Search PubMed⌕ Search

Biomedical subjects

M Kodama

Publications and source records attributed to M Kodama.

At least 181 records · Page 10Linked to original sources
PubMed1997

Evaluation of ability to defecate using saline evacuation from the rectum.

PURPOSE: The purpose of this study is to establish a simple technique to evaluate anorectal motility and the dynamics of defecation. METHODS: Pressure fluctuations in the rectum and anal canal during 500 ml of saline infusion in the rectum and then a saline evacuation curve were recorded using manometer and uroflowmeter. RESULTS: This study consisted of 37 patients with a mean age of 49.6 years. All patients without problems with defecation showed periodic relaxation of the anal canal, which was synchronized with rectal contractions during saline infusion. The saline evacuation curves of these patients were characterized by short evacuation time and high-peak flow. Of the 13 patients with constipation, 9 showed no rectoanal synchronization and had segmental evacuation curves. The patients with incontinence tended to have poor ability for holding saline in the rectum, resulting in low-peaked evacuation curves. CONCLUSIONS: This simple and noninvasive technique for recording anorectal pressure fluctuations and dynamics of saline evacuation from the rectum enables quantitative and qualitative evaluation of the ability to defecate.

Anal Canal↗
PubMed1997

The effects of convenient vagorrhaphy on the early recovery of gastric secretion and emptying: an experimental study on function-preserving gastric cancer surgery.

An experimental study was conducted using a canine model to elucidate whether the once transected vagal nerve can be conveniently anastomosed, and to determine when and to what degree the vagorrhaphy retains its functions. In the vagorrhaphy group (n = 5), the anterior and posterior vagal trunks were transected 1.5 cm above the diaphragma and the cut ends were anastomosed using two stitches of 8-0 nylon and fibria glue adhesive without microsurgery. In the nonvagorrhaphy group (n = 5), a 1-cm length of the nerve segment was resected to prevent reinnervation. A microscopic study of the anastomotic site performed on postoperative day (POD) 10 indicated the intervention of nerve fibers between the cut ends. No differences were found in the gastric secretory function, as assessed by the Hollander insulin test, or in the emptying function, as assessed by the acetaminophen test, between the vagorrhaphy group and the control preoperative values. However, both of these functions were superior in the vagorrhaphy group compared to the nonvagorrhaphy group. These results indicate that the technique of convenient vagal anastomosis could be put to practical use in gastric cancer operations to avoid postvagotomy syndrome.

Anastomosis, Surgical↗
PubMed1997

Bacterial translocation as a cause of septic shock in humans: a report of two cases.

While bacterial translocation has been reported to occur under numerous conditions in animal models, there has been no paper to date focusing on bacterial translocation as a direct cause of septic shock in humans. We present herein the cases of two patients who developed septic shock believed to have been directly caused by bacterial translocation. Neither of the patients had a focus of infection, the intestinal walls were intact in gross appearance, and the peritoneal cavity had not been contaminated by surgery. Moreover, in both patients, the same organisms were detected in the blood, ascites fluid, and mesenteric lymph nodes, and bacilli were found in the intestinal wall.

Aged↗
PubMed1997

Benign cervical teratoma in an adult: report of a case.

Cervical teratomas are rarely encountered in adults. We report herein the case of a 21-year-old woman who was admitted to our hospital for surgical treatment of a neck tumor, 7.5 x 4.5 x 2.7 cm in size, located in the left lower pole of the thyroid. Ultrasonography (US) and computed tomography (CT) revealed a multicystic tumor. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and squamous cell carcinoma-related antigen (SCC) in the cystic fluid were extremely elevated in contrast to the normal levels found in the serum. The tumor was completely excised and histological examination revealed it to be composed of elements derived from the three germ layers, confirming a diagnosis of benign cystic teratoma.

Adult↗
PubMed1997

Efficacy of prostaglandin I2 analog on liver grafts subjected to 30 minutes of warm ischemia.

Due to the fact that no effective conditioning agent for hemodynamically unstable donors exists, the number of suitable donors is limited. The efficacy of OP-41483, a stable analog of prostaglandin I2, as a conditioning agent of the liver was investigated in this study using pigs. OP-41483 was administered via the portal tributary for 10 min before 30 min of warm ischemia. Graft livers were procured after perfusion with OP-41483 in cold normal saline, then flushed with OP-41483 in Euro-Collins solution and placed in cold storage prior to orthotopic transplantation. OP-41483 was also administered intraportally for 120 min after reperfusion. Biochemical and histological studies, and survival rates were compared with a control group not given OP-41483 in an otherwise similar experimental protocol. The graft function recovered better in the OP group than in the control group, shown by the lactate values and lactate-to-pyruvate ratios. The marked congestion noted in the parenchyma of the control group livers was minimal in the OP group, verifying the microcirculatory effect of prostaglandin I2 by its vasodilatory and antithrombotic actions. These findings suggest that OP-41483 has some protective effect as a conditioning agent in liver transplantation, with timing of administration being crucial.

Alanine Transaminase↗
PubMed1997

Development of black gallstones after the nonsurgical management of splenic injury: report of a case.

A 22-year-old man was admitted to our Emergency Department after suffering splenic injury in a traffic accident. His intraabdominal bleeding was treated nonsurgically by the administration of total parenteral nutrition (TPN) and blood transfusions of packed red cells. He presented again 2 months after his discharge, being 3 months after the injury, for right hypochondralgia, at which time a gallstone was demonstrated on ultrasound (US) and computed tomography (CT). After endoscopic laparoscopic cholecystectomy, his symptoms disappeared and he has remained well since. The clinical course of this patient indicates that hemolytic hyperbilirubinemia can cause black gallstones as a late complication of the nonsurgical management of abdominal blunt trauma.

Abdominal Injuries↗
PubMed1997

The growth hormone receptor gene mutation of a Japanese patient with Laron syndrome.

Deletions and point mutations of the growth hormone (GH) receptor gene (GHR) have been identified in patients with Laron syndrome. We report the first detection of the GHR mutation among Japanese patients with Laron syndrome. Using the Japanese female patient's genomic DNA as a template, all exons and flanking portions of introns of GHR were amplified by polymerase chain reaction (PCR). Sequencing of the PCR products showed that the patient was homozygous for a G to A substitution at the first position of intron 4. This substitution was same as that detected in a Spanish patient and a north European patient. The base change occurred at the 5' splice consensus sequence of intron 4, resulting in the abolition of a BanI restriction site. Since this substitution was not detected by a BanI restriction analysis in 85 control individuals, it is more likely a disease-related splice mutation than a polymorphism. The mutation in our patient was predicted to destroy the original 5' splice site of intron 4 of GHR and to produce a new cryptic splice site, leading to abnormal mRNA processing and a lack of GH binding activity of GH-binding protein (GHBP).

Adult↗
PubMed1997

Saxitoxin as a toxic principle of a freshwater puffer, Tetraodon fangi, in Thailand.

Saxitoxin was identified in a freshwater puffer, Tetraodon fangi, which caused food poisoning in Thailand. Tetrodotoxin, a puffer toxin, was not detected in the species by the HPLC-fluorometric analysis, showing that tetrodotoxin is absent or under any detectable level. The result of this study shows that saxitoxin can be a major toxin in puffer.

Animals↗
PubMed1997

Glucoregulatory disorders in school refusal students.

OBJECTIVES: Our previous studies demonstrated autonomic nervous system disorders and cerebral blood hypoperfusion in school refusal students with underlying emotional distress due to fear or anxiety associated with school attendance. Because severe stress is known to affect glucoregulatory metabolism, this study used the oral glucose tolerance test (OGTT) to measure glucose metabolism in school refusal students. DESIGN: A three-hour OGTT was performed. In preparation for the test, students fasted overnight. After a fasting blood sample was drawn, students were given solutions containing a predetermined amount of glucose based on their body weight (1.75 g/kg to a maximum 75 g). After glucose ingestion, blood samples were drawn at 30, 60, 90, 120, 150, and 180 mm to measure blood glucose (BG), immunoreactive insulin (IRI), pancreatic glucagon (IRG) and growth hormone (GH) levels. BG levels, IRI response, cumulative BG (sigma BG), cumulative IRI (sigma IRI), insulin/glucose ratio (delta IRI/delta BG), and insulinogenic index (sigma IRI/sigma BG) were then compared to previously reported normal control data. As an index of emotional difficulties, the self-rating depressive scale (SDS) was carried out. PATIENTS: Eighty-one school refusal students (40 males and 41 females), 11-19 years of age (14.8 +/- 2.1), were studied. Their school refusal periods ranged from one month to eight years. All students were within -15 to +20% (-0.04 +/- 8.6) of ideal body weight. MEASUREMENTS: BG levels were determined using a glucose oxidase reaction method. Serum hormones were measured by radioimmunoassay. RESULTS: BG levels at all OGTT time intervals and sigma BG were significantly higher in school refusal students than the normal control data (sigma BG: 39.5 +/- 4.4 vs 33.3 +/- 3.4 mmol/l P < 0.001). Although the insulin response was abnormally low relative to the prevailing hyperglycaemia (sigma IRI/ sigma BG: subjects vs control = 232 +/- 129 vs 375 +/- 271, P < 0.01), normal beta cell secretory ability was speculated (sigma IRI: subjects vs controls = 2805 +/- 1274 vs 2523 +/- 1219 pmol/l). This suggests a relative suppression of insulin secretion. A paradoxical increase of GH was observed in 19 students after glucose ingestion. CONCLUSIONS: Glucoregulatory disorders observed in school refusal students may be caused by emotional distress. Multiple factors including autonomic nervous system disorders, derangement of neuropeptides in the hypothalamus, and hormonal imbalances may also affect glucoregulatory metabolism, predisposing these students to hyperglycaemia. We speculate that the glucoregulatory system compensates for decreased blood flow to the brain by increasing blood glucose concentrations, thereby providing sufficient glucose as the primary energy source used during normal brain metabolism.

Adolescent↗
PubMed1997

Bicycloillicinone asarone acetal: a novel prenylated C6-C3 compound increasing choline acetyltransferase (ChAT) activity from Illicium tashiroi.

Bicycloillicinone asarone acetal (1), a novel bicyclic prenylated C6-C3 compound, has been isolated from the woods of Illicium tashiroi and its structure has been elucidated by spectroscopic analyses and chemical degradation. Compound 1 was found to increase choline acetyltransferase (ChAT) activity in culture of P10 rat septal neurons.

Allylbenzene Derivatives↗
PubMed1997

Three-dimensional helical computed tomography with intravenous cholangiography for sclerosing cholangitis manifested as postcholecystectomy symptom.

A 46-year-old woman who had upper abdominal pain 10 years after cholecystectomy, and who had incidental sclerosing cholangitis (SC), was investigated by three-dimensional helical computed tomographic (3-DHCT) cholangiography with contrast medium, because endoscopic retrograde cholangiography (ERC) was unsuccessful and a second ERC was not permitted by the patient. The cholangiogram demonstrated annular strictures of the bilateral hepatic duct at the confluence of the common hepatic duct, and dilatation of the left intrahepatic biliary duct. Although we could not clarify the cause of the biliary tract deformity at the time of the 3-DHCT, the tentative diagnosis of postcholecystectomy deformity of the biliary tree led to successful treatment by right liver lobectomy and hepaticojejunostomy. Histologic findings were compatible with SC. From this experience and the literature, we suggest that 3-DHCT cholangiography with contrast medium can contribute to the preoperative diagnosis of morphological changes in the biliary tree in patients with postcholecystectomy symptoms.

Cholangiography↗
PubMed1997

Hepatocytes entrapped in collagen gel following 14 days of storage at 4 degrees C: preservation of hybrid artificial liver.

Preservation of hepatocytes is a key technical factor toward the successful clinical application of hybrid artificial livers. It was possible to culture hepatocytes that had been preserved with collagen gel for 8 and 14 days in 4 degrees C University of Wisconsin solution. Phase-difference and scanning electron microscopy showed that most of the stored hepatocytes maintained a round-shaped morphology. In the 14 day preservation group, on Days 2 and 8, respectively, ureogenesis was 98.3% and 69.6%, gluconeogenesis was 65.2% and 80.7%, lidocaine clearance was 81.7% and 72.5%, urea synthesis after ammonia load was 47.6% and 57.5% of those in the comparable control group. This implies that preserved hepatocytes maintained adequate functional capability even after 14 days of preservation. We suggest that our preservation method will be valuable for the future application and development of a practical hybrid artificial liver.

Ammonia↗
PubMed1997

Comparison of acute physiology and chronic health evaluation III and II for prediction of mortality in multiple organ failure patients treated by plasma exchange.

This study examined the efficacy of a different scoring system for multiple organ failure (MOF) patients treated by plasma exchange (PE). Twenty-five patients with MOF resulting from fulminant hepatitis who had been treated by PE for a total number of 91 PEs in a consecutive period of 22 months were included in our study. Data were collected from each patient to compute acute physiology and chronic health evaluation (APACHE) II and APACHE (AP) III scores. The sensitivity, specificity, and correct prediction of outcomes were measured. The correct prediction of outcomes was 86.5%in AP III and 77.5% in AP II. For the prediction of patient mortality, the AP III system seems to be more reliable than AP II.

APACHE↗
PubMed1997

Theoretical background of effect mechanism by extracorporeal immunomodulation.

Therapeutic plasmapheresis has usually been applied to diseases with unknown causes. Clear analysis of the mechanism of the effect that apheresis has on diseases derived from unknown causes has not been completed. The effect of leukocytapheresis on ulcerative colitis (UC) or rheumatoid arthritis (RA) also lacks clear analysis, but removal of 10(10) adhesive cells resulted in the suppression of both acute and chronic inflammatory reactions. The number of cells removed was not unreasonable for efficacy. A quite acceptable explanation is that the cells activated in the inflammatory lesions are more adhesive than nonactivated cells. However, only a few minutes of contact with the surface of the device can activate blood immune cells. All of the apheresis therapies, not only leukocytapheresis, should be evaluated for their efficacies, excluding the effects of contact activation. According to results presently available, the suppressive effect of leukocytapheresis on RA or UC is through to depend upon the removal of activated inflammation related cells that might transfer inflammatory signals. It may be that those cells removed are bound because of cell stimulation caused by microorganisms or foreign bodies.

Arthritis, Rheumatoid↗
PubMed1997

Blood purification for critical care medicine: endotoxin adsorption.

Many kinds of blood purifying technologies have been applied to the treatment of critically ill patients since 1979 when plasma exchange with hollow-fiber membranes was developed. These technologies have been applied not only to the removal of toxic substances, but also to the treatment of objective diseases and the removal of the factors relating to the associated inflammation. This article summarizes these methods and their efficacies for critically ill patients, especially those with severe sepsis. Attempts have been made to remove endotoxin, the main cause of sepsis, from the circulation using polymyxin B immobilized fiber, charcoal hemoperfusion, and plasma or whole blood exchange. Attempts have also been made to remove proinflammatory cytokines, eicosanoides, and coagulative factors from the circulation in the human body. Continuous hemofiltration or hemodiafiltration is the representative technology. The efficacy of these methods has been established, but several issues remain unresolved. All methods of the treatment of severe sepsis are discussed with reference to treatment indications, efficacy, and outcome parameters. In particular, the clinical results of endotoxin removal with polymyxin B immobilized fiber are summarized in this article.

Adsorption↗
PubMed1997

Effects of a thromboxane A2 receptor antagonist in an animal model of inflammatory bowel disease.

BACKGROUND/AIMS: We evaluated the effects of an antagonist of the thromboxane A2 receptor (ONO-NT-126) in an animal model of inflammatory bowel disease (IBD). METHODS: Colitis was induced by intracolonic instillation of trinitrobenzenesulfonic acid/ethanol in male Wistar rats. ONO-NT-126 or vehicle alone was administered intraluminally via anus once a day. The rats were killed after 7 days for assessment of colonic damage by the colonic damage score. RESULTS AND CONCLUSION: ONO-NT-126 markedly reduced the colonic damage. Our findings suggest that the thromboxane-thromboxane receptor system plays an important role in this model of IBD and that antagonism of the thromboxane A2 receptor may prove useful for the treatment of IBD.

Animals↗