Biomedical subjects

A Kanazawa

Publications and source records attributed to A Kanazawa.

131 records · Page 8Linked to original sources

PubMedDate not supplied

Risk factors for and clinical findings of liver abscess after biliary-intestinal anastomosis.

BACKGROUND/AIMS: Aggressive treatment for malignancy of the biliary tract has resulted in an increased incidence of pyogenic liver abscess. We retrospectively studied risk factors for and clinical findings of the liver abscess. METHODOLOGY: The subjects were 45 patients who underwent pancreatoduodenectomy (group A), 38 patients who underwent liver resection with biliary-intestinal anastomosis (group B), and 55 patients who underwent biliary-intestinal anastomosis alone (group C) during the past 13 years. We retrospectively studied risk factors by univariate and multivariate analyses. RESULTS: Liver abscess occurred in 6 patients in group A and 4 in group B. No patient developed liver abscess in group C. The incidence of liver abscess was significantly higher in groups A and B than in group C (p = 0.0068 and p = 0.0253, respectively). The incidence was significantly higher in patients who underwent anastomosis with subsegmental bile ducts (p = 0.0264). The incidence was significantly higher in patients with vascular reconstruction (p = 0.0254). Abscess or biliary drainage and administration of antibiotics were performed. Five patients died secondary to multiple organ failure. CONCLUSIONS: Pancreatoduodenectomy or liver resection with biliary-intestinal anastomosis, anastomosis with subsegmental bile ducts, and vascular reconstruction are risk factors for refractory liver abscesses after biliary-intestinal anastomosis.

Adult↗

PubMedDate not supplied

Perioperative changes in hepatic function as assessed by asialoglycoprotein receptor indices by technetium 99m galactosyl human serum albumin.

BACKGROUND/AIMS: Perioperative changes in intrinsic hepatocyte function and functional volume were investigated. METHODOLOGY: 52 cases of liver cancer, including hepatocellular carcinoma, cholangiocellular carcinoma and metastatic carcinoma were studied. There were diagnoses of liver cirrhosis, liver fibrosis and normal liver in 20, 23 and 9 cases, respectively. Hepatic resection of subsegment, one segment, two segments and three segments were performed in 11, 6, 23 and 4 cases, respectively, while 8 cases were diagnosed as inoperable. Assessments were performed before and 4 weeks after hepatectomy with asialoglycoprotein (ASGP) receptor indices, i.e., technetium-99m-galactosyl human serum albumin (TcGSA) uptake by the liver, TcGSA retention in the blood and functional volume as measured by single emission computed tomography (SPECT) with TcGSA as a probe. RESULTS: The hyperbolic relationship between galactosyl human serum albumin (GSA) uptake by the liver and GSA retention in the blood, both of which were independent of functional volume, shifted to the right after hepatectomy. The number of conventional liver function tests correlating to the GSA uptake increased after hepatectomy. By contrast, none of the pre-operative and post-operative tests were correlated with functional volume. Post-operative decrease in intrinsic hepatocyte function can be minimized by selection of mode of hepatic resection. CONCLUSIONS: These results indicate that GSA uptake by the liver can reveal information regarding intrinsic liver function which deteriorates and becomes a decisive factor after hepatectomy.

Adult↗

PubMedDate not supplied

[Executive function in Parkinson's disease].

Executive function declines in Parkinson's disease (PD). However, it has not been clearly shown at what stage in PD, this decline starts to occur. We here report a study aiming to answer this question. We conducted Wisconsin Card Sorting Test (WCST) and Trail Making Test A and B (TMT A, B) in three normal control groups (young, adult, and aged) and three PD patients groups (Hoehn & Yahr stage I, II, and III). We intend to analyze at what age or stage the decline in executive function would take place. The score of all the normal subjects and PD patients were 25 points or above by Mini-Mental State Examination. WCST in stage I PD patients (mean age 60.8, n = 9) was essentially same as those of young normal (mean age 23.1, n = 9) and adult normal (mean age 61.5, n = 10) subjects. Elderly normal subjects (mean age 75.8, n = 4) showed a significantly lower mean category achievement score (3.0 as the mean score) and higher numbers of errors and perseverations compared with those of young and adult normal subjects. Stage II (mean age 62.6, n = 8) and III PD (mean age 62.9, n = 8) patients showed significantly lower mean category achievement scores (2.4 and 2.1, respectively as the mean scores) and higher numbers of errors and perseverations compared with those of adult control subjects (5.4 as a mean score). TMT (B-A) in elderly normal subjects revealed significantly longer score (209 seconds as the mean score) compared with those of young and adult normal subjects (20 and 45 seconds, respectively as the mean scores). TMT (B-A) in stage III PD patients was significantly longer (219 seconds) compared with that of adult normal subjects (45 seconds as the mean), however TMT (B-A) in stage II PD patients (102 seconds as the mean) did not show prolongation. TMT (B/A) showed essentially similar results as TMT (B-A), however, stage II PD patients showed significant prolongation compared with that of normal adult subjects. Therefore, TMT (B/A) appears to be a more sensitive indicator of decline in executive function in PD. Between WCST and TMT, the former appeared to be a more sensitive indicator. Our results indicate that the decline in executive function takes place in normal ageing. In PD, this decline starts much earlier than the normal subjects. The onset in this decline coincides with the stage of PD, in which bilateral symptoms start to present. Anatomo-chemical subsrate of cognitive decline in PD is still to be debated, however, we believe that involvement of nigro-caudatal projection is at least in part responsible, as nigroputaminal pathway is mainly involved in motor functions. We also point out the importance of age factor in the evaluation of cognitive-executive function in PD, as this function is age-dependent in normal subjects.

Adult↗

PubMedDate not supplied

A 14-year-old patient with Ewing's sarcoma presenting at autopsy with multiple neurofibrillary tangles and Lewy bodies in addition to hemiatrophy of the central nervous system.

The autopsy findings of a 14-year-old Japanese girl with Ewing's sarcoma, who had multiple neurofibrillary tangles and Lewy bodies and hemiatrophy of the central nervous system (CNS), are reported. She had retinoblastoma of her right eye 8 months after birth, which was treated with chemotherapy and irradiation (40 Gy), twice, seizures 1 year and 2 months after birth, and thereafter severe mental retardation. She showed left hemiparesis after a febrile seizure at the age of 7 years and CT disclosed the right cerebral hemiatrophy. For the last 2 years of life she suffered from Ewing's sarcoma. Extrapyramidal signs were absent. Neuropathologically, tangles consisting of paired helical filaments were distributed symmetrically in virtually all the grey matter. They were particularly numerous in the frontal cortex and substantia nigra, but sparse in the nucleus of Meynert, hippocampus, and brainstem. Several Lewy bodies, which were ultrastructurally identical to those seen in Parkinson's disease, were present in the substantia nigra (more on the left than right) and locus coeruleus. Morphometrically, the number and size of substantia nigral neurons were reduced, the reduction in the latter being more marked than the former, but the melanin pigment contents and shapes of the remaining neurons appeared normal. The right cerebral hemiatrophy with contralateral cerebellar hemiatrophy may have been attributable to irradiation. Although our patient did not have parkinsonism, her features resembled those of a 28-year-old autopsy case reported by Popovich et al. [1987].

Adolescent↗

PubMedDate not supplied

Preclinical primary central nervous system lymphoma.

We report an autopsy case of preclinical primary central nervous system (CNS) lymphoma. The case was an 89-year-old female who died of rupture of a thoracic aortic aneurysm. No neurological abnormalities were found throughout our clinical observation. Serum anti-human T-cell leukemia virus type 1 and anti-human immunodeficiency virus were negative. Grossly, the brain was normal except for a small solid tumor, 6 by 6 by 2.5 mm, in the lateral ventricular wall at the left hippocampal fimbria, and multiple smaller disseminated nodules. Histological examination revealed multiple microscopic disseminated foci throughout the brain, including the cerebral subcortical white matter, basal nucleus, thalamus, brainstem and cerebellum. Histological classification is of lymphoblastic type non-Hodgkin's lymphoma of high-grade malignancy. Lymphoma cells are positive for leukocyte common antigen and L-26, indicating a B cell phenotype. In situ hybridization with Epstein-Barr viral probes is negative. It is concluded that this case may represent a relatively early preclinical stage of multifocal type of primary CNS lymphoma.

Aged↗