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Biomedical subjects

M Imamura

Publications and source records attributed to M Imamura.

At least 703 records · Page 39Linked to original sources

Gastric acid secretion and gut hormone release in patients undergoing pancreaticoduodenectomy.

The changes in gastric acid secretion and gut hormone release were investigated in 11 patients who underwent pancreaticoduodenectomy. The amount of acid output showed normoacidity before surgery and hypoacidity after surgery. No peptic ulcers were detectable after surgery. Plasma gastrin levels were markedly reduced after surgery both in the fasting state and after a test meal loading. Although fasting plasma levels of both gastric inhibitory polypeptide (GIP) and insulin after surgery were close to those before surgery, the response of these hormones to the meal was significantly reduced after surgery. On the other hand, blood glucose concentrations increased gradually after feeding, and the elevation was greatly prolonged after surgery compared with preoperative levels. From these results, it is concluded that peptic ulcer will not occur if subtotal gastrectomy is performed during Whipple's procedure. It is presumed that the diminished release of gut hormones such as gastrin, GIP, and insulin was due to the massive resection of the distal stomach, the upper small intestine, and the head of the pancreas and to the diversion of the stream of food from the duodenum to the jejunum. It is also assumed that the glucose-dependent insulinotropic action of GIP would be impaired by the procedure.

Adult↗

[Selective arterial secretin injection test for localization of gastrinoma].

We have already shown that gastrinomas release gastrin when stimulated with secretin in vitro. In order to ascertain whether this is true in vivo and whether the reaction is clinically useful in the localization of gastrinomas, secretin was injected into a feeding artery of the gastrinoma in four patients, and blood samples were taken from a peripheral artery (PA) and the hepatic vein (HV) for determination of immunoreactive gastrin (IRG) and immunoreactive insulin (IRI) levels. When secretin was injected into a feeding artery of the gastrinoma, IRG rose within 40 seconds in the HV and within 60 seconds in the PA. When secretin was injected into a nonfeeder, IRG did not rise for 2 min in the PA. This test was performed to two of the postgastrectomized patients and a patient with hypergastrinemia due to atrophic gastritis. In these patients, IRG in the hepatic vein did not rise for two minutes. It was concluded that secretin directly stimulates gastrinomas to release gastrin in vivo and that the selective arterial secretin injection test is helpful in determining the location of the gastrinoma.

Adult↗

[Maffucci's syndrome with intracranial manifestation and chromosome abnormalities--a case report].

The patient was a 52-year-old woman who was initially admitted to our hospital with a recent history of diplopia, ptosis and visual impairment on the right, adding to 6 years history of the right orbital pain and temporal headache. She had gradually developed pain and fatigue of the right knee since childhood and had been suffered from multiple subcutaneous tumor in the both hands and the right foot from youth onward. On neurological examination, she has had right exphthalmos and 3rd and 6th cranial nerve palsies on the right. Skull X-ray and CT scan showed parasellar calcified mass on the right. In chromosome examination, the inversion of the No. 1 chromosome was disclosed by the Q- and C-band dyeing of her leucocytes and skin culture. Cavernous hemangioma of her skin lesion and enchondroma of the skeletal lesion were diagnosed by X-ray examination and histological specimen, indicating so-called Maffucci's syndrome. One year and a half later, she was readmitted to our institution, because of progressive visual loss on the right and left hemiparesis. Malignant change of the parasellar lesion was suspected by the clinical course and neuroradiological findings and was confirmed histologically by the second peration. During postoperative course, intratumoral hemorrhage had occurred twice and the patient died, and postmortem examination confirmed her clinical affair. This is the case which was clarified malignant transformation of enchondroma in the parasellar region, and is the first case verified the chromosome abnormalities in Maffucci's syndrome.

Brain Neoplasms↗

Portal arteriovenous fistula following partial gastrectomy.

An emergency transthoracic transection of the esophagus was performed on a 62 year old man for hematemesis caused by rupture of esophageal varices. Hepatic functional reserve of this patient was classified as Child C. Postoperative celiac arteriography revealed an arteriovenous fistula between a branch of the gastroduodenal artery and a branch of the superior mesenteric vein. He had undergone a partial gastrectomy with Billroth II reconstruction 15 years earlier. Bleeding from the esophageal varices did not recur, but he subsequently died of liver failure. In some areas of the liver the microscopic changes were similar to those occurring in cirrhosis, but in most areas they resembled those seen in congestive liver fibrosis. This case suggested that portal arteriovenous fistula is an important predisposing cause leading to deterioration of liver function.

Arteries↗

Regulation of ADP-Glucose Pyrophosphorylase from Chlorella vulgaris.

ADP-glucose pyrophosphorylase was partially purified from Chlorella vulgaris 11h. 3-Phosphoglycerate activated the enzyme by lowering the Michaelis constant for glucose-1-phosphate (from 0.97 to 0.36 millimolar in the presence of 2 millimolar phosphoglycerate) and ATP (from 0.23 to 0.10 millimolar), as well as increasing the V(max). Saturation curves for 3-phosphoglycerate were hyperbolic and the activator concentration at half V(max) value for 3-phosphoglycerate was 0.41 millimolar either in the presence or absence of phosphate. Phosphate inhibited the enzyme in a competitive manner with respect to glucose-1-phosphate, but did not affect the Michaelis constant value for ATP. 3-Phosphoglycerate changed neither the inhibitor concentration at half V(max) value of 1.0 millimolar for phosphate nor the hyperbolic inhibition kinetics for phosphate. The enzyme required divalent cations for its activity. The activation curves for Mn(2+) and Mg(2+) were highly sigmoidal. The activator concentration at half V(max) values for Mn(2+) and Mg(2+) were 2.8 and 3.7 millimolar, respectively. With optimal cations, the Michaelis constant values for ATP-Mn and ATP-Mg were 0.1 and 0.4 millimolar, respectively.

Journal Article↗

Role of vagus nerve in secretion of gastric inhibitory polypeptide in dogs.

In order to clarify the role of the vagus nerve in the secretion of gastric inhibitory polypeptide (GIP), experiments were performed on dogs. Response of plasma GIP to intraduodenal instillation of glucose was slightly lower in a group which received atropine, than in a group of normal dogs. The response of plasma GIP to intraduodenal glucose load was not different between vagotomized dogs and normal dogs. Electric stimulation of the vagus nerve did not produce any significant changes in plasma GIP in anesthetized dogs. In conclusion, the present study indicates that the role of the vagus nerve on GIP secretion is tiny, if any, and that the nervous influence does not overcome the effect of intraluminal administration of glucose.

Animals↗

Effects of intragastric ethanol administration on gastric acid secretion and gastrointestinal hormone release in dogs.

Dogs with a vagally denervated (Heidenhain) pouch and a gastric fistula were used to investigate the humoral mechanism which would affect the gastric acid secretion following acute intragastric ethanol administration. Ethanol solutions induced a dose-related secretion of gastric acid. Although plasma gastrin levels increased after the loading of both 20% and 30% ethanol solutions, there was a discrepancy between total acid output and the integrated gastrin response. Plasma secretin levels also augmented after the administration of ethanol solutions, with a delay of about one hour after the onset of acid secretion. The response of gastric inhibitory polypeptide (GIP) to ethanol was very slight, similar to that of insulin. There was a significant rise in plasma glucose levels after the instillation of 30% ethanol solution as in the case of liquid meal. It is concluded that gastrin may be merely one of the factors which stimulate acid secretion after ethanol administration, and that gastric acid would have a close relationship with secretin release. It is also probable that acid is not an effective stimulant to the release of GIP.

Animals↗

[A case of triple neoplasm with acute myelogenous leukemia, squamous cell carcinoma of the lung and adenocarcinoma of the stomach].

A 70-year-old man had undergone middle and lower lobectomy of the right lung for pulmonary squamous cell carcinoma in January 1979. He was treated with anticancer drugs including alkylating agents. In February 1983, he was diagnosed as AML (FAB, M2). Although cytoreduction effect was observed, he died of prolonged pneumonia on the 30th admission day. Autopsy revealed a well-differentiated tubular adenocarcinoma of the stomach (Borrman II type) and a poorly differentiated epidermoid carcinoma of the right hilar lymph node.

Adenocarcinoma, Mucinous↗

[Phase II study with methyl 6-[3-(2-chloroethyl)-3-nitrosoureido]-6-deoxy-alpha-D-glucopyranoside (MCNU) in hematological malignancies].

Forty-two cases of hematological malignancy (18 cases of CML, three cases of polycythemia vera, 10 cases of malignant lymphoma and 11 cases of multiple myeloma) were treated with MCNU. The results obtained were as follows. MCNU was markedly effective on CML cases, being especially useful during the chronic phase, and a partial remission was observed in one of three patients with CML blastic crisis. A good response was observed in all cases with polycythemia vera. In some cases of malignant lymphoma, a fair response was observed. No response was observed in any of the cases of multiple myeloma. Myelosuppression was a major side effect of MCNU, but other side effects other than melena were not severe.

Adult↗

Gastric acid secretion and gastrin and gastric inhibitory polypeptide release in cirrhotic patients.

Gastric acid secretion, incidence of gastric mucosal lesion, and gut hormone responses were studied in 24 patients with liver cirrhosis. Gastric acid output in these subjects showed normal acidity and was nearly similar to that in patients with gastric ulcer. The incidence of gastric mucosal lesion was high, especially in patients whose plasma disappearance rate of indocyanine green was low. Plasma levels of both gastrin and gastric inhibitory polypeptide were higher in cirrhotic patients than in control subjects both in the fasting state and after the ingestion of a test meal. Gel chromatography of the postprandial plasma of cirrhotics showed a higher immunoreactivity at the second peak than in controls. This is because cirrhotics have a higher percentage of authentic gastric inhibitory polypeptide, although the elution patterns were similar in both groups. It is suggested that impairment of extraction of some molecular components of both gastrin and gastric inhibitory polypeptide may occur in the cirrhotic liver.

Adult↗

Immunohistologic detection of lymphocyte subpopulations infiltrating in human oral cancer with special reference to its clinical significance.

Cancer tissues from 30 patients with squamous cell carcinoma of the oral cavity were examined immunohistopathologically as to the responsiveness of the host against its own cancer cells in both biopsy and surgically resected specimens from the same patients. Subpopulations of the infiltrating lymphocytes in cancer tissues were identified on paraffin-embedded serial sections by a modified indirect immunoperoxidase technique (PAB method) in which it was combined with peroxidase-antiperoxidase (PAP) complex and avidin-biotin system with rabbit anti-human B-cell, peripheral T-cell sera. Macrophages were also identified by nonspecific acid esterase staining. T-cells were predominant over B-cells in 26 of 30 tissues in biopsy specimens and 23 of 30 in surgically resected specimens with bleomycin treatment. T-cell infiltration in the peripheral region of the tumor was more prominent than that in the stroma among the cancer nests. T-cells surrounded the cancer nests, occasionally accumulated around the cancer cells, infiltrated at the marginal part of the cancer nests, and frequently produced perivascular massive accumulations. B-cells and macrophages, on the other hand, were almost absent or negligible around cancer tissues. The grade of T-cell infiltration, especially in biopsied specimens, was correlated well to the size of the tumor, and also more marked significantly in patients without cervical lymph node metastasis than in those with lymph node metastasis. Furthermore, there was a significant correlation between the grade of T-cell infiltration at the peripheral region of the invading cancer mass in initial biopsy specimens and the clinical tumor regression rates with bleomycin treatment, but it did not correlate to the surgically resected specimens. These facts suggest that T-cells might inhibit the development and spreading of the cancer cells, and that the T-cell infiltration correlates with the clinical course or prognosis of the oral cancer patients.

Adult↗

Lymphocyte subpopulations and T-cell subsets in human oral cancer tissues: immunohistologic analysis by monoclonal antibodies.

A series of T-cell-specific monoclonal antibodies (Leu-1, Leu-2a, and Leu-3a) and B-cell-specific monoclonal antibody (HLB-1) were used to detect the localization and intensity of infiltration of lymphocyte subpopulations and T-cell subsets in frozen sections of 17 patients with the oral cancer. The vast majority of the lymphocyte infiltrates in the oral cancer tissues were reactive with Leu-1. In contrast, B cells were detectable with HLB-1 in only 2 of 17 cases. Leu-2a-positive cells were dominant in four cases, whereas Leu-3a positive cells were dominant in only three cases. In seven cases, both cells infiltrated to the same degree. Leu-2a positive cells tended to be dominant in the cases with earlier clinical stages.

Adult↗

Influence of vagotomy upon GIP release in patients with peptic ulcer.

Twenty-two vagotomized peptic ulcer patients were studied on the influence of vagotomy on the release of GIP. Moreover, the relationship between acid output and GIP release was analyzed. These patients underwent one of the three types of operation; truncal vagotomy with pyloroplasty (TV + P) selective vagotomy with pyloroplasty (SV + P) and selective vagotomy with antrectomy (SV + A). Before and after surgery, a gastric juice study and an oral glucose tolerance test were performed on separate days. Maximum acid output in response to tetragastrin correlated significantly with integrated GIP response after oral glucose loading. In the SV + P group, the response of GIP was slightly greater after surgery. In the SV + A group, the integrated GIP response diminished postoperatively, although, after surgery, GIP reached its peak sooner. The integrated GIP response was greater in the SV + P group than in the TV + P group. The response of GIP was less in the SV + A group than in the SV + P group. These changes were insignificant. In conclusion, it is presumed that GIP release is affected by gastric acid, gastric emptying time, intestinal transit time and vagal nerve action.

Adult↗

Cholangiocellular carcinoma associated with multiple liver cysts.

A 46-year-old woman visited our outpatient clinic complaining of dull right hypochondrial pain. Ultrasonography revealed four cysts in the right lobe of the liver. Arteriography and CT could not determine whether these cysts were benign or malignant. Because one of these cysts contained chocolate-colored fluid, amebic abscess was suspected, and the cyst was drained. No amebae were found in the cultured exudate, and fresh bleeding continued; therefore, laparotomy was performed. A tumor was present on the surface of the liver. Right lobectomy was performed. The resected specimen contained one nonepithelialized cyst which was invaded by surrounding cholangiocellular carcinoma and three epithelialized cysts. Preoperative diagnosis of this kind of cholangiocellular carcinoma seems to be very difficult. Recently cholangiocellular carcinoma associated with developmental cysts has been classified as a new entity different from cystadenocarcinoma. Cholangiocarcinoma, which belongs to this group, seems to deserve special attention.

Adenoma, Bile Duct↗

A trial of fasting cure for PCB-poisoned patients in Taiwan.

Sixteen patients poisoned by ingestion of a rice oil contaminated with polychlorobiphenyls (PCBs) in Taiwan voluntarily joined a trial of fasting cure for either seven or ten days approximately 26 or 35 months after being poisoned. During fasting, mixed juice made of fresh vegetables and fruits and milk or "tohnyu," that is, boiled soybean juice, were given on a fixed schedule. All these patients showed improvements of their symptoms and signs caused by the poisoning. Some of them enjoyed a dramatic relief of their sufferings such as severe headache, lumbago, arthralgia, pain at the sole, cough, sputa, and/or acneiform eruptions. The eruptions forming abscesses or cysts were, however, hard to cure. Thus, the fasting cure was demonstrated to be effective in the treatment of the patients. PCB concentrations in blood were rather elevated during and after the fasting.

Adult↗

A trial of fasting cure for PCB-poisoned patients in Taiwan.

Sixteen patients poisoned by ingestion of a rice oil contaminated with polychlorobiphenyls (PCBs) in Taiwan voluntarily joined a trial of fasting cure for either seven or ten days approximately 26 or 35 months after being poisoned. During fasting, mixed juice made of fresh vegetables and fruits and milk or " tohnyu ," that is, boiled soybean juice, were given on a fixed schedule. All these patients showed improvements of their symptoms and signs caused by the poisoning. Some of them enjoyed a dramatic relief of their sufferings such as severe headache, lumbago, arthralgia, pain at the sole, cough, sputa, and/or acneiform eruptions. The eruptions forming abscesses or cysts were, however, hard to cure. Thus, the fasting cure was demonstrated to be effective in the treatment of the patients. PCB concentrations in blood were rather elevated during and after the fasting.

Adolescent↗