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S Kakizoe

Publications and source records attributed to S Kakizoe.

At least 19 recordsLinked to original sources
PubMed2001

Changes in the caudate lobe that is transplanted with extended left lobe liver graft from living donors.

BACKGROUND: Caudate lobe transplantation with an extended left lobe graft is an innovative and promising method for increasing the graft volume in living donor liver transplantation. However, little is known about the fate of the caudate lobe after transplantation. METHODS: Eight extended left lobe grafts with the caudate lobe were included in this study. No attempt was made to reconstruct the short hepatic veins. On the basis of the computed tomography scans that were obtained before the operation and 1 month after the transplantation, the increase in the graft volume by the addition of the caudate lobe and the changes in the transplanted caudate lobe were evaluated. RESULTS: The addition of the caudate lobe increased the graft volume by 25 +/- 2 g, corresponding to a 2% increase in graft volume/standard liver volume ratio. One month after the transplantation, the caudate lobe volume increased in all patients but 1. The regeneration rate of the caudate lobe and other segments (segments II-IV) 1 month after transplantation was 62% +/- 24% (24 +/- 4 mL- 37 +/- 4 mL) and 152% +/- 35% (374 +/- 45 mL-930 +/- 65 mL), respectively (P <.01). CONCLUSIONS: This technique affords a modest increase in liver volume with living donor left liver procurement.

Humans↗
PubMed1999

Deletion variant of hepatocyte growth factor prolongs allograft survival after liver transplantation in rats.

BACKGROUND: Despite continued progress in the development of immunosuppressive agents, allograft rejection remains an important cause of morbidity and mortality after liver transplantation. We examined the effect of the deletion variant of hepatocyte growth factor (dHGF) on allograft rejection after liver transplantation. METHODS: Male Dark Agouti rats (RT1a) were selected as donors and male Lewis rats (RT1l) as recipients for a rejection model. The recipients were divided into 2 groups after orthotopic liver transplantation (OLTx): in the dHGF group dHGF was given intravenously twice a day (1 mg/kg/day) after OLTx, whereas in the control group vehicle buffer was given intravenously daily twice after OLTx. The survival period, serum chemistry studies, and histopathologic findings were then compared between the 2 groups. RESULTS: The mean survival period after OLTx in the dHGF group was significantly longer than that in the control group (21.4 +/- 1.3 days vs 11.8 +/- 0.4 days, P < .001). On the 10th posttransplant day the serum albumin level significantly improved in the dHGF group (P < .01), and the serum total bilirubin and aspartate aminotransferase levels were significantly lower in the dHGF group (P < .01 and P < .05, respectively). On the 10th posttransplant day a histologic examination revealed no apparent difference in the severity of rejection between the 2 groups. The number of proliferating cell nuclear antigen-positive hepatocytes in the dHGF group significantly increased (P < .01), whereas the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling-positive hepatocytes were significantly reduced in the dHGF group (P < .01) in comparison with those in the control group. CONCLUSION: dHGF has an antiapoptotic property as well as a proliferative and protective effect on hepatocytes under allograft rejection. dHGF might serve as a novel agent for reducing the harmful effects of hepatic allograft rejection in rats.

Amino Acid Sequence↗
PubMed1998

Rectal expander-assisted transanal endoscopic microsurgery in rectal tumors.

Rectal expander-assisted transanal endoscopic microsurgery (RE-TEM) was performed for two cases of early rectal cancer and a case of villous tumor under saddle block anesthesia. RE-TEM is the new technique for local excision of rectal tumors with a rectal expander that we developed. The rectal expander expands the rectum after insertion through the anus and provides adequate vision for microsurgery with standard video monitors. Tumors were located 8, 8, and 5 cm from the anal verge, and all of them were excised completely with no difficulty. Minor bleeding was noted in all cases and was controlled by electric coagulation and/or sutures. Average operative time for the three cases was 105 min. We conclude that RE-TEM is useful for rectal tumors and/or early rectal cancer that cannot be removed by endoscopy.

Adenocarcinoma↗
PubMed1998

[Frequent chemolipiodolization and prostaglandin E1 administration for hepatocellular carcinoma with advanced liver cirrhosis].

"Frequent Chemolipiodolization & Prostaglandin E1 administration Therapy (FCPT)" which performed frequent chemolipiodolization to Hepatocellular carcinoma (HCC) and Prostaglandin E1 (PGE1) intra-hepatic arterial administration for avoiding serious liver damage by using reservoir was carried out for 7HCC cases with severe liver cirrhosis. Chemolipiodolization was performed every 4 weeks to 6 cases. PGE1 was given to all cases with 10 or 20 micrograms/4 hours every week after 7 days administration. In 6 cases that carried out Chemolipiodolization, FCPT demonstrated complete response in a case and partial response in 3 cases. Two other cases showed the progression of HCC in spite of the frequent chemolipiodolization. The serum hepaplastin levels were stable or improved in 5 cases. Improvement of the serum total protein levels was seen in the long survival cases. The general malaise of all cases was disappeared after FCPT. In 5 cases who had ascites before FCPT, the ascites was gradually decreased. We concluded that the FCPT was useful to treat HCC with advanced liver cirrhosis, and also the intra-hepatic arterial administration of PGE1 might have the possibility that is contributing to the liver function improvement of a liver cirrhosis.

Aged↗
PubMed1998

[Japan Surgical Society recertification: the viewpoint of surgeons in a local area].

The system of recertification is evaluated from the view point of the surgeons in a local area. The system only requires attendance at the national meeting of the Japan Surgical Society and/or meetings that are designated by the Japan Surgical Society for recertification. Half of such meetings have been held in the Kanto area over the past 10 years, resulting in an imbalance in the status of recertification between surgeons in the Kanto area and in local areas. In questionnaires about surgical recertification in local areas, many respondents pointed out this imbalance and the necessity for changing the conditions of recertification. The aim of recertification must be clarified and a new system of recertification investigated based upon the purpose of certification without imbalances between areas.

Certification↗
PubMed1996

Tolerance of the cirrhotic liver to cold ischemia: ex vivo analysis in rats.

We investigated the viability of rat cirrhotic livers preserved cold using an isolated rat liver perfusion model. Cirrhosis was induced by intravenous thioacetamide injection. Normal and cirrhotic livers were reperfused immediately or following 6 h of preservation through the portal vein with Krebs-Henseleit buffer and hyaluronic acid added. Cirrhotic livers with short cold ischemia showed higher portal venous resistance than their normal counterparts (p < 0.05), while cirrhotic livers preserved for 6 h exhibited marked elevation of the portal venous resistance as compared with their fresh counterparts or normal liver preserved cold for 6 h (p < 0.05). Similarly, the oxygen consumption of cirrhotic livers with short cold preservation was lower than that of normal livers (p < 0.05), which was further reduced by 6 h of cold preservation (p < 0.05). The bile output was not different between normal and cirrhotic livers. The sinusoidal endothelial cell function of cirrhotic livers as assessed by the clearance of hyaluronic acid was impaired even after a short period of cold ischemia. Histologically, cirrhotic livers showed severe sinusoidal endothelial cell damage, hepatocellular swelling, and marked septal edema which became more prominent by cold preservation. We conclude that the viability of the cirrhotic liver is impaired even by a short cold exposure, and that the prolongation of cold ischemia of the cirrhotic liver leads to further deterioration of the viability.

Animals↗
PubMed1995

Partial hepatic grafting: porcine study on critical volume reduction.

BACKGROUND: The safe limit of volume reduction in partial hepatic transplantation, including extracorporeal hepatic resection, remains to be clarified. This study evaluated such a limit and pathologic features associated with transplantation of a less than critical volume. METHODS: Partial hepatic grafting was performed in a porcine orthotopic autotransplantation model. According to the remnant liver volume, animals were classified into three groups: group 1, 73.8% +/- 4.2% (SD); group 2, 52.6% +/- 6.7%; and group 3, 29.4% +/- 6.7% of the whole liver (n = 5 each). RESULTS: Three-day survival was achieved in five (100%), four (80%), and zero animals, respectively. All animals in group 3 died of graft nonfunction; their intraoperative clearance of the total bile acids was significantly worse than the other groups (p < 0.01). After operation the clearance of the total bile acids and hyaluronic acid, which is selectively cleared by hepatic endothelial cells, was significantly better in group 1 than group 2 (p < 0.01 and < 0.05, respectively). On histologic examination postperfusion biopsy specimens of group 3 exhibited severe ischemic changes and portosinusoidal hyperemia, whereas that of groups 1 and 2 exhibited only mild ischemic damages. CONCLUSIONS: Transplantation of less than 30% of expected full liver volume could lead to primary graft nonfunction after partial hepatic grafting.

Animals↗
PubMed1995

Endoscopic findings and clinical manifestation of gastric anisakiasis.

OBJECTIVES: To identify the endoscopic findings and clinical manifestations of anisakiasis, we studied 87 cases of gastric anisakiasis. METHODS: Patient information was analyzed by means of patient records. The interval between the day of intake of Anisakis and endoscopic examination was determined in 86 cases. Then the endoscopic findings of each interval were elucidated. RESULTS: Moderate to severe gastric mucosal edema tends to occur within 1 or 2 days after Anisakis infection, accompanied by leukocytosis. As to the sites of penetration of Anisakis, 55% of cases were found in the greater curvature with severe mucosal edema. Among 87 cases, four patients experienced anisakiasis twice during the interval examined, and six patients had past histories of anisakiasis before the investigated interval. CONCLUSIONS: Gastric anisakiasis may be caused by an allergic reaction to the Anisakis antigen. There is a classic relationship between clinical and endoscopic findings and the interval after Anisakis administration. Anisakis usually is found in the greater curvature.

Adolescent↗
PubMed1994

Serum hyaluronic acid for the assessment of graft viability in porcine liver transplantation.

For the assessment of graft viability, serum hyaluronic acid (HA) levels during porcine orthotopic liver transplantation were measured in two groups: group 1 (viable: n = 5) in which allografts were transplanted following a minimal cold (4 degrees C) preservation, and group 2 (nonviable: n = 4) in which allografts were transplanted after cold static storage (4 degrees C) for 24 h in University of Wisconsin solution. The changes in the HA levels reached a significant difference between the two groups at 30 min after reperfusion (P < 0.02). In group 1, all animals survived for over 4 days, while all animals in group 2 died within 24 h. The serum HA also demonstrated a significant correlation with prothrombin time, beta-glucuronidase, and aspartate aminotransferase at 120 min after reperfusion. These results suggest that the measurement of serum HA is a potentially effective index for evaluating hepatic allograft viability.

Animals↗
PubMed1994

A small pedunculated adenomatous polyp of the colon found to contain the focus of invasive carcinoma extending to the serosa: report of a case.

A small pedunculated polyp was detected among other polyps in the transverse colon of a 64-year-old man, the resected specimen of which showed an adenomatous polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the submucosa, muscularis, and serosa. This case report stresses the importance of performing careful pathologic examination of resected specimens obtained from endoscopic polypectomy, even for small pedunculated colon polyps.

Adenocarcinoma↗
PubMed1994

Percutaneous transhepatic portacaval shunt for high-risk esophageal varices.

Percutaneous transhepatic portacaval shunt (PTPS) was performed in a patient with high-risk esophageal varices prior to sclerotherapy. PTPS was accomplished with the aid of two catheters. The first catheter was placed in the right hepatic vein under ultrasonographic guidance, and the second was placed in the portal vein. The two catheters were then connected together. The color of the esophageal varices changed from blue to white, and serum protein levels were increased 8 weeks after PTPS. Sclerotherapy was then performed without any difficulty. PTPS is the easy and quick method of performing a portacaval shunt and may have importance for the management of patients with high-risk esophageal varices prior to the treatment of sclerotherapy or liver transplantation.

Aged↗
PubMed1993

Prediction of hepatic graft viability before reperfusion: an analysis of effluent from porcine allografts.

Rapid and reliable assessment of hepatic graft viability is important for successful orthotopic liver transplantation (OLTx). OLTx was performed in 11 pairs of pigs via a venovenous bypass. Six of these grafts were transplanted immediately (group A), while the other five were preserved in University of Wisconsin (UW) solution for 24 h and then transplanted (group B). All grafts were flushed with 300 ml of chilled (4 degrees C) Ringer's lactate solution before reperfusion of the graft, when 20 ml of effluent from the graft was collected and the concentrations of ammonia, lactic acid, GOT, and LDH were measured. Four of the six pigs in group A survived longer than 3 days, while the other two pigs died of causes other than graft dysfunction. All five pigs in group B died either of hemoperitoneum or hemodynamic instability due to liver failure. The histology of postperfusion biopsies in group A showed minimal pathological changes, while the grafts in group B revealed moderate to severe ischemic injuries. Ammonia and lactic acid in the effluent of group B were significantly higher than those of group A (1511 +/- 216 vs 417 +/- 333 micrograms/dl and 114.1 +/- 12.2 vs 91.4 +/- 12.2 mg/dl, respectively; P < 0.05 in both cases). Before reperfusion, the rate of total adenine nucleotides in all of the substances in the graft, which were measured using high performance liquid chromatography (HPLC), inversely correlated with the ammonia levels in the effluent. We conclude that an analysis of the effluent, (i.e. the levels of ammonia and lactic acid), flushed from a hepatic graft before reperfusion could serve as a predictor of hepatic graft viability.

Adenine Nucleotides↗
PubMed1993

Extracorporeal hepatic resection for previously unresectable neoplasms.

BACKGROUND: Some hepatic tumors are judged inoperable solely for anatomic reasons, such as the proximity of the tumor with the major vasculature. This is because of high mortality and morbidity rates, as well as a compromised surgical margin. METHODS: We successfully performed extracorporeal hepatic resections in two patients who were judged to have inoperable tumors by conventional means. RESULTS: Both patients had an uneventful postoperative course, and although one patient had intrahepatic recurrence 6 months after operation, the other patient shows no recurrence 10 months later. CONCLUSIONS: Advances in techniques for liver transplantation and organ preservation now allow resection of anatomically unresectable hepatic tumors that were deemed inoperable in the past.

Extracorporeal Circulation↗