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Biomedical subjects

H Umemura

Publications and source records attributed to H Umemura.

At least 19 recordsLinked to original sources

Coloanal anastomosis using a circular stapling device following perineal rectosigmoidectomy for rectal prolapse.

Perineal rectosigmoidectomy with a hand-sewn anastomosis is thought to be the most appropriate procedure for elderly patients deemed unfit to tolerate a major abdominal operation. However, the use of a circular stapling device to perform the coloanal anastomosis following rectosigmoidectomy shortens the operative time and provides a more secure anastomosis than the traditional hand-sewn technique.

Anal Canal↗

Anterior resection following posterior transsacral stapling and transection of the anal canal for low-lying rectal cancer in males.

In anterior resection with anastomosis using the double-staple technique for low-lying rectal cancer in male patients, the approach to the anal canal with a stapling instrument via the abdominal area is limited by the narrow pelvis. The stapling and transection of the anal canal via the posterior transsacral approach prior to performing an anterior resection thus enables the lower rectum and anal canal to be visualized, so that the anal canal can be accurately stapled and transected even in male patients with a narrow pelvis.

Anal Canal↗

[MALT lymphoma of large intestine as multiple large polypoid lesions].

We report a case of mucosa associated lymphoid tissue (MALT) lymphoma in the large intestine in a 38-year-old Japanese female. She developed a dull pain in the right lower abdomen and was found to have ileocecal intussusception. The terminal ileum, cecum and ascending colon were resected. Macroscopically, multiple polypoid lesions were found. Although some authors reported that MALT lymphoma of the colon tend to be solitary, the present case showed seven lesions. Two of the polypoid lesions in the present case were marked large. No such large polypoid MALT lymphoma has been described to our knowledge. A histological and immunohistochemical study revealed those seven lesions to be low grade B cell lymphomas of MALT type.

Adult↗

[Clinical studies on various therapy for the intractable trauma of toes and fingers in cases of diabetes mellitus and peripheral ischemic diseases].

In cases of ischemic extremities and diabetes mellitus, the trauma on finger and toe is very intractable. For such injuries amputation of extremity is indicated very often because of severe necrosis. The number of such cases has been increasing recently because many cases of these patients have arteriosclerotic arterial occlusion and diabetes mellitus, and these are correlated with the changes of aging. The number of cases of Buerger's disease has been also increasing and it is another etiology of intractable trauma in ischemic extremity. The repeated hyperbaric oxygenation, sympathetic block, warfarin therapy and insulin bath with bubbling of hyperbaric oxygen, were applied to has been of such necrosis. By these procedures, the rate of amputation of extremity decreasing. It was concluded that the surgical reconstruction of artery for ischemic extremity has never any meaning as the therapy of such intractable injuries, if blood flow in the peripheral tissue is not kept physiologically, before vascular reconstruction. In order to increase peripheral tissue circulation, the hyperbaric oxygenation, sympathetic block and warfarin therapy wer performed in many cases and these methods were very effective for intractable injuries with severe necrosis.

Adult↗

[Tuberculoma and tuberculous meningitis mimicking metastatic brain tumor and meningeal carcinomatosis--case report].

A 45-year-old man was well until February 1986, when he experienced gait disturbance and psychiatric symptoms. On February 11 he fell down several times and developed generalized convulsion on the following day. He was admitted to a hospital in a delirious condition. The chest X-ray film showed infiltration in the left upper lobe, but computed tomographic (CT) scan of the head revealed no abnormality. Cerebrospinal fluid obtained by lumbar puncture contained 155 cells/mm3, all of which were lymphocytes, and protein and glucose concentrations were 372 mg/dl and 68 mg/dl respectively. In spite of negative smear tests of sputum and cerebrospinal fluid for tubercle bacilli he was administered antituberculosis drugs on the suspicion of pulmonary tuberculosis and tuberculous meningitis. His level of consciousness gradually returned to normal but the follow-up CT scans showed a low density area with contrast enhancement in the right thalamus and obliteration of the right quadrigeminal cistern which was also enhanced with contrast medium. He was transferred to our hospital on March 28 for further evaluation. On admission to our hospital he was alert and oriented, his pupils were equal and reactive to light and he had mild left hemiparesis, left hyperreflexia and left hemihypesthesia. Cell count of the cerebrospinal fluid was 243/mm3, 90% of which were lymphocytes and protein and glucose contents were 340 mg/dl and 42 mg/dl respectively. Both smear and culture of the cerebrospinal fluid were negative for tubercle bacilli and other organisms. Cytological examination of the cerebrospinal fluid demonstrated clusters of cells of various sizes with high N/C ratio which suggested these cells were malignant.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗

[Changes in pancreatic hormones in portal blood and morphological changes of islet cells of Langerhans after hepatectomy].

Hybrid adult dogs weighing 12 to 15 kg were laparotomized before, one week, and one month after partial hepatectomy: Pancreatic tissues were taken and examined by the PAP staining. Also, the animals were intravenously injected via peripheral veins with 50 percent glucose 0.5 g/kg before, one week, and one month after surgery, and their portal blood was taken before, 5, 15, 30, 45 and 60 minutes after injection, and submitted to examination of insulin, glucagon, somatostatin and blood sugar levels. We obtained these results as follows. sigma IRI which represents an increment of insulin secretion after glucose loads, showed a decrease at one week after surgery (p less than 0.05) and an increase at one month after surgery (p less than 0.05). Somatostatin levels of portal blood showed marked increase after surgery (p less than 0.05). Observation on the area of Langerhans islets revealed approximately 4.6 fold hypertrophy from the size of 486 +/- 23 microns m2 before surgery to 2236 +/- 98 microns m2 one month after surgery (p less than 0.05). Insulin secreting B cells were found to contain increased secreting granules. Somatostatin secreting D cells increased 2.8-fold in number one month after surgery, showing mitotic figures.

Animals↗

[Plasma gastrin and secretin levels in patients with carcinoma of the esophagus before and after operation].

Twenty-two patients with esophageal cancer (8: preoperative, 8: one-month after surgery, and 6: more than 3 months after surgery) were orally loaded with 50 g of glucose, to determine the plasma gastrin levels. They were also loaded with oral 0.1N hydrochloride preoperatively and also one month after operation to examine the secretion kinetics of plasma secretin. In addition, the correlation between the G-cell (gastrin secretory cell) population in the pyloric region of the postoperative intrathoracic stomach and the plasma gastrin was investigated. The following results were obtained. Hypergastrinemia developed one month after surgery, but after 3 months or later, plasma gastrin levels almost returned to normal. Plasma secretin levels tended to decrease postoperatively; however, no statistically significant differences were observed. G-cell stain by the enzyme antibody method revealed hyperplasia of G-cells in some of the hypergastrinemic cases without accompanying atrophy of the pyloric mucosa and/or the intestinal epithelial metaplasia, although there were some hypergastrinemic cases with a decrease of G-cells due to the atrophy of the pyloric mucosa and/or the intestinal epithelial metaplasia. In the latter cases, gastrin was thought to be secreted probably from the duodenal mucosa.

Aged↗

Changes in plasma gastrin and secretin levels after pancreaticoduodenectomy.

The kinetics of secretion of gastrin and secretin before and after pancreaticoduodenectomy were studied. Prior to pancreaticoduodenectomy, gastrin secretory function was within the normal range; it was significantly reduced postoperatively. Preoperatively, patients had elevated basal levels of secretin with depressed reactivity. During pancreaticoduodenectomy, the upper part of the jejunum should be preserved as far as possible. Ulcers occurring after pancreaticoduodenectomy are more probably due to vagus nerve activity and other factors rather than to an imbalance between gastrin and secretin.

Adult↗