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Biomedical subjects

J Kamiya

Publications and source records attributed to J Kamiya.

At least 109 records · Page 6Linked to original sources
PubMed1989

Effect of aging on estimates of hypercapnic ventilatory response during sleep.

By recording only inspired PCO2 (PICO2) in a hood and transcutaneous PCO2 (PsCO2) the Hazinski method was used to estimate nonintrusively the slope (Sr) per Torr PsCO2 of the fractional ventilatory response to approximately 18 and 30 Torr PICO2 in 17 healthy elderly subjects (10 women) and 17 younger controls (9 women) during wakefulness, slow-wave sleep (SWS), and rapid-eye-movement (REM) sleep. Eight of the older subjects had sleep disturbance indexes (RDI) greater than 5. Sr fell with SWS from 0.90 +/- 0.34 to 0.60 +/- 0.29 (P less than 0.006) in the younger group (n = 16) but in the older subjects was 0.60 +/- 0.27 awake and 0.58 +/- 0.34 (NS) asleep (n = 15). The changes from awake to REM in subsets of 9 younger and 10 older subjects who successfully completed REM tests were from 0.95 +/- 0.32 to 0.70 +/- 0.38 (P less than 0.03) and 0.53 +/- 0.31 to 0.57 +/- 0.25 (NS), respectively. We conclude that the increased incidence of respiratory disturbance during sleep in these older subjects cannot be attributed to greater sleep-induced reduction of CO2 sensitivity.

Adult↗
PubMed1989

[Studies on cholangiographic and endoscopic findings of primary intrahepatic cholesterol stones].

Cholangiographic investigations in 16 patients with primary intrahepatic cholesterol stones yielded some characteristic findings as follows. 1. Several numbers of stones were filled within locally dilated portion of the subsegmental or more peripheral intrahepatic bile duct branches, with no or minimal dilatation of the more peripheral portion and no stenosis-like lesions of the more hilar portion. 2. The lesion was single or multiple scattered in the liver and intrahepatic cholangiogram excluding involved segments was almost normal. 3. Although extrahepatic bile duct and/or gallbladder stones were often associated, the normal gallbladder, cystic duct and papillary portion and slightly dilated common bile duct were demonstrated. These cholangiographic findings were compatible with the endoscopic findings that inflammatory changes of the bile duct were rarely observed. According to above mentioned findings, it is suggested that the etiology of this disease differs from intrahepatic stones of calcium bilirubinate and dissolution therapy with bile acid may be available.

Adult↗
PubMed1989

Gastrinoma in a mesenteric lymph node.

A 36-yr-old man was admitted to our hospital complaining of severe vomiting and diarrhea. Upper gastrointestinal series showed deformity of the duodenum. Serum gastrin level was very high (1,829 pg/ml) and secretin provocative test presented a positive result (peak 4,535 pg/ml). We diagnosed his illness as Zollinger-Ellison syndrome, but failed to identify the site of tumor. His symptoms were controlled with cimetidine 1,600 mg qid, but serum gastrin level was increasing. A year after the first admission, computed tomographic scan and selective angiography demonstrated the tumor, and surgery was performed. A solitary 2-cm tumor was noted at the surface of mesenterium of the duodenum. Frozen and paraffin section of the tumor revealed islet cell tumor apparently within a lymph node. Immunohistological examination revealed positive staining for gastrin alone. No other tumors were detectable by inspection and palpation during the operation. After excision of the tumor, serum gastrin and secretion test were normalized, and the patient remains asymptomatic 1 yr after surgery.

Adult↗
PubMed1989

[Analysis of pancreatic enzymes in the bile of congenital choledochal cyst with anomalous pancreaticobiliary ductal union].

Pancreatic enzymes in the bile of congenital choledochal cyst with anomalous pancreaticobiliary ductal union were analyzed. Almost all pancreatic proteases were already activated in the bile aspirated immediately after insertion of PTCD tube. However, inactive proteases gradually increased after continuation of drainage by PTCD. Pancreatic protease activities appeared again after clamping the PTCD tube. In vitro study of trypsin activities in the bile containing no initial trypsin activity, active type of trypsin did not appear throughout the experimental period. It is suggested that continuous reflux of pancreatic juice into the bile and certain incubation time are necessary for activation of pancreatic protease in bile of congenital choledochal cyst.

Adult↗
PubMed1989

[A study of concomitant chronic pancreatitis in forty-one cases of adult congenital biliary dilatation].

Forty-one cases of adult congenital biliary dilatation (CBD) were studied for concomitant chronic pancreatitis. Of the 41 cases, 8 had had such previous operations as choledochojejunostomy or choledocho-duodenostomy without biliary diversion (reoperated cases) and the other 33 had not received previous operations (primary cases). All of the 36 cases whose type of pancreatico-biliary junction could be examined revealed anomalous pancreatico-biliary junction. Four cases (10%) of CBD (1 of the primary and 3 of the reoperated cases) were complicated by chronic pancreatitis. On examining the elapsed time between the first and the final operation of the reoperated cases, in the 5 cases whose periods were less than 13 years, none was complicated by chronic pancreatitis. On the contrary, in the 3 cases whose periods of time were more than 17 years, all were complicated by chronic pancreatitis. The results suggest that choledochoenterostomy without biliary diversion enhances pancreatic damage in cases with anomalous pancreatico-biliary junction.

Adolescent↗
PubMed1988

Value of percutaneous transhepatic cholangioscopy (PTCS).

Since July 1975, percutaneous transhepatic biliary drainage (PTBD) has been performed in 533 cases, and since April 1977 we have developed percutaneous transhepatic cholangioscopy (PTCS) as a diagnostic and therapeutic endoscopical tool in 198 cases of malignant disease and 195 benign cases. After dilating the sinus tract of PTBD using a 15-Fr catheter about 2 weeks after PTBD, PTCS was carried out through the sinus tract. PTCS has diagnostic advantages: the lesion can be accurately diagnosed histologically and the extent of cancer in the biliary tract can be assessed by taking biopsy specimens before the operation. PTCS has been applied for cholangioscopic lithotripsy in 145 cases of gallstone disease. In 44 cases, the Nd-YAG laser and/or electrohydraulic shock wave has been used to break up the stones. The PTCS morbidity was 6% and mortality was 0.3%.

Biliary Tract Diseases↗
PubMed1988

Cardiovascular properties of MS-857, a new and potent cardiotonic agent, on normal and failing hearts.

The cardiovascular properties of MS-857 [4-acetyl-1-methyl-7-(4-pyridyl)-5,6,7,8-tetrahydro-3(2H)-isoquinolinone ], a novel cardiotonic agent, were investigated in anesthetized and conscious dogs. MS-857 (1-100 micrograms/kg i.v.) produced a significant and dose-dependent increase in cardiac contractility with relatively small changes in heart rate and blood pressure. This indicates a sizable separation between positive inotropic and other effects of MS-857. Oral administration of MS-857 to conscious dogs (0.1-1 mg/kg) also produced a sustained increase in cardiac contractility in a dose-dependent manner. The total duration of action was longer than 7 h at a dose of 1 mg/kg p.o. There occurred no arrhythmias and no changes in animal behavior. After chronic oral administration, MS-857 completely retained its activities, indicating the lack of tachyphylaxis. In the acute heart failure models induced by either propranolol or pentobarbital, MS-857 reversed the cardiac depressant effects of these drugs. Moreover, MS-857 also significantly improved the pentobarbital-induced heart failure in the heart-lung preparation. MS-857 did not inhibit the Na+, K+-ATPase, but inhibited the phosphodiesterase (PDE) III selectively, both of which were prepared from the dog ventricular muscle. Thus, MS-857 can be characterized as a potent nonsympathomimetic, nonglycoside cardiotonic drug with a selective inhibitory activity on PDE III. The cardiovascular properties revealed by this study strongly suggest that MS-857 will exert a beneficial effect in the treatment of congestive heart failure.

Anesthesia↗
PubMed1988

[Diagnostic value of computed tomography for the detection of invasion of the caudate bile duct branch in carcinoma of the hepatic hilum].

The visualization of the caudate bile duct branch (B1) in computed tomography (CT-scan) with a high dose of contrast medium was evaluated in 71 patients with carcinoma of the liver, biliary tract and pancreas, preoperatively. The patients were classified into four groups: Group A, 22 patients (twelve hepatomas, six gall bladder cancers and four cancers of the pancreas body or tail) without abnormal findings in the biliary tract; Group B, two patients (cancer of the pancreas head and the common bile duct) with obstructive jaundice whose CT-scans were taken before percutaneous transhepatic cholangio-drainage (PTCD); Group C, 22 patients (16 cancers of the pancreas head and six common bile duct cancers) whose CT-scans were taken after release of jaundice by PTCD; Group D, 25 patients with carcinoma of the hepatic hilum whose CT-scans were taken after release of jaundice by PTCD. The results were as follows. 1) In Group A, B1 was invisible in all the patients. 2) In Group B, B1 was clearly visible in all the patients. But in Group C, B1 was visible only in one patient. 3) In Group D, B1 was visible in 19 out of 25 patients and in 18 patients out of these 19 patients, cancer invasion toward B1 was histopathologically confirmed. In contrast, invasion was revealed only in one out of six patients whose B1s were invisible. From these results, it is concluded that in carcinoma of the hepatic hilum the visualization of B1 in CT-scan after release of jaundice by PTCD strongly suggests the cancer invasion on B1, and requests the caudate lobe resection.

Aged↗
PubMed1988

[A case of advanced gallbladder carcinoma of a 77-year-old female successfully resected with extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy].

A 77-year-old woman was admitted with obstructive jaundice. US and CT demonstrated a solid mass 2.5cm in diameter in the hepatic hilum. Cholangiography revealed not only severe stenosis of the hilar hepatic duct but also involvement of the right-posterior-inferior-ventral branch and right caudal branch. Angiography showed almost normal appearance except cystic artery. Duodenal invasion was also detected by per oral duodenography. These findings forced to plan extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy for radicality. In spite of the aged and her complications such as DM, hypertension, scoliosis and bradyacusia, liver function was good and she was mentally very active for life. Therefore, planned operation was performed and the suitability of this operation was proved by histological examination. She underwent resection of the abdominal wall for recurrence 8 months after and now alive without the disease 27 months after the first operation. It is stressed that the most suitable operation should be selected conceiving the mode and severity of cancer extension which is revealed by precise preoperative examinations and extended operation may be indicated in even the elderly if various conditions are good.

Adenocarcinoma↗
PubMed1988

[A case of primary intrahepatic cholesterol gallstones difficult to manage by percutaneous transhepatic cholangioscopy].

A case of a 60-year-old man with primary intrahepatic cholesterol gallstone was reported. Several stones, each size 3mm in diameter, were packed in the diverticulum-like dilated part of the posterior-inferior-ventral bile duct branch of the right lobe and 3 stones, each size 3-4mm in diameter, were scattered separately in the lateral segment of the left lobe of which the bile duct branches were diffusely tortuous and with mildly irregular dilatation. Morphologic appearance of the biliary system except in these 2 areas was normal. All stones including a large gallbladder stone consisted of cholesterol. Intraluminal approach, not only ERC but also PTCS, can hardly detect intrahepatic stones of more peripheral areas, although combination of US and enhanced CT may be useful even though bile duct branches are not dilated. We failed in PTCS lithotomy in this case for the first time in our experience with more than seventy cases of intrahepatic stones. However, by PTCS it was possible to investigate the morphology of the biliary system in detail and consequently, to make the diagnosis of primary intrahepatic stones. This patient has cured by cholecystectomy and minimum hepatectomy.

Bile Ducts, Intrahepatic↗
PubMed1987

Effect of aging on sleep-related changes in respiratory variables.

Several respiratory variables were examined in 11 healthy elderly (greater than 60 years) and 12 younger (30-39 years) control subjects during all-night sleep runs, with a view to determining the effect of the aging process on breathing during sleep. O2 saturation, end-tidal PCO2, and transcutaneous PCO2 were monitored, together with standard sleep staging measures. Estimates of tidal volume (Vt) and ventilation (Ve) were obtained using a Respitrace inductive plethysmography system, from which respiratory rate (fb) was also measured. Older subjects had more sleep apnea/hypopnea than younger subjects, an incidence of 55 versus 8%, respectively. More of their arousals were associated with respiratory disturbance than those of the younger subjects, and they had more brief, but not longer, arousals. Mean O2 saturation was lower in older subjects during wakefulness but did not decrease more in older subjects than in control subjects during sleep. Mean end-tidal/transcutaneous PCO2 did not differ between groups during wakefulness or sleep. Vt and Ve estimates did not decrease during slow wave sleep in older subjects as they did in the younger subjects. It was concluded that aging by itself does not significantly alter average sleep-related changes in O2 saturation or PCO2, although the increased incidence of respiratory disturbance does produce transient swings in these variables. The lack of a decrease in ventilation estimates during sleep in spite of the usual changes in O2 saturation and PCO2 in the older group indicates a possible decrease in effective gas exchange.

Adult↗
PubMed1987

[A case of retroperitoneal lymphangioma successfully treated by pancreatoduodenectomy].

A rare case of retroperitoneal lymphangioma in 44-year-old male complaining of high fever and right hypochondralgia is reported. Retroperitoneal malignant tumor was suspected preoperatively, and pancreatoduodenectomy was performed because the tumor infiltrated to duodenum and head of the pancreas. Histopathological examination revealed that the tumor was lymphangioma infiltrating to the duodenum. There are two types of lymphangioma, solitary lymphatic cyst and true proliferating lymphangioma and in this case, the tumor is diagnosed as true proliferating lymphangioma which is cavernous and infiltrating.

Adult↗
PubMed1987

[A case of polypoid carcinoma of the left hepatic duct].

A case of polypoid carcinoma of the left hepatic duct in 50-year-old male was reported. Extended left hepatic lobectomy with total caudate lobectomy and resection of the right hepatic duct were performed because the tumor involved the right hepatic duct and bile duct branches of caudate lobe, medial and lateral segment. Papillary growth of the tumor was diagnosed definitely by percutaneous transhepatic cholangioscopy (PTCS) and computed tomography. The tumor infiltrated the liver parenchyma of medial segment and compressed the middle hepatic vein. These findings were revealed by selective middle hepatic venography preoperatively.

Adenocarcinoma↗
PubMed1987

[Anatomical studies on the biliary tree of the caudate lobe using an endoscopic retrograde cholangiogram].

The purpose of this study is to clarify positional relationship between the bile duct of the caudate lobe and the bile duct of the hepatic hilum through endoscopic retrograde cholangiogram (ERC). Until December 1984 all 100 ERC that met the following three conditions were studied which at Yachio Hospital. 1. The first cholangiogram. 2. Without obstructive jaundice. 3. No existence of lesion at the hepatic hilum. Bile duct of the caudate lobe were classified into 4 separate types: 1) Ducts from the cranialis of the right caudate lobe which pass via the inferior vena cava to the hepatic hilum named Blr, were confirmed in 32. 2) Ducts from the cranialis of the left caudate lobe to the hepatic hilum named Bl l s, were confirmed in 19. 3) Ducts from the left lateral part of the left caudate lobe to the hepatic hilum named Bl l i were confirmed in 37. 4) Ducts from the caudate process to the hepatic hilum named Blc, were confirmed in 5. One or more of the above bile ducts were confirmed in 53 cases. All four of the above were confirmed in only 2 cases out of 53 cases. Three were confirmed in 7 out of 53 cases, two were confirmed in 20 cases out of 53 cases and one was confirmed in 24 out of 53 cases. Studies for the bile duct of the caudate lobe have been conducted anatomically, but there has been no research by clinical examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Ducts, Intrahepatic↗