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Biomedical subjects

Y Tsuchiya

Publications and source records attributed to Y Tsuchiya.

At least 253 records · Page 14Linked to original sources

Ultrasonic aid in transvenous instrumental dilatation for patients with membranous stenosis of the hepatic portion of the inferior vena cava.

We report two cases of a membranous stenosis of the hepatic portion of the inferior vena cava. Membranotomy was performed with a specially designed instrument similar to a Tubbs' dilator following balloon membranotomy. During the procedures, ultrasonographic observations were made and this technique was confirmed to be effective for proper placing of a balloon and a dilator in the stenotic portion. Follow-up evaluation of the procedures was also feasible with this ultrasonic aid.

Angioplasty, Balloon↗

Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union.

A total of 96 patients with gallbladder carcinoma in whom direct cholangiography clearly opacified the pancreaticobiliary ductal union and the common channel, and 65 patients with an anomalous union of these two duct systems at a distance greater than 15 mm from the papilla of Vater (normally less than 4.6 +/- 2.2 mm, mean +/- SD) were studied. It was found that this anomalous ductal union occurred in 16.7% of the patients with gallbladder carcinoma in comparison with an incidence of 2.8% among 641 consecutive patients with various hepatobiliary and pancreatic diseases studied by endoscopic retrograde cholangiopancreatography who did not have gallbladder carcinoma. It was also found that gallbladder carcinoma occurred in 24.6% of the 65 cases of anomalous ductal union in comparison with a 1.9% incidence of this cancer among 635 consecutive patients similarly studied and found to have normal ductal union (p less than 0.001). Thus, a close etiologic association was suggested between this anomaly in the terminal segment of the biliary tract and gallbladder carcinoma. Of the 65 patients with anomalous ductal union, 50 had the so-called congenital cystic dilatation of the common bile duct and 15 did not. Five of the 50 (10%) and 11 of the 15 (73.3%) had gallbladder carcinoma (p less than 0.01), and this carcinoma seems to be related to anomalous ductal union rather than to cystic dilatation of the common bile duct. As a tumorigenic factor in this anomaly, regurgitation of pancreatic juice has been stressed.

Adult↗

[Clinical manifestation of small thalamic hemorrhage].

CT scan is useful for the simultaneous evaluation of the relation between the thalamic lesions and the clinical manifestations. According to CT findings, twenty-three patients with thalamic hemorrhage measuring less than 2 cm in size could be classified into 4 groups: 1) anterior group--hematoma located in the anterior nuclear group, 2) medial group--hematoma located in the medial nuclear group, 3) lateral group--hematoma located in the lateral nuclear group close to the internal capsule, 4) posterior group--hematoma located in the pulvinar. The clinical manifestations of both the anterior and medial groups were characterized by the disturbance of consciousness followed by the mental impairment; the lateral group, by the hemiparesis or hemiplegia with the sensory disturbance, and the posterior group, especially with left thalamic lesions, by the speech disturbance. The motor palsy in cases of thalamic hemorrhage differed from that of putaminal hemorrhage: the patients with thalamic hemorrhage could move their fingers despite being unable to move their shoulders and elbows, or the motor weakness was more severe in their lower extremities than in their upper ones. As the sensory disturbance, the sensory impairment (hypesthesia) was frequently associated with the numbness (dysesthesia). The prognosis of motor palsy, ocular manifestations, and speech disturbance was good, whereas that of sensory and mental disturbance was not always good.

Adult↗

Bacteriological study of transhepatically aspirated bile. Relation to cholangiographic findings in 295 patients.

The purpose of this study was to elucidate the frequency of bacterial infection of intrahepatic bile in relation to biliary tract pathology. Bile was aspirated during percutaneous transhepatic cholangiography, with or without combined biliary tract drainage, and subjected to bacteriological investigations in 295 patients with various hepatobiliary diseases. Bile was infected in 89% of the 92 patients who had high fever and were on antibiotics at the time of study. Positive cultures were obtained in 39% of the patients who were not so ill as to require antibiotics. The overall incidence of biliary infection was 90% in bile duct stones, particularly high in patients with primary intrahepatic stones, regardless of the presence of stones in the common bile duct, and in patients who had dilation of the common bile duct, presumably due to obstructive involvement of the ampulla of Vater. E. coli and Klebsiella were the most frequent among the aerobic species isolated, and mixed infection involving these organisms was common. Anaerobes were much less frequent, always mixed with aerobes, but positive cultures would increase with more rigorous anaerobic conditions for culture. Duodenal fluid collected simultaneously did not always grow the same microorganisms, but showed a 86-87% coincidence with intrahepatic bile in terms of positive or negative cultures. It is recommended that bile be cultured at the time of percutaneous transhepatic cholangiography.

Ampulla of Vater↗

Inhibition by indomethacin of in vitro reactivation of latent herpes simplex virus type 1 in murine trigeminal ganglia.

Infectious virus could no longer be detected in the trigeminal ganglia removed from mice 25 days after infection with herpes simplex virus type 1 (HSV-1) by the lip route. When the ganglia were cultured in vitro for 1 or 2 days, infectious HSV-1 was again detected in the ganglia, indicating the reactivation of latent HSV-1. The effect of indomethacin on this reactivation was examined. When the ganglia were cultivated in the presence of 5 X 10(-4) M-indomethacin, the appearance of infectious virus in the ganglia was almost completely inhibited. After removal of indomethacin, infectious virus appeared and the virus titre reached levels found in the ganglia cultured in indomethacin-free medium, indicating that the inhibition of the reactivation may not be due to the cytotoxic effect of indomethacin on the ganglionic cells. The inhibitory effect of indomethacin was only seen when it was added shortly after explantation. These results suggest that indomethacin affects some early processes of viral reactivation in the explanted ganglia. The synthesis of prostaglandins (PGE and PGB) found in the explanted ganglia was strongly suppressed by indomethacin, as was the viral reactivation. Other inhibitors of prostaglandin synthesis, i.e. tetracaine, mepacrine and mefenamic acid, also inhibited viral reactivation in the explanted ganglia. These results suggest that the inhibitory effect of indomethacin on the reactivation of latent HSV-1 may be due to the inhibition of prostaglandin synthesis, although it is possible that other cellular changes which could be caused by indomethacin contributed to the suppression of reactivation.

Animals↗

Effects of nicotine on canine intestinal blood flow and oxygen consumption.

The purpose of this study was to determine the effects of nicotine on intestinal blood flow and oxygen consumption. The intravenous infusion of nicotine at doses corresponding to those experienced by smokers produced a transient increase in systemic arterial blood pressure and mesenteric blood flow. Subsequently a steady-state response developed that consisted of a reduction in mesenteric blood flow due to both a decrease in blood pressure and an increase in intestinal vascular resistance. This increase in resistance was probably due to increased levels of circulating catecholamines. The intra-arterial infusion of nicotine into the intestinal circulation at doses experienced by the average smoker had no effect on either intestinal blood flow or oxygen consumption. Similarly, under in vitro conditions nicotine had no direct effect on intestinal vascular smooth muscle tension. Thus, nicotine appears to reduce intestinal blood flow indirectly as a result of its systemic effects.

Animals↗

Seroepidemiological survey on dengue and Japanese encephalitis virus infections in Asian monkeys.

To investigate the ecology of dengue and Japanese encephalitis (JE) viruses in the forest in Asia, a seroepidemiological survey was carried out on 358 Southeast Asian cynomolgus (Macaca iris), 33 Indian bonnet (Macaca radiata) and 37 Japanese (Macaca fuscata) monkey sera by a plaque reduction neutralization test. The results indicated that Southeast Asian monkeys were naturally infected with these viruses but the frequency of antibody to them varied considerably according to the geographical origin of the monkeys. The frequency of antibody to one or more types of dengue virus were 87.2, 49.5, 34.3, 34.2 and 14.9% in Malaysian, Vietnamese, Cambodian, Indonesian and Filipino cynomolgus monkey sera, respectively. None of the Indian bonnet monkey sera neutralized type 1 dengue virus which was the only virus type examined with this monkey species. Monkey sera collected in Japan where dengue virus infection had not been known since 1944 did not significantly neutralize dengue viruses. JE virus antibody was detected at 29.7, 9.0, 8.6, 2.7, 1.4 and 0% in Japanese, Cambodian, Vietnamese, Indonesian, Filipino and Malaysian monkey sera respectively.

Animals↗

Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography. A study in 51 patients.

The clinical features and usefulness of various methods for diagnosis of small hepatocellular carcinoma, no greater than 5 cm in diameter, were studied in 51 patients. The diagnosis was verified in 28 patients by hepatic resection and in 4 patients at autopsy. The tumor was less than 3 cm in diameter in 23 patients. In 37 patients (72.5%), the tumor was first discovered by real-time linear scan ultrasonography, generally during a routine periodic follow-up examination of patients with chronic liver disease, mostly cirrhosis. Clinically, 62.7% of the patients were asymptomatic, and symptoms in the remainder were not suggestive of carcinoma. Most patients showed only mildly abnormal liver function tests that did not suggest the diagnosis. Serum alpha-fetoprotein level was normal in 25.5%, and it was elevated above 200 ng/ml in only 33.3%. Among the various imaging modalities, ultrasonography had the highest detection rate (92.2%) for these small hepatocellular carcinomas compared with computed tomography (73.2%), scintigraphy (50.0%), and angiography (86.0%). False-positive lesions, however, were also found frequently by ultrasonography, requiring ultrasonography-guided biopsy for differential diagnosis in some of the patients. Routine examination at regular intervals of patients with chronic liver disease using a combination of real-time ultrasonography and alpha-fetoprotein measurement is currently the most effective approach to detecting small hepatocellular carcinoma.

Adult↗