of adenoma from type IIa early gastric cancer is often difficult by visual observation alone; biopsy was essential in most patients. A group III adenoma verified on biopsy should be followed closely because the lesion may harbor a cancer (so-called carcinoma-in-adenoma) or a cancer may later develop.

Adenoma↗
PubMed1990

Prognostic factors in liver metastases after transcatheter arterial embolization or arterial infusion.

From January 1986 to December 1988, 85 patients (55 men and 30 women, mean age 59 years) with metastatic liver tumors were treated with hepatic artery embolization (TAE) or infusion (HAI). Sixty-eight patients with successful catheterization were treated with TAE using iodized oil (Lipiodol) mixed with anticancer agent (ACA). In 12 of 68 patients with hypervascular tumors gelatin sponge was added. Patients with unsuccessful catheterization were treated with hepatic artery infusion of ACA. Forty-three patients received oral chemotherapy following TAE or HAI. Overall, the 6-month, and 1- and 2-year survival rates were 69.5, 31.8 and 4.1 per cent, respectively (mean 233 days). A univariate analysis of prognostic factors showed that number of metastases, stage, treatment times and oral chemotherapy were all significant factors (p less than 0.05). Ascites, jaundice, percentage of hepatic replacement and treatment protocol also had some influence (p less than 0.1). Sex, age, primary site, elevation of tumor markers, other metastatic lesions, portal vein involvement and difference in anticancer agent had no prognostic significance. A multivariate analysis using Cox's proportional hazard model revealed that the number of treatments had the most important prognostic significance, followed by oral chemotherapy, stage and percentage of hepatic replacement.

Antineoplastic Agents↗
PubMedDate not supplied

Clinical evaluation of gastric fundic gland polyps without familial polyposis coli.

BACKGROUND: Assessments were made of 63 cases of fundic gland polyposis (FGP) unassociated with adenomatosis coli. These cases were evaluated by radiological examination over 2 years follow-up. All polyps were pathologically confirmed by endoscopic biopsies. METHODS: Most cases were asymptomatic when diagnosed during mass radiological surveys of the upper gastrointestinal tract. The majority of patients ranged in age from 40-60 years, and the polyps numbered fewer than 20 in 55 cases (87.3%). Polyps were detected in the fundic glands using the congo red test and by biopsies. RESULTS: All serum gastrin values were within the normal range. During the course of this study, the polyps of 13 cases (20.6%) increased and those of three cases (4.8%) decreased or resolved completely. CONCLUSION: From these findings it is considered that FGP are observed in stomachs with less atrophy, and that polyps follow courses in which they increase, decrease, disappear, along with atrophy.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Metastatic liver tumor from cystic ovarian carcinomas: CT and MRI appearance.

OBJECTIVE: The initial and follow-up CT and MRI images of ten patients with hepatic metastases from ovarian tumors were retrospectively analyzed to establish their features and sequential changes in appearance. MATERIALS AND METHODS: Ten patients with hepatic metastasis from ovarian tumors received initial and follow-up CT and MRI examinations. Six patients were followed up every two to three weeks before surgical tumor resection. Both CT and MR images were analyzed by two radiologists. RESULTS: A total of fourteen lesions were detected by CT and MRI in 10 patients. All 14 lesions were demonstrated as areas of marked hyperintensity on T2-weighted MRI. Eleven cyst-like tumors were demonstrated as round or oval low density lesions on CT and as areas of hypointensity on T1-weighted imaging. Three lesions were shown as solid masses with slightly low attenuation at the initial CT examination and slightly low or iso-intensity areas on T1-weighted imaging, and these lesions showed early peripheral globular enhancement and delayed enhancement on contrast-enhanced CT and MR imaging. Cystic formation was observed two to three weeks later after initial study in all the 3 solid lesions. Rapid subcapsular effusion, which showed obvious enhancement on delayed Gd-DTPA enhanced MR imaging, was observed in two patients. CONCLUSION: The hepatic metastatic tumor from cystic ovarian carcinoma may manifest as a well-defined cystic lesion or as a solid mass, and the solid mass shows delayed enhancement on contrast-enhanced CT and MR imaging. Furthermore, rapid cystic formation and rapid subcapsular extension is frequently seen.

Adult↗
PubMedDate not supplied

Small cell carcinoma of the stomach: a case report.

A case of a gastric small cell carcinoma discovered incidentally by screening ultrasonography is presented. Ultrasonography demonstrated a subcardial metastatic lymph node and multiple hepatic metastatic lesions. Upper GI series and gastroendoscopy revealed a large ulcerated tumor in the cardia of the stomach, and a Borrmann type II tumor, 4 x 2.5 cm, was found in the resected stomach. We describe the radiological findings of the upper GI series, ultrasonography, CT, and gastroendoscopy, and review the literature.

Aged↗
PubMedDate not supplied

Transjugular intrahepatic portosystemic shunt: initial clinical experience and three-year follow-up.

To define the role of transjugular intrahepatic portosystemic shunt (TIPS), we prospectively studied 12 patients undergoing this procedure for variceal bleeding, refractory ascites, and hemorrhagic gastropathy due to portal hypertension. The TIPS creation was successful in 11 patients, and portal pressure immediately decreased an average of 8.3 cm H2O. Esophageal varices improved in six of seven patients, but gastric varices with spleno- or gastro-renal shunt did not change in three of four patients. A hemorrhage from portal hypertensive gastropathy was controlled immediately. Ascites improved in all six patients. Hepatic encephalopathy newly developed in four patients, but was controllable with medical treatment. During the follow-up period (mean, 25 months), shunt dysfunction was evident in eight of 10 patients. Stenosis and occlusion of the shunt were successfully treated by redilatation and/or placement of an additional stent. The cumulative survival rate was 73% at one year and 64% at two years. These results suggest that TIPS is a safe and effective treatment for uncontrollable complications due to portal hypertension, but is not effective for gastric varices with spleno- or gastro-renal shunt. Careful follow-up and shunt revision are necessary for the maintenance of shunt patency.

Adult↗