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Biomedical subjects

H Kitamura

Publications and source records attributed to H Kitamura.

At least 631 records · Page 35Linked to original sources
PubMedDate not supplied

Technique of ultrasound examination during laparoscopic cholecystectomy.

Intracorporeal ultrasonography was used as a new method to examine the bile ducts during laparoscopic cholecystectomy. A prototype rigid 7.5-MHz ultrasound probe, 10 mm in diameter and 50 cm in length, was introduced during 25 laparoscopic cholecystectomies. A dual scanning technique was developed for complete examination of the bile duct. This entailed transverse scanning via the subxyphoid trocar and longitudinal scanning via the umbilical trocar. The intrahepatic ducts were also visualized by placing the probe on the liver surface. Color Doppler imaging was useful to quickly distinguish the duct from vascular structures. Laparoscopic ultrasonography clearly delineated the bile ducts in all operations except one. The time required for imaging was significantly shorter for ultrasonography than for cholangiography. Our preliminary experience demonstrates that a complete examination of the bile ducts can be performed with intracorporeal ultrasonography in a relatively short period of time.

Bile Ducts↗
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Differential alterations in levels of hepatic microsomal cytochrome P450 isozymes following intracerebroventricular injection of bacterial lipopolysaccharide in rats.

To investigate the effect of central inflammation due to bacterial infection, such as meningitis, on the activities of hepatic cytochromes P450 (CYPs), rats were injected intracerebroventricularly (i.c.v.) with 0.1 microg of bacterial lipopolysaccharide (LPS). The LPS i.c.v. injection significantly decreased the total P450 contents (by 30% of the levels of control rats treated with saline i.c.v.), the contents of CYP1A (48%), 2B (54%), 2C11 (37%) and 3A (40%) and related drug metabolizing activities, 7-ethoxycoumarin O-deethylation (36%), imipramine N-demethylation (41%) and erythromycin N-demethylation (33%) in liver microsomes 24 h after the treatment. In contrast, intraperitoneal (i.p.) injection of LPS at the same dose as i.c.v. (0.1 microg) did not significantly affect the hepatic microsomal contents of total P450 or the content of each individual CYP isozyme and its activity. CYP2D1 protein and the activity of imipramine 2-hydroxylase were not significantly decreased by LPS injection regardless of the route of administration. The inhibitory effects of 0.1 microg i.c.v. LPS on the activities of these CYPs were almost equal to those of 10 microg i.p. LPS, and 0.01 microg of i.c.v. LPS significantly decreased the activity of imipramine N-demethylase only. Therefore, the LPS i.c.v. injection resulted in CYP isozyme-selective inhibition at an ineffective dose when injected i.p.. It is suggested that a central inflammation, such as meningitis, differentially decreases the levels of hepatic CYP isozymes. A possible involvement is discussed of the central nervous system in this down-regulation.

Animals↗
PubMedDate not supplied

Loss of sulfated carbohydrate from the glomerular podocyte as a cause of albuminuria in experimental diabetic rats: ultrastructural histochemical study.

Decrease of anionic sites and heparan sulfate proteoglycan has been demonstrated in diabetic glomerular basement membrane (GBM) and causally related to albuminuria. The HID-TCH-SP-PD technique is a sensitive histochemical method for negatively charged sulfated carbohydrates. In this study, we examined the localization of HID-TCH-SP-PD reaction in the glomeruli of diabetic and control rats. In both rats, the reaction was found in association with the surface of podocytes and with GBM. In diabetic rats, the former-associated reaction was markedly reduced. By contrast, the latter-associated reaction did not show any differences between both animal groups. Urinary albumin excretion (UAE) increased significantly in alloxanized rats. It is suggested that a decrease of podocyte-associated sulfated carbohydrates, the primary observed change, gives rise to albuminuria in alloxan diabetic rats.

Albuminuria↗
PubMedDate not supplied

Accessory nerve damages and impaired shoulder movements after neck dissections.

PURPOSE: After neck dissection, where the accessory nerve is often excised patients usually complain of impaired shoulder movements. The accessory nerve forms a plexus with branches of the cervical nerves C2, C3, and C4. In the present study, the accessory nerve was examined during neck dissections to clarify the incidence of motor fibers in joining branches, and the function of the motor fibers was evaluated postoperatively in relation to shoulder movements. MATERIALS AND METHODS: Presence of cervical contributions to the accessory nerve were examined in 20 neck sides in 15 patients. Postoperative function of the shoulder movements was evaluated by manual muscle testing (MMT) and electromyography (EMG). RESULTS: Motor fibers in cervical contributions were noted on four sides (20%) by stimulation of joining branches. When the accessory nerve was excised, scapular elevation was rarely impaired even if there were no motor fibers in the cervical contributions. Excision of the accessory nerve caused poor scapular adduction and impaired scapular depression and adduction in most cases even if motor fibers in the cervical contributions existed. CONCLUSION: Postoperative impairment of scapular movements was not attributed to the presence or absence of motor fibers in joining branches. Results obtained with electromyography did not represent the practical function of the muscle.

Accessory Nerve↗
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Apoptosis in glomerular endothelial cells during the development of glomerulosclerosis in the remnant-kidney model.

Capillary obsolescence with subsequent glomerulosclerosis is a common finding in most progressive glomerular diseases. In this study we investigated apoptosis, focusing on glomerular endothelial cells during the development of glomerulosclerosis in five-sixths nephrectomized rats for 6 months. Apoptosis was recognized by light and electron microscopy. Biochemical labeling of apoptosis was morphologically confirmed by in situ end labeling of fragmented DNA using terminal deoxynucleotidyltransferase. Glomerular endothelial cells were identified by electron microscope and immunostaining for thrombomodulin which is known to be an endothelial cell surface glycoprotein. Glomerular hypercellularity occurred by month 2, peaking by month 3, and an extracellular matrix accumulation was evident by month 3. Subsequently, most of the glomeruli progressed to diffuse sclerosis by months 4-6. During the progression of the disease, the glomerular endothelial cells decreased in number and finally could not be detected in the sclerotic lesion, and apoptotic cells apparently increased in number in the lesion. Significant apoptosis was present from month 3, thereafter it gradually increased to peak by month 6. Double immunostaining for apoptosis and thrombomodulin demonstrated that apoptosis occurred in the glomerular endothelial cells as well as in mesangial cells and infiltrating cells. The number of glomerular endothelial cells with apoptosis increased with the development of glomerulosclerosis, and maximum expression was observed by month 6. We conclude that the depletion of glomerular endothelial cells is associated with apoptosis in the remnant-kidney model, and apoptosis in glomerular endothelial cells may contribute to the development of glomerulosclerosis.

Animals↗
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Effects of enalapril on the exercise capacity and neurohumoral factors during exercise in patients with chronic heart failure.

The effects of enalapril on exercise capacity and neurohumoral factors during exercise were evaluated in 10 patients with heart failure. Echocardiograms and exercise testing with expired gas analysis were performed before and after enalapril. Blood samples were obtained before and after exercise. Both ejection fraction and percent fractional shortening increased with enalapril (p < 0.05). The anaerobic threshold and peak VO2 did not change with enalapril. Epinephrine and norepinephrine levels at peak exercise decreased with enalapril (p < 0.1). Plasma renin both at rest and at peak exercise increased with enalapril (p < 0.1). Angiotensin II was lower after enalapril both at rest and at peak exercise (p < 0.1 and p < 0.05, respectively). Aldosterone was lower after enalapril both at rest and at peak exercise (p < 0.05). Atrial natriuretic peptide (ANP) was lower after enalapril both at rest and at peak exercise. There was no significant correlations between peak VO2 and changes in neurohumoral factors before and after enalapril during exercise. In conclusion, neurohumoral changes with enalapril occurred during exercise even if exercise capacity did not improve. Moreover, the improvement of cardiac function at rest and neurohumoral factors with enalapril did not lead to a change of exercise capacity.

Aged↗
PubMedDate not supplied

Müllerian carcinofibroma of the uterus. A case report.

BACKGROUND: Müllerian carcinofibroma is composed of malignant epithelial tumor (cancer) and benign mesenchymal tumors. It is the least frequent among mixed müllerian tumors. There are eight reported cases of carcinofibroma or cases showing similar histology, with only two of these cases recurrent. CASE: A case of müllerian carcinofibroma arose in the uterine body. The patient was an 83-year-old, postmenopausal female whose endometrial cytology revealed cell clusters of adenocarcinoma and scattered nonepithelial cells with enlarged nuclei without nuclear atypism or mitosis. Histology of the resected uterus showed a mixture of well to poorly differentiated adenocarcinoma, and fibromatous and leiomyomatous nonepithelial tumors without a transition between them. There was no sign of recurrence nine months after hysterectomy. CONCLUSION: Müllerian carcinofibroma seems to have a better prognosis than malignant mixed müllerian tumor. When both cancer cells and an abundance of nonepithelial cells are seen on gynecologic cytology, it may be important to consider mixed müllerian tumor and to differentiate müllerian carcinofibroma from malignant mixed Müllerian tumor by careful observation of the nuclear size, nucleoli, nuclear atypism and mitosis of the nonepithelial cells.

Aged↗
PubMedDate not supplied

Cardiac neurosis: exercise tolerance and the role of sympathetic activity.

To evaluate the cardiovascular and plasma catecholamine responses to dynamic exercise in patients with cardiac neurosis (CN), treadmill testing was performed. Thirty-four patients with CN were chosen for this study based on exercise tolerance and the results were compared with those in 31 patients with organic heart disease and 12 normal subjects. Patients with CN showed an augmentation of cardiovascular and plasma catecholamine responses. The augmentation of the norepinephrine response in patients with CN was not as remarkable as that in patients with organic heart disease. On the other hand, the augmentation of the epinephrine response was greater in patients with CN than in those with organic heart disease. Administration of metoprolol (40 mg/day) for two weeks improved exercise tolerance in patients with CN. We suggest that anxiety augments both sympatho-neural and sympatho-adrenal activity and that it is the symptoms induced by the augmented cardiovascular response which reduce exercise tolerance in patients with CN.

Adult↗
PubMedDate not supplied

Electron microscopic and immunoelectron microscopic demonstration of pancreatic polypeptide cells in glucagonoma: colocalization of pancreatic peptide and glucagon in single secretory granules.

We describe a case of pancreatic tumor in a 65-year-old woman with typical glucagonoma syndrome. Plasma glucagon (GL) and pancreatic polypeptide (PP) were markedly elevated up to 1404 and 1200 pg/ml, respectively. Histologic examination of the metastatic tumors in liver and lymph nodes showed endocrine-type tumors composed of GL-positive cells some of which coexpressed PP immunoreactivity. Electron microscopy revealed the tumor cells with single-type secretory granules similar to normal A cell granules. Double immunogold staining demonstrated both GL and PP immunoreactivities in the same secretory granules. Biologic and diagnostic significance of coexpression of PP and GL in a single secretory granules of pancreatic endocrine tumors is discussed briefly.

Adenoma, Islet Cell↗
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Cytotoxic activity of normal mouse serum on mouse tumor cells in vitro.

Cytotoxic effects of normal mouse serum on mouse tumor cells were investigated in vitro. When FE melanoma cells of C57BL/6 mouse origin, were cultured in medium containing 1% fetal calf serum (FCS) and 10-30% C57BL/6 mouse serum, number of viable FE cells markedly decreased after a little increase in their number, indicating cell death of FE cells in culture with mouse serum. Phase-contrast microscopic examination showed appearance of fatty degeneration in FE cells after 24 h, and an increase in cell death after 48 h. Electron microscopic examination, and agarose gel electrophoresis of DNA at 72 h of culture showed that their cell death occurred as necrosis. This cytotoxic effect of mouse serum was also found in culture of combinations of C57BL/6 mouse serum and C57BL/6 mouse melanoma cells (G6 cells), and BALB/c mouse serum and various BALB/c mouse tumor cells (G-5 and G-1 liver tumor cells, and Colon 26 cells). Furthermore, sera of BALB/c and B10D2 mice also showed the cytotoxic effect on FE cells. The cytotoxic effect of mouse serum was not ascribed to complement activity because all mouse sera were treated at 56 degrees C for 30 min before use, and this heat treatment completely abolished complement activity, and because serum of C5-deficient mice also showed the cytotoxic effect. This cytotoxic activity was stable at heat treatment at 100 degrees C for 10 min, and was in a serum fraction of molecular weights more than 30,000 dalton. The present results show that normal mouse serum has a factor(s) inducing fatty degeneration and necrosis of mouse tumor cells.

Animals↗
PubMedDate not supplied

Caudal left hepatic duct in relation to the umbilical portion of the portal vein.

BACKGROUND/AIMS: Intrahepatic ducts from the left lateral segment of the liver are generally considered to run from the cranial to the umbilical portion of the left portal vein. This understanding often limits surgical exploration of the left hepatic ducts during both curative and palliative surgical procedures. The prevalence of ducts from the lateral segment running caudally to the umbilical portion was studied retrospectively on computed tomography (CT) films, and its clinical implications were evaluated. METHODOLOGY: One hundred and sixty-six DIC (drip infusion cholangiography) CT and 30 post-PTCD (percutaneous transhepatic cholangio-drainage) CT films taken during 4 consecutive years were reviewed giving special consideration to whether the ducts from the left lateral segment of the liver run caudal to the umbilical portion of the left portal vein. RESULTS: Corresponding variation was found in 3.6% of the DIC-CT examinations and in 3.3% of the CT examination after PTCD, respectively. CONCLUSIONS: The incidence of caudal left hepatic ducts with respect to the umbilical portion of the left portal vein was higher than expected from clinical experience. These results emphasize that more careful planning is necessary prior to hepatobiliary surgery.

Biliary Tract Surgical Procedures↗
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Primary ovarian lymphoma associated with Meigs' syndrome: a case report.

A case is presented of primary undifferentiated lymphocytic lymphoma, non-Burkitt, of the right ovary associated with Meigs' syndrome. The diagnosis was based upon the findings of tumor imprint cytology, histopathology and electron microscopy. The ultrastructural observations were the most diagnostic, revealing well-developed, rough endoplasmic reticulum and dilated cisternae in the cytoplasm of the tumor cells. An association of Meigs' syndrome with a rare ovarian lymphoma has not been previously reported. The abnormal-appearing mesothelial cells in the pleural effusion were proven to be reactive and not malignant by comparison with the tumor cells demonstrated by imprint cytology of this ovarian lymphoma.

Adult↗