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Biomedical subjects

F Nakayama

Publications and source records attributed to F Nakayama.

At least 109 records · Page 6Linked to original sources
PubMed1985

Hepatolithiasis associated with cholangiocarcinoma. Possible etiologic significance.

Three cases of primary bile duct carcinomas (cholangiocarcinomas) were found among 61 cases of hepatolithiasis. Cholangiocarcinoma arose from the extrahepatic bile duct in one and from the dilated intrahepatic bile duct in two patients. Hyperplasia of the columnar cells was often present. These hyperplastic epithelial cells often show papillomatous or adenomatous pattern, which are frequently associated with the presence of stones and the contaminated bile, and may show malignant changes leading to the development of cholangiocarcinoma.

Adenocarcinoma↗
PubMed1985

Manometric diagnosis of sphincter of Oddi spasm as a cause of postcholecystectomy pain and the treatment by endoscopic sphincterotomy.

Seventeen patients with postcholecystectomy pain and nine controls were studied by nonoperative biliary manometry with stimulation of sphincter of Oddi spasm by morphine. The controls remained asymptomatic despite an elevation of bile duct pressure after morphine. In 13 patients with postcholecystectomy pain, morphine induced pain paralleling a pressure rise. Three other patients had pain not paralleling a pressure change, and another showed a pressure rise without pain. None of the controls, four with the parallel pain-pressure change, and one with the discordant pain-pressure correlation were positive at the traditional morphine-Prostigmin test. Endoscopic sphincterotomy provided complete (8), moderate (3), or slight (1) relief of pain to 12 patients with the parallel pain-pressure relationship. Postsphincterotomy manometry showed disappearance of both the pressure elevation and pain induction, and the morphine-Prostigmin test turned negative. It is concluded that morphine-induced bile duct pressure elevation coinciding with pain is diagnostic of sphincter spasm as a cause of postcholecystectomy pain, the morphine-Prostigmin test, although helpful, is less specific and less sensitive in diagnosing sphincter spasm than the manometry, and endoscopic sphincterotomy relieves the pain due to this condition in most cases.

Adult↗
PubMed1985

Gardner's syndrome associated with carcinoma of the duodenal bulb: report of a case.

A 49-year-old woman with Gardner's syndrome, who underwent total proctocolectomy in 1982, was found to have a cancer of the duodenal bulb. Subsequently, resection of the stomach and duodenal bulb was performed in 1983. The surgical specimen showed an ulcerating tumor in the duodenal bulb which was a moderately differentiated adenocarcinoma histologically. Multiple adenomas were present in the gastric antrum and the duodenum. Duodenal cancer so far reported has been mostly confined to the periampullary region, and cancer of the duodenal bulb associated with familial polyposis coli has not been reported.

Adenocarcinoma↗
PubMed1985

Primary carcinoma of the gallbladder.

Sixty-five Japanese patients with primary carcinoma of the gallbladder treated in the Department of Surgery I at Kyushu University from 1965 through 1982 were reviewed. Forty-one patients had histologically proven primary carcinoma and the other 24 patients were diagnosed by laparotomy and/or combination of several diagnostic procedures. The female to male ratio was 1.5 to 1. The peak incidence was at the ages of 60-69 years for both sexes. Gallstones were found in 53 per cent of resected patients and were demonstrated in 58 per cent of unresected patients by ultrasonography. Laparotomy was performed on 50 patients and the tumor could be removed in 15 patients. Resection could be done in only one of 18 patients correctly diagnosed. Fourteen of 15 patients who underwent resection had been diagnosed as cases of benign lesions. Curative resections were feasible in six of 15 patients. In curative resection cases, the longest survival time was 42 months; and in cases of non-curative resection, 26 months. Most of the nonresected patients died within 6 months with an operative mortality of 16.6 per cent. This report reinforces the difficulty in diagnosis and the poor prognosis for patients with primary carcinoma of the gallbladder. However, ultrasonography seems to be the best tool at present for detecting early cancer, especially cancer of the polypoid type. We hold the view that more radical approaches for relatively early cancer will enhance the operative results.

Adenocarcinoma↗
PubMed1985

[Treatment with combination of antibiotics and human gamma-globulin (SM-4300) for severe infection in surgery].

The beneficial effects of gamma-globulin, which were used for agammaglobulinemia and severe infectious disease as an adjuvant or combination therapy in conjunction with antibiotics, are well known. In this study, a new intravenous human gamma-globulin (SM-4300) was administered to 5 patients with bacterial infection and 2 patients with viral infection. In 4 out of 7 patients (57.1%), several symptoms such as high fever, general fatigue and pain were improved clinically. Furthermore, there were no side effects due to SM-4300 either in clinical findings or in laboratory examinations.

Aged↗
PubMed1984

Bile salts of the coelacanth, Latimeria chalumnae.

Bile salts of the coelacanth, Latimeria chalumnae, Smith, have been analyzed and shown to have three bile alcohols, latimerol, 5 alpha-cyprinol, and 5 alpha-cholestane-3 beta, 7 alpha,-12 alpha,25,26-pentol, two C24 bile acids, chenodeoxycholic acid and cholic acid, one C26 bile acid, probably 3 beta, 7 alpha, 12 alpha-trihydroxy-27-nor-5 alpha-cholestan-26-oic acid, and two C27 bile acids, 3 alpha,7 alpha,12 alpha-trihydroxy-5 alpha-cholestan-26-oic acid and 3 beta,7 alpha,12 alpha-trihydroxy-5 alpha-cholestan-26-oic acid as determined by gas-liquid chromatography and gas-liquid chromatography-mass spectrometry.

Animals↗
PubMed1984

Effect of chenodeoxycholic and ursodeoxycholic acids on isolated adult human hepatocytes.

Chenodeoxycholic and ursodeoxycholic are effective cholelitholytic agents, but differ in their side effects. Chenodeoxycholic acid administration induces diarrhea and a transient rise of GOT, which are virtually nonexistent with ursodeoxycholic acid treatment. Lithocholic acid, a bacterial metabolite of chenodeoxycholic acid, has been implicated as a possible hepatotoxin. In the present investigation, the effect of chenodeoxycholic acid or ursodeoxycholic acid and their glycine and taurine conjugates on isolated human hypatocytes was directly assessed. Chenodeoxycholic acid had drastic effects on isolated human hepatocytes by reducing the number of microvilli and disrupting cell membranes. Pronounced release of GOT was observed. In contrast, ursodeoxycholic acid produced only slight morphological changes and enzyme release. Conjugation of each respective bile acids had a moderating effect.

Adult↗
PubMed1984

Ultrasound survey of hepatobiliary lesions in Kaohsiung, Taiwan.

An ultrasound survey of the liver and biliary system was made in the city of Kaohsiung and a neighbouring village in the southwest of Taiwan. 1,166 persons (538 males and 628 females between 5 and 83 years) from 388 families were examined. Abnormalities were found in 104 cases (8.9%). Hepatolithiasis was suspected in 22 cases (1.9%). This gives an incidence of hepatolithiasis of 42.3% in a total of 52 cases of cholelithiasis. Hepatoma was suspected in 4 (0.3%) of cases.

Adolescent↗
PubMed1984

Bacteriology of hepatolithiasis.

Hepatolithiasis is associated with bile stasis and bacterial infection. Gallstones found in the intrahepatic bile duct are mostly calcium bilirubinate stones, the presence of which is closely related to the presence of bacteria. In the present study, a high incidence of bile infection was found in hepatolithiasis: 52 of 54 cases (96.3%). This is in concordance with the other reports from Japan as well as from East Asia. E coli was the most frequent isolate followed by Klebsiella, Streptococcus (D), and Pseudomonas. Because of the frequent isolation of E coli in calcium bilirubinate stone cases, beta-glucuronidase from E coli has been thought to be responsible for the formation of calcium bilirubinate stones by effecting hydrolysis of bilirubin glucuronide to free bilirubin, which is insoluble in water. The recent introduction of improved anaerobic culture techniques has led to an increasing number of reports on the presence of anaerobes in the biliary tract. Anaerobes were isolated in 6 of 29 cases of hepatolithiasis (20.7%) in our series but more frequently in Kaohsiung, Taiwan (25 of 57 cases, or 44.4%). Bacteroides and Clostridium were the most frequent isolates from the biliary tract and were shown to have beta-glucuronidase activity. Anaerobes were often found together with aerobes, suggesting the possibility of a synergistic effect that may influence the occurrence and development of cholangitis, which is often associated with hepatolithiasis. Though the biliary tract and liver are usually sterile, when an infection of the biliary tract occurs the route by which bacteria reach the region is thought to be hematogenous, lymphatic, or direct intraluminal ascending infection, the last being the most likely. Treatment of cholangitis associated with hepatolithiasis should be directed toward the removal of stones and termination of bile stasis. When cholangitis ensues, control of bacterial infection by antibiotics should be started without delay. The choice of antibiotics in controlling cholangitis is presented.

Anti-Bacterial Agents↗
PubMed1984

Critical evaluation of the existence of so-called tissue-bound lithocholate in human liver tissue by selected ion monitoring.

Monohydroxy bile acids in liver tissue may be of importance because of their hepatotoxicity and strong cholestatic effects. Recently, the existence of lithocholate in liver tissue in two forms was suggested by Nair et al. (Lipids. 1977. 12: 922-929) i.e., either in free form or as so-called tissue-bound lithocholate released exclusively by cholylglycine hydrolase treatment. The presence of the latter aroused much interest in relation to its hepatotoxicity and possible role in tumor induction. In the present investigation lithocholyl-epsilon-L-lysine, proposed as the predominant tissue-bound bile acid, was synthesized and its metabolic behavior was tested. Lithocholyl-epsilon-lysine was not deconjugated by cholylglycine hydrolase treatment but only by alkaline hydrolysis. Bile acids in seven cirrhotic and three noncirrhotic liver samples were extracted with 95% ethanol-0.1% ammonium hydroxide. The bile acids in the extract and residue were quantified by glass capillary gas-liquid chromatography using selected ion monitoring. The presence of so-called tissue-bound lithocholate could not be substantiated in either cirrhotic or noncirrhotic liver tissues. Nearly complete extraction of lithocholate was achieved by the use of organic solvent alone. Therefore, tissue-bound lithocholate, if it exists at all, may be attached to tissue by a physical linkage which can be disrupted by the use of conventional organic solvent.

Adult↗
PubMed1984

Clinical features and classification of hepatolithiasis.

A newer classification of hepatolithiasis based on the prevailing pathology was applied to 59 cases of hepatolithiasis. The results indicated once again the preponderance of stones and strictures in the left lateral segmental ducts. In addition, involvement of peripheral segmental ducts is most commonly found in the anterior inferior area of the right hepatic lobe and in the left lateral inferior area duct of the left lateral hepatic segment. Such incidence of segmental or area involvement is expected to rise because of improved techniques for imaging the hepatobiliary tree. The disease classification presently used offers several advantages. It is solely based on an exact description of the prevailing pathology and therefore is devoid of subjective bias such as that involved in designating without much factual basis whether disease is primary or secondary or is congenital or acquired. The coding used offers easier compilation of data, which can be stored in a computer for later retrieval and computation.

Adult↗