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Biomedical subjects

Y Shoji

Publications and source records attributed to Y Shoji.

At least 19 recordsLinked to original sources
PubMed1995

Experiences with the linear cutter technique for performing Roux-en-Y anastomosis following total gastrectomy.

The use of stapling devices for performing gastro-intestinal anastomosis has recently gained wide acceptance. In fact, since 1991, we have been using linear cutter devices for performing the Roux-en-Y anastomosis, transection of the duodenum, and closure of the jejunal stump (except following esophagojejunostomy), and are no longer employing hand-sewn procedures. In this report, the linear cutter technique used after total gastrectomy is described and the differences in anastomotic leakage, morbidity, operating time, and reconstruction time are evaluated in comparison with those following hand-sewn anastomoses. A total of 22 patients undergoing total gastrectomy within a 2-year period were randomized into two groups of 11, to have reconstruction performed by either a stapled or hand-sewn Roux-en-Y anastomosis. One patient from the stapled group died of acute myocardial infarction 6 days after the operation. Anastomotic leakages from the esophagojejunostomy region occurred in 18% of the patients in the stapled group, but fortunately no leakage was apparent from the Y-anastomosis when the linear cutter technique was used. The most obvious significance was the short mean reconstruction time in the stapled group of 19.1 +/- 3.56 min (P < 0.01) being 31 min shorter than that of the hand-sewn group (n = 11). Thus, we proposed that the linear cutter technique is a safe technique for performing anastomosis following total gastrectomy, which would significantly reduce the reconstruction time.

Adenocarcinoma↗
PubMed1995

Human colonic smooth muscle electrical activity during and after recovery from postoperative ileus.

Colon smooth muscle electrical control (ECA) and response activities (ERA) were recorded for up to 4 wk postoperatively for 48 patients after major abdominal operations. Bipolar electrodes were implanted into right and left colon circular muscle and exteriorized through the flanks, and signals were tape recorded for 2-24 h daily beginning on the 1st postoperative day. A computer program was used for data reduction and analysis. Recorded signals were digitized and filtered. The ECA frequency components were identified by fast Fourier transformation, and their relative tenancy in low, mid, and high frequency ranges was determined. Short and long ERA burst duration and frequency and number and velocity of propagating long ERA bursts were determined. ECA was omnipresent and exhibited a downshift of the dominant frequency from the mid to the low range as recovery from postoperative ileus progressed. Concurrently, first in the right and then in the left colon, the frequency of long ERA bursts increased, followed by the appearance of propagating long ERA. After the 6th postoperative day, no further significant changes in parameters of colon electrical activity occurred with time.

Adolescent↗
PubMed1995

[Separate perfusion of upper and lower body under mild hypothermia during operation on the thoracoabdominal aorta].

During last 7 years, we performed 24 operations on the thoracoabdominal aorta. There were 9 true and 15 dissecting aneurysms. There were two cases of ruptured aneurysm and thoracoabdominal replacement was performed as a last stage operation for total aortic replacement in 4 cases. Three cases with aortic dissection died within 30 days after surgery. Femoro-femoral bypass was used in 4 cases (1 case died of brain damage, paraplegia and MOF), left heart bypass in 5 cases and separate perfusion of upper and lower body (SPULB) under deep hypothermia in 7 cases (2 cases died of LOS and cerebrovascular accident occurred at 2 weeks after operation) and SPULB with mild hypothermia in 8 cases for circulatory support. There was one case of renal dysfunction and transient mild liver dysfunction occurred in 7 cases. There was no evidence on relationship between surgical outcome and methods of circulatory supports, but we recently prefer SPULB under mild hypothermia for thoracoabdominal surgery since intraoperative massive bleeding and cardiac arrest can be easily treated and major organs can be protected by introducing hypothermia in this perfusion technique.

Adult↗
PubMed1995

Surgical management of total ulcerative colitis and familial adenomatous polyposis.

Total ulcerative colitis (UC) and familial adenomatous polyposis (FAP) are two major diseases that require total removal of the colorectal mucosa. To provide a high quality of postoperative life, various surgical techniques have been used. However, results were far from ideal. Since 1978, we have worked on the ileoanal anastomosis (IAA) technique to achieve both radical removal of the mucosa and preservation of natural anal function. From 1979 to 1991, a total of 155 patients were treated by IAA. To evaluate the surgical results, these patients were divided into three groups: the Tokyo series (49 cases, 1979-1983), Hyogo I series (49 cases 1983-1988) and Hyogo II series (57 cases, 1989-1991). The success rates in terms of preservation of anal continence were: 58% (UC) and 78% (FAP) in the Tokyo series, 84% (UC) and 96% (FAP) in the Hyogo I series and 92% (UC) and 100% (FAP) in the Hyogo II series. The surgical time and blood loss were significantly reduced in the later series. Of the 82 patients followed up for 6 mo in the two Hyogo series, anal continence was normal or nearly normal in 54 patients, with only minor leakage at night in 22 patients. Septic complications in the pelvic caused the majority of surgical failures. We conclude that improved IAA techniques can achieve total removal of the colorectal mucosa and preserve anal function in more than 90% of patients with UC or FAP. However, the skill of an experienced surgeon is still required to achieve this goal. The long-term outcome of anal function after such procedures needs further evaluation.

Adenomatous Polyposis Coli↗
PubMed1995

[Hemodynamic response to pericardiectomy in the patients with constrictive pericarditis: with reference to surgical approaches and responses to exercise].

Between 1975 and 1994, we performed 20 pericardiectomies for 19 patients with constrictive pericarditis (CP) through a median sternotomy (13 cases), a left thoracotomy (2 cases), a median sternotomy combined with a left thoracotomy (4 cases) or a median sternotomy under ECC (1 case). One patient died from LOS at 1st POD due to myocardial failure. Pericardiectomy through a median sternotomy decreased RA pressure but PAW pressure did not decrease in some patients. On the contrary, pericardiectomy through either a left thoracotomy or a median sternotomy combined with a left thoracotomy decreased PAW pressure as well as RA pressure significantly. Responses to bicycle exercise demonstrated marked elevation of RA and PAW pressures even in a mild case of CP, so that the exercise testing seems to be useful for early detection of CP and evaluation of the operative results.

Adolescent↗
PubMed1995

[Surgical treatment of type A aortic dissection based on the location of the entry].

From 1987 to February of 1994, 42 cases of acute aortic dissection and 31 cases of chronic dissection have been operated in out institution. Our surgical technique for the treatment of aortic dissection is a tubular graft replacement following a resection of the segment of aorta containing the intimal tear. The location of the entry was, therefore, important to determine the extension of graft replacement and to select the circulatory support method during operation. 52%, 33% and 14% of cases in acute aortic dissection had entries in ascending, arch and descending aorta, respectively. Entries of 52%, 32% and 16% of cases in chronic dissection located in ascending, arch and descending aorta, respectively. In cases with the entry in ascending aorta, ascending aorta and partial aortic arch replacement was performed in 12 and 10, respectively, for acute dissection, whereas more extensive graft replacement procedure was selected for chronic dissection including complete arch replacement in three cases and two of them had concomitant Bentall type operation. Likewise, with the entry in aortic arch, partial arch replacement was performed more often in 9 than complete arch replacement in 5 for acute dissection, on the other hand, complete arch replacement procedure tended to be preferable in 6 cases for chronic dissection. For retrograde dissection with the entry in descending aorta, ascending aorta and complete arch replacement were performed in 4 and 6 cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

DNA damage induced by tumour necrosis factor-alpha in L929 cells is mediated by mitochondrial oxygen radical formation.

Treatment of L929 cells with tumour necrosis factor-alpha (TNF-alpha) plus actinomycin D induced DNA damage (indicated by the appearance of a sub-G1 peak due to extracellular leakage of low molecular weight DNA following DNA fragmentation) before significant cell lysis occurred. The DNA damage occurred in parallel with a decrease of the intracellular total glutathione content and an increase of intracellular reactive oxygen intermediates (ROI), as indicated by increased dihydrorhodamine 123 oxidation. Because the inhibition of mitochondrial respiration suppressed the increase of dihydrorhodamine 123 oxidation and DNA damage as well as the decrease in the total glutathione content, it was suggested that increased mitochondrial formation of ROI was responsible for DNA damage after TNF treatment. Deferoxamine (a ferric iron chelator) and dithiothreitol (a sulfhydryl reagent) both prevented DNA damage and cell killing, indicate that hydroxyl radicals generated from O2- and H2O2 produced by the mitochondria in a process catalysed by iron contributed to DNA damage and that this pathway may be involved in TNF-alpha-induced cytotoxicity. An inhibitor of poly(ADP)-ribose polymerase (3-aminobenzamide), worsened DNA damage, but was protective against cell lysis, suggesting that DNA repair subsequent to injury was more important than DNA damage per se in development of TNF-alpha cytotoxicity.

Cell Cycle↗
PubMed1994

Anti-human immunodeficiency virus type 1 activity of phosphorothioate analogs of oligodeoxynucleotides: penetration and localization of oligodeoxynucleotides in HIV-1-infected MOLT-4 cells.

Phosphorothioate antisense oligodeoxynucleotide against HIV-1 rev (S-ODN-rev) inhibits virus-induced cytopathic effects (CPE) in acute infection and inhibits the expression of HIV-1 core protein, p24, in chronically infected cells in vitro. HIV-1 reverse transcriptase activity was not affected by S-ODN-rev at the high concentrations of 5-25 microM, which were 250-1250 times higher than the concentration required to achieve 100% HIV-1-induced CPE inhibition. [32P]-labeled S-ODN-rev was rapidly uptaken by MOLT-4 cells, whereas [32P]-SO-ODN-rev and [32P]-O-ODN-rev were not. In the observation of FITC-S-ODN-rev-treated MOLT-4 cells by a confocal laser scanning microscope, diffuse fluorescence was apparently observed in the cytoplasm. Interestingly, fluorescence signals were accumulated in the nuclear region of chronically infected MOLT-4/HIV-1 cells 60 min after incubation. FITC-labeled homooligomer, FITC-S-dC20 and FIT-C-S-dT20, also accumulated in the nucleus of MOLT-4/HIV-1 cells, but weak fluorescence was observed on the cell membrane and in the cytoplasm of the FITC-S-random treated MOLT-4/HIV-1 and MOLT-4 cells.

Cell Line, Transformed↗
PubMed1994

Effects of cholera toxin adjuvant on IgE antibody response to orally or nasally administered ovalbumin.

Effects of cholera toxin B subunits supplemented with 0.1% cholera toxin (CTB*) on systemic IgE antibody responses to ovalbumin (OVA) were examined in BDFI (H-2b/d), Balb/c (H-2d) and C3H (H-2k) mice given OVA intragastrically or intranasally. Two successive doses of OVA intragastrically administered to Balb/c and C3H mice induced little IgE response and resulted in almost complete unresponsiveness to subsequent intraperitoneal challenge with OVA in Al(OH)3, while the intragastric administration to BDF1 mice induced high IgE response and resulted in abrogation of the unresponsiveness to the subsequent challenge. The intranasal administration of OVA induced little IgE response and suppressed response to the subsequent challenge in any strain of mice. On the other hand, two successive doses of intragastric or intranasal OVA together with CTB* enhanced IgE response in all three strains and the subsequent challenge with OVA in Al(OH)3 induced higher IgE responses. These results suggest that CTB* augments IgE response to OVA and abrogates the unresponsiveness when administered orally or intranasally into mice together with OVA, regardless of the H-2 haplotype of the mice.

Adjuvants, Immunologic↗
PubMed1994

Light and electron microscopic analysis of liver sinusoids during hepatocarcinogenesis with 2-acetylaminofluorene in rats.

To clarify the sequential changes and morphological differences of the sinusoidal structures between hepatocellular carcinoma (HCC) and hepatocellular adenoma (HA), we examined morphological changes of sinusoidal cells and related structures such as basement membrane during hepatocarcinogenesis in the rat. During continuous feeding of carcinogenic diets containing 2-acetylaminofluorene to rats, HA appeared at the 8th week in the peripheral area and then extended toward the centrolobular area. The appearance of HCC was recognized at the 27th week. In the HA lesion, the morphology of sinusoidal cells and related structures was basically the same as that of normal liver except for a slight thickening of the basement membrane and a decreased amount of vitamin A-lipid droplets of stellate cells. In HCC, the fenestrations of endothelial cells disappeared and the basement membrane became continuous, thick and often multilayered. Stellate cells contained almost no vitamin A-lipid droplets and were associated with abundant collagen fibers. Kupffer cells and pit cells were not seen inside the sinusoid. All these features of the sinusoids in HCC resembled the morphological characteristics of the capillary. The present study has revealed that HCC possesses sinusoid structures distinct from those of HA. This suggests that HCC may not derive directly from HA but may develop newly within the HA.

2-Acetylaminofluorene↗
PubMed1994

Effect of topical preparation of mycophenolic acid on experimental allergic contact dermatitis of guinea-pigs induced by dinitrofluorobenzene.

The effects of a topical preparation of mycophenolic acid on the experimental allergic contact dermatitis induced by dinitrofluorobenzene was investigated. Visual assessment of skin reactions showed significant efficacy of a topical preparation of mycophenolic acid. This efficacy appeared from the early stage and endured up to 3 days. Morphological changes in the epidermis and dermis layers of animals treated with a mycophenolic acid cream were moderate compared with that in animals treated with vehicle only. In particular, hyperkeratosis was strongly suppressed. Since suppression of inflammatory cell infiltration was also observed, this efficacy might reach to the epidermis and dermis layer.

Administration, Topical↗
PubMed1994

Insulin response to glucose-6-phosphate dehydrogenase activity is elevated in rats fed diets low in polyunsaturated fatty acids.

Glucose-6-phosphate dehydrogenase (G6PD) activity in the rat liver was elevated when the animals were fed a diet that contained 5% coconut oil or 1% corn oil plus 4% palmitic acid, in comparison with that of rats fed 5% corn oil. G6PD activity correlated inversely with the PUFA/SFA ratio of total liver phospholipid as well as the ratio of plasma membrane phospholipid. Elevation of G6PD activity was slightly affected by dietary protein. Serum insulin levels were apparently not influenced by dietary fats, and were not correlated with G6PD activity. Insulin dose-response to G6PD activity was augmented in primary cultured hepatocytes isolated from rats fed a diet with 1% corn oil plus 4% palmitic acid in comparison with those fed a diet with 1% corn oil plus 4% palmitic acid in comparison with those fed a diet with 5% corn oil. These findings indicate that augment in insulin dose-response to G6PD and elevation of its activity shown in rats fed diets low in polyunsaturated fatty acid are associated with lowering the PUFA/SFA ratio in plasma membrane phospholipid.

Animals↗
PubMed1994

A mitochondrial tRNA(Leu)(UUR) mutation at 3,256 associated with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS).

Enzymatic and molecular analyses were conducted on the muscular tissue of a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Significant decreases in activity of complexes I and IV were found and three nucleotide substitutions in the mitochondrial tRNA genes were detected. Two of the substitutions were detected in unaffected members of the family and in some healthy controls. A C-to-T transition mutation at the nucleotide position 3,256 in the mitochondrial tRNA(Leu)(UUR) gene was detected only in the patient and not in unaffected members of the family or 100 healthy controls. The data strongly suggest that this mutation at nucleotide position 3,256 in the mitochondrial tRNA(Leu)(UUR) gene is associated with MELAS.

Adult↗
PubMed1994

[Staged operation for aneurysm of the entire aorta: report of four cases].

Between September 1989 and May 1994, 3 patients with aortic dissection and one with atherosclerotic total aortic aneurysm associated with annuloaortic ectasia underwent successful staged operation for aneurysm of the entire aorta and aortic regurgitation. A composite graft was used for total aortic root replacement. Carbrol and Piehler techniques, Carrel patch and saphenous vein grafting were employed for coronary artery reconstruction. En bloc arch reconstruction was performed in one patient and three vessels graft replacement in 3 patients under hypothermic separate cerebral perfusion. Combined antegrade with retrograde oxygenated crystalloid cardioplegia and terminal warm blood cardioplegia were used for myocardial protection during prolonged aortic cross clamping in a simultaneous total aortic root and arch replacement. Elephant trunk was used at the distal arch anastomosis in 3 patients and useful for following thoracoabdominal surgery. In 3 patients, separate perfusion of upper and lower body technique with moderate hypothermia was employed and seemed to be useful in the patients who require extensive thoracoabdominal replacement to prevent spinal cord injury. All patients had no major complications and have been well.

Adult↗
PubMed1994

Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging.

BACKGROUND: We evaluated the ability of magnetic resonance imaging (MRI) to define local extension of rectal carcinoma. STUDY DESIGN: Thirty-three patients with rectal carcinoma were preoperatively assessed by MRI. RESULTS: When sagittal or coronal images, or both, were added to transverse images as needed, the sensitivity rate was 84.2 percent and the specificity rate was 92.9 percent. False-positive results when using only transverse images were mainly related to slight extramural spread, to an anterior location in the lower rectum (partial volume effect), and to massive extramural spread of the middle rectal tumors. CONCLUSION: Preoperative MRI was helpful to define tumor extension three-dimensionally.

Aged↗
PubMed1994

Clinicopathological study of anorectal mucosa in total colectomy with mucosal proctectomy and ileoanal anastomosis.

OBJECTIVE: To find out whether the extent of inflammation of the anorectal mucosa affects the quality of the mucosectomy and postoperative function in patients undergoing total colectomy with mucosal proctectomy and ileoanal anastomosis. DESIGN: Prospective study. SETTING: University hospital. SUBJECTS: 33 patients with ulcerative colitis and 17 with familial adenomatous polyposis. INTERVENTIONS: With the patient in the prone jackknife position, the anorectal columnar mucosa above the dentate line was removed transanally by the forceps coagulation technique. MAIN OUTCOME MEASURES: Score of histological appearance on light microscopy. RESULTS: All the patients with ulcerative colitis had moderate (n = 17, 52%) or severe (n = 16, 48%) inflammation, and their mean histological score was 12 (range 7-16). The patients with polyposis had little or no inflammation, and a mean histological score of 0.4 (range 0-2). The mucosectomy became more difficult as the severity of the inflammation increased, but there were no significant differences between the two groups in operating time, blood loss, or bowel function postoperatively. CONCLUSION: Though mucosectomy is technically more difficult in the presence of severe inflammation, there were no adverse effects on bowel function postoperatively.

Adenomatous Polyposis Coli↗