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Biomedical subjects

K Umeyama

Publications and source records attributed to K Umeyama.

At least 109 records · Page 6Linked to original sources
PubMed1985

[A case of primary lymphoma of the stomach, diffuse lymphoplasmacytic type, with massive hematemesis].

A case of primary lymphoma of the stomach with massive hematemesis and melena who underwent emergency gastrectomy is reported. The patient was a 72-year-old woman. The tumor was 3.5 X 3.0 cm in size and occupied the posterior wall of the upper part of the gastric body. The surface of the tumor was covered with hematoma, and was there was a lack of gastric mucosa. Histological diagnosis of the tumor was primary gastric lymphoma, diffuse lymphoplasmacytic B-cell type, and monoclonal kappa-light chain was demonstrated by the immunohistochemical method. The bleeding source of the tumor tissues was a ruptured artery invading the tumor tissue in the submucosal layer of the stomach.

Aged↗
PubMed1985

A large retroperitoneal encapsulation of bile from a spontaneous perforation of the common bile duct.

We report a patient with spontaneous rupture of the common bile duct. This is an extremely rare condition which produces free leakage of bile into the peritoneal cavity. There has been no previous report concerning the formation of a large retroperitoneal encapsulation of bile. The preoperative diagnosis in our patient was very difficult and endoscopic retrograde pancreatocholangiography and cystography by ultrasound guidance were helpful.

Aged↗
PubMed1985

Electron microscopic studies of human pancreatic adenocarcinoma.

Tissue samples from 12 patients with pancreatic carcinoma were studied by light and electron microscopy. Ten were diagnosed as adenocarcinoma by light microscopy. However, three different electron microscopic findings were observed among these ten adenocarcinomas. One showed that the tumour cells had large nuclei with poorly developed intracellular organelles. Many mucinous granules, well developed cellular projections and intracellular microcysts were observed. In the second findings were different in that these cells had no granules. The intracellular organelles were developed poorly and abundant microvilli and cellular projections were observed. These observations suggest that the tumour cells may arise from pancreatic ductular cells. The third specimen showed a completely different appearance. There were pleomorphic nuclei with enlarged nucleoli and the cytoplasm contained swollen mitochondria, a well developed rough endoplasmic reticulum and varying numbers of zymogen-like granules. Occasionally, the zymogen-like granules were absent. These characteristics resemble the de-differentiation of acinar cells which has been repeated in experimental pancreatic carcinoma. These results suggest that careful examination of human pancreatic carcinoma may show more cells of acinar origin.

Adenocarcinoma↗
PubMed1985

[Postprandial plasma secretin response in various types of reconstructive surgery of the stomach and pancreas].

The postprandial plasma secretin concentrations were investigated in patients with Billroth I, Billroth II, Roux-en Y and jejunal interposition following gastrectomy or modified Child's reconstruction after pancreatoduodenectomy. In patients with Billroth I anastomosis the postprandial plasma secretin response was not so high as that for normal volunteers, however it was much better compared with Billroth II anastomosis and Roux-en Y anastomosis after total gastrectomy. In an interposed jejunal anastomosis after total gastrectomy the plasma secretin increased at 20 minutes in postprandial state, even though there was not clear postprandial response of plasma secretin in patients with Roux-en Y anastomosis. Following the modified Child's method after pancreatoduodenectomy the postprandial plasma secretin response was similar to that of Billroth II anastomosis. Following acid load plasma secretin response was much higher than that of postprandial state in patients with Billroth-I, Billroth-II and Roux-Y anastomosis after gastrectomy. The results indicate that acid is important in stimulating secretin release and also the passage of food through the duodenum is important for the release of secretin.

Duodenum↗
PubMed1985

[Pathophysiology and treatment of severe pancreatitis].

The current study was designed to characterize toxic substances in hemorrhagic ascitic fluid by using in vivo dogs model and to examine the toxicity of hemorrhagic ascitic fluid by using an in vivo mice model injecting the fluid intraperitoneally. Our experiment showed that high levels of bradykinin, histamine and prostaglandin E were found in serum and in hemorrhagic ascitic fluid which reported as toxic substances during severe pancreatitis. A similar finding was also obtained clinically in four patients with severe acute pancreatitis. The mortality rate on 72 hours following the intraperitoneal injection of 2.0 and 3.0 ml of ascitic fluid were 66.0% and 89.7% respectively. Mice which died following the injection of ascitic fluid showed shock lung at autopsy. These results indicate that peritoneal lavage might be an effective method for the treatment of severe pancreatitis. We evaluated 25 patients with severe acute pancreatitis clinically. Laparotomy and drainage operations were performed in 16 patients of these patients. Twelve among 16 patient had good results. The cause of death were multiorgan failures.

Acute Disease↗
PubMed1984

Nonfunctioning islet cell carcinoma presenting bleeding gastric varices and splenomegaly.

This is a report of a 63-year-old Japanese woman with a nonfunctioning islet cell carcinoma of the pancreas presenting bleeding gastric varices and splenomegaly. These manifestations are extremely rare in patients with nonfunctioning islet cell tumor. The tumor originated in the tail of the pancreas and grew mainly within the spleen. The gastric varices due to increased blood flow to the tumor and arteriovenous fistulas within the tumor were confirmed by angiography and operation. The tumor was resected and she is in a good health for 14-months after the operation.

Adenoma, Islet Cell↗
PubMed1984

[Ultrastructural observations of human pancreatic duct cell carcinoma].

The great majority of human pancreatic duct cell carcinoma are thought to be of ductal origin and acinar cell carcinoma has been reported to be very rare. This paper reports electron microscopic observations of human pancreatic duct call carcinoma. The results were as follows. In the cases which were diagnosed as well or moderate differentiated adenocarcinoma of the pancreas by light microscope, three different types of tumor cells were observed by electron microscope. Two of them had characters of ductal cells. The origin of these tumor cells were considered to be originated from the relative large and small pancreatic ducts. Third type was a little different from cell types mentioned above. Some of these cells had swollen mitochondria and well developed rough endoplasmic reticulum with a various distribution of zymogen granules. Microvilli and cellular projects were scant. These findings were considered to be the dedifferentiation of the acinar cells and this type belonged to be acinar cell carcinoma.

Aged↗
PubMed1984

Experimental pancreatic carcinoma as a model of human pancreatic carcinoma.

Experimental pancreatic carcinoma induced by BHP in hamsters and by DMBA in rats are compared with human pancreatic carcinoma. Tubular adenocarcinoma and papillary adenocarcinoma in human pancreas and hamster pancreas appeared to be similar. However, poorly differentiated adenocarcinoma and acinar cell carcinoma were not observed in the experimental hamster model. Poorly differentiated adenocarcinoma and acinar cell carcinoma in human and rat pancreas were similar but experimentally induced papillary adenocarcinoma and cystoadenocarcinoma were not observed in the rat. Mucin producing cells were usually observed in human and experimental pancreatic carcinoma in the hamster but were rarely noted in the rat. These results indicate that experimental pancreatic carcinoma either in rats or hamsters is a good model for the understanding of both the histogenesis and the carcinogenesis of human pancreatic carcinoma.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1984

"Idiopathic" duodenal obstruction due to chronic pancreatitis.

Three cases of idiopathic duodenal obstruction due to chronic pancreatitis are described. Each received a different surgical treatment. One had a pancreatoduodenectomy because of the difficulty in distinguishing the benign mass from a malignant tumor, one had a cholecystectomy with conservative treatment and the third had a subtotal gastrectomy with a Billroth II anastomosis. All patients were free of symptoms from 1 to 4 years postoperatively. It is very important to establish the correct diagnosis before or during operation in the management of these patients.

Adult↗
PubMed1983

Transabdominal oesophageal transection for oesophageal varices: experience in 101 patients.

The results of transabdominal oesophageal transection in 101 patients with oesophageal varices are reported. The primary diagnosis was liver cirrhosis and 65 patients, idiopathic portal hypertension in 29 and extrahepatic portal obstruction in 7. Twelve patients died postoperatively. The mortality rate for emergency operations was higher than that for elective and prophylactic procedures. The majority of patients died from hepatic failure. Improvement, judged by radiographic and endoscopic examination, was 100 per cent and 96 per cent, respectively. Post-transection rebleeding was observed in 14 of 89 patients during the follow-up period of 1-13 years. There were 25 late deaths, caused mainly by hepatic failure. The 5-year survival rate, including postoperative deaths, was 72 per cent in idiopathic portal hypertension and 55 per cent in liver cirrhosis. We suggest that transabdominal oesophageal transection is an acceptable operative procedure for oesophageal varices.

Adolescent↗
PubMed1983

Pancreatic somatostatinoma.

A 66 year old woman was admitted for right hypochondriac pain and an abdominal tumor. A tumor of the pancreatic head with duodenal infiltration and liver metastases was found by laparotomy, and pancreaticoduodenectomy was performed. In addition, there was associated cholelithiasis and a goiter. Histopathologically, a tumor of the islets of Langerhans was suspected. The tumor tissue was positive by the Hellman-Hellerström silver impregnation method, and electron microscopy confirmed the presence of secretory granules similar to D cells. The tumor tissue contained a large quantity of somatostatin (1.3 micrograms/g). Finally, the diagnosis of somatostatin-producing tumor originating in the pancreas was made.

Adenoma, Islet Cell↗
PubMed1983

[The value of estimation of serum pancreatic elastase in experimental pancreatic disorders in rats].

The elastase levels in rat serum were measured in experimental pancreatic disorders by radioimmunoassay. After the induction of acute pancreatitis either by trypsin or normal saline, the serum elastase levels increased significantly. The serum elastase levels in trypsin induced pancreatitis were significantly higher than in normal saline induced pancreatitis. The levels in ascitic fluid were also higher in trypsin induced pancreatitis than in normal saline induced pancreatitis. Microscopically, haemorrhagic pancreatitis was found in trypsin induced pancreatitis and edemotous pancreatitis was found in normal saline induced pancreatitis. The serum elastase levels decreased significantly in rats who were treated by ethionine for long period. Microscopically, atrophic pancreas was found in those rats. These results suggest that the measurement of pancreatic elastase in either blood or ascitic fluid by radioimmunoassay is a useful diagnostic method for pancreatic disorders, especially in acute pancreatitis.

Acute Disease↗