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Biomedical subjects

N Umekita

Publications and source records attributed to N Umekita.

At least 19 recordsLinked to original sources
PubMed2005

Bile duct schwannoma developed in the remnant choledochal cyst-a case associated with total agenesis of the dorsal pancreas.

A 59-year-old Japanese woman was referred to our hospital due to upper abdominal pain. At the age of 44, she was diagnosed with a congenital choledochal cyst, Todani's type Ic. She then underwent bypass operation with end-to-side choledochojejunostomy with Roux-en-Y technique as well as cholecystectomy. Magnetic resonance cholangiopancreatography revealed an 'oval' shaped cystic lesion with a maximal diameter of 25 mm, which had been 'spindle' shaped with a maximal diameter of 18 mm, 15 years ago. It also showed an anomalous pancreaticobiliary ductal union. In addition, a complete absence of the dorsal primordia of pancreas was revealed by magnetic resonance image and computed tomography scan. The patient underwent the surgical exploration for the resection of the 'oval' shaped cystic lesion. Haematoxylin and eosin staining of the thin section of the resected cyst showed a compact spindle cell pattern which was compatible with schwannoma, Antoni type A, which was confirmed by immunocytochemical technique. We present a very interesting case showing choledochal cyst, anomalous pancreaticobiliary ductal union, total agenesis of the dorsal pancreas and late-development of bile duct schwannoma in the remnant choledochal cyst.

Abdominal Pain↗
PubMed2000

[Two patients with liver metastasis from gastric cancer who responded remarkably to combined therapy of 5'-DFUR and PSK].

Two patients with liver metastasis from gastric cancer who responded remarkably to a combined therapy of 5'-DFUR and PSK are reported. The first patient had liver metastases 8 months postoperatively. Her AFP level was 513 ng/ml and CEA was 30 ng/ml. After the combined therapy, all liver metastases showed a calcified change. Tumor markers of AFP and CEA decreased remarkably to the normal level within 3 weeks after the therapy. The patient had no relapse as of December 1999. The second patient with liver metastases was treated using the same combined therapy for 14 days preoperatively. The size of liver metastases had decreased remarkably by the time of the operation. A small metastasis of S8 (0.5 x 0.5 cm) was resected. No other liver metastasis was detected by intraoperative ultrasonography. The patient had no relapse as of February 2000. It is reported that PSK produces several cytokines which induce thymidine phosphorylase expression. The present report suggests that the upregulation of PyNPase might enhance the antitumor effect of 5'-DFUR.

Aged↗
PubMed2000

[Thymidylate synthase and dihydropyrimidine dehydrogenase activity in a metastatic liver tumor from colorectal cancer].

The value of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) activity in metastatic liver tumor from colorectal cancer as predictive parameters for hepatic artery infusion (HAI) chemotherapy with 5-FU was investigated. Thirteen patients with metachronous liver metastases underwent hepatic resection and primary site colectomy. We measured TS and DPD activity in normal colonic mucosa, primary colon tumor, and metastatic liver tumor in these patients. The TS (pmol/g-tissue) of primary tumor, metastatic tumor, and normal colonic mucosa was 6.6 +/- 1.40 (mean +/- SE), 3.2 +/- 0.83 and 2.5 +/- 0.83 respectively. The DPD (pmol/min/mg/protein) of primary tumor, metastatic tumor, and normal colonic mucosa was 31.7 +/- 5.49, 82.1 +/- 12.5 and 50.6 +/- 8.46, respectively. There was significant relationship between DPD activity level and recurrence. It is suggested that 5-FU catabolism in metastatic liver tumor was increased, and DPD activity may be a valuable predictive marker for tumor response to HAI therapy.

Antimetabolites, Antineoplastic↗
PubMed1999

[Incidence of recurrence after hepatic resection and prophylactic hepatic arterial infusion chemotherapy for liver metastases from colon cancer].

We studied recurrence after hepatic resection and prophylactic hepatic arterial infusion chemotherapy for liver metastases from colon cancer, retrospectively. Eighty-six patients underwent curative hepatic resection for liver metastases, and 41 of them received arterial infusion chemotherapy. Eight patients (20%) developed only remnant liver metastases, 6 patients (15%) had hepatic and extrahepatic recurrences, and 10 patients (24%) developed only extrahepatic recurrences. Regional therapy including hepatic resection for residual liver metastases should be indicated for recurrences after hepatic arterial infusion chemotherapy.

Antineoplastic Agents↗
PubMed1998

[Preoperative CEA level predicts outcomes of hepatic resection for liver metastases from colorectal cancer].

We analyzed patients receiving hepatic resection for liver metastases from colorectal cancer to determine prognostic factors. Seventy-one patients underwent curative hepatic resection for liver metastases and 32 of them were treated with arterial infusion chemotherapy (AIC) using implantable port. Five-year survival rates in the AIC group and non-AIC group calculated by the method of Kaplan-Meier were 43% and 22%, respectively (p < 0.01, logrank test). By multivariate analysis calculated by the Cox proportional hazard model, the preoperative CEA level (cut point 10 ng/dl) and existence of AIC predicted survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

[Three cases of Pseudomyxoma peritonei treated with intraperitoneal inoculation of cisplatin through an implantable port system].

Three patients with Pseudomyxoma peritonei were treated with intraperitoneal chemotherapy through an implantable port system which had been used subcutaneously. Three patients were given 100 mg of cisplatin for intraperitoneal chemotherapy and adjuvant chemotherapy was needed for only one of them. An adjuvant chemotherapy through an implantable port is an easy method and a useful therapy.

Aged↗
PubMed1998

[Effective splenectomy in a patient with HIV-associated thrombocytopenia].

A 31-year-old man presented with a 3-month history of petechial hemorrhages. Physical examination revealed no splenomegaly. The patient's platelet count was 1.0 x 10(9)/l and bone marrow aspiration showed an elevated number of megakaryocytes. A diagnosis of HIV-associated thrombocytopenia was made on the basis of HIV seropositive results. The CD4 cell count was 400 x 10(6)/l. No opportunistic infections indicating AIDS were detected. Initially the patient was treated with predonisolone, but showed only a transient response. He also failed to respond to zidovudine, lamivudine, or indinavir. Following splenectomy, however, his platelet count rose above 80 x 10(9)/l (normal level: 150-350 x 10(9)/l).

Adult↗
PubMed1997

[Evaluation of hepatic resection and hepatic arterial infusion chemotherapy for multiple liver metastases from colon cancer].

We examined the significance of hepatic resection and hepatic infusion chemotherapy for multiple liver metastases from colon cancer. Twelve patients underwent curative hepatic resection for multiple liver metastases (more than five), and 10 of them received arterial infusion chemotherapy. The number of metastases ranged 5 to 30 (mean 9.4). Recurrence rates in the remnant liver were 50%, and five-year survival rates were 31%.

Aged↗
PubMed1997

[Liver abscess caused by hepatic artery infusion chemotherapy].

A 48-year-old man underwent left hemicolectomy and right extended hepatectomy for colon cancer and its synchronous multiple liver metastasis. Sixteen months after, multiple metastases in the remnant liver were found, so he was given bolus hepatic infusion of 5-FU 1,000 mg/week, total amount, 25 g. The response was CR, but he developed a liver abscess in segment 4.

Adenocarcinoma↗
PubMed1996

[Indication of prophylactic hepatic arterial-infusion chemotherapy after hepatic resection for liver metastases from colorectal cancer].

The purpose of this study was to clarify the indication of prophylactic hepatic arterial-infusion chemotherapy (PHAIC) after hepatic resection for liver metastases from colorectal cancer. Sixty-one patients underwent curative hepatectomy, and 27 of them were treated with PHAIC using implantable port. According to clinicopathological factors of primary colorectal cancer and liver metastases, the prognoses were analyzed. In conclusion, PHAIC was not useful for patients who had distant lymph node metastases (paraaortic lymph node) from primary cancer.

Colorectal Neoplasms↗
PubMed1996

[Common bile duct fistula caused by hepatic arterial infusion chemotherapy].

We often use hepatic arterial infusion chemotherapy to control recurrence of metastatic cancer of liver. Recently, we encountered a case of common bile duct fistula caused by hepatic arterial infusion chemotherapy. A 61-year-old man had undergone right hepatic lobectomy for liver metastasis of gastric cancer, 7 months after total gastrectomy. A hepatic arterial infusion catheter was placed. Since then he has received continuous and/or bolus hepatic artery infusion of 5-FU, ADR and CDDP+5-FU. There was a recurrence of gastric cancer in segment 2 of the liver. On his second admission, when we administered contrast medium to the infusion port, a common bile duct was found.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Study of hepatic arterial infusion chemotherapy for prophylaxis of liver metastases of colorectal cancer after hepatic resection].

We examined the significance of hepatic arterial infusion chemotherapy (HAIC) for prophylaxis of liver metastases of colorectal cancer after hepatic resection using an implantable port. Fifty-five patients operated at the hospital from August 1988 to December 1994 were divided into two groups consisting of 23 patients with HAIC group: (HAIC (+)), and 32 patients without HAIC group: (HAIC (-)) retrospectively. The cumulative survival rates and recurrent rates of cancer free in remnant liver of HAIC (+) were improved, compared with HAIC (-). This suggests that HAIC was effective in improving the prognosis and preventing recurrence in remnant liver.

Adult↗
PubMed1995

[Sclerosing cholangitis-induced biliary cyst formation: complication of hepatic artery infusion chemotherapy].

A 60-year-old man underwent resection of a sigmoid colon adenocarcinoma, left hepatic lobe, part of segment 6 and 8, due to its metastasis. He received hepatic artery infusions of 5-FU total amount, 15.5 g. There was no recurrence in the liver, but he developed sclerosing cholangitis, and a large biliary cyst formed in segment 8. After drainage of the cyst by percutaneous-trans-hepatic approach, bile leakage persisted, and liver dysfunction was progressive. Sclerosing cholangitis-induced biliary cyst formation is rare. Occlusion, or necrosis of the peripheral bile duct may be the cause.

Adenocarcinoma↗
PubMed1995

[Two cases of catheter tip dislocation to the duodenal bulb: a rare complication of hepatic arterial infusion chemotherapy].

Case 1: A 63-year-old woman underwent transverse colectomy and hepatectomy for colonic cancer and liver metastasis. A hepatic arterial infusion port (HAIP) was implanted. Continuous infusion of 5-FU (total amount, 7,500 mg) caused a hemorrhagic duodenal ulcer 15 months after. Follow-up endoscopy revealed the catheter tip was in the duodenal bulb. Case 2: A 62-year-old man underwent abdominoperineal resection for rectal cancer. Repeated hepatectomy for liver metastases was performed at 3 and 5 years after the first operation. HAIP was implanted at the last operation, but was not available at all due to the wound infection. The port was removed, but the catheter remained. Three years after, the catheter tip was found in the duodenal bulb by endoscopy.

Catheters, Indwelling↗
PubMed1992

[A pharmacokinetic study of intra-arterial chemotherapy for prophylactic treatment of liver metastasis after hepatectomy for liver cancer].

As a fundamental study of efficacy of intra-arterial administration using ADM, ERB and MMC for prophylactic treatment of liver metastasis after hepatectomy for liver cancer, the pharmacokinetics of three drugs (ADM 10mg (n = 5), ERB 20mg (n = 3) and MMC 6 mg (n = 3)) were studied in patients who underwent hepatectomy after intra-arterial injection. The hepatic extraction calculated from the areas under the plasma concentration time curve of both administrations was 40% in ADM, 60% in ERB, and 0% in MMC. From these findings, it is suggested that intra-arterial administration could reduce by half the systemic toxic side effects of ADM or ERB, but the advantage of intraarterial infusion of MMC was not obvious.

Chemotherapy, Adjuvant↗
PubMed1990

Squamous cell carcinoma after endoscopic injection sclerotherapy for esophageal varices.

We report two cases of squamous cell carcinoma of the esophagus following endoscopic injection sclerotherapy for esophageal varices. The interval between sclerotherapy and the development of carcinoma was 24 months in case 1 and 21 months in case 2. The sclerosant was 5% sodium morrhuate in case 1 (total dose, 10 ml) and 5% ethanolamine oleate in case 2 (45.5 ml). Although no recurrent variceal bleeding occurred after sclerotherapy, we could not perform any curative surgical treatment for esophageal cancer because of the advanced stage of the cancer and the severity of the accompanying liver dysfunction. It is difficult to determine the relationship between sclerotherapy and carcinoma; however, long-term surveillance is essential to avoid overlooking a neoplasm in the esophagus after endoscopic injection sclerotherapy.

Carcinoma, Squamous Cell↗
PubMed1986

[Experimental studies on respiratory insufficiency after endoscopic injection sclerotherapy using ethanolamine-oleate].

To study the influence of Ethanolamine-Oleate (EO) used for endoscopic injection sclerotherapy for esophageal varices on the pulmonary hemodynamics, extra vascular lung water (EVLW), and pulmonary and systemic pressures measurements, and blood gas analysis were performed after injection of EO directly into the right atrium in 18 mongrel dogs. Studies were made in three groups, group A (6 dogs) in which the bolus of 1 ml/kg of EO was injected with 1 second; group B (6 dogs) in which 0.25 ml/kg of EO was injected for four times successively within a minute; and controls (6 dogs) the bolus of 1 ml/kg of saline was injected within 1 second. EVLW was measured by thermal-green dye double indicator dilution method. Pulmonary pressures were measured using Swan-Ganz catheter. Results were as follows. In group A, 4 of the 6 dogs died with a symptom of pulmonary edema within several minutes. In the other two, systemic and pulmonary artery pressure did not change, but EVLW and pulmonary artery resistance significantly increased compared to the controls. Intrapulmonary shunt ratio and PO2 were reduced significantly compared to the controls. In group B no systemic hemodynamic changes were observed. But again EVLW significantly increased. These results suggest that the injection sclerotherapy using EO affects pulmonary hemodynamics. And this effect of EO doesn't depend on the total amount of injected EO, but on the concentration of EO reaching the lung. Careful respiratory monitoring seems necessary in patients undergoing injection sclerotherapy.

Animals↗