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Biomedical subjects

Hiroyuki Konomi

Publications and source records attributed to Hiroyuki Konomi.

23 records · Page 2Linked to original sources
PubMed2003

Role of duodenum on sphincter of Oddi motility in conscious dogs.

Our aim was to determine the role of the duodenum in controlling sphincter of Oddi motility using conscious dogs after total duodenectomy. In a control group (N = 6), a cannula was implanted into the duodenum opposite to the papilla to allow retrograde sphincter manometry. In a duodenectomy group (N = 6), the papillae were preserved at total duodenectomy and sutured to thejejunum anastomosed to the stomach (neoduodenum). The cannula was implanted opposite to the implanted papillae. Interdigestive and postprandial sphincter and duodental or neoduodenal motility were recorded by manometric and myoelectric methods. Duodenectomy disrupted sphincter cyclic motility associated with the intestinal migrating motor complex and increased sphincter activity throughout the cycle. Sphincter activity increased immediately after feeding and did not differ between the two groups. In conclusion, during the interdigestive period, the duodenum has a distinct role in regulating sphincter cyclic motility. The initiation of the fed pattern of sphincter motility does not need the duodenum.

Animals↗
PubMed2002

Characterization of circular muscle motor neurons of the duodenum and distal colon in the Australian brush-tailed possum.

The motor innervation of the duodenum and distal colon remains uncharacterized within the same species. Our aim was to compare the projections and neurochemical properties of duodenal and distal colon circular muscle motor neurons. Circular muscle motor neurons were retrogradely traced by using a neural tracer in vitro, processed for choline acetyltransferase (ChAT) and nitric oxide synthase (NOS) immunoreactivity and then visualized by using indirect immunofluorescence. A mean of 372 +/- 64 and 156 +/- 23 neurons (mean +/- SEM) were tracer-labeled within the duodenum and colon, respectively. The ChAT+/NOS- neurons comprised 57.6 +/- 6.6% and 39.6 +/- 4.4% of all labeled cells in the duodenum and colon, respectively, and projected mainly in the oral direction. Of all labeled cells, the ChAT-/NOS+ neurons comprised 8.5 +/- 2.3% in the duodenum and 46.6 +/- 5.0% in the distal colon and projected mainly in the anal direction. Of the remainder, 20.6 +/- 5.0% and 8.2 +/- 2.4% were ChAT+/NOS+ and 13.2 +/- 0.9% and 5.6 +/- 1.4% were ChAT-/NOS- in the duodenum and distal colon, respectively. Within both regions, the distribution of the ChAT+/NOS- and ChAT-/NOS+ neurons are consistent with the ascending excitatory and descending inhibitory reflexes. The proportion of ChAT-/NOS+ neurons is greater within the colon in comparison with the duodenum. A considerable proportion of duodenal motor neurons were ChAT+/NOS+ and ChAT-/NOS-. These two classes may underlie nonperistaltic motor patterns, which predominate within the duodenum. These findings demonstrate regional differences in the innervation of intestinal circular muscle.

Acetylcholine↗
PubMedDate not supplied

ERT following IORT improves survival of patients with resectable pancreatic cancer.

BACKGROUND/AIMS: The clinical course of patients with pancreatic carcinoma remains dismal despite the recent advances of diagnostic and therapeutic procedures. One of the main causes is residual carcinoma cells, especially at the retroperitoneal aspect after pancreatectomy. Radiation therapy (RT) [intraoperative radiation therapy (IORT) and external radiation therapy (ERT)] is a therapeutic strategy to conquer the remaining cancer cells. METHODOLOGY: Effects of RT were retrospectively examined in 81 patients with pancreatectomy for pancreatic cancer together with early and late complications. RESULTS: Preoperative clinical data were not different between the RT(+) and RT(-) groups excluding peripheral lymphocyte counts. Postoperative early complications equally occurred including pancreatic fistula. Regarding late complications (>2 months after operation), stomal ulcer, vertebral fracture, pseudoaneurysm, intraabdominal hemorrhage, and liver abscess were present only in patients with RT. Glucose intolerance tended to be more frequent in the RT (+) group, i.e. 12 (63%) of the 19 with RT examined and 14 (42%) of the 33 without RT examined. Follow-up imaging showed recurrence in 27 (71%) of the 38 patients without RT and 13 (52%) of the 25 patients with RT. The sites of the recurrence were not different by the presence or absence of RT. One-year, 3-year and 5-year cumulative survival rates were similar between the RT (-) group (100%, 39%, 21%, respectively) and IORT (+) alone group (100%, 29% and 17%, respectively). The rates in the IORT (+) and ERT (+) group were 100%, 54% and 28%, respectively, which tended to be better than those in the other two groups, but the differences were not statistically significant. CONCLUSIONS: These findings suggest that only the combination of IORT and ERT somewhat improves the short-term clinical course of patients with resectable pancreatic cancer, although there are some RT-related late complications. It is recommended that ERT be added to IORT after pancreatectomy for pancreatic cancer to improve the clinical course, once IORT has been performed.

Aged↗
PubMedDate not supplied

Total pancreatectomy for intraductal papillary-mucinous tumor of the pancreas: reappraisal of total pancreatectomy.

BACKGROUND/AIMS: Total pancreatectomy is rarely performed as the treatment of pancreatic carcinoma because of markedly impaired quality of life and poor prognosis. Intraductal papillary-mucinous tumor (IPMT) of the pancreas is characterized by extensive intraductal spread and favorable outcome even in its invasive stage. The role of total pancreatectomy was reappraised in the treatment of IPMT. METHODOLOGY: A total of five Japanese patients with IPMT underwent total pancreatectomy and their clinical follow-up data were reviewed. RESULTS: Total pancreatectomy was performed due to massive involvement of the entire pancreas in two patients, positive surgical margins on frozen section in one, benign IPMT with concomitant pancreatic cancers in one and recurrent IPMT in the remnant pancreas after distal pancreatectomy for IPMT in the other. Three of them underwent total pancreatectomy of the Whipple type, another underwent total gastrectomy and the other underwent the pylorus-preserving method. Surgical margins were negative by histology and no lymph node metastases were evident. Two patients had severe infection including liver abscess in one and pneumonia in the other. The former died on postoperative day 82 and the latter was controlled by medical treatment and discharged on postoperative day 73. The other three patients had an uneventful postoperative course and were discharged from 29 to 62 days after the operation. Long-term follow-up of the four patients revealed that three patients had hypoglycemic attacks, two diabetic retinopathy and two fatty liver. The four patients were doing well from 683 to 4,140 days after the operation without signs of recurrence. CONCLUSIONS: Total pancreatectomy would be indicated as a treatment of benign or malignant IPMT with extensive involvement when patients' condition permits and gives a chance of cure, although careful long-term medical care and follow-up are essential.

Adenocarcinoma↗