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Biomedical subjects

F Nakayama

Publications and source records attributed to F Nakayama.

At least 127 records · Page 7Linked to original sources
PubMed1984

Change in bile duct pressure responses after cholecystectomy: loss of gallbladder as a pressure reservoir.

Coordination of gallbladder and sphincter of Oddi and effect of cholecystectomy on biliary pressure physiology were investigated in 7 patients using an indwelling microtransducer catheter placed in the bile duct by duodenoscopy. Intramuscular morphine (0.2 mg/kg) to induce a sphincter of Oddi spasm produced no change before cholecystectomy but intravenous caerulein (0.1 microgram/kg) induced pressure elevation coincident with gallbladder contraction on echogram. After cholecystectomy, however, morphine caused a pressure rise and a coarse and irregular change of the tracings, which seemed attributable to sphincter of Oddi spasm. Caerulein promptly reduced the pressure and eliminated the irregularity. These results show (a) the sphincter of Oddi relaxes when the gallbladder contracts in response to caerulein and (b) the gallbladder acts as a pressure reservoir against the sphincter of Oddi spasm caused by morphine. The latter implies that the spasm of the sphincter of Oddi readily leads to a pressure rise if the gallbladder is absent, which may partly explain a development of postcholecystectomy syndrome.

Adult↗
PubMed1984

Presence of monohydroxy bile acids in the urinary precipitates: a pitfall in the analysis of urinary bile acids.

The importance of the method of handling the urinary precipitates frequently present in urine samples, especially after freezing-thawing, for bile acid analysis is emphasized because of the presence of a considerable proportion of monohydroxy bile acids such as lithocholic and 3 beta-hydroxy-5-cholenoic acids. Filtration of the urinary precipitates may lead to the underestimation of these important bile acid species.

Bile Acids and Salts↗
PubMed1984

A prospective study on primary gastric stump cancer following partial gastrectomy for benign gastroduodenal diseases.

A prospective study was made on 3827 Japanese patients who had undergone partial gastrectomy for benign gastroduodenal diseases to examine whether they are at a high risk of mortality from primary gastric stump cancer (PGSC) and whether the risk is determined by the surgical procedure. The patients were followed up from the time of surgery (from 1948 to 1970) to June 30, 1981. Of 3,701 patients (96.7%), the vital status at the end of observation was determined, the total person-years at risk being 62,286.33. The observed deaths were compared with the expected deaths calculated from the mortality rates of Japan. An elapsed time of 10 years from operation to death was set not only to exclude possible recurrent, remaining, or multiple cancers but also to allow a certain latency period for the development of PGSC. The observed and expected deaths from PGSC were 11 and 52.85, respectively, the ratio being 0.21 (p less than 0.01). The ratios were uniformly less than 1 for both sexes and across three operative groups: Billroth I, Billroth II with Braun's anastomosis; or Billroth II without Braun's anastomosis. No difference was observed between the death rates from PGSC by operation type. The possible role of the postoperative nonphysiological (pathological) environment or duodenogastric reflux in gastric stump carcinogenesis was not detected in the present study.

Adult↗
PubMed1983

The possible carcinogenic effect of cholecystectomy. No postoperative increase in the proportion of secondary bile acids.

In consecutive patients with gallstones in well-functioning gallbladders, duodenal bile was sampled before and 2 to 3 months after cholecystectomy. The preoperative and postoperative bile acid patterns were compared. Cholecystectomy resulted in a significant shift from cholic- to chenodeoxycholic acid. This shift could help to explain the low incidence of recurrent common duct stones. The percentage of secondary bile acids showed very little change. An increase of the mean preoperative value of 3.9 percentage points or more was improbable (P = 0.025). This finding refutes the hypothesis that cholecystectomy could lead to colonic cancer via an increase in the proportion of secondary bile acids. An alternative hypothesis is proposed for the reported high incidence of previous cholecystectomy in colonic cancer. Both gallstones and cancer of the colon may be associated with high levels of secondary bile acids.

Bile↗
PubMed1983

Correlation of bile acid composition between liver tissue and bile.

Bile acid composition of ten paired human livers and bile specimens were compared with gas chromatography-selected ion monitoring. The bile acid composition in liver and in bile was found to be similar but not identical. This difference seems to be a reflection of bile acid synthesis in liver tissue. It is suggested that analysis of bile acid composition in liver tissue is useful to evaluate abnormality of bile acid synthesis in several pathological states.

Bile↗
PubMed1983

Changing state of gastric cancer in Japan. Histologic perspective of the past 76 years.

One thousand thirty-eight patients with primary gastric cancer treated operatively during the past 20 year period were described. The results were compared with those in the period from 1904 to 1927 to illustrate the changes which have taken place in diagnosis and treatment of gastric cancer during the past 76 years in Japan. All data was from the Department of Surgery I, Kyushu University. After half a century of status quo, improvement started around the mid 1960s, which coincided with the introduction of newer, improved procedures for diagnosis of gastric cancer, such as double contrast roentgenography of the stomach, endoscopic observation, and biopsy of suspected lesions. A mass population survey for the presence of gastric cancer in persons of approximately 40 years of age has led to an ever increasing number of early gastric cancer cases. The emergence of early simulating advanced cancer with relatively good prognosis and the changing state of the Borrmann type of advanced cancer have contributed to the improvement. The present study demonstrates once again the importance of early detection of gastric cancer for an increased chance of cure, since conventional lymph node dissection seems to be unnecessary, and of even earlier detection of gastric tumors of less than 1 cm in diameter for the best chance of complete cure in the latter.

Adult↗
PubMed1983

Preparation and antigenic property of methyl 3 beta-hydroxy-19-oxo-5-cholen-24-oate 19-(O-carboxymethyl) oxime-bovine serum albumin conjugate.

The preparation and antigenic property of 3 beta-hydroxy-5-cholen-24-oic acid-bovine serum albumin (BSA) conjugate in which the hapten is linked to the carrier protein through an (O-carboxymethyl) oxime bridge at the C-19 position on the steroid nucleus is described. Antibody raised against antigen in the rabbit possessed high titer and specificity to 3 beta-hydroxy-5-cholen-24-oic acid, exhibiting no significant cross-reactions with various bile acids.

Antigen-Antibody Complex↗
PubMed1983

Preparation and antigenic property of 3-dehydrolithocholylglycine 3-(O-carboxymethyl) oxime-bovine serum albumin conjugate.

The preparation and antigenic property of 3-dehydrolithocholyglycine-bovine serum albumin (BSA) conjugate in which the hapten is linked to the carrier protein through an (O-carboxymethyl) oxime bridge at the C-3 position on the steroid nucleus is described. Antibody raised against antigen in the rabbit possessed high titer and specificity to lithocholylglycine, exhibiting no significant cross-reaction with free lithocholic acid or lithocholyltaurine.

Antigen-Antibody Complex↗
PubMed1983

Continuous measurement of common bile duct pressure with an indwelling microtransducer catheter introduced by duodenoscopy: new diagnostic aid for postcholecystectomy dyskinesia--a preliminary report.

Morphine was given to two patients suspected of having postcholecystectomy dyskinesia to induce spasm of sphincter of Oddi and was successful in reproducing pain, while common bile duct pressure was continuously monitored with an indwelling high fidelity microtransducer catheter introduced by duodenoscopy. The rise of intracholedochal pressure was found to coincide exactly with the occurrence of the pain, thus suggesting the biliary origin of the symptom. The common bile duct pressure started to rise immediately after the injection of morphine, and the pressure waves initially showing biphasic variation of respiratory origin became irregular in shape and height, probably reflecting the spasm of the sphincter; these changes were well related to the intensity of the pain. Endoscopic sphincterotomy gave complete relief. A repeat morphine-induced pressure study after the sphincterotomy confirmed the disappearance of both the pain and the irregular waves.

Adult↗
PubMed1982

Effect of female sex hormones on lithogenicity of bile.

Effect of female sex hormones on lithogenicity of bile was investigated in an attempt to explain the female preponderance of cholesterol gallstones in man. Estrogen in a form of Estradiol valerate or progesterone in a form of 17 alpha-Hydroxy-progesterone caproate was administered to female dogs oophorectomized to negate influence of endogenous sex hormones from the gonads. Gallbladder bile was puncture aspirated at intervals before, during and after the administration. Lithogenicity of the bile increased markedly during the administration of estrogen. The increase was not so pronounced during the progesterone administration. The increase of lithogenicity is apparently mainly due to increase in the absolute concentration of cholesterol. Differences in the effect of estrogen and progesterone suggest the presence of fluctuation of lithogenicity of bile during the menstrual cycle and pregnancy.

Animals↗
PubMed1982

The presence of a positive pressure gradient from pancreatic duct to choledochal cyst demonstrated by duodenoscopic microtransducer manometry: clue to pancreaticobiliary reflux.

A case of choledochal cyst is presented. The diagnosis was established by endoscopic retrograde cholangiopancreatography, which also demonstrated that the common bile duct joined the pancreatic duct at an abnormally long distance from the papilla. Duodenoscopic manometry using a microtransducer catheter showed that the pressure in the pancreatic duct was higher than that in the choledochal cyst by 1.1 mmHg. The cyst-to-duodenum pressure gradient of 3.5 mmHg was not different from the common duct-to-duodenum gradient in patients with other common biliary tract diseases, making the presence of a stenosis as an etiology of this entity unlikely. The bile aspirated from the gallbladder had an extremely high amylase content, suggesting influx of the pancreatic juice into the biliary system. The pancreaticobiliary reflux caused by the positive pressure gradient from the pancreatic duct to the choledochal cyst may be related to the development of the disease.

Bile Reflux↗
PubMed1982

Hepatic versus duodenal bile.

During nonacute operations for uncomplicated gallstone disease hepatic bile was obtained from a catheter placed in the common duct via the cystic duct. Simultaneously, duodenal bile was obtained via a duodenal tube placed as close as possible to the duodenal papilla. Fifteen patients were studied. The mean concentration of lipids of the duodenal bile was 55% of that of the hepatic bile. Comparison of the samples showed duodenal bile to contain relatively less phospholipids and more bile acids. Incubation of bile with pancreatic juice showed a gradual decrease of lecithin compensated for by an increase of lysolecithin. This degradation might facilitate absorption, and this could explain the difference found between duodenal and hepatic bile. Simple storage at -20 degrees C resulted in a loss of phospholipids in duodenal but not in hepatic bile.

Bile↗
PubMed1982

[Treatment of cancer of the gallbladder and bile duct].

The records of 166 patients (85 men and 81 women) with extrahepatic bile duct cancers consisted of 58 patients with gallbladder cancer, 76 patients with bile duct cancer, and 32 patients with cancer of the papilla of vater were reviewed. A mean age was 60 years old (ranged: 30-80 years old). Twelve of 58 patients with gallbladder cancer were treated with simple cholecystectomy or extended cholecystectomy. Remaining 46 patients were treated with palliative treatments. The longest survival time of the resected patients was 3 1/2 years. Mean survival time of patients with palliative treatments was 5.6 months in external biliary drainage and 2.2 months in internal drainage. Thirteen of 76 patients with bile duct cancer were treated with bile duct resection or pancreatoduodenectomy. Remaining 63 patients were treated palliatively. Resectability rate was 10% in upper bile duct, 33% in middle and 36% in lower bile duct. The longest survival time was 3 1/2 years in upper bile duct, 2 2/3 years in middle and 3 5/6 in lower bile duct. Mean survival time of palliative treatments was 5.4 months in external drainage and 8.4 months in internal drainage. Twenty two of 32 patients with cancer of the papilla of Vater were treated with pancreatoduodenectomy. Remaining 10 patients received palliative treatments. The longest survival time was 11 years and 5 year survival rate was 14%. The longest survival time of the palliative treatments was 3 3/4 years and mean survival time was 14.2 months. To improve the resectability and operative results, early diagnosis and extended radical resection are necessary.

Adult↗