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Biomedical subjects

Takashi Kenmochi

Publications and source records attributed to Takashi Kenmochi.

13 recordsLinked to original sources
PubMed2006

Aortic occlusion balloon catheter technique is useful for uncontrollable massive intraabdominal bleeding after hepato-pancreato-biliary surgery.

Massive intraabdominal hemorrhage sometimes requires urgent hemostatic surgical intervention. In such cases, its rapid stabilization is crucial to reestablish a general hemodynamic status. We used an aortic occlusion balloon catheter in patients with massive intraabdominal hemorrhage occurring after hepato-pancreato-biliary surgery. An 8-French balloon catheter was percutaneously inserted into the aorta from the femoral artery, and the balloon was placed just above the celiac artery. Fifteen minutes inflation and 5 minutes deflation were alternated during surgery until the bleeding was surgically controlled. An aortic occlusion balloon catheter was inserted on 13 occasions in 10 patients undergoing laparotomy for hemostasis of massive hemorrhage. The aorta was successfully occluded on 12 occasions in nine patients. Both systolic pressure and heart rate were normalized during aortic occlusion, and the operative field became clearly visible after adequate suction of leaked blood. Bleeding sites were then easily found and controlled. Hemorrhage was successfully controlled in 7 of 10 patients (70%), and they were discharged in good condition. The aortic occlusion balloon catheter technique was effective for easily controlling massive intraabdominal bleeding by hemostatic procedure after hepato-pancreato-biliary surgery.

Abdomen↗
PubMed2006

Acute cellular rejection occurring on the first day after living-related renal transplantation: a case report.

The patient was a 52-year-old man who received an ABO-compatible but non-identical living-related renal graft from his wife. The graft started to function immediately and the urine output rate was over 100 mL/h. However, this was gradually decreased within 12 h after transplantation. On day 2 post-transplant, the urine output almost stopped. A biopsy specimen revealed lymphocyte dominant cellular infiltration in the interstitium with mild tubulitis (according to Banff's schema grade Ia) and no C4d deposition in peritubular capillaries. Immunohistochemistry disclosed T-cell infiltration. The patient responded to a course of steroid pulse therapy (five days of 500 mg of methylprednisolone). The urine output gradually increased and the level of serum creatinine gradually decreased to 1.0 mg/dL. These clinical and histological findings strongly suggested acute cellular rejection. Acute cellular rejection occurring within 24 h post-transplant is extremely rare. In the present case acute cellular rejection occurred within the first day after living-related renal transplantation and was strongly suspected from histopathological findings in the allograft biopsy specimen.

ABO Blood-Group System↗
PubMed2005

Hemodynamic changes of splenogastric circulation after spleen-preserving pancreatectomy with excision of splenic artery and vein.

BACKGROUND: The safety of spleen conservation without preservation of the splenic artery and vein was proved on the basis of short-term observation, but the long-term results of this procedure have been uncertain. To clarify the hemodynamic changes of splenogastric circulation of patients undergoing spleen-preserving pancreatectomy with excision of the splenic artery and vein, we retrospectively analyzed patient outcome with particular reference to the assessment of hemodynamic changes of splenogastric circulation. METHODS: Ten patients who had undergone spleen-preserving pancreatectomy with excision of the splenic artery and vein were retrospectively analyzed. In all patients both the short gastric and left gastroepiploic arteries and veins were preserved. All patients were observed for a minimum of 52 months. Collateral venous pathways were evaluated by computed tomography and endoscopy. RESULTS: Early complications such as splenic infarction and atrophy did not occur in any of the patients, but computed tomography revealed perigastric varices in 7 patients (70%) and submucosal varices in 2 patients (20%). Endoscopy showed gastric varices in 2 patients in whom submucosal gastric varices were identified on computed tomography. Gastrointestinal bleeding from gastric varices occurred in 1 patient. In 1 patient without gastric varices, a gastrorenal shunt was demonstrated on computed tomography. CONCLUSIONS: This study confirmed that gastric varices frequently occurred in patients who underwent spleen-preserving pancreatectomy with excision of the splenic artery and vein.

Esophageal and Gastric Varices↗
PubMed2004

Laparoscopic distal pancreatectomy as the total biopsy of the pancreas: tool of minimally invasive surgery.

Because of recent progress in imaging modalities, the opportunities to detect pancreatic cystic neoplasms are increasing. However, serous cystadenoma is still uncommon. We report a case of serous cystadenoma treated by laparoscopic distal pancreatectomy. A 52-year-old woman presented with mild upper abdominal pain. Dynamic computed tomography (CT) revealed a solitary cystic lesion 3 cm in diameter in the pancreatic tail. Endoscopic ultrasound showed a honeycomb pattern, indicative of serous cystadenoma. To obtain the final diagnosis of the tumor, we performed laparoscopic distal pancreatectomy. A histopathological study showed microcystadenoma with no evidence of malignancy.

Cystadenoma, Serous↗
PubMed2004

Effects of carbon-ion beams on human pancreatic cancer cell lines that differ in genetic status.

The relative biologic effectiveness (RBE) of carbon-ion beams at 3 different linear energy transfer (LET) values (13, 50, and 80 keV/microm) accelerated by the Heavy Ion Medical Accelerator in Chiba on human pancreatic cancer cell lines differing in genetic status was determined. The RBE values were calculated as D10, the dose (Gy) required to reduce the surviving fraction to 10%, relative to X-rays. We also investigated apoptosis and the relationship between D10 and the cell cycle checkpoint using morphologic examination and flow cytometry analysis, respectively. The RBE values calculated by the D10 values ranged from 1.16 to 1.77 for the 13-keV/microm beam and from 1.83 to 2.46 for the 80-keV/microm beam. A correlation between the D10 values of each cell line and intensity of G2/M arrest was observed. In contrast, LET values did not clearly correlate with induction of apoptosis. These results suggest that carbon-ion beam therapy is a promising modality. Elucidation of the mechanisms of G2/M arrest and apoptosis may provide clues to enhancing the effects of radiation on pancreatic cancer.

Apoptosis↗
PubMed2003

Effectiveness of hydroxyethyl starch (HES) on purification of pancreatic islets.

BACKGROUND: The isolation of large-scale and high-quality islets from the pancreas is essential for a successful islet transplantation. We developed a hydroxyethyl starch (HES)-Collins solution as the purification medium and evaluated its usefulness on islet isolation from the pancreas of beagle dogs. MATERIALS AND METHODS: The pancreas of beagle dog was digested using our original 2-step automated technique. Islets were purified by discontinuous purification method on HES-Collins solution (group 1, n = 10) or Euro-Ficoll solution (group 2, n = 16) with a COBE2991 cell processor. Islet yield and purity, changes in islet number during 3-day cultures, static incubation, perifusion study, and insulin content were examined. In addition, the islets were autotransplanted into the liver via the portal vein. RESULTS: Although no significant differences were detected, yield and purity were higher in group 1. After 3 days of culture, the islet number decreased less in group 1. Both under static incubation and in the perifusion study, stimulation indices were 4.50 +/- 1.82 and 6.02 +/- 1.05, which were significantly higher than the 2.18 +/- 0.67 and 3.32 +/- 1.46 observed in group 2. Also, insulin content of the islets was significantly higher in group 1 than in group 2. Fasting blood glucose levels were maintained at values below 100 mg/dl for 100 days in group 1 and around 200 mg/dl in group 2. CONCLUSIONS: The use of HES-Collins solution was associated with an improvement of islet yield and purity. Also, islet viability and function were preserved longer during culture. Accordingly, islet purification using HES-Collins solution might be recommended for clinical islet transplantation.

Animals↗
PubMed2003

Aggressive surgical resection for hilar-invasive and peripheral intrahepatic cholangiocarcinoma.

The clinicopathology and surgical outcome of intrahepatic cholangiocarcinomas are not fully understood. The objective of this study was to clarify the clinicopathologic features of intrahepatic cholangiocarcinoma and evaluate prognostic factors influencing survival. Forty consecutive patients with intrahepatic cholangiocarcinomas undergoing surgical resection at Chiba University Hospital between October 1981 and October 1997 were analyzed retrospectively. Intrahepatic cholangiocarcinomas were classified as hilar-invasive type ( n = 26) or peripheral type ( n = 14). Patients with peripheral-type tumors had a significantly ( p = 0.005) better 5-year survival rate (43%) than those with the hilar-invasive type (4%). Hilar-invasive-type tumors had perineural invasion (100%) and nodal involvement (85%) more frequently than did peripheral-type tumors. Despite aggressive surgical resection, the surgical margin was positive in 88% of patients with hilar-invasive type tumors (23/26) and 29% of patients with peripheral-type tumors (4/14). There was no evidence of a survival benefit of vascular resection for patients with a hilar-invasive intrahepatic cholangiocarcinoma. Patients with lymph node metastasis had a significantly worse prognosis ( p = 0.0004). No patients with nodal involvement survived more than 38 months. Negative perineural invasion ( p = 0.008) and a negative microscopic margin ( p = 0.008) were significantly associated with improved survival. Better survival results could be achieved by curative resection with a free margin for hilar-invasive and peripheral intrahepatic cholangiocarcinoma.

Bile Duct Neoplasms↗
PubMed2002

Long-term surgical outcome of noninvasive and minimally invasive intraductal papillary mucinous adenocarcinoma of the pancreas.

The objective of this study was to clarify the long-term outcome after surgical resection in patients with noninvasive and minimally invasive intraductal papillary mucinous adenocarcinoma. We performed a retrospective review of the clinicopathological features and outcome in patients who underwent pancreatic resection for noninvasive and minimally invasive intraductal papillary mucinous adenocarcinoma between November 1982 and December 1997 at Chiba University Hospital. Minimally invasive structures were pathologically observed in five cases. The mean age of patients with either noninvasive (n = 16) or minimally invasive n = 5) adenocarcinoma was 61 years. Of the patients with minimally invasive adenocarcinoma, 4 had abdominal pain. Conversely, 7 patients with noninvasive adenocarcinoma had no complaint. The mean size of noninvasive and minimally invasive tumors was 2.5 cm (range 0.8 to 4.0) and 3.3 cm (range 2.5 to 4.5), respectively. The overall 5-year and 10-year survival rates for all 21 patients were 89% and 47%, respectively. Disease recurred in 3 patients; 2 patients with minimally invasive adenocarcinoma and 1 with noninvasive adenocarcinoma. Recurrence sites were peritoneum = 2) and main pancreatic duct of the remnant pancreas (n = 1); 5 disease-free patients died of unrelated causes. The remaining 13 patients are alive and disease free 3 to 12 years after surgery. Noninvasive and minimally invasive intraductal papillary mucinous adenocarcinoma had a favorable prognosis after surgical treatment.

Adenocarcinoma, Mucinous↗
PubMed2002

Clinical application of (11)C-methionine positron emission tomography for evaluation of pancreatic function.

INTRODUCTION: In recent years, it has become increasingly necessary to evaluate pancreatic function after pancreatectomy, but few precise methods are available. AIMS: To evaluate different surgical techniques for pancreatectomy in terms of the preservation of pancreatic function by (11)C-methionine positron emission tomography (PET), which determines amino acid metabolism in the pancreas. METHODOLOGY: The study included 33 pancreatectomy cases: 5 of distal pancreatectomy, 5 of pancreaticoduodenectomy, 10 of pylorus-preserving pancreaticoduodenectomy, 7 of duodenum-preserving pancreatic head resection, and 6 of inferior pancreatic head resection. The method was as follows. Approximately 370 MBq (11)C-methionine was intravenously injected. Cross-sectional imaging of the pancreas was performed by PET after 30 minutes. The images obtained were used to determine the radioactivity concentration in the pancreas. By adjustment of the radioactivity concentration for body weight and dosage, the differential absorption ratio could be determined to indicate the level of accumulation in the pancreas. Each surgical method used was evaluated on the basis of the differential absorption ratio. Postoperative total pancreatic accumulation was divided by preoperative level to calculate the total preserved pancreatic function rate (TPPFR), and postoperative local pancreatic accumulation was divided by preoperative level to calculate the local preserved pancreatic function rate (LPPFR). These rates were then compared for the individual techniques used. RESULTS: The results indicated that TPPFR and LPPFR were 61.2 +/- 20.0% and 114.6 +/- 29.4% for distal pancreatectomy (n = 5), 31.8 +/- 20.0% and 58.7 +/- 30.0% for pancreaticoduodenectomy (n = 5), 21.6 +/- 14.7% and 58.4 +/- 29.8% for pylorus-preserving pancreaticoduodenectomy (n = 10), 47.9 +/- 35.5% and 67.7 +/- 30.6% for duodenum-preserving pancreatic head resection (n = 7), and 48.1 +/- 29.5% and 83.9 +/- 30.5% for inferior pancreatic head resection (n = 6). TPPFR was highest in distal pancreatectomy cases. Among the pancreatic head resections, TPPFR was quite high for both inferior pancreatic head resection and duodenum-preserving pancreatic head resection. In contrast, TPPFR for pancreaticoduodenectomy and pylorus-preserving pancreaticoduodenectomy was quite low. LPPFR was highest for distal pancreatectomy and only slightly lower for inferior pancreatic head resection. In contrast, LPPFR was markedly lower for pancreaticoduodenectomy and pylorus-preserving pancreaticoduodenectomy. CONCLUSION: In conclusion, this method using (11)C-methionine PET is clearly useful for the evaluation of pancreatic function after pancreatectomy.

Aged↗
PubMedDate not supplied

Modified radiosensitivity of pancreatic cancer xenografts by farnesyl protein transferase inhibitor and MEK inhibitor.

We investigated the effects of the farnesyl transferase inhibitor (FTI) manumycin and the MEK inhibitor PD98059 on growth of human pancreatic cancer, with mutant (SUIT2) or wild-type (BxPC-3) K-ras, xenografted into nude mice. Tumor growth was not reduced by either of the agents at a dose of 3 mg/kg without irradiation. Growth of SUIT2 irradiated at 15 Gy or 30 Gy was reduced by manumycin and PD98059: at 15 Gy, tumor volume doubling time (TVDT) increased from 18.6+/-3.8 to 36.3+/-14.2 days with PD98059 (p<0.05); at 30 Gy, TVDT increased from 32.8+/-6.8 to 70.5+/-10.5 days and 70.7+/-1.5 days, respectively. Manumycin tended to reduce growth of BxPC-3, but the difference in TVDT was not statistically significant. PD98059 significantly increased the TVDT of BxPC-3 at 30 Gy from 34.4+/-18 to 62.6+/-9.8 at 30 Gy. The present results suggest that Ras signaling pathways are potential targets for manipulation of radiosensitivity, and that induction of an alternative pathway may enhance radiosensitivity of pancreatic cancer.

Alkyl and Aryl Transferases↗
PubMedDate not supplied

Radiofrequency ablation therapy for bone metastasis from hepatocellular carcinoma: case report.

BACKGROUND: Radiofrequency ablation (RFA) is one of the standard percutaneous therapies for hepatocellular carcinoma (HCC), but RFA has not been applied to treat bone metastasis from HCC. CASE: A 65-year-old male patient, who underwent hepatectomy for HCC two and a half years previously, complained of pain in his right thigh. Imaging modalities and a needle biopsy revealed metastatic HCC in his right acetabulum. The first RFA therapy was attempted under computed tomography (CT) guidance with 42 Gy radiation therapy. The second RFA therapy was performed for tumor recurrence in his pelvis at 4 years after the first RFA. CONCLUSION: RFA is a safe, easy, repeatable and effective therapy and should be one of the most important therapeutic modalities for bone metastasis from HCC.

Bone Neoplasms↗