Biomedical subjects
Y Tameda
Publications and source records attributed to Y Tameda.
Effects of ranitidine on plasma clearance of indocyanine green in patients with liver cirrhosis.
The effects of ranitidine on plasma clearance of ICG were investigated in 68 cirrhotic patients (9 were positive for HBsAg, 33 were alcoholics and 26 had cryptogenic cirrhosis). The ICG clearance test was performed before and after ranitidine administration. In 31 patients treated with ranitidine (150 mg perorally), the plasma ICG clearance were 233.6 +/- 20.4 ml/min (mean +/- S.E.) and 239.2 +/- 20.5 ml/min before and after ranitidine, respectively. In the 37 treated with intravenous ranitidine 50 mg, the corresponding values were 205.4 +/- 17.7 ml/min and 206.4 +/- 17.9 ml/min. There was no significant change in the plasma clearance of ICG or the elimination rate constant after ranitidine administration. Even in patients with decompensated liver cirrhosis, no significant change was demonstrated in the plasma ICG clearance after ranitidine. These results led to the conclusions that ranitidine does not reduce the hepatic blood flow and that it is a safe and useful drug for the treatment of gastrointestinal tract bleeding in patients with liver cirrhosis.
[Pharmacokinetics of cefoperazone in liver diseases].
To obtain useful informations for determining the optimal dosage of drugs in patients with impaired liver function, pharmacokinetics of cefoperazone (CPZ) was studied in healthy adults (normal control group) and 35 patients with liver disease (liver disease group). CPZ is a new third generation cephalosporin which is mainly excreted into the bile and has serum half-life of about 2 hours. After a rapid intravenous injection of CPZ, peripheral blood and urine samples were obtained at the time according to the protocol of this study. Serum and urine concentrations of CPZ were determined by the bioassay method using Micrococcus luteus ATCC 9341 as the test strain. From the concentrations of CPZ in serum and urine, pharmacokinetic parameters were calculated by means of a "two-compartment open model". After an administration of CPZ, the serum concentration declined more slowly in the liver disease group as compared to the normal control group. At 1 hour after intravenous injection of CPZ, the difference of the serum level was already observed between these 2 groups. The half-life of elimination (T 1/2) was 2 to 4 times longer in the liver disease group. The elimination rate constant (K10) and total clearance (Clt) of CPZ were much lower in the liver disease group than in the control group except for hepatocellular carcinoma. On the other hand, urinary excretion rate (Ur) was lower in the normal control group than in the liver disease group. There was a close correlation between disappearance rate of indocyanine green (KICG) and parameters such as T1/2, K10, Clt and Cler with coefficients of -0.642, 0.723, 0.690 and 0.682, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
[Prognosis of acute liver failure].
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A study on the relationship between the prognosis of chronic active hepatitis and the HBV associated antigen/antibody systems.
The relationship between the prognosis of the disease based on liver histology and HB virus (HBV) associated antigen/antibody systems was investigated in twenty seven patients with chronic active hepatitis (CAH). These patients were followed up over extended periods with mean duration of 44.3 months. On initial liver biopsy five of twelve patients with CAH with spotty or focal necrosis were HBs antigen (HBsAg) positive, as were also five of six patients with sublobular necrosis and six of nine patients with lobular disorganization. Most of the HBsAg negative patients were anti-HBs or anti-HBc positive: HBV associated antigen or antibody was completely undetectable in only three of the twenty seven patients. There was no difference in the frequency of progression to liver cirrhosis (LC) between the sixteen HBsAg positive and the eleven HBsAg negative patients with CAH. On the other hand, progression to LC occurred in only one of seven HBe antigen (HBeAg) negative patients, compared to four of nine HBeAg positive patients, who were HbsAg positive. There were four patients who were HBeAg positive initially but then became HBeAg negative in the course of observation. LC developed in two of these four patients. These results suggest that in HBsAg positive patients with CAH the presence or absence of HBeAg and the variation in its level can provide useful indicators of the prognosis of the disease.
[Prognostic evaluation of chronic hepatitis with particular reference to the findings of repeated liver biopsy (author's transl)].
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[Acute hepatic failure after exposure to halothane -the clinical study of 10 cases- (author's transl)].
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[Renal failure in fulmiant hepatitis--the clinicopathological study of 39 cases (author's transl)].
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[Study of the serum lipoproteins in patients with chronic liver diseases (author's transl)].
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[Porphyria cutanea tarda: with special reference to ultrastructural findings of the liver (author's transl)].
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[Effects of immunopotentiator on six patients with HBeAg positive chronic hepatitis (author's transl)].
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[The constitutional indocyanine green excretory defect -- the clinicopathological study of 10 cases (author's transl)].
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Acid-base disturbance in patients with fulminant hepatic failure.
Forty-two arterial blood pH and gas determinations were carried out on 11 patients with fulminant hepatic failure. The most common type of acid-base disturbance was that of respiratory alkalosis in 22 cases (52.4%). This was partially compensated in 13 subjects (31.0%) while an accompanying metabolic alkalosis was present in 9 (21.5%). Partially compensated metabolic acidosis was observed on 15 occasions (35.7%), all of which were in patients with laboratory evidence of impaired renal failure. The mental status of the patients was evaluated in each of the categories of acid-base disturbances. Some degree of correlation was evident between the PCO2 and the magnitude of base excess and that of the severity of the encephalopathy. The lower PCO2 and greater negative base excess values tended to be nearly always present in totally comatose subjects. By contrast, there was no clear cut relationship between pH and mental state.
Prognostic value of peritoneoscopic findings in cirrhosis of the liver.
The prognostic value of peritoneoscopy was examined in 372 patients with liver cirrhosis according to the degree of development and size of regenerating nodules, the development of reddish markings, the development of small lymphatic vesicles, the presence or absence of patchy markings, the size of the right and left hepatic lobes, and the degree of splenomegaly. The cumulative survival rate was compared with these peritoneoscopic parameters. The usefulness of peritoneoscopic and histological findings in the prognosis of liver cirrhosis was evaluated using the proportional hazard model of Cox. Significant differences were observed in the cumulative survival rate with respect to the degree of development of regenerating nodules, the size of the right hepatic lobe, the formation of small lymphatic vesicles, and the degree of splenomegaly. Analysis using Cox's proportional hazard model indicated that peritoneoscopic findings are of greater clinical use than histological findings in determining the prognosis of liver cirrhosis.
Detection of doxorubicin cardiotoxicity by using iodine-123 BMIPP early dynamic SPECT: quantitative evaluation of early abnormality of fatty acid metabolism with the Rutland method.
BACKGROUND: To evaluate the possibility of predicting the development of doxorubicin-induced cardiomyopathy, we performed quantitative assessment of the early kinetics of iodine-123 beta-methyl-iodophenyl-pentadecanoic acid (I-123 BMIPP) by means of dynamic myocardial SPECT. METHODS: Thirty-six patients with various malignancies were examined. I-123 BMIPP dynamic myocardial SPECT was performed before chemotherapy, after chemotherapy, or both. Immediately after the injection of I-123 BMIPP (111 MBq), 30-second dynamic SPECT data were acquired successively for 15 minutes. The left ventricular (LV) myocardium was divided into 8 segments in short-axial and vertical slices. By using the time-activity curve (TAC) of each myocardial segment [Mo(t)] as an output function and the TAC of the LV cavity [B(t)] as an input function, the Rutland equation, Mo(t)/B(t)= F + K Integral of(B(t)dt/B(t)), was used as a means of assessing all segments. RESULTS: Mo(t)/B(t) showed a good linear correlation with Integral of(B(t)dt/B(t)) from 30 seconds to 4 minutes in all 456 segments. The mean K value of 8 LV segments was significantly lower after chemotherapy than before chemotherapy (0.071+/-0.019 [n = 21] vs. 0.095+/-0.025 [n = 36], P<.001). In 21 patients in whom dynamic SPECT was performed both before and after chemotherapy, the mean K values of left ventricle showed a significant decrease, from 0.101+/-0.024 to 0.071 +/-0.019 (P<.0001). The fractional change in the value of K after chemotherapy showed a significant linear correlation with the administered dose of doxorubicin (r = 0.648, P<.002). CONCLUSION: I-123 BMIPP dynamic myocardial SPECT may be clinically useful, because it permits the early detection of doxorubicin-induced cardiomyopathy.
Splenectomy enhances liver regeneration through tumor necrosis factor (TNF)-alpha following dimethylnitrosamine-induced cirrhotic rat model.
BACKGROUND/AIMS: We demonstrated that partial splenic embolization for hematological disorders in cirrhotic patients also improved liver function. Therefore, we investigated the mechanism of the beneficial effects of splenectomy on a rat cirrhotic model. METHODOLOGY: 1) Rats were administered DMN (dimethylnitrosamine) after splenectomy (splenectomized DMN rats) or a sham operation (DMN rats). 2) After completion of DMN administration, a tumor necrosis factor-alpha inhibitor (E3330) was administered on the same day as the splenectomy. Histological examination and cytokine expressions were analyzed. RESULTS: The splenectomy apparently reduced liver damage. This may be partially due to the enhancement of liver regeneration since the proliferating cell nuclear antigen labeling index in the DMN-treated liver was significantly increased by splenectomy. Tumor necrosis factor-alpha was down-regulated in the DMN rats, whereas its expression was preserved in the splenectomized DMN rats. There were no apparent differences in the number of Kupffer cells between the splenectomized DMN and the DMN rats, suggesting that the down-regulation of tumor necrosis factor-alpha may contribute to the reduction of Kupffer cells' function. In addition, a tumor necrosis factor-alpha production inhibitor (E3330) significantly reduced the proliferating cell nuclear antigen labeling index after splenectomy. CONCLUSIONS: Splenectomy, in this model, may promote liver regeneration by preserving Kupffer cell function, especially the secretion of tumor necrosis factor-alpha.
Long term follow-up for patients with liver cirrhosis after partial splenic embolization.
BACKGROUND/AIMS: Fifteen cases of liver cirrhosis (LC) were examined to determine whether the partial splenic embolization (PSE), done to improve hematological disorders, could also improve liver function for at least 12 months. MATERIALS AND METHODS: Peripheral blood count, serological and coagulatory examination were retrospectively examined before PSE, 6 months and 12 months after PSE. RESULTS: Hematological disorders were improved (p < 0.01) and persisted at improved levels in all cases. In patients in Child A or Child B classification, the levels of cholinesterase, total cholesterol and prothrombin time were also improved significantly after PSE (p < 0.05). However, those parameters were not improved in Child C classification. CONCLUSION: PSE may improve not only hematological disorders but also liver functions for at least one year.
Long-term effect of prophylactic endoscopic injection sclerotherapy on liver function.
BACKGROUND/AIMS: The aim of this study was to investigate the long term effect of prophylactic endoscopic injection sclerotherapy (EIS) on liver function. METHODOLOGY: This study was a retrospective investigation of seventy-eight patients with liver cirrhosis, whose liver function was classified as Child's A before follow-up. Laboratory data were retrospectively examined before and after follow-up, and a comparison was made between the EIS group (n=21) and the non-treated group (n=57). RESULTS: In the 3 or more years of follow-up, cholinesterase and total cholesterol levels deteriorated in several severe-variceal cases. However, these levels did not deteriorate over the 3 or more years of follow-up in the EIS group. CONCLUSION: Prophylactic endoscopic injection sclerotherapy among patients with early stage LC may prevent the deterioration of liver function.