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Biomedical subjects

K Iwase

Publications and source records attributed to K Iwase.

At least 91 records · Page 5Linked to original sources
PubMed1993

[The effectiveness of preservation of hepatic arterial blood flow by modified Appleby procedure with reconstruction of the hepatic artery--serial changes in postoperative liver function].

We investigated whether modified Appleby procedure with reconstruction of the hepatic artery can avoid complications due to a decrease in heptic arterial flow which has been comprehended in conventional Appleby's operation. The postoperative liver function of 17 patients undergoing modified Appleby's procedure was compared with that of 16 patients undergoing total gastrectomy and distal pancreato-splenectomy (control group). (1) Anticoagulant therapy was not required during and after operation. The common hepatic arterial flow after vascular anastomosis was 396 +/- 101 ml/min. Postoperative celiac arteriography revealed good patency of anastomosis. (2) There were no significant differences between the modified Appleby group and the control group in any of the blood levels of GOT, GPT total bilirubin and alkaline phosphatase at any point until the fourth postoperative week. In none of the patients in the modified Appleby group, the blood levels of GOT and GPT exceeded 250 IU/l. (3) In the modified Appleby group, ICG-R15 was 4 +/- 1% before operation and 6 +/- 3% at the first postoperative month. These results suggested that modified Appleby procedure enabled us to perform resection according to Appleby's operation safely, without need for preoperative or intraoperative examination about the retrograde blood flow mediated by the gastrodudenal artery.

Adult↗
PubMed1993

[Surgical stress induces the secretion of alpha human atrial natriuretic peptide].

The changes in plasma alpha-hANP level and the factors affecting its secretion were studied in 35 patients treated by surgery for gastrointestinal disease (laparotomy group, 17) and (non-laparotomy group, 18). They did not have any particular complication during the study period. alpha-hANP, catecholamine (CA), antidiuretic hormone (ADH), aldosterone and plasma renin activity (PRA) were determined serially before and after the surgery. Plasma alpha-hANP level elevated on the post-operative day 1 and dropped to the upper limit of the normal range by the day 3, then gradually recovered to the level of before surgery. This early elevation of alpha-hANP was more marked in the laparotomy group than in the non-laparotomy group. These change in alpha-hANP level correlated well to those of CA, but not to those of ADH, aldosterone, and PRA. Age, sex, duration of surgery, bleeding and infusion volume during surgery did not affect the difference in alpha-hANP secretion between the two groups. In conclusion, the early elevation of plasma alpha-hANP level was correlated well to the surgical stress, and that this alpha-hANP secretion might be induced by CA secretion.

Adult↗
PubMed1993

[Report of a case of angiodysplasia of the sigmoid colon associated with aortic stenosis].

Partial sigmoidectomy and then after 84 days aortic valve replacement were performed as a staged operation on a patient with Heyde syndrome, consisting of aortic stenosis and angiodysplasia of the sigmoid colon. An emergent sigmoidectomy was performed because of continuous bleeding from angiodysplasia of the sigmoid colon. Postoperative arteriography showed the persistence of angiodysplasia. Endoscopic examination of the residual angiodysplasia was performed before and after valve replacement and there was no morphological change.

Aged↗
PubMed1993

[Treatment of advanced gastric and colorectal cancer with 5-FU, leucovorin and interferon-alpha].

Twenty-four patients with advanced or relapsed gastric or colorectal cancer were treated with a combination of 5-fluorouracil (5-FU), leucovorin (LV) and interferon-alpha (IFN-alpha). 5-FU was administered by rapid intravenous infusion at 350 mg/m2 for 5 consecutive days. Intravenous bolus administration of LV 20 mg/m2 was given before each 5-FU administration. This combination was repeated every 3 to 4 weeks. IFN-alpha (HLBI), 6MU, was administered subcutaneously daily. Of 13 patients with gastric cancer, there were 2 PR, 4 NC and 7 PD, and among 11 patients with colorectal cancer, there were 1 CR, 8 NC and 2 PD. All 16 previously treated patients had no clinical response. Responses were seen in patients with no prior chemotherapy and with good performance status. Most common toxicities observed were leucopenia, fever, stomatitis and diarrhea, which were all tolerable and reversible.

Adult↗
PubMed1993

[Experience with radical operation for lower thoracic esophageal cancer through left diagonal thoraco-laparotomy and right posterolateral thoracotomy].

Two cases were reported in which subtotal thoracic esophagectomy, total gastrectomy, splenectomy and distal pancreatectomy was performed for the lower thoracic esophageal cancer through right diagonal thoraco-laparotomy and left posterolateral thoracotomy. Reconstruction was done with the intrathoracic esophagojejunostomy. Extubation could be done on the 1st postoperative day, and postoperative course was uneventful. It was thought that the approach with left diagonal thoraco-laparotomy and right posterolateral thoracotomy was useful for the easy and complete lymph node dissection from the middle mediastinum to the intra-abdominal cavity.

Carcinoma, Squamous Cell↗
PubMed1992

Determination of tumor marker levels in cystic fluid of benign liver cysts.

The levels of tumor markers in cystic fluid and serum were measured in six patients with benign biliary cyst of the liver. AFP in the cystic fluid was lower than the upper normal limit for serum in all cases, and CEA in the cystic fluid was higher than the upper normal limit for serum in one of the six cases. CA19-9, DU-PAN 2, and SPAN 1 in cystic fluid were much higher than the upper normal limit for serum in all cases (more than 100-fold for CA19-9, twofold for DU-PAN 2, and ninefold for SPAN 1). CA19-9, DU-PAN 2, and SPAN 1 in cystic fluid were significantly higher than the levels in the corresponding serum. Positive immunohistochemical staining against CA19-9, DU-PAN 2, and SPAN 1 was observed in the cytoplasm of the epithelial cells of the cyst wall. These results suggested that the high concentrations of CA19-9, DU-PAN 2, and SPAN 1 in the cystic fluid were due to secretion from the epithelial cells in the benign biliary cysts.

Aged↗
PubMed1992

A case of pancreatic cyst containing gall sludge.

A case of acquired retention cyst of the pancreas containing gall sludge was reported. Gallstones or gall sludge recognized in pancreatic cysts has not been reported. Histological examination suggested that the gall sludge in the pancreatic cyst was caused by the reflux of bile into the pancreatic duct through the papilla of Vater. However, endoscopic retrograde cholangiopancreatography showed no anomalous junction of the pancreatico-biliary ductal system. Crystallization of the components of bile can occur in the pancreas even in a case without anomalous junction of the pancreatico-biliary ductal system.

Bile Reflux↗
PubMed1992

Cushing's syndrome induced by hypersecretion of cortisol from only one of bilateral adrenocortical tumors.

A case of Cushing's syndrome induced by the unilateral (right side) dominance of cortisol secretion in the face of bilateral adrenal tumors is reported. The adrenal tumor resected on the right side was a so-called black adenoma and histologically without any findings of nodular hyperplasia. After resection of the adrenal adenoma, no findings of cortisol hypersecretion from the remaining adrenal tumor on the left side were observed until the present, suggesting that the tumor of the left adrenal gland is a nonfunctioning adenoma. These data imply that the adrenal adenomas have primarily developed from the adrenal gland itself, rather than from micronodular hyperplasia by corticotropin stimulation, and that one of these tumors produces excess hormones initially by corticotropin stimulation, but the other remains in cell proliferation.

Adenoma↗
PubMed1992

Hemodynamic changes during laparoscopic cholecystectomy in patients with heart disease.

Changes in the hemodynamics and urine output were investigated in 19 patients undergoing laparoscopic cholecystectomy, five of whom had heart disease with the New York Heart Association classification I (n = 1) and II (n = 4). Systemic blood pressure, central venous pressure, pulmonary capillary wedge pressure and cardiac output did not significantly change during the procedure including the establishment of pneumoperitoneum. Urine output 30-60 min after starting the pneumoperitoneum was significantly lower in the patients with heart disease compared to the values before and in the initial phase (0-30 min), and also to the values before and during the procedure in the control group. One patient suffered temporary cardiac decompensation following laparoscopic cholecystectomy which prolonged his hospital stay to seven days. The remaining four patients with heart disease could be discharged on the third or fourth day postoperatively. It is concluded that laparoscopic cholecystectomy is feasible in patients with heart disease but attention should be paid to the possibility of oliguria during prolonged pneumoperitoneum.

Aged↗
PubMed1992

[A five-year-survival case in which complete response was recognized after combined chemotherapy using 5-fluorouracil, adriamycin and mitomycin C (FAM) for unresectable gastric cancer].

FAM (5-fluorouracil, adriamycin, mitomycin C) therapy was performed on a 65-year-old man with unresectable gastric cancer. Cancer cells have not been recognized by endoscopic biopsy after the patient's complete response. He is alive without metastasis of recurrence for five years.

Adenocarcinoma, Papillary↗
PubMed1992

[Clinical experience of reoperation for anastomotic stricture following proximal gastrectomy for esophageal varices].

A few cases were reported in which second reconstructive operation on gastrointestinal tract for reflux esophagitis following the proximal gastrectomy was performed. But no previous report of the removal of anastomotic region for treating anastomotic stricture due to reflux esophagitis has appeared. Also, there are no reports on second operations to treat anastomotic strictures following proximal gastrectomy for esophageal varices. We report a case in which we obtained favorable results in treating an anastomotic stricture due to reflux esophagitis, which developed following a proximal gastrectomy for esophageal varices, by performing removal of the anastomotic region and resection of the remaining stomach with reconstruction by the Roux-en Y method.

Aged↗
PubMed1992

[Traumatic rupture of the diaphragm--a case of lung herniation into the abdominal cavity].

A first case of lung herniation into abdominal cavity with traumatic diaphragmatic rupture is described. A 41-year-old Japanese man with chronic obstructive pulmonary disease suffered traumatic diaphragmatic rupture. He needed to get continuous mandatory ventilation for a long time. At the time of operation, left lung herniation into the abdominal cavity was observed. When those who have chronic obstructive pulmonary disease suffered thoraco-abdominal injury, we should take care that pulmonary herniation might exist.

Abdomen↗
PubMed1990

A new method for induction of experimental autoimmune uveoretinitis (EAU) in mice.

Experimental autoimmune uveoretinitis (EAU) was induced in two strains of mice by repeated-immunization protocol. SMA mice (H-2 nondefined) and C57BL/6 mice (H-2b) were immunized with S-antigen mixed with Klebsiella 03 lipopolysaccharide (K03 LPS) repeatedly at intervals of 1 to 4 weeks. Following the tertiary immunization, the mice exhibited histopathological changes of EAU as well as significant immune responses to the antigen. The antigen doses required for successful EAU induction were 4 micrograms or more at each immunization time. The histopathology of EAU was characterized by mild infiltration of mononuclear cells in the retina and the choroid, particularly, at the retinal blood vessels and the photoreceptor cell layer. The anterior segment of the eye was not affected by inflammation, and therefore clinical signs of EAU were not detected even under an operating microscope. Since the mouse is a genetically and immunologically well-defined species, this model is useful for study of immunopathogenic mechanisms of EAU.

Adjuvants, Immunologic↗