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Biomedical subjects

H Takasan

Publications and source records attributed to H Takasan.

At least 19 recordsLinked to original sources

[A clinical study on acute mesenteric arterial occlusion].

Thirteen patients with acute occlusion of superior mesenteric artery are presented. Eight of them presented with sudden abdominal pain as the initial complaint while the others did with vomiting, abdominal distension or general fatigue. Arterial blood gas and deficit determinations revealed metabolic acidosis in 45.5% and large deficit in 100%, which was considered to be a reliable method for accurate early diagnosis of acute mesenteric arterial occlusion. Eleven patients underwent laparotomy and massive bowel resection, two of which had treatment with selective intraarterial infusion of urokinase prior to operation. One of two remaining patients did not need operation because she went on to complete recovery after fragmentation of embolus in the superior mesenteric artery by the percutaneously inserted catheter on angiography. The other one was inoperable because of poor general condition. The overall mortality in this series was 53.8%.

Acute Disease↗

Nuclear DNA content as a prognostic predictor in carcinoma of the pancreas.

Eighty-six patients with carcinoma of the pancreas were studied retrospectively. Paraffin-embedded specimens and flow cytometry were used to evaluate the accuracy of the measurement of nuclear DNA as a predictor of the postoperative prognosis. From the series of 86 patients, 72 with a diagnosis of tubular adenocarcinoma (Japanese classification) were selected, and their DNA ploidy pattern and clinical and pathological features were correlated; 52.3% of the 86 patients and 52.8% of the 72 tubular adenocarcinoma patients showed DNA aneuploidy. Histological examinations of the tubular adenocarcinomas showed 42.9% DNA aneuploidy in well differentiated, 56.8% in moderately differentiated, and 71.4% in poorly differentiated types. The DNA ploidy showed a statistically significant positive correlation with the T category. The presence or absence of retroperitoneal invasion was thought to be the most important prognostic factor. Cumulative survival rates showed that the prognosis for patients with retroperitoneal invasion and DNA aneuploidy was significantly worse than for those with DNA diploidy or those without retroperitoneal invasion.

Adenocarcinoma↗

Flow cytometric analysis of nuclear DNA content of duct cell carcinoma of the pancreas.

BACKGROUND: This study was designed to evaluate the efficacy of nuclear DNA content analysis in determining the prognosis of carcinoma of the pancreas. METHODS: Resected and paraffin-embedded specimens from 72 patients with duct cell carcinoma of the pancreas were examined, and flow cytometry was used to explore the relationship between DNA ploidy and TNM classification or histologic grade. RESULTS: DNA aneuploidy was found histologically in 42.9%, 56.8%, and 71.4% of Grade 1, 2, and 3 tumors, respectively. DNA ploidy showed a statistically significant correlation with T category and retroperitoneal invasion. The cumulative survival rate of patients with retroperitoneal invasion was shorter than that of those without retroperitoneal invasion. Among the patients with retroperitoneal invasion, those with DNA aneuploidy had a significantly shorter survival time than did those with DNA diploidy. CONCLUSIONS: The DNA ploidy pattern, in combination with the presence or absence of retroperitoneal invasion, appears to be useful in predicting the prognosis for duct cell adenocarcinoma of the pancreas.

Adult↗

[Two cases of pancreatic serous cystadenoma].

Two cases of operated pancreatic serous cystadenoma were reported with radiological findings. A 67-year-old man was admitted to our hospital complaining of pain in the left upper quadrant. Ultrasonography revealed a mass having a mixed hypoechoic and echogenic pattern at the body of the pancreas. Computed tomography showed a honeycomb appearance. Angiogram showed hypervascularity and ERCP finding showed narrowing of the main pancreatic duct at the body of the pancreas. A 73-year-old man was detected incidentally to have a low density mass with central satellite appearance by computed tomography at the tail of the pancreas during the examination for the renal tumor. The mass showed hypervascularity and A-V shunt angiographically and narrowing of the main pancreatic duct at the tail of the pancreas by ERCP. Both patients underwent distal pancreatectomy. Histopathological findings showed microcystic pattern with single lining epithelial cells which were low cuboidal or flattened and contained intracytoplasmic glycogen.

Aged↗

Changes in the reticuloendothelial phagocytic function after partial hepatectomy.

The changes in the phagocytic function of the reticuloendothelial (RE) system after 67% hepatectomy in rats were studied by use of 51Cr-endotoxin as the phagocytable material. The humoral opsonic index was significantly increased to approximately 1.2 to 1.8 (control, 1.0 +/- 0.2, mean +/- SD) until the fourteenth postoperative day. In contrast, the phagocytic index was decreased to 0.068 +/- 0.016 (control, 0.103 +/- 0.015) on the first day, then returned to the normal level on the second day. In this early postoperative period, uptake rates of 51Cr-endotoxin in the liver were remarkably decreased to about 50% to 70% of control, whereas those in the spleen and lung were increased two- to threefold of control. From the third to the fourteenth day, the phagocytic index was significantly increased compared with the preoperative level. During this period, the uptake rates in the liver and spleen were within the normal range. These results suggest that the increases in the opsonic index of 67% hepatectomized rats represent the homeostatic response for maintaining or stimulating RE system phagocytic function, and that high or normal phagocytic index, concomitant with the increase in the opsonic index, implies an enhanced or compensatory stage, respectively. The decrease in the phagocytic index despite the high opsonic index is assumed to represent a compromised stage of the RE system.

Animals↗

[A case of portal hypertension with massive gastrointestinal bleeding from ileal varices].

A rare case of massive gastrointestinal bleeding from ileal varices was reported. On December 28, 1982, a 49-year-old male was admitted to Kurashiki Central Hospital because of massive gastrointestinal bleeding. Eleven years ago, the patient underwent an emergency operation for rupture of esophageal varices. The venous phase of selective superior mesenteric and celiac angiography showed mesenteric varices, but no definite bleeding point was noted. Endoscopy revealed esophageal varices, but no area of bleeding was encountered. Because of frequently repeated hemorrhages, laparotomy was performed. A large vein was found on the surface of the ileal wall, through an adhesion to the lateral pelvic wall. Partial resection of ileum was performed. Histological examination of the resected small bowel demonstrated ruptured submucosal varices. The postoperative course was uneventful and he was discharged on the 40th postoperative day. It is stressed that this disease should be considered as a differential diagnosis for a patient with lower gastrointestinal bleeding and portal hypertension.

Gastrointestinal Hemorrhage↗

Minimal requirement of the remnant pancreas for protein and DNA synthesis of cultured hepatocytes prepared from pancreatectomized rats.

The incorporation of 3H-thymidine and 3H-leucine into the hepatocytes was studied, using cultured hepatocytes prepared from normal and pancreatectomized rats. (1) In the cultured hepatocytes prepared from 80% pancreatectomized rats, the incorporation of 3H-thymidine and 3H-leucine into hepatocytes remained unchanged compared with those of sham-operated controls. In contrast, in those from totally pancreatectomized rats, the incorporation of 3H-thymidine and 3H-leucine decreased to approximately 67% and 37% respectively of sham-operated controls. However, those returned to near normal in the cultured hepatocytes from totally pancreatectomized rats treated by 0.8 IU/kg of insulin. (2) The addition of insulin (10(-4) M) to the culture medium stimulated the incorporation of 3H-thymidine into cultured hepatocytes prepared from normal rats to 148% of controls. The insulin-stimulated incorporation was inhibited by the addition of glucagon to the culture medium. The combined addition of insulin and glucagon did not synergistically act on DNA synthesis. It is suggested that the portal blood insulin in the presence of more than 20% of the pancreas is imperative for maintaining spontaneous regeneration.

Animals↗

[Treatment of unresectable liver cancer with intrahepatic arterial infusion chemotherapy].

Intra-arterial infusion chemotherapy was performed in 50 patients with cancer of the liver including 12 primary hepatoma and 38 metastatic cancers, at Kurashiki Central Hospital from December 1977 through December 1981. B.D. Fomocath 5 French catheter was inserted through the lateral femoral circumflex artery and advanced retrogradely to the common hepatic or proper hepatic artery using a loop catheter technique and the catheter was connected to the tube of infusion pump. The dose of 5-Fluorouracil and Mitomycin C was 250 mg per day and 4-10 mg once a week, respectively. The patients had average survival of 8.2 months in hepatoma and 4.8 months in metastatic tumor. The results were unfortunately not encouraging but this regimen occasionally provides excellent results and has no contraindication.

Adult↗

Role of portal venous blood supply from the pancreas in maintaining hepatic functional reserve. Appraisal of Warren's shunt operation.

Mitochondrial phosphorylative activity was measured in the livers of various shunted or pancreatectomized dogs. In simple portal vein branch-ligated dogs, the mitochondrial phosphorylative activity in the nonligated lobe, which was supplied with excess portal blood, increased to approximately 150% of control values. In splenocaval-shunted or totally pancreatectomized dogs, the mitochondrial phosphorylative activity did not increase even in the nonligated lobe. However, the mitochondrial phosphorylative activity in the nonligated lobe increased to 120% of control in 80%-pancreatectomized and 150% in 50%-pancreatectomized dogs. In distal splenorenal-shunted (Warren-shunted) dogs, the mitochondrial phosphorylative activity increased to 150% of control values. Thus, the Warren's shunt operation is considered to be the more reasonable procedure for treatment of liver cirrhosis with esophageal varices, from the point of view of hepatic functional reserve based on the energetic metabolism of the liver.

Animals↗

Effect of 4-methylumbelliferone on the oxidative metabolism of liver mitochondria in jaundiced rats and its relationship of choleretic action.

The effect of 4-methylumbelliferone (4-MU) on the oxidative metabolism of liver mitochondria and its relationship to choleretic action were investigated on 40 bile duct-ligated rats and 40 rats after biliary decompression. The oxidative metabolism of liver mitochondria fell rapidly to 50% of controls within 7 days after bile duct-ligation, whereas that in rats with 4-MU fell only slightly. Such effect of 4-MU on the liver mitochondrial metabolism was most prominent when it was administered to rats after biliary decompression. In rats with 4-MU the depressed oxidative metabolism of cholestatic liver mitochondria recovered rapidly toward normal with accelerated amelioration of serum total bilirubin as compared to that in rats without 4-MU after biliary decompression by loosening of the ligation of the common bile duct. Thus, 4-MU appeared to exert some stimulation or amelioration of the impaired liver mitochondrial metabolism due to jaundice, which may have a close relationship to its choleretic action or effective bile excretory action.

Animals↗

Ligation of a branch of the portal vein for carcinoma of the liver.

Portal branch ligation, a new surgical treatment for unresectable carcinoma of the liver, was performed in twenty patients. All the patients tolerated the procedure, and morbidity and mortality were minimal, even in patients in poor general condition. The responses to ligation differed considerably, but significant palliation was attained in some patients and one survived six years. The effect of portal branch ligation on the tumor appears to be closely related to the degree of tumor vascularity, tumor malignancy, and portal circulatory disturbances such as cirrhosis, portal hypertension, or portal thrombosis. We believe that the present procedure can be recommended for clinical application in some patients with unresectable carcinoma of the liver.

Adenoma, Bile Duct↗

Oral glucose tolerance in patients with jaundice.

A glucose tolerance test was performed on 21 patients with jaundice. The glucose tolerance patterns were principally classified into a parabolic pattern characterized by the return toward normal within 120 minutes and a linear pattern with long-standing increase for more than 120 minutes. Of these, 13 patients showed the parabolic pattern and tolerated the operation well. The other eight patients showed the linear pattern. Of the latter, four patients died within three weeks postoperatively, and the others died without leaving the hospital following operation. From the results, it was suggested that the parabolic glucose tolerance pattern is indicative of compensated damage to the liver, while the linear glucose tolerance pattern shows critically decreased hepatic functional reserve. Experimentally, the close relationship between the severity of the derangement of metabolism in the mitochondria of the liver and the degree of glucose intolerance was studied in rats and rabbits with jaundice subjected to the ligation of the common bile duct. In rats with jaundice in which the phosphorylative activity is significantly higher than that in the mitochondria from the tissues of the liver deprived of endogenous insulin through portal blood, the parabolic patterns develop. In rabbits with jaundice in which the phosphorylative activity is considerably lower than that in the mitochondria from tissues of the liver deprived of endogenous insulin, the linear pattern occurs. It was suggested that the two distinct patterns in patients with jaundice are closely related to the severity of the derangement of the phosphorylative activity of the mitochondria.

Adult↗