[Gastric mucosal blood flow: the effect of esophageal transection and endoscopic sclerotherapy of treatment of esophageal varices in liver cirrhosis].
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Adult↗
Biomedical subjects
K Umeyama
Publications and source records attributed to K Umeyama.
Isolation of Vibrio fluvialis, and unusual pathogen in acute suppurative cholangitis.
We report a case of acute suppurative cholangitis, from which were isolated Enterobacter aerogenes and Vibrio fluvialis. There have been no previous reports of the isolation of V. fluvialis in this disease. It is usually found in seawater and various seafoods and may cause acute diarrhea, but this is the first report in which it has been associated with acute suppurative cholangitis.
Acute Disease↗
[A new series of monoclonal antibodies against pancreatic cancer cells].
A new series of monoclonal antibodies (Span 1-7) was produced by immunizing mice with SW 1990 human pancreatic cancer cells. Span 1-4 antibodies (Ab) reacted with 4-5 of 8 pancreatic cancer cell lines tested and with 5-6 of 9 colon cancer cell lines and some lung cancer cell lines. Span 1-4 antigens (Ag) were detected not only on cell surface but also in cultured spent medium of SW 1990 cells by ELISA. They were also found in the fractions of a cesium chloride gradient of SW 1990 xenograft homogenates which have the highest molecular weight, density and carbohydrate content. Their immunoreactivity is dependent upon sialic acid because prior digestion with neuraminidase abolished their immunoreactivity. Span 5,6,7 Ab reacted with only 3 of 8 pancreatic cancer cell lines tested and did not reacted with any other cell lines such as colon cancer, lung cancer and melanoma. The epitopes which were recognized by Span 5,6,7 Ab did not contain sialic acid. These results suggest that Span 1-4 Ab has potential application in the detection of gastrointestinal cancers and that Span 5,7 may be useful to detect the origin which is unknown by using immunohistochemistry method for metastatic lesions.
Animals↗
Serum fatty acid concentrations in patients on postoperative parenteral nutrition with and without fat.
To examine changes in fatty acid composition of serum lipids, sixteen patients with gastric cancer were maintained on total parenteral nutrition (TPN) or intravenous feeding immediately after total gastrectomy. Subjects receiving no fat showed decreases in linoleic acid, linolenic acid and arachidonic acid and increases in palmitoleic acid and oleic acid, whereas those receiving fat emulsion showed no detectable changes. Decrease in the linoleic acid content was greater in subjects on a higher carbohydrate intake, but less in those on a higher fat intake. Multiple regression analysis of the relationships among carbohydrate intake (X1) and fat intake (X2) and changes in the linoleic acid percentage of total serum fatty acids (Y) in each case yielded an equation: Y =-4.75 X1 + 69.0 X2 - 27.9 (R = 0.885, p less than 0.05). Approximately 1 g/kg/day of fat provided in 40-50 kcal/kg/day of nonprotein energy intake was estimated to prevent decrease in the linoleic acid content in the serum fatty acid pattern during the postoperative catabolic stage.
Adult↗
Effects of cerulein on the normal pancreas and on experimental pancreatic carcinoma in the Syrian golden hamster.
The effects of cerulein on normal pancreas and on N-nitrobis (2-hydroxypropyl) amine (BHP)-induced experimental pancreatic carcinoma in Syrian golden hamsters were studied. Twenty hamsters received a subcutaneous injection of cerulein (20 micrograms/kg). The results showed that when cerulein was injected subcutaneously for 10 days, pancreatic weight and amylase increased. DNA and the pancreatic weight/DNA ratio were also increased significantly in treated hamsters compared with controls (p less than 0.02 versus p less than 0.01). These results indicated that chronic cerulein injection had hypertrophic and hyperplastic effects. DNA synthesis, as measured by histoautoradiography of tritiated thymidine-labeled tissue, increased in pancreatic acinar cells (p less than 0.01) and increased slightly in islet cells and in ductal cells. Tritiated thymidine uptake in the pancreas of the treated group indicated a rather selective exocrine gland incorporation by acinar rather than ductal cells. Sixty hamsters received a subcutaneous injection of BHP (500 mg/kg) once a week, while 63 hamsters received BHP (500 mg/kg) plus cerulein (20 micrograms/kg). Twenty-seven hamsters received cerulein (20 micrograms/kg) alone. All animals were killed from 8 to 27 weeks later, and no cancer-bearing hamsters were observed during the eighth and ninth week following administration. From the 10th to 14th weeks after administration of BHP and cerulein, 87.9% (13 of 15) had tumors compared with 18.7% (3 of 16) after BHP alone (p less than 0.01). One of three and two of 13 tumors were adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
Pancreatic microcirculation of dogs measured by hydrogen gas generated by electrolysis.
Electrochemically generated hydrogen gas was used to measure pancreatic regional blood flow in dogs by Koshu's method. This method is not necessary to inhale H2 gas and it is possible to generate H2 gas from H3O- in tissue in precise areas and to measure pancreatic regional blood flow easily, immediately, and steadily. Reliability and reproducibility were as good as for the H2 gas clearance method. Although the H2 gas clearance method has disadvantages in measuring pancreatic regional blood flow, especially in hypocirculation and in small animals, this new method can be used effectively. It will be useful in the investigation and examination of pathologic conditions in small animals and in humans.
Animals↗
Effects of bethanechol on the pancreas in antrectomized and normal rats.
The effect of chronic administration of bethanechol and pentagastrin on the pancreas was examined. Rats were either antrectomized or subjected to a sham operation. Three weeks after surgery, rats received a daily intraperitoneal injection of either bethanechol (12 mg/kg) or pentagastrin (250 micrograms/kg) for 14 days. The fasting serum gastrin after bethanechol treatment increased to 1.89 times that of controls treated with saline. Although antrectomy decreased fasting serum gastrin to approximately 40% of controls, serum gastrin increased by 2.17 times that of the antrectomized rats and 1.37 times that of controls in the bethanechol group. After 14 days of bethanechol treatment, weight and amylase in the pancreas increased significantly compared with control; DNA and protein also increased 1.3 and 1.5 times that of control. The increase in DNA and pancreatic weight indicated that hyperplasia was the predominant mechanism. The pancreas showed atrophy in antrectomized rats but this was reversed by both bethanechol and pentagastrin. The results indicate that either endogenous gastric or extragastric gastrin release by cholinergic stimuli may have an important role in the regulation of pancreatic growth.
Animals↗
[The effect of RT1 subregion differences on pancreatic islet allograft survival in the rat].
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Animals↗
Pyloric stenosis: an unusual complication of Behçet's disease.
A 20-yr-old Japanese man with longstanding Behçet's disease had pyloric stenosis and multiple duodenal ulcers. The pyloric stenosis was due to edematous hypertrophy of the pyloric ring and was unrelated to duodenal ulceration. The evidence suggests that the pyloric stenosis and multiple duodenal ulceration were a manifestation of Behçet's syndrome and not merely incidental peptic ulcer disease.
Adult↗
[Primary malignant melanoma of the esophagus].
A case of primary malignant melanoma of the esophagus is reported. The patient was a 44-year-old man. The tumor occupied Ea approximately C (E less than C) and was a large protruding mass. Partial esophagectomy (Ei approximately Ea) and total gastrectomy with splenectomy (R2), postoperative adjuvant chemotherapy (DTIC.CDDP) and radiation against the metastatic lesion of the right adrenal were performed. The patient died eight months postoperatively with massive multiple metastases to the liver. Histologically, the tumor tissue was diagnosed as primary malignant melanoma of the esophagus with junctional change and esophageal melanocytosis.
Adult↗
[Clinical studies on selective percutaneous transhepatic left cholangio-drainage (s-PTLD)--a procedure to prevent spontaneous slippage of the catheter].
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Adolescent↗
[Measurement of pancreatic microcirculation using hydrogen gas generated by electrolysis in dogs].
Measurements of pancreatic microflow were investigated using hydrogen gas generated by electrolysis in dog. After laparatomy under general anesthesia, uncinate process of the pancreas was punctured by a needle electrode for electrolysis and determination of hydrogen gas. The consecutive measurements of pancreatic microflow revealed the good reproducibility at the same point of the pancreas. The simultaneous measurements of pancreatic microflow by electrolysis and pancreatic tissue blood flow by H2 inhalation method were carried out at the same point of the pancreas. Correlation analysis of both measurements revealed coefficient of 0.751 and a significant relationship was observed (p less than 0.05). However, the value was a little higher in pancreatic microflow as compared with pancreatic tissue blood flow. Pancreatic microflow and pancreatic exocrine secretion increased after intravenous administration of Dopamine and Secretin (10 micrograms/kg/min). It is concluded that the measurement of pancreatic microflow by hydrogen gas generated by electrolysis is a useful method on understanding the microcirculation of the pancreas.
Alprostadil↗
[A study of nuclear DNA ploidy patterns of gastric carcinoma].
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DNA, Neoplasm↗
A clinical evaluation of carbohydrate antigen 19-9 and carcinoembryonic antigen in patients with pancreatic carcinoma.
We have studied serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in 221 persons to assess their usefulness in the diagnosis of pancreatic carcinoma. Although serum CA 19-9 and CEA in all healthy controls were within normal limits, the positive ratings of serum CA 19-9 and CEA in all benign disease were 9.8% and 18.1%, respectively. Sensitivity of serum CA 19-9 for pancreatic carcinoma was 70.5%, which was higher than that found in healthy controls, benign disease, and other malignant disease except biliary carcinoma; but sensitivity of serum CEA levels (67.7%) was not different from that seen in malignant disease. Three of 34 patients (8.8%) with pancreatic carcinoma who had a above-normal levels of serum CA 19-9 but not serum CEA were resectable. Although there was no correlation between serum CA 19-9 and CEA, advanced stages of pancreatic, gastric, and colorectal carcinoma tend to show high serum CA 19-9 and CEA, but no statistical differences were observed in relation to the stages of these carcinomas. Comparative studies of serum CA 19-9 and CEA for sensitivity and the predictive value of true positive and negative results for detecting pancreatic, gastric, and colorectal carcinoma showed that serum CA 19-9 has significantly higher sensitivity and predictive value of true positive results for pancreatic carcinoma than for gastric and colorectal carcinoma (P less than 0.05). However, serum CEA measurements did not show any difference between these carcinomas, and the highest predictive value of a true negative result for excluding pancreatic carcinoma was also observed in serum CA 19-9. These results indicate that although the CA 19-9 assay is not specific for pancreatic carcinoma, it is more useful adjunct method for diagnosing pancreatic carcinoma, possibly in resectable stages.
Adult↗
Postoperative total parenteral nutrition in patients with liver disorders.
Sixty-one patients with liver disorders receiving total parenteral nutrition (TPN) for about 14 postoperative days were divided into three groups based on the parenteral nutritional regimen. The influence of these TPN solutions on the liver function tests and the nutritional assessments, and the availability of the specially formulated amino acid solution were studied. Glucose alone as energy source was infused in Group Ia. The mixture of glucose and fructose was infused in Group Ib. In these patients (Group I), a commercially available amino acid solution was administered simultaneously. A specially formulated amino acid, rich in branched-chain amino acids but poor in aromatic amino acids was infused with the mixture of glucose and fructose in Group II. There was no remarkable elevation of blood glucose and lactate levels in all patients. Blood glucose levels in Group Ib were maintained lower than that in Group Ia. Except for serum alkaline phosphatase, no remarkable abnormality was observed in liver function tests. Body weight changes were less than 5% in each group. Average nitrogen balances were -44.5 mg/kg/day in Group Ia, -5.5 mg/kg/day in Group Ib, -51.5 mg/kg/day in Group II. While the abnormalities in serum amino acid pattern and molar ratio of leucine, isoleucine, and valine to phenylalanine and tyrosine tend to be more enhanced in Group I, these abnormalities returned to near normal in Group II during TPN. By multiple linear regression analyses, 45 kcal/kg/day of energy intake would be required to maintain nitrogen equilibrium and zero body weight change. And when nitrogen intakes were 159 mg/kg/day in Group Ia, 114 mg/kg/day in Group Ib, and 189 mg/kg/day in Group II at 45 kcal/kg/day in energy intake, nitrogen balances were expected to be equivalent. These results suggest that postoperative TPN is good for nutritional support in patients with liver disorders. And also, the combination of glucose and fructose has better effect on nitrogen balance. The postoperative TPN with a specially formulated amino acid solution may be a valuable way of maintaining the nutritional status as well as normal serum amino acid pattern in patients with liver disorders.
Adult↗
Comparative studies of plasma secretin response after reconstructive surgery of the stomach and pancreas.
The postprandial plasma secretin response was examined in ten normal persons, seven patients with a Billroth I and seven with a Billroth II anastomosis after subtotal gastrectomy, seven with a Roux-en-Y anastomosis, two with an interposed jejunal anastomosis, and five with a modified Child's anastomosis after pancreatoduodenectomy. The postprandial plasma secretin response in patients with Billroth I anastomosis was better than that in patients with a Billroth II anastomosis but was less than that of normal subjects. Although no postprandial secretin response was noted in Roux-en-Y anastomosis after total gastrectomy, a response was seen in patients with the interposed jejunal anastomosis because the digested food passed through the duodenum, but it was less than that for Billroth I and II patients and normal controls. After a modified Child's reconstruction, the postprandial secretin response was similar to that of patients with the Billroth II, which preserved the duodenum. A patient with a modified Child's reconstruction was examined 12 years after surgery and had the same response as other patients with the modified Child's reconstruction and those with a Billroth II anastomosis within 2 months after surgery. After ingestion of hydrochloride solution, the plasma secretin release in patients with a Billroth I and II anastomosis after subtotal gastrectomy and Roux-en-Y anastomosis after total gastrectomy had a better response than after a meal, but this was less than in normal subjects. The authors suggest that careful selection of intestine for the gastrointestinal anastomosis, which contains many secretin secretory cells, is important to obtain endogenous secretin release. For gastrojejunostomy after pancreatoduodenectomy, a method preserving the pylorus is better than the usual gastrojejunostomy because it maintains gastric acid. The ingestion of secretin stimulants, such as hydrochloride, may help to prevent pancreatic dysfunction after gastrectomy and other surgical reconstructions.
Duodenum↗
Toxic products in hemorrhagic ascitic fluid generated during experimental acute hemorrhagic pancreatitis in dogs and a treatment which reduces their effect.
Toxic substances produced in hemorrhagic ascitic fluid during experimental hemorrhagic pancreatitis in dogs were investigated. An average of 394 ml of ascitic fluid was produced within 5 h after the induction of acute pancreatitis by intraductal injection of a mixture of autologous bile and trypsin. Hemorrhagic ascitic fluid was collected under sterile conditions, which was confirmed by aerobic and anaerobic culture and a Limulus test. The sterile fluid was injected intraperitoneally into mice in doses of 2 and 3 ml, and the mortality rate 72 h after injection was 66.0 and 88.4%, respectively. It contained high concentrations of pancreatic enzymes, including trypsin and esterase activity, as well as bradykinin, histamine and prostaglandin. Autopsy and histological examination of mice revealed shock with lung damage. The results suggest that hemorrhagic ascitic fluid produced in pancreatitis may be an important factor for early deaths in acute pancreatitis. When a new synthetic antiprotease (nafamstat mesilate) in a dosage of 0.2 mg was mixed with 1 ml of ascitic fluid, trypsin was not detectable, and bradykinin was reduced 1.0 ng/ml from 8.0 ng/ml, while esterase activity decreased to one tenth of its previous activity. The mortality following injection of the solution decreased to 26.7 and 80.6%, respectively. These results indicate that peritoneal lavage with a solution containing antiprotease may be an effective treatment for hemorrhagic acute pancreatitis.
Acute Disease↗
Evaluation of serum pancreatic enzymes, carbohydrate antigen 19-9, and carcinoembryonic antigen in various pancreatic diseases.
Comparative studies of pancreatic enzymes carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) were performed in various pancreatic disease. In acute pancreatitis as well as during acute exacerbation of chronic pancreatitis, all pancreatic enzymes were abnormally high. In chronic pancreatitis, they did not have any diagnostic sensitivity for pancreatic insufficiency. In pancreatic carcinoma, serum elastase levels may have a diagnostic value compared with other pancreatic enzymes. In studies of CEA and CA 19-9, both tumor markers were within normal range in benign pancreatitis but 27.7% of CEA and 30.7% of CA 19-9 in acute pancreatitis were above normal. In pancreatic carcinoma, although most of these patients had advanced disease, both tumor markers were extremely high and 61% for CEA and 71% for CA 19-9 were above normal. In patients with resected pancreatic carcinoma, serum CEA was slightly higher than normal CA 19-9 was much higher than normal. The sensitivity of CEA and CA 19-9 in this group were 33 and 77.7%, respectively. The results indicate that the CA 19-9 assay is a useful adjunct in the diagnosis of pancreatic carcinoma, possibly in the resectable stage especially combined measurement of serum elastase and CEA.
Adolescent↗