[Sodium-ultrafiltration gradient method in hemodialysis].
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Diabetic Nephropathies↗
Biomedical subjects
A Koga
Publications and source records attributed to A Koga.
[Spontaneous pneumothorax in pregnancy: a case report and review of the literature].
Spontaneous pneumothorax in pregnancy is said to be a rare condition. A 37-year-old woman at 13 weeks' gestation with this rare complication, was reported. The patient was first treated by chest tube drainage, which failed to get complete reexpansion of the lung, and she was managed by thoracotomy twenty days after. She delivered, at full term, a healthy normal infant by cesarean section. Indications for operative treatment of pneumothorax in pregnancy, in general, are not absolutely defined. We believe that the usually accepted indications for operation, such as persistence of air leakage despite adequate drainage and multiple recurrences of pneumothorax, are valid during pregnancy, if the patient allows the pregnancy to proceed.
Adult↗
Gene duplication and concerted evolution of the GPDH locus in natural populations of Drosophila melanogaster.
The sn-glycerol-3-phosphate dehydrogenase (GPDH, EC 1, 1, 1, 8) locus of Drosophila melanogaster is polymorphic with respect to the number of tandemly duplicated genes in natural populations. The duplicated genes were cloned and the nucleotide sequences were determined. The duplication deletes both the first and second exons and has a size of 4500 b.p. The fact that there is no sequence variation at the junction point of the duplicated units among strains suggests a single origin for the duplication event. Comparison of the nucleotide sequences among the duplicates indicates that the frequent transfer of genetic information occurs from one to the other of the duplicates on the same chromosome either by gene conversion or by unequal crossing over. Because the GPDH duplication is partial and therefore a kind of pseudogene, the observed polymorphism of the number of tandemly duplicated GPDH genes appears to have been driven mainly by random genetic drift.
Animals↗
Time-related morphological changes in cold-stored rat livers. A comparison of Euro-Collins solution with UW solution.
Rat livers were stored in cold UW solution and Euro-Collins solution for various periods. Morphological investigations were performed using light microscopy, as well as scanning and transmission electron microscopy. In the UW-stored livers, the appearance of blebs derived from hepatocytes and the destruction of sinusoidal endothelial cells (SEC) occurred more slowly than in the EC-stored livers. Almost no ultrastructural damage in the hepatocytes was observed even after 48 hr of storage in UW solution, while extremely swollen and degenerated hepatocytes were observed in the 48-hr EC-stored livers. After 48-hr of storage, livers stored in UW solution lost 7.9% of their weight though EC-stored livers gained 29.7% of weight. Light microscopic morphometry revealed that there was a significant increase of 24.3% in the mean hepatocyte area of 24-hr EC-stored livers, whereas the UW-stored hepatocytes did not show any significant increase even after 48 hr of storage. After perfusion fixation, livers stored for more than 8 hr in EC solution showed a mosaic pattern of uneven fixation indicating a microcirculatory disturbance, whereas the UW-stored livers showed a rather uniform fixation after 12 hr of storage. It is suggested that the microcirculatory disturbance occurred more slowly in the UW-stored livers than in the EC-stored livers, which might be due to the protection of SEC and the suppression of bleb formation and the swelling of hepatocytes by UW solution.
Adenosine↗
[Computed tomography of obturator foramen hernia].
A 89 year-old female was admitted with the complaint of right hypochondralgia. And also she complained of right thigh pain after admission. On hospital day 4, she underwent CT examination in order to evaluate right thigh with severe pain. The preoperative diagnosis of obturator foramen hernia was performed.
Aged↗
Subcutaneous transposition of the spleen enhances the survival rate following 90% hepatectomy in rats.
The effects of subcutaneous transposition of the spleen (STS) on the survival rate following 90% hepatectomy were investigated in rats. The survival rate was significantly higher in the STS group than in the non-STS group. Light microscopy enabled us to note that congestion in the terminal portal veins and sinusoids occurred either slightly earlier or to a higher degree in the non-STS group.
Animals↗
Ultrastructural changes in rat liver sinusoids during storage in cold Euro-Collins solution.
Changes in the sinusoids of rat livers stored in cold (2 degrees C) Euro-Collins solution for various periods were observed using combined scanning (SEM) and transmission electron microscopy (TEM). The sinusoidal endothelial cells were vulnerable to cold ischemia. Fenestrations of the endothelial cells were enlarged and became mesh-like after a 4-h preservation period. Following 8 h storage the sieve plates and cytoplasmic processes of the endothelial cells were destroyed and there was a tendency for the perikaryon to desquamate. Blebs derived from hepatocytes were seen after 4 h and these increased in number and size with prolonged preservation. Although the sinusoids were filled with blebs after 24 h preservation. no irreversible ultrastructural damage in the parenchymal cells was observed. Within 12 h storage, the liver had a mosaic pattern after perfusion fixation indicating uneven fixation and profound circulatory disturbance. These results suggest that endothelial cell destruction and/or numerous blebs may have unfavorable effects on the microcirculation of the transplanted liver after prolonged preservation.
Animals↗
Polymorphism for the number of tandemly multiplicated glycerol-3-phosphate dehydrogenase genes in Drosophila melanogaster.
A 26-kilobase-pair region encompassing the sn-glycerol-3-phosphate dehydrogenase (sn-glycerol-3-phosphate:NAD+ 2-oxidoreductase, EC 1.1.1.8) locus in Drosophila melanogaster from two natural populations in Japan was surveyed by restriction mapping. Both tandem duplications and triplications in this region were found in both populations. Detailed analysis of 86 chromosome 2 lines revealed restriction site and allozyme polymorphisms in the transcriptional unit: two restriction sites and the allozymes [fast (F) or slow (S)] were polymorphic among both duplication-bearing chromosomes and those carrying the standard sequence. This finding suggests recurrent recombination and/or gene conversion in this 5-kilobase-pair region. The differences observed for restriction site and allozyme haplotypes among the triplicated sequence both within and between populations, together with the distribution in natural populations, suggest a relatively recent ancestry of the triplication events and an independent origin in respective populations. Such events may represent the process of the formation of multigene families [compare Ohta, T. (1987) Genetics 115, 207-213]. Finally, the evolution of this type of polymorphism is discussed.
Animals↗
Diagnosis and operative indications for polypoid lesions of the gallbladder.
In 411 patients undergoing cholecystectomy, benign polyps were present in 32 gallbladders and malignant polyps were present in eight. Histologically, cholesterol polyps accounted for most of the benign lesions, and all the malignant lesions were adenocarcinomas. Gallstones coexisted in 50% of the malignant lesions and endoscopic retrograde cholangiography revealed anomalous pancreaticobiliary junctions in three of five patients with malignant lesions. Sixty-nine percent of patients with benign lesions were under 60 years of age, whereas 75% of those with malignant lesions were over 60. Ninety-four percent of the benign lesions were under 1.0 cm in diameter, while 88% of the malignant lesions exceeded this size. Spread and size of the tumor showed a close correlation. Therefore, size of the tumor is a vital indicator in the treatment of polypoid lesions of the gallbladder, and a malignancy should be considered when the tumor exceeds 1.0 cm in diameter.
Adult↗
Glucose intolerance and pancreatic endocrine dysfunction in dogs with obstructive jaundice.
Mechanisms involved in pancreatic endocrine disturbances in the presence of obstructive jaundice were studied in mongrel dogs with a ligated bile duct. Slower disappearance rate of glucose (KG) and lower portal insulin responses within ten minutes following intravenous glucose loading were observed in jaundiced dogs than in the controls. Hyperglucagonemia in the portal vein was evident in jaundiced dogs for five weeks. Morphometrical analysis of the beta-cells showed that the volume density of secretory granules decreased in jaundiced dogs. However, in three types of beta-granules, the change of size was observed only in the bar-shaped core granules. The volume density of the rough endoplasmic reticulum increased whereas that of the Golgi apparatus decreased in jaundiced dogs for five weeks. In contrast with beta-cells, alpha-cells revealed no morphological changes in any groups. These findings suggest that the beta-granules fail to mature if there is an inhibition by a blockade of energy-requiring steps such as the ER-Golgi transfer system. Impairment of beta-granules is considered to lead to glucose intolerance. Hyperglucagonemia is probably secondary to abnormal beta-cell function, which causes insulin deficiency and the loss of the relation between alpha-cells and beta-cells.
Animals↗
Effects of partial hepatectomy on microtubules and hepatocellular transport of indocyanine green in rats.
The effects of partial hepatectomy on plasma disappearance and biliary excretion of indocyanine green (ICG) have been studied in rats and correlated with morphometric changes of hepatocellular microtubules. The plasma disappearance rate of ICG was in good accord with recovery of liver weight after partial hepatectomy. Biliary excretion of ICG per 100 g liver significantly increased between 3 h and 7 days postoperatively. Colchicine significantly reduced plasma disappearance and biliary excretion of ICG, with no reduction in bile flow, in both intact and hepatectomized rats. Morphometrically, microtubules significantly increased from 3 h following partial hepatectomy and reached a maximum at 24 h with a gradual return to preoperative values at 5 days. These observations suggest that the increased hepatocellular transport of ICG after partial hepatectomy is related to an increase in the number of microtubules.
Animals↗
Effects of bile acids and endotoxin on the function and morphology of cultured hamster Kupffer cells.
The mechanisms of hepatic reticuloendothelial cell dysfunction in obstructive jaundice were investigated using cultured hamster Kupffer cells. The introduction of free bile acids, cholic acid (CA) at concentrations over 2 mM and chenodeoxycholic acid (CDCA) over 1 mM inhibited colloidal carbon pinocytosis. CA and CDCA at concentrations over 0.5 mM inhibited IgG-coated sheep red blood cell phagocytosis. With the application of conjugated bile acid and endotoxin at concentrations over 50 micrograms/ml, endocytic function was inhibited. With bile acids, a dose-dependent increase in the concentration of beta-glucuronidase occurred in the culture medium, and with endotoxin a time-dependent increase in beta-glucuronidase was noted. Bile acids produced alterations in cell organelles before destruction of the cell membrane. The presence of endotoxin led to the appearance of large vacuoles in the cytoplasm. These observations suggest that bile acids and endotoxin inhibit Kupffer cells by different mechanisms. We tentatively conclude that bile acids rather than endotoxin influence Kupffer cells in vivo.
Animals↗
Effects of bile duct obstruction and decompression on hepatic microsomal mixed function oxidase system in rats.
The effects of biliary obstruction and drainage on the hepatic microsomal mixed function oxidase system were studied in rats. Bile duct obstruction produced a significant reduction in the hepatic cytochrome P-450 dependent mixed function oxidase system. After release of the bile duct obstruction, the reduction in microsomal enzymes was practically reversible; however, the process of recovery was slow and differed with the microsomal enzymes in question. Increases in cytochrome b5 content and NADH-cytochrome b5 reductase activity were slower than increases in cytochrome P-450 content and NADPH-cytochrome c reductase activity. Aniline hydroxylase activity increased more rapidly and corresponded to cytochrome P-450 contents more so than did the aminopyrine demethylase activity. After the release of bile duct obstruction, however, the bile acids which had accumulated in the liver during cholestasis were reduced rapidly, to a normal range. These results suggests that there is a discrepancy between reductions in hepatic bile acids and those in the hepatic microsomal mixed function oxidase system after biliary decompression.
Alanine Transaminase↗
Alterations with time of secretion and ultrastructure of the exocrine pancreas in rats with an obstructed biliary system.
The effects of biliary obstruction on the secretory activity and ultrastructure of the exocrine pancreas were studied in rats. Increased volume, protein and amylase secretion were observed in the early periods, under basal conditions and in response to cerulein-secretin stimulation. Bicarbonate concentrations in the pancreatic juice were not significantly altered during the experiments, under either basal or stimulated conditions. The wet weight of the pancreas, and the tissue protein and amylase content of the pancreas increased progressively after bile duct ligation, under basal conditions. Morphological changes were marked in the acinar cells, the most characteristic being an increase in the size and number of zymogen granules and dilatation of the Golgi cisternae. These findings demonstrate a hyperfunctional state of the acinar cells following progressive suppression of granule discharge. It is suggested that the inhibition of granule discharge from acinar cells in rats with prolonged bile duct ligation may be due to the cytotoxic effects of hyperbilirubinemia and inhibition of normal mitochondrial function.
Amylases↗
One stage hepaticocholecystojejunostomy as an easy and long term effective bilioenteric bypass for unresectable carcinoma of the pancreas.
A new anastomotic technique was used as an initial operation for jaundice due to an unresectable carcinoma of the pancreas. This bypass operation consisted of interposition of the gallbladder between the common hepatic duct and the jejunum by which bile drainage was excellently facilitated.
Cholestasis↗
[Surgical treatment of total anomalous pulmonary venous return--evaluation of five successful cases].
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Echocardiography↗
Anomalous junction of pancreaticobiliary duct without congenital choledochal cyst: a possible risk factor for gallbladder cancer.
Among 1586 patients subjected to endoscopic retrograde cholangiopancreatography, an anomalous junction of the pancreaticobiliary duct (AJPB) was found in 24 patients (1.5%). Eighteen of the 24 had an associated congenital choledochal cyst, and six did not. Four of these six patients (66.7%) had gallbladder cancer. A clinicopathological study was performed on these four and 43 such cases reported in the literature. The diagnosis of AJPB was made by direct cholangiography. Median age of these 47 (53.5 yr) was younger than those without AJPB. The length of the common channel ranged from 15 to 53 mm. The pancreatic-biliary type junction was present in 36 of 39 cases (92.3%). Gallstones were present in 7 of 40 (17.5%). Levels of amylase in bile were high in 10 of 11. Presence of AJPB without congenital choledochal cyst may be a high risk factor in gallbladder cancer; hence prophylactic cholecystectomy should be considered for patients with AJPB, without congenital choledochal cyst.
Adenocarcinoma↗
Intrahepatic calculi associated with cholangiocarcinoma.
A unique case of hepatolithiasis associated with cholangiocarcinoma is described. The intrahepatic calculi consisted mainly of cholesterol rather than calcium bilirubinate. A bacteriological study of the intrahepatic and gallbladder bile was negative, though bacterial infection of the bile duct has been considered a main factor responsible for formation of intrahepatic calculi.
Adenoma, Bile Duct↗