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Biomedical subjects

H Yanagi

Publications and source records attributed to H Yanagi.

211 records · Page 12Linked to original sources
PubMedDate not supplied

Intraoperative colonoscopy.

From 1987 to 1991, we performed intraoperative colonoscopy on 66 patients as a result of the following indications: the air leakage test (53%), detection of a previous malignant polypectomy site (20%), inability to complete preoperative colonoscopy (17%), detection of the source of intestinal bleeding (4%), and detection of impalpable colonic lesions (4%). Intraoperative colonoscopy was successful in 61/66 patients and provided information that altered the planned operation in 10 of 61 completely examined patients. The air leakage test proved useful in detecting subclinical anastomotic leaks. The indications for intraoperative colonoscopy have been expanded, and this procedure is often useful when one is attempting to decide on the appropriate surgical strategy for patients.

Anastomosis, Surgical↗
PubMedDate not supplied

Accuracy of three-dimensional volume measurement using biplane transesophageal echocardiographic probe: in vitro experiment.

Two phased-array scanning methods can be used for volumetric transesophageal echocardiographic imaging: (1) pull-back "breadloaf" reconstruction, and (2) rotation "fan-like" reconstruction. The purpose of this study was to (1) test accuracy and precision of pull-back versus rotational geometries for three-dimensional volume determination, and (2) test accuracy of the resulting surface/volume rendered images. The endoscope shaft was inserted into a tube with the handle connected to a stepper device. Seventeen balloons (61 to 471 ml) were put into a water bath consecutively. Two scans were performed: (1) pull-back: the probe was withdraw in 1 mm steps to obtain parallel "breadloaf" slices, and (2) rotational: the probe was rotated in increments of 1.8 degrees, 3.6 degrees, or 5.4 degrees to obtain "fan-like" slices. Each image was digitized for computer analysis. The data were interpolated into 128 x 128 x 128 voxels for three-dimensional reconstruction. Volume measurement was done using a stereometric random marking method. Volumes obtained from the reconstructed images were compared with the true volume (weight) by linear regression analysis. Excellent correlation between measured and actual volumes was obtained from rotation scans as follows: for 1.8 degrees steps (r = 0.9987, SEE = 6.5 ml), for 3.6 degrees steps (r = 0.9959, SEE = 11.5 ml), and for 5.4 degrees steps (r = 0.9943, SEE = 13.5 ml). The pull-back scans showed r = 0.9990, SEE = 5.8 ml. Three-dimensional surface/volume rendered images of the balloons indicate that 1.8 degrees rotation scans are almost as good as 1 mm pull-back scans. We conclude that volume measurements from rotation scans in vivo will not be hindered by scan geometry or software interpolation.

Animals↗
PubMedDate not supplied

Recombinant human erythropoietin produced by Namalwa cells.

To establish a practical exogenous gene expression system in human cells, a cDNA coding for human erythropoietin (EPO) was expressed in human B-lymphoblastoid Namalwa cells. The Namalwa-derived recombinant EPO was purified from the culture fluid by a simple three-step procedure. The Namalwa EPO showed an equivalent activity in vivo to that of human urinary EPO. Oligosaccharide structure analyses suggested that almost all N-linked oligosaccharide chains of Namalwa EPO are shared by urinary EPO. The two major N-linked oligosaccharides of Namalwa EPO were fucose-containing tetraantennary and fucose-containing triantennary structures.

Animals↗
PubMedDate not supplied

Sandwich technique via right ventricle incision to repair postinfarction ventricular septal defect.

We describe two cases where postinfarction ventricular septal defect (VSD) was treated with a new technique. Application of direct ultrasonography to the right ventricular (RV) wall enables the surgeon to visualize the region and perform appropriate incision into the right ventricle and trabecula resection. The VSD is sealed with gelatin-resorcin-formal (GRF) glue between two patches, one placed on the left ventricular side and the other on the right ventricular side. RV incision provides easy bleeding control and the "sandwich technique" using two patches and GRF sealing provides geometric preservation of the left ventricular shape and prevents residual shunt.

Aged↗
PubMedDate not supplied

The usefulness of pharmacokinetic modulating chemotherapy (UFT plus 5FU) in the treatment of unresectable colorectal carcinomas.

This study was performed to improve the prognosis of unresectable (primary non-curative and recurrent) colorectal carcinoma by using pharmacokinetic modulating chemotherapy (PMC), a combination of oral UFT and continuous venous 5FU infusion. The subjects were 120 patients who were prospectively selected for this study. The patients selected PMC or alternative treatment. Fifty-six patients received PMC. The PMC group received 200-400 mg/body/ day UFT orally 5-7 days per week and 600 mg/m2/24 h 5FU infusion once a week. PMC markedly improved the median survival period (26.6 months vs. 9.2 months P<0.000001). This significant improvement as observed in unresectable primary colorectal carcinoma (P=0.0003), recurrent tumors (P<0.00001), local extension (P=0.01), lung metastases (P=0. 03), liver metastases (P=0.0001), and peritoneal seedings (P=0.02). One of 56 patients who received PMC developed grade 4 toxicity. PMC significantly improved the prognosis of unresectable colorectal carcinoma which has a low survival rate. PMC also indicated tolerable compliance and cost effectiveness.

Administration, Oral↗
PubMedDate not supplied

Possible development of idiopathic sclerosing encapsulating peritonitis.

We report a rare case of idiopathic sclerosing encapsulating peritonitis (SEP). During a laparotomy before undergoing a distal gastrectomy with Billroth II reconstruction for early gastric cancer, the patient was found to have a membranous encapsulation wrapping each small bowel loop, unlike peritoneal encapsulation or typical SEP. He had complained of persistent heartburn, distension and diarrhea for 2 months in the post-operative course. The second laparotomy, which was performed to improve prolonged transit, revealed typical SEP with a thick and fibrotic membrane that encased the small bowel entirely. Stripping of the sclerosing encasing membrane, separation of the adherent loops of the proximal small bowel, and Braun's anastomosis were performed. The patient complained of epigastric fullness and diarrhea after he was relieved from the complete bowel obstruction for 45 days post-operatively. Trimebutine maleate was administrated 5 months after the second operation and this markedly improved his symptoms. This case might reflect the developmental process of idiopathic SEP. In addition, the use of a motility regulator may improve symptoms related to the abnormal intestinal motility by this disease.

Adenocarcinoma↗
PubMedDate not supplied

Effects of elemental diet (ED) on surgical treatment in Crohn's disease.

BACKGROUND/AIMS: Patients with Crohn's disease are at risk of developing short bowel syndrome if they are treated with repeated operations. We examined the effect of preoperative nutritional therapy with elemental diet on the interval until and the outcome after surgical treatment in patients with Crohn's disease. METHODOLOGY: We reviewed the records for 73 patients with Crohn's disease who underwent intestinal resection in our department between January 1, 1974 and December 31, 1996. Thirty-two of them had not received elemental diet (No ED group) and 41 had received elemental diet therapy (ED group) before the first resection. RESULTS: The median interval between the onset and first resection was 19.3 months for the NoED group and 67.5 months for the ED group (P = 0.0005). All patients received ED therapy after the first resection. The incidence of second resection was significantly different between the ED and the NoED group after the first operation. (P = 0.045). CONCLUSIONS: Elemental diet therapy is effective in prolonging the interval between the onset and first resection and in reducing the incidence of second resection. The initial introduction of elemental diet therapy is useful in the management of the clinical course of Crohn's disease minimizing surgical intervention.

Adolescent↗
PubMedDate not supplied

Expanded selection criterion for Fontan's operation based on the size of distal pulmonary arteries.

This study examined pulmonary arterial size to clarify a quantitative selection criterion for Fontan's operation in six cases without pulmonary hypertension. Pulmonary arterial size was angiographically assessed before and after the operation. No enlargement of the artery was observed, even after the procedure, confirming the importance of preoperative pulmonary arterial size. All three cases with preoperative PAa/N-RPAa of more than 0.5 survived the operation, whereas two of the remaining three cases (less than 0.5) died due to low cardiac output. The only survivor in the latter group had previously received Glenn's anastomosis. Hemodynamic study was done simultaneously, and a significant exponential correlation was obtained between preoperative PAa/N-RPAa and perioperative post-repair right atrial pressure (p less than 0.025). It was concluded that the selection criterion based on pulmonary arterial size could be expanded to a PAa/N-RPAa value of 0.5 when no Glenn's anastomosis had previously been done and the rudimentary right ventricle was not to be utilized. The exponential curve is useful for postoperative care in Fontan's operation, since it indicates the central venous pressure necessary to sustain the circulation at a level corresponding to the preoperative pulmonary arterial size.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Colonic J pouch-anal reconstruction with gluteus maximus transposition for a post-irradiation rectovaginal fistula.

A 44-year-old female with rectal cancer underwent anoabdominal rectal resection and colonic J pouch-anal anastomosis after preoperative intraluminal brachytherapy. Pelvic sepsis developed a rectovaginal fistula. We attempted to close the fistula and restore the anal function with coloanal re-anastomosis and bilateral gluteus maximus transposition. She regained good anal function without recurrence of the fistula.

Adult↗
PubMedDate not supplied

The regrowth of rectal adenocarcinoma after pre-operative radiotherapy with a report of two cases.

To evaluate the factors that contribute towards the regrowth of rectal carcinoma after pre-operative radiotherapy. Of 120 patients, we pre-operatively treated with intraluminal brachytherapy or external beam radiotherapy since 1986, two showed regrowth of rectal carcinoma. For them, the case reports and findings for the resected specimen obtained using immunohistochemical staining for the P53 tumor suppressor gene (P53) and proliferating cell nuclear antigen (PCNA) were retrospectively evaluated. The regrowth of rectal carcinoma was observed 40 days after intraluminal brachytherapy in one patient, and 33 days after external radiotherapy in the other. Both P53 and PCNA staining was seen in the recurrent tumors or during the examination of the resected specimen. These results suggest that polypoid tumors with regrowth have a malignant potential. The interval between radiotherapy and operation reported in the literature varies widely. The potential for regrowth should be considered in the preoperative radiotherapy for rectal cancer.

Adenocarcinoma↗
PubMedDate not supplied

Magnetic resonance imaging in the diagnosis of jejunal leiomyoblastoma.

We report a case of large leiomyoblastoma of the jejunum. The sagittal views in pre-operative magnetic resonance imaging (MRI) indicated that a cystic tumor with solid component was present, sequential from the small bowel. We suspected a smooth muscle tumor of the small bowel, but did not rule out the malignancy. The operative diagnosis was smooth muscle tumor of the proximal jejunum, and partial resection of the small bowel was performed. The pathological examination revealed benign leiomyoblastoma of the jejunum without metastasis. MRI contributed to the pre-operative diagnosis of the origin of this rare tumor, in a non-invasive fashion.

Aged↗
PubMedDate not supplied

The prediction of the prognosis for rectal carcinoma down-staged by pre-operative radiotherapy by transrectal ultrasonography.

BACKGROUND: We attempted to determine whether the results of transrectal ultrasonography (TRUS) could provide any prognostic information about patients with rectal carcinoma treated with pre-operative radiotherapy (RT). METHODS: Ninety-eight patients with rectal carcinoma were treated with pre-operative RT and radical surgery. We categorized the TRUS results with respect to TNM classification before the RT (Pre-RT staging), those after the RT (Post-RT staging), and the results of the pathological examination (Post-OP staging). We analysed the associations among these three stagings, and the survival time of the patients. RESULTS: The prevalence of under T2-stage (TNM classification) in the pre-RT staging was significantly lower than that in both the Post-RT and Post-OP staging. The number of tumours diagnosed as T4 stage in both the Post-RT and Post-OP staging was significantly lower than that before irradiation. The survival periods of the patients with tumours remaining as T4 after radiation were significantly shorter than those of the patients diagnosed as having T4 tumours at the Pre-RT staging (Pre-RT versus Post-RT, p = 0.019; Pre-RT versus Post-OP, p = 0.030). These results suggested that radio-insensitive residual cells might associate with the poor prognosis. CONCLUSION: We could predict the possible prognosis in rectal carcinoma patients treated with pre-operative radiotherapy before operation by TRUS.

Aged↗