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Biomedical subjects

M Kusunoki

Publications and source records attributed to M Kusunoki.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Intraoperative colonoscopy.

From 1987 to 1991, we performed intraoperative colonoscopy on 66 patients as a result of the following indications: the air leakage test (53%), detection of a previous malignant polypectomy site (20%), inability to complete preoperative colonoscopy (17%), detection of the source of intestinal bleeding (4%), and detection of impalpable colonic lesions (4%). Intraoperative colonoscopy was successful in 61/66 patients and provided information that altered the planned operation in 10 of 61 completely examined patients. The air leakage test proved useful in detecting subclinical anastomotic leaks. The indications for intraoperative colonoscopy have been expanded, and this procedure is often useful when one is attempting to decide on the appropriate surgical strategy for patients.

Anastomosis, Surgical↗
PubMedDate not supplied

The effects of various peptides on the isolated pulmonary artery.

Helical strips of pulmonary arteries from rabbits were tested for their responses to the following peptides: neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), substance P (SP), cholecystokinin-octapeptide (CCK), somatostatin (SS), bombesin, neurotensin and gastrin. SP, in the absence of active base-tension, and NPY both induced concentration-dependent contractions, while VIP and SP, in the presence of active base-tone, and CCK induced relaxation. The pD2 (-log ED50) was in the order of NPY greater than SP and SP greater than CCK greater than VIP. SS, bombesin, NT and gastrin had no effect. These findings suggest peptidergic involvement in the vessels.

Animals↗
PubMedDate not supplied

Effect of small deep hemispheric infarction on the ipsilateral cortical blood flow in man.

The effect of small, deep ischemic lesions on the ipsilateral cortical circulation was investigated in 10 patients with persistent mild or moderate neurological deficits due to infarcts in the internal capsule. rCBF studies by the 133Xe intracarotid injection method were performed 14-180 days after the onset of the infarction. The rCBF functional image was made up from the data of 133Xe dynamic images measured by an Anger-type gamma camera and the rCBF values were calculated by the initial slope method. The average value of mean rCBFs (mCBF) in 10 patients was 44.9 +/- 7.1 ml/100g/min (average PaCO2; 39.9 +/- 4.3 mm Hg). In the rCBF functional images, a focal hypoperfusion area was observed in all cases and localized around the central sulcus, especially in the precentral and central areas. Significant decreases of mCBF and the tendency to decrease of the rCBFs in the hypoperfusion focus were noted in the patients with the larger infarcts in comparison with those with the smaller ones. These results suggest that a small, deep ischemic lesion such as a capsular infarct may have remote effects on the ipsilateral cortical circulation, due probably to the damage of a number of fibers passing through the lesion.

Adult↗
PubMedDate not supplied

Effect of aspirin and ticlopidine on platelet deposition in carotid atherosclerosis: assessment by indium-111 platelet scintigraphy.

The antiplatelet effects of aspirin and ticlopidine were studied by a dual-tracer method, using indium-111 labeled platelets and technetium-99m human serum albumin, in a group of 12 patients with suspected ischemic cerebrovascular disease. The magnitude of platelet accumulation at the carotid bifurcation was expressed as the ratio of radioactivity of indium-111 platelets deposited on the vascular wall to those circulating in the blood-pool (PAI, platelet accumulation index), 48 hr after injection of labeled platelets. PAI values were measured before (baseline studies) and after the antithrombotic therapies (aspirin studies: 325 mg bid for 22.3 +/- 1.3 days, ticlopidine studies: 100 mg tid for 21.8 +/- 2.1 days). At the baseline, the mean PAI value at 24 carotid bifurcations in the patient group was 15.7 +/- 15.3% (mean +/- S.D.) compared to -4.3 +/- 9.1 at 24 carotid bifurcations in 12 normal subjects (p less than 0.01). We defined the upper limit for a normal PAI (%) value to be +13.9, namely the mean PAI plus 2 SD for the carotid bifurcation in normal subjects and used this value for semiquantitative analysis. At the baseline, significant elevation of PAI (more than 13.9%; positive scintigram) was observed at 12 of 24 vessels, while 12 other regions were negative (less than 13.9%). In the lesions with positive scintigraphic results at the baseline, the mean PAI (%) value from the baseline, aspirin and ticlopidine studies was 29.5 +/- 7.0, 11.2 +/- 8.5 (p less than 0.01 versus baseline) and 21.4 +/- 21.3 (not significant from baseline), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Effect of dopamine on plasma growth hormone and prolactin concentrations under anaesthesia.

Five patients with acromegaly and five patients with prolactinoma undergoing general anaesthesia were studied. Concentrations of plasma growth hormone in patients with acromegaly and concentrations of plasma prolactin in patients with prolactinoma were measured before anaesthesia, when 250 mg levodopa was administered orally, and after anaesthesia when dopamine was infused intravenously at a rate of 5 micrograms/kg.min. There was no difference in hormonal (growth hormone or prolactin) response to either treatment in the anaesthetized and the awake states. These findings indicate that the functioning of dopamine receptors in the anterior pituitary is not affected by anaesthesia.

Acromegaly↗
PubMedDate not supplied

Inhibitory effect of barbiturates and local anaesthetics on protein kinase C activation.

A calcium- and phospholipid-dependent protein kinase C subspecies purified from rat brain was inhibited by thiamylal, thiopentone, pentobarbitone, mepivacaine and bupivacaine. This was attributed to the inhibition of the activation process rather than to direct interaction with the active site of the enzyme. It is well established that unsaturated diacylglycerol markedly increases the affinity of protein kinase C for calcium ions. Kinetic analysis suggested that pentobarbitone brought about the inhibition by competing with the diacylglycerol diolein and that mepivacaine and bupivacaine competed with the phospholipid phosphatidylserine used in the assay. The possibility exists that the effects of local anaesthetics on the function of various tissues are due, in part, to an inhibitory action on protein kinase C.

Anesthetics, Local↗
PubMedDate not supplied

Effects of diazoxide on the cardiovascular response to tracheal intubation.

The efficacy of 2 or 3 mg/kg diazoxide given 2.5 min before laryngoscopy in attenuating the cardiovascular responses to laryngoscopy and intubation was studied in 30 patients undergoing elective surgery. Data were compared with those from 10 control patients receiving saline. Anaesthesia was induced using 5 mg/kg thiopentone given intravenously and tracheal intubation was facilitated with 0.2 mg/kg vecuronium bromide. Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. The increases following tracheal intubation were significantly reduced (P less than 0.05) in diazoxide-treated patients compared with those in the control group, but there were no significant differences in heart rate following tracheal intubation among the three groups. Data suggest that diazoxide can be used as a supplement during induction of anaesthesia to attenuate the hypertensive response associated with laryngoscopy and tracheal intubation.

Adult↗
PubMedDate not supplied

The usefulness of pharmacokinetic modulating chemotherapy (UFT plus 5FU) in the treatment of unresectable colorectal carcinomas.

This study was performed to improve the prognosis of unresectable (primary non-curative and recurrent) colorectal carcinoma by using pharmacokinetic modulating chemotherapy (PMC), a combination of oral UFT and continuous venous 5FU infusion. The subjects were 120 patients who were prospectively selected for this study. The patients selected PMC or alternative treatment. Fifty-six patients received PMC. The PMC group received 200-400 mg/body/ day UFT orally 5-7 days per week and 600 mg/m2/24 h 5FU infusion once a week. PMC markedly improved the median survival period (26.6 months vs. 9.2 months P<0.000001). This significant improvement as observed in unresectable primary colorectal carcinoma (P=0.0003), recurrent tumors (P<0.00001), local extension (P=0.01), lung metastases (P=0. 03), liver metastases (P=0.0001), and peritoneal seedings (P=0.02). One of 56 patients who received PMC developed grade 4 toxicity. PMC significantly improved the prognosis of unresectable colorectal carcinoma which has a low survival rate. PMC also indicated tolerable compliance and cost effectiveness.

Administration, Oral↗
PubMedDate not supplied

Massive pleural effusion and ascites resulting from esophagectomy with extensive lymphadenectomy for cancer of the abdominal esophagus.

Chylothorax is an uncommon but well recognized complication of esophagectomy. We present the case of a 57 year-old man with squamous cell carcinoma of the abdominal esophagus who underwent subtotal esophagectomy by right thoracotomy. Post-operatively, the volume of pleural effusion from the right chest was increased (1600-2000 ml/day). The effusion was straw colored, not changing to milky after meals. The characteristics and composition of the pleural fluid were similar to those of chyle. We therefore treated this patient using methods for treatment of chylothorax, conservatively, by administration of OK-432 and minocycline/hydrochloride into the pleural cavity from the chest tube with success. We discuss the pathophysiology of this unusual condition and its treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Possible development of idiopathic sclerosing encapsulating peritonitis.

We report a rare case of idiopathic sclerosing encapsulating peritonitis (SEP). During a laparotomy before undergoing a distal gastrectomy with Billroth II reconstruction for early gastric cancer, the patient was found to have a membranous encapsulation wrapping each small bowel loop, unlike peritoneal encapsulation or typical SEP. He had complained of persistent heartburn, distension and diarrhea for 2 months in the post-operative course. The second laparotomy, which was performed to improve prolonged transit, revealed typical SEP with a thick and fibrotic membrane that encased the small bowel entirely. Stripping of the sclerosing encasing membrane, separation of the adherent loops of the proximal small bowel, and Braun's anastomosis were performed. The patient complained of epigastric fullness and diarrhea after he was relieved from the complete bowel obstruction for 45 days post-operatively. Trimebutine maleate was administrated 5 months after the second operation and this markedly improved his symptoms. This case might reflect the developmental process of idiopathic SEP. In addition, the use of a motility regulator may improve symptoms related to the abnormal intestinal motility by this disease.

Adenocarcinoma↗
PubMedDate not supplied

Effects of elemental diet (ED) on surgical treatment in Crohn's disease.

BACKGROUND/AIMS: Patients with Crohn's disease are at risk of developing short bowel syndrome if they are treated with repeated operations. We examined the effect of preoperative nutritional therapy with elemental diet on the interval until and the outcome after surgical treatment in patients with Crohn's disease. METHODOLOGY: We reviewed the records for 73 patients with Crohn's disease who underwent intestinal resection in our department between January 1, 1974 and December 31, 1996. Thirty-two of them had not received elemental diet (No ED group) and 41 had received elemental diet therapy (ED group) before the first resection. RESULTS: The median interval between the onset and first resection was 19.3 months for the NoED group and 67.5 months for the ED group (P = 0.0005). All patients received ED therapy after the first resection. The incidence of second resection was significantly different between the ED and the NoED group after the first operation. (P = 0.045). CONCLUSIONS: Elemental diet therapy is effective in prolonging the interval between the onset and first resection and in reducing the incidence of second resection. The initial introduction of elemental diet therapy is useful in the management of the clinical course of Crohn's disease minimizing surgical intervention.

Adolescent↗
PubMedDate not supplied

Limited proteolysis of protein kinase C subspecies by calpain: stimulation by basic polypeptides.

Limited proteolysis of Protein Kinase C (PKC) subspecies by Ca(2+)-dependent neutral protease II (calpain II) was remarkably stimulated by the presence of basic polypeptides, such as H1 histone, protamine, poly-L-arginine, and poly-L-lysine. The stimulatory effect of basic polypeptides was observed for proteolysis of the active form of PKC which was associated with diacylglycerol and phospholipid. The inactive form of PKC was far less susceptible to proteolysis, either in the presence or absence of the basic polypeptides. The basic polypeptides did not appear to interact with calpain II, but caused a conformational change in PKC to make the kinase molecule more susceptible to proteolysis. The relative rates of cleavage of the active form of types I (gamma), II (beta), and III (alpha) PKC by calpain II in the absence and presence of basic polypeptides were 100:48:23 and 100:100:50, respectively. Available evidence suggests that, like calpain I, calpain II may also contribute to the down-regulation or depletion of PKC.

Animals↗
PubMedDate not supplied

The efficacy of whole gut irrigation with polyethylene glycol electrolyte solution in elective colorectal surgery for cancer.

Sixty-four patients undergoing elective operations for cancer of the colon and rectum were given mechanical bowel preparation in the form of whole gut irrigation with polyethylene glycol electrolyte solution. When their colonic cleansing scores were compared, it was found that the preparation was significantly less effective in the left colon (n = 49) than in the right (n = 15), the mean (SEM) scores being 3.8 (0.56) and 2.65 (1.01), respectively, p less than 0.001. We then compared the scores of 26 patients with stenosing lesions with those of 38 that were not: in the right colon the score for stenosing tumours was 3.9 (0.14) compared with 3.8 (0.25) for non-stenosing tumours. In the left colon, however, they were 2.3 (0.23) and 2.9 (0.18), respectively (p less than 0.01). We conclude that stenosis of the colon caused by malignant lesions reduces the efficacy of mechanical bowel preparation with polyethylene glycol electrolyte solution in the left colon but not in the right colon.

Colon↗