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Biomedical subjects

Y Bandai

Publications and source records attributed to Y Bandai.

At least 19 recordsLinked to original sources
PubMed2000

Intraoperative Doppler color flow imaging combined with regulation of arterial inflow during surgery for intrahepatic arterioportal fistula.

Large fistulas associated with impaired liver function should be treated by direct obliteration or removal of the shunt orifice. In a large shunt with the portal branch lying on the arterial branch, identification of the exact site of the fistula can be a challenge. We report a case of impaired liver function due to a large intrahepatic arterioportal fistula. The site of the shunt orifice could not be located accurately by preoperative imaging. However, intraoperative color Doppler ultrasonography and the simple regulation of arterial inflow clearly demonstrated the shunt orifice. This original technique has allowed the precise definition of the problem and has optimized the surgical treatment for this critical condition. Consequently, it should be considered a new option for the definition and management of large intrahepatic arterioportal fistulas.

Aged↗
PubMed1998

[Adjuvant chemotherapy with UFT or UFT with OK-432 to patients with gastric and colorectal cancer. Kanto Adjuvant Study Group].

In Japan, long-term oral therapy with tegafur in combination with immunopotentiators is commonly used as adjuvant therapy after curative resection of gastric or colorectal can for gastric and colorectal cancer. When the outcome was analyzed in terms of the relative performance (R.P.) and the individual dose intensity (I.D.I.) of OK-432, gastric cancer patients with a R.P. of 0.5 or higher tended to have a better survival curve. There were no marked differences in lymphocytes subsets, except that the Leu 7 level at 3 months after gastric cancer resection was significantly higher (p < 0.05) in group B than in group A. Thus, no inhibition of the anticancer effect of UFT was noted during long term combination therapy with UFT and an immunopotentiator as postoperative adjuvant therapy for patients who underwent curative resection of gastric or colorectal cancer. The results suggest that UFT combined with long-term OK-432 maintenance therapy may contribute to improve survival rates in gastric cancer patients.

Adjuvants, Immunologic↗
PubMed1997

Reduced gastric surface mucus layer in experimental portal hypertension.

The pathogenesis of portal hypertensive gastropathy has not yet been thoroughly elucidated. Changes in the gastric surface mucus layer in prehepatic portal hypertensive and cirrhotic rat models were studied by observing frozen sections fixed with formaldehyde vapor and stained with hematoxylin and eosin. We produced prehepatic portal hypertensive rats by partial ligation of the portal vein, and cirrhotic rats by prolonged administration of carbon tetrachloride (CCl4) and phenobarbital sodium. The thickness of the corporal and antral gastric surface mucus was significantly reduced in prehepatic portal hypertensive and cirrhotic rats compared with the values obtained in control rats for portal hypertension (subjected to sham operation) and control rats for cirrhosis (treated with phenobarbital but not CCl4). These results indicate that the hemodynamic changes associated with portal hypertension reduce the thickness of the gastric surface mucus layer and may be one of the causes of the gastropathy associated with portal hypertension.

Animals↗
PubMed1997

Impact of intraoperative ultrasonography on surgery for cystic lesions of the pancreas.

The impact of intraoperative ultrasonography (IUS) on surgery for cystic lesions of the pancreas (CLPs) has not been fully clarified. Twenty patients with CLPs, including 5 pseudocysts and 15 true cysts, were scanned intraoperatively to evaluate the utility and practicality of IUS for CLPs. In four of the five patients with pseudocysts and two with retention cysts, the operative procedures were performed under IUS guidance. In one with a pseudocyst, IUS showed that the cyst did not involve the pancreas, and subsequently cystectomy without pancreatic resection was necessary. In one of the two patients with mucin-producing cystadenocarcinomas, IUS demonstrated a skip lesion in the duct of the pancreatic tail, which contributed to changing the operative procedure from pancreatoduodenectomy to total pancreatectomy; in the other, IUS showed that the lesion was localized in the body of the pancreas, and subsequently segmental pancreatectomy was carried out instead of scheduled pancreatoduodenectomy or distal pancreatectomy. Thus in these three patients the operative procedures were changed in light of the IUS findings. In the remaining 11, although IUS visualized CLPs clearly, it added no new information relevant to the operations. We conclude that IUS contributes to performing surgery for certain types of CLP, such as pseudocysts with severe inflammation, retention cysts with nonpalpable or invisible small cysts, mucin-producing cystadenocarcinomas, and possibly other lesions.

Cystadenocarcinoma, Mucinous↗
PubMed1997

Asialoglycoprotein receptor and hepatic blood flow using technetium-99m-DTPA-galactosyl human serum albumin.

UNLABELLED: Asialoglycoprotein receptor (ASGP-R) amount and hepatic blood flow were quantitatively measured by using a newly developed kinetic model of 99mTc-labeled diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) in which receptor-mediated endocytosis and receptor recycling were considered. METHODS: Five healthy volunteers were intravenously injected 3-mg and 9-mg 99mTc-GSA doses. The absolute amounts of 99mTc-GSA in the liver and extrahepatic blood were estimated from the time-activity curves for the liver, heart and lung. The metabolic process was represented by five differential equations with 10 parameters as variables. To estimate total receptor amount (Rtotal), hepatic plasma flow (Q) and hepatic plasma volume (Vh), other parameters were fixed and estimated by analyzing their data with the least-squares method. Nineteen patients with liver diseases were given a 3-mg dose, and the data were analyzed to estimate Rtotal, Q and Vh. RESULTS: The values of the fixed parameters were estimated as follows: dissociation constant, 0.032 microM; rate constant for internalization, 0.604 min(-1); and ratio of surface receptors to total receptors, 6.1%. The fitted liver uptake curve corresponded well to the measured data. The simulated liver uptake curve was significantly influenced by Rtotal and Q in cases with normal receptor amounts. Analysis in patients with normal livers, chronic hepatitis and liver cirrhosis showed statistically significant differences in their Rtotal values, but not in their Q or Vh values. The s.e. values of Rtotal, Q and Vh for normal livers were small, and the s.e. values of Q and Vh were high for cirrhotic livers. CONCLUSION: This method is useful for measuring ASGP-R amount and hepatic blood flow simultaneously based on dynamic images, without the need for blood sampling, and reflects the cellular transport of asialoglycoproteins and the ASGP-R recycling mechanism.

Adult↗
PubMed1996

Management of new hepatic nodules detected by intraoperative ultrasonography during hepatic resection for hepatocellular carcinoma.

BACKGROUND: During hepatic resection for hepatocellular carcinomas (HCCs) it is not uncommon that intraoperative ultrasonography detects "new nodules" that were not found by preoperative examinations. Because the operative procedure may have to be changed if the new nodule is another HCC lesion, differential diagnosis of such nodule is critical. This study examines ultrasonographic findings and clinical features of new nodules and discusses how to cope with such nodules in the operating room. METHODS: Fifty-one new nodules detected in 92 liver resections were analyzed. Intraoperative ultrasonography was performed by using 5.0 or 7.5 MHz probes after mobilization of the liver. Histologic diagnosis of the new nodules was made by means of enucleation, resection with the primary lesions, thick-needle biopsy, or additional partial resection of the liver. RESULTS: New nodules were detected in 27 (29.3%) of 92 resected cases. Internal echoic pattern of the nodules were type I, hypoechoic (29 nodules); type II, hyperechoic (19); and type III, mosaic (3). Ten HCC nodules (17.9%) were included, and chance of being malignant for each type was 24.1%, 0%, and 100%, respectively. Of the seven patients with malignant new nodules, three underwent additional systematic resection and all were alive without recurrence 49, 13, and 11 months after the operation. Others were treated by use of enucleation (two cases), intraoperative ethanol injection (one case), and intraarterial chemotherapy (one case). CONCLUSIONS: Although most of the new nodules lacked specific findings for HCC, hypoechoic nodules, 24.1% of which were HCCs, should not be overlooked. Histologic confirmation of the new nodules is necessary especially when the number of lesions detected before operation is multiple or the interval between lipiodol computed tomography and the operation is longer than 2 months. Once the diagnosis of HCC has been made for the new nodule, systematic additional resection to remove the new lesion is recommended.

Adult↗
PubMed1996

A World Wide Web-based user interface for a data management system for use in multi-institutional clinical trials--development and experimental operation of an automated patient registration and random allocation system.

We have employed the Hypertext Transfer Protocol (HTTP) and Hypertext Markup Language (HTML) to develop an automated patient registration and random allocation system for use in a multi-institutional clinical trial. We made it available on-line to World Wide Web clients in each hospital through a user friendly graphical user interface. During experimental operation, the physicians found it satisfactory from the viewpoint of both ease of operation and response time. For the development of a graphical user interface in network-based information system for use in multi-institutional clinical trials, HTTP/HTML has several advantages over an ordinary client-server model. Therefore, we concluded that we would adopt HTP/HTML for the construction of user interfaces for physicians in each spital and for data managers in our coordinating center.

Chemotherapy, Adjuvant↗
PubMed1995

Healing process of sutureless choledochojejunostomy in an experimental model.

The healing characteristics and morphological features of sutureless choledochojejunostomy were investigated in a rat experimental model. The common bile duct of 34 conditioned Wistar rats was exposed, divided transversely and a choledochojejunostomy constructed with only a vinyl chloride tube positioned between the common duct and jejunum. The animals were killed 4, 12 and 52 weeks after surgery. Cholangiographic evaluation of the anastomosis in all three groups showed wide openings with dilatation of the extrahepatic bile duct. Microscopic examination of the anastomosis showed hyperplastic changes of the bile duct epithelium. The epithelial defect was completely covered with proliferative epithelium 12 weeks after operation. At long-term follow-up of 52 weeks there were no biliary strictures after the sutureless technique. This surgical approach may be useful for patients in whom sutured anastomosis of the bile duct might lead to stricture, such as those with a normal thin-walled bile duct.

Alanine Transaminase↗
PubMed1995

How should polypoid lesions of the gallbladder be treated in the era of laparoscopic cholecystectomy?

BACKGROUND: Definitive criteria for choosing the most appropriate treatment for each type of polypoid lesion of the gallbladder (PLG) have yet to be established. METHODS: The shapes, sizes, echo patterns, and echogenicities of PLGs that had been evaluated by means of ultrasonography in 72 patients who had undergone resective surgery were analyzed retrospectively to elucidate the ultrasonic characteristics of polypoid cancers and to establish criteria for selecting the most suitable treatment such as laparoscopic cholecystectomy for each type of PLG. RESULTS: Histologic examinations showed cholesterol polyps in 47 patients, adenomas in 8, cancers in 16, and an inflammatory polyp in 1. The diameters of 61% of the benign PLGs were less than 10 mm, whereas those of 88% of the cancers were more than 10 mm; 80% of the former were pedunculated and 56% of the latter were sessile. Seven of eight early-stage cancers had diameters less than 18 mm, whereas those of all eight more advanced cancers were greater than 18 mm. Five of the eight early-stage cancers were pedunculated, and six of the eight more advanced cancers were sessile. Cholecystectomy with or without full-thickness dissection were main surgical procedures used to resect benign PLGs and early-stage cancers, whereas cholecystectomy with partial liver resection was used for more advanced cancers. Laparoscopic cholecystectomy was performed in the recent 34 patients, four of whom had early-stage cancers. CONCLUSIONS: A PLG with a diameter of less than 18 mm is a potential early-stage cancer and therefore can be resected by laparoscopic cholecystectomy with full-thickness dissection. However, when cancer invades the subserosal layer or beyond, a second-look operation is necessary. A PLG with a diameter of greater than 18 mm may be an advanced cancer and should be removed by using cholecystectomy with partial liver resection or a more extended procedure with lymph node dissection.

Adenocarcinoma↗
PubMed1995

Appraisal of intraoperative ultrasonography during laparoscopic cholecystectomy.

BACKGROUND: The usefulness of intraoperative ultrasonography during laparoscopic cholecystectomy (LC) has yet to be evaluated fully. METHODS: In 50 patients who underwent LC, the intraoperative ultrasonography findings were compared with those of preoperative ultrasonography, intraoperative cholangiography, and histology, and then its usefulness for examining anatomic relationships in the hepatoduodenal ligament, detecting bile duct stones, diagnosing gallbladder polyps and abnormally thickened walls, and determining the propriety of LC was appraised. RESULTS: The preoperative ultrasonography diagnoses were gallstones in 38 patients, polyps in 10, and cancer and adenomyomatosis in one each. In four patients endoscopic retrograde cholangiography showed bile duct stones. In all 50 patients intraoperative ultrasonography was useful for examining the anatomic relationships between the bile duct and vessels, such as the portal vein and hepatic artery, and showing the presence or absence of bile duct stones. On the basis of the intraoperative ultrasonography findings, gallstones were diagnosed in 38 patients, in five of whom bile duct stones were shown clearly, cholesterol polyps in eight, early-stage cancer or adenoma in two, and adenomyomatosis in two, and subsequently LC was performed. Histologic diagnoses of cholesterol polyps were made in eight of ten patients with polyps, and intramucosal cancer and an inflammatory polyp in one each. In one patient with a preoperative diagnosis of cancer the apparently elevated flat lesion was found to be partial thickening of the gallbladder wall, which was diagnosed as adenomyomatosis, and LC was chosen as the operative procedure. CONCLUSIONS: Intraoperative ultrasonography during LC is useful for detecting bile duct stones, diagnosing gallbladder polyps and abnormally thickened walls, and deciding whether LC is adequate for resection of the gallbladder.

Adult↗
PubMed1995

Segmental occlusion of the pancreatic duct with prolamine to prevent fistula formation after distal pancreatectomy.

OBJECTIVE: The authors used prolamine (Ethibloc, Ethicon GmBH, Norderstedt, Germany) for segmental obstruction of the pancreatic duct to prevent pancreatic fistula development after distal pancreatectomy combined with total gastrectomy for gastric malignancies. SUMMARY BACKGROUND DATA: Although the initial clinical application of prolamine was pancreatic duct obstruction for patients with pancreatitis and undergoing pancreatic transplantation and pancreaticoduodenectomy for pancreatic cancer, there are no reports on prevention of pancreatic fistula formation after distal pancreatectomy. METHODS: Prolamine (0.2 mL) was injected into the distal segment of the main duct in the remaining pancreata of 51 patients. Small pancreatic ducts on the cut surface, from which prolamine extravasates, were closed by ligation, the main duct was ligated doubly, and the transected pancreatic margin was closed 15 minutes after phenylpropanolamine hydrochloride injection. RESULTS: No patient developed a pancreatic fistula or the complication of arterial bleeding due to prolonged infection. CONCLUSION: Segmental obstruction of the pancreatic duct with prolamine is useful for preventing pancreatic fistula development after distal pancreatectomy.

Amylases↗