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K Tsukada

Publications and source records attributed to K Tsukada.

At least 19 recordsLinked to original sources
PubMed1995

Hepatic metastases from carcinoma of the gallbladder.

BACKGROUND: The optimal hepatic resection margin for gallbladder cancer (GBC) is still debated. To explore this issue, the authors analyzed the mode of hepatic spread of GBC. METHODS: Of 85 patients undergoing radical cholecystectomy, 20 had hepatic metastases. The pattern of hepatic metastasis was examined grossly and histologically in specimens. RESULTS: Twelve patients had evidence of microscopic angiolymphatic portal tract invasion, with or without direct liver invasion. Four had direct invasion alone, and three had distant hepatic metastatic nodules. The distance (y axis) between the farthest angiolymphatic lesion and primary tumor (mm) correlated significantly with the gross depth (x axis) of direct invasion (mm): y = 1.3 + 0.33x (r = 0.88, P < 0.01). Three patients with metastatic nodules died of blood-borne disease within a year. Eight of the others obtained either long-term palliation or cure after potentially curative resection. Lymph node metastases were detected in 90% of patients. CONCLUSIONS: The extent of microscopic angiolymphatic portal tract invasion correlates well with the gross depth of direct invasion of the liver. This correlation may be useful for estimating adequate hepatectomy margins. A hepatectomy with an adequate margin combined with a radical lymphadenectomy provides benefit for selected patients with hepatic metastases.

Aged↗
PubMed1995

Blunt pancreatic trauma with main pancreatic duct disruption managed successfully with total parenteral nutrition: report of a case.

Although surgery is the usual treatment of choice for pancreatic trauma with disruption of the main pancreatic duct, we report herein the case of a patient in whom blunt pancreatic trauma with disruption of the proximal main pancreatic duct was successfully managed by conservative treatment. An 18-year-old women presented with abdominal pain 22 days after being involved in a car accident in which her upper abdomen was thrust against the steering wheel. Computed tomography revealed a pancreatic pseudocyst and a prevertebral pancreatic fracture, and endoscopic retrograde pancreatography showed complete disruption of the main pancreatic duct at the neck. Considering that the patient had been clinically stable since the accident, we elected to continue with conservative management and placed her on total parenteral nutrition. Rapid recovery followed and 6 years later, the patient remains well without any exocrine or endocrine insufficiency despite atrophy of the distal pancreas. This experience indicates that selected cases of main pancreatic duct disruption following blunt trauma may be amenable to conservative management.

Adolescent↗
PubMed1995

Hepatic functional reserve in patients with obstructive jaundice: an assessment by the redox tolerance test.

PURPOSE: Hepatic mitochondrial response to oral glucose load (redox tolerance test) was evaluated as an indicator of hepatic functional reserve of patients with obstructive jaundice. PATIENTS AND METHODS: The redox tolerance test was performed in 29 patients with obstructive jaundice before percutaneous transhepatic biliary drainage and 2 weeks after the procedure. RESULTS: The redox tolerance index (RTI) before drainage was not related to conventional parameters other than albumin, but was significantly associated with bilirubin half-life (P < 0.01). Of 19 patients with an RTI > or = 0.5 before drainage, all maintained similar values after drainage and experienced satisfactory clinical courses, even after major surgery. Of 10 patients with an RTI < 0.5 before drainage, 5 showed improvement and 5 deteriorated after drainage. Four of the latter 5 died within 60 days after drainage. The hospital mortality was significantly greater in patients with initial RTI < 0.5 than in patients with RTI > or = 0.5 (P < 0.01). CONCLUSION: The redox tolerance test is useful for evaluating hepatic functional reserve and prognosis in patients with obstructive jaundice.

Adult↗
PubMed1994

Molecular properties, substrate specificity and regulation of DNA-dependent protein kinase from Raji Burkitt's lymphoma cells.

A double-stranded DNA-dependent protein serine/threonine kinase (DNA-PK) was purified from a nuclear extract of Raji Burkitt's lymphoma cells by a three-step column-chromatographic procedure. The main silver-stained band visualized after SDS/PAGE corresponded to an autophosphorylated polypeptide of about 350-kDa that represents the catalytic component. The existence of Ku DNA-binding protein as a regulatory component in the purified enzyme was revealed by Western blot/enzyme immunoassay and direct inhibition test with anti-Ku sera from the autoimmune patients. The DNA-PK catalyzed phosphorylation of synthetic peptides corresponding to Myc and RB proteins in a DNA-dependent manner, indicating that DNA-PK may recognize a second core-sequence motif Pro-Ser/Thr- in addition to the putative consensus sequences of -Ser/Thr-Gln. The level of enzyme activity was significantly higher in DMSO-induced G0/G1-arrested Raji cells as well as in the cells after release from DMSO than in the log-phase cells.

Amino Acid Sequence↗
PubMed1994

Stimulation of DNA-dependent protein kinase activity by high mobility group proteins 1 and 2.

After incubation of high mobility group (HMG) proteins 1 and 2 with DNA-dependent protein kinase (DNA-PK) and [gamma-32P]ATP in the presence of double-stranded DNA, not only phosphorylation of HMG proteins but also enhancement of autophosphorylation of the catalytic polypeptide of 350 kDa in DNA-PK was observed. DNA-PK activity determined with a synthetic peptide and alpha-casein as substrates was stimulated several-fold by HMG1, HMG2, and the DNA-binding domains. The stimulation was decreased at higher concentrations of HMG proteins, and DNA-PK activity was inhibited by histone H1. Electrophoretic mobility shift analysis suggests that HMG proteins facilitate the binding of DNA-PK to DNA.

Adenosine Triphosphate↗
PubMed1994

Major hepatectomy and pancreatoduodenectomy for advanced carcinoma of the biliary tract.

Seven patients with advanced carcinoma of the extrahepatic biliary tract, including two with cancer of the gallbladder, underwent major hepatectomy with concomitant pancreatoduodenectomy. The mean hepatic volume resected was 64 (range 35-81) per cent. Postoperative complications occurred in all patients and accounted for two hospital deaths. Two patients with gallbladder carcinoma survived without recurrence for 22 and 58 months. Three of five patients with bile duct cancer survived operation, although all three subsequently died from recurrent disease at 8, 10 and 27 months. Combined major hepatectomy and pancreatoduodenectomy may be appropriate in selected patients with advanced cancer of the gallbladder. Further evaluation is necessary before this approach can be recommended for those with advanced bile duct carcinoma.

Aged↗
PubMed1994

Liver regeneration is enhanced by omeprazole in rats following partial hepatectomy.

The effect of omeprazole on liver regeneration was studied in rats following partial (65 per cent) hepatectomy. Omeprazole 0.2 mg/kg increased the relative liver weight (weight of liver as a proportion of body-weight) and mitotic index (P < 0.05). There was no difference in food and water intake. The serum gastrin concentration was significantly higher in animals receiving omeprazole 0.2 mg/kg than in controls (P < 0.05). Omeprazole administration induced an increase in the level of serum alkaline phosphatase (P < 0.05) but had no effect on serum albumin, glutamic-pyruvic transaminase and total bilirubin levels. Omeprazole stimulates liver regeneration after partial hepatectomy and this regeneration may be mediated by gastrin.

Animals↗
PubMed1994

OK432 inhibits experimental hepatic metastasis of colon adenocarcinoma ACL-15 in F344 rats.

The effect of OK432 on hepatic metastasis, induced by inoculating 1 x 10(6) ACL-15 cells from a rat colon adenocarcinoma cell line into the ileocolic vein of male F344 rats, was investigated in this study. Metastases were detected 14 days after inoculation in the control rats, however, pretreatment 3 days prior to the tumor cell inoculation with an anti-asialoGM1 antibody, which eliminates natural killer (NK) cell activity in vitro, increased the number of hepatic metastases, shortened the survival time, and decreased the NK activity of the nonparenchymal liver cells (NPC). In contrast, pretreatment with OK432 2 days prior to tumor inoculation significantly decreased the number of hepatic metastases, prolonged the survival time, and augmented the NK activity of the NPC, although treatment with OK432 3 or 7 days after inoculation did not decrease the number of hepatic metastases. Moreover, NPC from the OK432-pretreated rats had a marked antitumor effect against ACL-15 cells in the Winn's neutralization test. The results of this study indicate that pretreatment with OK432 before tumor cell inoculation inhibits hepatic metastasis in this experimental model, possibly by augmentating liver-associated NK activity.

Adenocarcinoma↗
PubMed1994

Enhanced hepatic portal blood flow induced by prostaglandin E1 following liver transplantation in pigs.

Portal venous blood flow (PVF), hepatic arterial blood flow (HAF), and systemic arterial pressure (SAP) were examined after prostaglandin E1 (PGE1) was injected into the vena cava superior (VCS) of liver-transplanted pigs. The injection of PGE1 at 0.2 micrograms/kg/min for 2 min on the day of transplantation and 3 days later produced an increase in PVF without causing any change in HAF or SAP, the response in PVF being dose-dependent. However, no reliable change in PVF, HAF, or SAP was seen when the same dose of PGE1 was administered 7 days after transplantation. Furthermore, no significant difference was noted among the values for PVF and total hepatic blood flow (THF) during the experimented days, although the HAF value had increased markedly 3 days after transplantation. These findings suggest that PGE1 is effective in increasing PVF in the liver transplanted condition; however, the hepatic circulatory improvement attributed to this agent would be limited to the first few days following transplantation.

Alprostadil↗
PubMed1994

Long-term results after nonshunt operations for esophageal varices in children.

The clinical results of nonshunt operations for esophageal varices in 15 children were evaluated. The varices were caused by congenital extrahepatic portal obstruction (EHPO) in 10, liver cirrhosis or fibrosis (C/F) in 3, and idiopathic portal hypertension (IPH) in 2. The operative procedures were transthoracic esophageal transection with paraesophageal devascularization (TR) for 2 EHPO patients under 5 years of age, TR combined with splenectomy and paragastric devascularization (Sugiura procedure) for 11 (8 EHPO, 3 C/F), and splenectomy with devascularization (SP) or splenectomy for the 2 IPH patients. In the EHPO patient under 5 years of age, TR is associated with a likelihood of gastric or esophageal hemorrhage resulting from hypersplenism, gastric congestion, or persistent distal esophageal varices, which can be treated with partial splenic arterial embolization (PSE), endosclerotherapy, or an additional abdominal procedure. The Sugiura procedure has provided satisfactory long-term results, without rebleeding from esophageal varices, in patients with EHPO and C/F for 1 to 20 years. But EHPO patients who undergo the Sugiura procedure before age 6 can have gastric hemorrhage, because of mucosal congestion, for more than 10 years after the procedure, and selective gastric arterial embolization (GAE) might be necessary. In some EHPO patients, especially young ones who have variceal bleeding, a significant increase in hepatopetal portal flow may not develop, but hepatofugal natural shunts may progress. Therefore we recommend direct operative procedures, ie, TR for patients < or = 6 years of age and a one- or two-stage Sugiura procedure for those over 7 years old.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Peritoneal interleukin-6, interleukin-8 and granulocyte elastase activity after elective abdominal surgery.

In this study we investigated the interleukin-8 concentration (IL-8) and granulocyte elastase activity (GE) after elective abdominal surgery. Postoperative interleukin-6 (IL-6), IL-8 concentrations and GE in the peritoneal fluid were examined in 27 patients who underwent various types of elective abdominal surgery. We compared these results with clinical parameters of surgical stress, operating time (OT) and blood loss during the operation (BL). P-IL-6 and P-IL-8 were significantly correlated with OT (P-IL-6; r = 0.67, P < 0.001: P-IL-8; r = 0.59, P < 0.001) and BL (P-IL-6; r = 0.61, P < 0.001: P-IL-8: r = 0.48, P < 0.01). P-IL-8 was significantly correlated with P-IL-6 (r = 0.68, P < 0.001) and there was a positive correlation between GE and P-IL-8 (r = 0.37, P < 0.05). These findings indicate that IL-8 might activate granulocytes in the peritoneal cavity after elective abdominal surgery and that assaying P-IL-6 and P-IL-8 is useful in assessing the host's response to surgical stress.

Abdomen↗
PubMed1994

Endothelin-1 stimulates bile acid secretion and vesicular transport in the isolated perfused rat liver.

The effects of endothelin (ET) on portal pressure and bile secretion were examined using isolated perfused rat liver and rat hepatocyte preparations. ET-1 raised portal pressure dose dependently; administration at a high dose (10(-9) mol) induced a > 200% increase along with reduced bile flow and decreased secretion of bile acid and phospholipids. However, a low dose (10(-10) mol) of ET-1 brought about a < 100% portal pressure rise, enhanced both bile flow and excretion of bile acid and phospholipids, and significantly increased transfer of preadministered horseradish peroxidase (HRP) into bile. In addition, values for Ca2+ concentrations, examined by indo 1 fluorescence, were elevated in isolated hepatocytes after administration of ET-1. Papaverine suppressed the low-dose ET-1 stimulation effects on both portal pressure and bile secretion. Moreover, it also reduced the HRP excretion and suppressed intracellular Ca2+ release. This study demonstrated that ET-1 stimulates vesicular transport, probably via promotion of intracellular Ca2+ release, and, as a result, increases bile acid-dependent bile flow.

Animals↗
PubMed1994

[Thyroid function abnormalities during interferon therapy].

One hundred and twenty patients with chronic hepatitis C were treated with a 6-month course of recombinant alpha-interferon (a daily dose of 6 MU i.m. for the first two weeks and 6 MU or 3 MU i.m. three times weekly thereafter). Serum levels of thyroxine (T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), antithyroglobulin antibody (TGHA) and antimicrosomal antibody (MGHA) were measured before and three month after treatment. Ten of 106 patients with normal thyroid function test before therapy developed thyroid dysfunction; five with hyperthyroidism, four with hypothyroidism and one with positive MCHA. Fourteen patients had thyroid function disorder before treatment. Seven of eight patients with positive MCHA, showed a rise in the titer during the treatment. These data showed that a small proportion of patients treated with interferon developed thyroid dysfunction during the treatment. The interferon-induced thyroid dysfunction appears to be caused via the immune system but also by acting directly on the thyroid gland.

Adult↗
PubMed1994

The association between extrahepatic biliary carcinoma and the junction of the cystic duct and the biliary tree.

OBJECTIVE: To establish accurately the sites of primary extrahepatic biliary carcinomas, so that optimal treatment may be given. DESIGN: Retrospective study. SETTING: University department of surgery. SUBJECTS: 120 patients with 121 primary extrahepatic biliary carcinomas. MAIN OUTCOME MEASURES: Site of tumour (primary site being geometric centre of tumour) and distance from junction of cystic duct and the biliary tree on histological examination of the resected specimen. RESULTS: 64 of the tumours (53%) were within 5 mm of the junction; 14 were proximal to the junction, 32 distal, and 18 within the cystic duct itself. CONCLUSIONS: Over half the primary extrahepatic biliary tumours were within 5 mm of the junction of the cystic duct and the rest of the biliary tree. Further investigations are required to find out if any particular aetiological factor can be identified.

Adenocarcinoma↗