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Biomedical subjects

Y Shimamura

Publications and source records attributed to Y Shimamura.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Advantages and disadvantages of L-TAE in diagnosis and treatment of hepatocellular carcinoma].

Transcatheter arterial embolization using lipiodol ultra-fluid (L-TAE) is frequently used for hepatocellular carcinoma (HCC). Its advantages are: (1) Excellent therapeutic and diagnostic ability in our pathological study of 153 resected tumors. (2) Preoperatively, we can localize HCC and prevent spreading of cancer cells by manipulation at hepatectomy. (3) Postoperatively, we can detect and treat recurrence early, and we hope to prevent recurrence by repeated L-TAE. (1) Liver infarction has occurred after L-TAE, because some lipiodol flows into the portal vein. Lipiodol remains long in the infarction area and interferes with the diagnosis of HCC. (2) Liver abscess has rarely occurred. (3) Repeated L-TAE does not impair the liver function much.

Carcinoma, Hepatocellular↗
PubMed1988

[Trans-arterial embolization or transarterial infusion of anti-cancer drugs suspended in a lipid contrast medium against unresectable metastatic liver cancer].

We had 84 patients with unresectable metastatic liver cancer from May, 1980 to December 1987 in the National Matsudo Hospital. Eighteen of them had no treatment; 26 of them had serial transarterial embolization (TAE) with or without infusion of anti-cancer drug dispersed in lipiodol; 7 of them had only serial trans-arterial infusion (L-TAI) of an anticancer drug suspended in lipiodol. A significant survival advantage of patients with TAE or L-TAI was noted when compared with no treatment, but there was no difference between the survival rate of patients with TAE and L-TAI. There were some 82 patients with unresectable metastatic liver cancer from October 1984 to March 1988 in Kyto Prefectural University of Medicine Hospital. Thirteen of them had L-TAI using one anti-cancer drug (one-drug group); 8 of them had L-TAI using two drugs (two-drug group); 22 of them had L-TAI with three drugs (three-drug group). The survival rate of the three-drug group was superior to the one- and two-drug groups. It was concluded that TAE was not necessary for metastatic liver cancer, but L-TAI must be undertaken, because combined cancer chemotherapy enhanced the effect of L-TAI.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cisternal drainage after early operation of ruptured intracranial aneurysm.

The authors reviewed 22 cases of intracranial aneurysm of the anterior part of the circle of Willis. All patients presented with the signs and symptoms of subarachnoid hemorrhage (SAH) and were in good neurological condition on admission. In all cases, early operation was performed to obliterate aneurysm. Subarachnoid blood clots were extensively removed and cisternal drainage was done. With topical application of povidone-iodine and intravenous administration of antibiotics, cisternal drainage continued for 14 days or more after the onset of SAH in 21 cases. Five patients developed symptomatic vasospasm, which was treated with hypervolemia and hypertension, and three received shunts later for chronic hydrocephalus. The overall result demonstrated that 21 patients were independent and had returned to their previous social lives. Therefore, it was strongly recommended that patients is good neurological condition after SAH secondary to ruptured intracranial aneurysm be treated with early operation, removal of subarachnoid clots, and long term application of cisternal drainage.

Adult↗
PubMed1987

[Experiences with FT+BrdU+radiation therapy of esophageal cancer].

Three patients with esophageal cancer, who were treated by FT+BrdU+radiation with good results, are reported. This method is theoretically almost the same as BAR therapy which was originally developed for the treatment of brain cancer using BrdU aimed at enhancing the sensitivity to irradiation. In two patients who had advanced lung cancer on the vertical axis, a good effect was achieved with only 8 Gy and 24 Gy of irradiation. In the other cases, who had circumferentially invasive superficial cancers, we also achieved on effect as good a CR clinically.

Aged↗
PubMed1987

[Intraoperative radiotherapy].

Intraoperative radiotherapy, which delivers a large single dose of electrons to a tumor intraoperatively, is applied for locally advanced and/or difficult to cure malignancies which are rather difficult to treat by conventional external beams. Although this method was initially developed in Japan, increasing numbers of institutes have recently been working with IORT on a world-wide basis because of the increased availability of medical accelerators and the better results obtained. The malignancies for which IORT is indicated are cancers of the stomach, liver, biliary tract, pancreas, colo-rectum, urinary bladder, prostate and uterus, which are surrounded by normal tissues or organs with low tolerance doses, and also recurrent or difficult to cure malignancies of the brain, lung, mediastinum, bone and soft tissues are becoming candidates for IORT treatment.

Female↗
PubMed1987

[Rib fracture after postoperative tangential irradiation in breast cancer].

Incidence of rib fracture was analyzed for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology, Kyushu University, from 1961 to 1976 and followed more than 5 years. Rib fracture was observed in 5% and 50% of cases treated with total radiation doses of 32.5 Gy and 52.5 Gy respectively.

Actuarial Analysis↗
PubMed1987

[Skin damage after postoperative tangential irradiation in breast cancer].

Incidence of telangiectasia and ulcer among 118 postoperated breast cancer patients, who were tangentially irradiated at Department of Radiology, Kyushu University from 1961 to 1980, followed more than 5 years were evaluated. Telangiectasia occurred in 5% at 20-35 Gy, in 50% at 50-55 Gy. Ulcer occurred in 5% at 50-55 Gy, in 50% at 70-75 Gy. Skin tolerance dose in Rubin's Table (1972) is correct.

Actuarial Analysis↗
PubMed1987

[Pulmonary fibrosis after postoperative tangential irradiation in breast cancer].

Incidence rate of pulmonary fibrosis with elevation of diaphragma was calculated for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology Kyushu University from 1961 to 1980 and followed more than 5 years. 5%, 50% occurred at 40-45 Gy, 60-65 Gy, Rubin's Table (1972) is possible correct.

Actuarial Analysis↗
PubMed1987

[Brachytherapy--carcinoma of the tongue].

In a review of 193 patients with carcinoma of the tongue who underwent interstitial radiotherapy in our hospital from November 1978 to 1986, 5 year actuarial local control rate were 97%, 87%, 58% and 77% for T1, T2, T3 and T4 respectively. Mucosal ulcers with tissue defects and bone exposure of the mandible occurred in 5 years after the treatments, 6%, 22%, 44%, and 100% for T1, T2, T3 and T4, respectively. Therapeutic ratio was 1 in patients with T1 who underwent interstitial radiotherapy (70 Gy/7 days) alone while it was less than 1 in those with T2 or more. Therapeutic gain factor was less than 1 in patients with combined external radiotherapy.

Adult↗
PubMed1986

Clinical and radiologic features of hepatocellular carcinoma originating in the caudate lobe.

Five patients with hepatocellular carcinoma in the caudate lobe were evaluated. Computed tomography (CT) scan and/or angiography clearly demonstrated multiple intrahepatic metastases in four (80%), and tumor thrombi in the portal vein in two (40%), and in the inferior vena cava in one. Even though there was no recognizable lung metastasis, metastases were found in the orbita in one patient, and in the ribs and thoracic vertebrae in two patients. Four patients died after a mean period of 5.5 months from the initial diagnosis. The mechanism for early invasion into the vessels and multiple intrahepatic metastases of hepatocellular carcinoma arising from the caudate lobe is discussed.

Angiography↗
PubMed1986

Mucinous adenocarcinoma associated with long-standing fistula in the cecal region.

A patient with mucinous adenocarcinoma associated with long-standing chronic fistula in the cecal region is presented. Association of mucinous carcinoma with chronic fistula seems to occur not infrequently in the anal region, but is extremely rare elsewhere in the large intestine. This is the first report of an occurrence in the cecal region.

Adenocarcinoma, Mucinous↗
PubMed1986

[Multidisciplinary therapy of hepatocellular carcinoma--TAI. TAE treatment by intra-arterial catheterization].

Two hundred sixty-six cases of hepatocellular carcinoma (HCC) were treated between June 1980 and October 1985 (4 years and 4 months) at our hospital. Hepatectomy was performed in 118 patients, 82 of which had received transcatheter arterial embolization with iodized oil (Lipiodol) 58 of then with an intraarterial catheter. HCC tumors were often multiple when they were combined with liver cirrhosis and smaller than 3 cm in diameter. For this reason treatment of HCC by surgery alone has limitations for prolongation of life. A multidisciplinary treatment is therefore necessary. We have found hepatectomy and transarterial embolization to be the most effective treatment for HCC. In order to perform repeated embolizations after hepatectomy, we developed a heparinized catheter with notches to permit safe fixation. This is suitable for long-term intraarterial use. While previous arterial catheters only permitted infusion of drugs due to their small diameters, our new catheter can be used for embolizations with Lipiodol and Gelfoam and for angiography. It is inserted through the right gastroepiploic artery into the gastroduodenal artery so that its tip lies at the level of the hepatic artery. It is brought out through the abdominal skin and flushed at two-week intervals with heparin-urokinase. The indications for the use of the catheter have been repeated embolizations 1) for prevention of tumor recurrence (surgical adjuvant therapy), and 2) after absolutely non-curative operations. For the first indication, we have found that multiple tumors and tumors larger than 5 cm frequently recur within 1 year after surgery. We have, since July 1983, used the catheter treatment to prevent recurrence in 30 such cases. Embolization with Lipiodol + Adriamycin followed by Gelfoam cubes is performed at three-month intervals for one year after surgery, starting one month after surgery, as a rule. The preliminary results indicate an improved survival rate after the treatment.

Aged↗
PubMed1986

Selective portal branch occlusion by balloon catheter during liver resection.

An intraoperative ultrasonographically guided introduction of a balloon catheter into labor or smaller branches of the portal vein within the liver parenchyma made it possible to temporarily occlude them and perform regional staining during resection for tumors. The technique minimized blood loss without hilar dissection for vascular control, and the presence of the catheter facilitated intraparenchymal dissection of the portal stalk to the part of the liver to be resected.

Carcinoma, Hepatocellular↗
PubMed1986

[Two cases of recurrent gastrointestinal carcinoma treated with long-term THP].

Two patients with recurrent gastrointestinal carcinoma were treated with THP. Partial response was recognized in the local recurrent tumor of one patient and in liver metastasis of a second patient. THP was administered every three weeks at a dose of 60 mg per total body weight intravenously. The total dose of THP achieved was 720 mg in the first patient and 920 mg in the second. Despite the high dosage, neither cardiotoxicity nor alopecia was observed. These results suggest that the administration of THP may be efficacious and safe in the management of patients with recurrent gastrointestinal carcinoma.

Adenocarcinoma↗
PubMed1985

Tension pneumocephalus following surgical evacuation of chronic subdural hematoma.

A case among 23 consecutive cases of chronic subdural hematoma developed tension pneumocephalus following surgical evacuation via a burr hole under local anesthesia. A closed drainage system applied into the subdural space was considered to be responsible for its formation as a result of one-way valve mechanism. In all 23 cases, preoperative and postoperative CT scans were reviewed in order to evaluate clinical significance of air in the subdural space after surgery. Air was noticed in all cases with various amount. However, unless the mass effect by air was more than the mass effect by chronic subdural hematoma, it was not necessary to remove air regardless of its amount.

Adolescent↗