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Biomedical subjects

H Kasugai

Publications and source records attributed to H Kasugai.

At least 37 records · Page 2Linked to original sources

Sarcomere dynamics in a spontaneous contraction wave and its effect on the following, electrically triggered twitch in rat myocyte. Comparison with the rested state twitch.

A spontaneous contraction (SC) wave propagates among sarcomeres in heart muscle by the mechanism of Ca(++)-induced release of Ca++ from sarcoplasmic reticulum (SR). In the present study, some characteristics of unloaded shortening during the SC and its effect on a subsequent, electrically triggered twitch (Tsc) were examined at a sarcomere level in isolated rat myocytes. The results were compared with those of a rested state twitch (RS), which was accompanied by an action potential. Average shortening velocity from onset to peak of shortening was 3.74 +/- 1.25 (mean +/- SD, n = 18) and 5.35 +/- 2.30 microns/s per sarcomere (n = 54) in SC and RS, respectively. That the former was smaller than the latter (P < 0.01, t test) suggests that Ca++ are released from the SR more slowly in the SC than the RS. There were no differences in either the extent or area of shortening between SC and RS. The extent of shortening increased significantly as shortening velocity increased in all the SC (P < 0.05), RS, Tsc, and triggered twitch (Trs) after the RS (P < 0.001 in the last three). The slope of the line for the regression of the extent upon the velocity of shortening in the SC was approximately 1.5 times greater than the other three. This suggests that the SC has a different time course of change of myoplasmic [Ca++] and therefore a different mode of the causal SR Ca++ release from the electrically triggered twitches (RS, Trs, Tsc). There were positive correlations between the extent and the area of shortening in each of the RS (P < 0.01), the Trs (P < 0.05), and the Tsc (P < 0.001), but not in SC. The slope of the line for the regression of the extent upon the area of shortening in the Tsc was about three times greater than those in the RS and the Trs, suggesting characteristics of the Tsc from different those of the RS and the Trs. An SC inhibited a Tsc in an interval-dependent manner. The shortening velocity in the Tsc recovered fully at a test interval of approximately 0.6 s between the onsets of the two successive contractions. The velocity increased further with further increasing the test interval (up to 0.9 s). At a test interval of 0.8-0.9 s, the shortening velocity in the Tsc was greater than those in the preceding SC and the corresponding Trs by 1.17- and 1.80-fold, respectively, as compared in the same five sarcomeres.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗

Hookwire localizer as an aid for ultrasonic detection of small liver nodules.

We applied a V-shaped localizer and evaluated its clinical usefulness in nine patients with small hepatic nodules less than 2 cm in diameter. A small hepatic nodule was punctured with a 21-gauge localization needle under ultrasonic guidance, and the V-shaped localizer was pushed into the nodule with a wire. The localizer could be observed as a strong echo line by ultrasonography and as a high-density bar by computed tomography (CT). By this method, it was possible to precisely localize the nodule. Intraoperative ultrasonography became less time-consuming, and resection of the nodules could be confirmed with low-kilovoltage radiography.

Aged↗

A clinical and radiologic study of primary liver cancer associated with extrahepatic primary cancer.

In a consecutive series of 393 patients with excised and pathologically proven primary liver cancer (PLC)--including 374 hepatocellular carcinomas (HCC), nine cholangiocellular carcinomas (CCC), and ten mixed type of HCC and CCC--33 patients (8.4%) had one or two other malignancies in the extrahepatic organ(s). Of these, 29 had double cancers and four, triple cancers. This was synchronous in 11 patients, metachronous in 20 (including 18 with double cancers and two with triple cancers) and synchronous and metachronous in two with triple cancers. Metachronous cancer was found in 21 patients 1 year before hepatectomy for PLC and in three patients, 1 year after hepatectomy. The median age of PLC patients with multiple primary cancer (MPC) was 63.6 +/- 6.9 years; this was significantly greater than that of PLC patients without MPC (P less than 0.01). The associated cancer was gastric cancer in 11 patients (29.7%), colorectal cancer in six, pharyngeal cancer in four, and other cancers in ten different organs in 16. Thirteen of 22 patients had a history of blood transfusion. The incidence of liver cirrhosis in PLC associated with MPC (57.6%) was significantly lower than that without MPC (82.8%, P less than 0.01). The differential diagnosis of PLC from liver metastasis was possible retrospectively in 78.6% using sonograms, 79.3% using computed tomograms, and 91.3% using angiograms. The survival rates of patients with PLC with (n = 33) and without (n = 299) MPC who had undergone hepatectomy were 97.0% and 85.4% at 1 year, 55.5% and 59.5% at 3 years, and 40.5% and 40.1% at 5 years, respectively. There was no significant difference between the survival rates of those who underwent operations for PLC and extrahepatic primary cancer(s) synchronously and metachronously.

Adenoma, Bile Duct↗

Intrahepatic venous and portal venous aneurysms examined by color Doppler flow imaging.

Thirteen cases with liver cystic lesions, which were suspected to communicate with intrahepatic vessels on the basis of ordinary sonography, were examined by color Doppler flow imaging. By this method, blood flow within the cystic lesion was detected in 5 of these cases, and the communication to the intrahepatic vessel confirmed. Information about the hemodynamics of aneurysms was obtained. Two of these lesions were diagnosed as an aneurysmal porta-hepatic venous fistula, another 2 as a portal venous aneurysm, and the remaining 1 as a hepatic venous aneurysm.

Aneurysm↗

Small hepatocellular carcinoma: differentiation from adenomatous hyperplastic nodule with color Doppler flow imaging.

Liver nodules smaller than 25 mm in diameter (19 hepatocellular carcinomas [HCCs] and nine adenomatous hyperplastic nodules [AHNs]) were examined with color Doppler flow imaging and hepatic angiography. Angiography revealed a tumor vessel in eight (42%) of the 19 HCCs, while color Doppler flow imaging revealed an arterial pulsating afferent tumor vessel in 10 (53%) of the 19 HCCs but in none of the AHNs. In addition, color Doppler flow imaging revealed a constant-flow efferent tumor vessel continuing to a portal branch in 10 (53%) of the 19 HCCs but in none of the AHNs. In 15 (79%) of the 19 HCCs, a pulsating afferent tumor vessel or a constant-flow efferent tumor vessel or both were observed. Therefore, in this series, color Doppler flow imaging was of value in distinguishing between these two lesions.

Angiography↗

[Evaluation of 99mTc-PMT delayed imaging in diagnosis of hepatocellular carcinoma].

99mTc-PMT delayed imaging was performed on 199 patients with hepatocellular carcinoma (HCC), and 72 patients with various hepatic diseases, from which HCC should be differentiated. Of the 199 patients with HCC, 128 (64.3%) showed positive results on 99mTc-PMT images. Of these 128, 102 (51.3%) showed increased uptake of radioactivity by the hepatic tumor as compared with the surrounding non-tumorous area of the liver, and 26 (13.1%) showed equal uptake. On the contrary, only 2 (9.1%) of the 22 patients with other malignant hepatic tumors (7 with cholangiocellular carcinoma and 15 with metastatic liver tumors) showed equal uptake of 99mTc-PMT. These findings indicated that 99mTc-PMT delayed imaging was useful for increasing the specificity in diagnosis of HCC. Of the patients with HCC showing increased uptake on 99mTc-PMT images taken 5-hour after the injection of the radioisotope, 26.3%, 69.6%, and 96.0% showed intense 99mTc-PMT uptake by hepatic tumor on 1-hour, 2-hour, and 3-hour images, respectively. These findings indicated that in diagnosing HCC, 5-hour image should be taken only in the patients with a hepatic tumor showing no increased uptake of radioactivity even on 3-hour image. Moreover, the rate of HCC to take up 99mTc-PMT intensely was higher in patients with hepatic tumor showing filling defect on colloid liver image than in those showing no filling defect (p less than 0.001). The points in the assessment of radioactivity uptake by hepatic tumor on 99mTc-PMT delayed image were as follows: Overlapping of radioactivity excreted into the gall bladder or intestine with the radioactivity of the liver tumors, radioactivity retention in the non-neoplastic portion of the liver, and the radioactivity of the dilated intrahepatic bile duct were noted in 6 (2.6%), 15 (6.5%) and 9 (3.9%), respectively, among the 230 patients with focal space occupying lesions. Further, a patient of giant nodular regenerative hyperplasia showed increased uptake of 99mTc-PMT consistent with the hepatic lesion.

Carcinoma, Hepatocellular↗

[Evaluation of hepatic resection for stage IV hepatocellular carcinoma-comparison with arterial embolization therapy].

To evaluate the application of hepatic resection (HR) for patients with Stage IV hepatocellular carcinoma (HCC), we compared the back-ground factors and survivals after therapies between Stage IV HCC patients who underwent HR (n = 38) and those who received arterial embolization (n = 186, group C). Of the patients who had HR, 17 (45.1) had relative noncurative (RN) resection (group A) and the remaining 21 (55%) had absolute noncurative (AN) resection (group B). Back-ground factors in relation to liver function were significantly better in both A and B than in C. On the other hand, tumor-relating factors were better in A than in both B and C, and were worse in B than in C. Five-year survival rates of group A and group C were 37.1 and 13.1 respectively (A to C; p < 0.05) and there were no longer survivors than two years in group B. These results suggested that the group which had better back-ground factors gained the better prognosis. To compare the survivals in the patients having well back-ground factors who were dominant in group A, the patients whose clinical stage was I or the number of tumors was two or less were selected from each group. Among these selected patients, the survivals of group A were significantly better than those of the other groups.

Aged↗

[Evaluation of energy metabolism on the myocardium analyzing of creatine kinase isoenzymes in rats].

The purpose of this study is to evaluate the efficiency of energy metabolism in the myocardium by means of the activities of creatine kinase (CK) and CK isoenzyme following age-related change in the heart and experimental heart failure. Wistar strain male rats aged from 3 weeks to 57 weeks after birth were used. The main experimental results obtained are as follows. (1) There were differences in the compositions of CK isoenzyme of the ventricular, atrial, and papillar muscles. No apparent variation, however, was noted among the basal portions of the left and right ventricular muscles, free wall of the left ventricle, and apex. (2) Compositions of CK isoenzyme analyzed from the ventricle and atrium were clearly different. The level of CK-B subunit activity of the ventricular muscle was highest level in the 5-week-old rat, and subsequently dropped significantly in the 24-week-old rat. Thereafter, the level gradually increased with aging. Dramatic change in the energy metabolism in the myocardium occurred in rats more than 3 weeks old. (3) Decrease in activity of m-CK but increase in activity of succinate dehydrogenase analyzed from the ventricular muscle of experimental heart failure induced by monocrotaline was recognized. From these results, the author assumed that the trend of the composition of CK isoenzyme is one of the indices in the determination of the regulation of energy metabolism of the myocardium.

Aging↗

[Percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE) for recurrent hepatocellular carcinoma--report of 2 cases].

Two patients with recurrent hepatocellular carcinoma underwent reoperation following percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE). In the first case, although the nodules where the accumulation of Lipiodol (LpD) was seen showed complete necrosis, viable cancer cells were seen in the areas with slight accumulation of LpD. One nodule with no accumulation of LpD where PEIT seemed to have been performed, developed necrosis. In the second case, the nodules with LpI) accumulation also showed almost complete necrosis. The area where PEIT was performed was mixed with necrosis and bleeding, where a small viable cancer nodule existed. The reason for incomplete anticancer effects by PEIT seemed to be the too small ethanol injection.

Aged↗

[Chemoembolization therapy with lipiodol, cisplatin and etoposide for hepatocellular carcinoma].

Chemoembolization using CDDP, VP-16 and lipiodol was carried out for 7 patients with hepatocellular carcinoma (HCC). CDDP/lipiodol, CDDP/VP-16, CDDP/lipiodol (lipiodol 2-10 ml, CDDP 1-2 mg/kg, VP-16 100 mg/body) and gelatine sponge were administered in that order through the catheter located in the proper, or right or left hepatic artery. Three patients underwent hepatic resection 38-50 days after this treatment. Complete necrosis of the tumor was recognized in the one case, although the portion of necrosis did not exceed 70% in large sized HCC as the diameter of more than 10 cm. In 4 unresectable cases the decreases in tumor size were observed by ultrasonography and computed tomography. The response was: 3 partial responses and 1 no change. One out of 4 cases could undergo hepatic resection 17 months after this treatment. Two patients are alive 20 months after this treatment, although one patient died of HCC after 25 months. Serious side effect was not observed.

Aged↗

A case-control study of hepatocellular carcinoma in Osaka, Japan.

A case-control study was undertaken to evaluate the roles of hepatitis B virus (HBV), blood transfusion, alcohol drinking and cigarette smoking in the etiology of hepatocellular carcinoma (HCC) in Osaka, Japan. A total of 229 cases and 266 hospital controls were included in our study. The relative risks of HCC obtained after adjustment for age, sex and other important variables were 14.3 (95% confidence interval (CI): 5.7-36.3) for HBsAg positives, 4.3 (95% CI: 1.9-9.6) for blood recipients and 3.2 (95% CI: 2.0-5.1) for heavy drinkers. A statistically significant dose-response relationship was observed between the risk of HCC and total alcohol consumption. The overall risk for HCC was also significantly elevated among smokers; however, there was no consistent dose-response relationship between the risk and cigarette consumption. We conclude that HBV, blood transfusion and excessive alcohol drinking play important roles in the etiology of HCC in Osaka, Japan. Further investigation is needed to clarify the possible etiological role of smoking.

Adult↗

Diagnosis of hepatic cavernous hemangioma by fine needle aspiration biopsy under ultrasonic guidance.

Percutaneous aspiration biopsy of the liver using a heparinized 22-gauge needle was performed under ultrasonic guidance in 11 patients with hepatic cavernous hemangioma. Ten (91%) of 11 biopsy specimens obtained were cytologically diagnostic for hemangioma. No indications of malignancy were found. There was no relation between the cytological diagnosis and the location, size, or ultrasonographic findings. No complications were encountered. These findings indicate that cytological examination of the liver by fine needle aspiration biopsy is useful in diagnosing hepatic cavernous hemangioma of any size and in any location, provided optimal route to the lesions is chosen.

Aged↗

New plastic-coated coaxial catheter system for superselective hepatic catheterization: technical note.

With the use of a new improved coaxial catheter system, superselective hepatic catheterization has become easier. The improvements consist of a decrease in the outer and an increase in the inner diameters of the coaxial catheters from 0.98 to 0.96 mm and from 0.55 to 0.65 mm, respectively, and thickening of core guidewire material from 0.014 inch (0.35 mm) to 0.018 inch (0.40 mm). With this new catheter system, it is possible to inject contrast medium (iopamidol 300) at a higher rate (3 ml/sec) and gelatin sponge particles instead of gelatin powder for arterial embolization. The success rates for superselective catheterization using conventional (n = 10 procedures) and the improved coaxial catheter systems (n = 7) were 30% and 86%, respectively.

Catheterization↗

[A successfully treated case of infective endocarditis due to Candida tropicalis].

A 34-year-old man, a heavy drinker, was admitted with a high fever and hematuria two months previously. Surgery was performed for acute sever pancreatitis and postoperatively antibiotics were administered with intravenous hyperalimentation. After discharge he was readmitted and infective endocarditis was strongly suspected because of high fever, hematuria, Osler's nodes, Janeway's lesions, splinter hemorrhages and mitral regurgitation. Penicillin G in combination with Gentamycine therapy was started on the first hospital day. On the second hospital day, blood culture revealed Candida tropicalis so Miconazole therapy was commenced. On the forth hospital day, he underwent surgery for replacement of a mitral prosthesis with a prosthetic valve because he had embolus in the radial artery. Despite intensive antifungal therapy, he showed no improvement in clinical symptoms. Then we changed the antifungal drug from Miconazole to Amphotericin B and 5-fluorocytosine. On the 109th hospital day, his clinical symptoms improved. Antifungal therapy was halted and at present 10 months later, he is healthy.

Adult↗

Decollateralization with silicone rubber sheeting for advanced hepatocellular carcinoma: a preliminary report.

A new treatment method, interception of collaterals with a silicone rubber sheet, was applied to three patients with advanced hepatocellular carcinoma in whom arterial chemoembolization was assessed as ineffective because of the developed collateral feeding arteries. This procedure was followed by arterial chemoembolization or intraportal infusion chemotherapy or both. Follow-up celiac angiography confirmed that the long-term decollateralization was achieved by shielding the liver with silicone rubber sheeting. This technique resulted in partial responses without serious complications in all the patients including two who had no responses to chemoembolization before the procedure. The response durations were 5, 21, and 27, months, respectively. One patient died of gastrointestinal bleeding 7 months after the decollateralization. The other two patients are still alive, and the survivals after the procedure are 28 and 30 months, respectively. This therapy is considered promising and may be worth choosing as an adjuvant treatment for advanced hepatic malignancies uncontrolled by arterial chemotherapy or chemoembolization.

Aged↗

A pre-operative chemoembolization therapy using lipiodol, cisplatin and gelatin sponge for hepatocellular carcinoma.

The significance of pre-operative transcatheter arterial chemoembolization therapy using lipiodol, cisplatin and gelatin sponge (Gelfoam) for the prevention of the recurrence of hepatocellular carcinoma (HCC) was evaluated. On the 103 patients who underwent radical operations for HCC with a tumor size less than 10 cm, 52 patients received no pre-operative therapy (group C), and 51 patients received pre-operative chemoembolization using lipiodol, a chemotherapeutic agent and Gelfoam. Of these 51 patients, 37 patients received a combination of lipiodol, cisplatin and Gelfoam (group A), while the remaining 14 patients received lipiodol, adriamycin and Gelfoam (group B). The disease-free survival rates after surgery were compared between group A, group B and group C. The 2-year disease-free survival rates in group A, group B and group C were 72%, 46% and 54%, respectively. These rates therefore suggest that pre-operative chemoembolization using lipiodol, cisplatin and Gelfoam is a useful method to prevent the recurrence of HCC after surgery.

Adult↗