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Biomedical subjects

S Uetsuji

Publications and source records attributed to S Uetsuji.

At least 37 records · Page 2Linked to original sources

Gallbladder cancer with double pancreatic ducts--a case report.

Various forms of anomalous pancreatic ducts may be encountered. We treated a patient with very rare courses of pancreatic ducts associated with gallbladder cancer. The patient, a 65-year-old female, attended our hospital with epigastric pain and general malaise. Abdominal sonography and a CT scan led to the diagnosis of gallbladder cancer. Endoscopic retrograde cholangiopancreatography revealed two main pancreatic ducts that followed a parallel course and joined the end of the common bile duct to form a common duct. The common duct opened at the ampulla of Vater. Thus, duplicated ducts of Wirsung served as the main pancreatic ducts, with no duct of Santorini. The embryonal mechanism and the clinical significance of double pancreatic ducts remains unknown, and our case is very rare.

Adenocarcinoma↗

Clinical evaluation of a low junction of the cystic duct.

The point of the junction of the cystic duct with the common hepatic duct was studied by means of various preoperative and intraoperative cholangiographic procedures and by gross intraoperative examinations in 468 surgical patients with biliary diseases. The cystic duct entered the hepatic duct at a very low position and was consequently long in 39 patients. The clinical significance of this abnormally low junction of the cystic duct was studied in comparison with 358 patients with gallstones with a normal cystic duct-hepatic duct junction. In the low-junction group with a short common bile duct several complications, including gallstone pancreatitis (7 patients), the Mirizzi syndrome (7), confluence stones (2), gallbladder cancer (3), and congenital dilation of the cystic duct (1), were demonstrated preoperatively. The anomalous junction of the cystic duct with the common bile duct may cause stagnation of bile and/or reflux of pancreatic juice into the bile duct, producing a choledochopancreatic ductal junction and posing difficulties at surgery.

Adult↗

[Prognostic judgment of fulminant hepatitis by measurement of hepatosplenic volume ratio by computed tomography].

The liver and spleen volume ratio (S/L ratio) was estimated with X-ray computed tomography and evaluated by comparison with the prognosis in 10 patients with fulminant hepatitis. S/L ratio of control group (n = 10) was 0.122 +/- 0.026 (mean +/- SD), that of the alive group with fulminant hepatitis (n = 5) was 0.112 +/- 0.021, and that of the dead group (n = 5) was 0.308 +/- 0.136. There is a significant difference between S/L ratio of control group and that of the dead group with fulminant hepatitis. The rise of S/L ratio on the patients with fulminant hepatitis reflects the liver atrophy or splenomegaly and the prognosis was poor. The prognosis of the patients with fulminant hepatitis, whose S/L ratio indicated the near value of control group, was good. The measurement of S/L ratio by computed tomography was considered to be useful to evaluate the prognosis of fulminant hepatitis.

Adult↗

Effect of aprotinin on metastasis of Lewis lung tumor in mice.

Kallikrein activity in human stomach tissue was measured and found to be about threefold higher in cancer tissue than in normal tissue. To clarify the physiological role of this tissue kallikrein, we investigated its effects on the spontaneous metastasis and tumor growth of Lewis tumors (3LL). Antiprotease, aprotinin, and gabexate mesilate (FOY) inhibited spontaneous metastasis but did not inhibit tumor growth, while tissue kallikrein and plasmin enhanced the spontaneous metastasis of 3LL. The results suggest that the inhibitory effects of aprotinin and FOY on metastasis are not only due to an inhibition of tumor cells released by tissue kallikrein, but that tissue kallikrein, a protease, also participates in metastasis. We thus conclude that aprotinin or FOY should be administered either before or immediately after operation to inhibit spontaneous metastasis.

Animals↗

Absence of colorectal cancer metastasis to the cirrhotic liver.

Hepatic metastasis of colorectal cancer was found in 40 (16%) of 250 patients with colorectal cancer treated in our department during the past 5 years. Liver cirrhosis was not found among the 40 patients with metastases (16%) but was present in 46 (21.9%) of the 210 nonmetastatic patients, with a significant difference between the two groups (p less than 0.001). The rate of patients who were positive for hepatitis B surface antibody was 10% in the metastatic group and 34.3% in the nonmetastatic group, with a significant difference (p less than 0.01). These findings suggest that colorectal cancer does not metastasize to the injured liver, especially the cirrhotic liver.

Colorectal Neoplasms↗

[Clinical evaluation of the measurement of hepatosplenic volume ratio by computed tomography].

The liver and spleen volume ratio (S/L ratio) was estimated with X-ray computed tomography. Clinical usefulness of S/L ratio was evaluated by comparison with other liver functions (retention rate of ICG, total bilirubin, serum albumin and cholinesterase activity) in 42 hepatocellular carcinoma patients with liver cirrhosis. The correlation between S/L ratio and retention rate of ICG, total bilirubin, serum albumin or cholinesterase activity was good (r = 0.870, r = 0.719, r = -0.691, or r = -0.606, respectively p less than 0.001). Positive correlation was observed between S/L ratio and retention rate of ICG or total bilirubin. Negative correlation was observed between S/L ratio and serum albumin or cholinesterase activity. In conclusion, the measurement of S/L ratio on computed tomography was considered to be useful as an evaluation for the degree of severity in liver cirrhosis by considering both effective hepatic blood flow and portal hypertension.

Adult↗

[Disappearance of lung metastases from hepatocellular carcinoma following bronchial arterial infusion of CDDP and MMC].

A 58-year-old man was admitted to our department because he had been diagnosed as hepatocellular carcinoma, which was located at S6 segment, and posterior segmentectomy was performed. After 6 months, right lung metastases of HCC were found and right bronchial arterial infusion of CDDP and MMC was performed twice. Dramatic effects were obtained such as disappearance of lung metastases. We emphasize the useful effect of CDDP and MMC for metastases of HCC.

Antineoplastic Combined Chemotherapy Protocols↗

Change in the acid protease activity in plasma of patients with disseminated intravascular coagulation.

Lysosomal protease was determined in the serum of patients with disseminated intravascular coagulation (DIC) to clarify whether the platelet count is an appropriate diagnostic index which allows the early initiation of treatment. The platelet count and the serum level of cathepsin D, a lysosomal protease, were determined in 60 patients diagnosed to have DIC. The cathepsin D activity could not be detected in the sera of healthy individuals with a platelet count of 100,000 or above, but was detectable in the serum of DIC patients with a platelet count of 100,000, and this activity increased as the platelet count decreased to 70,000 and 50,000, and was about 5 times higher at a platelet count of 30,000 than at 70,000. In DIC patients, the decrease in the platelet count was correlated with the increase in the serum lysosomal protease activity. The appearance of cathepsin D activity in the serum of DIC patients is considered to reflect the release of lysosomal enzyme activities from damaged organs, and the treatment for DIC must be initiated before the platelet count decrease below 100,000, and cathepsin D activity then appears in the serum. At a platelet count of 30,000 or less, DIC becomes established, and no therapeutic effects can be expected because of the associated multiple organ failure.

Cathepsin D↗

Inhibition by selenium of intrahepatic cholangiocarcinoma induction in Syrian golden hamsters by N'-nitrosobis(2-oxopropyl)amine.

The effects of selenium supplementation on induction of cholangiocarcinomas and related precancerous lesions in female Syrian Golden hamsters by N'-nitrosobis(2-oxopropyl)amine (BOP) were investigated. Four-week-old animals were divided into two groups according to the selenium level contained in the drinking water (0.1 ppm or 4.0 ppm) and fed a purified diet containing less than 0.05 ppm of the trace element. Starting at Week 4 of the experiment, hamsters were administered 10 weekly injections of BOP (10 mg/kg body wt) and then killed 18 weeks after the last carcinogen administration. Animals receiving physiological saline alone served as controls. Cholangiocellular carcinomas tended to be reduced, and putative preneoplastic lesions of cholangiofibrosis were significantly decreased in the high-as opposed to the low-selenium groups in terms of both incidence rate and number per effective animal. The respective high and low selenium values for incidence and number were 24/38% and 0.34/0.66, respectively, for cholangiocarcinomas and 50/89% and 1.21/8.44, respectively, for cholangiofibroses. Proliferation of intrahepatic bile ducts was also significantly inhibited in the high-selenium group along with cyst formation. Biochemical investigation revealed both selenium level and glutathione peroxidase activity to be significantly greater in the high-than in the low-selenium group livers. The results thus suggest that selenium may inhibit BOP-induction of bile duct lesions, possibly via glutathione peroxidase-mediated alteration of carcinogenesis.

Adenoma, Bile Duct↗

Inhibitory effect of selenium on hamster pancreatic cancer induction by N'-nitrosobis(2-oxopropyl)amine.

The effect of selenium intake on the development of pancreatic cancer was investigated in female Syrian golden hamsters. Four-week-old hamsters were divided into 2 groups according to the selenium level in their drinking water and were fed a purified diet containing less than 0.05 ppm selenium. Starting 4 weeks later, groups received 10 s.c. injections at weekly intervals of N'-nitrosobis(2-oxopropyl)amine (BOP) dissolved in saline, while controls received saline alone. When the animals were killed 18 weeks after the last injection, palpable tumors were less frequent in the high-selenium group than in animals receiving low-selenium supplement, the numbers of histologically diagnosed cancerous lesions also being significantly reduced by high selenium intake. The selenium level and glutathione peroxidase activity in serum and pancreas were significantly greater in the high-selenium group. Moreover, selenium levels and glutathione peroxidase activity were both significantly higher in tumor-bearing tissue. The results suggest that glutathione peroxidase is involved as an intermediate factor in prevention of carcinogenesis by selenium.

Animals↗

Response of fibronectin to liver regeneration after hepatectomy.

The relationship between plasma fibronectin concentration and the regenerative process in liver remnants after hepatectomy was studied in 12 patients and in male Sprague-Dawley rats with and without cirrhosis. Plasma fibronectin levels were reduced immediately after hepatectomy in humans and rats. Patients and rats without cirrhosis displayed preoperative fibronectin levels within 1 mo and 1 wk, respectively, but low fibronectin levels persisted longer in those with cirrhosis. Plasma fibronectin levels correlated well with the degree of hepatic regeneration in the patients with cirrhosis (r = 0.4227; p less than 0.05) and without cirrhosis (r = 0.8148; p less than 0.001), and also with the percentage of change in liver weight during regeneration in the rat with thioacetamide-induced cirrhosis (r = 0.4905; p less than 0.01) or in the rat without cirrhosis (r = 0.6422; p less than 0.001). These results suggest that plasma fibronectin is a useful marker for the detection of regenerating liver.

Adult↗

Effect of administration of fibronectin or aprotinin on liver regeneration after experimental hepatectomy.

Following 70% hepatectomy, male Sprague-Dawley strain rats were given purified human plasma fibronectin and/or aprotinin intraperitoneally after hepatectomy and were divided into 4 groups: Group FA (40 mg/kg of FN and 25,000 KIU/kg of aprotinin), Group F (40 mg/kg of fibronectin), Group A (25,000 KIU/kg of aprotinin), and Group C which served as a control. The liver regeneration rate 72 hours after hepatectomy in Groups FA and F, and the plasma FN levels at 24 and 72 hours following hepatectomy in groups with FN, were significantly higher than that of the control group. The incorporation of 3H-thymidine into DNA and the phagocytic index of the reticuloendothelial system at 24 hours in Groups FA and F, and the mitotic index at 72 hours after hepatectomy in Group FA were significantly increased as compared to the control. But the supplementation of 20 mg/kg of indomethacin to the 4 groups resulted in significant suppression of 3H-thymidine uptake 24 hours after hepatectomy. Moreover, plasma fibronectin levels in rats correlated well with the phagocytic index and DNA synthesis 24 hours following partial hepatectomy. These results suggest that fibronectin may act as an activator of the reticuloendothelial system, related to prostaglandins, in the process of liver regeneration.

Animals↗

[Primary liver cancer coincident with schistosomiasis japonica].

The etiologic relationship of a parasitic liver disease to primary liver cancer has long been debated, and reported is a case that has been encountered of a primary liver cancer coincident with Schistosomiasis japonica. A fifty-nine year-old-man was diagnosed as having a primary liver cancer complicated with liver cirrhosis. A posterior segmentectomy was performed and a microscopic examination revealed a primary liver cancer with multiple ovae of Schistosoma japonicum in the fibrous stroma of the portal spaces. Discussed is the etiologic relationship of Schistosomiasis japonica to the primary liver cancer.

Carcinoma, Hepatocellular↗

[A double cancer of the gallbladder and common bile duct associated with an anomalous arrangement of the choledocho-pancreatic ductal junction--a case report and a review of the literature].

Reported is the case of a 65-year-old woman who complained of general fatigue and itching. The cancer of the gallbladder and the common bile duct associated with anomalous arrangement of choledocho-pancreatic ductal junction was diagnosed after examination by ERCP, PTCS, US, and CT. The cancer of the common bile duct had metastasized to the pancreas, the portal vein, and the regional lymph nodes and was unresectable. It is well known that an anomalous arrangement of the choledocho-pancreatic ductal junction is highly associated with a cancer of the common bile duct or the gallbladder. But a case that is associated with double cancers is rare and only 6 cases have been reported in the Japanese literature. In addition to a discussion of this case, the literature is reviewed.

Aged↗