Biomedical subjects

H Shinohara

Publications and source records attributed to H Shinohara.

At least 145 records · Page 8Linked to original sources

PubMed1997

Distribution of lymphatic stomata on the pleural surface of the thoracic cavity and the surface topography of the pleural mesothelium in the golden hamster.

BACKGROUND: The distribution of lymphatic stomata that open to the pleural cavity is unclear. The distribution and the surface topography of the pleural and visceral pleurae are key factors in the turnover of pleural fluid and respiration physiology. METHODS: Nine golden hamsters (Mesocricetus auratus) from 26 to 33 weeks of age were used for the study. The gross anatomy of the thorax and the arterial supply to the lung were studied in four hamsters. Five thoracic hemispheres, three diaphragms, and tissue blocks of the heart and lung were prepared from the remaining five hamsters. The thoracic hemispheres were fixed in 2.5% glutaraldehyde and the muscular bands at each intercostal space were carefully cut along the costae. The intercostal bands were processed for scanning electron microscopy (SEM) and the localization and the number of lymphatic stomata were recorded. The diaphragms and blocks of the lung and heart were also processed for SEM and the surface topography was observed. RESULTS: The right and left superior lobes of the lung were supplied by the bronchial artery that originated from the right costocervical trunk and left internal thoracic artery, respectively. Lymphatic stomata and mesothelial discontinuities (pores and gaps) were predominantly located in areas lined with cuboidal cells. The areas of cuboidal cells occupied approximately 4.6 mm2, namely, 1% of the total area of the thoracic hemisphere. There were about 1,000 lymphatic stomata per thoracic hemisphere. About 15% of lymphatic stomata were distributed in the ventro-cranial regions of the thoracic wall, with about 85% in the dorsocaudal region. In the former region, lymphatic stomata were found along the costal margins. In the latter, they were predominantly located in the pre- and paravertebral fatty tissue. There were also areas of cuboidal cells on the pleural surface of the diaphragm. Some mesothelial pores and gaps were found, but no lymphatic stomata opened on the pleural surface of the diaphragm. The pleural surface of the lung and that of the heart were lined with flattened polygonal cells. The topography of the surface varied, but there were no mesothelial discontinuities of the type commonly found in the parietal pleura. CONCLUSIONS: 1) The parietal pleura has a surface structure that is more permeable and absorptive for fluid and particulate matter than the visceral pleura. 2) The distribution of lymphatic stomata does not correspond directly to the pleural liquid pressures that have been reported. 3) The functions of lymphatic stomata should be considered not only in terms of fluid turnover but also in terms of self-defense mechanisms. 4) The presence or absence of lymphatic stomata on the diaphragmatic pleura should be re-examined and determined in a variety of animal species.

Animals↗

PubMed1997

Lymphatic system of the mouse diaphragm: morphology and function of the lymphatic sieve.

BACKGROUND: The diaphragm has a unique system that collects peritoneal fluid and carries it into the lymphatic system. However, our understanding of the morphology and function of this system is still incomplete. METHODS: Twelve C57BL/6 mice of 13 to 25 weeks of age were used without regard to sex. In one series of experiments, the diaphragm was isolated and fixed 10-15 minutes after injection of india ink into the peritoneal cavity and then the peritoneal mesothelium was peeled off from the submesothelial connective tissue. The lymphatic vessels attached to the mesothelial strip were examined by scanning electron microscopy. The diaphragm was also observed in plastic-embedded semithin and ultrathin sections. In another series of experiments, the diaphragm was stained by 5'-nucleotidase histochemistry (Wachstein and Meizel, 1957a. Am. J. Clin. Pathol., 27:13-23), and several microdrops of india ink were placed on the peritoneal or pleural surface to reveal the profile of the lymphatic vessels. RESULTS: The lymphatic vessels on the peritoneal side of the diaphragm were flattened. They usually ranged from several to 100 microns in width and from close to zero to a few micrometers in thickness. In other words, they formed extremely flat lumina, differing from the more usual tubular lymphatic vessels. Several lymphatic vessels extended radially and parallel to one another from the central tendon to the thoracic wall, with numerous connecting branches, forming an area of lymphatic vessels. The india ink that had been injected intraperitoneally and the staining with 5'-nucleotidase revealed that there were seven to nine such lymphatic areas in one hemisphere of the diaphragm. The lymphatic areas spread in parallel with the peritoneal surface of the diaphragm and all the areas together appeared to occupy more than half the surface area of the sternocostal part of the diaphragm. Each area was a relatively distinct functional unit with respect to the draining of india ink. Microdrops of india ink placed on the pleural surface did not enter the lymphatic vessels, while those placed on the peritoneal surface immediately entered the peritoneal lymphatic vessels and migrated to the pleural lymphatic vessels via the transmuscular lymphatic branches. CONCLUSIONS: The peritoneal lymphatic vessels of the diaphragm have extremely flat lumina that spread in parallel with the peritoneal surface of the diaphragm and form a lymphatic sieve that covers approximately half or more of the surface area of the sternocostal region for drainage of fluid and particulate matter from the peritoneal cavity. The lymphatic system has been characterized by the presence of openings (= stomata) to the peritoneal cavity and the amplitude of the lumina (= lacunae). However, the fundamental characteristic of the system is the extremely flat lumen (= vadum), which facilitates the formation of the lymphatic sieve.

Animals↗

PubMed1997

Characterization, guanosine 5'-O-(3-thiotriphosphate) modulation, daily variation, and localization of melatonin-binding sites in the catfish (Silurus asotus) brain.

Characteristics, guanosine 5'-O-(3-thiotriphosphate) (GTPgammaS) modulation, daily variation, and localization of melatonin-binding sites in the brain of a nocturnal teleost, the catfish Silurus asotus, were studied by radioreceptor assay using 2-[125I]iodomelatonin as the radioligand. The specific binding was rapid, stable, saturable, and reversible. The radioligand binds to a single class of receptor site with an affinity (Kd) of 30.7 +/- 7.3 pM and total binding capacity (Bmax) of 9.76 +/- 0.79 fmol/mg protein (mean +/- SE, n = 5). The binding sites were highly specific for 2-iodomelatonin and melatonin. The specificity was almost identical to that of functional melatonin receptors in the dermal and epidermal melanophores in this species and that of ML-1 subtype melatonin receptors in vertebrates, including melatonin-binding sites in the goldfish brain. GTPgammaS treatment altered both the Kd and Bmax values, indicating that melatonin-binding sites in the catfish brain are coupled to G protein. The Bmax values exhibited no daily variation under light-dark cycles of 12 hr light:12 hr dark whereas plasma melatonin levels and Kd fluctuated in a rhythmic fashion. The density of melatonin-binding sites in discrete brain areas was determined to be highest in optic tectum-thalamus and hypothalamus, intermediate in telencephalon, cerebellum, and medulla oblongata, and lowest in olfactory bulbs. These results suggest that melatonin secreted from the pineal organ and/or retina plays neuromodulatory roles in the catfish brain via G protein-coupled melatonin receptors. Characteristics of melatonin receptors seem to be highly conserved during evolution, although the density of melatonin receptors is not regulated by melatonin itself in this species.

Animals↗

PubMed1997

The protective effects of prostaglandin E1 on sinusoidal endothelial cells in xenogeneic pig liver perfusion.

The effects of prostaglandin E1 (PGE1) on hepatic sinusoidal endothelial cells (SEC) in the xenogeneic immunoreaction were investigated. Porcine livers were perfused with fresh human blood via the portal vein (PV) and the hepatic artery (HA) either with the administration of PGE1 (Group PG) or without PGE1 (Group C). The creatine kinase-BB component (CK-BB) in the perfusate was measured to assess SEC damage. SEC activation and complement activation were evaluated immunohistochemically by the expression of von Willebrand factor (vWF) and by the deposition of membrane attack complex (MAC), respectively. Xenoperfusion in Group C was discontinued between 4 and 6 hr due to the rapid elevation of HA pressures and the massive loss of perfusate. In Group PG, both PV and HA pressures were kept stable for up to 9 hr. In Group C, severe interlobular bleeding and diffuse extrasinusoidal hemorrhage were observed at 4 hr histologically, while in Group PG, the hepatic architecture was maintained without hemorrhage at 6 hr. MAC was markedly deposited on SEC and parenchymal cells at 3 hr in both groups. The amount of vWF, however, was expressed on SEC in large amounts at 1 hr in Group C, while small amounts were expressed at 1 hr in Group PG. In Group PG, CK-BB release was significantly lower than in Group C (P < 0.01). These results suggest that PGE1 suppressed SEC activation and protected the impairment of hepatic SEC during xenoperfusion without suppressing complement activation, resulting in the prolongation of xenogeneic liver perfusion.

Alprostadil↗

PubMed1997

Precision of the gallbladder ejection fraction obtained with Tc-99m-pyridoxyl-5-methyl-tryptophan (99mTc-PMT) hepatobiliary scintigraphy as compared with the contraction ratio in three-dimensional computed tomography.

UNLABELLED: The gallbladder ejection fraction (GBEF) obtained with Tc-99m-pyridoxyl-5-methyl-tryptophan (99mTc-PMT) hepatobiliary scintigraphy has been used as a parameter of gallbladder function. To determine the accuracy of GBEF, the relationship with the contraction ratio of the gallbladder (GBCR) obtained with three-dimensional helical computed tomography (3D-CT) was studied. PATIENTS AND METHODS: A normal volunteer, 8 patients suffering from cholecystolithiasis and a patient with gallbladder dyskinesia were examined. The percent initial dose (%ID) for the gallbladder and GBEF with hepatobiliary scintigraphy were used to compare the volume of the gallbladder and GBCR which was measured by 3D-CT. RESULTS: The %ID of the gallbladder was correlated with the volume of the gallbladder by 3D-CT (Y = 1.000X - 1.818, r = 0.928). GBEF was correlated well with GBCR by 3D-CT (Y = 0.916X + 6.296, r = 0.975). CONCLUSIONS: The %ID of the gallbladder obtained with hepatobiliary scintigraphy may be a good indicator of the volume of the gallbladder. The accuracy of GBEF was confirmed by comparison with 3D-CT examination. GBEF is considered a useful parameter of pathophysiological gallbladder function.

Adult↗

PubMed1997

The associations of optic disc hemorrhage with retinal nerve fiber layer defect and peripapillary atrophy in normal-tension glaucoma.

OBJECTIVE: The purpose of the study is to elucidate a topographic correlation between optic disc hemorrhages and retinal nerve fiber layer defects as well as peripapillary atrophy in normal-tension glaucoma (NTG). DESIGN: The authors prospectively studied the relation between the precise locations of disc hemorrhages and retinal nerve fiber layer defects in the first part of the study. The authors also compared morphometrically the peripapillary atrophy and the optic disc in eyes with disc hemorrhage with eyes without a history of disc hemorrhage in age-matched patients in the second part of the study. PARTICIPANTS: In part 1, 42 patients with NTG (male/female = 11/31; age, 56.8 +/- 14.2 years) in whom new disc hemorrhages developed were enrolled. In part 2, 51 randomly selected age-matched patients with NTG without a history of disc hemorrhage (male/female = 16/35; age, 55.7 +/- 12.5) were examined. MAIN OUTCOME MEASURE: In part 1, retinal nerve fiber layer defects were observed by scanning laser ophthalmoscopy using an argon-blue laser. In part 2, the area, angular extent, and radial extent of zone beta of peripapillary atrophy and the structural parameters of optic disc were measured by scanning laser tomography using a diode laser. RESULTS: In part 1, the authors detected 64 disc hemorrhages in 48 eyes of 42 patients; retinal nerve fiber layer defects were shown in 47 (97.9%) of 48 eyes by scanning laser ophthalmoscopy. Of 64 disc hemorrhages, 51 (79.7%) coincided with retinal nerve fiber layer defects in location. These 51 hemorrhages were present on the border (41.2%) or adjacent to the border (58.8%) between the retinal nerve fiber layer defect and the apparently healthy-looking retinal nerve fiber layer. In part 2, the prevalence, area, angular extent of zone beta, and ratio of zone beta area to disc area were significantly greater in the disc hemorrhage group than in the nonhemorrhage group, even though there were no significant differences in disc parameters between the two groups. CONCLUSIONS: Disc hemorrhage is associated closely with retinal nerve fiber layer defect in location and the size of peripapillary atrophy in NTG.

Adult↗

PubMed1997

Hepatic preservation with histidine-tryptophan-ketoglutarate solution in living-related and cadaveric liver transplantation.

1. Living-related liver transplantation has some advantages in the evaluation of novel clinical protocols, since many complicated factors affecting initial graft function are almost uniform in grafts obtained from healthy donors. 2. To compare histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) solution in terms of tissue oxygenation in living-related liver transplantation, oxygen saturation of haemoglobin (SO2) in hepatic tissue and its heterogeneity (CV, coefficient of variation) were measured by near-infrared spectroscopy. The HTK and UW groups consisted of 15 and 49 successful transplants respectively, in which no statistical differences in background were observed. 3. In the HTK group, hepatic SO2 after portal vein reflow was higher (P < 0.01) than that in the UW group, as was that after hepatic artery reflow (P < 0.05). In the UW group, hepatic SO2 remained at the lower level at the end of the operation. 4. Furthermore, the increase in CV after portal vein reflow was normalized after hepatic artery reflow in the HTK group. However, the CV remained at a high level at the end of the operation in the UW group. 5. Postoperative peak aspartate aminotransferase level in the HTK group was lower than that in the UW group (P < 0.05). 6. In cadaveric liver transplantation, higher hepatic SO2 and lower CV of hepatic SO2 in the early phase after reperfusion compared with the UW group (n = 18) were also observed in the HTK group (n = 30) (P < 0.05). 7. In conclusion, recovery of tissue oxygenation and its heterogeneity after reperfusion in HTK-preserved livers were more rapid and homogeneous than in UW-preserved livers in living-related liver transplantation. Accordingly, HTK solution may be a potential alternative to UW solution.

Adenosine↗

PubMed1997

Changes in the surface of the superior articular joint from the lower thoracic to the upper lumbar vertebrae.

Thirty-two human vertebral columns were selected from the Kanazawa Collection at the University of Kanazawa, Japan. The superior articular joint surface was categorised into the thoracic type and the lumbar type, and the pattern of the change from one type to the other in the lower thoracic and upper lumbar region was examined. In 21 of 32 cases (66%), the change from the thoracic to the lumbar type occurred over 2 vertebral segments, either between the 12th thoracic and 1st lumbar vertebrae (44%) or between the 11th and 12th thoracic vertebrae (22%). In the remaining 11 cases (34%), the change occurred over 3 vertebral segments, with a transitional type of articular surface. The change from the thoracic to lumbar type of articular surface has been believed to occur over 2 vertebral segments, but occurs over 3 segments in as many as 34% of the articular surfaces.

Adolescent↗

PubMed1997

Association of the gamma12 subunit of G proteins with actin filaments.

Recent studies have suggested an association between heterotrimeric G proteins, which play a major role in transmembrane signal transduction, and intracellular components. We therefore examined the subcellular localization of isoforms of G protein gamma subunits in Swiss 3T3 and C6 glioma cells, mainly containing the gamma5 and gamma12 subunits. Immunocytochemical double staining with phalloidin showed co-localization of the gamma12 subunit with actin filaments (F-actin), while the gamma5 co-localized with vinculin, suggesting an association with focal adhesion. Pretreatment of cells with Triton X-100 eliminated the gamma5 but not the gamma12 staining. Co-localization of gamma12 and F-actin was preserved when F-actin was disorganized with cytochalasin D or reorganized using fetal calf serum. Large amounts of gamma12 were recovered in the vimentin- and tubulin-free F-actin-rich fraction prepared from crude cytoskeleton preparations by double depolymerization-repolymerization. Co-localization of Gi2alpha, beta and gamma12 in the F-actin-rich fraction suggested the existence of gamma12 as a betagamma or heterotrimeric complex. Furthermore, purified betagamma12 was found to associate with F-actin in vitro more tightly than betagamma5. These results strongly suggest that the gamma12 subunit associates with F-actin in cells. The observed differential distribution of gamma12 and gamma5 implies functional differences for the two gamma subunits.

3T3 Cells↗

PubMed1997

[Examination of scanning technique for lung cancer screening with helical CT].

As a new application of helical CT scanning we evaluated the parameters for lung cancer screening with an extremely low doses and large helical pitch. On the phantom studies, the image quality obtained with the low dose parameter was not inferior to that of the usual screening technique but artifacts were increased with the large helical pitch. A scanning technique using 120 kv, 40-60mA, 10mmth, 20mm/ sec, and a reconstruction pitch of 2 was used for lung cancer screening (screening parameters) (50 cases), and comparison was made between the detectability of the screening parameters and the routine parameters (120 kv, 200mA, 10mmth, 10-13mm/sec, and a reconstruction pitch of 1-1.3). Detectability with the screening parameters was as follows: nodular lesions (< 5mm in size: 76%. 5-10mm: 90-93% 10mm < 100%), linear lesions: 94-95%, infiltrations: 93-100%. There were no false negative lesions, when the reconstruction pitch of the screening parameters was changed from 1 to 0.25. In conclusion, reconstruction pitch had the most influence on lesion detectability.

Adult↗

PubMed1997

[Significant findings on CT performed before presence of post-surgical bowel obstruction].

We evaluated whether CT performed before the presence of bowel obstruction (pre-CT) is useful in predicting the presence of post-surgical bowel obstruction. Thirty-three patients with post-surgical bowel obstructions who had pre-CT were reviewed. The pre-CT findings were compared with the findings of CT performed after the presence of bowel obstruction (post-CT) in 16 patients, and with the intraoperative findings in 18 patients. Pre-CT demonstrated many interesting findings, such as a discrepancy in the caliber of the bowel, the presence of two adjacent collapsed loops, a beak-like appearance of the bowel, focal distention and/or wall thickness of bowel loops, and twisted mesentery. Twenty-three (70%) of 33 patients had one or more of these findings on pre-CT. All patients with a surgically proved closed loop obstruction had two adjacent collapsed loops on both pre- and post-CT. In six (86%) of seven patients who had focal dilated bowel loops and twelve (71%) of seventeen patients who had twisted mesentery on pre-CT, conservative management was proved ineffective. Pre-CT showed many significant findings. Attention should be paid to these findings, because they can predict the presence of post-surgical bowel obstruction. In particular, we stress that two adjacent collapsed loops on pre-CT is a sign of the presence of post-surgical closed loop obstruction.

Adult↗

PubMed1997

Tricuspid inflow and regurgitant flow dynamics after mitral valve replacement: differences relating to surgical repair of the tricuspid valve.

BACKGROUND AND AIMS OF THE STUDY: Changes in tricuspid inflow and regurgitant flow dynamics were evaluated in patients with functional tricuspid regurgitation (TR) who underwent mitral valve replacement (MVR) with and without tricuspid annuloplasty (TAP). METHODS: In a group of 30 patients, all with atrial fibrillation, 15 underwent TAP performed according to the modified De Vega technique; the remaining 15 did not undergo TAP. Patients were studied before and serially after surgery, using pulsed and color Doppler echocardiography. The mean follow up was 4.7 years in the TAP group and 5.1 years in the non-TAP group. RESULTS: In the TAP group, immediately after surgery, the area of the TR jet decreased markedly, and the deceleration time of the tricuspid inflow velocity wave was significantly prolonged compared with that before surgery. By contrast, in the non-TAP group, both the area of the TR jet and deceleration time of tricuspid inflow velocity were virtually unchanged. The area of the TR jet remained small for a long period in the TAP group, but in non-TAP patients was increased in four cases over seven years, with two patients developing right-sided heart failure. Recent data showed the area of the TR jet to be significantly smaller, with maximum tricuspid inflow velocity significantly increased, and deceleration time of the tricuspid inflow velocity wave significantly prolonged in the TAP group compared with the non-TAP group. CONCLUSIONS: In patients with functional tricuspid regurgitation undergoing MVR, concomitant TAP may cause mild tricuspid stenosis, but produces sustained preventive effects against TR. Careful follow up is needed in patients who have not undergone TAP, as TR is not markedly decreased and may even be exacerbated. Aggressive TAP is recommended in patients showing dilatation of the tricuspid annulus, even if TR is mild.

Adult↗

PubMed1997

[Proposal on new formulas for renal depth in the technetium-99m-mercaptoacetyltriglycine (MAG3) scintigraphy].

UNLABELLED: Recently, camera-based techniques to measure effective renal plasma flow (ERPF) have become more popular than single plasma sample techniques because camera-based measurements avoid the necessity of delayed plasma samples and in vitro techniques. The measurements of ERPF are used to estimate the clearance of technetium-99m-mercaptoacetyltriglycine (MAG3). However, camera-based techniques are dependent on an accurate estimate of renal depth to correct for soft-tissue attenuation. Then, new formulas for renal depth correction of technetium-99m-MAG3 clearance in place of Tønnesen's, M. Ito's, K. Itoh's, and Taylor's methods were tried to establish in this paper. PATIENTS AND METHODS: Eleven hundred and seventy patients without any renal disease were objected. The data from measurement of renal depth using X-ray CT in supine position were analyzed statistically. RESULTS: The depths of right kidney (Dr) and left kidney (Dl) were 7.33 +/- 1.27 and 7.07 +/- 1.27 cm. The correlation coefficients between Dr and height (H) body weight (W), body surface area (BSA: W0.425 x H0.725 x 0.007184 m2), age, and abdominal thickness (Ta) were 0.275, 0.709, 0.615, 0.087, and 0.743. The correlation coefficients between Dl and H, W, BSA, age, and Ta were 0.269, 0.732, 0.629, 0.029, and 0.812. Ta had best correlation with both Dr and Dl. The calculation formulas for Dr and Dl using Ta were as follows: Dr = 0.32 x Ta + 0.87 cm, and Dl = 0.36 x Ta - 0.08 cm. On the other hand, the multiplex calculation formulas of Dr or Dl with H, W, and Ta were as follows: Dr = 0.18Ta + 8.54 x (W/H) + 0.75 (r = 0.768), and Dl = 0.26Ta + 5.90 x (W/H)-0.16 (r = 0.823). CONCLUSION: The new regression equations provide superior estimates of renal depth compared to conventional equations. Application of these new formulas into camera-based protocols to determine renal clearances may lead to more accurate measurements of ERPF using technetium-99m-MAG3 scintigraphy.

Adolescent↗

PubMed1997

Participation of the pituitary-thyroid axis in the cardiovascular system in elderly patients with congestive heart failure.

The relationship between the pituitary-thyroid axis and the cardiovascular system in patients with congestive heart failure (CHF) remains unknown. Therefore, we attempted to determine serum levels of thyroid hormones in relation to plasma atrial natriuretic peptide (ANP) levels and left ventricular (LV) function in patients with CHF. The echocardiographic ejection fraction significantly correlated with the thyroid stimulating hormone (TSH) (p < 0.005) and free triiodothyronine (FT3)/free thyroxine (FT4) ratio (p < 0.005), respectively, in patients with CHF but not in control subjects. TSH was positively correlated with the FT3/FT4 ratio (p < 0.01) in CHF. In patients with CHF, TSH and thyroid hormones may participate in regulatory mechanisms of the cardiovascular system and altered thyroid hormone metabolism, which was characterized by a euthyroid sick syndrome.

Aged↗

PubMed1997

[Can 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) evaluate the renal function without blood sampling?: consensus report from multicenter study].

A multicenter study was undertaken in Japan to evaluate the correlation between the percentage of renal uptake of 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) estimated by the count-based gamma camera method and the blood clearance of 99mTc-MAG3. Twenty four centers were enrolled and 172 cases were finally analyzed in this study. The renal clearance of 99mTc-MAG3 (TER) was obtained by using a single blood sample taken at 44 min after injection. Comparison of TER and renal uptake provided a coefficient of correlation of 0.874; suggesting that sufficiently accurate quantification of renal function could be obtained from the renal uptake estimate by the gamma camera method. This study also showed that the comparison of renal function might be feasible among patients under the same protocols, although precise and careful consideration is required in each center.

Adolescent↗

PubMed1997

[Preoperative evaluation of the limitation of hepatic resection using 99mTc-GSA (galactosyl human serum albumin) scintigraphy].

UNLABELLED: Preoperative evaluation of the operative indication of hepatic resection using the parameters obtained by 99mTc-GSA scintigraphy has been done. In particular, the accurate evaluation of the postoperative hepatic functional reserve essentially depends on these parameters. In the present study, a preoperative evaluation of postoperative hepatic functional reserve using 99mTc-GSA scintigraphy was performed in our operated cases retrospectively. PATIENTS AND METHODS: Thirty-eight patients who underwent hepatic resection were studied on 99mTc-GSA scintigraphy before and after operation. These patients were divided into two groups. Group A; had no postoperative complications (n = 31). Group B; had some postoperative complications (n = 7). Preoperative parameters of 99mTc-GSA liver scintigraphy (HH15, LU15) were calculated from the activities of liver and cardiac ROIs at 5 and 15 minutes after injection. The resection ratio (RR) was obtained by comparing the liver volumes which were calculated from the pre- and postoperative SPECT studies. The resectability indices (Res) were as follows: Res (LU15) = LU15 x (100-RR(%)/100, Res (HH15) = (1/HH15) x (100-RR (%)/100. RESULTS: There were statistically significant differences in the distribution of Res between A and B groups (p = 0.002, Mann-Whitney test). The values of Res, of which half of patients have complication, were 1.10 (Res (HH15)) and 16.4 (Res (LU15)). CONCLUSION: The resectability indices using 99mTc-GSA liver scintigraphy are useful for the preoperative evaluation of the limitation of hepatic resection.

Adult↗

PubMed1996

Postoperative monitoring of the oxygenation state of the graft liver in cases with hepatopulmonary syndrome.

Postoperative changes in the oxygen saturation of hemoglobin in the graft liver (graft SO2) were monitored by near-infrared spectroscopy in four cases complicated by hepatopulmonary syndrome. A plastic cylinder was placed in the abdominal wall, and optical measurements of the graft liver were obtained through this window. Our findings were as follows; (1) graft SO2 decreased after abdominal wall closure, and decreased further 1 day after surgery. (2) Graft SO2 was maintained despite severe hypoxemia, with partial pressure of oxygen in arterial blood as low as 50 mmHg. High hematocrit was beneficial for oxygenating the graft. (3) Graft livers could tolerate hypoxia with a graft SO2 as low as 20%. (4) It may be useful to monitor graft SO2 during the critical period after transplantation for the assessment of graft function.

Adolescent↗

PubMed1996

Disorganization of microtubular network in postischemic liver dysfunction: its functional and morphological changes.

Microtubules in the hepatocytes have been implicated to serve as lines of cytoplasmic transport of secretory materials, but are highly labile structures sensitive to pathological conditions in the cytosol. We examined the role of ischemia/reperfusion-induced cytoskeletal alterations in postischemic liver dysfunction. Rabbit livers were subjected to 60-min warm ischemia followed by 1 h or 24 h of reperfusion. Liver function was assessed by directly measuring hepatic clearance of indocyanine green (ICG), an organic anion whose cytoplasmic transport is assumed to depend on intact microtubules, using near-infrared spectroscopy. Structural alterations of microtubules were observed immunohistochemically using tissue sections stained with monoclonal anti-beta-tubulin antibody. ICG removal from hepatocytes into bile canaliculi deteriorated 1 h but reversed 24 h after reperfusion. Immunohistochemistry showed fragmentation of microtubules at the end of liver ischemia. This cytoskeletal alteration was evident 1 h but was not observed 24 h after reperfusion. Treatment with prostaglandin E1 exerted its beneficial effect by preserving ICG clearance and microtubular network. These results demonstrate that liver ischemia and subsequent reperfusion both affect the organization of microtubular network and suggest that structural disruption of microtubules may be a cause of postischemic liver dysfunction.

Actin Cytoskeleton↗