[Serum type IV collagen (7S domain) levels as the marker of hepatic metastases in gastrointestinal carcinomas: preliminary report].
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Biomarkers, Tumor↗
Biomedical subjects
K Okui
Publications and source records attributed to K Okui.
[Preoperative radiotherapy in rectal carcinoma. I. The effect of irradiation on the tumor volume].
We studied an effect of preoperative radiation upon the change of tumor volume in rectal carcinoma. As a preliminary study, tumor volume of 15 cases of rectal carcinoma with no preoperative irradiation was estimated preoperatively using the transrectal ultrasonography, and were compared with those determined by resected specimens after operation. As a result, there was a parallel relationship between the two values, and mean estimation error rate was 14.6%. Next, the same method was applied to 15 patients with rectal carcinoma who underwent preoperative radiation in order to detect the reduction rate of tumor volume after radiation therapy (42.6 Gy). As a consequence, 80% of cases exhibited the reduction rate more than 50% with an average of 61.7%. It was suggested that the determination of pre- and postoperative tumor volume would be beneficial to evaluation of preoperative radiation therapy as well as decision of the optimal dose of radiation in rectal carcinoma.
Adenocarcinoma↗
[Open aortic technique for DeBakey type II dissection].
Two patients with chronic dissecting aneurysm (DeBakey type II) underwent graft replacement using open aortic technique. During proximal anastomosis, the body temperature of the patients was lowered to 23 degrees C and open distal anastomosis was performed under circulatory arrest of the lower body using selective perfusion to the brain. Graft-to-aorta anastomosis was performed in distal ascending aorta (case 1) and in aortic arch (case 2), after the approximation of inner and outer layer of the false lumen. Two patients survived operations, and the postoperative courses and postoperative angiograms were satisfactory. Open aortic technique was considered to be applied not only to patients with arch aneurysm or arch dissection but also to patients with DeBakey type II or type I dissection.
Aged↗
[Transcatheter embolization of splenic artery aneurysm; a case report].
A 76-year old woman with splenic artery aneurysm was treated by nonsurgical treatment. Surgical treatment has been recommended for the treatment of visceral aneurysms because these aneurysms may rupture and lead to fatal hemorrhage. This report describes the successful interventional coil and Gelfoam occlusion of splenic aneurysm.
Aged↗
The diagnostic accuracy of magnetic resonance imaging in pancreatic carcinoma based on a retrospective analysis of vascular involvement.
A retrospective analysis was made to evaluate the diagnostic accuracy of magnetic resonance (MR) imaging for pancreatic cancer. Twenty-one lesions from 21 patients with pancreatic cancer were examined and all except one, were identified on MR images by a disparity in contrast and/or morphological enlargement. The patients were divided into 3-groups, based on the relationship between the tumor and the portal vein, seen on the MR images. These groups were defined as the separate, touching, and surrounding groups. The MR findings correlated with the findings at laparotomy in 16 patients, 10 of whom underwent tumor excision. In the remaining 4, the MR findings correlated with the angiographic findings. The presence or absence of vascular involvement was correctly diagnosed in 18 of the 21 patients. MR imaging proved useful for detecting pancreatic cancer and cancerous infiltration into the portal vein. MR imaging should therefore aid the surgeon in determining the operability and/or curability of patients with pancreatic cancer.
Adult↗
Mucinous cystadenocarcinoma of the colon. Report of a case.
A rare case of mucinous cystadenocarcinoma arising in the sigmoid colon, found accidentally during an operation for cholecystolithiasis, is reported. The tumor was located 40 cm from the anal verge, and had two histologic variations consisting of a large distended cystic lesion and branching cystic channels with papillary proliferation of the epithelium. Serial sections revealed the existence of a luminal communication between the two lesions. The tumor tissue was seen mainly in the muscularis propria with no mucosal involvement. The papillary portion had a highly differentiated appearance, giving rise to considerable difficulty in determining whether it was benign or malignant. In a localized area, however, the tumor invaded into the subserosa and showed distinctive atypical changes. The tumor cells showed intense reactivity for carcinoembryonic antigen. This mucinous cystadenocarcinoma was considered to be originated from an enterogenous cyst, a possible derivative of duplication of the colon. The differential diagnosis concerning this rare tumor is also discussed.
Aged↗
[Pharmacokinetic analysis in intraperitoneal hyperthermic perfusion using mitomycin C in far-advanced gastric cancer].
Postoperative intraperitoneal hyperthermic perfusion (IPHP) using MMC was performed with marked success on 15 gastric cancer patients with peritoneal dissemination or serosal invasion (first surgery group) and on 5 recurrent gastric cancer patients with ascitic retention (recurrent cancer group), and the MMC concentrations was studied in the perfusate and circulating blood. The perfusate contained MMC 10 micrograms/ml at the onset of IPHP, except one recurrent case of 20 micrograms/ml, and IPHP was performed for 120 minutes except in one case given 20 micrograms/ml of MMC. There was little difference in the hepatorenal functions and perfusate temperatures between the first surgery group and the recurrent cancer group. The drug levels were measured by HPLC method with minimal assay levels of 2 ng/ml. Perfusate drug levels in the first surgery group reduced by half at 12 minutes after the start of IPHP, whereas in the recurrent cancer group, they decreased by half about 60 minutes later. Perfusate drug levels in the first surgery group decreased twice as rapidly as in the recurrent cancer group. The area under the curve (AUC) and average drug levels in the first surgery group were 7,900 micrograms.hr/l and 3.3 micrograms/ml, respectively, and those in the recurrent cancer group were 12,620 micrograms.hr/l and 5.3 micrograms/ml, respectively. On the other hand, the drug levels in peripheral blood were almost the same between the two groups. These data suggest that although recurrent gastric cancer is well suited for IPHP because of high AUC, it is worthwhile performing IPHP combined with surgery for gastric cancer with peritoneal seeding, with due consideration for AUC of 7,900 micrograms.hr/l and the average drug level of 3.3 micrograms/ml.
Adult↗
Pharmacokinetic analysis in intraperitoneal hyperthermic chemotherapy of far-advanced gastric cancer patients.
The pharmacokinetics of mitomycin C (MMC) has been evaluated in 10 far-advanced gastric cancer patients by means of an intraperitoneal hyperthermic perfusion (IPHP) using MMC to prevent and/or treat peritoneal dissemination. Further, misonidazole (MIS), which was used as a thermosensitizer, also was evaluated. The IPHP was performed for 120 min right after surgical procedure, using a closed-circuit with an inflow perfusate temperature from 46.3 approximately 47.5 degrees C and an outflow temperature of 44.0 approximately 46.0 degrees C. The MMC level in the perfusate was 10 micrograms/ml at the onset of IPHP and thereafter decreased to 1.7 +/- 0.4 micrograms/ml minutes later. The average AUC (area under the curve) in the perfusate was 3.3 micrograms/ml during the IPHP. The MMC level in the peripheral blood was 0.15 +/- 0.04 micrograms/ml 30 min after start of the IPHP and increased to 0.18 +/- 0.05 micrograms/ml at the end of IPHP. Additionally, the MIS level in the peripheral blood was 64.7 +/- 10.3 micrograms/ml 60 min after the IPHP, 60.6 +/- 9.2 micrograms/ml at 120 min, and then decreased to 32.8 +/- 10.3 micrograms/ml at 12 hours after IPHP. The AUC was calculated as being 975 micrograms.hr/ml. Again, the level in the portal vein blood was calculated from the peritoneal permeability and the peripheral blood level of the drug. From data, it was concluded that the perfusate and portal vein blood level of MMC, the peripheral blood level of MIS, as well as the perfusate temperature, are important in providing a favorable, safe, antitumoral treatment.
Adult↗
[A study of adequate energy, amino acid, and carbohydrate requirements in postoperative total parenteral nutrition--the effect of branched chain amino acid (BCAA) and carbohydrate mixture of glucose, fructose, and xylitol (GFX)].
This study was performed to elucidate adequate energy and amino acid (AA) requirements for TPN patients after abdominal surgery. The effects of AA formula, rich in BCAA (30% BCAA), as a nitrogen source and the carbohydrate mixture of glucose, fructose, and xylitol (GFX = 4:2:1), on nitrogen sparing were also studied. Forty-nine patients having undergone major abdominal surgeries, were divided into 5 groups. The regimens were as follows: G1: 40kcal/kg, standard amino acid (21% BCAA) 1.5g/kg. day, G2: 40kcal/kg, 30% BCAA 1.5g/kg.day, G3: 30kcal/kg, 21% BCAA 1.5g/kg.day, G4: 30kcal/kg, 30% BCAA 1.5g/kg.day, G5: 40kcal/kg, 21% BCAA 1.5g/kg.day. Glucose was the sole carbohydrate energy source in G1 through G4. In G5, GFX was used. (1) Accumulated nitrogen balances during the week immediately after operation were significantly higher in G1 and G2 where higher energy intakes were administered than G3 and G4. (2) The nitrogen balances during the 2nd or 3rd postoperative days in G2 or G4, using 30% BCAA as a nitrogen source, were higher than in G1 or G3 respectively. (3) The changes in serum rapid turnover proteins were not significantly different among these groups. (4) The accumulated nitrogen balance in G5 tended to be higher than that of G1. These results indicate that BCAA rich amino acid formula will induce a more favorable nitrogen sparing effect than a conventional AA formula on TPN patients under surgical stress.
Adult↗
[Clinical evaluation of intraperitoneal hyperthermic perfusion in far-advanced gastric cancer].
Nineteen far-advanced gastric cancer patients, including peritoneal dissemination, underwent surgical treatment followed by intraperitoneal hyperthermic perfusion (IPHP). Seven of them had cancerous ascites, 5 had ovarial metastasis, and in 7 the primary tumor extended to the adjacent organs. Postoperatively, ascitic effusion was absent after IPHP, and all patients were discharged. The survival of the IPHP group was compared with that of 27 advanced gastric cancer patients with serosal invasion (control group), who underwent gastrectomy without IPHP. In the IPHP group, the average and 50% survival was 400 and 520 days, respectively, and 1-year survival rate was 73.3%, against 273 days, 250 days, and 31.8%, respectively, in controls. The survival rate for the IPHP group was statistically better than that of the control group (p less than 0.01). In patients with peritoneal dissemination, the average survival and 50% survival for the IPHP group was 396 and 380 days, respectively, and 1-year survival rate was 62.5%, against 204 days, 170 days, and 16.6%, respectively, in controls. Based on these results, IPHP was suggested to be effective for gastric cancer with serosal invasion, especially with peritoneal dissemination.
Adult↗
[Effect of degradable starch microspheres (DSM) on hepatic hemodynamics].
The effect of intra-arterial infusion of degradable starch microspheres (DSM) on hepatic arterial blood flow was measured using a transit-time ultrasonic blood flow meter. Before the infusion of DSM, the mean hepatic arterial flows were 316 +/- 79 ml/min. After infusion, the mean flows decreased to 43 +/- 86 ml/min (86%). RI-angiography using 99mTc-macroaggregated albumin (MAA) was performed to measure hemodynamic changes in the liver. T/N ratio of 99mTc-MAA accumulation was increased from 0.37 to 0.62. Based on the peripheral MMC blood levels after combined infusion with DSM and MMC, the mean AUC with MMC plus DSM was decreased to 55% of that of AUC with MMC alone. These results show that combined use of DSM is effective for intra-arterial chemotherapy against the hepatic cancer.
Hemodynamics↗
[A case report of hypertrophic obstructive cardiomyopathy after the correction of atrioventricular septal defect].
A 47-year-old woman who had closure of an atrioventricular septal defect and repair of mitral cleft developed severe dyspnea on effort 6 years after surgery. An echocardiography showed asymmetric left ventricular hypertrophy and a left cardiac catheterization revealed marked intraventricular pressure gradient and moderately severe mitral regurgitation. The patient underwent mitral valve replacement through transseptal approach during empty beating heart. Symptomatic relief was obtained and marked reduction of intraventricular systolic pressure gradient was noted in postoperative cardiac catheterization about 40 days after the operation. Mitral valve replacement should be considered for the treatment of hypertrophic obstructive cardiomyopathy in severe cases with associated morphological abnormality of mitral leaflet or severe mitral regurgitation.
Cardiomyopathy, Hypertrophic↗
[Morphological study on aspiration cytology of breast cancer--relationship to prognosis and malignancy grade: preliminary report].
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Biopsy, Needle↗
Combined treatment with surgery and intraperitoneal hyperthermic perfusion (IPHP) for far-advanced gastrointestinal cancer with peritoneal seeding.
In 19 patients with advanced gastric carcinoma intraperitoneal hyperthermia combined with mitomycin C was administered. After this therapy in repeated cytological examinations of the peritoneal effusion malignant cells could be determined. From 19 patients 5 died innert the first 10 months. The other patients lived 12 months without recurrence.
Chemotherapy, Cancer, Regional Perfusion↗
[Beneficial effects of glucagon-insulin infusion on hepatic protein synthesis and DNA synthesis in partial hepatic ischemia].
To study the effects of glucagon-insulin (G-I) infusion on protein synthesis and DNA synthesis in a condition with partial hepatic ischemia, G-I or saline was infused via portal vein for 40 minutes before and after a period of partial hepatic ischemia or following a period of partial hepatic ischemia. Protein synthesis was measured by 14C-leucine incorporation into proteins in incubated liver slices and DNA synthesis by 3H-thymidine incorporation into DNA. Protein synthesis in the postischemic liver was significantly recovered faster and more completely in G-I treated rats. G-I infusion enhanced the DNA synthesis of postischemic liver significantly, peaking 48 hours after the period of partial hepatic ischemia. However, the dosage of G-I infused in this investigation couldn't increase the hepatic tissue blood flow measured by hydrogen gas clearance method. On the histological examination, mitotic index was significantly higher in G-I treated group than in control. These results suggest that G-I infusion could be beneficial effects on the liver in situation with partial ischemic injury and that G-I infusion could remarkably augment hepatic tissue repair following ischemic damage.
Animals↗
[A new trial assessment of left ventricular function before and after aorto coronary bypass surgery--application of ejection vector (E.V.)].
In 34 patients underwent aorto coronary bypass, left ventriculography was analyzed and ejection indexes (E.F. 100, E.F. 50, E.V. = 2 X E.F. 50/E.F. 100) were calculated. There was not difference in ejection indexes of patients between who had been complicated with preoperative myocardial infarction and not. E.F. 100 was not changed postoperatively, otherwise, E.F. 50 and E.V. showed significant increase. In 15 patients whose quality of life remarkably was improved postoperative period, E.F. 100 was not changed but E.F. 50 and E.V. were significantly increased. Four patients could not perform exercise test to full dose because of intractable ischemic calf pain. In twelve patients, whose left ventricular function was improved at postoperative exercise test, their E.F. 100 was found to be unchanged, but in contrast, E.F. 50 and E.V. were increased significantly. In conclusion, we found that E.V. could become to be more sensitive indicator of left ventricular function compared with E.F. 100 before and after aorto coronary bypass surgery.
Adult↗
[Polarographic analysis of tumor tissue oxygen tension after hyperthermia combined with misonidazole].
For the purpose to analyse the influence of a thermosensitizing drug, misonidazole (MIS), on tissue oxygen tension (TpO2), TpO2 in human gastric cancer tissue (H-23) was measured by a polarographic method. MIS, 500 mg/kg, was given i.p. and then the heat treatment was done in a water bath at 43.5 +/- 0.1 degrees C for 23 minutes. A second treatment was performed to develop thermotolerance at the following intervals: 24 hours, 72 hours, 5 days, and 7 days. Tumor doubling time was shortest at 72-hour interval, i.e., the maximal thermotolerance of the tumor developed at 72-hour interval, whereas the tumor doubling time in case of combined use of MIS was shortest at 24-hour interval. TpO2 in the 72-hour interval treatment decreased soon after hyperthermia, and returned to a pre-heated value 3 hours after, whereas in the other 3 treatments the recovery time was 6 to 12 hours. On the other hand, in 24-hour interval of the combined use of MIS, the post-thermal value of TpO2 was about a half of the pre-thermal value and recovered 24 hours after. In the 5- and 7-day interval treatments, TpO2 declined notably and did not return to the pre-thermal value during 24 hours. These data suggest that the thermo-sensitizing effects of MIS were brought about by prolonged and extreme decrease in TpO2.
Adaptation, Physiological↗
[Predictability of tumor invasion to the portal vein by pre-operative transarterial portography in biliary tract carcinoma].
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Bile Duct Neoplasms↗