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Biomedical subjects

K Inokuchi

Publications and source records attributed to K Inokuchi.

At least 325 records · Page 18Linked to original sources
PubMed1981

Ultrasonic flow wave pattern as a prognostic indicator in peripheral arterial reconstruction.

A prognostic flowmetric study on 80 reconstructed arteries of the lower extremity was carried out to assess the flow wave patterns detected using a bidirectional doppler flowmeter. In 21 of 80 arteries, changes in the flow wave pattern were noted. For 10 of 21 affected arteries, an immediate arteriography revealed localized stenotic lesions at the distal anastomosis, in a short segment of the implanted autogenous vein graft or at the proximal host artery. Immediate repairs for the lesions were successfully performed by a minor surgery in 8 of 10 cases and the flow wave pattern reverted to normal. Two were not successful as the occlusion was complete before attempting the repair. The remaining 11 are now under conservative management as these patients refused further surgery. The ultrasonically driven flow wave pattern proved to be a useful indicator to assess the patency of the reconstructed peripheral artery to detect possible stenosis and thereby to take proper corrective measures and hence prevent a late occlusion.

Arterial Occlusive Diseases↗
PubMed1981

Late results of postoperative long term cancer chemotherapy for advanced carcinoma of the stomach.

Postoperative long term cancer chemotherapy (PLCC) with the combination of Mitomycin-C, FT-207, a furanyl analog of 5-fluorouracil, and PSK, an immunopotentiator, was prescribed for patients with advanced gastric cancer. Five year survival rates for all stage III and stage IV patients were 52.8 and 19.3 per cent in the PLCC group. The rates were 26.7 and 2.2 per cent in the control groups (p less than 0.05). In curative cases of stage IV, the 5-year survival rate was 50.0% in the PLCC group while the rate was 11.1% in the controls. Mean survival time of patients with peritoneal dissemination or hepatic metastases was 12.8 and 10.9 months, respectively, for the PLCC group, in contrast to the lower 6.4 and 4.3 months for the controls. Thus, the 5-year survival rate of advanced gastric cancer patients in stage III and stage IV was markedly improved when these patients were treated with the protocol. Our findings clearly show that adjuvant chemotherapy should be administered for a long period postoperatively in order to achieve a significant improvement in patients with gastric cancer.

Adjuvants, Immunologic↗
PubMed1981

Experimental studies on the treatment of nonresectable liver cancer.

In cases of metastatic cancer of the liver in rats, the effect of ligation of the hepatic artery (HAL) or portal vein (PVL) with or without intraportal chemotherapy with Mitomycin C (MMC) was studied in Experiment I. HAL or PVL alone and chemotherapy alone induced only a slight anti-cancer effect. The most striking effect was found in the group treated with HAL plus MMC. PVL plus MMC produced intermediate results. To evaluate which route, via the hepatic artery or portal vein, is more effective for the adjuvant chemotherapy after HAL, Experiment II was conducted on the rats with a minute and/or a rather advanced metastatic cancer of the liver. Chemotherapy with MMC by either route alone and HAL alone did not substantially prolong the survival time, irrespective of the tumor size. HAL plus chemotherapy via both routes produced a statistically longer survival time compared with the control, however, better results were obtained by intraarterial chemotherapy. When compared with the two groups treated by the same procedures but at the different times, the earlier treatments produced better results. In the light of the present studies, it can be concluded that if cytocidal drugs with dose independent effects are given in a single bolus, HAL in connection with intra-arterial chemotherapy is a beneficial modality for the treatment of nonresectable liver cancer.

Animals↗
PubMed1981

Effect of decreased plasma colloid osmotic pressure on development of pulmonary edema in dogs.

The effect of decreased plasma colloid osmotic pressure on the development of pulmonary edema was studied in anesthetized dogs. Lung lymph flow was used aa a sensitive and reliable indicator of fluid filtration rate in the lung. When plasma colloid osmotic pressure alone was reduced by slow infusion of saline, and hydrostatic pressure in the pulmonary vascular bed was maintained at normal level by exsanguination, lung lymph flow increased almost linearly with the reduction in colloid osmotic pressure, but was not increased more than five fold of the control, despite a reduction of 80% in the plasma colloid osmotic pressure. Furthermore, there was no evidence of fluid in the tracheal aspiration and no gross evidence of pulmonary edema. In contrast, both decrease in colloid osmotic pressure and increase in pulmonary capillary hydrostatic pressure produced a marked increase in lung lymph flow. This flow varied linearly with the level of the pulmonary artery wedge-plasma colloid osmotic pressure difference and approached twelve fold of the control, when the plasma colloid osmotic pressure was reduced by 73% and the pulmonary artery wedge pressure was elevated by 20 mmHg from the baseline. Our data indicate that decreased colloid osmotic pressure is not associated with the development of pulmonary edema, when there is no increase in pulmonary vascular hydrostatic pressure.

Animals↗
PubMed1981

Relationship between postoperative hypoxemia and the operative site.

The effect of the site of operation on postoperative hypoxemia was studied in 104 patients undergoing thoraco-abdominal, thoracic, upper abdominal, lower abdominal, extra-abdominal and non-thoracic operations. The degree of postoperative hypoxemia was the most extensive in patients undergoing thoraco-abdominal, moderate in thoracic and upper abdominal operations, and minimal in lower abdominal and other operations. On the other hand, the duration of hypoxemia also differed with the surgical procedures. Arterial oxygen tension returned to almost control values by the 3rd postoperative day in cases of lower abdominal and extremity operations and by the 7th postoperative day in those undergoing thoracic and upper abdominal surgery. Postoperative hypoxemia, however, remained throughout the fourteen day study period, in patients undergoing thoraco-abdominal operation. True shunt was measured in 27 patients with thoraco-abdominal, thoracic and upper abdominal operations. An increase in true shunt was evident postoperatively in the entire group of patients. The increase was significantly larger and longer lasting in cases of thoraco-abdominal incision than that in cases of thoracic and upper abdominal incision alone. Differences in postoperative true shunt between cases of thoracic and upper abdominal incisions were nil.

Abdomen↗
PubMed1981

Prediction of variceal hemorrhage by esophageal endoscopy.

To assess the risk of variceal bleeding, endoscopic findings in 172 patients with esophageal varices were classified based on the "General Rules for Recording Endoscopic Findings on Esophageal Varices" prepared by the Japanese Research Society for Portal Hypertension. Among the factor which enabled an accurate prediction of bleeding were the red wale marking and cherry-red spot of the red color sign category and blue varices of the fundamental color category with large varices. Other factors in the "General Rules" such as the form and location were of minor significance in prediction of the bleeding. Each of these factors can be quantified and an assessment can be made of the likelihood of bleeding. By calculating the total score of these factors, the risk of bleeding in individual patients was accurately estimated.

Esophageal and Gastric Varices↗
PubMed1981

Decreased arteriovenous flow resistance in the left gastric venous area in cirrhotic patients.

To assess the relationship between the fluid mechanics in the left gastric venous area and the portal trunk, manometric measurements were made in patients with or without cirrhosis of the liver. In ten normal subjects, temporary portal vein occlusion produced comparable elevation in both the occluded left gastric venous pressure (OLGP) and the portal vein pressure (PVP); 152-429 mm of water in OLGP and 115-452 mm of water in PVP. In sixty cirrhotic patients, however, the portal vein occlusion resulted in far less increase in OLGP than that in PVP; 281-365 mm of water in OLGP and 281-540 mm of water in PVP. In other words, regarding pressure measurements, the relationship was 'separated' in cirrhotics, but 'continuous' in normal subjects. Mathematical analysis of the data using a modification of Wheat-stone bridge model suggested that the arteriovenous flow resistance in the left gastric venous area of cirrhotics was reduced to less than one fifth of that in the controls. It would appear that the increased flow capacity as a result of a reduced arteriovenous flow resistance is responsible for the functional 'separation' from the portal trunk.

Humans↗
PubMed1981

Hemodynamic and morphological changes in the stomach of portal hypertensive rats.

To determine hemodynamic and morphological changes in the stomach of portal hypertensive rats, male WKA rats were given CCl4 subcutaneously in order to induce liver cirrhosis. The portal venous pressure of cirrhotic rats was significantly higher (17.7 cm H2O) than that of controls (10.5 cm H2O). Mucosal blood flow of the stomach in the portal hypertensive rat was increased (+ 46%) compared with that of controls and the peripheral vascular resistance of the stomach was significantly low. Morphological studies revealed that capillaries, collecting, submucosal, serosal and portal veins were significantly dilated; however, there were no apparent alterations in the arterial system of the stomach of the portal hypertensive rats. These results suggest that in the stomach of the portal hypertensive rat there is an increased blood flow and decreased peripheral vascular resistance and that this hyperdynamic circulatory state may derive from the dilatation of microvascular systems.

Animals↗
PubMed1981

Alteration in plasma amino acid concentrations following subtotal hepatectomy in dogs.

Plasma amino acid concentrations were serially estimated after 82.5% resection of the liver in dogs. Slight to moderate decreases were found in valine, leucine, isoleucine, threonine and methionine concentrations for the first 12 hours. The first three branched chain amino acids thereafter increased up to 180%. Between 24 and 72 hours, threonine and methionine increased markedly in four surviving dogs but not in two which died in hepatic coma. Significant increases were found in phenylalanine and lysine concentrations but there was no substantial change in tryptophan levels throughout the experiment. Among the non essential amino acids, the most striking increase was seen in tyrosine and serine concentrations with their peak at 48 to 72 hours. Arginine and aspartate transiently decreased within 12 hours but most of other amino acids increased more or less during the observation. Although the molar ratios of the branched chain to the aromatic amino acids dropped dramatically, it was difficult to draw definitive remarks on the relationship between the molar ratio and the grade of hepatic coma in each animal. A further study is necessary to determine whether the correction of plasma amino acid alterations is beneficial or not following critical liver resection.

Amino Acids↗
PubMed1980

Recurrence in early gastric cancer: a pathologic evaluation.

The cause of death in 26 of 220 cases of early gastric carcinoma was studied, particularly in relation to the mode of recurrence. Of the 26, 7 patients died of disease related causes and gross appearance revealed that 4 cases were IIa predominant, 2 were IIc (or +I), and 1 was IIc predominant. Histologic examination indicated that all 7 cases were differentiated-type adenocarcinomas. Two of 7 recurring carcinomas were due to residual carcinoma in the resected stumps and 5 patients had hematogenous metastases, particularly in the liver. Eighteen of the 26 patients died of other causes, in 1 case of unknown causes, and it is interesting that in 5 of the 18 cases, simultaneous or nonsimultaneous double carcinomas at sites other than the stomach were noted. In order to prevent recurrence in early gastric carcinoma, it is important that no carcinoma be left in the resected stump or remnant, and that the prophylaxis be achieved through the administration of adequate amounts of anticancer chemotherapy, in order to prevent hematogenous metastasis, particularly to the liver.

Adenocarcinoma↗
PubMed1980

Experimental gastric carcinoma induced by N-methyl-N'-nitro-N-nitrosoguanidine.

Serial studies by endoscopy and biopsy were made in a Beagle dog during and after oral administration of N-methyl-N'-nitro-N-nitroguanidine (MNNG). Between the 23rd and the 45th week of observation erosions and ulcers appeared at the angulus of the stomach and turned into ulcer scar. A depression with atypical glands was seen in the ulcer scar of the posterior wall of the angulus at the 94th week. It developed elevated margins at the 102nd week, when a well differentiated adenocarcinoma was found histopathologically. Ulceration and reepithelialization were observed in the early carcinoma. The carcinoma progressed into a larger one of Borrmann's type 2 at the 115th week and further into its type 3 at the 181st week. A second carcinoma with signet ring cell carcinoma developed in the anterior wall of the angulus. The two carcinomas fused and formed a single lesion. At autopsy in the 216th week the carcinoma invaded the serosa, and metastasis to regional lymph nodes was observed.

Adenocarcinoma↗
PubMed1980

Serum alpha-fetoprotein in patients following partial hepatectomy.

Serum alpha-fetoprotein (AFP) concentrations were estimated postoperatively at weekly intervals with the radioimmunoassay in eight adult patients. Seven patients underwent partial hepatectomies of up to 80% of the liver. Surgical drainage was carried out in one individual who had a huge pyogenic abscess in the right hepatic lobe. Despite evidence of clinical and biochemical recovery associated with normal liver regeneration, none of the sera were positive for AFP during the period 4-12 weeks after operation. This study does not support the hypothesis that the elevation of serum AFP in benign liver diseases reflects the extent of liver regeneration.

Aged↗
PubMed1980

Lymphangioma of the esophagus presenting symptoms of achalasia--a case report.

A case of lymphangioma of the esophagus with symptoms of achalasia was presented. Compressible and folded intramural tumors were found from the middle to the lower part of the esophagus and the Mecholyl test was positive. After incisional biopsy at lower esophagus through full thickness of the wall, the opening was repaired with Thal-Hatafuku's fundic patch procedures to relieve achalasia. Postoperative course was uneventful and symptoms of achalasia completely disappeared.

Esophageal Achalasia↗
PubMed1980

A case of a developmental anomaly of the femoral artery: persistent sciatic artery.

A case of a persistent sciatic artery in a 68-year-old farmer, showing symptoms of acute arterial occlusive lesion of the right lower limb is presented. The persistent sciatic artery was joined to the internal iliac artery proximally and to the popliteal artery distally. The anomalous artery was occluded by atheromatous thrombi. The superficial femoral artery was hypoplastic and terminated in the descending genicular artery at the midthigh level. A successful bypass was performed between the common femoral artery and proximal popliteal artery utilizing a woven teflon graft.

Acute Disease↗
PubMed1980

Venous reconstruction by endvenectomy with temporary arteriovenous fistula for stasis syndrome of lower extremity: experimental and clinical studies.

Effect of the temporary arteriovenous fistula on venous reconstruction for stasis syndrome of the lower extremity was studied experimentally and clinically. The canine iliac vein was replaced with an autogenous vein graft in which the intimal surface was roughened by scrubbing with sponge. A temporary arteriovenous fistula which was closed surgically three or four weeks later was created between the femoral vessels. The patency rate for twenty-one grafts was 80.9 per cent for one to thirty-six weeks (mean 8 weeks), in contrast to complete failure in the control group in which no arteriovenous fistula was created. Adequate healing of the luminal surface of the grafts were experimentally demonstrated by light microscopic examination and en face silver staining of the endothel-like cells with the aid of patent arteriovenous fistula for three weeks. This procedure was clinically applied in four patients with stasis syndrome of the lower extremities. Good function of the reconstructed venous segments in three of four patients was observed for the last 3 to 8 years after the operations. A looping technique using 2-0 monfilament nylon around the fistula devised by us was very helpful to make easy the shunt closure later. Open endvenectomy with a temporary arteriovenous fistula is believed to be an acceptable approach for segmental chronic occlusive lesion in the iliac vein.

Adolescent↗