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Biomedical subjects

K Tsukada

Publications and source records attributed to K Tsukada.

At least 109 records · Page 6Linked to original sources
PubMed1997

Patterns of lymphatic spread of carcinoma of the ampulla of Vater.

BACKGROUND: The pattern of lymphatic spread of ampullary cancer is poorly documented. This pattern was clarified in order to define the rational extent of radical lymphadenectomy. METHOD: Thirty-nine consecutive patients who underwent pancreaticoduodenectomy with radical lymphadenectomy were included in the study. A total of 1447 lymph nodes dissected from the resected specimens was examined to detect the presence of metastatic foci. RESULTS: Twenty-one of the 39 patients had a total of 97 positive nodes. The sites of nodal involvement were the posterior pancreaticoduodenal (20 of 21 patients), inferior pancreaticoduodenal artery (IPDA; 12 of 21), anterior pancreaticoduodenal (three of 21), trunk of the superior mesenteric artery (three of 20), pericholedochal (three of 21), retroportal (two of 21), and para-aortic (three of five) regions. No metastases were found in the hepatic artery, cystic duct, perigastric, right coeliac, middle colic artery or right caval node groups. CONCLUSION: Ampullary cancer mainly spreads to the posterior pancreaticoduodenal node group, then to the IPDA node group, and finally to the para-aortic area. The rational extent of radical lymphadenectomy should include the pancreaticoduodenal, superior mesenteric, pericholedochal, retroportal and para-aortic nodes.

Ampulla of Vater↗
PubMed1997

Differential expression of S-adenosylmethionine synthetase isozymes in different cell types of rat liver.

Mammalian S-adenosylmethionine (AdoMet) synthetase exists as two isozymes, liver-type and nonhepatic-type enzymes, which are the products of two different genes. It is known that the liver-type isozyme is only expressed in adult liver. Whereas, the nonhepatic-type isozyme is widely distributed in various tissues. In addition to the liver-type isozyme, a minor amount of the nonhepatic-type isozyme is also detected in adult liver. To investigate the distribution of these two isozymes in the liver in detail, the localization of these two isozymes was examined in each cell type of liver using a combination of cell fractionation technique and Western blot analysis. In the parenchymal cells, the liver-type isozyme protein was predominantly expressed, and a small amount of the nonhepatic-type isozyme protein was also detected. On the other hand, in the stellate cells the nonhepatic-type isozyme protein was exclusively or only expressed. Interestingly, a large amount of both isozymes were present in endothelial and Kupffer cell fraction. Using both antibodies to anti-rat nonhepatic-type and liver-type isozymes, respectively, immunohistochemical analysis clearly confirmed these results. In addition, in cultured hepatocellular carcinoma cells (FAA-HTC1), the nonhepatic-type isozyme protein only was detected, and the liver-type isozyme protein completely disappeared. This result indicates that the changes in the isozyme expression is regulated within the parenchymal cells. Administration of hepatotoxic drug carbon tetrachloride (CCl4) to rats resulted in about 40% to 50% reduction of enzyme activity in parenchymal cells and stellate cells compared with those of control rats. However, enzyme activity in endothelial and Kupffer cell fraction was not changed.

Animals↗
PubMed1997

Right hepatectomy for pyogenic liver abscesses with true multiloculation.

We report the case of 61-year-old woman with cryptogenic liver abscesses who had been profoundly ill with severe upper abdominal pain, impaired consciousness, prostration, continuous high fever secondary to sepsis, and thrombocytopenia (platelets, 1-5 x 10(4)/mm3) since admission. Ultrasonograms and computed tomograms revealed two separate multiloculated lesions in the right lobe of the liver, consistent with the liver abscesses. Immediately after diagnosis, percutaneous abscess drainage was performed under ultrasonographic guidance; however, only a small amount of pus was drained, prompting continuous irrigation of the abscess cavity. Four days later, transcatheter hepatic arterial infusion of antibiotics was attempted. However, the abscesses had enlarged and her general condition had worsened. On hospital day 8, she underwent right hepatectomy because the multiloculated lesions were refractory to drainage. The operation was successful in terms of hepatectomy, although she continued to suffer from sepsis, secondary right subphrenic abscess formation, and prolonged thrombocytopenia with associated coagulation disorders for two months. Examination of multiple cross sections of the resected specimen disclosed that the lesions consisted of aggregations of multiple small locules. There was no communication between the locules and there were true septations, rather than multiloculated lesions with pseudoseptations. The patient has been well for 2 years without recurrent abscess of the liver or any infectious disease.

Drainage↗
PubMed1997

Omental delivery of prostaglandin E1 effectively increases portal venous blood flow in 66%-hepatectomized rats.

Changes in portal venous blood flow (PVF) and systemic arterial blood pressure (SAP) were examined following prostaglandin E1 (PGE) application to the greater omentum and femoral vein in 66%-hepatectomized rats. PVF increased when PGE was administered to the omentum and femoral vein at 7.5 micrograms/kg per min for 2 min. The magnitude of PVF response due to both administrations was dose-dependent, but the duration of the PVF response in the omental application was longer than that in the femoral administration. SAP was unchanged after omental application, while femoral administration reduced SAP concomitant with an increase in PVF. These results suggest that, in this hepatectomized model, the omentum is a better site for PGE administration than the vein, and that omental PGE delivery is also effective for enhancing PVF without inducing any changes in SAP.

Alprostadil↗
PubMed1997

Acute portal hypertension reflecting shear stress as a trigger of liver regeneration following partial hepatectomy.

The concept of injury in liver regeneration after partial hepatectomy (PHx), and the reason hepatocytes that have not been directly injured regenerate, remain unclear. It is known that shear stress resulting from blood flow plays an important role in the mechanism of remodeling blood vessels, and portal pressure reflects shear stress. This study was conducted to determine whether acute portal hypertension (APH) can become a trigger of liver regeneration as shear stress following PHx in a rat model. Portal pressures became elevated immediately after 70% and 90% PHx, peaking on postoperative day (POD) 3, and thereafter decreasing in proportion to the diminution of liver regeneration. The portal pressures after 90% PHx were significantly higher than those after 70% PHx even on POD 7, while those of the portocaval (PC) shunt groups decreased following PC shunting both with and without 70% PHx. The liver/body weight (LW/BW) ratio also decreased in the PC shunt both with and even without 70% PHx. The gradient expressions of class I antigen on sinusoidal endothelial cells (SEC) were found only in the periportal area, which has the highest portal pressure in the healthy rat liver. However, after hepatectomy these expressions were detected from the periportal area to the central venous area. These results suggest that APH as shear stress following PHx may not only become a trigger of hepatocyte regeneration, but also of SEC regeneration, and that surplus APH induces liver dysfunction.

Animals↗
PubMed1997

Lymph node recurrence of gallbladder carcinoma successfully managed by systemic chemotherapy with 5-fluorouracil and mitomycin C: report of a 5-year survivor.

Although gallbladder cancer (GBC) is believed to be chemoresistant, the effectiveness of chemotherapy against lymph node metastasis has been reported. We report a 70-year-old woman with advanced GBC in whom isolated, widespread lymph nodal recurrence after a radical resection responded completely to systemic chemotherapy with mitomycin C and 5-fluorouracil. This patient remains symptom-free with no evidence of disease at 6 years after surgery (5 years after the initiation of chemotherapy). Both our case and a literature review suggest that nodal disease appears more chemosensitive than the primary lesion in GBC. Chemotherapy may provide long-term palliation for selected patients with isolated nodal recurrence.

Aged↗
PubMed1997

Serial changes in contribution of substrates to energy expenditure after transthoracic esophagectomy for cancer.

This study was designed to examine the metabolic response of patients following transthoracic esophagectomy for carcinoma of the esophagus during the administration of total parenteral nutrition. Thirty-five patients underwent a right thoracotomy and transthoracic esophagectomy with nodal dissection in the neck, mediastinum, and abdomen. The resting energy expenditure (REE) was measured preoperatively, and on the 1st, 3rd, 5th, and 7th postoperative days (PODs) using indirect calorimetry. The REE was significantly higher following transthoracic esophagectomy on PODs 1, 3, 5, and 7 than preoperatively. The caloric contribution of fat was significantly less on 3rd, 5th, and 7th PODs than on the 1st POD. In contrast, carbohydrate oxidation increased significantly on the 3rd, 5th, and 7th PODs compared to that of the 1st POD. These results may help optimize the nutritional support regimen for post-esophagectomy patients.

Adult↗
PubMed1997

Correlation between salpingoscopic score and subsequent pregnancy outcome in patients with tubal infertility.

PURPOSE: This study evaluated the efficacy of the salpingoscopic scoring system of tubal function. METHODS: Twenty-seven infertile patients, including 10 patients with proximal tubal occlusion, 12 with endometriosis and 5 with inflammatory hydrosalpinx, were studied. All 54 tubes were examined using a 0.5-mm-diameter salpingoscope and scored. RESULTS: The mean scores for patients with proximal tubal occlusion, endometriosis, and inflammation were 18.6 +/- 2.0, 15.6 +/- 0.7, and 20.8 +/- 3.4, respectively. Eight patients (29.6%) conceived; their mean tubal score was 12.6 +/- 0.5 (12-16). Nineteen patients did not conceive, and their mean score was 18.8 +/- 1.4 (12-31). There was a significant difference between these two scores (P < 0.001). CONCLUSIONS: Scoring of the tubes by salpingoscopic examination is useful for evaluating tubal function with regard to prediction of pregnancy and also for selecting IVF or tubal reconstructive surgery as the preliminary treatment.

Endoscopy↗
PubMed1997

Effects of alcohol intake on organ injuries in normotensive and hypertensive human subjects.

1. This cross-sectional study examined the influence of alcohol intake on organ injuries in normotensive and hypertensive subjects. 2. A total of 514 normotensive subjects and 302 never-treated hypertensive subjects were screened from 4557 men who entered the health check programme of our institute during the period 1990 to 1994. According to the daily alcohol consumption data reported by a self-administered questionnaire, the normotensive and hypertensive subjects were both classified into four categories; very light and non- (0-10 ml of ethanol), light (11-29 ml), moderate (30-58 ml) and heavy (> or = 59 ml) drinker groups. In these four pairs of groups, organ injuries in the heart, kidney and optic fundus were evaluated and serum lipids were measured. 3. Although the blood pressure levels were similar among the four groups of hypertensive subjects, the electrocardiographic findings of left ventricular hypertrophy were significantly more common among the moderate and heavy drinkers but not in the light drinkers compared with the very light and non-drinkers (very light and non-drinkers 25%, light drinkers 23%, moderate drinkers 38%, heavy drinkers 40%; P = 0.026). The alcohol intake increased the serum level of high-density lipoprotein cholesterol in a dose-dependent manner without changing the total cholesterol level; however, the serum gamma-glutamyl transpeptidase and triacylglycerol levels were increased in the moderate and heavy drinkers. Urinary albumin excretion and fundoscopic lesions were not associated with the drinking habit in either the normotensive or hypertensive subjects. 4. These data suggest that habitual alcohol consumption exceeding 29 ml per day facilitates the development of left ventricular hypertrophy in hypertensive patients. Among the hypertensive subjects, light drinkers consuming 11 to 29 ml of ethanol daily showed preferable profiles in terms of organ injuries and risks of cardiovascular diseases.

Alcohol Drinking↗
PubMed1997

Molecular cloning of rat p38 mitogen-activated protein kinase and it's osmotic regulation in rat kidney.

Rat p38 mitogen-activated protein (MAP) kinase cDNA was isolated from rat kidney cDNA library using a PCR cloning strategy. The deduced amino acid sequence consists of 360 amino acids and shares 95.3% similarity with human p38 MAP kinase. The message for rat p38 MAP kinase was about 3.4 kilobases and was highly expressed in the kidney. In water-deprived rat kidneys, the steady-state levels of p38 MAP kinase mRNA increased about 2.7-fold as compared with those of control rats. This result suggests that p38 MAP kinase may play an important role in the osmoregulation in the kidney.

Amino Acid Sequence↗
PubMed1997

Hemorrhagic shock induces G-CSF expression in bronchial epithelium.

Hemorrhagic shock (HS) initiates a series of inflammatory processes that includes the activation of polymorphonuclear granulocytic neutrophils (PMN). We tested the hypothesis that HS induces granulocyte colony-stimulating factor (G-CSF), a cytokine that augments PMN effector functions, in the lungs of rats. Sprague-Dawley rats were subjected to compensated or decompensated HS followed by resuscitation and death at 4 or 8 h. Animals subjected to HS demonstrated acute lung injury with PMN infiltration, edema, and hypoxia. Using semiquantitative reverse transcriptase-polymerase chain reaction, we detected a 1.9- to 7.1-fold increase in G-CSF mRNA levels in the lung of animals subjected to HS compared with sham controls. Levels of G-CSF mRNA increased with increased duration of the ischemic phase of resuscitated shock. In situ hybridization revealed that bronchoepithelial cells were the major cellular site of G-CSF mRNA. Thus production of G-CSF mRNA by bronchoepithelial cells is dramatically increased in a rat model of HS that also demonstrated lung injury. Increased local G-CSF levels may contribute to PMN recruitment and activation and resultant lung injury in HS.

Amino Acid Sequence↗
PubMed1997

Nuclear translocation of the catalytic component of DNA-dependent protein kinase upon growth stimulation in normal human T lymphocytes.

DNA-dependent protein kinase (DNA-PK), consisting of the 470-kDa catalytic component (DNA-PKcs) and the DNA-binding regulatory component Ku protein (p70/p80), catalyzes phosphorylation of a variety of DNA replication/transcription/repair factors in the presence of double-stranded DNA. In the resting states of human peripheral blood mononuclear cells, DNA-PK activity and the protein level of DNA-PKcs were very low in the nuclear extracts, but they were high in the whole cell extracts. Depending upon proliferation of the T lymphocytes, DNA-PK activity and the protein level of DNA-PKcs in the nuclear extracts greatly increased. Immunocytochemical analysis suggested translocation of DNA-PKcs from the cytoplasm to the nucleus upon growth stimulation in the T lymphocytes.

Amino Acid Sequence↗
PubMed1997

Angiotensin-converting enzyme gene polymorphism and cardiovascular endocrine system in coronary angiography patients.

There is continuing interest in the link between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and cardiovascular diseases. Studies on various ethnic populations have shown conflicting evidence as to the association of the DD genotype with an increased risk of myocardial infarction. We examined the relationship between various cardiovascular hormones and ACE gene polymorphism in 149 subjects who underwent cardiac catheterization and had normal cardiac function. The distribution of the II, ID, and DD genotypes was 68, 67, and 14, respectively. Although serum ACE activity was higher in DD and ID than in II (II 9.7+/-0.5 IU/l, ID 12.2+/-0.5, DD 12.8+/-1.2; p < 0.005), other factors of the renin-angiotensin system such as plasma renin activity and plasma concentrations of angiotensin II and aldosterone were not different among the three genotypes. Plasma catecholamines did not differ among the ACE genotypes either, however, plasma atrial natriuretic peptide (ANP) was significantly lower in the subjects carrying the D allele (II 38+/-5 pg/ml, ID 26+/-2, DD 21+/-3; p < 0.05). In particular, the DD genotype showed a low plasma ANP level although the left ventricular mass index was greater than the other genotypes (II 133+/-5 g/m2, ID 137+/-6, DD 165+/-7; p < 0.05). The low plasma ANP in the DD genotype may contribute to the increased risk of cardiovascular diseases.

Atrial Natriuretic Factor↗
PubMed1997

Groove pancreatitis with recurrent duodenal obstruction. Report of a case successfully treated with pylorus-preserving pancreaticoduodenectomy.

Groove pancreatitis is a rare subtype of chronic pancreatitis that is difficult to distinguish from pancreatic carcinoma. Most reported patients have undergone a Whipple procedure because pancreatic cancer was not ruled out. We report a case of groove pancreatitis in a patient who presented with recurrent duodenal obstruction without biliary stricture. The diagnosis of groove pancreatitis was based on characteristic episodes of repeated duodenal obstruction and the absence of radiographic evidence of cancer. Subsequently, our patient underwent a successful pylorus-preserving pancreaticoduodenectomy (PPPD). PPPD is a favorable alternative to the Whipple operation for duodenal obstruction resulting from this disease.

Adult↗
PubMed1997

Preventive effect of 1-(2-tetrahydrofuryl)-5-fluorouracil in combination with uracil on colonic carcinogenesis induced by 1,2-dimethylhydrazine in rats.

Thymidylate synthetase (TS) and thymidine kinase (TK) are key enzymes in de novo and salvage pathways for pyrimidine nucleotide synthesis, respectively. A high incidence of colorectal adenocarcinomas with varied grades of cell differentiation can be induced by 1,2-dimethylhydrazine (DMH) in rats. The marked increases of TS and TK activities were found in the poorly and well-differentiated adenocarcinomas of the colon, respectively. Oral administration of 1-(2-tetrahydrofuryl)-5-fluorouracil in combination with uracil (UFT) markedly reduced the number and accumulated area of colonic carcinomas, and TS activity in the poorly differentiated adenocarcinomas. A potential balance between the de novo and the salvage pathways for pyrimidine nucleotide synthesis was suggested to be related with the histopathological grades of cell differentiation. Suppression of colonic TS activity by UFT administration reduced the colonic carcinogenesis and the potency of the poorly differentiated adenocarcinomas of the colon.

1,2-Dimethylhydrazine↗
PubMed1997

[New aspects in the liver regeneration following partial hepatectomy].

We demonstrated the new two concepts for the liver regeneration after partial hepatectomy (PHx). The first is immunological findings in the regenerating liver. Th1 type T cells, which produce IFN gamma, and extrathymic T cells may play an important role in immunological control system of liver regeneration after PHx on the basis of the cellular immunity restricted by MHC class I and II molecules. The second is the mechanism of "on and off" on liver regeneration after PHx. Portal pressure, which reflecting wall shear stress of sinusoid, may trigger the liver regeneration and control the liver volume after PHx. There are two type of intrahepatic leukocytes; one type would tend to stay associated with SEC, while the other would not. Therefore shear stress may have a great influence on the leukocytes-sinusoidal endothelial cells (SEC) adhesion immediately after partial hepatectomy.

Animals↗