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Biomedical subjects

T Matsushiro

Publications and source records attributed to T Matsushiro.

At least 19 recordsLinked to original sources
PubMed1992

[Prospective randomized trial comparing modified FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus 5-FU alone for the treatment of non-resectable pancreatic and biliary tract carcinomas (the 1st trial in non-resectable patients). Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].

The modified FAM (5-fluorouracil (5-FU) + adriamycin (ADR) + mitomycin C (MMC)) therapy (FAM group) was compared with 5-FU mono-therapy (F group) by multi-institutional randomized trial in the patients with cancer of the pancreas or the biliary tract who underwent non-resection. The patients in FAM group received 6 mg/m2 of i.v. MMC during operation, 310 mg/m2 of i.v. 5-FU for 5 days in the 1st and 3rd postoperative weeks and 12 mg/m2 of i.v. ADR in the 2nd postoperative week. Those in F group received only 5-FU course in the administration schedule of FAM group. Among the cases which completed respective whole administration schedules. 35 cases in FAM group and 36 in F group, better effect than partial response (PR) was observed in neither groups, and there was no significant difference between groups with respect to overall/each disease survival duration, progression-suppressed duration and clinical effect. Primary adverse effects were alimentary symptoms and hepatic dysfunction, neither of which was serious, and there was no difference between groups except that hair loss was observed in more cases in FAM group (p less than 0.05). Results in FAM group did not statistically surpass those in F group, but a tendency was observed that FAM group was better than F group in terms of survival duration and clinical effect for cancer of the gall-bladder.

Adult↗
PubMed1991

[Cell kinetic studies on the gallbladder epithelium in patient with anomalous arrangement of pancreatobiliary duct].

It is well known that the patients with anomalous arrangement of pancreatobiliary duct (AAPBD) are combined with biliary tract cancer. To clarify possible carcinogenesis of the gallbladder with AAPBD, DNA analysis of the gallbladder epithelium was performed in control (9 cases), AAPBD (26), gallbladder cancer confined in mucosa (10) and noncancerous epithelium around the gallbladder cancer (21). The mean values of DNA score, as already reported by us as an indicator of cell kinetics, were 12.1 (control), 27.2 (AAPBD, Type a), 13.3 (AAPBD, Type b), 14.8 (noncancerous epithelium around cancer) and 77.2 (gallbladder cancer confined in mucosa). The values of DNA score in the epithelium of AAPBD (Type a) showed significantly high level, which was next to that of cancer. Type a AAPBD may be supposed to have potential malignancy because of its accelerated cell cycle. But as Type b AAPBD without accelerated cell cycle combines cancer at least as often as Type a, further studies should be performed to reveal the relationship between cell cycle and malignancy.

Bile Ducts↗
PubMed1990

Lymphoepithelial cyst in the pancreas: a case report.

A case of lymphoepithelial cyst in the pancreas was reported. A 64-year-old man without any specific complaints was found to have a cystic lesion in the anterior portion of the pancreas, as revealed by ultrasonography of the abdomen at an annual medical examination in 1988. This was dissected easily from the pancreas. Histologically, it was diagnosed to be a benign lymphoepithelial cyst in the pancreas. Cysts of this type are rare, and their histogenesis is also not well understood.

Branchioma↗
PubMed1986

Valvuloplasty plus fundoplasty to prevent esophageal regurgitation in esophagogastrostomy after proximal gastrectomy.

To prevent regurgitation esophagitis in esophagogastrostomy after proximal gastrectomy, valvuloplasty plus fundoplasty was carried out in 17 patients with stomach cancer or cancer of the abdominal esophagus. For this purpose, an equilateral triangular flap of 2.5 cm per side was formed at the upper margin of the remaining stomach along the greater curvature. The flap was inverted into the stomach only to serve as a valve. After the esophagogastrostomy was properly performed, fundoplasty was carried out, lifting and suturing the uppermost edge of the stomach to the esophagus along the greater curvature. To prevent pylorospasm as a result of reduced gastric volume, pyloromyotomy was also performed. The results were excellent in those followed for more than 1 year. The technique is simple and effective and, we believe, deserves further clinical evaluation.

Esophagitis, Peptic↗
PubMed1985

Precancerous lesions of the gallbladder mucosa.

To elucidate the morphological characteristics and the incidence of precancerous lesions of the gallbladder, 200 gallbladders removed for presumed benign diseases were examined histopathologically. Dysplastic epithelia with distinct cellular and structural atypia were graded into either mild or moderate to severe degree. Twenty-nine (14.5%) of 200 cases showed dysplasia; 5 (2.5%) was to moderate to severe degree and 24 (12%) to mild degree. Carcinoma in situ was found in 4 cases (2%) and occult invasive carcinoma in 2 cases (1%). Simple hyperplasia was seen in 54 cases (27%). Abnormal epithelia showed a male preponderance in consistent with the previous report on cancer epidemiology in Japan. Dysplasia and hyperplasia were found to have close association with chronic cholecystitis, but not with gallstones per se. It was postulated that the progression of dysplasia or carcinoma in situ into invasive carcinoma may occur in the sixties to seventies.

Adult↗
PubMed1985

[Pathophysiology of duodenal papillitis in cholelithiasis].

Pathological features of duodenal papillitis relative to cholelithiasis were analyzed in terms of dilatation of the bile duct, intracholedochal pressure, and histopathological pictures of papillitis, and the following conclusions were drawn: The principal causes of bile duct dilatation appeared to be pathological changes in the papilla per se; Papillitis accompanying choledocholithiasis with cholesterol stone were secondary to those gallstones evacuated from the gallbladder; Calcium bilirubinate stones seemed to be formed primarily as the result of papillitis. In some cases, ascariasis in their past history was thought responsible for the papillitis; and 4. It is suggested that as the papillitis advances, papillary incompetence will emerge.

Adult↗
PubMed1984

Exfoliation as a mode of cancer elimination in rectal carcinoma.

A histopathological survey of surgical materials from 143 patients with rectal carcinoma subjected to chemotherapy and low-dose radiotherapy with tegafur and bleomycin was carried out. The chemotherapy combined with radiotherapy brought about better results than chemotherapy alone. In 4 of the 58 patients treated with radiochemotherapy, no cancer cells could be found in surgical specimens. Exfoliation into the rectal lumen of cohorts of cancer cells may occur in some cases of rectal carcinoma thus treated, resulting in cancer cell elimination.

Combined Modality Therapy↗
PubMed1984

Perfusion cholangiomanometry with papillary stimulation by dilute hydrochloric acid.

A modification of cholangiomanometry in which the papilla of Vater was stimulated by hydrochloric acid was devised as a means to evaluate the papillary function. Manometric tracings could be classified into four patterns according to the mode of response to hydrochloric acid of the papilla. Pattern I was the type in which a group of regular, high-amplitude spikes appeared within 60 seconds after the onset of perfusion. This represented a normally functioning papilla. Pattern II was characterized by rhythmic occurrence of low-amplitude waves. This represented a reversible papillitis as evidenced by the fact that postoperatively such cases exhibited pattern I results as examined through T tube. In pattern III the perfusion pressure remained flat, showing no reaction waves. This represented an incompetent papilla. The pattern III patients with conditions which were reversible responded to intravenous pentazocine. In pattern IV the perfusion pressure continued to increase without reaction waves, representing cicatricial stenosis of the papilla or incarcerated stone in the papilla. This method of cholangiomanometry was thus found to be useful for selecting candidates for sphincteroplasty.

Ampulla of Vater↗
PubMed1981

Bile acid composition affecting cholesterol dissolution rate: a use of multiple regression analysis.

The dissolution rate of cholesterol in human gallbladder bile was measured by a rotating-disk method using 14C-labeled cholesterol, and was compared with concentrations of the biliary lipids. Computed multiple regression analysis of the results showed that the dissolution rate of cholesterol could be presented as a function of the concentrations of deoxycholic and chenodeoxycholic acid (multiple correlation 0.905; F-value 51.8 (p less than 0.001)). To examine the effect of different kinds of bile acids on cholesterol solubilization, the cholesterol solubility in a gallbladder bile with addition of a conjugated bile acid was determined. Greater solubilization of cholesterol was observed in the bile with addition of sodium deoxycholylglycine and chenodeoxycholylglycine than that with addition of sodium cholylglycine. There was no additional enhancement of the solubility with addition of sodium ursodeoxycholylglycine. These results suggest that the cholelitholytic effect of chenodeoxycholic acid may be greater than that of ursodeoxycholic acid, since the administration of chenodeoxycholic or ursodeoxycholic acid to patients with cholesterol gallstones induced different alterations of biliary bile acid composition.

Bile Acids and Salts↗
PubMed1981

Factors affecting the cholesterol dissolution ability of human bile.

Bile samples were obtained from 13 patients with cholesterol gallstones at laparotomy. Control bile samples were obtained from 15 patients with gastric cancer or gastric ulcer. One mixed stone was cut in half and serial thin sections, 10 micrometers in thickness, were prepared from the cut surface. The solubility of cholesterol in these gallstone sections after immersion in the bile samples was observed microscopically after 1, 3, 5 and 24 hr. Of 15 control bile samples, 9 showed a marked cholesterol dissolution after 1 hr, and 6 showed it after 3 and 5 hr. Three out of 13 bile samples from the patients with cholesterol stones dissolved the gallstone section after 1 hr, and 7 after 3 and 5 hr. The dissolution was not observed in the remaining 3 bile samples. Cholesterol and total bile acid concentrations of the control bile were significantly higher than those of the bile from the cholesterol gallstone patients (p less than 0.05 and p less than 0.02, respectively). Correlative studies of the composition of bile and its ability to dissolve cholesterol revealed that bile samples with a high total bile acid concentration possessed a higher dissolution ability, even when the ratios of total bile acid to cholesterol were almost the same in control and cholesterol gallstone bile. On the basis of these findings, it may be concluded that the solubility of cholesterol in bile cannot simply be explained in terms of relative concentrations of cholesterol, phospholipids and total bile acid, because the absolute concentration of total bile acid also plays a significant role for the dissolution ability.

Bile↗
PubMed1978

The effect of oral chenodeoxycholic acid on cholesterol solubility in hepatic bile.

By oral administration of chenodeoxycholic acid (CDCA) varying in dose for 7 consecutive days to patients who underwent cholecystectomy with biliary drainage for cholesterol gallstone, the biliary cholesterol dissolubility was studied in pursuit of the optimum dose in CDCA therapy for cholesterol gallstone. The rate of dissolution of biliary cholesterol by CDCA administration was highest in cases of 250 mg/day in dose, followed by those of 750 mg/day. When the dose was observed from per kg of body weight, the dissolubility of cholesterol was highest in the case of 6.3 mg/kg, followed by one of 12 mg/kg. Thus, it is presumed that in CDCA therapy for cholesterol gallstone a dose of 250 mg/day is too small and 750 mg/day too large in amount from the viewpoint of its effectiveness. The optimum dose probably lies between 5 mg/kg and 12 mg/kg. A transient elevation in levels of SGOT and SGPT was observed only in one case treated with 750 mg/kg.

Administration, Oral↗
PubMed1977

Results of surgical treatment for intrahepatic gallstones.

On the basis of the results of our surgical treatment of 85 patients with intrahepatic gallstones, effective methods for surgical treatment of this disease were discussed. The operative mortality rate for these patients was 10.6 percent. Most of the fatal cases had long duration of symptoms and showed evidence of hepatic fibrosis or biliary cirrhosis at the time of operation. The results emphasize that, in cases of long duration of symptoms, it is generally necessary to examine thoroughly prior to operation the presence or absence of liver parenchymal injury and to pay deliberate attention to minimizing operative intervention. Especially, in hepatic lobectomy, its indication must be scrutinized carefully assessing the condition of the patient. In our follow-up study, 80 percent of the patients were found living with almost no complaints, 5 patients having occasional bouts of cholangitic attack included 3 patients who had left the hospital having residual gallstones. Including these 3 patients, 7 of 9 patients with residual gallstones showed severe hepatic dysfunction. In general, indications of our operations for different types of patients with intrahepatic gallstones have been evaluated as satisfactory. For the favorable management of intrahepatic gallstones, two points are specially emphasized: thorough scrutinization of liver parenchymal disorder prior to operation, and long-term observation for care of survivors with residual gallstones.

Adult↗