Search PubMed⌕ Search

Biomedical subjects

Y Asanuma

Publications and source records attributed to Y Asanuma.

At least 55 records · Page 3Linked to original sources
PubMed1991

Insemination of bile duct carcinoma to the liver after insertion of percutaneous biliary endoprosthesis.

Percutaneous transhepatic biliary drainage is widely used to relieve bile duct obstruction which can be caused by bile duct or pancreas carcinomas. Although the incidence is low, insemination of carcinoma along the transhepatic catheter tract is considered to be a serious complication of percutaneous transhepatic biliary drainage. The authors present a case of intrahepatic insemination of bile duct carcinoma along the catheter that subsequently underwent a curative resection consisting of pancreaticoduodenectomy and right hepatic lobectomy. It is suggested that a percutaneous biliary endoprosthesis through the tumor should be avoided in patients in whom a possible curative resection can be considered. External biliary drainage should only be performed in order to minimize the manipulation of the tumor in such patients.

Adenocarcinoma↗
PubMed1991

Intracavitary irradiation treatment via the inferior vena cava for caudate lobe invasion in hepatic hilar bile duct cancer.

Cancer invasion to the caudate lobe of the liver is considered an important prognostic factor in hepatic hilar bile duct cancer, and caudate lobectomy is required in cases with massive invasion. In many cases, however, the invasion is difficult to confirm even at intraoperative examination. As the caudate lobe is close to the inferior vena cava, it can be irradiated by a source in the inferior vena cava. In this paper, intracavitary irradiation of the caudate lobe via the inferior vena cava is proposed instead of resection for possible, but not confirmed, invasion. In experiments on dogs, intracavitary irradiation was performed by remote after-loading using 60Co at a dose of 20 and 300 Gy via the inferior vena cava. The radiation is so highly concentrated on the designated target that an anticancer effect can be expected. No noteworthy side effects were observed by functional and morphological studies after 20 Gy irradiation. This treatment has been applied clinically, with favorable results. This treatment modality is a non-surgical caudate lobectomy aimed at avoiding useless, and potentially hazardous, resection.

Animals↗
PubMed1991

[Experimental studies on tissue injury by microwave tissue coagulator].

The tissue injury caused by Microwave Tissue Coagulator (MTC) was assessed clinically and experimentally with dogs. Following hepatic transection using MTC on condition that the output was 60 watts and radiation lasted for 60 seconds at one time, GOT, GPT, lactic acid, FDP and endotoxin concentration increased and coagulation parameters such as hepaplastin test were deteriorated transiently. Of tissue injury, following results were obtained. 1) The mechanism of tissue injury by MTC consists of direct heat injury and infarct by circulatory disturbance. The extent of injury from the needle electrode is approximately 10 mm in the former mechanism and 20mm in the latter. 2) Injury of vessels in Glisson's sheath was confirmed up to 50mm apart from the needle electrode by labelling index of bromodeoxyuridine in bile duct epithelial cells. 3) The granulation formation at the site of necrosis was considerably retarded by wound infection. Accordingly, when MTC is utilized on hepatectomy, followings should be noted: 1) To prevent the large intrahepatic vessels from heat injury, MTC may be utilized at the surface of the liver and the needle electrode must be punctured more than 10mm apart from them. 2) Bile leakage at the resected stump should be eliminated to prevent infection at the stump.

Animals↗
PubMed1991

[Adult dermatomyositis with angiopathy and cecum perforation].

This previously healthy 43-year-old man was admitted to our hospital with a history of rash, dysphagia and severe myalgia for two months. Physical examination showed prominent edema and erythema over the face and the chest, scattered ulcerations on the trunk, and muscle atrophy most prominent proximally. Serum levels of muscle enzymes were remarkably increased. Two weeks of oral prednisolone therapy (40 mg/day) was not effective, and betamethasone intravenous pulse therapy (3 x 1000 mg) was followed by slight clinical improvement. However, 12 days after pulse therapy, he complained abdominal pain on the right lower quadrant. The surgical findings included peritonitis due to single perforation of the cecum. After operation, cyclosporine therapy was added and over the next 14 month a considerable clinical improvement was noted. Prednisolone was reduced from 80 mg to 10 mg daily. Biopsy specimens from ulcerated+ skin and perforated cecum showed prominent vascular abnormalities: arterial and venous intimal hyperplasia, occlusion of vessels by fibrin thrombi, and lymphocytic infiltration which affected veins of all sizes. The evidence strongly suggests that both skin ulcers and cecum perforation were caused by vasculitis and occlusion of vessels, which often seen in childhood dermatomyositis.

Cecal Diseases↗
PubMed1991

Hepatic hemodynamics and functions in extrahepatic portal obstruction in the rat with liver cirrhosis.

Portal vein obstruction due to a thrombus may be encountered in liver cirrhosis. However, the effect of portal vein obstruction on hepatic hemodynamics and functions, and on collateral formation has not been clear in liver cirrhosis. To rectify this, the cirrhotic rat model with portal vein ligation was evaluated. In addition to the early recovery of hepatic blood flow, the reduction in hepatic blood flow after portal vein ligation was less in the cirrhotic rat than in the normal rat. The portogram showed that, in addition to hepato-fugal collaterals, hepato-petal collaterals developed well and early in the cirrhotic rat as compared with the normal rat. Although mitochondrial functions before portal vein ligation deteriorated in the cirrhotic rat, the decrease after portal vein ligation was less, and the recovery of function was earlier in the cirrhotic than the normal rat. The influence of portal vein obstruction on hepatic hemodynamics and functions in the cirrhotic rat was less than in the normal rat, due to earlier and significant formation of hepato-petal collaterals.

Animals↗
PubMed1990

Metabolism of 3,7-dioxo-5 beta-cholanoic acid in the biliary fistula rodents and rabbits.

Intestinal absorption and metabolism of 3,7-dioxo-5 beta-cholanoic acid, were studied in the bile fistula rats, hamsters, guinea-pigs and rabbits. The influence of dose (1 and 100 mg/kg) on the absorption and the metabolism was also estimated. The dioxo bile acid was absorbed efficiently from the intestine and quickly excreted into bile in these animals. Large dose did not retard the absorption rate and showed a significant choleretic effect for a few hours. Species differences were observed in the metabolism of this compound. In hamsters and guinea-pigs, most of the metabolites in the bile were conjugated with either taurine or glycine. The proportion of bile acids amidated with glycine was greater with the large dose. In rats, the biliary metabolites were conjugated with taurine, but not with glycine, whereas in rabbits, glycine conjugates were the only recovered metabolites. Unconjugated metabolites were also detected in the bile of the rodents, and the proportion of them rose to 17-29% after the administration of 100 mg/kg quantities. A small part of unchanged 3,7-dioxo-5 beta-cholanoic acid was excreted into the bile as both the conjugated and unconjugated forms in these animals. The greater part of this compound administered was metabolized to 7-ketolithocholic acid, chenodeoxycholic acid and ursodeoxycholic acid. In hamsters and guinea-pigs, chenodeoxycholic acid was a greater metabolite of this compound than ursodeoxycholic acid, while in rats and rabbits, the amount of ursodeoxycholic acid exceeded that of chenodeoxycholic acid. In rats, the resulting dihydroxy bile acids were further metabolized to alpha- and beta-muricholic acids.

Amidohydrolases↗
PubMed1989

Targeting chemotherapy for intrahepatic periductal lymphatic invasion by mitomycin C adsorbed to activated charcoal in hepatic hilar bile duct cancer.

A new dosage form of anticancer agent, mitomycin C adsorbed to activated charcoal (MMC-AC), was evaluated in the rabbit model of hepatic hilar bile duct cancer. The model was produced by inoculation of VX2 cells into the wall of the hepatic hilar bile duct. Histologic examination revealed that the mode of spreading of VX2 cells in the model closely resembles that of human bile duct cancer. On the other hand, selective accumulation of MMC-AC into the lymphatic vessels around the intrahepatic bile duct was observed after its injection into the hepatic hilum in rabbits. To assess the anticancer effect, 1 ml of MMC-AC was injected into the bile duct wall near the VX2 tumor. The numbers of lymphatic vessels where necrosis of VX2 cells was observed in one-third or more were 34 of 103 vessels 0.5 cm away from the tumor, 23 of 80 vessels 1.5 cm away, and 9 of 67 vessels 2.5 cm away. We believe that the injection of MMC-AC into the hepatic hilum can be effective adjuvant therapy for hepatic hilar bile duct cancer.

Animals↗
PubMed1989

Mitochondrial function of isolated rat hepatocytes from normal and cirrhotic liver.

Mitochondrial fractions were obtained from purely isolated hepatocytes of the normal and cirrhotic livers. Mitochondrial function of isolated hepatocytes was evaluated to compare between those from the normal and those from the cirrhotic livers in addition to the evaluation of the mitochondrial function of the normal and cirrhotic liver tissues. Respiratory control, ADP/O ratio and ATP synthesis were significantly lower in the cirrhotic liver tissue than those in the normal liver tissue. However, the mitochondrial function of isolated hepatocytes showed no difference between normal and cirrhotic groups. By electron microscopic examination, debris was more observed in the mitochondrial fractions from the normal and cirrhotic tissues compared to those from hepatocytes. However, no difference of the shape and size of the mitochondria was seen between the fraction from hepatocytes and that from the tissue in each group. These results suggest that as far as hepatocyte itself is concerned, the cirrhotic liver preserves the sufficient function as well as the normal liver.

Adenosine Triphosphate↗
PubMed1989

On-line plasma exchange for sepsis in neonates and infants.

The present study was designed to assess the effectiveness of on-line plasma exchange (on-line P.E.) between septic infants and healthy adults using septic puppies. The plasma separation system consisted of a membrane plasma separator and a plasma treatment system, KM-9027 (Kurarey Co.) equipped with small 2 channel blood and plasma pumps. 5 X 10(9) CFU/ml/kg of E. coli with endotoxin was injected intravenously into 22 puppies and they were divided into 4 groups, namely untreated group (n = 7), on-line P.E. group (n = 5), P.E. group (n = 5), sham group (n = 5). In the on-line P.E. group, about 80 ml/kg of plasma in septic puppy was replaced during 2 hr with fresh plasma simultaneously obtained from healthy adult dog. As the results, 4 of 5 survived in the on-line P.E. group and 1 of 5 survived in the P.E. group, while all other puppies died within 24 hr. In the P.E. group and on-line P.E. group, mean blood pressure and urinary output were significantly improved (p less than 0.05) by the treatment. The numbers of E. coli and endotoxin concentration in the blood were reduced significantly (p less than 0.05) only in the treatment with on-line P.E. opsonic activity recovered significantly (p less than 0.05) in P.E. group. This system appears to be effective and applicable for sepsis in infants and neonates.

Age Factors↗
PubMed1989

New strategy for treatment of carcinoma of the hilar bile duct.

Surgical treatment for carcinoma of the hilar bile duct has been a challenging problem, because the five year survival rate is less than 5 per cent and the mean survival period is 17 to 24 months even in curatively resected instances. The prognostic factors of carcinoma of the hilar bile duct are remnant carcinoma at the bile duct stump and cancerous invasion into the lymphatics, veins, perineural spaces around the intrahepatic bile duct and caudate lobe of the liver. Based on these data, a new strategy for treatment of carcinoma of the hilar bile duct has been developed and applied clinically. The strategy consists of three procedures. The first is resection of the hilar bile duct with portajejunostomy; the second, specific anticancer therapy with mitomycin C (4 milligrams) adsorbed to the activated charcoal (MMC-CH) focused on the invasion of carcinoma to the periductal lymphatics, and third, intracavitary irradiation (32 to 40 gray) by 60Co using the remote after loading system (RALSTRON 20B, Shimazu Co. Ltd., Tokyo) through the bile duct focused on the periductal infiltration of the carcinoma and through the inferior vena cava focused on the caudate lobe of the liver. In this article, the operative procedures and theoretic background of the specific chemotherapy and irradiation are described. Seven patients have been treated using this regimen. Follow-up study ranged from seven to 38 months. All patients are alive, and five of seven are disease-free.

Adenoma, Bile Duct↗
PubMed1989

[Treatment of endotoxin shock due to gram-negative bacteremia using extracorporeal circulation].

The effectiveness and significance of the various therapeutic methods of extracorporeal circulation were assessed in an experimental model of septic endotoxin shock. After sepsis was produced in 30 puppies by intravenously injecting 5 X 10(9) CFU/ml/kg of E. coli, on-line plasma exchange, conventional plasma exchange, charcoal plasma perfusion, hemofiltration, and sham perfusion were performed for 2 hr. As a result, 4 of the 5 puppies in the on-line plasma exchange group and one of the 5 in the conventional plasma exchange group survived; the others all died. In the on-line plasma exchange group, the number of E. coli decreased to 2.5 X 10 CFU/ml at the end of the treatment, while it was 1.3 X 10(3) CFU/ml in the sham perfusion group. The endotoxin concentration was also reduced significantly, while plasma opsonin activity was remarkably elevated. These results suggest the significance of achieving the elimination of endotoxin in blood and an increase in plasma opsonin activity simultaneously in the treatment of septic endotoxin shock.

Animals↗
PubMed1989

[Experiences of postoperative staphylococcal enteritis caused by methicillin-cephem resistant Staphylococcus aureus (MRSA) and the state of the isolation of MRSA].

During the last 12 months, three cases of postoperative staphylococcal enteritis were experienced in our surgical ward. Kanamycin, Clindamycin and Latamoxef were given prophylactically in all cases. They developed dehydration with severe diarrhea and paralytic ileus in three to ten days after abdominal surgery. MRSA was cultured from the intestinal fluid or feces and Minocycline, sensitive anti-microbial agent to the organism, was administered intravenously and their conditions improved dramatically. Since the nosocomial infections of MRSA are believed to be the cause of these cases, following items were investigated; 1) the frequency of MRSA among Staphylococcus aureus clinically isolated from patients in surgical ward, 2) the state of nasal carriage of MRSA in medical staffs and inpatients without infections in surgical ward, 3) drug sensitivity of MRSA to ten kinds of antibiotics. The results were as follows; 1) the frequency of MRSA was 83% of all the strains of Staphylococcus aureus, 2) the nasal carrier status was 2 in 46 medical staffs and 4 in 17 inpatients, 3) 124 strains of MRSA, 114 isolated from patients and 10 from nasal carriers, showed the identical drug sensitivity, that is, MRSA is sensitive to Minocycline and resistant to every other antibiotics. It is believed that these three cases were due to nosocomial infections of MRSA, and early diagnosis of MRSA enteritis should lead to early antibiotic therapy and to a cure of this serious postoperative complication.

Adult↗
PubMed1988

Effect of blood purification on the kidney function of the jaundiced rat.

This paper is aimed at evaluating the effect of blood purification on the mitochondrial functions of the kidney in jaundiced rats. At 1, 2, or 3 weeks after bile duct ligation and dissection, obstructive jaundiced rats were utilized for experiment. Cross circulation in 1 ml/min between jaundiced rats and normal rats was performed for 1 or 3 h. Immediately and 24 h after cross circulation, the rats were killed and mitochondrial respiratory functions of the kidney were assessed by measuring oxygen consumption. Mitochondrial function, especially ATP synthesis, showed significant improvement in jaundiced rat with 2 or 3 weeks of biliary obstruction. Cross circulation for 3 h was more effective than that for 1 h. These data suggest that the renal energy production can be increased significantly in obstructive jaundice by blood purification treatment.

Animals↗
PubMed1988

An evaluation of serum high density lipoproteins-phospholipids.

Phospholipids in high density lipoproteins (HDL) is being used as a negative risk indicator of atherosclerosis. Phospholipids in HDL may not demonstrate the actual level of HDL-phospholipids when determined by the precipitation or ultracentrifugal methods, because HDL fractions contain very high density lipoproteins (VHDL) and albumin. In the present study, the true level of phospholipids in HDL was estimated using high performance liquid chromatography (HPLC), and it was compared with the level of phospholipids in HDL determined by the precipitation method. Sera from 18 healthy subjects were used as materials. In the HPLC method, the HDL fraction was extracted making sure that it contained no free albumin, which is albumin not bound to phospholipids. The HDL fraction was separated into subfractions. It was found that phospholipids in the VHDL fraction make a 20.2 +/- 7.3% (mean +/- S.D.) part of the total HDL-phospholipids. A large part of the VHDL fraction was constituted of albumin-bound phospholipids. A significant correlation was observed between HDL-phospholipids determined by the precipitation method, which contain albumin, and the actual HDL fraction phospholipids determined by HPLC, which do not contain VHDL (r = 0.903, p less than 0.01). These results suggest that HDL-phospholipids values determined by the precipitation method give useful clinical data.

Adolescent↗
PubMed1988

[Respiratory function of mitochondria fractionated from isolated hepatocytes of rats with obstructive jaundice].

Obstructive jaundice model was created using rats by the ligation of bile duct. One, 2, 3 weeks later, the respiratory function and morphology of the hepatic mitochondria were comparatively evaluated between mitochondria directly fractionated from liver tissue and mitochondria from isolated hepatocytes. Respiratory function of the former deteriorated with the duration of jaundice. ATP synthesis decreased to 75% of the control at 1 and 2 weeks, and 58% at 3 weeks after ligation. On the contrary, it was 97%, 88% and 87% of the control. On the contrary, it was 97%, 88% and 87% of the control at 1, 2 and 3 weeks in the latter. By electron microscopic examination, the size of mitochondria of the jaundiced liver is inconsistent and smaller in general than the control. These data suggest that the deterioration of mitochondrial function in the jaundiced liver is not caused mainly by the disturbance of mitochondria themselves, but caused by the respiratory inhibitory factors which exist around the mitochondria.

Animals↗
PubMed1987

Clinical usefulness of intrathecal injection of methylcobalamin in patients with diabetic neuropathy.

Seven men and four women with symptomatic diabetic neuropathy were treated with methylcobalamin (2,500 micrograms in 10 ml of saline) injected intrathecally. Treatment was begun when patients had good metabolic control, as determined by measurements of plasma glucose and hemoglobin, and was repeated several times with a one-month interval between injections. Three patients were re-treated one year after the last intrathecal injection. Symptoms in the legs, such as paresthesia, burning pains, and heaviness, dramatically improved. The effect appeared within a few hours to one week and lasted from several months to four years. The mean peroneal motor-nerve conduction velocity did not change significantly. The mean (+/- SD) concentration of methylcobalamin in spinal fluid was 114 +/- 32 pg/ml before intrathecal injection (n = 5) and 4,752 +/- 2,504 pg/ml one month after intrathecal methylcobalamin treatment (n = 11). Methylcobalamin caused no side effects with respect to subjective symptoms or characteristics of spinal fluid. These findings suggest that a high concentration of methylcobalamin in spinal fluid is highly effective and safe for treating the symptoms of diabetic neuropathy.

Adult↗
PubMed1987

[Effects of hydrostatic pressure on cardiac function in human].

Effects of hydrostatic pressure on cardiac function were measured by echocardiography and radiography. Seven normal subjects (three females and four males) aged from 21 to 45 years were performed echocardiography on long axis of the heart at standing position in air and in head-out water (36 degrees C) immersion. A same trials were done at long sitting position in four subjects (one female and three males). The measurement of cardiac functions was calculated by Pombo's method. A chest radiography of a normal male individual (45 years) was taken at the time of functional residual capacity of lung in air and in head-out water (36 degrees C) immersion. For taking the chest radiography in water and in air, a box made by wood was used. X-ray exposure was synchronized with R wave of electro-cardiogram. The end-diastolic left ventricular volume, end-systolic volume and cardiac output in water immersion were significantly increased to compare with that of in air. Mean +/- SD of these percent changes were 213 +/- 71% (p less than 0.005), 193 +/- 90% (p less than 0.05), 220 +/- 83% (p less than 0.005), respectively. A same results were obtained at long sitting position. There was no significant changes on the heart rate between in water and in air. The circumstance of the abdomen decreased significantly in water immersion in comparison to in air. The percent change was 94.4 +/- 3.1% (p less than 0.001). There was a significant correlation between percent changes of abdominal circumstance and percent changes of end-systolic left ventricular volume (r = 0.754, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗