[Relationship between reported flushing response and drinking pattern].
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Alcohol Drinking↗
Biomedical subjects
T Tsunoda
Publications and source records attributed to T Tsunoda.
Portal hemodynamic responses after oral intake of glucose in patients with cirrhosis.
UNLABELLED: Changes of portal, superior mesenteric, and splenic venous flows, and portohepatic gradient (portal vein pressure minus free hepatic vein pressure) after a meal were studied in patients with cirrhosis using the duplex ultrasonic Doppler flowmeter, and portal and hepatic vein catheterizations after ingestion of 227 ml of 33% glucose solution (300 kcal). As a control, changes of portal venous flow and portohepatic gradient after drinking 227 ml of water, were studied. Portal and superior mesenteric venous flows increased significantly at 30 min after glucose intake, and they returned gradually to the basal values, whereas no significant postprandial change occurred in splenic venous flow. The sum of superior mesenteric and splenic venous flows was greater than the estimated portal venous flow before glucose intake, and the difference widened during post-prandial mesenteric hyperemia, indicating an increase of blood flow into the portal-systemic shunts. After glucose intake, portohepatic gradient elevated immediately, in parallel with an increase of portal venous flow, and these changes persisted for the 30 min studied; however, no significant change occurred in these parameters after drinking water. IN CONCLUSION: 1) In patients with cirrhosis, hyperemia occurs in the intestine but not in the spleen after glucose intake, and 2) postprandial mesenteric hyperemia causes an increase of portal venous inflow, portal-systemic collateral flow, portal venous flow, and an elevation of portohepatic gradient.
Blood Pressure↗
The surgical treatment for carcinoma of the gallbladder--rationale of the second-look operation for inapparent carcinoma.
Eighty-seven patients with carcinoma of the gallbladder treated in our hospital over a 15-year period were reviewed. Macroscopic curative resection was performed in 30 cases, 6 of which received second-look operations, and their cumulative five-year survival rate was 42.6 per cent. Histological and clinical analysis of our cases initially diagnosed by postoperative histologic examination revealed that the depth of carcinomatous invasion was the most important criterion for the indication of second-look operation, and that the second-look operation is mandatory for the inapparent carcinoma limited to the muscularis or subserosa. The surgical procedures of the second-look operation were: resection of the anterior inferior and medial inferior areas of the liver and dissection of the regional lymph-nodes. The presence of invasion of carcinoma to the cut end of the cystic duct or severe carcinomatous invasion to the lymphatic vessels were also important histopathologic findings for a second-look operation. Cases in which lymphatic invasions are remarkably observed, should receive an en bloc hepato-cholecystectomy plus a resection of the extrahepatic bile duct with neural tissues and soft fatty tissues in the hepatoduodenal ligament in a two-stage operation.
Carcinoma↗
Prospective controlled trial of elective endoscopic sclerotherapy in comparison with percutaneous transhepatic obliteration of esophageal varices in patients with nonalcoholic cirrhosis.
The results of a prospective randomized controlled trial of elective endoscopic intravariceal sclerotherapy carried out over a 36-mo period in comparison with elective percutaneous transhepatic obliteration of varices (PTO) are presented. Sixty-six patients with nonalcoholic cirrhosis were randomized after they had stabilized, usually between 7 and 14 days after variceal bleeding had stopped following medical treatment (balloon tamponade and vasopressin infusion). Thirty-three patients were assigned to the sclerotherapy group and the other 33 patients were assigned to the PTO group. The mean follow-up period was similar in both groups. There was no significant difference in demographic, clinical, and laboratory data between the two groups. Six patients (18%) in the sclerotherapy group and 21 (64%) in the PTO group had at least one episode of gastrointestinal bleeding during the follow-up period (p less than 0.005). Three patients in the sclerotherapy group and 1 patient in the PTO group bled from lesions other than varices; therefore the incidence of variceal bleeding was 9% in the former and 61% in the latter (p less than 0.005). The cumulative variceal bleeding rate was significantly lower in the sclerotherapy group than the PTO group (p less than 0.05). Five patients in the sclerotherapy group died during the follow-up period but none died of recurrent variceal bleeding. Nineteen patients in the PTO group died and 10 of them died of bleeding from varices. The cumulative survival rate was significantly better in the sclerotherapy group (p less than 0.05). These results indicate that elective endoscopic intravariceal sclerotherapy is superior to elective PTO in the prevention of recurrent variceal hemorrhage and mortality in nonalcoholic cirrhosis.
Clinical Trials as Topic↗
Portal venous hemodynamics in hepatocellular carcinoma. Effects of hepatic artery embolization.
Portal hemodynamics were studied in 55 patients with hepatocellular carcinoma in comparison with 41 normal subjects, using the duplex system that consists of an electronic sector scanner and a pulsed Doppler velocitometer. Changes of portal hemodynamics after transcatheter hepatic artery embolization were also investigated in 15 of the patients with hepatocellular carcinoma. The duplex system showed that 9 of the 55 had no Doppler signal in the portal trunk, suggesting portal vein thrombosis, 2 had hepatofugal flow in the portal trunk indicative of arterioportal shunts, and 44 had hepatopetal flow in the portal trunk. One of the 9 patients with no significant portal venous flow showed hepatopetal flow in collateral veins at the porta hepatis, suggesting cavernous transformation of the portal vein. All of these ultrasound findings were confirmed by subsequent celiac-mesenteric angiography. In 44 of the 55 patients there was no tumor invasion in the portal trunk, and portal venous flow was found to be close to that of normal subjects regardless of the stage or size of tumor, and tumor invasion into relatively large portal branches. After transcatheter hepatic artery embolization, portal venous flow was increased, even on the next day, and it remained increased for at least 2 wk. Thus, the duplex system is useful to study qualitative and quantitative changes of portal hemodynamics in hepatocellular carcinoma. Our observations suggest that the portal venous flow is kept relatively constant by some homeostatic mechanism even in advanced hepatocellular carcinoma until the tumor invades into the portal trunk, and that it increases when hepatic arterial flow is occluded.
Adult↗
Objective testing of the efficiency of denture-cleansing agents.
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Aged↗
[Early determination of the effect of preoperative TAE by observation of serum AFP changes in patients with hepatocellular carcinoma].
Serum Alpha-fetoprotein (AFP) was assessed several times after preoperative TAE on 18 patients with hepatocellular carcinoma, and postoperatively the resected specimens were examined histopathologically. Changes in AFP level after TAE showed five typical patterns: AFP continued to rise in spite of treatment (non-effective type); AFP shows regular and equal increases and decreases (undulating type); AFP showed an increase after initially decreasing (increasing after decreasing type); AFP decreased gradually to normal levels (gradually decreasing type); and AFP decreased along a half-value period line to normal levels (half-value period type). These AFP patterns were intimately related to necrosis rate of tumor and other factors such as tumor size and existence of daughter tumors. Even when the AFP level decreased to 1/2 one week after TAE, the tumor showed only about 70% necrosis. Only when the AFP level fell into 1/4 of the original level after one week we could expect complete necrosis. Immuno-histological findings revealed AFP-producing cells in carcinoma but not in necrotic cells. It seems therefore, that the immuno-histological technique is uneffective in determining the viability of tumor cells.
Carcinoma, Hepatocellular↗
Adenosquamous carcinoma of the liver.
Two cases of adenosquamous carcinoma of the liver are presented. In one case, the carcinoma probably arose in the left hepatic duct, whereas in the other, it probably developed from a liver cyst. Only 10 other such tumors have been reported in the literature. Analysis of these cases indicates that the prognosis etiology of adenosquamous carcinoma may be similar to that of intrahepatic bile duct carcinoma. The prognosis for this tumor is very poor. Operation seems not to be an effective treatment, but radiation therapy may be of some use. Several terms, such as adenosquamous, adenoacanthoma, and mucoepidermoid carcinoma, have been used for carcinomas containing both adenomatous and squamous elements. We discuss the etiology and the origin of this rare liver tumor and conclude that the term adenosquamous carcinoma is the most apt.
Adenocarcinoma↗
Changes of splanchnic circulation with progression of chronic liver disease studied by echo-Doppler flowmetry.
Changes that occurred in splanchnic circulation with the progression of chronic liver disease were investigated using an ultrasonic Doppler flowmeter in healthy adults and in patients with chronic active hepatitis and liver cirrhosis in the supine position after an overnight fast. Superior mesenteric venous flow, splenic venous flow, and portal venous flow were significantly increased in patients with liver cirrhosis but not in patients with chronic active hepatitis compared with normal subjects. Portal venous flow (control value 10.5 +/- 2.3 ml/min/kg body weight) minus the sum of superior mesenteric venous flow and splenic venous flow was 0.8 +/- 2.1 ml/min/kg body weight in the control, (0.1 +/- 1.9) in chronic active hepatitis, and (-2.2 +/- 4.3) in liver cirrhosis; the difference was significant between the control and cirrhosis groups. These results indicate that in patients with liver cirrhosis a hyperdynamic state occurs in the splanchnic circulation of the intestine and spleen and that some portion of splanchnic blood flow bypasses the liver into the systemic circulation.
Adult↗
Portal hemodynamics after meal in normal subjects and in patients with chronic liver disease studied by echo-Doppler flowmeter.
Changes of portal, superior mesenteric, and splenic venous flows after a meal were studied with the duplex ultrasonic Doppler flowmeter in normal subjects, in patients with chronic active hepatitis, and in those with cirrhosis for 2 h after ingestion of a liquid meal (14% protein, 56% lipid, 30% carbohydrate, 300 kcal). Portal and superior mesenteric venous flows increased significantly throughout the experiment, whereas no significant change occurred in splenic venous flow after the meal in all three groups. The extent of the increase in portal venous flow was significantly lower in patients with cirrhosis, compared with normal subjects and patients with chronic active hepatitis, whereas superior mesenteric venous flow increased to the same extent in all three groups. The sum of superior mesenteric and splenic venous flows was less than the estimated portal venous flow in both normal subjects and patients with chronic active hepatitis; however, this value was greater than the portal venous flow in patients with cirrhosis. The difference widened during postprandial mesenteric hyperemia, indicating an increase of blood flow into the portal-systemic shunts. In conclusion 1) postprandial hyperemia occurs in the intestine, but not in the spleen, to the same extent in patients with chronic active hepatitis or with cirrhosis, as in normal subjects, and 2) a considerable amount of postprandial mesenteric hyperemia bypasses the liver into the systemic circulation of patients with cirrhosis but not in patients with chronic active hepatitis and normal subjects.
Adult↗
Immunogenicity and viability of alpha-class II immunotoxin-treated pig islet cells.
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Animals↗
[Comparative clinical studies of colorectal tumor tissue and normal tissue following arterial injection of tegafur].
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Adult↗
Leiomyoblastoma of the greater omentum. A case report and review of literature.
A case of leiomyoblastoma of the greater omentum, occurring in a 36-year-old man was described. Leiomyoblastoma of the omentum is extremely rare and only 6 cases have been reported in the Japanese and English literature up to date. According to the review of these cases, including the present case, 1) females were affected more frequently than males, and the age ranged from 36 to 76 years; 2) leiomyoblastoma was usually a large tumor which caused abdominal fullness and pain, and occasionally complicated with anemia and bloody ascites; 3) mitosis was rare, and there was no sign of metastasis and recurrence. Finally the morphological criteria and clinical parameters of malignancy in leiomyoblastoma were discussed.
Adult↗
Fatty liver in rats induced by excessive intake of a nutritionally adequate liquid diet.
In order to test whether or not overeating of a nutritionally adequate diet with reasonable fat content could result in significant fat accumulation in the liver, male Sprague-Dawley rats were provided with free access to either a nutritionally adequate liquid diet with 35 per cent of calories as fat or a regular diet (controls) for 3 months. After the feeding period, body weight, Lee index, and epididymal adipose tissue weight, were significantly greater in rats fed with the liquid diet than in the controls. Liver weight, hepatic triglyceride levels were also greater in the liquid diet group. Histologically, remarkable fatty infiltration was observed predominantly in periportal areas in rats fed with the liquid diet ad libitum for 3 months. Compared to a large body of the literature concerning diet-induced obesity in experimental animals, information on animal models of fatty liver by dietary manipulations is insufficient. The results of this study clearly indicate that the overeating of a nutritionally adequate diet with reasonable fat content could result in remarkable fat accumulation in the liver in rats.
Animal Nutritional Physiological Phenomena↗
The effects of endoscopic sclerotherapy combined with transhepatic variceal obliteration on portal hemodynamics.
We studied the effects of endoscopic sclerotherapy with transhepatic variceal obliteration on portal hemodynamics in 20 patients with cirrhosis (six with a spontaneous splenorenal shunt and 14 without it). Portal venous flow 1 month after combined therapy (measured by pulsed Doppler flowmeter) was significantly increased compared with that before therapy (n = 20, 843 +/- 339 vs. 669 +/- 253 ml/min, p less than 0.001). Portal vein catheterization and portal venous flow measurement were repeated 18 months after therapy in eight patients without a splenorenal shunt before therapy and in two patients with a splenorenal shunt before therapy. Two of the former developed a splenorenal shunt. In these 10 patients, portal venous flow before, one month, and 18 months after therapy was 617 +/- 219, 784 +/- 227, and 720 +/- 224 ml/min, respectively, and in 8 of 10 patients the portal venous flow at 18 months remained similar to the values at one month. Portal vein pressures were not significantly elevated 18 months after therapy (35.4 +/- 6.4 vs. 33.6 +/- 5.1 cm H2O) and the mean portal vein pressure change was 2.75 cm H2O (range -6 to +7.5 cm H2O). To summarize, portal venous flow was significantly increased one month after combined sclerotherapy in cirrhotics, the portal venous flow at 18 months remained similar to the values at 1 month in most patients, and the change in portal vein pressure after therapy was small.
Blood Flow Velocity↗
Cystadenoma and cystadenocarcinoma of the liver: localization of carcinoembryonic antigen.
Cystadenomas and cystadenocarcinomas of the liver are rare tumors. The distribution of carcinoembryonic antigen (CEA) in two cystadenomas and a cystadenocarcinoma was examined immunohistochemically by the peroxidase-labeled antibody method, at the light microscopic level. In the cystadenomas and areas consisting of benign-appearing cells in the cystadenocarcinoma, CEA was localized to the luminal surfaces of the glandular cells appearing as thin linear stains. In malignant epithelial cells forming nests and daughter cysts of the cystadenocarcinoma, CEA was demonstrated throughout the cytoplasm, in a diffuse pattern. Thus, the immunohistochemical localization of CEA may be helpful in the diagnosis of borderline lesions and in determining the distribution of benign and malignant epithelium in cystadenocarcinomas. The etiology, clinical features, pathology and treatment of these rare tumors are discussed.
Adult↗
Mucus-secreting presacral cyst--a case report.
A mucus-secreting presacral cyst was found in a 49-year-old woman who complained of dysuria. A routine rectal digital examination revealed a retrorectal mass. Diagnostic imaging demonstrated a large presacral cystic tumor. The cyst was removed through a transsacral approach. Histologically, the cyst membrane consisted of squamous and columnar mucus-secreting epithelium, and was diagnosed as a mucus-secreting presacral cyst.
Cysts↗