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Wakabayashi Hiroyuki Kuwabara Yoshihiro Murata Hiroyuki Kobashi Kyoich Watanabe Akiharu 《Metabolic brain disease》1997,12(2):161-169
Alghough gaseous ammonia (NH3) can freely enter cells through the plasma membrane where NH3 is cyto(neuro)toxic, NH3 and ionic ammonia (NH4
+) contents have not been studied in biological materials. We developed a new method for measurement of expiratory NH3 concentration, which may reflect blood NH3 concentrations. The method is a sensor tube type-gas assay system. Expiratory NH3 concentrations in patients with chronic liver diseases increased when their blood ammonia (NH4
++NH3) concentrations increased above 90 μg/dl (normal range; 12–66 μg/dl). However, cirrhotic patients, who had relatively higher
expiratory NH3 concentration compared to blood NH3 concentrations (calculated from Henderson-Hasselbalch formula), were found to have subclinical encephalopathy. Measurement
of experatory NH3 concentration may be of clinical significance for the diagnosis of encephalopathy associated with hyperammonemia. 相似文献
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Masaki Suzuki Kyoichi Ogata Norimichi Kogure Akiharu Kimura Yoshitaka Toyomasu Tetsuro Ohno Erito Mochiki Hiroyuki Kuwano 《International surgery》2015,100(6):1138-1143
Recently, the right gastroepiploic artery (RGEA) has been used in coronary artery bypass graft (CABG) as an alternative arterial graft. Because of the improvement of prognosis after CABG, malignant diseases are more common in older patients. However, there is a serious problem in patients with gastric cancer after CABG with RGEA graft. In these patients, an interruption of coronary blood supply through the RGEA may cause a life-threatening myocardial ischemia. Therefore, an appropriate strategy is very important to avoid risk while retaining the curability of the operation. We herein describe a 76-year-old Japanese man with advanced gastric cancer who underwent CABG using the RGEA. Abdominal computed tomography (CT) showed #6 lymph nodes (sub-pyloric lymph nodes) metastases surrounding the RGEA. We concluded that curative resection was impossible while preserving the RGEA and started combination chemotherapy using S-1 and cisplatin. After 2 courses of that, #6 lymph nodes were reduced extremely. Thereafter the patient underwent distal gastrectomy with regional lymph node dissection around the RGEA without excision of the RGEA. Histologically, there were no metastases in #6 lymph nodes. Neoadjuvant chemotherapy may be effective for preserving the RGEA graft in a patient with advanced gastric cancer after CABG.Key words: gastric cancer, CABG, RGEA bypass graft, neoadjuvant chemotherapyThe right gastroepiploic artery (RGEA) has been used in coronary artery bypass graft (CABG) surgery.1,2 It is recognized as a reliable conduit with superior long-term patency.3–5 The right gastroepiploic artery is mainly targeted to the right coronary artery because of the limitation of its length. According to the report of a Japanese association for coronary artery surgery, CABG was carried out in more than 0.1 million patients over a period of 7 years that ended in 2004, and the RGEA has been used in more than half of these patients.6 After CABG for either triple-vessel or left main disease, patients have a 5-year actual survival rate of 92.9% and a cardiac death-free rate of 97.8%.7 Long-term survival increases the opportunity for patients to develop malignant diseases. An increased incidence of gastric cancer after CABG with the use of RGEA has been reported.6 In these patients, an interruption of coronary blood supply through the RGEA may cause a life-threatening myocardial ischemia. Therefore, an appropriate strategy is required to avoid risk while retaining the curative potential of the operation. We present a case of gastric cancer after CABG with the RGEA in which neoadjuvant chemotherapy led to curative operation while preserving the RGEA. 相似文献
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Yata Y Nakayama Y Takahara T Yamazaki K Masuyama K Sawataishi M Suzuki S Honma M Ishizawa S Tanaka M Watanabe A Sugiyama T 《Acta medica Okayama》2004,58(6):275-278
We present a case of a primary advanced gastric tumor that was composed of 2 different pathological components: small cell carcinoma and moderately-differentiated adenocarcinoma. The patient was still alive four years after the surgery was performed, without recurrence. A large part of the tumor consisted of a diffuse sheet of small cell carcinoma, which transitioned into another small portion consisting of moderately-differentiated tubular adenocarcinoma components. Therefore, this case raised the possibility that small cell gastric carcinoma may originate from totipotential stem cells of the stomach. Although small cell carcinoma progresses aggressively, and patients with it have an extremely poor prognosis, this patient recovered uneventfully after the surgical resection, and has remained in good health, without any recurrences. 相似文献
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Morioka CY Saito S Machado MC Ohzawa K Kubrusly MS Cunha JE Watanabe A 《In vivo (Athens, Greece)》2004,18(2):113-117
K-ras point mutation at codon 12 has a relationship greater than 90% with pancreatic cancer. Cancer therapy should also include the treatment of metastatic disease because it is known that the properties of metastatic cells may vary considerably from those of the primary tumor. AIM: To clarify if the same drugs, which can inhibit the tumor growth in the parental cell line, can inhibit the pancreatic metastatic and remetastatic cell lines at the same concentrations and to compare the inhibition with antisense oligonucleotides mismatched to K-ras gene, in Syrian golden hamsters. MATERIALS AND METHODS: HaP-T1, a BHP-induced hamster pancreatic cancer cell line, MS-PaS-1 (a metastatic cell line established from "return trip" metastases from the liver to the pancreas) and MS-PaS-2 named as a "remetastatic cell line", i.e., metastases from MS-PaS-1 were used. MTT and MTT-agarose assays were performed, using 5-Fluorouracil (5-FU), Mitomycin C (MMC) and antisense oligonucleotide specific to K-ras oncogene. RESULTS: The inhibitory concentration (IC50) of 5-FU, which inhibited HaP-T1, had to be increased by 50-fold to inhibit MS-PaS-1 and 100-fold to inhibit MS-PaS-2. MMC had to be increased by 10-fold to inhibit MS-PaS-1 and 50-fold to inhibit MS-PaS-2. However, IC50 was the same when antisense oligonucleotide was tried in these 3 cell lines. CONCLUSION: Antisense oligonucleotide-targeted K-ras gene may be a good choice for therapy because it could inhibit the growth in metastatic and remetastatic cells as well as in primary tumor cells. 相似文献
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Seiji SAITO Yoshinari ATARASHI Akiharu WATANABE Masanobu KITAGAWA 《Digestive endoscopy》1999,11(3):246-249
We report a 36–year-old female patient with small cell carcinoma of the gallbladder with liver metastasis, that was associated with pancreaticobiliary maljunction (PBM) without bile duct dilatation. On admission, a gallbladder mass and multiple liver tumors were detected by US, CT and ERCP. Moreover, ERCP clearly demonstrated an abnormally long common channel between the pancreatic and bile ducts, indicating PBMwithout choledochal dilatation. US-guided biopsy of the tumor histopathologically confirmed small cell carcinoma. The serum neuron-specific enolase (NSE) level was very high. Transarterial chemo-embolization followed by systemic chemotherapy resulted in marked tumor reduction, but this was followed by rapid exacerbation. The patient died of the tumor 145 days after admission. The proposed mechanism of the car-cinogenesis of this rare gallbladder malignancy under the preexisting condition of PBM was discussed. (Dig Endosc 1999, 11: 246–249) 相似文献
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