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Biomedical subjects

S Shionoya

Publications and source records attributed to S Shionoya.

At least 73 records · Page 4Linked to original sources
PubMed1988

Complement activation by vascular prostheses and its role in progression of arteriosclerotic lesions.

This study, using C3a, C4a, and C5a assay and crossed immunoelectrophoresis in vitro and in vivo, was designed to determine whether vascular prostheses activate the complement system. The degree of complement activation and the pathway of activation were also studied. The complement levels (C3, C4, CH50) in different arterial diseases were measured, and the relationship of complement levels to serum lipids in patients with arteriosclerosis obliterans (ASO) was also investigated, in order to clarify a relationship between the complement system and arteriosclerosis or other arterial diseases. Bovine graft, dacron, and PTFE activated the complement system in vitro. In order of the degree of complement activation, bovine graft ranked first, followed by dacron and PTFE. The patient group with acute arterial occlusion showed high C3 and C4 levels. The healthy elderly group showed higher C3 and C4 levels than the healthy persons in their twenties. In ASO patients, C3 levels correlated with serum lipid levels. Judged from the relation of complement activation by vascular prostheses to the progression of arteriosclerotic changes, vascular prostheses should be assessed with regard to complement activation.

Arterial Occlusive Diseases↗
PubMed1988

[Diagnostic value of computed tomography for the detection of invasion of the caudate bile duct branch in carcinoma of the hepatic hilum].

The visualization of the caudate bile duct branch (B1) in computed tomography (CT-scan) with a high dose of contrast medium was evaluated in 71 patients with carcinoma of the liver, biliary tract and pancreas, preoperatively. The patients were classified into four groups: Group A, 22 patients (twelve hepatomas, six gall bladder cancers and four cancers of the pancreas body or tail) without abnormal findings in the biliary tract; Group B, two patients (cancer of the pancreas head and the common bile duct) with obstructive jaundice whose CT-scans were taken before percutaneous transhepatic cholangio-drainage (PTCD); Group C, 22 patients (16 cancers of the pancreas head and six common bile duct cancers) whose CT-scans were taken after release of jaundice by PTCD; Group D, 25 patients with carcinoma of the hepatic hilum whose CT-scans were taken after release of jaundice by PTCD. The results were as follows. 1) In Group A, B1 was invisible in all the patients. 2) In Group B, B1 was clearly visible in all the patients. But in Group C, B1 was visible only in one patient. 3) In Group D, B1 was visible in 19 out of 25 patients and in 18 patients out of these 19 patients, cancer invasion toward B1 was histopathologically confirmed. In contrast, invasion was revealed only in one out of six patients whose B1s were invisible. From these results, it is concluded that in carcinoma of the hepatic hilum the visualization of B1 in CT-scan after release of jaundice by PTCD strongly suggests the cancer invasion on B1, and requests the caudate lobe resection.

Aged↗
PubMed1988

[A clinical study of extended profundaplasty for severely ischemic limbs].

Between January 1986 October 1987, extended profundaplasty was performed on 11 severely ischemic limbs of eight patients with extended arteriosclerotic occlusions, associated with surgery for improvement in inflow. The subjects were all males, and ages ranged from 62 to 84 years (mean: 72.8 years). Symptoms were disabling claudication in one limb (1 case), rest pain in 5 (4 cases), and gangrene of the foot or ulcer of the toes in 5 (3 cases). Preoperative ankle pressure index (API) was 0 in 7 limbs (5 cases), and between 0.11 and 0.27 in the remaining 4 limbs (3 cases). Thrombectomy was performed in two cases, axillo-bifemoral bypass in 5, femoro-femoral bypass in one, and aorto-bifemoral bypass in one, as surgery for improvement in inflow. Although postoperative API remained 0 in 4 limbs, it increased between 0.36 and 0.56 in the remaining limbs. One subject died of heart failure on the 22nd postoperative day, and two limbs required below-knee amputation. Limb salvage rate was 81.8%. Extended profundaplasty seems to be a worthwhile choice of treatment as a limb salvage operation for severely ischemic limbs due to extended arteriosclerotic occlusions involving not only aorto-iliac but also femoro-popliteal or crural segment.

Aged↗
PubMed1988

[A case of primary intrahepatic cholesterol gallstones difficult to manage by percutaneous transhepatic cholangioscopy].

A case of a 60-year-old man with primary intrahepatic cholesterol gallstone was reported. Several stones, each size 3mm in diameter, were packed in the diverticulum-like dilated part of the posterior-inferior-ventral bile duct branch of the right lobe and 3 stones, each size 3-4mm in diameter, were scattered separately in the lateral segment of the left lobe of which the bile duct branches were diffusely tortuous and with mildly irregular dilatation. Morphologic appearance of the biliary system except in these 2 areas was normal. All stones including a large gallbladder stone consisted of cholesterol. Intraluminal approach, not only ERC but also PTCS, can hardly detect intrahepatic stones of more peripheral areas, although combination of US and enhanced CT may be useful even though bile duct branches are not dilated. We failed in PTCS lithotomy in this case for the first time in our experience with more than seventy cases of intrahepatic stones. However, by PTCS it was possible to investigate the morphology of the biliary system in detail and consequently, to make the diagnosis of primary intrahepatic stones. This patient has cured by cholecystectomy and minimum hepatectomy.

Bile Ducts, Intrahepatic↗
PubMed1988

[Carotid endarterectomies for cerebral ischemia: a follow up study of surgical results and late neurologic complications].

Twenty five carotid endarterectomies were performed in 24 patients with cerebral ischemia due to atherosclerosis. Four of these patients were asymptomatic, 7 suffered from hemispheric TIA (hemispheric attack group), 7 suffered from nonhemispheric TIA (nonhemispheric attack group) and other 6 had previous completed stroke (completed stroke group). The average length of follow-up study was two and half years with a range of 2 months to 6 years. Completed strokes occurred in 1 patient following the operation and in 3 patients during the follow-up period (16.7%). Two patients were reoperated upon because of recurrent carotid stenosis (8.3%). Four patients continued to have neurologic symptoms postoperatively. Ultimately 10 of 24 patients had some neurologic complications even following carotid endarterectomies (41.7%). The first postoperative year was the worst period because almost all late neurologic complications occurred in that time. Kaplan-Meier's analysis demonstrated a relatively favorable result in the hemispheric attack group among these 3 groups. The completed stroke group was followed by that and the nonhemispheric attack group was proved to be the worst, although there was no statistical significance.

Aged↗
PubMed1987

Abdominal aortic aneurysm complicated with chronic disseminated intravascular coagulopathy: a case of surgical treatment.

This article reports a case of an infrarenal abdominal aortic aneurysm complicated with chronic disseminated intravascular coagulopathy (DIC). The patient was a 68-year-old man; bleeding of 20 months' duration was reported. Physical examination indicated a pulsating mass in the abdomen. The diagnosis of DIC was made on the basis of standard coagulation studies. Indium 111-labeled platelet scintigraphy demonstrated an increased accumulation of radioactivity over the aneurysm. After preoperative control of the bleeding tendency was obtained by continuous intravenous infusion of gabexate mesilate (FOY), the aneurysm was successfully replaced with a prosthetic graft. Gabexate mesilate therapy is useful for DIC as is heparin therapy. If surgical intervention is required for an abdominal aortic aneurysm with concomitant DIC, preoperative control of bleeding with gabexate mesilate or heparin is recommended to lessen operative bleeding.

Aged↗
PubMed1987

Polycythemia of end-stage renal failure: no inhibition of erythropoiesis by uremic serum and markedly increased serum erythropoietin level.

This report describes the case of a 50-year-old male with end-stage renal failure accompanied with congenital heart disease and polycythemia. After he had received continuous ambulatory peritoneal dialysis for 1 year, he still remained polycythemic and his serum erythropoietin titer, assayed using fetal mouse liver cells, was markedly increased. An inhibitory effect on erythropoiesis was not detected by this method. Bone marrow examination showed erythroid hyperplasia. These phenomena could be explained by an overproduction of erythropoietin by the remnant kidneys or extrarenal organs, such as the liver, in response to persisting hypoxia. The patient's bone marrow was still responsive to erythropoietin.

Erythropoiesis↗
PubMed1987

Characterization of histamine H1-receptor on rat hepatocytes.

The binding sites for [3H]pyrilamine in isolated rat hepatocytes were characterized. Scatchard analysis revealed two kinds of binding sites in hepatocytes, a high-affinity site and a low-affinity one. The rates of binding of the radioligand with the high-affinity binding site and its dissociation were rapid. The specificity of the sites for various histamine antagonists indicated that the high-affinity [3H]pyrilamine binding site is representative of the histamine H1 receptor. Treatment of hepatocytes with protease or phospholipase A2 significantly decreased the maximum binding capacity of the high-affinity site without affecting its dissociation constant, suggesting that the binding site is proteinaceous and is sensitive to a change in the lipid moiety of the membrane. Hepatocytic cyclic AMP and cyclic GMP were not significantly modulated by incubating hepatocytes with histamine. Thus, the action of histamine on hepatocytes might not be mediated by the cyclic nucleotides.

Animals↗
PubMed1987

[Three cases of thoracic or thoracoabdominal aortic aneurysm successfully treated with cell saver].

During a three-month period from January to March 1986, reconstructive surgery was performed on three patients with thoracic or thoracoabdominal aortic aneurysm using a temporary bypass procedure. To reduce the amount of blood transfusion required during operation, an autologous blood recovery system, Cell Saver, was used in these three cases. The amount of blood loss, including the blood passing through the Cell Saver, was 7,020g in Case 1, 6,600g in Case 2 and 16,700g in Case 3. The amount of blood transfusion given to these three cases was 1,400g, 4,400g and 6,800g, respectively. The results indicated that the ratio of transfused blood amount to blood loss during operation was successfully reduced to a level of 20-67% of two other cases with thoracoabdominal aortic aneurysm, operated upon without using Cell Saver. Cell Saver was especially effective in Case 3 in which the blood for transfusion was restricted, for it was difficult to collect enough donors to complete operation because of rare blood type of Rh(-) in this case. That is, Cell Saver withdrew 15,000ml of blood through the sucker from the patient and returned it as concentrated and washed RBC during operation.

Aorta, Abdominal↗
PubMed1987

Predominance of prostaglandin D2 and I2 in the rat gastric mucosa--analysis by high-performance liquid chromatography.

We have developed a method for measuring prostaglandins (PGs) in rat gastric mucosa by high-performance liquid chromatography (HPLC). The levels of PGD2 and 6-keto-PGF1 alpha, a degradation product of PGI2, were five times higher than those of PGE2 and PGF2 alpha. Oral administration of indomethacin (6 mg/kg body weight) completely abolished the synthesis of all detectable PGs uniformly. These results suggest that endogenous PGs, especially PGD2 and I2, play some roles in the function of the gastric mucosa.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

[A case of polypoid carcinoma of the left hepatic duct].

A case of polypoid carcinoma of the left hepatic duct in 50-year-old male was reported. Extended left hepatic lobectomy with total caudate lobectomy and resection of the right hepatic duct were performed because the tumor involved the right hepatic duct and bile duct branches of caudate lobe, medial and lateral segment. Papillary growth of the tumor was diagnosed definitely by percutaneous transhepatic cholangioscopy (PTCS) and computed tomography. The tumor infiltrated the liver parenchyma of medial segment and compressed the middle hepatic vein. These findings were revealed by selective middle hepatic venography preoperatively.

Adenocarcinoma↗
PubMed1987

[Anatomical studies on the biliary tree of the caudate lobe using an endoscopic retrograde cholangiogram].

The purpose of this study is to clarify positional relationship between the bile duct of the caudate lobe and the bile duct of the hepatic hilum through endoscopic retrograde cholangiogram (ERC). Until December 1984 all 100 ERC that met the following three conditions were studied which at Yachio Hospital. 1. The first cholangiogram. 2. Without obstructive jaundice. 3. No existence of lesion at the hepatic hilum. Bile duct of the caudate lobe were classified into 4 separate types: 1) Ducts from the cranialis of the right caudate lobe which pass via the inferior vena cava to the hepatic hilum named Blr, were confirmed in 32. 2) Ducts from the cranialis of the left caudate lobe to the hepatic hilum named Bl l s, were confirmed in 19. 3) Ducts from the left lateral part of the left caudate lobe to the hepatic hilum named Bl l i were confirmed in 37. 4) Ducts from the caudate process to the hepatic hilum named Blc, were confirmed in 5. One or more of the above bile ducts were confirmed in 53 cases. All four of the above were confirmed in only 2 cases out of 53 cases. Three were confirmed in 7 out of 53 cases, two were confirmed in 20 cases out of 53 cases and one was confirmed in 24 out of 53 cases. Studies for the bile duct of the caudate lobe have been conducted anatomically, but there has been no research by clinical examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Ducts, Intrahepatic↗