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Biomedical subjects

K Iwamura

Publications and source records attributed to K Iwamura.

At least 73 records · Page 4Linked to original sources
PubMed1980

Abnormalities of serum cholinesterase isozyme in liver cirrhosis and hepatoma (Part II).

The pattern of serum cholinesterase (ChE) isozyme appeared to be characteristically abnormal in liver cirrhosis and hepatoma. In liver cirrhosis an abnormal fast moving peak was observed in 92.5% of fifty three patients studied. Further, diminishing activities of ChE 3 and 4, accompanied by an emergence of weak bands with unusual rates of flow, were noted in 58.5%. The latter abnormality was always associated with the former one. The pattern in hepatoma was essentially the same with liver cirrhosis, though diversity of bands was also present in some cases. It was ascertained that these abnormalities was due to sialic acid content bound to the enzyme, but was not due to production of abnormal enzyme protein moiety. It was suggested by clinical analysis that the degree of the abnormality of the isozyme may be useful for the diagnosis and prognostic evaluation of liver cirrhosis.

Carcinoma, Hepatocellular↗
PubMed1980

Cruveilhier-Baumgarten disease in Japan--on the basis of our own case.

The article reports on a patient with Cruveilhier-Baumgarten disease. The anamnesis of the 59-year-old housewife revealed previous anemia, splenomegaly and abnormal liver function 21 years ago. Three years ago, esophageal varices were found. A tortuously distended vein was seen in the falciform ligament at the time of laparoscopy, and this finding was confirmed by angiography and ultrasonography. Esophageal varices and hypersplenism were also noted. Despite these findings, liver biopsy specimens of both lobes showed only slight fibrosis with minimal lymphocyte infiltration in some portal areas, and no evidence of cirrhosis. Patency of the umbilical vein and portal hypertension without significant histologic change of the liver, are both in keeping with the features of this disease. Dilatation of the umbilical vein seemed to be congenital and did not contribute to active blood flow of portal hypertension in this patient. In Japan, development of "caput medusae" in portal hypertension is rather rare, whereas esophageal varices and splenomegaly are more frequent. Venous hum is also seldom found. 14 cases of Cruveilhier-Baumgarten disease and 28 cases of Cruveilhier-Baumgarten syndrome have been reported from Japan in the literature since 1911.

Celiac Artery↗
PubMed1980

Evaluation of blood cultures following laparoscopy.

To determine the incidence of transient bacteremia associated with laparoscopy, a prospective study was carried out in 113 patients with diverse liver diseases. Blood samples for aerobic and anaerobic cultures were obtained for each patient immediately before laparoscopy, within three minutes after creation of pneumoperitoneum and within three minutes after needle biopsy of the liver. Five subjects were culture positive, and all isolates were of the propionibacterium species. Positive cultures did not correlate with the nature of underlying liver disease, and none of these patients developed clinical evidence of bacterial infection. Positive isolates might be assumed to be contaminants, but the fact propionibacterium has been known to cause endocarditis cannot be ignored. Until further evidence accumulates, antibiotic coverage in "high risk" patients with cardiac lesions who are predisposed to endocarditis undergoing laparoscopy may be warranted.

Adult↗
PubMed1980

Clinical studies on cheno- and ursodeoxycholic acid treatment for gallstone dissolution.

We treated 30 patients with radiolucent gallstones with chenodeoxycholic acid (CDCA) or ursodeoxycholic acid (UDCA) at daily dosages of 300 to 600 mg. Duration of treatment ranged from 5 to 16 months. Gallstone dissolution was noted in 23.3% of the group. CDCA was effective in 22.2%, and UDCA was effective in 25%. Treatment with these bile acids was usually effective when radiolucent stones smaller than 5 mm in diameter were found in the normally functioning gallbladder. Improvement of symptoms was noted in 60.9% of the patients who had symptoms related to biliary disease prior to the treatment. There was no definite evidence of hepatotoxicity due to these bile acids, although transient elevation of transaminase activity of unknown clinical significance was observed in 36.7% of the patients during the course of treatment. Five patients (16.7%) experienced diarrhea during treatment, but it was transient as long as the dose remained at 300 mg daily. Our experience with UDCA revealed comparative efficacy to that of CDCA, and side effects were rare. Long-term low-dose therapy with CDCA or UDCA seems to be an effective and safe treatment for radiolucent gallstones.

Adult↗
PubMed1980

Endogenous bile acid tolerance test and its clinical significance--series of total bile acid levels in plasma before and after contraction of the gallbladder in patients with chronic liver diseases.

Series of total bile acid levels in blood plasma of definite time intervals before and after administration of three different stimulants, i.e. caerulein, egg yolk and fatty meal, were investigated in 10 normal subjects as a control group, in three patients in the florid stage of acute viral hepatitis, in 15 patients in the convalescent stage of acute viral hepatitis, in 10 patients with chronic persistent hepatitis, in 15 patients with chronic aggressive hepatitis, in 20 patients with cirrhosis of the liver and in 15 patients with fatty liver. This procedure can be regarded as an endogenous bile acid tolerance test and can be utilized as a differential diagnostic tool for chronic liver diseases.

Adult↗
PubMed1980

Pathogenetic significance of bile acid metabolism in the postcholecystectomy syndrome.

There is a long-pending question if the clinical concept of the "postcholecystectomy-syndrome" should be eliminated from the medical literature and medical praxis. To answer this question, the pathophysiological aspect of bile acid metabolism was investigated. Total bile acid level and basic bile acid concentration in blood serum and bile were estimated in the clinical course of 45 patients with cholelithiasis before and after cholecystectomy. In these patients, the endogenous bile acid tolerance test following intramuscular administration of 20 micrograms of caerulein was also performed. These patients were divided into two groups, i.e. patients with the postcholecystectomy syndrome and those without the syndrome. The postoperative clinical course was observed for at least one year. In both groups, the results of clinical examinations were compared. Based on the results of these investigations, it should be stressed that the derangement of bile acid metabolism contributes to the pathogenesis of the postcholecystomy syndrome, and that this clinical concept must be admitted in practice, although the pathophysiology of this disorder has not been clarified in detail.

Adult↗
PubMed1979

Clinical significance of estrogens in chronic aggressive hepatitis.

For a long time, it has been assumed that stagnation of active estrogens in the blood gives rise to liver injury and causes a severe inflammatory process in the liver as well as affecting the clinical course of chronic aggressive hepatitis in women. During reproductive years, estrogen production, as gaged by the values of urinary excretion, follows a cyclic pattern. As the menopause is approached, urinary excretion of estrogens gradually diminishes and the cyclic fluctuation becomes more shallow. The titer continues to fall progressively in the post-menopausal years although some estrogen may be found even in aged women. Even though it must be assumed that estrogens are rarely produced in bilaterally ovariectomized women, chronic aggressive hepatitis is rather frequently encountered in practice in women after ovariectomy. To find a solution to the question of whether stagnation of active estrogen in the blood actually gives rise to liver injury, estrogen levels in the blood must be estimated in these patients. It will be desirable to estimate not the metabolites of estrogens in the urine but the estrogens or estrogenic substances themselves in the blood. The authors have estimated estrogens in the blood by means of radioimmunoassay and revealed a decrease in quantity of the estrogen values in the blood. Therefore, it can be stressed that the lack of estrogens in the blood must be taken into consideration because it has been pointed out that estrogens exert some form of liver-protecting influence against infection as well as the protracting factors of hepatitis.

Adult↗
PubMed1978

Laparoscopic finding of the gallbladder in a case of intramural gallstones.

In this 42-year-old-man with suspected cholelithiasis the following finding of the serosal surface of the gallbladder was discovered by laparoscopic examination: Smooth serosal elevation, dark-greenish in color in a size of the small bean; No hypervascularity in the surrounding serosa. This finding was confirmed to be due to intramural gallstones. This is the first description of the laparoscopic finding of the intramural stones of the gallbladder, which may assist in establishing the clinical characteristics of the intramural gallstones.

Adult↗