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Biomedical subjects

H Higashi

Publications and source records attributed to H Higashi.

314 records · Page 18Linked to original sources
PubMedDate not supplied

Systemic effects of ethanolamine oleate in analbuminemic rats.

BACKGROUND/AIMS: The present study was an attempt to clarify whether only serum albumin inactivates ethanolamine oleate (EO) in vivo and whether EO has an adverse effect on the lung, kidney, and liver in the presence of analbuminemia. METHODOLOGY: Fifty-five female Nagase Analbuminemia Rats (NAR) and 55 female Sprague-Dawley Rats (SDR) were injected with 5% EO in the left femoral vein. Changes in respiratory, renal, and hepatic function and the extent of hemolysis following the injection of the EO were examined. RESULTS: In both groups, a transient but significant increase was seen in serum hemoglobin at up to 1 hour after injection of EO. No significant changes in PaO2, PaCO2, blood urea nitrogen, or serum creatinine following injection of EO were seen in either group. The total bilirubin significantly increased within 30 min in the SDR group, but this increase was prolonged for 5 days in the NAR group. Glutamic pyruvic transaminase (GPT) increased for 12 hours in the NAR group, while no change was seen in the SDR group. CONCLUSIONS: These observations suggest that EO may have hepatotoxic effects, that serum albumin may afford protection, and that other humoral substances which inactivate EO, including serum globulin, may be present.

Alanine Transaminase↗
PubMedDate not supplied

Gastric bleeding after endoscopic injection sclerotherapy for esophageal varices may be fatal.

Among 457 Japanese cirrhotic patients with esophageal varices, 28 (6%) bled from the upper gastrointestinal tract after the initial session of endoscopic injection sclerotherapy (EIS); 13 bled during the course of repeated EIS and 15 bled mainly from gastric lesions after eradication of the varices. Of these 28 patients, bleeding from gastritis occurred in 13 (46%), from esophageal varices in 10 (36%), from gastric varices in 4 (14%) and from gastric ulcer in one (4%). Six of 13 patients with gastritis-related bleeding and 3 of 4 patients with gastric variceal bleeding died of uncontrollable hemorrhage complicated liver failure, while 9 of 10 patients with esophageal variceal bleeding were controlled and reinjection was feasible. Ten (36%) of the 28 patients, with Child's grade B or C and severe ascites, died, mainly following bleeding from gastric lesions. This study shows that bleeding from gastric lesions after EIS can be uncontrollable and fatal in patients with poor liver function.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Sclerotherapy superior to surgery for longer survival and less rebleeding in 103 cirrhotics with variceal bleeding.

In the ten years period from 1976-1986, 103 cirrhotic Japanese with acute variceal bleeding underwent either surgical treatment (48) or endoscopic injection sclerotherapy (55) at Kyushu University Hospital. We retrospectively analysed the clinical records of these patients. The two groups were comparable with regard to clinical condition and liver function, except for the higher rate of Child's C patients in the sclerotherapy group than in the surgical group (29 vs. 16; P less than 0.05). Control of variceal bleeding was attained in all of the 48 surgical patients and in 54 (98.2%) of the 55 sclerotherapy patients. Bleeding recurred in five (10.4%) of the surgical group and in one (1.8%) of the sclerotherapy group, resulting in four and one deaths, respectively, during the hospital stay. Mortality rates at 30 days and six months were 16.7% (8/48), 43.8% (21/48) in the surgical group, and 9.1% (5/55), 14.5% (8/55) in the sclerotherapy group. The five-year cumulative survival rate was significantly higher (P less than 0.01) in the sclerotherapy group (53.3%) than in the surgical group (29.4%). Therefore, in our patients sclerotherapy led to a longer survival with fewer rebleedings, as compared to other patients who underwent conventional surgical treatment.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Morbidity and mortality after hepatic resection in the modern era.

BACKGROUND/AIMS: The purpose of this study was to clarify the risk factors associated with complications following hepatic resections and discuss the appropriate types of perioperative management. MATERIALS AND METHODS: A retrospective analysis was made of the complications in 355 patients undergoing hepatic resection between April 1985 and August 1992 at the Second Department of Surgery, Kyushu University Hospital. The patients were placed in two groups according to the occurrence of complications: patients with morbidity and/or mortality (187 patients); patients without either morbidity or mortality (168 patients). RESULTS: The leading complications were the accumulation of fluid in the abdominal and pleural cavities along with septic complications. The only significant factory affecting morbidity and mortality among the preoperative medical conditions was the presence of diabetes while, in addition, the patients with morbidity and/or mortality had higher levels of perioperative transaminase and serum creatinine as compared with those in patients without either morbidity or mortality. CONCLUSIONS: The perioperative strategies for reducing morbidity include the strict control of diabetes to reduce septic complications as well as preserve renal function, which can protect against the refractory accumulation of fluid in the peritoneal and pleural cavities.

Adult↗
PubMedDate not supplied

Influence of blood transfusion on postoperative long-term liver function in patients with hepatocellular carcinoma.

BACKGROUND/AIMS: To research for possible adverse effects of blood transfusion on liver function at a relatively long term after hepatic resection, liver function tests at one and two years after the surgery were studied in patients with hepatocellular carcinoma. MATERIALS AND METHODS: Seventy-one patients with no evidence of cancer recurrence during two years after the surgery were selected for this retrospective analysis. Patients were divided into two groups depending on perioperative blood transfusion: those who received blood transfusion (BT(+), n = 38), and those without blood transfusion (BT(-), n = 33). RESULTS: There were no statistical difference in the preoperative clinical features including liver function tests except decreased prothrombin time index (P < 0.01) and larger amount of intraoperative blood loss (P < 0.01) in BT(+) group. Platelet counts at 2 year after the surgery were significantly higher in the BT(-) group (P < 0.05). Two-way ANOVA showed no significant difference in liver function tests between the two groups. In multiple regression analysis, blood transfusion significantly correlated with serum total bilirubin at 1 year, but did not at 2 years after the surgery. CONCLUSIONS: The influence of blood transfusion in the patients with hepatocellular carcinoma was considered to be minimum within 2 years after hepatectomy.

Analysis of Variance↗
PubMedDate not supplied

Circulating intercellular adhesion molecule-1 in patients with hepatocellular carcinoma before and after hepatic resection.

BACKGROUND/AIMS: We recently demonstrated that an activated inflammation in a non-tumorous portion was a significant risk factor for recurrence in patients with small hepatocellular carcinoma. The purpose of this study is to provide further proof for this mechanism by explaining the relation ship between the post-operative hepatitis state and intrahepatic recurrence. PATIENTS AND METHODS: We used an enzyme-linked immunosorbent assay to detect cICAM-1 in the serum of 18 patients with hepatocellular carcinoma before and after hepatic resection. RESULTS: A complete surgical resection of the tumor masses did not result in a significant reduction of cICAM-1 levels. The levels of aminotransferase after hepatic resection in patients with an increased level of cICAM-1 in the post operative period (n = 7) were much higher than in patients with a decreased level of cICAM-1 (n = 11) (p < 0.05). The 1-, 2- and 3- year disease free survival rates in the former group were 42.9%, 14.3% and 0%, respectively, and those in the later group were 72.7%, 54.5% and 54.5%, respectively (p < 0.05). CONCLUSIONS: The enhancement of inflammation in the remnant liver tissue is related to intrahepatic recurrence after hepatic resection through adhesion molecules, such as cICAM-1.

Aged↗