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T Matsushiro

Publications and source records attributed to T Matsushiro.

At least 37 records · Page 2Linked to original sources
PubMed1981

Bile acid composition affecting cholesterol dissolution rate: a use of multiple regression analysis.

The dissolution rate of cholesterol in human gallbladder bile was measured by a rotating-disk method using 14C-labeled cholesterol, and was compared with concentrations of the biliary lipids. Computed multiple regression analysis of the results showed that the dissolution rate of cholesterol could be presented as a function of the concentrations of deoxycholic and chenodeoxycholic acid (multiple correlation 0.905; F-value 51.8 (p less than 0.001)). To examine the effect of different kinds of bile acids on cholesterol solubilization, the cholesterol solubility in a gallbladder bile with addition of a conjugated bile acid was determined. Greater solubilization of cholesterol was observed in the bile with addition of sodium deoxycholylglycine and chenodeoxycholylglycine than that with addition of sodium cholylglycine. There was no additional enhancement of the solubility with addition of sodium ursodeoxycholylglycine. These results suggest that the cholelitholytic effect of chenodeoxycholic acid may be greater than that of ursodeoxycholic acid, since the administration of chenodeoxycholic or ursodeoxycholic acid to patients with cholesterol gallstones induced different alterations of biliary bile acid composition.

Bile Acids and Salts↗
PubMed1981

Factors affecting the cholesterol dissolution ability of human bile.

Bile samples were obtained from 13 patients with cholesterol gallstones at laparotomy. Control bile samples were obtained from 15 patients with gastric cancer or gastric ulcer. One mixed stone was cut in half and serial thin sections, 10 micrometers in thickness, were prepared from the cut surface. The solubility of cholesterol in these gallstone sections after immersion in the bile samples was observed microscopically after 1, 3, 5 and 24 hr. Of 15 control bile samples, 9 showed a marked cholesterol dissolution after 1 hr, and 6 showed it after 3 and 5 hr. Three out of 13 bile samples from the patients with cholesterol stones dissolved the gallstone section after 1 hr, and 7 after 3 and 5 hr. The dissolution was not observed in the remaining 3 bile samples. Cholesterol and total bile acid concentrations of the control bile were significantly higher than those of the bile from the cholesterol gallstone patients (p less than 0.05 and p less than 0.02, respectively). Correlative studies of the composition of bile and its ability to dissolve cholesterol revealed that bile samples with a high total bile acid concentration possessed a higher dissolution ability, even when the ratios of total bile acid to cholesterol were almost the same in control and cholesterol gallstone bile. On the basis of these findings, it may be concluded that the solubility of cholesterol in bile cannot simply be explained in terms of relative concentrations of cholesterol, phospholipids and total bile acid, because the absolute concentration of total bile acid also plays a significant role for the dissolution ability.

Bile↗
PubMed1978

The effect of oral chenodeoxycholic acid on cholesterol solubility in hepatic bile.

By oral administration of chenodeoxycholic acid (CDCA) varying in dose for 7 consecutive days to patients who underwent cholecystectomy with biliary drainage for cholesterol gallstone, the biliary cholesterol dissolubility was studied in pursuit of the optimum dose in CDCA therapy for cholesterol gallstone. The rate of dissolution of biliary cholesterol by CDCA administration was highest in cases of 250 mg/day in dose, followed by those of 750 mg/day. When the dose was observed from per kg of body weight, the dissolubility of cholesterol was highest in the case of 6.3 mg/kg, followed by one of 12 mg/kg. Thus, it is presumed that in CDCA therapy for cholesterol gallstone a dose of 250 mg/day is too small and 750 mg/day too large in amount from the viewpoint of its effectiveness. The optimum dose probably lies between 5 mg/kg and 12 mg/kg. A transient elevation in levels of SGOT and SGPT was observed only in one case treated with 750 mg/kg.

Administration, Oral↗
PubMed1977

Results of surgical treatment for intrahepatic gallstones.

On the basis of the results of our surgical treatment of 85 patients with intrahepatic gallstones, effective methods for surgical treatment of this disease were discussed. The operative mortality rate for these patients was 10.6 percent. Most of the fatal cases had long duration of symptoms and showed evidence of hepatic fibrosis or biliary cirrhosis at the time of operation. The results emphasize that, in cases of long duration of symptoms, it is generally necessary to examine thoroughly prior to operation the presence or absence of liver parenchymal injury and to pay deliberate attention to minimizing operative intervention. Especially, in hepatic lobectomy, its indication must be scrutinized carefully assessing the condition of the patient. In our follow-up study, 80 percent of the patients were found living with almost no complaints, 5 patients having occasional bouts of cholangitic attack included 3 patients who had left the hospital having residual gallstones. Including these 3 patients, 7 of 9 patients with residual gallstones showed severe hepatic dysfunction. In general, indications of our operations for different types of patients with intrahepatic gallstones have been evaluated as satisfactory. For the favorable management of intrahepatic gallstones, two points are specially emphasized: thorough scrutinization of liver parenchymal disorder prior to operation, and long-term observation for care of survivors with residual gallstones.

Adult↗
PubMed1977

Effects of diet on glucaric acid concentration in bile and the formation of calcium bilirubinate gallstones.

The authors reported previously that beta-glucuronidase in bile, especially during biliary infection with Escherichia coli, plays a substantial role in producing cium bilirubinate gallstones. In the present study, bile levels of glucaro-1:4-lactone (measured as glucaric acid) the leading inhibitor of beta-glucuronidase, were measured in both man and in rats fed high, medium, and low protein-fat diets. Glucaric acid and total bilirubin in bile correlated well in human controls but not in gallstone patients. In animal experiments, the levels of these substances in bile were high in rats on high protein-high fat and low in those on low protein-low diets. These data suggest that when bile is infected with E. coli, calcium bilirubinate gallstones seemed to form more easily in patients on low protein-low fat diet than in those consuming food rich in protein and fat. On the other hand, the ratio of lecithin to cholesterol was higher in low protein-low fat rats than in high protein-high fat rats, suggesting that cholesterol gallstones were more likely to form on the latter diet. The animal, clinical, epidemiological, and dietary data are consistent with the known trend to a decreased incidence of calcium bilirubinate and an increased incidence of cholesterol gallstones in Japan.

Animals↗
PubMed1975

Problems of retained calculi in the bile duct.

A study of 68 patients subjected to re-surgery for residual or recurrent gallstones provided the following results: Among the 68 patients, the stones were recurrent in only 4, residual in 38, and uncertain but mostly suggesting residual in the other 26 cases. In many of the residual stone cases, the previous operations were cholecystectomy alone, retrospectively suggesting insufficient search for residual stones and other abnormalities in the biliary tract during the operations. Of the 4 recurrent stone cases, 3 of them showed bile duct stricture, papillary stenosis and idiopathic choledochus dilatation, respectively, while the remaining one, though free of any sign of bile stasis, had a gallstone formed around a silk-thread core. The indications for additional sphincteroplasty and biliodigestive anastomosis in re-operations were strictly consistent with those in the first operations. Seven operative fatal cases (10%) were mostly those of long persistent gallstones with serious hepatic failure. The follow-up studies in 53 patients showed as many as 51 cases returning to the preoperative occupation without any significant complaints. These results emphatically suggest that retained gallstone cases should be referred to surgical treatment as early as possible.

Bile Ducts, Intrahepatic↗
PubMed1975

Histochemical studies of pancreatic calculi.

Fourteen pancreatic calculi from the corresponding number of pancreatic lithiasis patients were examined mineralogically and histochemically. The following results were obtained. The main components of calculi were calcium carbonate in 13 of the 14 cases, and calcium phosphate in the remaining one. Calcium carbonate calculi were all so-called intraductal calculi, with acidic glycoprotein apparently enwrapping the component particles. Acidic glycoproteins acted to bridge calcium carbonate particles, as in the cases of gallstone and urinary stone. The calcium phosphate calculus had a histochemical feature of pathologic calcification with degenerated collagen fibrils as the matrix, suggesting the calcification of the fibrotic pancreatic parenchyma after pancreatitis.

Adult↗