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Biomedical subjects

I Kawamura

Publications and source records attributed to I Kawamura.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Nutritional management of patients with cirrhosis after hepatectomy].

Nutritional management for the patients with cirrhosis after hepatectomy was studied. Based on the experimental results, 1-1.5g/kg/day of branched chain amino acid (BCAA) enriched solution with 30 kcal/kg/day of glucone was given to the cirrhotic patients after hepatectomy for 10-14 days. Sodium and total fluid volume were strictly restricted. Elemental diet for liver failure (ED-H) was started to give within 7 days after surgery for 6-21 days. High relationships were observed between preoperative nutritional status such as prealbumin and retinol binding protein (RBP) and incidence of postoperative complications, suggesting that postoperative nutritional supply was very important. Changes of albumin, hepaplastin test and prothrombin time were rather good and the BCAA to aromatic amino acids molar ratio was maintained high when nutritional management was performed. Overall one and two year survival rates were 74% (20/27) and 36% (5/14), respectively. No significant difference was seen between the prognoses of the patients with and without liver dysfunction. Immediate postoperative nutritional management must be essential to get over critical stage safely and long-term nutritional supply may be necessary to get better prognosis.

Hepatectomy↗
PubMed1983

The contribution of phenylalanine to tyrosine metabolism in vivo. Studies in the post-absorptive and phenylalanine-loaded rat.

1. Rates of appearance and oxidation of plasma L-leucine, L-phenylalanine and L-tyrosine, as well as conversion of plasma phenylalanine into plasma tyrosine, were determined in 90-120 g rats after overnight starvation and while receiving 115-120 mumol of L-phenylalanine/h. 2. In the post-absorptive state, plasma tyrosine and phenylalanine appearances were similar, despite the fact that 22% of plasma tyrosine appearance could be attributed to the hydroxylation of phenylalanine. 3. A constant infusion of 115-120 mumol of L-phenylalanine/h did not significantly alter plasma leucine kinetics, but increased appearance of plasma phenylalanine and tyrosine. The percentage of phenylalanine and tyrosine appearance that was oxidized increased from 12.1% and 24.4% to 37.3% and 48.0% respectively. In phenylalanine-loaded rats, 72% of plasma tyrosine appearance could be attributed to the conversion of phenylalanine. 4. Whole-body tyrosine oxidation measured from a continuous infusion of either L-[14C]tyrosine or L-[14C]phenylalanine differed by 165%. 5. It can be concluded that, in the post-absorptive state, phenylalanine hydroxylation makes a substantial contribution to the plasma appearance of tyrosine and is significantly increased when phenylalanine is administered. The disposal of excess infused phenylalanine is a result of a greater percentage of plasma phenylalanine being converted into tyrosine and a greater proportion of tyrosine being further oxidized. However, apparent tyrosine oxidation rates estimated from plasma tyrosine specific radioactivities and appearance of expired 14CO2 during administration of [14C]tyrosine are underestimates of true rates, in part because tyrosine generated from phenylalanine hydroxylation is catabolized without freely equilibrating with the plasma compartment.

Amino Acids↗
PubMed1983

Experimental studies on an artificial esophagus using a collagen-silicone copolymer.

An artificial esophagus consisting of a collagen-silicone copolymer prepared by special chemical and physical procedures proved to be advantageous by both physical and histological examination. The adherence to the host tissue was satisfactory when collagen was used. The esophageal prosthesis was anastomosed to the jejunum in 5 dogs and no leakage occurred during 10-30 days. In subsequent experiments, use of the artificial prosthesis in the thoracic esophagus was followed by leakage in 5 of 14 cases (35 per cent). Five of these dogs survived for over 30 days, and the longest survival was 212 days. The incidence of leakage was acceptable but stricture was a common long-term complication. Further studies are underway to refine the prosthesis, the method of anastomosis, and post-operative management.

Animals↗
PubMed1982

An altered response by peripheral leukocytes to synthesize or release leukocyte endogenous mediator in critically ill, protein-malnourished patients.

LEM derived from fixed and circulating macrophages is involved in certain aspects of the metabolic response to infection. A reduction in the synthesis or release of LEM from leukocytes of nonstressed, protein-malnourished patients has been demonstrated. In this study, blood leukocytes from 15 protein-malnourished patients (serum albumin less than 2.5 gm/dl) who were critically ill were assayed for their in vitro capacity to produce LEM. Samples were taken before (day 0) and 3 or 7 days after the institution of parenteral nutrition. Hospitalized patients were judged capable of producing LEM (responders) if the percentage of polymorphonuclear leukocytes in the blood of the rats injected with their LEM was greater than 52% ( the minimum value obtained when LEM from 10 human volunteers was injected into the rats). With this criterion, eight patients were responders and only one died during their hospital stay, whereas five of seven nonresponders expired (p less than 0.05). On day 0, prior to intravenous nutritional support, there was no difference in the capacity to produce LEM between responding and nonresponding patients. However, those patients whose leukocytes were capable of responding received significantly greater quantities of dietary protein and calories over the 7-day study period than nonresponders (p less than 0.05). There was a correlation between the polymorphonuclear leukocyte response to LEM in rats and the patients' dietary protein intake (r = 0.719, p less than 0.005). these findings suggest that an appreciable fraction of severely ill, protein-malnourished patients have a reduced capacity to synthesize LEM, as judged by bioassay and an increased risk of mortality. The in vitro capacity to produce LEM in a critically ill population appears to be associated with the dietary intake of the patient.

Animals↗
PubMed1982

Altered amino acid kinetics in rats with progressive tumor growth.

The present study was designed to determine whether alterations in host metabolism associated with progressive tumor growth were a result of the anorexia frequently observed with cancer or could be attributed to other direct tumor effects. Rates of tyrosine flux, oxidation, and incorporation into protein, as well as fractional protein-synthetic rates in nonsecretory liver, muscle, and tumor, were determined in overnight-fasted rats, 5 to 6 (Stage I), 10 to 11 (Stage II), and 15 to 16 (Stage III) days following s.c. implantation of RNC-254 fibrosarcoma. Tumor-bearing rats were allowed to consume a purified diet containing 20% protein ad libitum, and results were compared to non-tumor-bearing rats pair fed quantities of food equivalent to tumor-bearing animals or allowed to consume the diet ad libitum. Results demonstrate that during later stages of tumor growth (Stage III) calorie intake and nontumor body weight gain were reduced in tumor-bearing rats (p less than 0.05). Fifteen and 16 days following implantation, there were significant changes in amino acid kinetics that were not observed after earlier periods of tumor growth and that could not be explained by any reduction in dietary intake. Rates of tyrosine appearance in the plasma and subsequent incorporation into whole-body protein were increased 33 and 34%, respectively (p less than 0.05), when compared to non-tumor-bearing rats fed equivalent quantities of food. Whole-body tyrosine oxidation rates were unchanged. Skeletal protein synthesis, as reflected by gastrocnemius or rectus abdominus muscle, was reduced from 10.5 and 10.1%/day to 7.4 and 6.0%/day, respectively (p less than 0.05), in tumor-bearing compared to pair-fed animals. The findings suggest that significant alterations in protein metabolism occur in advanced stages of experimental neoplastic disease which cannot be explained by reductions in dietary intake and are aimed at providing adequate quantities of endogenous amino acids for net tumor growth.

Animals↗
PubMed1978

Results of esophagocardioplasty with gastric patch in the treatment of esophageal achalasia.

Since 1968 esophagocardioplasty with gastric patch was employed in 57 patients as a primary operation for achalasia of the esophagus and eight patients with previous operations for achalasia. Satisfactory results were obtained in follow-up studies up to eight years. The results indicate that this procedure is successful in dilating the lower part of the esophagus and esophagocardiac junction without interfering with their proper functions. This provides better passage through the junction with preservation of the mechanism which prevents reflux.

Adult↗
PubMed1977

A double-blind comparative study of the inhibitory effect of intraduodenally administered hyoscine-N-butylbromide on human duodenal motility.

In a double-blind crossover study hyoscine-N-butylbromide (HBB) was compared with placebo in its inhibitory effect on duodenal motility stimulated by metoclopramide. Measurements were made both by the balloon technique and the open-tipped tube method with pressure transducer. 20 mg or 50 mg HBB or placebo were instilled in random sequence into the intestinal tract of 12 healthy volunteers. The frequency of Type II waves was determined in each experiment after administration of the test substance following prior metoclopramide stimulation. This frequency was used as the inhibitory index for each drug. The test substance was administered 15 minutes before a second stimulation. A four-way analysis of variance (mixed model) was applied to the calculated number of waves per period. Subjects were required to respond equally to stimulation with increased motility on both trial days as evidenced by a minimal difference in the averages following the first stimulation on each trial day and before application of the test substance. The frequency of Type II waves after 20 mg and 50 mg HBB was reduced in a statistically significant manner in each case when compared with placebo. The probabilities of error were p less than 0-05 and p less than 0-025.

Adolescent↗