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Biomedical subjects

K Mieno

Publications and source records attributed to K Mieno.

17 recordsLinked to original sources
PubMed1998

A new method of peritoneal closure following laparoscopic herniorrhaphy.

Of the three most commonly used methods of repairing inguinal hernias laparoscopically, we believe that the transabdominal (TAPP) approach is the most effective. To perform this technique successfully, complete closure of the peritoneum is recommended to avoid the formation of postoperative adhesions. Here we describe a technique that employs the Endo Stitch instrument, facilitating easier closure of the peritoneum.

Hernia, Inguinal↗
PubMed1992

[Decision analysis in therapeutic strategies for small bowel obstructions].

Clinical decision analysis was applied in therapeutic decision-making regarding small bowel obstructions. For strangulation obstruction, the three strategies of immediate surgery, observation of clinical course, and decision according to ultrasonographic findings were analyzed. When mortality rate, morbidity rate, or duration of hospital stay was used as the utility value, decision on the basis of ultrasonographic findings was selected as the most effective strategy, while the strategy of immediate surgery was selected when the rate of intestinal necrosis was used as the utility value. For adhesive obstructions, the three strategies of immediate surgery, conservative treatment with long tube decompression, and long tube decompression with enteroclysis (infusion contrast radiography) were analyzed. The strategy of enteroclysis was selected when morbidity rate and duration of hospital stay were used as utility values, while immediate surgery was selected when recurrence rate of adhesive obstruction was used as the utility value. For obstruction caused by intraabdominal recurrent cancer, operative treatment and conservative treatment were analyzed. The strategy of surgery was selected when rate of obstruction resolved and number of months of survival were used as utility values. Clinical decision analysis is valuable in quantitatively assessing individual variables affecting therapeutic decision-making.

Decision Support Techniques↗
PubMed1991

[Problems with topical therapies for extensive squamous cell carcinoma of the buttocks].

In patients in whom cancer originating from a bed-sore has advanced to a stage where radical treatment is impossible, topical treatment with ointment, or systemic anti-cancer chemotherapy, is usually applied. We recently attempted treatment of extensive squamous cell carcinoma of the buttocks, for which radical treatment was impossible, by chemotherapy using a reservoir for intraarterial injection. This therapy involved intraarterial injection of bleomycin and 5-FU, together with topical treatment with 5-FU ointment. We describe the problems encountered with this therapy, e.g., measures against fever after intraarterial injection, management of the affected area, evacuation, possibility and limits of radiation therapy, and assessment of its efficacy.

Administration, Topical↗
PubMed1990

[Evaluation of reservoir inserted for the prevention of liver metastasis of colorectal cancer].

The subjects were 22 patients who had undergone intra-arterial chemotherapy using reservoirs for prevention of postoperative liver metastasis during the period from January 1986 to September 1989, 3 with non-resected liver metastasis, 1 with resected liver metastasis with intra-arterial chemotherapy, and patients with systemic chemotherapy. None of the 7 patients with macroscopic stage II disease, who had undergone intra-arterial therapy for the prevention of liver metastasis survived (maximum duration, 25 months), had liver metastasis. Two of 8 patients with stage III disease died, and liver metastasis was observed. Two of 7 patients with stage IV disease died, one of whom them had liver metastasis. Four of 12 patients with stage II disease treated by systemic chemotherapy died, and 2 of them had liver metastasis. Four of 18 patients with stage III disease treated by systemic chemotherapy died, and one of them had liver metastasis. One of 11 patients with stage IV disease systemic chemotherapy died, and liver metastasis was noted in another. None of the patients who had undergone intra-arterial chemotherapy for the prevention of liver metastasis had liver metastasis within a period of one year. At present there is no difference in survival period between the group given intra-arterial chemotherapy for the prevention of liver metastasis and the group given systemic chemotherapy.

Colorectal Neoplasms↗
PubMed1989

[Effects of intra-arterial infusion chemotherapy in local recurrence of anal cancer].

At present, there is no effective local therapy for skin metastasis after radical operation for anorectal cancer. Most local recurrent lesions of this type are not indications for surgery. However, successful control of the local lesion can enhance the quality of life because the general condition is good. We performed intra-arterial infusion chemotherapy for skin metastasis after Miles operation for anorectal cancer and observed marked effects. A 62-year-old female with anal cancer underwent Miles operation in November, 1987. About July, 1988, an indurated mass appeared in the perineal region but was left untreated. However, urinary disturbance due to the mass developed, and she was admitted in September. A catheter for Intra-arterial infusion chemotherapy was inserted via the lateral deep femoral artery, and 5-FU, BLM, and MMC were administered. Local bleeding was stopped, and the mass began to be reduced about 16 days after the administration. After about 1 month, no secretion from the mass was observed, and the urinary disturbance improved due to a reduction in the mass.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Improvements in placement of implantable drug delivery catheter for prevention and treatment of hepatic metastases from colorectal cancer].

Intra-arterial infusion chemotherapy was carried out using a subcutaneously implantable drug delivery system in 7 patients with rectal cancer, 5 patients with sigmoid colon cancer, 2 patients with transverse colon cancer, and 1 patient with ascending colon cancer, for prevention and treatment of hepatic metastases. The transport of intra-arterially infused drugs to the liver was examined during surgery using an infusion catheter, which was inserted by the fluorescence technique using Fluorescein-Na. The gastroepiploic artery was shifted to the abdominal wall to avoid leaving the infusion catheter as a foreign body after removal of the port. The fluorescein test, which is safe and can be performed in a short period by a simple procedure, is considered to be useful for intraoperative evaluation of the distribution of the drug to the liver. Since the infusion catheter remaining in the body after removal of the port may cause thrombosis and infection, measures to avoid leaving foreign bodies are considered to be necessary.

Antineoplastic Agents↗
PubMed1987

Effects of medroxyprogesterone acetate on sleep of healthy young male adults.

The effects of a single 100 mg dose of medroxyprogesterone acetate (MPA) on human sleep were investigated using healthy young male adults. After a baseline night recording, two consecutive MPA nights and the following two withdrawal nights were recorded. The total sleep time was reduced after the 2nd MPA night and the decrease was significant on the 1st withdrawal night. The time of intrasleep awakening increased after the 2nd MPA night. Stage 1 sleep increased significantly on the 2nd MPA and 1st withdrawal nights. Stage 4 sleep decreased and the sleep latency gradually increased after the MPA administration. REM sleep reduced slightly on the 1st withdrawal night. These results indicate that MPA has a mild arousal action on human sleep and that the action may be pronounced a few days after administration of MPA.

Adult↗