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Biomedical subjects

Y Idezuki

Publications and source records attributed to Y Idezuki.

At least 109 records · Page 6Linked to original sources
PubMed1989

Extracorporeal immunoadsorption with IM-PH or IM-TR column.

In order to selectively remove pathogenic macromolecular reactants, a biological affinity type adsorbent (a DNA colloidin charcoal column or protein A sepharose CL4B = Prosorba) has been developed and used for the treatment of immune disorders, alloimmunization and cancer. However, because physiologically active materials are required in this procedure, it is difficult to ensure an adequate supply of raw materials (and their handling, sterilization and preservation as an immunoadsorbent. To overcome the above-mentioned problems, we developed physicochemical type immunoadsorbents IM-TR and IM-PH, which consist of polyvinyl alcohol gel where tryptophan, in the former, and phenylalanine, in the latter, is used as a ligand. IM-PH has a better selectivity than IM-TR, however, IM-TR is a more efficient adsorbent of anti-acethylcholine receptor antibody than IM-PH. IM-PH plasma perfusion has been successfully used with patients with rheumatoid arthritis, systemic lupus erythematosus (SLE), and multiple sclerosis (MS).

Animals↗
PubMed1989

Prevention of the spread of experimental acute pancreatitis by intraductal administration of a synthetic protease inhibitor in dogs.

The effect of a synthetic protease inhibitor, gabexate mesilate (GM), which was administered directly into the pancreatic duct, on acute pancreatitis induced by sodium taurocholate in dogs was investigated. Intraductal administration of GM significantly inhibited intrapancreatic trypsin activity at 24 h, compared with the control. The survival rate 10 days after initiation of pancreatitis for the group in which GM was administered intraductally was 100%, whereas that for the control group was 25%. Serial blood biochemical analysis and histopathological findings suggested that the progress of pancreatitis was favorably influenced by intraductal administration of GM.

Amylases↗
PubMed1989

[Effect of sequential MTX/5-FU therapy for a case of disseminated intravascular coagulation syndrome associated with recurrence of gastric cancer--a case report].

Although a 39-year-old male received the curative operation of total gastrectomy for advanced scirrhous carcinoma of the stomach, recurrence of cancer was occurred soon after the surgery, accompanied by hemorrhagic diathesis from DIC. The abdominal CT scan examination revealed the rapid enlargement in the size of the several lymphnodes around the abdominal aorta, and the blood chemistry tests showed marked increase of the serum CEA value. The sequential chemotherapy with intermediate dose of MTX and 5-FU in conjunction with OK-432 was started to treat the case. This chemotherapy was carried out once a week for 5 times and consequently DIC was led to the perfect remission. Furthermore, CEA level decreased within normal range, and the size of the enlarged lymphnodes at paraaortic area diminished remarkably. Although he complained of nausea and loss of appetite during the treatment, no severe adverse effects such as granulocytopenia, diarrhea, or loss of hair were observed. The successful result in this patient suggests that sequential therapy of intermediate dose of MTX and 5-FU with administration of OK-432 may be effective in the treatment of advanced scirrhous carcinoma of the stomach.

Adenocarcinoma, Scirrhous↗
PubMed1989

[Indications and results of non-shunting operations for esophageal varices].

Non-shunting operations were performed in 522 patients with esophagogastric varices in our department from January 1964 to March 1989. Transthoracoabdominal esophageal transection was performed in 287 patients (devascularization of the distal esophagus and the proximal half of the stomach and transection of the esophagus). Transthoracic esophageal transection was performed in 125 patients (31 Walker's transection, 94 esophageal transection with devascularization of distal esophagus). Transabdominal esophageal transection was performed in 49 patients. Hassab's operation was performed in 49 patients and three patients were treated with other direct operations (proximal gastrectomy, etc.) Overall mortality of non-shunting operation was 5.0%. The five year survival of idiopathic portal hypertension was 77.6%, extrahepatic portal obstruction was 90.7% and liver cirrhosis was 63.1%. Five year survival of Child's grade A was 79.8%, Child's grade B was 72.9% and Child's grade C was 38.6%. Operation on Child's C patients should be avoided since the results in these patients have been unsatisfactory. Our overall results with esophageal transection over the last two decades are satisfactory.

Adult↗
PubMed1989

Effect of oral adsorbent on blood metabolites in hepatic failure dogs.

AST-120 is a specially synthesized carbonaceous adsorbent for oral use. It mainly adsorbs low to middle molecules in the alimentary tract. In the present study, AST-120 was administered to hepatic failure dogs, and blood metabolites were analyzed by high performance liquid chromatography (HPLC). Thirty adult mongrel dogs underwent posta-cavae (P-C) shunts with 40% and 70% hepatectomies. They were divided into two groups, the AST group (n = 19) and control group (n = 11). The AST group received about 0.5 g/kg of the adsorbent intermittently with diet after the operation. The control group was fed the ordinary diet. Body weight, blood ammonia, plasma bile acids were measured, and blood metabolites were analyzed by the multi-column HPLC system. P-C shunt dogs with 70% hepatotectomies died within three months showing about 40-50% body weight loss. HPLC analysis of their plasma showed some specific peaks for middle molecules, about 3000-5000 daltons. After administration of the adsorbent, these peaks were not detected, so it was considered that these substances had been adsorbed.

Administration, Oral↗
PubMed1989

Twenty-five-year experiences with esophageal transection for esophageal varices.

Results of 287 transthoracoabdominal esophageal transections (Sugiura procedure), 125 transthoracic esophageal transections, 48 transabdominal esophageal transections, and 58 other nonshunting operations performed during the past 25 years were analyzed. Overall operative mortality rate was 5.0% (26/518); however, it was observed only in patients with liver cirrhosis (7.0%) and was higher in emergency cases (23.3%) and patients classified Child C (17.1%). Two hundred two patients died during the follow-up period, which lasted 24 years; 33 patients died of rebleeding, 89 of hepatic failure, 65 of hepatoma, and 35 of other causes. Cumulative survival rates of patients after non-shunting operations differed significantly according to the nature of the original diseases and the severity of liver damage. The cumulative survival rate at 10 years in patients with extrahepatic portal obstruction was 90.7%, 77.6% in idiopathic portal hypertension, and 33.0% in liver cirrhosis and at 20 years, 85.6%, 37.9%, and 8.1% respectively. The cumulative survival rate at 5 years in patients classified Child A was 88.7%, 77.7% in Child B, and 39.5% in Child C, and at 10 years, 73.4%, 45.3%, and 14.1%, respectively. Esophageal transection can be performed safely and is recommended in patients classified Child A or B. Patients in Child C should be treated by endoscopic sclerotherapy and other conservative measures.

Adolescent↗
PubMed1988

Identification of a tumor-associated target antigen, ATM-1, for a human T-cell clone with activated killer activity and its existence in sera of cancer patients.

Three human T-cell clones with activated killer activity (5B5, 5C1, and 7B5) which could lyse various tumor cell lines were established. The cytotoxic activity of these clones was decreased by incubation with anti-CD3 monoclonal antibody, suggesting that they recognized tumor cells by T-cell antigen receptor. A monoclonal antibody which blocked the cytotoxic activity of clone 5B5 was obtained. This antibody (N1977) blocked the binding and cytotoxic activity of clone 5B5 at the target cell level, suggesting that the antigen defined by N1977 antibody, designated as ATM-1, was a target molecule recognized by 5B5 cells. ATM-1 in the conditioned medium of a cancer cell line (NBT-2) and serum from a patient with lung cancer was characterized by following its immunoreactivity. On gel filtration, both the conditioned medium and the serum gave three peaks of ATM-1 immunoreactivity, corresponding to approximate molecular weights of 1,200,000, 700,000, and 120,000, respectively. They were chromatofocused at pH 4.0, 4.8, and 6.5, respectively. The high molecular weight forms were shown to be molecules with the disulfide-linked elementary glycoprotein with ATM-1 immunoreactivity and approximate molecular weight of 120,000. Most of the molecules with ATM-1 immunoreactivity bound to both concanavalin A and wheat germ agglutinin, and their binding activity to the antibodies was lost by treatment at 60 degrees C for 30 min. An assay of ATM-1 level in sera was performed by a sandwich enzyme immunoassay. The following positive percentages were obtained from preliminary clinical studies: breast cancer, 67% (8 of 12 cases); hepatocellular carcinoma, 83% (10 of 12 cases); gastric cancer, 58% (7 of 12 cases); lung cancer, 41% (5 of 12 cases); hematological malignancies, 0% (0 of 9 cases); systemic lupus erythematosus, 0% (0 of 8 cases); rheumatoid arthritis, 0% (0 of 8 cases).

Animals↗
PubMed1988

Hepatic clearances of antipyrine, indocyanine green, and galactose in normal subjects and in patients with chronic liver diseases.

Blood clearance of antipyrine, indocyanine green, and galactose were measured to evaluate the alterations of effective hepatic blood flow and hepatic intrinsic clearances in chronic liver diseases. Galactose blood clearance, which may be taken as effective hepatic blood flow, decreased by approximately 30% in patients with cirrhosis (12.49 +/- 0.76 ml/min/kg; mean +/- SE; n = 17) compared with normal subjects (18.17 +/- 1.03 ml/min/kg; n = 5). In patients with cirrhosis, intrinsic clearances of antipyrine (0.178 +/- 0.014 ml/min/kg; n = 17) and indocyanine green (6.19 +/- 1.38 ml/min/kg; n = 7) showed 61% and 85% reduction, respectively, compared with those of normal subjects (0.462 +/- 0.048 ml/min/kg; n = 5; 41.72 +/- 7.75 ml/min/kg; n = 5). Considering that indocyanine green and antipyrine are eliminated by different hepatic mechanism, these mechanisms may not be equally sensitive to decrements in hepatic function. In addition, fractional reductions of intrinsic clearances for these compounds are thus much greater than that of effective hepatic blood flow.

Adult↗
PubMed1988

Clinical experiences using pneumatic massage therapy for edematous limbs over the last 10 years.

UNLABELLED: A pneumatic massage apparatus has been developed for the treatment of peripheral lymphedema. The stagnant lymph and venous blood are displaced toward the heart by this pneumatic massage. It has been applied to more than 650 patients with edematous limbs in the authors' Hadomer clinic over the last ten years. Satisfactory results were obtained, including decrease in swelling, pain, and induration. The authors' clinical experiences and statistical analysis of the patients are reported here. STATISTICAL ANALYSIS: 9 primary (4 males and 5 females) and 646 secondary (28 males and 618 females) patients with lymphatic edema of extremities have been treated. The majority of the patients had postmastectomy edema of the upper extremity. CLINICAL STUDIES: The circumference of the edematous limb was measured before and after pneumatic massage treatment of forty to sixty minutes, daily or every second day. (Formula: see text). The rate of swelling was calculated by the formula described above. Twenty-six cases, treated with pneumatic massage for more than fifteen months, have been investigated. A decrease in the rate of swelling was observed in 14 cases (54%), there was no change in 7 (27%), and an increase was seen in 5 (19%). Electric impedance plethysmographic analysis of peripheral lymph volume and blood flow indicated that pneumatic massage was effective in the treatment of edema of the limbs, and its effectiveness was confirmed also by core temperature measurement of the hand during pneumatic massage. The decreased circumference of the edematous limb was kept constant for a long period of time by daily repeated pneumatic massage and ordinary conservative treatments. In conclusion, most lymphedema is of a secondary type. Pneumatic massage was effective in the treatment of peripheral lymph edema, and the improvement was maintained by repeated daily pneumatic massage and ordinary conservative treatment. Therefore, before it becomes worse, lymphedema of the limb should be treated by use of conservative treatments, including pneumatic massage continued as a long-term schedule.

Adult↗
PubMed1988

[Pseudocoarctation of the aorta associated with aortic arch aneurysm--a case report].

A twenty-nine-year old female was diagnosed as the associated aortic arch aneurysm 14 years after the initial diagnosis of the pseudocoarctation of the aorta. The aneurysm was asymptomatic and aortogram revealed that it was located just proximal to the pseudocoarctation. The aneurysmal wall was so thin that intraluminal blood stream could be visible easily during operation. Aneurysmectomy and Dacron graft implantation was successfully performed with temporary bypass procedure. In most of the cases, pseudocoarctation of the aorta has been reported to be a congenital entity without indication for any surgical intervention. However some cases in the literature were combined with formation of the aneurysm during the long term follow-up period. Careful observation must be needed for a case of pseudocoarctation of the aorta and the associated aneurysm should be treated surgically even if asymptomatic.

Adult↗
PubMed1988

Plasma collection using nafamostat mesilate and dipyridamole as an anticoagulant.

Nafamostat mesilate (FUT-175) is a strong protease inhibitor and is used as an anticoagulant in extracorporeal circulation. In the present study, we administered FUT and dipyridamole as anticoagulants during donor plasmapheresis, and the additional effect of dipyridamole was examined. In dogs weighing about 15 Kg, donor plasmapheresis was performed using a cellulose triacetate membrane plasmaseparator (PEX-15, Nipro), and 300 ml of filtrated plasma was obtained within 30 minutes. These dogs were divided into two groups, 50 mg/h of FUT alone was infused (group A, n = 10), and the same dose of FUT and 25 mg/h of dipyridamole were infused (group B, n = 5) during plasmapheresis. Changes of the coagulation system, blood cell counts and complement system were investigated. In clinical cases, an artificial liver support therapy using FUT as an anticoagulant was performed on 8 patients with acute liver failure, and blood compatibility was examined. In dogs, RBC counts and hematocrits were almost stable, but WBC counts were decreased to about 70% of the previous value. Platelets counts were about 60% and 80% of the previous value, in group A and group B, respectively, at the end of the plasmapheresis (P less than 0.01). Clotting factor VII was diminished to about 20% and 35% of the previous value in group A and B, respectively. In clinical cases, all patients received the plasma exchange combined with hemodialysis using FUT as an anticoagulant, and no distinct side effect was observed during plasma exchange.

Adult↗
PubMed1987

Effects of nonshunting operations on portal venous pressure and hepatic blood flow.

A comparative analysis has been presented of the effect of the nonshunting operation on portal venous pressure and effective hepatic blood flow in patients with liver cirrhosis and idiopathic portal hypertension. A reduction of portal pressure after splenectomy with esophagogastric devascularization in 17 patients with idiopathic portal hypertension was significantly greater than that in 79 patients with liver cirrhosis (-21 +/- 4.1 percent versus -8.9 +/- 1.6 percent, p less than 0.01). Clearance of galactose from the blood, which approximates effective hepatic blood flow, was decreased after the nonshunting operation by 6.7 percent in five patients with liver cirrhosis (p value not significant). On the other hand, there was a 19.4 percent reduction (statistically significant) in galactose clearance in four patients with idiopathic portal hypertension (p less than 0.05). Based on these data, we suggest that in patients with idiopathic portal hypertension, the splenic circuit largely contributes to the portal hypertension, the effective hepatic blood flow, or both. We recommend a nonshunting operation for the treatment of esophageal varices from the hemodynamic viewpoint in cirrhotic patients.

Adult↗