Biomedical subjects

S Masutani

Publications and source records attributed to S Masutani.

At least 37 records · Page 2Linked to original sources

PubMed1998

[Neoadjuvant intraarterial chemotherapy for ten cases of inflammatory breast cancer by Seldinger's methods].

The conventional methods (CM) of intraarterial (IA) chemotherapy for inflammatory breast cancer were catheterizations from superior epigastric and brachial artery under general anesthesia. Since 1997, we selected the Seldinger's methods (SM) for ten cases of the disease to control local effects and simplify the technique. Complications of the SM were slight, and side effects were equal to those with CM. The postoperative pathological findings of the SM showed the direct effects of chemotherapy to tumor cells (degenerative and necrotic changes) as compared with the embolism-like effects of CM. But the overall histological effects of chemotherapy by SM were almost equal to those for CM. The strong points of the SM were as follows: 1) More selective IA chemotherapy is available, 2) one can find the passage of the aim vessels and no trouble related to catheter, 3) general anesthesia is not necessary, and the techniques are simple, 4) the wounds are not remarkable. The disadvantages are as follows: 1) Patients must rest the day of IA chemotherapy, 2) in 20% of the procedures, one can not search the vessels, and 3) in 4 cases complications of stiffness of Mj or Mn pectral muscles were found. In future, we expect more effective results by dose escalation or combination chemotherapy.

Adenocarcinoma↗

PubMed1998

[Microwave tissue coagulation therapy with mini-laparotomy for hepatocellular carcinoma].

Recently microwave tissue coagulation therapy (MCT) has been established as a therapeutic procedure for hepatocellular carcinoma (HCC). The route of approach to penetrate the tumor is two-fold: By the percutaneous route (PMCT) or by conventional laparotomy. PMCT has the advantage of less invasive therapy, however, it is not applicable to a tumor that cannot be detected by ultrasonography. Therefore, we tried MCT with mini-laparotomy. The patient was a 57-year old man with HCC located in the S6 subsegment. The operation was performed at the semi-right side up position, and laparotomy was done by skin incision of 12 cm in the right hypochondral area. MCT was performed about 30 times, with an output of 60 watts for 45 seconds at a time. Abdominal CT image showed a low-density area of 7 x 4 cm on the 18th postoperative day. Slight damage to the liver and no obvious complications were observed. We concluded that a much wider range-coagulation than PMCT was able to be obtained by MCT with mini-laparotomy, and postoperative quality of life was better than MCT with conventional laparotomy.

Carcinoma, Hepatocellular↗

PubMed1997

[A case of malignant hemangioendothelioma of the lung with rapid growth of pulmonary metastasis].

Malignant hemangioendothelioma of the lung is very rare and difficult to diagnose. The growth is rapid and the prognosis is very unfavorable. We report an operated case of the disease with rapid growth of pulmonary metastasis. The silver, vimentin and factor VIII stainings were available for diagnosis of this disease. The 46-year-old female patient died of bleeding from the pulmonary metastasis eight months after the operation without other distant metastasis. Even if a lung tumor is pointed out and thought to be benign, frequent follow up is necessary. Furthermore, we recommend positive lung biopsy by thoracotomy or video-assisted-thoracic-surgery.

Female↗

PubMed1997

[Hepatic arterial chemotherapy for liver cancer over a period of 8 years].

Hepatic arterial chemotherapy was performed for 27 patients with primary (3), metastatic liver cancer (21), and 3 other cases, over a period of 8 years. Chemotherapy was performed by intermittent hepatic arterial infusion of 5-FU or FAM (in case of metastatic tumor from colorectal cancer), FAM (from gastric cancer), and CDDP or Farmorubicin (HCC). Hepatic resection was performed in 10 cases of metastatic tumor from colorectal cancer, and 8 cases of 10 were curative operation. The 5-year survival rates of curative liver resection group, and non-curative liver resection or non-resection group were 57.1% and 12.5%, respectively. As is the case with metastatic cancer from gastric cancer, pancreatic cancer, and hepatocellular carcinoma (HCC), the prognosis was poor except for one CR case of HCC. We concluded that hepatic arterial chemotherapy may be recommended for a curative resected case of liver metastasis from colorectal cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[A case of liver metastasis of gastric leiomyosarcoma successfully treated by transarterial hepatic chemo-embolization and intra hepato-arterial chemotherapy repeated with infusion-a-port].

The patient was a 68-year-old male, who underwent total gastrectomy for giant leiomyosarcoma of the stomach and then had multiple hepatic metastases one year and six months later. Thus, transarterial hepatic chemo-embolization therapy with Lipiodol, adriamycin and gelfoam was given. Moreover, using a reservoir catheter and infusion arterial port, intermittent arterial infusion therapy with adriamycin, cyclophosphamide, and vincristine was attempted. In the metastasis lesion where there were rich blood vessels, Lipiodol was accumulated and the tumor was reduced on abdominal CT. The result indicated the efficacy of this treatment.

Aged↗

PubMed1996

Neurally mediated syncope complicated with paroxysmal atrial fibrillation.

Recently, it has come to be accepted that the result of the tilt test is specific to neurally mediated syncope (vasovagal syncope). Only rarely is a case of paroxysmal atrial fibrillation without any organic diseases in childhood reported. A case reported here of a 14-year-old boy with neurally mediated syncope; which was complicated by paroxysmal atrial fibrillation, and which was diagnosed by performing the tilt test. Atrial fibrillation can be induced by the extraordinary stimulation of the vagal nerve during syncope. In a child, neurally mediated syncope complicated with paroxysmal atrial fibrillation has not been previously reported.

Adolescent↗

PubMed1994

The prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

OBJECTIVE: To evaluate the prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma. DESIGN: Retrospective study. SETTING: The Center for Adult Diseases, Osaka, Japan, between 1980 and 1989. PATIENTS: One hundred eighty-five patients with hepatocellular carcinoma who underwent liver resection with complete extirpation. MAIN OUTCOME MEASURE: Cumulative survival rate. RESULTS: The patients were divided into a wide surgical margin group, in which the lesion was excised with a margin of 1.0 cm or more, and a narrow surgical margin group, in which the margin was less than 1.0 cm. No significant differences could be detected in survival rates for 3 years or longer. Mean +/- SE tumor sizes were 3.4 +/- 0.4 cm and 4.4 +/- 0.3 cm, respectively, in the wide and narrow surgical margin groups. The patients were divided into three groups according to tumor size: group 1, 2.0 cm or less in diameter; group 2, greater than 2.0 cm but 5.0 cm or less in diameter; and group 3, greater than 5.0 cm in diameter. In groups 2 and 3, no significant differences in survival rates were found between the wide and narrow surgical margin groups. In group 1, the survival rate was significantly higher in the wide surgical margin group than in the narrow surgical margin group (P < .05). CONCLUSIONS: Small hepatocellular carcinomas of 2.0 cm or less in diameter should be resected with an adequate surgical margin. However, surgical margin was not a significant factor in the resection of hepatocellular carcinomas larger than 2.0 cm.

Adult↗

PubMed1994

Apoptosis of acinar cells in the pancreas of rats fed on a copper-depleted diet.

Male Fischer 344 rats weighing 80-90 g were fed on a copper-depleted diet supplemented with 0.6% triethylenetetramine tetrahydrochloride (a copper chelator), and the death of pancreatic acinar cells of these rats was investigated morphologically and biochemically. The weight of the pancreas of these rats decreased from 3 weeks after feeding, and concomitantly the percentage of dead acinar cells increased to the maximum in about the 5th week and decreased subsequently. These dead acinar cells showed light microscopic and electron microscopic characteristics of apoptosis. Furthermore, the electrophoretic pattern of DNAs extracted from the pancreas having many dead acinar cells showed a ladder-like distribution, characteristic of apoptosis. The present results indicate that feeding of rats on a copper-depleted diet supplemented with a copper chelator results in apoptosis of acinar cells of the pancreas.

Animals↗

PubMed1994

Necrosis of hepatocellular carcinoma caused by spontaneously arising arterial thrombus.

This paper describes a 65-year-old Japanese man with hepatocellular carcinoma (HCC) in whom the alpha-fetoprotein level decreased remarkably without any treatment. Plain computed tomography disclosed a low-density area in the left lateral segment. Liver scintigraphy revealed a filling defect with 99mTc-Sn colloid and increased uptake of 67Ga-citrate. The latter was smaller in area than the former. This indicates that non-necrotic HCC was still present at this time. There was no hypervascular lesion in the hepatic angiogram obtained 22 days after liver scintigraphy. The tumor was resected by partial hepatectomy 24 days after hepatic angiography. The histological section showed almost complete necrotization of the tumor, and the necrotic change consisted of old and recent necrosis. An arterial thrombus was formed in non-tumor liver tissue. It was presumed that coagulative necrosis was produced by interruption of the blood supply due to the spontaneous formation of an arterial thrombus.

Aged↗

PubMed1994

[A long-survival case of unresectable liver metastasis of colon cancer by hepatic arterial intermittent multidrug infusion chemotherapy].

We experienced a long-survival case with unresectable liver metastasis of sigmoid cancer by hepatic arterial intermittent multidrug infusion chemotherapy. The patient was a 65-year-old man. A movable tumor was palpable at the left lower abdomen. The serum CEA value was 15.6 ng/ml. Abdominal CT scan showed a 3 cm-sized low-density area near the root of the right and middle hepatic vein in segment 4. He had undergone sigmoidectomy, cholecystectomy and cannulation into the proper hepatic artery. Chemotherapy was performed by using 5-FU (250 mg), Adriacin (5 mg) and mitomycin C (4 mg) every second week from 4 months after surgery as an outpatient. In the CT scan image, the low-density area completely disappeared at 10 months after treatment, and the CR interval was 14 months. The patient has been alive for 5 years after surgery.

Adenocarcinoma↗

PubMed1993

Palliative surgical treatment for recurrent and non-resectable hepatocellular carcinoma.

Of 275 patients who had a radical hepatic resection for HCC, 143 (52%) experienced recurrences. Of these 143 patients, the liver was the site of first recurrence in 130 patients (91%). The first form of therapy for recurrent patients was transarterial chemoembolization (TACE) in 82 (74%), hepatic resection in 15 (14%) and percutaneous ethanol injection in 6 (5%) of the 111 patients who received regional therapy. Post-recurrent survival rates of TACE and hepatic resection were 37%, 77% at 3 years and 17%, 77% at 5 years, respectively. Wrapping therapy was performed in seven patients, two of whom had received repeat TACE for intrahepatic recurrence; the remaining 5 were unresectable cases. After wrapping therapy, the area of previous collateral feeders was be supplied by the hepatic artery. The high level of AFP decreased dramatically. This procedure resulted in a complete response in 2 patients, a partial response in 3 and no change in 2. Overall survival was 4-54 months, and the median survival was 18 months. Two patients are still alive, 18 and 20 months after the procedure.

Adult↗

PubMed1993

[Changes of serum interleukin 6 (IL6) and acute phase protein after hepatectomy in patients with chronic liver disease].

We examined the changes in serum levels of interleukin 6 (s-IL6) and acute phase protein (APP) during perioperative periods in patients with or without chronic liver disease (CLD) who underwent hepatectomy or other surgeries. The elevation of s-IL6 on the first postoperative day was only correlated with preoperative values of indocyanine green retention test (ICG-R15) (r = 0.56, p < 0.01), and not concerned with any operative factors. We divided the patients into the following three groups; the patients with CLD undergoing hepatectomy (n = 21, group A), the patients without CLD undergoing hepatectomy (n = 7, group B), and the patients without CLD undergoing surgeries other than hepatectomy (n = 7, group C). The values of s-IL6 on preoperative day, 1st, 4th, and 7th days after surgery in group A were significantly higher than the corresponding values in group C (p < 0.05). Among the hepatectomy groups, the serum levels of APP on the 4th day after surgery were significantly higher than those on preoperative day. We concluded that the changes in s-IL6 after hepatectomy were strongly concerned with preoperative liver function, especially with values of ICG-R15. However, it seemed that the induction of APP was negatively correlated with the preoperative liver function.

Acute-Phase Proteins↗

PubMed1993

[Pharmacokinetics following intraperitoneal sequential administration of cisplatin and fluorouracil for gastric cancer].

Gastric cancer patients with peritoneal dissemination underwent a palliative resection of the stomach and received an intraperitoneal administration of CDDP (70 mg/m2) and 5-FU (700 mg/m2), immediately after the surgery. The levels of CDDP and 5-FU in serum and peritoneal cavity were serially monitored in order to study the pharmacokinetics of these drugs. group A (n = 9): CDDP dissolved in 500 ml saline was infused intraperitoneally at 200 ml/min, and one hour later, 5-FU dissolved in 500 ml saline was infused at the same speed. The infusion catheter was clamped for two hours after completion of 5-FU infusion. Group B (n = 3): CDDP in 500 ml saline were infused at 10 ml/min and then 5-FU in 500 ml were infused at 5 ml/min. Group C (n = 2): CDDP in 1,000 ml saline was infused at 200 ml/min. Group D (n = 2): 5-FU in 1,000 ml saline was infused at 200 ml/min. The free CDDP levels in the peritoneal cavity were 22 micrograms/ml in group A, 57 micrograms/ml in group B, and 13 micrograms/ml in group C at one hour after completion of the infusion. The 5-FU levels in the peritoneal cavity measured two hours after completion of the infusion were significantly higher in the group B (349 micrograms/ml) than in group A (132 micrograms/ml) and C (71 micrograms/ml). The Cmax of 5-FU in serum was lowest in group B. The AUCs in the peritoneal cavity of free CDDP and 5-FU were 63.6 micrograms.hr/ml and 925 micrograms.hr/ml, respectively. These values were above the 10th percentile of IC90 for gastric cancer. No serious complications were encountered in group A and B where both CDDP and 5-FU were administered as compared with group C and D, where either CDDP or 5-FU was administered.

Chemotherapy, Adjuvant↗

PubMed1993

[Evaluation of intra-arterial infusion chemotherapy and radical pancreatectomy in patients with locally advanced pancreatic cancer].

This is a retrospective study to evaluate arterial infusion chemotherapy and resection for locally advanced pancreatic cancer involving retro-peritoneal organs or large vessels such as superior mesenteric artery or celiac trunks. Intra-arterial chemotherapy was performed for 19 patients, and 15 underwent pancreatectomy. Patients in the intra-arterial chemotherapy group could live 11 months out of the hospital, against 4 months in the resected cases (p < 0.05). The period of over 2nd degree in performance status was 11 months in the arterial chemotherapy group and 3 months in resected groups (p < 0.05). The survival rates were 53, 18 and 9% at 1, 2 and 3 years in the patients with arterial chemotherapy, respectively, against 22, 15 and 15% in the resected patients (p < 0.05). These results suggested that intra-arterial chemotherapy was significantly effective in prolonging the survival period with a better quality of life.

Angiotensin II↗

PubMed1993

[Significance of preoperative TAE as an adjuvant therapy for hepatocellular carcinoma].

In 304 patients with hepatocellular carcinoma who underwent hepatic resection, 162 patients received chemoembolization before surgery (group A) and the remaining 142 patients received no therapy before surgery (group B). The 5-year disease-free survival (DFS) of group A and B were 36% and 21%, respectively, and there were no significant differences between them. In the groups of patients with good liver function (Child A), or patients with solitary tumor, or patients with tumors more than 5 cm in size, DFSs of group A were significantly better than those of group B. The difference of DFS between group A and B was largest in the group of the patients with tumors more than 5 cm in size.

Carcinoma, Hepatocellular↗

PubMed1993

["Partial wrapping therapy" for recurrent hepatocellular carcinoma by transthoracic route].

Two patients with recurrent hepatocellular carcinoma close to the diaphragma, underwent TAE following decollateralization using silicone rubber sheeting with thoracotomy. The patients suffered from severe liver cirrhosis. Laparotomy was not carried out for the preservation of hepatic function. After wrapping therapy, serum AFP level was reduced to almost the normal range in one case, but in another case to half because of bilateral lung metastasis. The maximum serum level of postoperative serum total bilirubin in these 2 cases was 2.0 mg/dl and 1.6 mg/dl, respectively. We think wrapping therapy with thoracotomy is readily applicable for patients with severe cirrhosis.

Aged↗

PubMed1992

Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma.

BACKGROUND: As one of the reasons for the poor prognosis of patients with hepatocellular carcinoma (HCC) and cirrhosis, the influence of cirrhosis itself has not been clarified. METHODS: We compared the postoperative long-term courses of patients with HCC and cirrhosis with the courses of patients with HCC and without cirrhosis to determine how the coexisting cirrhosis affected the prognosis after surgery. The patients with HCC who underwent curative hepatic resection consisted of 142 with associated histologically confirmed cirrhosis and 48 without cirrhosis. RESULTS: The 5-, 7-, and 9-year survival rates were 44%, 32%, and 26%, respectively, in the patients with cirrhosis and 68%, 57%, and 57%, respectively, in the patients without cirrhosis. The prognosis of the group with cirrhosis was significantly worse than that of the group without cirrhosis. The main cause of death in both groups was cancer recurrence. The patients with cirrhosis had significantly lower recurrence-free survival rates at 3 years and later than had the patients without cirrhosis. A comparison of the background factors revealed no substantive disadvantages with regard to tumor-related and surgical factors in the patients with cirrhosis compared with the patients without cirrhosis. The recurrence-free survival rates after minor and major resection indicated fewer disadvantages of limited hepatectomy in the group with cirrhosis than in the group without cirrhosis. Moreover, the recurrence-free survival of the group with cirrhosis was shorter at less advanced stages than at more advanced stages when compared with that of the group without cirrhosis. CONCLUSIONS: The higher carcinogenic potential in cirrhosis could be presumed to be the most likely reason for the poorer prognosis after surgery in the patients with HCC and cirrhosis.

Carcinoma, Hepatocellular↗

PubMed1992

["Wrapping therapy" for advanced hepatic cancer with arterial and intraportal infusion chemotherapy].

A new treatment method to intercept collaterals using silicone rubber sheeting was used for 5 patients with advanced hepatic cancer. The therapy was carried out to prevent new collaterals. This procedure was followed by arterial chemoembolization, arterial infusion chemotherapy and intraportal infusion chemotherapy. The results were complete response in 2 patients, partial response in 2 patients, and no change in 1 patient. The overall survival time was 7-54 months after wrapping. Although a randomized control study is necessary to assess the true value of this method, the new therapy is considered worth using as an adjuvant treatment for advanced hepatic malignancies uncontrolled by arterial chemotherapy or chemoembolization.

Antineoplastic Agents↗