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Biomedical subjects

M Ebara

Publications and source records attributed to M Ebara.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Non-vascular interventional radiology--percutaneous ethanol injection (PEI) in hepatocellular carcinoma smaller than 3 cm in diameter].

Percutaneous ethanol injection (PEI) was carried out for 109 lesions in 85 patients with hepatocellular carcinoma (HCC) smaller than 3 cm in diameter during the period from Dec. 1982 to Mar. 1989. Therapeutic effect of PEI on HCC was evaluated by ultrasound showing that 15 of 68 HCCs disappeared and the remaining 53 HCCs decreased in size with regression rates ranging from 8% to 88% at 6 months after PEI. Survival rates from PEI calculated by the Kaplan-Meier method showed a 1-yr survival of 92%, a 2-yr survival of 81%, a 3-yr survival of 61%, a 4-yr survival of 55%, and a 5-yr survival of 41%. These survival rates were better than those of patients with HCCs smaller than 3 cm in size who had not received anti-cancer treatment (p less than 0.05).

Administration, Cutaneous↗
PubMed1989

[Classification of liver cirrhosis based on parenchymal echo patterns and its clinical usefulness for diagnosis of liver cirrhosis].

Owing to the recent advancement of ultrasonographic instruments, we can now easily detect variously sized hypoechoic nodules as well as coarse echo pattern in cirrhotic liver. Based on the size and distribution of such hypoechoic nodules, we classified echo patterns of liver parenchyma into four types as follows. Type 0: Homogeneous echo pattern. Type I: Coarse echo pattern with no distinct hypoechoic nodules. Type II: Echo pattern showing scattered hypoechoic nodules sized 3 approximately 5 mm. Type III: Echo pattern showing scattered hypoechoic nodules sized more than 5 mm. In the present study, all the 25 patients of normal liver showed type 0, 29 of 42 patients with chronic hepatitis showed type 0 and the remained 13 type I. In 65 patients with liver cirrhosis, 54 (83.1%) were classified as type I, II, or III. The grade of parenchymal echo pattern was significantly correlated with the severity of liver cirrhosis. In addition, the parenchymal patterns proved to be very useful in diagnosis of liver cirrhosis, presenting overall accuracy value of 81.8%. The value was the highest compared with those of other diagnostic factors on ultrasonograms. Immersion experiment with autopsied liver specimens evidenced that hypoechoic nodules on ultrasonogram represent regenerative nodules of cirrhotic liver. It was also revealed that the parenchymal echo patterns closely corresponded to gross or histologic findings of the liver.

Adult↗
PubMed1988

Pulsed Doppler in the diagnosis of small liver tumours.

Doppler ultrasound detection of the blood flow associated with liver tumours was studied in primary hepatocellular carcinoma as well as in metastatic liver cancer and haemangioma. Doppler signals were detected from 48 of 55 hepatocellular carcinomas (87.3%), seven of 25 metastatic liver cancers (28.0%) and four of 30 haemangiomas (13.3%). The waveforms of Doppler signals were divided into two types: the pulsatile wave, which was detected from hepatocellular carcinoma (in 35 of the 48 with Doppler signals) and metastatic liver cancer (in all seven with positive signals), and the continuous wave, which was seen from hepatocellular carcinoma (41 out of 48) and haemangioma (in all four with signals). In six patients with hepatocellular carcinoma who underwent transcatheter arterial embolization, the pulsatile wave detected before therapy disappeared immediately thereafter and it is possible that this type of wave originates from tumour vessels. In the study of small, hypoechoic, mass lesions appearing in liver cirrhosis, such signals were also demonstrated, even in eight of 10 small hepatocellular carcinomas less than 2 cm in diameter, whilst they were not detected from nine regenerative nodules related to cirrhotic change. In conclusion, the Doppler ultrasound method may be a useful technique in detecting blood flow within liver tumours and may offer the possibility of a differential diagnosis of small tumours.

Adult↗
PubMed1986

Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis. A study in 22 patients.

Twenty-two patients with cirrhosis and minute hepatocellular carcinoma less than 3 cm in diameter were followed for periods of 6-37 mo without specific treatment. The survival curve drawn by the Kaplan-Meier method showed a 1-yr survival of 90.7%, a 2-yr survival of 55.0%, and a 3-yr survival of 12.8%. The ultrasonic patterns of these masses in the liver were correlated with the size and showed a tendency to change from a low echo pattern to a low periphery and, finally, to a massive pattern. The growth speed calculated from the doubling time for tumor volume varied considerably from case to case with an average of 6.5 +/- 5.7 mo; it also changed in some cases during the observation period. Serum alpha-fetoprotein levels were generally low, rarely assisted in diagnosis, but tended to increase when the mass attained a diameter of greater than 3 cm; sudden acceleration in the rate of increase in alpha-fetoprotein level often coincided with a change of ultrasonic pattern to the massive one.

Aged↗
PubMed1986

Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies.

Magnetic resonance (MR) images of the liver were used to study 43 patients with relatively small hepatocellular carcinomas (HCCs) and 36 with other hepatic mass lesions. In 27 HCC patients, histologic findings were available. All focal lesions detectable by CT without contrast media were delineated with greater contrast by MR imaging. The rate of detection depended on tumor size, being 97.5% for HCCs greater than 2 cm in the longest axis and 33.3% for those less than 2 cm. MR imaging demonstrated the ring sign characteristic of encapsulated HCC twice as frequently as CT scans. Inversion recovery (IR) images depicted the internal structure of the HCC better than T2-weighted spin-echo images. Lesions were classified into four patterns of intensity: low, iso, high, and mixed. The latter three were relatively characteristic of HCC and related closely with steatosis of cancer tissue. HCCs with fibrosis tended to have long T1 values; those with steatosis had short T1 values. T1 and T2 relaxation times were useful in the differential diagnosis.

Adult↗
PubMed1986

Accuracy of angiography in the diagnosis of small hepatocellular carcinoma.

Conventional hepatic arteriography combined with superselective infusion arteriography was carried out in 51 patients with hepatocellular carcinoma smaller than 5 cm, and angiograms of varying phases were analyzed. In cancers smaller than 40 mm, particularly in those smaller than 20 mm, so-called tumor stain in the capillary phase was the only abnormality seen in most but not all cases. Within a tumor stain, there were unstained areas in most cases and histologic examination in resected specimens showed them to be due to either necrosis, fibrosis, or fatty changes. Homogeneity and shape of the stain seemed to be related to growth speed and invasiveness of the cancer. Although overall diagnostic value of angiography for small hepatocellular carcinoma was high, super-superselective infusion hepatic arteriography produced nodular stains in 7 of 11 control cases of nonalcoholic cirrhosis without cancer, making difficult the differential diagnosis between stains due to tumors and those due to hyperplastic nodules of cirrhosis.

Adult↗
PubMed1986

[Treatment of hepatocellular carcinoma by alcohol injection into the tumor and irradiation of the tumor].

Small hepatocellular carcinoma has come to be diagnosed by imaging modalities recently progressed. However, in patients with the carcinoma surgery is often contraindicated due to liver dysfunction. From such reason intratumor alcohol injection therapy has been developed and the efficacy has been clearly demonstrated in hepato cellular carcinoma with tumor under 3 cm is diameter. While in radiation therapy has been effective in that with tumor up to 10 cm in diameter. In treatment of hepatocellular carcinoma, it is important to choose a therapeutic method by considering the degrees of cancer progress and liver dysfunction.

Administration, Topical↗
PubMed1986

[Ultrasound diagnosis of hepatocellular carcinoma].

Nowadays, ultrasound has been widely used in clinical practice of gastroenterology. A recently developed ultrasound apparatus with a higher resolution of image and less artifacts makes it possible to find out a small HCC sized about 1.0 cm. Moreover, a new convex type of probe with a wide field of view enables us to detect a small HCC locating in the upper part of the right lobe which has been done with difficulty before. Early diagnosis of HCC by detecting a small mass lesion will be carried out reliably by a modern ultrasound modality.

Carcinoma, Hepatocellular↗
PubMed1985

Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union.

A total of 96 patients with gallbladder carcinoma in whom direct cholangiography clearly opacified the pancreaticobiliary ductal union and the common channel, and 65 patients with an anomalous union of these two duct systems at a distance greater than 15 mm from the papilla of Vater (normally less than 4.6 +/- 2.2 mm, mean +/- SD) were studied. It was found that this anomalous ductal union occurred in 16.7% of the patients with gallbladder carcinoma in comparison with an incidence of 2.8% among 641 consecutive patients with various hepatobiliary and pancreatic diseases studied by endoscopic retrograde cholangiopancreatography who did not have gallbladder carcinoma. It was also found that gallbladder carcinoma occurred in 24.6% of the 65 cases of anomalous ductal union in comparison with a 1.9% incidence of this cancer among 635 consecutive patients similarly studied and found to have normal ductal union (p less than 0.001). Thus, a close etiologic association was suggested between this anomaly in the terminal segment of the biliary tract and gallbladder carcinoma. Of the 65 patients with anomalous ductal union, 50 had the so-called congenital cystic dilatation of the common bile duct and 15 did not. Five of the 50 (10%) and 11 of the 15 (73.3%) had gallbladder carcinoma (p less than 0.01), and this carcinoma seems to be related to anomalous ductal union rather than to cystic dilatation of the common bile duct. As a tumorigenic factor in this anomaly, regurgitation of pancreatic juice has been stressed.

Adult↗