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Biomedical subjects

N Kawano

Publications and source records attributed to N Kawano.

At least 109 records · Page 6Linked to original sources
PubMed1987

Hepatic resection for hepatocellular carcinoma. Clinical features and long-term prognosis.

Ninety-eight hepatic resections for hepatocellular carcinoma were performed on 94 patients from 1963-1985. HBs antigen was positive in 17% of patients, preoperative serum alpha-fetoprotein was more than 20 ng/mL in 70% of patients, and liver cirrhosis was present in 75% of patients. Hospital mortality rate was 19%, and the volume of operative blood loss was the most decisive factor that affected the short-term prognosis. Excluding the 19 hospital deaths, the long-term survival rates of 75 patients were 73%, 42%, and 25% for 1, 3, and 5 years, respectively. Prognostic factors that influenced the long-term prognosis were investigated by comparing the survival curves. Significant differences of survival patterns were noted when analyzed on the basis of preoperative alpha-fetoprotein level (less than or equal to 200 vs. greater than 200 ng/mL), tumor size (less than or equal to 5 vs. greater than 5 cm), and tumor capsule. The recurrence of carcinoma was the main cause of death in 56% (42 patients) who died after discharge from the hospital. The development of effective prevention and treatment against recurrent tumors is necessary to improve long-term prognosis.

Adult↗
PubMed1987

[New knowledge on the calcium pyrophosphate dihydrate (CPPD) crystal deposition disease in the cervical ligamentum flavum].

A case of 64-year-old Japanese woman with cervical radiculomyelopathy caused by the deposition of both calcium pyrophosphate dihydrate (CPPD) and hydroxyapatite crystals in the cervical ligamentum flavum is reported. The patient developed paresthesia in her both hands and gait disturbance in the previous six months. Neurological examination revealed generalized hyperreflexia and hypesthesia in the C7 region. Neuroradiologically, two nodular opacifications were shown in the C3-4 and C5-6 level. CT scan revealed linear and symmetrical calcifications in the C3-4 and nodular calcifications in the C5-6 level. En bloc laminectomy was performed and the patient was discharged from the hospital with improvements of neurological symptoms. Specimens of the spinal laminae and ligamenta flava were studied by light microscopy, scanning electron microscopy (SEM), energy dispersive X-ray microanalysis (X-MA) on SEM, and an X-ray diffraction study was carried out on the crystals. The results showed A. CPPD crystal depositions throughout the ligamenta flava together with a minimal thickening of the ligaments. The deposition was seen in the midzone of the ligaments forming a plate-like distribution and forming lines in the cut surface, the latter coincided well with the CT finding at the C3-4 level. B. The nodule (7 X 6 X 6 mm in size) at the C5-6 level was composed of two crystals, CPPD and hydroxyapatite, the latter being encased by the former. The thickness of the CPPD layer was quite thin varying from 10 to 100 mu. Myelographically, the spinal cord was most severely compressed by the C5-6 nodule. C. Because of the absence of family histories and predisposing factors, the case was considered one of primary or idiopathic CPPD crystal deposition disease. The origin of the deposition of mixed crystals was discussed and it appeared likely that the central part of CPPD crystal deposition had transformed to hydroxyapatite at the C5-6 level. In the literature a considerable number of cases have been reported under the title, "Calcification of the Ligamentum Flavum", and some of them have been shown to have hydroxyapatite deposition. Considering the great similarities in clinical, radiological and histological findings between the so-called "calcification of the lig. fl." and CPPD crystal deposition disease, the present case was the first to clearly indicate that these two conditions belong to a single category, i.e. CPPD crystal deposition disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Calcium Pyrophosphate↗
PubMed1987

[Preoperative assessment of risk for gastroenterological operations in patients with hepatic cirrhosis].

In order to devise an easy and available method to assess the surgical risk of cirrhotic patients, we reviewed 52 cirrhotic patients who underwent gastroenterological operations at Tokyo Kosei Nenkin Hospital between 1968 and 1982, by means of multivariant discriminant analysis. Utilizing presence of ascites, serum albumin, ICG R15, prothrombin time and platelet count, we estimated the surgical risk as Risk Score. Furthermore, our method predicted short-term survival of other 150 cirrhotic patients who underwent gastroenterological operations at the First Surgical Department The University of Tokyo between 1968 and 1985. We conclude that our method is easily available, and that cirrhotic patients with Risk Score less than or equal to 2.5 tolerate all the gastroenterological operations except hepatic major resection, and that those with Risk Score of residual liver less than or equal to 2.5 tolerate well hepatic major resection.

Analysis of Variance↗
PubMed1985

Cyclosporine and partial liver allotransplants in a simplified rat model.

We designed a simplified rat model to assess the effects of cyclosporine (CsA) on liver transplants. Auxiliary liver grafts consisting of 20 per cent of the whole liver were supplied with portal inflow and the bile was drained into the stomach. The cuff technique was used routinely for both end-to-end and end-to-side venous anastomoses. The host liver was totally deprived of portal inflow. Two inbred strains of rats, LEW and F344, were used for isograft (LEW----LEW) and allograft (F344----LEW). All survivors were killed at the end of the fourth week after transplantation. During four weeks, the isografts increased by 108 per cent in wet liver weight. Animals with allograft were treated with CsA given i.m., in a daily dose of 20 and 40 mg/kg for the first ten days post transplantation. The CsA-treated rats were free from parenchymal destruction of the allograft, as was characteristic of the allograft controls. The rats given CsA in the dose of 40 mg/kg showed a 173 per cent increase in the wet liver weight of the transplant, such being greater than allografts in rats on 20 mg/kg of CsA (100 per cent) and even than isografts. These results indicate that auxiliary partial liver grafts benefit from the use of CsA not only through suppression of allorejection but through a potential "hepatotrophic effect" of the agent.

Alanine Transaminase↗
PubMed1985

One hundred hepatic resections. Indications and operative results.

The indications and operative results of hepatic resections were investigated in 100 consecutive patients over the past 20 years. There were 61 hepatocellular carcinoma, 13 hepatolithiasis, and 26 other miscellaneous diseases. An overall hospital mortality rate was 25%. It was 26, 0, and 35% in patients with hepatocellular carcinoma, hepatolithiasis, and other diseases, respectively. There was not any significant difference between survived and deceased cases in their preoperative laboratory data. The volume of operative blood loss in deceased cases was significantly larger than that in survived cases, so the influence of operative blood loss on morbidity and mortality was investigated. The incidences of postoperative bleeding, hepatic insufficiency, pulmonary insufficiency, and hospital death were significantly higher in patients whose operative blood loss exceeded 5000 ml. These results indicate that operative blood loss is one of the critical factors that decide the operative prognosis.

Adolescent↗
PubMed1985

A study on so-called novel inclusion body in human hepatocyte.

The so-called novel inclusion body (NIB) is an intrahepatocytic structure which is frequently observed in human cirrhotic liver. It resembles very much to, but definitely differs from Hepatitis B surface antigen (HBsAg) morphologically. The age distribution of liver cirrhosis cases positive for NIB is similar to that positive for HBsAg, except for an existence of a time lag in mean age. One of the best staining methods to demonstrate NIB, for example, is to exhibit it as a reddish body stained by Luna, with a contrast of HBsAg counterstained purple in color by aldehyde fuchsin after thiosulfation. Electron microscopy of the liver obtained from a patient, negative for both HBsAg and Hepatitis B e antigen (HBeAg) but positive for Hepatitis B core antibody (HBcAb) and Hepatitis B surface antigen antibody (HBsAb) clinically, revealed some unfamiliar, tubular and cisternal arrays showing a network pattern and ring-shaped structure at the site exactly corresponding to NIB localization. These are considered to have been induced from the endoplasmic reticulum by an unknown agent, for which non A non B hepatitis virus (NANBV) is rationally postulated as one of the possibilities. A close relation between NIB and NANBV is highly suspected because of much similarities in histology, histochemistry, age distribution, and electron microscopy. The true nature of NANBV should be rescrutinized, especially in relation with Hepatitis B virus infection, since NIB is quite often observed also in cirrhotic liver positive for HBsAg.

Adult↗
PubMed1983

Oligodendroglioma-like cells (clear cells) in ependymoma.

A brain tumor of a 22-year-old man was composed mostly of round cells with perinuclear halos (clear cells), forming clusters intersected by small blood vessels. In some areas, the tumor cells showed perivascular arrangement and epithelial pattern. Phosphotungstic-acid hematoxylin stain and immunoperoxidase stain for glial fibrillary acidic protein (GFAP) technique failed to stain the clear cells. Electron microscopy of the clear cells revealed them to be classical ependymoma cells with well developed intercellular junctions, microvilli and cilia. As no reporters in the past showed the evidence to clarify the nature of the clear cells, this case is considered a good example to support the viewpoint that the clear cells (oligodendroglioma-like cells) commonly observed in ependymomas are in reality ependymoma cells. It is stressed that the diagnosis of "mixed glioma" or "oligoependymoma" should be made with sufficient caution despite the recent advances of GFAP technique.

Adult↗
PubMed1983

Plasma somatostatin level during natural and interrupted nocturnal sleep in man.

The plasma levels of somatostatin (SRIF), growth hormone (GH) and thyrotrophin (TSH) in 4 normal men were measured during nocturnal sleep on 6 nights. In the waking state, the fluctuation of plasma SRIF level was within +/- 2.1 pg/ml (SD) of the mean value for each individual (range of mean value, 10.7 pg/ml-15.4 pg/ml). A marked episodic surge of GH release (peak value, 24.4 +/- 6.3 ng/ml (mean +/- SD] was noted in the initial period of slow wave sleep (SWS) in all subjects, but no significant negative correlation was observed between SRIF and GH in the plasma during either increase or decrease in the GH surge. There was no relation between the distribution of the plasma SRIF concentration and the stage of sleep, including the period before sleep, judged by electroencephalography (EEG). A small, but significant, increase of plasma TSH (10.0 muU/ml) independent of the SWS-related GH burst was detected in 1 of 4 subjects, but in that period the plasma SRIF level did not change. Even when the GH surge was suppressed by interruption of SWS, the plasma levels of SRIF and TSH did not show any significant change. From these findings, it is concluded that SRIF in the peripheral plasma does not fluctuate during the sleeping period as in the waking state and that, whatever its source, it is not related to the plasma GH or TSH level in the systemic circulation.

Adult↗
PubMed1982

Contiguous malignant astrocytoma and Wilms'-like tumor in the brain.

A case of primary brain tumor composed of two contiguous neoplasms in presented. At operation, a nodular tumor was embedded in the infiltrating tumor within the brain parenchyma. With light and electron microscopy, the nodular tumor was similar to Wilms' tumor (nephroblastoma). The infiltrating tumor was malignant astrocytoma. Autopsy revealed, besides the recurrence of malignant astrocytoma in the brain and its subarachnoid dissemination, extracranial metastases to the abdominal cavity, liver, lung, and bone marrow. Recurrent and metastatic tumors were glioblastoma multiforme, which was more malignant than the surgical specimen. The possibility of metastatic Wilms' tumor from the kidney was completely ruled out by extensive autopsy survey. The authors present an extremely rare tumor including detailed observations on the electron microscopic appearance of the tumor; the histogenesis of these tumors is briefly discussed.

Adult↗
PubMed1982

Hypothalamic-pituitary function in patients with congenital malformations accompanied by central nervous system disorders.

In 20 patients with congenital brain disorders, the influence of the CNS maldevelopment on the neuroendocrine system was investigated by assessment of the hypothalamic-pituitary function through measurements of the secretory reserve of pituitary hormones (GH, PRL, TSH, LH and FSH) in response to injections of insulin, TRH and LH-RH, and of the secretion of sleep-dependent pituitary hormones with polygraphic recording. The subjects consisted of 9 patients with midline anomalies of the brain and face, 3 patients with hydrocephalus, hydroencephalodysplasia or microcephalus, and 8 patients with the malformation syndrome associated with mental retardation. Ten of the 18 patients examined showed normal responses of GH secretion in the loading test (secretory peaks: greater than 10 ng/ml). But only 4 of these patients were found normal in respect of GH secretory peaks of more than 10 ng/ml during sleep. Of these 17 children, 5 showed abnormal values for basal secretion of PRL, and/or the secretory peak of PRL on injection of TRH. Two children showed hypersecretion of PRL during sleep. One patient out of the 19 examined was unresponsive in gonadotropin secretion to injection of LH-RH and 2 patients displayed excessive responses. During sleep, 4 of the 13 patients studied were found to be hypersecretory and 2 hyposecretory of gonadotropin. These results suggest that abnormalities in pituitary hormone secretion are frequently present in patients with CNS maldevelopment, and growth disturbances and abnormal sexual development may in some instances be due to endocrine abnormalities.

Adolescent↗
PubMed1982

Studies on the gonadotropin secretion during sleep in patients with abnormal sexual development--the role of the CNS in the onset of puberty.

In order to evaluate the secretory patterns of luteinizing and follicle-stimulating hormones in various forms of abnormal sexual development, plasma levels of these hormones were measured every 20-30 minutes during sleep in 9 patients with true precocious puberty and 2 patients with primary hypogonadism. Seven patients with idiopathic precocious puberty and 2 patients with organic CNS lesion-related precocious puberty exhibited fluctuating plasma concentrations of these hormones that resembled findings in normal pubertal subjects who had significantly increased concentrations of plasma luteinizing hormone during sleep. Two patients with primary hypogonadism also showed episodic fluctuation of both hormones and augmented luteinizing hormone concentrations during sleep. These results suggest that the pubertal sleep-related gonadotropin secretion is dependent on the sleep-entrained CNS mechanism, and that the central nervous system plays an important role in sexual maturation.

Adolescent↗