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Biomedical subjects

N Miyazono

Publications and source records attributed to N Miyazono.

At least 19 recordsLinked to original sources
PubMed2000

Transcatheter arterial chemoembolization therapy using iodized oil for patients with unresectable hepatocellular carcinoma: evaluation of three kinds of regimens and analysis of prognostic factors.

BACKGROUND: The current study was conducted to evaluate retrospectively the effects of three kinds of regimens used in transcatheter arterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC) and patients' prognosis, and to analyze their prognostic factors. METHODS: The study population was comprised of 152 patients who were treated by TACE alone. Three kinds of regimens were used successively: doxorubicin hydrochloride (ADM) and mitomycin C mixed with iodized oil in 26 patients (ADMOS group), a combination of cisplatin (CDDP) solution and ADMOS in 70 patients (CDDP-ADMOS group), and CDDP powder and pirarubicin hydrochloride mixed with iodized oil in 56 patients (CTLS group). The CTLS group was comprised of patients with significantly worse background factors than the other two groups. RESULTS: The initial tumor response rate with a > 50% reduction was 12%, 23%, and 30%, respectively, in the ADMOS, CDDP-ADMOS, and CTLS groups. CTLS was significantly more effective than ADMOS (P < 0.05), and slightly but not significantly better than CDDP-ADMOS (P <0.1). The cumulative survival rates for the ADMOS, CDDP-ADMOS, and CTLS groups were 59.0%, 70.1%, and 72.0%, respectively, at 1 year; 0%, 16. 3%, and 29.8%, respectively, at 3 years; and 0%, 4.1%, and 16.8%, respectively, at 5 years, with median survival times of 448 days, 574 days, and 758 days, respectively. The CTLS group showed a slightly but not significantly better survival than the ADMOS and CDDP-ADMOS groups (P <0.1). Multivariate analysis indicated that the significantly important prognostic factors (in order) were extrahepatic metastasis followed by the TACE regimen, serum alpha-fetoprotein levels, and portal vein involvement and that CTLS was the best of the three regimens. CONCLUSIONS: Although TACE, using an effective regimen, improves clinical results, tumor factors appear to be more important when determining prognosis.

Adult↗
PubMed2000

Localization of insulinomas. Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS.

PURPOSE: To examine the value of superselective arterial stimulation venous sampling (ASVS) to localize insulinomas. MATERIAL AND METHODS: Superselective ASVS (SS-ASVS) was performed in 9 patients with insulinoma. Injection of secretagogue (calcium gluconate: 0.01 mEq Ca++/kg) was performed into the gastroduodenal, splenic (proximal and distal), and superior mesenteric arteries in 9 patients and additionally into the dorsal pancreatic artery in 6 patients. Sampling from the hepatic vein was performed to measure serum insulin concentrations at 30, 60 and 120 s after each injection of secretagogue into these arteries. SS-ASVS results were correlated with surgical findings, compared to those of conventional ASVS. RESULTS: Insulinomas were correctly localized to the head, body or tail of the pancreas by SS-ASVS in 8 patients (89%). Conventional ASVS detected insulinomas in 7 patients (78%), although it could not distinguish whether the insulinoma was located in the pancreatic body or tail in 4 of the 7 patients. There were eight-fold or more increases in serum insulin levels in hepatic venous samples related to the artery supplying the tumor in 8 patients. Localization of the insulinomas was verified at surgery in all patients. CONCLUSION: SS-ASVS is a useful method for detailed evaluation of overproduction of insulin from pancreatic insulinomas and their localization. When the pancreatic insulinoma is situated in the pancreatic body or tail, the localization is more accurately made by SS-ASVS than by conventional ASVS.

Aged↗
PubMed2000

Hepatic falciform artery. Angiographic findings in 25 patients.

PURPOSE: To determine the frequency of hepatic falciform artery (HFA) occurrence on celiac or hepatic angiograms and elucidate the anatomy and clinical importance. MATERIAL AND METHODS: Among 1,250 patients who underwent celiac or hepatic arteriography, we encountered 25 patients (2%) with a HFA. Prospectively, CT hepatic falciform arteriography (CTHA) was performed in 4 patients. Indigocarmine dye was injected into the HFA in 6 patients to evaluate whether the abdominal skin was stained. Embolization of the HFA before chemoembolization for hepatocellular carcinoma was performed in 4 patients to prevent abdominal wall injury. RESULTS: Among 25 patients, the HFA arose as a terminal branch of the middle hepatic artery in 14 patients (56%) and of the left hepatic artery in 11 patients (44%). The vessel was single in 18 patients (72%) and double in 7 patients (28%). Two vessels ran side by side along the hepatic falciform ligament. On CTHA, the HFA ran within the hepatic falciform ligament and the branches were connected with the liver around the hepatic falciform ligament. After indigocarmine dye injection, the stain of abdominal skin was recognized in all 6 patients. No abdominal wall injury occurred in any of the 4 patients who were subjected to hepatic chemoembolization. CONCLUSION: HFA is an extrahepatic pathway which runs to the abdominal wall. Before chemoembolization of the middle or left hepatic artery for hepatic malignancy, the HFA should be recognized.

Abdominal Muscles↗
PubMed2000

Non-surgical therapy of primary aldosteronism: transcatheter arterial infusion of ethanol into an aldosteronoma.

Primary aldosteronism due to an adrenocortical adenoma can be cured by ablation of the adenoma, which produces an excess of aldosterone (aldosteronoma). This has traditionally been performed by surgical removal of the adenoma. However, some patients with aldosteronomas refuse surgical removal. Therefore, we developed a therapeutic method to ablate an aldosteronoma by transcatheter arterial infusion of ethanol. This method ablated the aldosteronoma in 27 (82%) of 33 treated cases and produced no serious complications, and may be one of the therapeutic choices for aldosteronomas.

Humans↗
PubMed1999

Transcatheter adrenal arterial embolization of cortisol-producing tumors. Two cases of Cushing's syndrome.

Transcatheter arterial embolization (TAE) was performed in 2 patients with Cushing's syndrome caused by adrenal adenoma by using a mixture of absolute ethanol and iohexol. In 1 patient successful suppression of the hypersecretion of cortisol has continued for 9 months after TAE without complications. However, in the other patient, TAE was discontinued due to marked hypertension and tachycardia induced by a massive release of catecholamines from the embolized "normal" part of the tumor-bearing adrenal gland during the procedure. These results suggest that it is important to perform TAE of only the arterial branches feeding the tumor.

Adenoma↗
PubMed1999

A case of renal juxtaglomerular cell tumor: usefulness of segmental sampling to prove autonomic secretion of the tumor.

A 27-year-old female patient had been treated for hypertension with conventional therapy for years, because renal vein renin levels failed to show lateralization in renal venous samplings and a renal juxtaglomerular cell tumor (RJGCT) had gone undiagnosed. Abdominal computed tomography revealed a mass at the middle of the right kidney. The right renal venogram demonstrated distinct segmental veins from the upper pole and from the middle and lower poles in the right kidney. On segmental renin sampling from each renal vein, the plasma renin concentration (PRC) of the segmental veins from the middle and lower poles was higher than that from other sites. We diagnosed RJGCT of the right kidney and performed right-sided nephrectomy. After the resection, the PRC rapidly decreased. Immunohistochemical studies using antihuman renin antibodies revealed positive staining of the tumor cells. It is an important strategy to make a segmental sampling at the site as close as possible to the RJGCT.

Adenocarcinoma↗
PubMed1999

Small hepatocellular carcinoma supplied by the right renal capsular artery. A case report.

We present a case of hepatocellular carcinoma (HCC), which was fed only by the right renal capsular artery. Ten years earlier, this patient underwent surgery for a solitary HCC in segment IV. However, the hepatic artery was patent and did not participate in feeding the HCC. We consider the renal capsular artery as an essential extrahepatic parasitic feeding artery to HCC.

Angiography↗
PubMed1998

Recanalization after coil embolotherapy of pulmonary arteriovenous malformations: study of long-term outcome and mechanism for recanalization.

OBJECTIVE: We investigated the efficacy of steel coils for embolotherapy of pulmonary arteriovenous malformations (PAVMs) by reimaging the embolized PAVMs. CONCLUSION: We found a high incidence (57%; 8/14) of recanalization in PAVMs embolized with steel coils. Contrast-enhanced CT is useful for detection of recanalized PAVMs. Half of the recanalized PAVMs were fed by bronchial artery branches. Thus, coil embolization should be performed as close as possible to the PAVM to avoid future development of bronchial artery-to-pulmonary artery anastomoses that may cause recanalization.

Adolescent↗
PubMed1997

Transcatheter arterial ablation of aldosteronomas with high-concentration ethanol: preliminary and long-term results.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of transcatheter arterial ablation (TAA) of aldosteronomas with high-concentration ethanol (HCE). MATERIALS AND METHODS: From August 1992 to August 1995, 18 patients with unilateral aldosteronoma, three men and 15 women, 28-65 years old, were treated by TAA with HCE. A single dose (0.2-7.0 ml) of HCE was selectively infused into the feeding arterial branches of the aldosteronoma using a microcatheter and the coaxial technique. The 18 patients underwent 31 TAA procedures. RESULTS: Ablation of the aldosteronoma was monitored by measuring plasma levels of aldosterone and was successful in 15 (83%) of 18 patients. The remaining three patients underwent surgery because results of TAA were insufficient. The destructive effect of ablation by HCE has persisted for 7-38 months (mean, 20 months) in 14 patients. Although one patient had recurrence of symptoms 15 months after the initial TAA, normalization of plasma levels of aldosterone continued for 3 months after TAA was repeated. No severe complications occurred in any of the 18 patients. However, back pain (18 of 18), slight fever (nine of 18), pleural effusion (two of 18), and labile changes in blood pressure (one of 18) were noted in patients 1-7 days after the procedure. CONCLUSION: TAA of aldosteronoma with HCE is an alternative to open adrenalectomy.

Adenoma↗
PubMed1997

Scintigraphic assessment of therapeutic success in aldosteronomas treated by transcatheter arterial embolization using absolute ethanol.

UNLABELLED: Adrenocortical scintigraphy was examined as an indicator of therapeutic success in aldosteronomas treated by transcatheter arterial embolization (TAE) with absolute ethanol (AE). METHODS: Adrenocortical scintigraphy was performed 7 days after intravenous injection of 37 MBq 131I-6-beta-iodomethyl-19-norcholesterol before and after TAE. Complete or incomplete therapeutic success was determined by periodic measurements of the levels of plasma aldosterone and correlated with the scintigraphic results. RESULTS: The aldosteronoma was visualized as a hot nodule in nine patients and a warm nodule in one patient before TAE. Scintigraphy showed a hot, residual hot or warm nodule on seven occasions (six occasions after the first TAE and one occasion after the second TAE) when the techniques were incompletely successful and disappearance on seven occasions when success was achieved (three occasions after the first TAE and one occasion after the second TAE). Of the seven occasions when TAE was unsuccessful, four patients received the second or third TAE to result in complete destruction of the aldosteronoma; three patients underwent unilateral adrenalectomy. CONCLUSION: Adrenocortical scintigraphy can correctly predict the effect of TAE on aldosteronomas and is a valuable indicator for decisions on the necessity of repeated TAE or adrenalectomy.

Adosterol↗
PubMed1996

Transcatheter arterial renal and adrenal embolization with iohexol-ethanol solutions. Animal experimental study and clinical application.

RATIONALE AND OBJECTIVES: The authors compared the embolic effect of radiolucent absolute ethanol (AE) with that of a radiopaque iohexol-ethanol (IES) solution for renal ablation in dogs and for the destruction of human aldosteronomas by the technique of transcatheter arterial embolization (TAE) to test whether IES can be an alternative to AE. METHODS: The embolic agents were infused through a balloon catheter into the renal arteries of 17 dogs (9 infused with 0.3 mL/kg AE; 8 infused with IES). The immediate and parenchyma were compared between the two groups. Transcatheter arterial embolization with IES also was performed in three humans with unilateral aldosteronoma. RESULTS: The IES was visualized faintly under fluoroscopy in all dogs. There were no significant differences in embolic effects between the AE and IES. Three patients with aldosteronoma were treated successfully by TAE with IES. CONCLUSIONS: The IES can be used as a "visible ethanol" to improve the safety and ease of ethanol embolization.

Adrenal Cortex Neoplasms↗
PubMed1996

[Results of radiotherapy combined with CDDP (BAI) plus VP-16 in the treatment of inoperable non-small cell lung cancer].

Twenty-six patients with unresectable non-small cell lung cancer were treated by chemotherapy alone or chemotherapy followed by radiotherapy from June 1988 to May 1990. CDDP (80 mg/m2) was given by bronchial arterial infusion (BAI) on day 1 in each course, VP-16 (80 mg/body) was given by drip intravenous infusion on days 1 and 2, and VP-16 (150 mg/body) was given orally on days 3 and 5. The patients were irradiated after this regimen with a single dose of 1.8-2.0 Gy, five times each week, to a volume which encompassed only the primary tumor. A total dose of 60 Gy or more was delivered. There were 10 squamous cell carcinomas, nine adenocarcinomas, five large cell carcinomas, one adenosquamous cell carcinoma and one poorly differentiated carcinoma. Median survival time (MST) was 354 days in stage III B patients and 280 days in stage IV patients. MST was 155 days in adenocarcinoma and 310 days in squamous cell carcinoma. MST was 372 days in PS 0 to 1 patients and 140 days in PS 2 patients. With chemo-radiotherapy in 17 cases resulted in no complete remissions and 10 partial remissions. The overall response rate was 58.8%. It is concluded that CDDP via BAI combined with VP-16 administration and sequential irradiation is useful to acquire a high response rate in non-small cell lung cancer. However, further studies on this modality are required.

Aged↗
PubMed1995

[Evaluation of anastomosis between intrahepatic or extrahepatic vessels by intra-arterial digital subtraction angiography using carbon dioxide].

Carbon dioxide (CO2) intraarterial subtraction angiography (IADSA) was performed in 31 patients with various hepatobiliary diseases. The injection sites of CO2 were proper hepatic artery (10/31; group A), segmental hepatic artery (18/31; group B), and peripheral inferior phrenic artery (3/31; group C), respectively. In group A, only the third order branches of the portal venous system were visualized anterogradely in 8 of 10 patients. In group B, the microcatheter was placed coaxially through a 5 French guiding catheter at the main arterial supply of the tumor in 7 patients and at the peripheral segmental branch of the hepatic artery in 11 patients. The portal venous system was visualized retrogradely in all of the patients regardless of the injection site. The injected CO2 may flow back into the portal vein through the anastomosis known as the peribiliary or periportal plexus. In group C, not only the portal vein but also the pulmonary artery or pericardial vein were visualized by this method. CO2-IADSA was useful to image the minute communications between the various vessels, which have been not hitherto visualized by iodinated contrast medium.

Adult↗
PubMed1993

[Anticancer and side effect of arterial subsegmental chemoembolization using cisplatinum/pirarubicin lipiodol suspension (CTLS) for hepatocellular carcinoma].

Twenty patients with unresectable hepatocellular carcinoma were treated by intra-arterial subsegmental injection of Cisplatin/4-0-Tetrahydro-Pyranyl-adriamycin Lipiodol suspension (CTLS). The mean single doses of Lipiodol, cisplatin and THP were 2.3 ml, 85 mg and 8.9 mg, respectively. The therapy was given once in 10 patients, twice in 8 and 3 times in two. Over 25% reduction in tumor size was recognized in 12 patients (60%). Fifty or more % decrease of alfa-feto-protein (AFP) was observed in all of 7 patients (100%) with the initial serum AFP level of more than 200 ng/ml. Although transitional and mild symptoms, such as fever, abdominal pain and vomiting were recognized in some cases, no severe complications were encountered. This method is promising as an excellent procedure for unresectable hepatocellular carcinoma.

Aged↗