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Biomedical subjects

Y Hamanaka

Publications and source records attributed to Y Hamanaka.

At least 37 records · Page 2Linked to original sources

Oral absorption tests: absorption site of each substrate.

Three oral absorption tests have been used in patients with short bowel syndrome (SBS) to evaluate the absorption site of each substrate. In this study, three absorption tests were applied: the oral pancreatic function test using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (NBT-PABA), the D-xylose tolerance test, and the oral fat tolerance test. Examinations were performed in eight patients with either a duodenostomy or a jejunostomy located less than 60 cm from the ligament of Treitz, and in a patient with an end ileostomy. Forty-six healthy volunteers participated as controls for the oral fat tolerance test. PABA and D-xylose concentrations were measured in urine. The serum triacylglycerol concentration was determined at 0, 1, 2, and 3 h after ingestion. All eight patients with SBS demonstrated pathologic absorption on each test. We conclude that small bowel integrity is critical for evaluation of the NBT-PABA test. We also determined that the duodenum and proximal jejunum do not play an important role in the absorption of D-xylose and triacylglycerol. We could also evaluate limitations and advantages of the other kinds of oral absorption tests and nutrients through patients with SBS.

4-Aminobenzoic Acid↗

[In vitro study of ultrasonic bone densitometry using dissected calcaneus].

Quantitative ultrasound (QUS) of the calcaneus is a widely utilized method for bone densitometry. However, the meaning of measured parameters, such as speed of sound (SOS) and broadband attenuation (BUA), is not well established. We performed in vitro measurement of dissected human calcaneus (n = 60; male 29, female 31; mean age 81 years) using two QUS machines and also measured bone densities using SXA, DXA and pQCT. Finally, we investigated breaking strength of the calcaneus and studied the correlation with QUS parameters and other assessed parameters. The two QUS measurements were in good agreement in most experiments. SOS correlated most closely with bone mineral densities assessed by pQCT and did not correlate with factors related to bone size, while BUA showed the highest correlation with BMC and association with parameters related with bone size such as bone area and bone width. With maximal breaking stress of the calcaneus, correlations were almost equal among QUS parameters and bone mineral density. We conclude that SOS is the parameter most closely associated with true bone mineral density (g/cm3), whereas BUA represents both bone mineral density and bone size, mimicing BMD assessed by DXA or SXA.

Aged↗

[Recent development and clinical application of bone mineral measurements].

Over the past decade, methodologies for the assessment of bone mineral density have markedly progressed, so that any sites of the skeleton now can be measured with high degree of accuracy and precision with safety. The number of devices distributed in Japan rapidly increased for the last 5 years and the total number installed nationwide reached over 7000 as with 1998. There are variety of techniques: microdensitometry (MD) or radiographic absorptiometry (RA), single X-ray absorptiometry (SXA), dual X-ray absorptiometry (DXA), quantitative CT (QCT), peripheral QCT, and quantitative ultrasonometry (QUS). There are, however, no such single technique as to fulfill the entire clinical requirements, since the time of initiation of bone loss, and the speed of bone loss are quite different from site to site of the skeleton, so that the correlations of bone density measured by each technique are not sufficiently high (gamma = 0.5-0.8) to predict BMD of other bones by measuring one bone. Since the relatively large amounts of data on the prediction of fracture (hip, spine and others) by these techniques have been accumulated, a specific guideline regarding the appropriate application of these techniques, including multiple combination measurements, should be established based on the worldwide consensus.

Bone Density↗

Correlation between the values of bone measurements using DXA, QCT and USD methods and the bone strength in calcanei in vitro.

In this study we used the calcanei from 32 female and 29 male cadavers, ages 58 to 100. The bone mineral density (BMD) and average bone density (ABD) were measured using dual energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) respectively, while speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) were measured using ultrasound densitometry (USD). Thereafter, the bone strength was measured using a compressor to cause bone fracture, and evaluated in comparison with the values of the three measurement methods. The scatter diagrams of the values of the three different methods versus age displayed a negative linear regression in both sexes. Values for BMD and ABD were generally about 20% higher in males than in females, while SOS, BUA and SI were a few percents higher in males than in females. A significantly high correlation existed between BMD and ABD (r = 0.95), and a moderate correlation between BMD and either SOS, BUA or SI (r = 0.65; r = 0.39; r = 0.57, respectively). Thus, among the values measured using USD, SOS most closely corresponded to BMD of the calcanei. The bone strength of the calcanei indicated a moderate correlation with BMD, ABD and SOS (r = 0.38, P < 0.01; r = 0.43, P < 0.001; r = 0.45, P < 0.001, respectively). However, 42 calcanei fractured under pressures of less than 40 kgf, although the other 19 calcanei endured pressure of 40 kgf or more. Two calcanei with high BMD over 0.7 g/cm2 by DXA were very fragile, whereas a few with low BMD less than 0.4 g/cm2 were not very fragile. Similarly, high SOS, BUA and SI values by USD did not always correspond to high bone strength. Thus, some discrepancies among the bone strength and measurement values remained to be solved in the future.

Absorptiometry, Photon↗

Successful preoperative diagnosis of a cholecystogastric fistula using endoscopic retrograde cholangiography: report of a case.

A 64-year-old woman who presented with pyrexia and severe right upper quadrant abdominal pain was suspected of a having a cholecystogastric fistula by the abdominal plain radiograph and gastrointestinal endoscopic findings. The diagnosis was established preoperatively by endoscopic retrograde cholangiography (ERC), following which a cholecystectomy and fistulectomy with resection of the extrahepatic bile duct and hepaticojejunostomy were performed. The patient has remained well since her discharge from hospital.

Biliary Fistula↗

Leiomyoblastoma and leiomyomatosis of the small intestine in a case of von Recklinghausen's disease.

A 70-year-old patient with von Recklinghausen's neurofibromatosis 1 (NF1) developed a stomach ulcer and underwent a total gasterectomy. During the laparotomy, a leiomyoblastoma and multiple leiomyomas, which were histologically diagnosed as such later, were found in the small intestine and resected. It is quite possible that the association of gastrointestinal leiomyomas and NF1 is more than coincidental. It is thus important to take this complication into account in clinical treatment of patients with NF1.

Aged↗

Diagnostic validity of bone metabolic markers for bone metastasis.

We measured bone resorption markers in tumor patients with and without bone metastases and evaluated the diagnostic validity of these biochemical parameters in the diagnosis of neoplastic bone involvement. On the basis of radiography and bone scintigraphy findings, subjects were divided into 3 groups, 83 patients without bone metastases (META(-)), 22 patients with 1 or 2 bone metastases (META(+)) and 22 patients with more than 3 bone metastases (META(++)). Among the biochemical markers, urinary pyridinoline (PYR), circulating C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen (NTx) were especially sensitive and specific and increased significantly not only in META(++) but also even in META(+). The efficacy of several bone metabolic markers in differentiating between patients with and without bone metastases was evaluated by receiver-operating characteristic (ROC) analysis, and PYR, ICTP and NTx were proved to have high diagnostic validity (area under the ROC curve; 0.75 for PYR, 0.77 for ICTP and 0.77 for NTx). Furthermore, their odds ratios showed significantly high values for both META(+) and META(++)(to META(++); 7.91 for PYR, 5.33 for ICTP and 5.70 for NTx). On the other hand, urinary deoxypyridinoline (DPYR) and serum total alkaline phosphatase (ALP) showed relatively low sensitivities, the odds ratio of ALP in particular being insignificant. In conclusion, several bone metabolic markers were proved to be useful in the diagnosis of bone metastases in patients with malignancies, particularly PYR, ICTP and NTx had rather high diagnostic validities among all markers examined in this study.

Adult↗

[Delineation of calf deep veins using 2D-TOF MR venography without contrast media: efficacy of tourniquet and leg-warming].

We evaluated the imaging quality of 2D-TOF MR venography of the lower part of the leg and the efficacy of a tourniquet around the knee and leg-warming. In 8 healthy volunteers, MR venography was carried out under the following four conditions: (a) usual MR venography, (b) MR venography with tourniquet around the knee, (c) MR venography after leg-warming and (d) MR venography with tourniquet after leg-warming. Our results suggested that MR venography with tourniquet after leg-warming is best suited for imaging the veins of the leg. We also compared the diagnostic image quality of MR venography and conventional contrast venography in 7 patients with varices. The results showed no significant differences between the two methods. We conclude that MR venography with tourniquet after leg-warming is a technique that provides reliable information about the veins of the leg.

Adult↗

Sulfatides as a predictive factor of lymph node metastasis in patients with colorectal adenocarcinoma.

BACKGROUND: Sulfatide is one of the acidic glycolipids that are components of the cellular membrane. It has been reported that sulfatide plays some important roles in cell functions, such as cell adhesion. The aim of this study was to investigate the relationship between sulfatide and the malignant potential of colorectal carcinoma. METHODS: Glycolipids were extracted from 22 primary colorectal cancer tumors and 6 adjacent normal mucosa using the Folch method. Qualitative analysis of the sulfatide contents was performed using thin-layer chromatography (TLC) and TLC immunostaining. Quantitative analysis was performed by densitometric scanning. RESULTS: Two bands of sulfatide were observed by TLC immunostaining and were designated as cerebroside sulfated ester (CSE)-A and CSE-B. Levels of CSE-A were found to be significantly decreased whereas those of CSE-B were significantly increased in cancerous tissue when compared with normal tissue (P<0.05). The CSE ratios (CSE-B/[CSE-A + CSE-B]) in the 15 tumors showing lymph node metastasisi were higher than in the 7 tumors without lymph node metastasis (P<0.05). The CSE ratios in 9 Dukes Stage C tumors and 6 Dukes Stage D tumors were higher than those in 7 Dukes Stage A tumors (P<0.02, and P<0.05, respectively). CONCLUSIONS: These data support the conclusion that changes in sulfatide composition may play an important role in lymph node metastasis of colorectal adenocarcinoma.

Aged↗

Cutaneous metastases from pancreatic cancer.

Cutaneous metastases originating from pancreatic cancer are relatively rare. Five cases of metastatic pancreatic cancer to the skin are presented and discussed with a review of 17 previous case reports. In 20 cases, the cutaneous metastases were present prior to the diagnosis of pancreatic cancer. The most common site of cutaneous metastases originating from pancreatic cancer was the umbilicus. Although such cases are rare, it is important to note that metastatic lesions in the skin may be the first sign and one type of distant metastases originating from pancreatic cancer.

Adenocarcinoma↗

Pancreatic juice output after pancreatoduodenectomy in relation to pancreatic consistency, duct size, and leakage.

BACKGROUND: A soft pancreas with a main pancreatic duct (MPD) with normal diameter has been considered a high risk for pancreatic anastomotic leakage because of a relatively high output of pancreatic juice, but data are lacking. METHODS: An attempt was made to assess the relationship between the consistency of the pancreas, MPD diameter, pancreatic juice output, and pancreatic leakage after partial pancreatoduodenectomy. The pancreatic parenchyma was classified as of soft, intermediate, and hard consistency in 70 consecutive patients undergoing operation (groups 1, 2, and 3, respectively) by one surgeon. The MPD diameter was determined by means of endoscopic pancreatography or abdominal ultrasonography. Pancreatic juice output was measured for 21 days after operation by using a catheter inserted into the MPD. Anastomotic leakage was identified radiologically by using contrast medium. RESULTS: The mean (SD) pancreatic juice output during a period of 10 days (postoperative days 5 to 14) was 1554 (1073) ml in group 1 (n = 29), 1513 (1060) ml in group 2 (n = 13), and 187 (220)ml in group 3 (n = 28) (groups 1 and 2 versus group 3, p < 0.0001). The MPD diameter was 3.0 (1.6) mm in group 1, 5.9 (2.5) mm in group 2, and 6.6 (2.6) mm in group 3 (group 1 versus groups 2 and 3, p = 0.0001). Anastomotic leaks occurred in four (14%) patients in group 1, three (23%) in group 2, and none in group 3 (p < 0.05). CONCLUSIONS: Patients with a pancreatic parenchyma with an intermediate or normal consistency produced more pancreatic juice and had a higher leak rate.

Adult↗

Sialyl Lewis(a) ganglioside in pancreatic cancer tissue correlates with the serum CA 19-9 level.

CA 19-9 ganglioside antigen was extracted from the tumors of 16 patients with pancreatic cancer and the antigen was confirmed by mass spectrometry to be a sialyl Lewis(a) ganglioside. Ductal adenocarcinomas from four patients, two whose Lewis blood phenotype was Le(a- b-), one with undifferentiated carcinoma, and one with an acinar cell carcinoma, did not contain detectable amounts of sialyl Le(a) ganglioside. A significant correlation was found between serum CA 19-9 levels and the recovery of ganglioside antigen from respective tumors, but not tumor burden.

Aged↗

Evaluation of gallbladder function before and after gastrectomy using a double-isotope method.

The motor function of the gallbladder after partial distal gastrectomy for gastric carcinoma (Billroth-I reconstruction) and its relationship to the motor function of the stomach was investigated using a double-isotope method. In this method, [99mTc]N-54-pyridoxyl-5-methyltryptophan ([99mTc]PMT) was utilized as a tracer for the biliary tract and [111In]diethyl-triaminopontacetic acid ([111In]DTPA) mixed with a liquid test meal was used as a tracer for the digestive tract. Gastric emptying half-time (GET1/2) was measured, since this was used historically as the physiologic indicator of gallbladder contractile stimulus. The volume of test meal that emptied from the stomach into the duodenum per minute (VOL/MIN) was measured, as was the gastric emptying duration (GED). A series of gallbladder emptying phenomena were analyzed using three different criteria: gallbladder emptying half-time (GBET1/2), retention rate of bile in the gallbladder (RR), and the start of gallbladder bile ejection into the duodenum after ingestion (TL: time lag). While GET1/2 was reduced (P < 0.01) and VOL/MIN was increased (P < 0.01) after gastrectomy, GED was shortened remarkably (P < 0.01). GBET1/2 showed no significant change, RR increased (P < 0.05), and TL was prolonged (P < 0.01). The postoperative dysfunction of the gallbladder was caused by the short and intense stimulus on the biliary tract during the duodenal phase and by intraoperative injury to the innervation of the gallbladder. In particular, the hepatic branch of the left vagus nerve was injured during the right paracardiac lymph node dissection performed as a component of the radical gastrectomy.

Adult↗

Lipid composition and fatty acid analysis of Helicobacter pylori.

Lipids extracted from Helicobacter pylori were separated into lipid classes by thin-layer chromatography. Simple H. pylori lipids consisted of cholesterol esters, triglycerides, free fatty acids, cholesterol, diacylglycerols, and monoacylglycerols. Fatty acids were released from each lipid class by acid methanolysis, and analyzed by gas liquid chromatography and mass spectrometry. Unique methoxy fatty acids, including 11-methoxy heptadecanoic and 11-methoxy nonadecanoic acids, were the major components of the cholesterol esters and triglycerides. The predominance of methoxy fatty acids in the cholesterol esters of H. pylori may contribute to the acid-resistant characteristic of this bacillus.

Chromatography, Gas↗