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Biomedical subjects

M Umehara

Publications and source records attributed to M Umehara.

54 records · Page 3Linked to original sources
PubMed1985

[Transcatheter embolization therapy of esophageal varices and hypersplenism with liver cirrhosis].

Transcatheter variceal embolization (PTO, TIO) has been performed in 71 cases and splenic artery embolization (SAE) in 22 cases (15 PTO-SAE combination and 7 SAE alone). Results for varices of PTO combined with SAE were better than with PTO alone. Furthermore PTO combined with SAE was found to be reliable even for long term control of bleeding, the longest follow up being almost over 3 years during which time we have had no case of rebleeding. Improvement of Child's criteria was seen to be better in SAE cases (52.4%) than in splenectomized cases (12.5%) and PTO alone (17.4%). Hepaplastin test and level of cholinesterase were used to assess liver function, before and after treatment. It was found that SAE cases improved considerably, in contrast to the splenectomized and control cases which showed little or no improvement. Thus to increase durability for long term control of bleeding and general condition, PTO should be combined with SAE. Furthermore, it is suggested that this combined embolization therapy should be used for nonsurgical treatment of esophageal varices and hypersplenism with liver cirrhosis.

Embolization, Therapeutic↗
PubMed1982

[Follow-up study of preoperative oral administration of an antineoplastic agent as an adjuvant chemotherapy in stomach cancer].

Based on the propensity of fat emulsion to be absorbed mainly into lymphatic capillaries and regional lymph nodes, preoperative oral administration of 5-FU emulsion was attempted as an adjuvant chemotherapy to surgery for gastric carcinoma. In our previous studies, it was demonstrated that the mean 5-FU level in the regional lymph nodes was higher in patients who received the 5-FU solution. Since 1974, we have administered 5-FU emulsion preoperatively to 167 patients with gastric cancer (500 mg X 10 days) and examined histologically the effect of this regimen on the metastatic foci in the lymph nodes. A positive change, such as marked necrosis or marked degeneration, was found in 58% of the metastatic lesions. Sixty-four patients with advanced cancer who received the preoperative 5-FU emulsion also received a curative resection between 1974 to 1977 in addition to postoperative chemotherapy (MMC 40 mg and 5-FU more than 5000 mg) (Group A). Their survival rate was compared with that of the curatively operated advanced cancer patients from 1959 to 1973 who received the same postoperative chemotherapy only (Group B, N = 59) and with that of patients, from 1959 to 1970, who received no chemotherapy (Group C, N = 222). The 5 year survival rate of Group A was 0.53 +/- 0.07, which was higher than that (0.49 +/- 0.07) of Group B and that (0.40 +/- 0.10) of Group C. Comparing the 5-year survival rates of the 3 groups from several points of view, such as a stage of cancer progress absence of serosal invasion, the 5-year survival rate of group A was higher than that of other groups. Although these differences between Group A and B were not statistically significant, but those between Group A and B were significant. From these results it is suggested that preoperative oral 5-FU emulsion might be effective as an adjunct to surgery for gastric cancer.

Administration, Oral↗
PubMed1980

Comparative studies on absorption patterns of the drug after intrarectal administration of 5-FU emulsion and 5-FU solution.

Intrarectal administration of 5-fluorouracil (5-FU) emulsion was compared experimentally with that of 5-FU solution as to the degree of absorption and tissue distribution. For the 5-FU levels in the rectal wall, the levels in the emulsion group remained at high levels during the 6 hour period after administration while the levels in the solution group decreased rapidly. For the 5-FU levels in the lymph nodes, those in the emulsion group were significantly higher (more than four times) and remained at relatively high levels for a longer period than those in the solution group. In the thoracic lymph, 5-FU levels in the emulsion group remained more than two times higher throughout the experimental period. The results suggest tha preoperative intrarectal administration of 5-FU emulsion may be effective as an adjunct to surgery for rectal cancer with lymph node metastasis, because of the long duration of high concentration resulting in the rectal lymphatics and rectal wall.

Animals↗
PubMed1980

Clinical studies of intrarectal administration of 5-FU emulsion as an adjunct to surgical treatment of rectal cancer.

Preoperative intrarectal administration of 5-FU emulsion was attempted as an adjuvant chemotherapy to surgery for rectal cancer. The drug concentrations of resected specimens were determined and histological examinations of them were carried out in order to evaluate the effect of anticancer drugs on the metastatic lymph nodes as well as on the primary tumors. 5-FU levels both in the regional lymph nodes and primary tumors of 18 patients with rectal cancer, who were given with the 5-FU emulsion (emulsion group) or 5-FU suppository (suppository group) intrarectally two hours before surgery, was found to be much higher in emulsion group than in suppository group. 46 patients with rectal cancer were treated preoperatively with intrarectal administration of 5-FU emulsion (25 cases) or 5-FU suppositories (21 cases) for a period of 10 days before surgery, and the histological effect of this regimen on the metastatic lesion in the lymph nodes, as well as in the primary tumor was examined. No detectable difference was found in the primary lesions between the emulsion group and the suppository group. In the metastatic lesions, however, the rate of effectiveness was higher in the emulsion group than in the suppository (68 percent versus 33 percent).

Emulsions↗
PubMedDate not supplied

Synthesis of novel poly(ethylene glycol) derivatives having pendant amino groups and aggregating behavior of its mixture with fatty acid in water.

Novel poly(ethylene glycol) (PEG) derivatives having pendant amino groups were prepared by copolymerization of allyl glycidyl ether with ethylene oxide followed by chemical modification of the double bond side chains. Dropwise addition of the mixture of monomers to the anionic initiator gave an almost monodisperse (Mw/Mn = 1.05) random copolymer. 1H NMR spectra showed that addition of 2-aminoethanethiol to the pendant allyl groups of the copolymer was completely carried out in methanol without catalyst, and an aminated PEG derivative with a definite structure was obtained. Acetylation of the pendant amino groups was readily performed by acetic anhydride with triethylamine. A gel permeation chromatogram of the acetylated polymer showed a very narrow molecular weight distribution (Mw/Mn = 1.06) of the polyamine. These cationic PEG derivatives make amphiphilic polyion complexes with fatty acids, and then aggregate in water. A fluorescence study using pyrene as a microenvironment probe revealed that the aminated PEG-lauric acid ion complex could take up the hydrophobic fluorescence probe into the lipophilic field inside, and they also had a critical aggregation concentration at [lauric acid] = 0.7 mM. It is much lower than the critical micelle concentration of the corresponding fatty acid sodium salts, indicating high stability of the polymer-fatty acid aggregate.

Carcinogens↗
PubMedDate not supplied

Treatment of spontaneous ruptured hepatocellular carcinoma.

BACKGROUND/AIMS: Spontaneous rupture with bleeding is a potentially life-threatening complication of hepatocellular carcinoma (HCC). We review our experience with treatments of ruptured HCC. METHODOLOGY: Between January 1988 and December 1997, 18 patients with ruptured HCC were admitted. The patients were divided into 4 groups according to the treatment type of ruptured HCC. Group 1 consisted of 10 patients treated by transarterial embolization (TAE) followed by elective hepatectomy. Group 2 consisted of 2 patients treated by only TAE. Group 3 consisted of 3 patients treated by emergency operation. Group 4 consisted of 3 patients who could not be treated by TAE or surgery. RESULTS: In Group 1, 4 of the 10 patients died; 3 from recurrent HCC and 1 from cerebral hemorrhage, and hospital mortality was absent. The 1-year survival rate was 87.5%. In Group 2, both patients recovered sufficiently well to be discharged. The 1-year survival rate was 50%. In Groups 3 and 4, hospital mortality rate was 100%. CONCLUSIONS: TAE followed by elective hepatectomy was an effective treatment in patients with ruptured HCC.

Aged↗
PubMedDate not supplied

Long-term results of modified distal splenorenal shunts for the treatment of esophageal varices.

BACKGROUND/AIMS: Long-term results were compared for 3 types of distal splenorenal shunt for the treatment of esophageal varices. METHODOLOGY: Between July 1983 and December 1997, 45 patients with esophageal varices underwent distal splenorenal shunt. Group 1 underwent standard distal splenorenal shunt (n = 11). Group 2 underwent distal splenorenal shunt with splenopancreatic disconnection (n = 11). Group 3 underwent distal splenorenal shunt with splenopancreatic disconnection and gastric transection (n = 23). RESULTS: Additional treatment for recurrent varices was required in group 1, (n = 1, 9.1%), group 2 (n = 2, 18.2%), and group 3 (n = 1, 4.3%). All of the patients with recurrent varices developed a shunt stenosis within the 1st year after distal splenorenal shunt. The prevalence of hyperammonemia in group 1 was 40.0% at 1, 5, and 10 years. In group 2, the prevalence was 14.3% at 1 year, 31.4% at 5 years, and 54.3% at 10 years. In group 3, the prevalence was 0% at 1 year, and 9.1% at 5 and 10 years. The differences between group 3 and groups 1 and 2 were significant (P < 0.01). The cumulative survival rates at 1 year were 90.9%, 63.6%, and 95.7% for groups 1, 2, and 3, respectively. At 10 years, the cumulative survivals rates were 70.7%, 63.6%, and 69.4% for groups 1, 2, and 3, respectively. There were no significant differences in survival between the 3 groups. CONCLUSIONS: Distal splenorenal shunt with splenopancreatic disconnection and gastric transection may reduce the incidence of postoperative hyperammonemia.

Adult↗
PubMedDate not supplied

Hepatocellular carcinoma responding to chemotherapy with 5-FU.

A 69-year-old man with unresectable hepatocellular carcinoma and portal vein tumor thrombus was treated by chemotherapy with 5-fluorouracil. A dose of 500 mg/day of 5-fluorouracil was continuously administered via a central venous catheter. After 4 months, the alpha-fetoprotein level was decreased from 50,000 ng/mL to 4,760 ng/mL. Computed tomography revealed disappearance of the low-density area in the liver parenchyma, but the portal vein tumor thrombus was not changed. After 6 months, pancytopenia appeared and continuous infusion of 5-fluorouracil was stopped. After 8 months, the patient died of pneumonia, at which time the alpha-fetoprotein level was 12,000 ng/mL. Continuous intravenous infusion of 5-Fluorouracil was effective against unresectable primary hepatocellular carcinoma, but had little influence on portal vein tumor thrombus.

Aged↗
PubMedDate not supplied

G-CSF producing malignant fibrous histiocytoma in the jejunum: a case report.

Malignant fibrous histiocytoma arising from the alimentary tract is extremely rare. We experienced a young patient with an inflammatory type of malignant fibrous histiocytoma in the jejunum which produced granulocyte-colony stimulating factor. A 16-year-old male was admitted to Umehara Hospital with abdominal pain, frequent vomiting of 2 days' duration, high fever and leukocytosis. Serum level of granulocyte-colony stimulating factor was 61.2 pg/mL. Plain abdominal X-ray, ultrasonography and computed tomography led to the diagnosis of intussusception with small intestinal tumor. On the 2nd hospital day, the patient underwent exploratory laparotomy. The jejunum showed intussusception with a hen's egg-sized tumor. After manual reduction, a 20-cm segment of the jejunum was removed. The patient was alive and doing well 29 months after the operation. Microscopic examination of the resected tumor disclosed an inflammatory type of malignant fibrous histiocytoma in the jejunum, and immunohistochemistry was positive for granulocyte-colony stimulating factor. This is the 5th case of malignant fibrous histiocytoma arising from the small intestine that has been described in the English literature.

Adolescent↗
PubMedDate not supplied

Disposition of a new orally active dopamine prodrug, N-(N-acetyl-L-methionyl)-O,O-bis(ethoxycarbonyl) dopamine (TA-870) in humans.

Dopamine (DA) levels in human plasma after oral administration of TA-870 and iv infusion of DA were measured by HPLC. The metabolites of TA-870 or DA in plasma and urine were also determined. The maximal concentrations (Cmax) of free DA in plasma after oral administration of 750 and 1500 mg of TA-870 to humans were 63 and 127 ng/ml, respectively, being higher than the concentrations of 8 and 31 ng/ml following the infusion of 1 and 3 micrograms/kg/min, the clinical doses of DA. These results demonstrated the clinical usefulness of TA-870. The plasma level of free deethoxycarbonylated TA-870 (DEC-TA-870) after oral administration of TA-870 was higher than that of DA. After oral administration of TA-870, the concentration of 3,4-dihydroxyphenylacetic acid (DOPAC) in plasma was higher than that after DA infusion, but the concentration of homovanillic acid (HVA) was about the same as that after DA infusion. The level of the total urinary metabolites (free and conjugated) after oral administration of TA-870 decreased as follows: DA greater than HVA greater than DOPAC greater than DEC-TA-870. The conjugated/free ratios of urinary metabolites after TA-870 dosing were 40-66 for DA, 0.5 for HVA, 0.6-0.9 for DOPAC, and 5.0-6.2 for DEC-TA-870. The composition of urinary metabolites after oral dosing of TA-870 was almost the same as that the DA metabolites. These results show that TA-870 is rapidly converted to DA in the human body.

3,4-Dihydroxyphenylacetic Acid↗