Comparison of three histochemical methods for assaying lactate dehydrogenase in liver.
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Animals↗
Biomedical subjects
Y Nakae
Publications and source records attributed to Y Nakae.
[Evaluation of low flow closed anesthesia technique for oxygen, nitrous oxide and isoflurane using Engström Elsa Anesthesia System].
We studied low flow closed anesthesia technique for oxygen, nitrous oxide and isoflurane using Engström Elsa Anesthesia System in 47 patients undergoing elective surgery. In the low flow group, anesthesia was maintained with oxygen 300 ml.min-1, nitrous oxide 300 ml.min-1 and optimal concentration of isoflurane after endotracheal intubation. The inspired oxygen concentration was kept higher than 35% through the operation. In the minimal flow group, anesthesia was maintained with nitrous oxide 4 l.min-1, oxygen 2 l.min-1 and optimal concentration of isoflurane after intubation until the inspired oxygen concentration reached approximately 35%. Then the fresh gas flow was reduced to oxygen 250 ml.min-1 and nitrous oxide 250 ml.min-1. In order to maintain the inspired oxygen concentration at 35%, the flow of nitrous oxide should have been reduced as low as to 150 ml.min-1 after 240 min. The volumes of consumption of nitrous oxide and isoflurane in the low flow and minimal flow groups were reduced to one fifth and one third respectively, compared with those of the high flow group. In conclusion, we can perform low flow closed anesthesia safely and easily with this equipment.
Adult↗
[Continuous thoracic epidural blockade in combination with general anesthesia with nitrous oxide, oxygen, and sevoflurane in two patients with myasthenia gravis].
Continuous thoracic epidural anesthesia (T4/5) using 4-5 ml.h-1 of 1.5% lidocaine with 1:200,000 epinephrine and inhaled anesthesia using nitrous oxide, oxygen and sevoflurane were performed in two patients, (40 and 22 yr-old females) with myasthenia gravis. This combined anesthetic technique provided muscle relaxation for endotracheal intubation and optimal operating conditions, including muscle relaxation and stability of hemodynamics during transsternal thymectomy. Further, continuous epidural anesthesia using 4 ml.h-1 of 0.25% bupivacaine provided postoperative pain relief without other analgesics and stable postoperative respiratory conditions. In conclusion, we confirm the benefits of this technique which provides not only safe and stable conditions during the surgery, but also an improved comfort for patients in the postoperative period following transsternal thymectomy for myasthenia gravis.
Adult↗
[Clinical evaluation of Engström's electrically controlled ELSA for low flow closed circuit anesthesia].
Many anesthesiologists are now interested in low flow, closed circuit anesthesia from an economical and environmental point of view. In order to evaluate clinically a newly developed electronically controlled anesthesia machine Engström's ELSA, we compared low flow, closed circuit anesthesia on 38 ASA I-II patients using ELSA, with high flow anesthesia on 12 ASA I-II patients using a conventional anesthesia machine. The results were as follows; 1. We could perform safe and economical low flow, closed circuit anesthesia using ELSA's injection vaporizer and accurate monitoring devices for O2, N2O, CO2 and concentrations of various volatile anesthetic agents. 2. Under low flow anesthesia, isoflurane consumption was 5.3 +/- 1.1 ml.h-1 x Vol.%-1 (mean +/- SE) with ELSA, which is about one fourth of the high flow anesthesia consumption (22.6 +/- 2.1 ml.h-1 x Vol.%-1 (mean +/- SE). 3. Low flow closed circuit anesthesia could maintain significantly higher temperature and humidity compared with high flow anesthesia. 4. Under low flow anesthesia of more than 7hrs, color of soda lime becomes blue, but this does not affect FIO2 nor PaCO2, and the method is clinically safe for patients.
Anesthesia, Closed-Circuit↗
Enzyme immunoassay and immunochemical characterization of pancreatic stone protein in human serum.
Monoclonal antibodies were raised against human pancreatic stone protein (PSP) and used for one-step enzyme immunoassay (EIA). PSP-S2-5 was employed as the standard in the assay. The assay's measurable range was 25-1,500 ng/ml and within run coefficient of variation was 3.7-6.4%. Analytical recovery of the assay was 101.5 +/- 5.65% (mean +/- SD). The results of experiments in which serum was fractionated by Mono S (cation exchange chromatography) suggested that most of immunoreactive material in human serum is PSP-S2-5. The EIA offers simple, rapid, and specific analysis of serum PSP level for clinical diagnosis.
Antibodies, Monoclonal↗
Initial reaction kinetics of succinate dehydrogenase in mouse liver studied with a real-time image analyser system.
The initial reaction kinetics of succinate dehydrogenase in situ were investigated in sections of mouse unfixed liver using an ARGUS-100 image analyser system. The sections were incubated on substrate-containing agarose gel films. Images of a section, illuminated with monochromatic light (584 nm), were captured with the image analyser in real time at intervals of 10 s during the incubation. The absorbances of selected hepatocytes in the successive images were determined as a function of time. In every cell, the absorbance increased nonlinearly after the first minute of incubation. The initial velocity of the dehydrogenase was calculated from the linear activities during the first 20 s of incubation. Hanes plots of the initial velocities and succinate concentration yielded the following mean kinetic constants. For periportal hepatocytes, the apparent Km = 1.2 +/- 0.8 mM and Vmax = 29 +/- 2 mumol hydrogen equivalents formed/cm3 hepatocyte cytoplasm per min. For pericentral hepatocytes, Km = 1.4 +/- 1.0 mM and Vmax = 21 +/- 2 mumol hydrogen equivalents/cm3 per min. The Km values are very similar to those determined previously from biochemical assays. These results, and the observed dependence of the initial velocity on the enzyme concentration, suggest that the technique reported here is valid for the histochemical assay of succinate dehydrogenase.
Animals↗
Pancreatic stone predominantly composed of fatty acid calcium.
A 41-year-old man with chronic pancreatitis and pancreatic stones predominantly composed of fatty acid calcium is reported. He had complained of occasional abdominal pain for 10 years and visited the hospital because of a severe attack of abdominal pain. Laboratory data supported a diagnosis of pancreatitis. Computed tomography (CT) showed a high-density area in the head of the pancreas, and the CT number of this high-density area was lower than usual for pancreatic stones. Ultrasonography and endoscopic retrograde pancreatography showed a cystic lesion with small pancreatic stones in the head of the pancreas and irregular dilatation of the main pancreatic duct. Pancreaticojejunostomy and resection of pancreatic cyst were carried out for repeated episodes of abdominal pain under the diagnosis of chronic pancreatitis. The pancreatic stones obtained at surgery were proved to be mainly composed of fatty acid calcium after analysis of chemical composition of the stones. Fatty acid calcium was sometimes found in the biliary stones but never in the pancreatic stones.
Adult↗
Effects of calmodulin inhibitors on amylase secretion from rat pancreatic acini.
To investigate the role of calmodulin in stimulus-secretion coupling in pancreatic acinar cells, we studied the effects of W-7, a calmodulin inhibitor, and KN-62, a specific inhibitor of Ca2+/calmodulin-dependent protein kinase II (Ca2+/CaM kinase II), on amylase secretion from rat pancreatic acini. Calmodulin inhibitor (W-7, 100 microM) and Ca2+/CaM kinase II inhibitor (KN-62, 10 microM) reduced amylase secretion stimulated by cholecystokinin (CCK) or carbachol. W-7 and KN-62 also inhibited amylase secretion stimulated by both calcium ionophore (A23187) and phorbol ester (12-O-tetradecanoylphorbol-13-acetate, TPA). To clarify the role of calmodulin in the interaction of intracellular mediators, pancreatic acini were permeabilized with streptolysin O. Following permeabilization, amylase secretion was stimulated by submicromolar free Ca2+, and this Ca(2+)-dependent amylase secretion was enhanced by guanosine 5'-[gamma-thio]triphosphate (GTP gamma S), TPA or cyclic adenosine 3',5'-monophosphate (cAMP). W-7 and KN-62 had no effects on amylase secretion stimulated by Ca2+ alone, but inhibited the enhancement in Ca(2+)-dependent amylase secretion by GTP gamma S, TPA or cAMP. These data suggest that calmodulin plays an important role in Ca(2+)-dependent amylase secretion from pancreatic acinar cells and in the interaction between Ca2+ and other intracellular messengers.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
[Bleeding Meckel's diverticulum in a patient with Crohn's disease].
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Adolescent↗
[Hemodilutional and blood salvaging autotransfusions in a case of aplastic anemia].
A 28-year-old female, weighing 46 kg, 155 cm in height, with aplastic anemia underwent implantation of iliac bone to the head of the femur. A combined technique of hemodilution and intraoperative blood salvaging was applied to supplement the blood loss during the operation. Intraoperative monitoring included continuous arterial pressure, heart rate, electrocardiograph, SVO2, bleeding time, prothrombin time (PT), activated thromboplastin time (APTT), and thromboelastography. A total of 900 ml of blood was drawn and the same volume of 5% albumin solution was infused over half an hour before the beginning of the surgery. During the operation, 2100 ml of blood was lost, and 1260 ml of autologous blood, 400 ml of homogeneous red blood cells and 5 units of fresh platelet were infused. The values of PT, APTT, bleeding time were within normal ranges after the surgery. Only 3 units of fresh platelet was infused in 2 weeks after the surgery. It was suggested that hemodilution and salvaging autotransfusion is safely performed and beneficial to minimize homogeneous blood transfusion even in a case of aplastic anemia.
Adult↗
[A case of adrenal myelolipoma].
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Adrenal Gland Neoplasms↗
The diagnostic value of serum pancreatic phospholipase A2 (PLA2) in pancreatic diseases.
The diagnostic significance of serum immunoreactive pancreatic phospholipase A2 (PLA2) was studied in 119 patients with pancreatic disease, 200 with various non-pancreatic disease, and 203 healthy controls using radioimmunoassay (RIA) specific to human pancreatic PLA2. This newly developed RIA using monoclonal antibody was satisfactorily sensitive and reliable. Serum PLA2 was elevated in all six patients with acute pancreatitis. Frequency of abnormal serum PLA2 levels was 60% in chronic pancreatitis (n = 52) and 67% in pancreatic cancer (n = 61). Serum PLA2 levels were low in chronic pancreatitis with severe exocrine insufficiency and advanced pancreatic cancer. In chronic pancreatitis, patients with low serum PLA2 level showed lower enzyme output in secretin test than patients with normal or high serum PLA2 level. Frequency of abnormal PLA2 levels was 27% in non-pancreatic disease and, in particular, patients with renal failure showed high PLA2 levels. Sensitivity (62%) and efficiency (69%) of serum PLA2 assay in pancreatic disease were superior to those of amylase. In conclusion, serum PLA2 determination using RIA was useful for the diagnosis of acute pancreatitis by high serum PLA2 levels and the diagnosis of severe exocrine pancreatic insufficiency by low serum PLA2 levels.
Amylases↗
Difference in the effect of pancuronium and vecuronium on baroreflex control of heart rate in humans.
The effects of pancuronium and vecuronium, each in doses of 0.05 and 0.08 mg.kg(-1), on the baroreflex control of the heart rate were studied in 40 adult patients of either sex (21 men and 19 women) during stable nitrous oxide-oxygen-fentanyl anesthesia. The blood pressure was elevated by intravenous infusion of phenylephrine (4 micro g.kg(-1).min(-1)) for the pressor test, and lowered by a bolus injection of nitroglycerin (0.3-0.5 mg) for the depressor test. Baroreflex sensitivity was judged from the slope of the regression of the systolic blood pressure on the succeeding R-R intervals on the ECG. There was no significant difference between the baseline blood pressure at which both tests were carried out. Nitrous oxide-oxygen-fentanyl anesthesia alone suppressed the baroreflex sensitivity to a level which was at the lower limit of the physiological and non-anesthetized state. The 0.08 mg.kg(-1) dose of pancuronium significantly suppressed the reflex sensitivity in both the pressor and depressor tests. However, the 0.05 mg.kg(-1) dose of pancuronium and both doses of vecuronium did not cause any significant change in the test results.
Journal Article↗
Epidermoid cyst occurring in a pancreatic accessory spleen.
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Adult↗
Developmental change of sucking response to taste in infants.
Seventy-one full-term normal newborns were studied at the age of 5-7 days. A 0.1% tartrate or a 0.25% saline solution was given to each infant after 1-2 min of breast or bottle feeding and then the same solutions were once more given to the same subjects. Sucking rhythm was recorded and the infants' behavioral reactions were observed by examiners and analyzed on videotape. There were individual differences in the newborn's response to taste. Infants showed a similar response tendency to tartaric acid and saline solution, when given on two different occasions, respectively. But generally they reacted more strongly to saline than to tartrate. Next, sucking response to taste was studied in 20 infants once a month from birth until 5 months old. Five of them had severe brain damage and the other 15 infants were normal. The methods used were the same as those described in part 1. All 5 infants with severe brain damage initially showed a strong reaction and then a decrease of reaction. Fourteen normal infants were followed until 5 months of age: 12 of them showed a decrease of reaction between 1 and 5 months. Most of them showed decrement between 3 and 5 months. From our results, sucking response to taste in the newborns is assumed to be a subcortical reflex and not a cortically recognizable one. It might be called a primitive sucking response, which gradually decreases like any other primitive reflex does.
Child Development↗
Exocrine pancreatic function in chronic liver diseases.
To confirm the respective influence of chronic alcoholism and liver disease on exocrine pancreatic function in cholecystokinin secretin (CS), tests were performed on patients with chronic liver cirrhosis (LC) and non-cirrhotic (nLC) disease of alcoholic (A) and nonalcoholic (nA) etiology. Results were compared in four subgroups (ALC, N = 26; AnLC, N = 45; nALC, N = 18; and nAnLC, N = 43). Volume of duodenal juice and bicarbonate output (BO) were increased and maximal bicarbonate concentration was decreased in ALC, compared with those in normal controls. Comparison of LC and nLC indicated that the volume, BO, and amylase output (AO) were greater in LC than in nLC of alcoholic etiology, but not in those of nonalcoholic etiology. The initial disappearance rate (KICG) of indocyanine green (ICG) excretion correlated with a parameter of CS test in alcoholic liver disease (vs. volume: r = -0.51, p less than 0.01 vs BO: r = -0.40, p less than 0.01), but not in nonalcoholic liver disease. Concurrent chronic pancreatitis with pain and definite exocrine insufficiency was observed in only one ALC patient and in four AnLC patients, but in none of the nonalcoholics. In alcoholic liver disease, exocrine pancreatic secretion tends to increase with severity of liver damage, but concurrence of definite chronic pancreatitis is not correlated with the severity.
Amylases↗
[A prospective trial of the mass survey for pancreatic cancer using serum markers and ultrasonography].
We designed a prospective trial of the mass survey for pancreatic disease, especially pancreatic cancer in consecutive 2576 subjects undergoing periodical health examination during 1989. In order to detect abnormality of the pancreas we measured serum amylase, elastase-1 and SPan-1 as serum markers and used ultrasonography (US). When abnormal elevation of serum markers or abnormal findings of US were obtained at the first screening, re-examination or further examination using ERCP, CT and endoscopic US were performed. Frequencies of elevated amylase, elastase-1 or SPan-1 were 0.9%, 3.4% or 1.7%, respectively. However, no pancreatic diseases were detected among the cases of elevated serum markers after subsequent further examination. Frequency of abnormal US findings of pancreas were 2.3% (59/2576), including dilatation of main pancreatic duct, cystic lesion, space occupying lesion and calcification. Subsequent further examinations on subjects with abnormal US revealed 8 cases of pancreatic diseases including one small pancreatic cancer. US may be an efficient tool of mass survey for pancreatic cancer in the health examination at present.
Adult↗
[Diagnostic value of serum level of alpha 2-macroglobulin-trypsin complex in pancreatic diseases using a colorimetric assay with a synthetic chromogenic substrate].
We measured serum level of alpha 2-macroglobulin-trypsin complex (alpha 2M-T complex) using a colorimetric assay with a synthetic chromogenic substrate, D-gamma-tert-butyloxy-Gly-Arg-3-carboxy-4-hydroxyanilide dihydrochloride. Serum level of alpha 2M-T complex was greater in acute pancreatitis patients than in chronic pancreatitis or pancreatic cancer patients. In severe acute pancreatitis patients, both mean level and frequency of abnormal value of serum alpha 2M-T complex were significantly greater than in mild acute pancreatitis patients (13.1 +/- 12.9 vs 2.9 +/- 3.5 U/L, p less than 0.01; 100 vs 41%, p less than 0.01). In conclusion, the determination of serum level of alpha 2M-T complex can be useful for the diagnosis of severe acute pancreatitis.
Acute Disease↗