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Biomedical subjects

K Ido

Publications and source records attributed to K Ido.

At least 109 records · Page 6Linked to original sources
PubMed1996

Suction/irrigation for deep wound infection after spinal instrumentation: a case study.

Deep wound infection after spinal instrumentation is a serious complication that is difficult to treat without removing the instruments and bone graft. Debridement and suction/irrigation is an effective method of treatment in these cases. It was performed on six patients in our department who developed this complication between 1985 and 1994. Four patients with early post-operative infection were cured by this method without removing the instruments and bone graft, and two patients with delayed post-operative infection were cured by this method with instrument removal. Debridement and suction/irrigation is a useful method of treatment for both groups of deep wound infection and gives good results when performed soon after infection onset together with additional antibiotic therapy.

Adult↗
PubMed1996

Confirmation of a "safety zone" by intraoperative cholangiography during laparoscopic cholecystectomy.

BACKGROUND: Creating a "safety zone" during laparoscopic cholecystectomy is defined as dissection of the cystic duct as close as possible to the gallbladder. METHODS: In 29 out of 802 cases in which laparoscopic cholecystectomy was difficult to perform due to uncertainty about the orientation of Calot's triangle, intraoperative cholangiography was performed, using a titanium clip as a marker that designated the safety zone. The distance between the clip and the common hepatic duct or the common bile duct could be determined by evaluation of two intraoperative cholangiograms taken in different orientation. RESULTS: If the clip was located in the safety zone, and was distant from the common hepatic duct or common bile duct, the safety of preparation around the clip was ensured. No complication was encountered in these cases with this method. Eventually, no biliary tract injury was experienced, and the overall conversion rate to open cholecystectomy was only 0.4% (3 of 802 consecutive cases). CONCLUSIONS: This method of confirming the safety zone by intraoperative cholangiography is a useful procedure for avoiding inadvertent injury to the biliary tract.

Bile Duct Diseases↗
PubMed1996

Deficiencies of automatic endoscopic reprocessors: a method to achieve high-grade disinfection of endoscopes.

BACKGROUND: We show that disinfection using the automatic endoscopic reprocessor is not complete and propose a method for high-grade disinfection of endoscopes. METHODS: We used an automatic endoscopic reprocessor, Pyser System 83, and 2% glutaraldehyde. After each endoscopic procedure, the endoscopes were divided into three groups. Endoscopes in group A were washed only by the reprocessor. Group B endoscopes were washed by the reprocessor after the connectors were soaked in glutaraldehyde for 5 minutes. The channels, valves, connecting sections of group C endoscopes, and the connectors of the machine were sprayed with glutaraldehyde before machine-washing. Swabs were taken from all 13 parts of each endoscope and machine for microbiologic culture. RESULTS: Six endoscopes were positive, cumulatively, for bacterial contamination in group A. Among group B endoscopes, one remained contaminated. No endoscope was positive in group C. The difference between group A and C was statistically significant (p < .05). CONCLUSIONS: Machine washing by automatic endoscopic reprocessors may not achieve complete disinfection. Additional procedures are necessary. High-grade disinfection of the connectors is critical. Disinfection of the interface between the connectors is important.

Disinfection↗
PubMed1996

Assessment of the course and variations of the hepatic artery in bile duct cancer by intraductal ultrasonography.

BACKGROUND: We evaluated the course and variations of the hepatic artery in bile duct cancer using intraductal ultrasonography (IDUS). METHODS: IDUS was used to demonstrate the course of the hepatic artery preoperatively in 20 patients with extrahepatic bile duct cancer, and the image was compared with angiographic and surgical findings. RESULTS: IDUS was able to assess tumor invasion to the main branch of the right hepatic artery in all cases. However, it demonstrated only three cases in the left hepatic artery and four cases in the proper hepatic artery. When the hepatic artery indicated re-entry or bifurcation on the IDUS image, the proximal portion of re-entry or bifurcation was established as the proper hepatic artery, but when it showed neither re-entry nor bifurcation it was established as the right hepatic artery. CONCLUSIONS: IDUS demonstrated the main branch of the right hepatic artery in all cases, but was not useful for demonstration of the left and proper hepatic arteries. Correct assessment of re-entry and bifurcation was essential on IDUS images for making the distinction between the right hepatic artery and the proper hepatic artery.

Aged↗
PubMed1996

Laparoscopic transcystic cholangioscopic lithotripsy for common bile duct stones during laparoscopic cholecystectomy.

BACKGROUND AND STUDY AIMS: Following the recent introduction of laparoscopic cholecystectomy (LC) for cholecystolithiasis, treatment of concomitant common bile duct (CBD) stones has been evaluated by using laparoscopic choledochotomy, a transcystic approach, or by means of endoscopic sphincterotomy (ES) before or after LC. PATIENTS AND METHODS: During laparoscopic cholecystectomy, we attempted lithotripsy of CBD stones using laparoscopic transcystic cholangioscopy with lithotripsy (LTCL), in 70 patients out of 950 laparoscopic cholecystectomies. Preparatory tests included laboratory values, ultrasound, and performance of endoscopic retrograde cholangiography (ERC) with placement of a nasobillary tube (without sphincterotomy). RESULTS: Introduction of the cholangioscope into the CBD was successful in 65 patients (92.9%) and CBD clearance was completely achieved by LTCL alone in 51 (78.5%). The overall success rate was therefore 73%. The remaining 19 cases required postoperative procedures such as extracorporeal shock-wave lithotripsy without ERC or ES (successful in all). The average hospital stay period was 9.4 days for patients in whom CBD clearance was achieved by LTCL alone. This period did not differ significantly from that of patients who underwent LC alone (8.4) days. The operation time was about 70 minutes longer for the LTCL group (total time 174 minutes on average) than for the LC group (107 minutes). We did not observe any series complications during or after LTCL (mean follow-up period: 34 months). CONCLUSION: LTCL in combination with LC allows shortening of the hospital stay and a swift return to work for patients with CBD stones. This procedure also preserves the function of the sphincter of Oddi, so that the longterm prognosis for patients is likely to be very good.

Adult↗
PubMed1996

Assessment of pancreatic parenchymal invasion by bile duct cancer using intraductal ultrasonography.

BACKGROUND AND STUDY AIMS: This study was performed to clarify the diagnostic accuracy of intraductal ultrasonography (IDUS) in assessing pancreatic parenchymal invasion by bile duct cancer. PATIENTS AND METHODS: Preoperative assessment of pancreatic parenchymal invasion was carried out by IDUS via a percutaneous tract or a transpapillary route in 18 patients with extrahepatic bile duct cancer. Various probes with diameters of 1.4, 2.0, 2.4, 2.6 and 3.2 mm, and frequencies of 7.5, 15, 20 and 30 MHz were used. All patients underwent angiography and endoscopic ultrasonography (EUS). In the first six cases, IDUS and EUS images were analyzed retrospectively without knowledge of the operative outcome or the results of other imaging tests. In the subsequent 12 cases, the IDUS und EUS images were prospectively reviewed prior to surgery. The diagnostic accuracy of IDUS was compared with angiography and EUS by means of a histopathological examination of the resected specimens. RESULTS: The accuracy of IDUS, EUS, and angiography in assessing pancreatic parenchymal invasion was 100%, 78% and 61%, respectively. However, IDUS could not assess pancreatic capsular invasion. The accuracy of IDUS in assessing horizontal tumor extension to the intrapancreatic bile duct and to the hepatic side was 83% and 72%, respectively. CONCLUSIONS: IDUS proved useful for assessing the extension of cancer invasion to the pancreatic parenchyma, but not to the pancreatic capsule or mucosal surface.

Aged↗
PubMed1996

Gastritis in the Japanese stomach.

Endoscopic studies of Japanese patients with gastritis have revealed the existence of an endoscopic atrophic border that marks the transition between non-atrophic gastritis and atrophic gastritis, and between fundic glands and pyloric glands. Marked changes in cell type, gastritis activity, atrophy and density of Helicobacter pylori infection occur across this border. Gastritis appears to extend from the antrum to the corpus more quickly in Japanese patients than in patients from other populations. Infection with H. pylori may be an important factor influencing the rate of progression of gastritis in Japanese patients.

Atrophy↗
PubMed1996

The usefulness of ultrasonic microprobe imaging for endoscopic variceal ligation.

OBJECTIVES: This study investigated whether ultrasonic microprobe (UMP) imaging was useful in judging the therapeutic effect of endoscopic variceal (EVL) on varices as well as assessing varices and surrounding vessels before and after EVL. METHODS: UMP imaging was performed repeatedly safely and easily via the biopsy channel of an endoscope in 20 patients with esophageal varices. Using this modality in combination with our method of "intensive ligation," we treated esophageal varices successfully. RESULTS: Before EVL, UMP imaging displayed esophageal varices, periesophageal collaterals, and the azygous vein as echo-free lumens. In 15 of 20 patients, UMP imaging clearly detected the perforating vein, one of the optimal ligation sites for EVL, connecting the varix and collateral vein. Just after EVL, UMP imaging revealed a hyperechoic change ("snow ball" sign or "snow channel" sign), indicating blood flow stasis in the esophageal varices. On subsequent EVL, UMP imaging showed the cross-sectional area of varices was undetectable (occluded) or partially detectaable. After repeated EVL (2.9 treatment sessions on average), UMP imaging, as well as endoscopy, indicated that almost all varices were eradicated (undetectable). However, UMP imaging demonstrated that neither collaterals nor the azygous vein had significantly changed in size. CONCLUSIONS: This modern diagnostic modality provided a clinical adjunct to current endoscopy when observing esophageal varices and surrounding vessels before and after EVL to determine the need for additional therapy.

Aged↗
PubMed1996

Distribution of inflammation and atrophy in the stomach of Helicobacter pylori-positive and -negative patients with chronic gastritis.

OBJECTIVES: To investigate the extent of inflammation and atrophy in the stomach of Helicobacter pylori-positive and -negative patients with chronic gastritis. METHODS: Endoscopy with biopsies from the lesser curvatures of the antrum, angulus, middle body, and the greater curvature of the middle body of the stomach was performed in 59 patients with histologically confirmed chronic gastritis. The extent of atrophic gastritis was assessed endoscopically as well histologically. H. pylori status was assessed by histology as well as enzyme-linked immunosorbent assay. The histological severity of chronic and acute inflammation, glandular atrophy, and intestinal metaplasia was assessed according to the Sydney system. RESULTS: In H. pylori-positive patients, H. pylori was evenly distributed throughout the stomach when the extent of atrophic gastritis was limited to the antrum and the lesser curvature of the body, but disappeared from the antrum of patients with more extensive atrophic gastritis. The severity of acute and chronic inflammation at the greater curvature of the body increased with the extension of atrophic gastritis. In H. pylori-negative patients, the severity of chronic inflammation at the greater curvature of the body was significantly higher in patients with extensive atrophic gastritis than in those with a lesser extent of atrophic gastritis. CONCLUSION: At the greater curvature of the body, the development of atrophy is closely associated with the increase in the severity of inflammation, which is more marked in H. pylori-positive patients.

Adolescent↗
PubMed1996

[Can we know the frequency of true late adverse reactions to nonionic contrast media?: Late adverse reactions due to factors other than contrast media].

We investigated the frequency and causative factors of symptoms unrelated to contrast media (false late adverse reactions) among patients who were evaluated as having late adverse reactions to contrast media. The nature and frequency of complaints stated by each 200 of patients who underwent plain CT scans and enhanced CT scans were evaluated. In the plain CT group, three patients showed false late adverse reactions. The frequency was 2.6% among respondents and 1.5% in the population. These symptoms encompassed psychological effects and diseases that developed after CT scanning. It is difficult to detect only true late adverse reactions, because of survey bias.

Adult↗
PubMed1996

A method of evaluating drug efficacy by statistical analysis of healing speed of peptic ulcer.

At present, the evaluation of anti-ulcer drugs is generally accomplished simply by calculating the cumulative healing rate at a certain point of time during treatment, which does not implicate any analysis of the healing speed of the ulcer. If the cumulative healing rate of an ulcer is expressed as a function of drug administration time, t, then it will be possible to calculate parameters concerning the healing speed of ulcers and thus evaluate drug efficacy as the time series analysis of the cumulative healing rate. A new method of evaluating anti-ulcer drugs by a statistical analysis of healing speed is proposed. A non-linear regression analysis was performed between two variables, t (time of drug administration: week) and y (non-healing rate: %), to obtain the exponential function y = Ae-kt. The theoretical values calculated from the exponential equation were in close proximity to the observed values. With this analysis, four parameters concerning the healing speed were defined, namely the healing rate constant, the initiation time of healing, the half-life of non-healing rate and the time necessary for 50% healing. With this method, the efficacy of drugs on peptic ulcer healing was dynamically analysed, the non-healing rate (y) being expressed as an exponential function of length of time (t) of treatment, thus obtaining digital parameters for healing speed.

Anti-Ulcer Agents↗
PubMed1996

[A case of right upper lobe carcinoma with lung torsion changed in position].

A 71-year-old man with a pulmonary carcinoma had torsion of the right upper lobe of the lung. A chest radiogram showed change of the opacified lobe in position. At right thoracotomy, we found that the atelectatic right upper lobe occupied with a giant tumor moved freely in the right thoracic cage due to the defect of parenchymal bridge between the contiguous lobes. Though lung torsion is a rare event, it might be kept in mind as a complication of malignant tumors or life-threatening lung infarctions.

Aged↗
PubMed1996

Correction of kyphotic deformity of the cervical spine in ankylosing spondylitis using general anesthesia and internal fixation.

Surgical correction of kyphotic deformity of the cervical spine caused by ankylosing spondylitis is usually done using local anesthesia to prevent undue spinal cord compression and paralysis followed by a sudden-extension maneuver. We report a case of kyphotic deformity that was corrected while the patient was under general anesthesia. To prevent cord compression and paralysis and to obtain an accurate and gradual correction, we used a Hartshill rod prebent to the desired angle, and correction was done by tightening sublaminar wires on the rod until the lamina made full contact with it. Somatosensory evoked potential and wake-up tests were also performed. Our successful result shows that correction of kyphotic deformity of the cervical spine in ankylosing spondylitis can be done more accurately and without discomfort using the present method.

Anesthesia↗
PubMed1995

Electrophoretic analysis of bile proteins from patients with and without gallstones.

Bile proteins from 82 cases with various types of gallstones (pure cholesterol stones, cholesterol stones with a small amount of other substances, mixed stones and pigment stones) and 9 controls without gallstones were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A unique bile protein with a molecular mass of 32 kDa was identified. The 32 kDa protein could be stained on immunoblotting membranes using immunoperoxidase with concanavalin A. The 32 kDa protein was found in all controls but only in a portion (22.2-36.4%) of the patients with gallstones of various types. Following electrophoretic elution from the SDS-PAGE gels, the 32 kDa protein was analyzed by reversed phase--high-performance liquid chromatography, yielding three peaks for controls and only two peaks for patients with gallstones.

Adult↗
PubMed1995

Lower-extremity venous stasis during laparoscopic cholecystectomy as assessed using color Doppler ultrasound.

Lower-extremity venous stasis during laparoscopic cholecystectomy was evaluated in 16 patients by monitoring the blood velocity in the femoral vein and the femoral vein size (cross-sectional area) using color Doppler ultrasonography. The blood velocity in the femoral vein decreased significantly after the start of 10-mmHg abdominal insufflation in the supine position. When the patients were placed in a reverse Trendelenburg position during 10-mmHg insufflation, blood velocity in the femoral vein further decreased. However, velocity returned to the baseline after deflation. The cross-sectional area of the femoral vein was significantly elevated after the start of 10 mm Hg insufflation in the supine position. When patients were placed in the reverse Trendelenburg position during 10-mmHg insufflation, this parameter was further elevated, but returned to the baseline soon after deflation. These results indicate that femoral vein stasis during laparoscopic cholecystectomy can be minimized by reducing the pressure of abdominal insufflation and avoiding elevation of the patient's head as much as possible.

Blood Flow Velocity↗
PubMed1995

Effects of luminance contrast and phase difference on motion assimilation for sinusoidal gratings.

When a sinusoidal (test) grating is displaced horizontally by a phase angle of 180 deg in a two-frame apparent motion display, the perceived direction of motion is ambiguous; the test grating appears to move either to the left or to the right (or to both directions). On the other hand, when the test grating is displaced by 180 deg synchronously with the inducing gratings which, presented above and below the test grating, jump unambiguously in one direction (e.g. displaced by 90 deg), the test grating always appears to move in the same direction as the inducing gratings (motion assimilation). In the present study, the effects of luminance contrast and phase difference on motion assimilation were examined. The proportion of perceived direction of motion (left or right) was measured as a function of phase difference between the test grating in the first and the second frame. The magnitude of motion assimilation was evaluated as the change in the phase difference for which the proportions of observers' response were equal (50%) for both directions. The magnitude of motion assimilation increased with increase in the contrast of the inducing gratings or with decrease in the contrast of the test grating. Also, the magnitude increased as the phase difference of the inducing gratings departed from 180 deg. Based on these results, a quantitative formulation between the magnitude of motion assimilation, and the contrast and the phase difference of the stimulus gratings was derived. Further, a model was proposed which explains the stimulus dependences of motion assimilation in terms of response-integration among local motion detectors.

Contrast Sensitivity↗