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Biomedical subjects

Y Idezuki

Publications and source records attributed to Y Idezuki.

At least 127 records · Page 7Linked to original sources
PubMed1987

Serum bile acid profile in thyroid dysfunction and effect of medical treatment.

1. Serum non-esterified bile acid profile was examined in patients with thyroid dysfunction. Sixteen hyperthyroid patients, six hypothyroid patients, nine patients taking thyroid or antithyroid drugs and 26 healthy controls were studied. The medicated patients were euthyroid when serum samples were collected. Bile acid concentration was determined by the simplified microassay method involving mass fragmentation spectrometry. 2. The sum of the concentrations of the individual bile acids was not significantly different among the four groups. However, the composition of bile acid reflected the thyroid function. The most prominent bile acid was deoxycholic acid in the hypothyroid patients and chenodeoxycholic acid in the hyperthyroid patients. The serum bile acid profile of medically treated patients was similar to that of normal controls. The ratio of the sum of deoxycholic and cholic acid to that of lithocholic and chenodeoxycholic acid was found to be a good indicator of thyroid function, while the ratio of cholic acid to chenodeoxycholic acid correlated poorly with it. 3. The characteristic effect of thyroid hormone on the serum bile acid composition in man was the shift from the 'family' of cholic acid to that of chenodeoxycholic acid. This is in agreement with experimental results in the rat, and suggests a specific action of thyroid hormone on the hydroxylating enzymes involved in the conversion of cholesterol into bile acids.

Adolescent↗
PubMed1986

Arteriovenous fistula following central venous catheterization.

We surgically obliterated arteriovenous fistulas in three cases that developed after subclavian catheterization. The first patient presented with heart failure two years after the catheterization, and the other two presented with asymptomatic continuous bruits. The intervals between the removal of the catheter and the appearance of the bruit were 1.5 years, three days, and two months. It took another six months for the appearance of heart failure in the first case. The feeder of the fistula was a branch of the subclavian artery in all cases. In previously reported cases, there was usually some interval between the removal of the catheter and detection of the fistula, and the feeder was much more commonly one of the branches of the subclavian artery than the subclavian artery itself.

Adult↗
PubMed1986

Hemodiafiltration treatment of deep hepatic coma by protein passing membrane: case report.

Based on the assumption that middle molecules that induce hepatic coma occur in the plasma of patients with fulminant hepatic failure (FHF), the authors have developed a hemodiafiltration (HDF) method using a large-pore poly(methylmethacrylate) (PMMA) membrane that allows proteins to pass through. PMMA HDF resulted in complete recovery of deep coma and long-term survival in a patient with severe FHF. Although a large-scale controlled trial is needed, PMMA HDF is believed to be promising as a future artificial liver support.

Adult↗
PubMed1986

[Clinical study of cefmenoxime in the field of abdominal surgery].

The effect of cefmenoxime (CMX) was evaluated in the abdominal surgery at 18 hospitals on the prevention and the treatment of postoperative infections. The results were summarized as follows. In 179 patients with prophylactic use of 2-4 g of CMX a day, no postoperative infection was observed in 94.4%. Using fever index to judge the effect of CMX in prevention of postoperative infections, the value of fever index was higher in the infected group than in the non-infected group. A significant difference was also observed in mean fever index value between the groups given CMX in 2 g and 4 g daily, being 15.4 degree hours and 1.7 degree hours. The incidence of postoperative infections was higher in cases with intraoperative bleeding of more than 500 ml than in cases with less bleeding. Postoperative infection and peritonitis subsided after the administration of 2-4 g of CMX/day for more than 8 days in 77.1% of cases. Very few side effects were noted due to CMX. These results suggest that CMX is safe and effective in the field of abdominal surgery for the prevention of postoperative infections and in the treatment of postoperative infections.

Abdomen↗
PubMed1985

[A case of mesenteric venous thrombosis: its sonographic and computed tomographic findings].

Primary mesenteric venous thrombosis is a rare disease and it is difficult to diagnose preoperatively. In this report, we present a case with interesting sonographic and computed tomographic findings. On March 15, 1984, a 53-year-old male was admitted to Central Hospital of Social Insurance because of intracranial hematoma, which was removed immediately. On May 17, the patient complained of a vague abdominal pain, in the left upper quadrant. Seven days later, the pain became severe and he was referred to our department. White blood cell count was 19300/mm3. On ultrasound and computed tomographic examination, a rigid thick-walled bowel loop was visualized. Laparotomy was performed and a gangrenous bowel loop (35cm long) was resected. Postoperative course was well. It should be emphasized that ultrasound and computed tomography are noninvasive and may be very helpful for differential diagnosis in the cases of acute abdomen.

Humans↗
PubMed1985

[Intra-arterial infusion chemotherapy of hepatic carcinoma using a totally-implantable Infusaid pump].

Three patients with primary carcinoma of the liver and 11 patients with metastatic carcinoma of the liver were treated by hepatic arterial infusion of 5-FU and Mitomycin C (MMC), using a totally-implantable, percutaneously-refillable infusion pump: INFUSAID 210, 400. The infusion cannulae were placed into the hepatic arteries under direct vision on laparotomy, and the pumps were placed in subcutaneous pockets. The implanted pumps were well tolerated in these patients, who received chemotherapy as outpatients; the only adverse effects noted were related to 5-FU and MMC toxicity. The cumulative duration of successful infusion exceeded 104 months (for individual patients: range 2 to 20 months; average 7.4 months). Complications associated with conventional intraarterial chemotherapy (artery thrombosis, catheter sepsis and dislodgement, pump infusion variation and pump failure) were not seen with the INFUSAID delivery system. The pump is refilled every two weeks via percutaneous puncture. All therapy was given on an outpatient basis. Pump acceptance and tolerance was 100%. Our study using this infusion pump to deliver 5-FU and MMC has shown response rates of 66% (2/3) for primary carcinoma of the liver with cirrhosis and 82% (9/11) for metastatic carcinoma of the liver. The average survival for the primary and metastatic carcinomas of the liver were 6.0 months and 8.4 months respectively. Utilization of the totally-implantable INFUSAID pump provides a convenient, cost-effective, and safe administration technique for patients with primary and metastatic carcinomas of the liver.

Aged↗
PubMed1985

[Successful surgical management of extracranial high internal carotid aneurysm. A case report].

A 76 year-old woman visited our university hospital with a complaints of dysphagia of 3 months duration and was discovered to have a right internal carotid aneurysm protruding to the right side of the larynx. A day prior to admission, dysarthria and left hemiparesis occurred with sudden onset. These ischemic attacks spontaneously remitted within 48 hours. A carotid arteriogram showed a saccular aneurysm located high in the right internal carotid artery. Four days after admission, aneurysmectomy with end-to-end anastomosis was carried out with the temporary internal shunt under the induced hypertension. There was no sign of ischemic brain damage after the operation. But she suffered from dysphagia due to the NO. 9, 10, and 12 cerebral nerve palsies, which took 5 months to recover completely. Despite several difficulties in the operation for a highly located internal carotid aneurysm, we emphasize in this report the necessity of aneurysmectomy and the establishment of vascular continuity with the aid of internal shunt to prevent the ischemic brain damage.

Aged↗
PubMed1985

Pharmacokinetic study on the hepatic uptake of indocyanine green in cirrhotic patients.

The mechanism by which the mean blood clearance (CLtot,B) of indocyanine green (ICG) was reduced in cirrhotic patients was examined pharmacokinetically. It was demonstrated that the reduction in the CLtot,B of ICG in cirrhosis would be mainly due to the decrease in the hepatic uptake clearance and partly due to the increase in the efflux clearance from the liver to plasma. It is suggested that the decrease in the hepatic uptake clearance in cirrhosis mainly reflects the decrease in the intrinsic clearance of hepatic uptake rather than the decrease in hepatic blood flow.

Adult↗
PubMed1985

[Artificial liver].

An artificial liver should in fact be called an artificial liver assist device or system because at this point in its development it is unable to prolong the life of an ahepatic animal, whereas, an artificial heart or an artificial kidney enables the animal to live without a heart or kidneys for a long period of time. The hepatic assist devices are classified into three types: Artificial (charcoal hemoperfusion, PAN membrane dialysis or filtration); biological (baboon liver perfusion, cross dialysis between pig liver and patients systemic circulation); and hybrid (combined form of artificial and biological). Our hepatic support system is composed of a membrane plasma separator, blood and plasma pumps, hemodialyzer and controller. Using this system, the patients plasma is replaced with fresh donor plasma in amount of 5,000 ml daily. This procedure are taken place in the intensive care unit, until the patient recovers consciousness or his cerebral death is confirmed. A national survey of the patients with fulminant hepatic failure, revealed that the survival rate of the patients treated with plasma exchange was 34.1% (15/45), while that of the patient untreated with plasma exchange was 14.3% (5/35). The difference is statistically significant. However, plasma exchange requires a large amount of fresh plasma which occasionally induce hepatitis or allergy and its detoxication of the patients plasma was insufficient in severe cases. To overcome these problems, specific adsorpton of hepatic toxins and a combined therapy of blood purification with plasma exchange will be studied further.

Adult↗
PubMed1985

[Effect of amino acid solutions on the blood ammonia level].

We have carried out several basic experiments on artificial liver support and found that the plasma free amino acid balance was lost after treatment according to this procedure. Application of fluid therapy--Using conventional amino acid preparations available on the market--Is not adequate during and after the treatment with artificial liver. Fluid therapy using mainly special amino acid preparations should have been established; preparations, named Todai Hospital fluid (THF), are intended to correct the deranged aminogram, supply nutrition and promote the improvement in symptoms. Furthermore, experimental animals with acute hepatic insufficiency of diverse severity were prepared and basic experiments were performed which these animals to see how the efficacy of THF developed. In the basic experiments, psychoneurotic symptoms and the electroencephalogram were improved with the lowering of the blood ammonia level. Clinically, THF was not only used as a therapeutic agent after treatment by artificial liver support in patients with fulminant hepatitis, but is also served as a further indication in hepatic encephalopathy accompanying chronic liver diseases in late stages. Improvement in encephalopathy was observed immediately after the administration of THF and persisted while the aminogram pattern returned to the premedication representation. There was more improvement in patients in whom ammonemia was complicated, and the blood ammonia level was reduced markedly.

Amino Acids↗