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Biomedical subjects

K Ido

Publications and source records attributed to K Ido.

At least 127 records · Page 7Linked to original sources
PubMed1995

Femoral vein stasis during laparoscopic cholecystectomy: effects of graded elastic compression leg bandages in preventing thrombus formation.

Venous stasis of the legs during laparoscopic cholecystectomy was compared between patients without graded compression leg bandages (Group 1; n = 12) and patients with such bandages (Group 2; n = 12) by measuring mean blood flow velocity and cross-sectional area of the femoral vein using a color Doppler ultrasonography. In Group 1, when velocity and area were measured in the supine position, a significant decrease in velocity (p < .05) and a significant increase in area (p < .05) occurred after abdominal insufflation to 10 mm Hg. These changes were greater during abdominal insufflation in the reverse Trendelenburg position than during abdominal insufflation in the supine position. In Group 2, flow velocity was significantly higher (p < .05) before abdominal insufflation as compared with Group 1. After abdominal insufflation to 10 mm Hg and a postural change, velocity significantly decreased (p < .05) and area significantly increased (p < .05) in Group 2, similar to the results in Group 1. During abdominal insufflation at 5 mm Hg or lower, the use of the graded compression bandage was found to be useful for preventing femoral vein stasis. During abdominal insufflation at 10 mm Hg or in the reverse Trendelenburg position, the bandage did not prevent femoral vein stasis.

Bandages↗
PubMed1995

Assessment of portal vein invasion by bile duct cancer using intraductal ultrasonography.

BACKGROUND AND STUDY AIMS: We recently reported on the contribution of intraductal ultrasonography (IDUS) to the regional staging of bile duct cancer, and we present here the first detailed study of the value of IDUS in assessing the portal vein invasion by bile duct cancer. PATIENTS AND METHODS: Preoperative assessment of portal vein invasion was performed by IDUS via a percutaneous tract or via 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 additionally underwent endoscopic ultrasonography (EUS) and angiography. In the first six cases, the IDUS and EUS images were analyzed retrospectively without the knowledge of operative results or the other imaging tests. In the remaining 12 cases, IDUS and EUS images were prospectively reviewed prior to surgery, without knowledge of the angiographic findings. The gold standard for the results of IDUS, EUS and angiography was the histopathological findings in 17 resected tumors, and the intraoperative findings in one patient who did not undergo resective surgery. RESULTS: IDUS was able to demonstrate the portal vein in all cases. Its accuracy in diagnosing portal vein invasion was 100% for all locations. EUS was useful in assessing portal vein invasion at the middle and distal bile duct (the accuracy was 91%), but was not useful in assessing invasion at the proximal bile duct (the accuracy was 57%). CONCLUSIONS: IDUS proved useful for assessing the extension of cancer invasion into the portal vein, even in proximal bile duct tumors.

Aged↗
PubMed1995

Assessment of hepatic artery 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 hepatic artery invasion by bile duct cancer. PATIENTS AND METHODS: Preoperative assessment of hepatic artery invasion was performed by IDUS via a percutaneous tract or the transpapillary route in a total of 22 patients with extrahepatic bile duct cancer. The probes used had a diameter of 1.4, 2.0, 2.4, 2.6, and 3.2 mm, and frequencies of 7.5, 15, 20, and 30 MHz. In the first six cases, IDUS images were analyzed retrospectively with no knowledge of the operative results or of the other imaging tests. In the following 16 cases, the IDUS images were prospectively reviewed prior to surgery without knowledge of the angiographic findings. The diagnostic accuracy of IDUS was compared with angiography in all cases, with the histopathological results in 20 resected cases, and with the intraoperative findings in two cases with only surgical exploration. RESULTS: IDUS was able to demonstrate the right hepatic artery in all cases, and its accuracy in diagnosing right hepatic invasion was 100%. However, IDUS was able to visualize the proper hepatic artery in only four cases (18%), and the left hepatic artery in only three cases (14%), respectively. IDUS could not visualize the area outside of the hepatoduodenal ligament, because of its low penetration depth. CONCLUSIONS: IDUS proved useful for assessing the extension of bile duct cancer invasion into the right hepatic artery. However, IDUS did not sufficiently demonstrate the proper hepatic artery and the left hepatic artery for diagnosing vascular involvement.

Aged↗
PubMed1995

Anterior decompression and fusion for ossification of posterior longitudinal ligament in the thoracic spine.

Twelve cases are reviewed of ossification of posterior longitudinal ligament (OPLL) in the thoracic spine for which anterior decompression and fusion were performed. A transthoracic approach was used in 10 patients, and median sternotomy and a transsternal approach were used in one each. The clinical symptoms and the Japanese Orthopaedic Association (JOA) score improved in 10 patients, whereas they were unchanged in two patients who underwent a revision operation for a previous laminectomy. An anterior procedure that results in adequate decompression of the spinal cord and good spinal stability is recommended for anterior lesions, such as OPLL, which compress the anterior spinal cord at each level of the thoracic spine.

Adult↗
PubMed1995

Efficacy of lansoprazole in eradication of Helicobacter pylori.

Fifty-eight Helicobacter pylori-positive ulcer patients received omeprazole 20 mg (n = 15), or lansoprazole 30 mg (n = 23), lansoprazole 60 mg (n = 13), or E3810 20 mg (n = 7) q.d. Another 63 H. pylori-positive ulcer patients received lansoprazole and clarithromycin for 2 weeks. Patients received lansoprazole 30 mg and clarithromycin 400 mg (group 1, n = 22), lansoprazole 30 mg and clarithromycin 800 mg (group 2, n = 12), or lansoprazole 60 mg and clarithromycin 800 mg (group 3, n = 29). Neither proton pump inhibitor (PPI) was capable of eradication by monotherapy, but the clearance rates in the lansoprazole group were 60.9 and 69.2%, which were higher than those for omeprazole (p < 0.05). In the dual therapy, eradication rates were 50, 50, and 72.4% in groups 1, 2, and 3, respectively. Minor side effects were observed in one case each in groups 1 and 3. Lansoprazole monotherapy proved more efficacious than omeprazole monotherapy, but it was unable to eradicate H. pylori. Dual therapy with lansoprazole 60 mg and clarithromycin 800 mg was an efficacious and safe regimen for H. pylori eradication in this study.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1995

A 1-h topical therapy for the treatment of Helicobacter pylori infection.

OBJECTIVE: A novel topical therapeutic methodology for the treatment of Helicobacter pylori infection was developed and studied in 25 patients with H. pylori to evaluate safety and efficacy. METHODS: The patients had been given lansoprazole (30 mg, hs) orally and pronase (18,000 tyrosine units, b.i.d.) for the 2 days before topical therapy. One hundred milliliters of solution with 80 ml of 7% sodium bicarbonate and 20 ml of contrast medium meglumine sodium amidotrizoate containing bismuth subnitrate (1 g), amoxicillin (2 g), metronidazole (1 g), and pronase (36,000 tyrosine units) were instilled into the stomach through a nasally introduced 16-Fr intestinal tube with a balloon at its radiopaque tip, which was inflated with approximately 25 ml of air and lodged postbulbarly at the superior duodenal angle under fluoroscopy, thus preventing leakage of the solution distally into the jejunum. The solution was kept in the stomach for 1 h, and the patient's position was changed every 15 min from the sitting to the supine, prone, and right lateral position to expose the entire gastric mucosa. The solution was suctioned at the end of the procedure. RESULTS: H. pylori infection was successfully cured in 24 (96%) patients, confirmed 4 wk after the therapeutic procedure by negative smear, culture, and histology of the antral and corpus biopsy specimens. No side effects were observed except for loose stools in one case. CONCLUSION: This 1-h topical therapy is a safe, effective, and well tolerated procedure for the treatment of H. pylori infection. With further improvements and modifications of the method itself, as well as of the drug regimens, this method may become a highly efficient modality for anti-H. pylori therapy.

Adult↗
PubMed1995

Preoperative staging of extrahepatic bile duct cancer with intraductal ultrasonography.

OBJECTIVE: To evaluate the tumor extension of extrahepatic bile duct cancer by means of intraductal ultrasonography (IDUS). METHODS: IDUS preoperatively assessed the tumor extensions in 25 patients with extrahepatic bile duct cancer. The diagnostic accuracy of IDUS was investigated by comparison with other diagnostic imaging modalities in all cases and with histopathological findings of resected specimens in 18 cases. RESULTS: IDUS proved useful in assessing the extension of cancer invasion to the pancreas parenchyma, portal vein, and right hepatic artery. The limitation of the degree of accuracy, based on the group staging criteria, was 68%. IDUS could not assess tumor invasion to the perimuscular loose connective tissue. Therefore, it could not distinguish stage II from stage I. IDUS could not sufficiently assess epicholedochal lymph node metastases (differential diagnosis between stages II and III) and could not demonstrate distant metastases (differential diagnosis between stages IVA and IVB) because of the inevitable attenuation of the echo itself. IDUS could assess cases of stage IVA correctly in 8/8 (100%) cases. The combination of PTC/ERC and IDUS could assess the horizontal extension correctly in 13/18 (72%) cases. The combination of PTC/ERC, percutaneous transhepatic cholangioscopy (PTCS), and IDUS assessed the horizontal extension in 14/15 (93%) cases. CONCLUSION: 1) IDUS, with a high-frequency probe, was very useful for assessing tumor infiltration in the hepatoduodenal ligament. 2) IDUS could not assess tumor extension outside of the hepatoduodenal ligament, but conventional ultrasonography and angiography could compensate for it. 3) The combination of PTC/ERC, PTCS, and IDUS could assess horizontal extension correctly.

Aged↗
PubMed1995

Dual therapy with lansoprazole and clarithromycin for eradication of Helicobacter pylori.

AIM: To evaluate the eradication of Helicobacter pylori by therapy with a combination of 60 mg lansoprazole and 800 mg clarithromycin. PATIENTS AND METHODS: In an open therapeutic trial, 30 H. pylori-positive patients with active ulcer disease took 30 mg lansoprazole twice a day and 400 mg clarithromycin twice a day for the first 2 weeks, followed by 30 mg lansoprazole once a day for 4-6 weeks. Endoscopy was performed both before and at the end of therapy, and 4 weeks after the end of the therapy. H. pylori was detected by using a combination of smear, culture and tissue sections. RESULTS: Complete pain relief occurred within 3 days in all patients and all ulcers were healed by the end of the therapy. The H. pylori clearance rate was 83.3% and the eradication rate was 73.3%. A minor side effect (metallic taste) was reported by only one patient (3.3%). CONCLUSIONS: Therapy with a combination of 60 mg lansoprazole and 800 mg clarithromycin is efficacious in the eradication of H. pylori and has the advantage of a low incidence of side effects and quick pain relief for patients with active ulcers.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1995

Helicobacter pylori detected deep in gastric glands: an ultrastructural quantitative study.

To determine the presence of Helicobacter pylori deep in the gastric glands and in the parietal cell canaliculi, biopsied specimens from 15 patients were observed by electron microscopy. In the specimens, 818 H. pylori and 1,846 parietal cells were detected. Most of the H. pylori (93.9%, 768/818) were present on the mucosal surface. However, a few organisms (50/818, 6.1%) were detected deep in the mucosa. The mean number of H. pylori per specimen was 2.13 (32/818, 3.9%) and 1.20 (18/818, 2.2%), deep in the gland and in the parietal cell canaliculi, respectively. All appeared morphologically intact. Although the combination of culture and histology from biopsy tissues is usually used for isolation of H. pylori in most laboratories, such organisms are considered difficult to detect with conventional methods and to dislodge with antimicrobial therapy. Therefore, H. pylori present deep in the mucosa are suggested to be one of the factors in recrudescence after eradication therapy. In addition, H. pylori in the parietal cell canaliculi may affect parietal cell function or alter gastric physiology.

Adult↗
PubMed1994

Morphological aspects of the cytotoxic action of Helicobacter pylori.

OBJECTIVE: To morphologically investigate the cytotoxic action of Helicobacter pylori on gastric mucosal cells. METHODS: Twenty biopsy specimens were obtained from the antrum and greater curvature of the upper body of the stomach, and examined by electron microscopy to elucidate the process of mucus cell injury induced by H. pylori. RESULTS: Only H. pylori colonies in intimate contact with the mucosal cells caused various cell alterations, including loss of microvilli, mucus depletion, cell membrane injury and degeneration of the cytoplasm. In contrast, H. pylori that were not in contact with the mucosa had no effect on the surface mucus cells. CONCLUSIONS: The results of this study suggested the following mechanism of H. pylori-induced gastric mucosal injury. Intimate contact between H. pylori and the epithelial cell is necessary for cytotoxic action. During the process of cytotoxic action, degradation of the mucous gel layer and the glycocalyx are first caused by the proteolytic enzymes produced by H. pylori. Then the microorganism approaches the surface mucus cell, making intimate contact with the cell surface. Finally, H. pylori adheres directly to the cell membrane, effecting direct action of the toxins on the cell membrane. Subsequently, the degenerative changes induced destroy the cell membrane, resulting in degeneration of the cell itself.

Bacterial Adhesion↗
PubMed1994

Some personal comments on the Sydney system for the classification of chronic gastritis.

The Sydney system for the classification of chronic gastritis is a system for describing the histopathological findings of a biopsy specimen. It involves the analysis of two to four biopsies of the gastric mucosa taken from arbitrary sites, which, taken alone, are insufficient for extrapolation to the diagnosis of the whole stomach. The system seems to be useful as a computer-oriented method fo documenting the histopathological analysis of the two to four biopsy specimens obtained from the arbitrary sites in the antrum or corpus. One biopsy specimen is obtained from the anterior wall of the antrum, the other from the posterior wall. They would be better obtained from the lesser and greater curvatures, which areas would provide more accurate data concerning the antrum or body. While this may be invaluable for researchers with particular interests, it is quite valueless for the majority of clinicians who must diagnose and treat their patients. When a classification is made, its purposes should, firstly, be clear and definite. Secondly, the classification should be simple and easy to use. If a classification is effective, it will be widely used. However, in this field, it is almost impossible to achieve a classification that will fully satisfy all practitioners and researchers with different interests. The Sydney system alone is not sufficient for the classification of chronic gastritis. It is merely a system for describing the histopathological findings of biopsy specimens. It does not allow for an integrated diagnosis of chronic gastritis of the entire stomach.

Adolescent↗
PubMed1994

A case of anomalous arrangement of the pancreaticobiliary ductal system demonstrated by intraductal ultrasonography.

A 55-yr-old female was hospitalized with epigastric pain. Conventional ultrasonography revealed marked dilation of the common bile duct (CBD). Endoscopic retrograde cholangiopancreatography showed fusiform dilation of the CBD. The common channel of the pancreatic duct and choledochus was 20 mm long. A diagnosis of congenital choledochal dilation accompanied by anomalous arrangement of the pancreaticobiliary ductal system (AAPBDS) was made. Intraductal ultrasonography (IDUS) was performed. IDUS demonstrated the union of the pancreatic duct and choledochus within the pancreatic parenchyma. This meant that the union existed outside the duodenal wall, confirming the diagnosis of AAPBDS. Although endoscopic retrograde cholangiopancreatography alone could show the maljunction in this case, simultaneous IDUS will be useful in making an accurate diagnosis of AAPBDS.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1994

Simultaneous separation and quantification of free and metal-chelated protoporphyrins in blood by three-dimensional HPLC.

In this new method for simultaneous separation and quantification of free and metal-chelated porphyrins in blood, the porphyrins are extracted from blood samples with a mixture of diisopropylamine:water:methanol (25:100:900, by vol) and separated by HPLC elution. The data are collected in three-dimensional form with a microcomputer. This method permits a high recovery of protoporphyrin (PP) and Zn-chelated PP as well as heme from blood. By this method, the amounts of these analytes in erythrocytes from normal or abnormal subjects can be determined more accurately than by conventional methods.

Adult↗
PubMed1994

[Respiratory and circulatory changes under high intra-abdominal pressure].

In order to determine the safety limit of abdominal pressure, the influence of abdominal pressure on the respiratory and circulatory systems was examined by changing it from 0 to 50 mmHg in dogs with carbon dioxide insufflation. Total peripheral resistance increased slightly after pneumoperitoneum but increased rapidly when 30 mmHg was exceeded. Cardiac output tended to decrease with an abdominal pressure above 30 mmHg. Static compliance decreased in response to the abdominal pressure up to 20 mmHg but the decrease became rather gentle when 30 mmHg was exceeded. Peak inspiratory airway pressure increased in response to the increased abdominal pressure up to 30 mmHg followed by small fluctuations thereafter. These evidences indicate that an abdominal pressure below 15 mmHg is desirable for performing a peritoneoscopic operation safely because the biocompensatory system may be impaired when the pressure exceeds 30 mmHg.

Abdomen↗
PubMed1993

[Advantages of intravascular ultrasound--preliminary experience in patients with peripheral and renal vascular disease].

Intravascular ultrasound (IVUS) is a new method in which endovascular images are obtained from a catheter inserted into an artery. We uses IVUS during PTA of iliac and renal artery, and examined its effectiveness. Three layers are well defined in normal arterial wall. Calcified deposits are recognized as a combination of strong echo and acoustic shadow. The absolute cross sectional area of patent lumen and atherosclerotic plaque can be calculated. IVUS is very effective for the assessment of PTA. The increased caliber of arteries following PTA is caused by the over stretching of the media rather than the compression of atheroma.

Arteriosclerosis↗
PubMed1993

Endoscopic ultrasonographic (EUS) evaluation of the quality of gastric ulcer healing.

EUS provides cardinal tomographic findings of gastric ulcer such as low echo mass (ulcer echo), thickening of the wall, a symmetrical or asymmetrical convergence of the submucosal layer, and a sharp (pin-point) or blunt (broad-surface) convergence, variously expressed in accordance with the depth or width, and also with the history of recurrence of ulcer. A low echo mass, or an ulcer echo histopathologically consists of fibrosis and granulation, sonographically correlating well with the thickening of the wall. Seventy nine cases of ulcer scar, 52 of which were evaluated endoscopically as S1 (red scar) and 27 as S2 (white scar), were scanned by EUS. The incidence of high quality healing recognized on EUS with complete disappearance of a low echo mass and subsidence of the wall thickness was 21.2% (11 of 52 ulcer scars) in the S1 stage group, which remarkably increased up to 70.4% (19 of 27) in the S2 group (P < 0.01). The results indicate a definite correlation between endoscopic and EUS assessment of an ulcer scar state. The cumulative relapse rate at 12 months during maintenance therapy with half doses of H2 blocker was found to be 4.5% (1 of 22 cases) in the group with high quality healing on EUS, 40.9% (9 of 22) in the group with fair quality healing, and 75.0% (12 of 16) in the group with poor quality healing. The results of the present study suggest that EUS assessment may be a reliable and objective predictor of susceptibility to ulcer recurrence, accurately evaluating the quality of gastric ulcer healing.

Gastroscopy↗
PubMed1993

The application of titanium alloy wires for the reattachment of the greater trochanter in total hip arthroplasty.

We developed a new fixing method using titanium alloy wires in order to facilitate the attachment of the greater trochanter in total hip arthroplasty. This wire is composed of Ti-3Al-2.5V by weight. According to the fatigue test in vitro, the titanium alloy wire had better fatigue properties than Ortron 90 wire of the same diameter. In experiments in vivo, both titanium alloy wires and SUS-316L wires were used for the reattachment of the greater trochanter of dogs, and the titanium alloy wires showed better biocompatibility than the latter. Thus, titanium alloy wires seem applicable for the reattachment of the greater trochanter in human total hip arthroplasty.

Alloys↗