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Biomedical subjects

H Yamaga

Publications and source records attributed to H Yamaga.

At least 55 records · Page 3Linked to original sources
PubMed1990

Hypercoagulopathy after repeated injection of 5% ethanolamine oleate to sclerose esophageal varices.

Hematological and coagulating parameters were examined in 53 patients in an attempt to find possible evidence of disseminated intravascular coagulation after intravascular injection of 5% ethanolamine oleate to sclerose esophageal varices. FDP-E in the peripheral blood measured by latex photometric immunoassay significantly increased from 111.2 +/- 112.9 to 234.2 +/- 178.3 ng/ml and 370.4 +/- 189.5 ng/ml one hour after the first and second sessions of sclerotherapy, respectively (p less than 0.01). The other parameters showed no significant change, except on the first day after sclerotherapy. The increase of FDP-E was closely related to fibrinopeptide A (r = 0.689, p less than 0.01) and fibrinogen (r = 0.585, p less than 0.05), before the sclerotherapy. As repeated intravariceal sclerotherapy over short time intervals can lead to a deterioration of the coagulating system, especially in patients with abnormal preoperative coagulopathy, latex photometric immunoassay for FDP-E is a rapid and useful method of monitoring alterations in the coagulating system.

Adult↗
PubMed1989

Angioarchitectural classification of esophageal varices and paraesophageal veins in selective left gastric venography.

An improved radiographic classification of esophageal varices and paraesophageal veins was devised. Esophageal varices were divided into palisading and bar types. Paraesophageal veins were divided into intra-abdominal and thoracoabdominal types, with the latter being further subdivided into right-side-predominant and left-side-predominant types. The existence of the thoracoabdominal paraesophageal veins was significantly related to the preoperative endoscopic findings of the red sign and the form of the esophageal varices. Left-side-predominant paraesophageal veins were likely to drain the splanchnic blood flow to the hemiazygos vein. The largest grade of red sign was found in 88.9% of the patients with combination of bar type and intra-abdominal type and the largest form was in 88.9% of those with palisading and right-side thoracoabdominal types. The pressure gradients across the shunt were significantly lower in the right thoracoabdominal type than in others. Our study suggests that treatment be designed according to the vascular patterns of the lower esophagus.

Esophageal and Gastric Varices↗
PubMed1989

Human thrombin plus 5 per cent ethanolamine oleate injected to sclerose oesophageal varices: a prospective randomized trial.

Fifty cirrhotic Japanese patients with oesophageal varices underwent sclerotherapy in a prospective randomized trial carried out to examine the effects of human thrombin given concomitantly with the sclerosant 5 per cent ethanolamine oleate. The two groups (25 patients each) were comparable with regard to size of the oesophageal varices, and the aetiology and severity of the liver disease. Twenty-five patients, 13 and 12 in the thrombin + and - groups, respectively, had at least one episode of variceal bleeding. The remaining 25 were given prophylactic injections. There was a significantly lower rate of occurrence of bleeding from injection sites when the injection needle was removed at the initial session of sclerotherapy in the thrombin + group, where human thrombin was injected (0.2-0.3 ml, 100-150 units per injection) just before removal of the injection needle. Endoscopy at 1 week after the initial session showed a significantly (P less than 0.05) higher rate of disappearance of red colour signs on varices in the thrombin + group (96 per cent) than in the thrombin - group (72 per cent). Fibrin degradation product E-fraction (FDP-E) values increased 1 h, 1 day and 6 days after the initial session of sclerotherapy in the two groups. The rate of increase in FDP-E values 1 h after sclerotherapy was significantly larger (P less than 0.001) in the thrombin + than in the thrombin - group. There was no clinical sign of disseminated intravascular coagulation. Administration of human thrombin plus a sclerosant seems to be useful and efficacious, especially for patients with huge oesophageal varices.

Endoscopy↗
PubMed1989

Platelet aggregability after endoscopic intravariceal injection of 5 per cent ethanolamine oleate into oesophageal varices.

Platelet aggregability and the coagulative and fibrinolytic systems were examined in 45 patients who underwent endoscopic injection sclerotherapy for oesophageal varices. Five per cent ethanolamine oleate, the sclerosant used, was injected into the oesophageal varices. There were significant increases in the concentrations of fibrinopeptide A, fibrinopeptide B-beta-15-42 and fibrin degradation products-E after the sclero-therapy. At 1 h after the sclerotherapy the mean(s.e.m.) platelet aggregation was significantly suppressed to 71.9(4.2) per cent of that before the treatment (P less than 0.01). There was a gradual recovery within 1 week to the same level seen before the sclerotherapy. Thromboxane B2 and 6-keto-prostaglandin F1 alpha, both stable products of thromboxane A2 and prostacyclin respectively, showed significant temporary increases after the sclerotherapy (P less than 0.01). The peak increase in the level of thromboxane B2 was noted within 1 h after the sclerotherapy and earlier than that for 6-keto-prostaglandin F1 alpha. This increased ratio of prostacyclin and thromboxane A2 may be related to the marked limitation in platelet aggregation.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

A prospective randomized trial of schedules for sclerosing esophageal varices. 1-versus 2-week intervals.

A prospective randomized trial was performed to compare the efficacy and complications of 1-week (20 patients) and 2-week (20 patients) interval schedules of endoscopic injection sclerotherapy for patients with esophageal varices; 6 were acute, 3 were elective and 31 were prophylactic cases. There were no significant differences between the 1-week and 2-week interval groups with regard to total number of sclerotherapy sessions, total volume of the sclerosant used (5% ethanolamine oleate) or rate of complications such as pyrexia, stricture and pleural effusion. The incidence of ulcer and/or slough formation after EIS was the same in the two groups. Neither early nor recurrent bleeding occurred in any patient in the two groups. Eradication of varices in the 2-week interval group was achieved significantly earlier (p less than 0.05) than in the 1-week interval group.

Acute Disease↗
PubMed1988

Trial of sclerosing agents in patients with oesophageal varices.

Forty-five cirrhotic patients with oesophageal varices underwent endoscopic injection sclerotherapy in a prospective randomized trial carried out to compare two sclerosing agents (5 per cent ethanolamine oleate and 2 per cent sodium tetradecyl sulphate (STD] with respect to safety, efficacy and complications. Twenty-three patients were allocated to the ethanolamine group and twenty-two to the STD group. The rate of control of acute bleeding was 100 per cent (6/6) in the ethanolamine group and 75 per cent (3/4) in the STD group. There was a significantly lower rate of postinjection bleeding after the over-tube was removed at the initial session of sclerotherapy when ethanolamine was injected 0/23 versus 7/22, 32 per cent; P less than 0.01) and at the second session there was a significantly (P less than 0.01) higher rate of jet-like bleeding from injection sites in the STD group (6/21, 29 per cent) than in the ethanolamine group (0/22). The disappearance rate of red colour signs 1 week after the initial session of sclerotherapy in the ethanolamine group was 100 per cent and 62 per cent in the STD group. Early oesophageal ulcers developed less frequently in the ethanolamine group (0 and 9 per cent) than in the STD group (24 per cent and 43 per cent both after the initial (P less than 0.05) and the second session of sclerotherapy (P less than 0.01]. Early bleeding from an oesophageal ulcer occurred only in the STD group (5/21, 24 per cent) before the third session of sclerotherapy (P less than 0.05). The rate of early mortality did not differ between the two groups. We conclude that ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal varices.

Clinical Trials as Topic↗
PubMed1988

Temporary deterioration of pulmonary functions after injection sclerotherapy for cirrhotic patients with esophageal varices.

In 34 cirrhotic patients with esophageal varices, a significant but temporary deterioration in pulmonary function tests occurred 24 h after endoscopic injection sclerotherapy using 5% ethanolamine oleate. Included were vital capacity, forced expiratory volume in 1 s, closing volume/vital capacity and arterial oxygen content. Twenty-four hours after the sclerotherapy, the patients complaining of postinjection retrosternal pain had a larger fall in vital capacity and forced expiratory volume in 1 s than did the patients without pain. Before the injection sclerotherapy, 11 of 34 patients had an arterial hypoxemia (PaO2 less than 80 mm Hg). In these patients, there was a significantly (p less than 0.001) higher value of closing volume before sclerotherapy and there were larger changes in both closing volume (p less than 0.01) and arterial oxygen content (p less than 0.01) 24 h after the injection sclerotherapy than in the patients without hypoxemia. Reversion to a state before sclerotherapy was attained 7 days after the sclerotherapy. Thus, patients undergoing sclerotherapy for bleeding esophageal varices should be closely monitored with regard to pulmonary function.

Adult↗
PubMed1988

Arthroscopic meniscectomy for discoid lateral meniscus in children.

We reviewed the cases of forty-six children who were less than fifteen years old and in whom total, subtotal, or partial arthroscopic meniscectomy was performed for symptomatic discoid lateral meniscus in fifty-three knees. The average length of follow-up was 31.2 months. A meniscal tear was evident in each knee. The extent of the meniscectomy depended on the site and shape of the tear, as did the symptoms and signs. We tried to establish the width of partial meniscectomy of a discoid meniscus that would prevent new tears.

Adolescent↗
PubMed1987

[Pathomorphological study of metastatic liver tumors].

Pathomorphologic features of metastatic liver tumors were studied in 362 autopsy cases at the Pathology Department of Kurume University Hospital for 7 years, from 1979 to 1985. The incidence of metastasis in cirrhotic liver was found to be 50%, and 45.1% for non-cirrhotic livers. Metastatic liver tumors were roughly classified into 4 categories: a small nodular type, a large nodular type, a mixed small and large nodular type, and an infiltrative type. The large nodular type tumor seemed be the most frequent in a metastasis via the portal vein, and the small nodular type was frequent in a metastasis via the artery. The gross characteristics of a metastatic tumor nodule could be grouped into 3 classifications: a solid type, a central necrosis type, and a mosaic type. The tumor of central necrosis type was frequent in cases of adenocarcinoma, and the solid type tumor was more prevalent in squamous cell carcinoma and free-cell type carcinoma.

Adenocarcinoma↗
PubMed1985

[Specific protein in the plasma of rheumatoid arthritis patients].

A unique protein was detected in the plasma of rheumatoid arthritis patients by two-dimensional electrophoresis. We named it rheumatoid arthritis specific protein (RASP). According to the pattern and concentration of its spot, RA patients were classified into three groups as RASP+, RASP +/- and RASP-. RASP+ was detected only in RA and its occurrence was 45/120 (38%). The occurrence of RASP including RASP +/- was 84/120 (70%) in RA, 6/13 (46%) in SLE, 2/8 (25%) in PSS, 11/51 (22%) in liver disease and 4/44 (9%) in normal. RA patients with RASP+ indicated significantly high level of ESR, CRP and platelet counts comparing with RA patients with RASP-. These results suggested that RASP might be a good indicator for the diagnosis and evaluation of the activity of RA. RASP was purified with gel chromatography repeated three times. RASP was very similar with immunoglobulin G in its biochemical and immunological properties.

Acute-Phase Proteins↗
PubMedDate not supplied

Endoscopic classification of gastric varices.

Endoscopic observations of gastric varices in 124 patients were classified according to form, location, and color. Form was classified into three types: tortuous (F1), nodular (F2), and tumorous (F3). Location was classified into five types: anterior (La), posterior (Lp), lesser (Ll) and greater curvature (Lg) of the cardia, and fundic area (Lf). Color was white (Cw) or red (Cr). Glossy, thin-walled focal redness on the varix was defined as red color spot (RC spot). Stepwise logistic regression analysis for multivariate adjustments was performed for all of the endoscopic covariates, and four risk factors (La, Lg, F2, RC spot) that affect bleeding from gastric varices were independently identified. This classification should aid in assessing gastric varices observed by fiberoptic endoscopy and help design appropriate treatment.

Adult↗
PubMedDate not supplied

Comparative effects of 5% ethanolamine oleate versus 5% sodium morrhuate for sclerotherapy of oesophageal varices.

Forty-five cirrhotic patients with oesophageal varices were randomized to receive endoscopic injection sclerotherapy with either 5% ethanolamine oleate (EO), or 5% sodium morrhuate (SM). In the EO group, there was a statistically significant higher rate of disappearance of red colour signs on the varices a week after the initial session of sclerotherapy than in the SM group (91.3% vs 45.5%, P less than 0.05). A jet-like bleeding from injection sites at the second session of sclerotherapy occurred in three patients in the SM group and they experienced blurred vision. There was no such occurrence in the EO group. Oesophageal bleeding requiring blood transfusion during the course of repeated sclerotherapy occurred only in the SM group (five patients): bleeding was from a partly thrombosed varix and in four was from oesophageal ulcers. We found that EO administered intravariceally is more efficacious than SM for sclerotherapy of oesophageal varices.

Esophageal and Gastric Varices↗