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Biomedical subjects

K Umeyama

Publications and source records attributed to K Umeyama.

At least 127 records · Page 7Linked to original sources
PubMed1983

[Postprandial plasma secretin concentration and luminal pH in patients with gastrectomy].

The plasma secretin concentration in response to a meat meal and luminal pH were investigated in patients with gastrectomy: total gastrectomy with Roux-Y anastomosis or interposed jejunal anastomosis and partial gastrectomy with Billroth I or Billroth II anastomosis. The fasting plasma secretin concentration was significantly elevated in relation to the decreases of duodenal pH in postprandial state in normal subjects. No significant response of the plasma secretin and jejunal pH were observed in patients with total gastrectomy with Roux-Y anastomosis, however total gastrectomized patients with jejunal interposition showed the peak plasma secretin response in postprandial state. In patients with Billroth I the postprandial plasma secretin concentrations were well responded when the duodenal pH was below 4.5, however it was less than that of normal subjects. In patients with Billroth II the response of plasma secretin was much less than that of Billroth I, even though the decrease of jejunal pH was as comparable as in Billroth I. These studies suggest that a Billroth I operation after subtotal gastrectomy and interposed jejunal anastomosis after total gastrectomy are better procedures than the Billroth II or Roux-Y anastomoses to obtain endogenous secretin release.

Adult↗
PubMed1983

Postprandial plasma secretin response in patients following gastrectomy.

Endogenous secretin release and luminal pH changes after a test meal were investigated in five normal persons and in 22 patients after gastrectomy and various anatomic reconstructions, such as Billroth I and II anastomoses after subtotal gastrectomy and Roux-en-Y and interposed jejunal anastomosis after total gastrectomy. In patients in the Billroth I group, the response of postprandial secretin was good if the duodenal pH was below 4.5 but it was less than that of normal persons. After the Billroth II operation, even when the jejunal pH was below 4.0, the response was much less than that for the Billroth I group. After the complete abolishment of gastric acid secretion by total gastrectomy, no postprandial secretin response was noted in patients with the Roux-en-Y anastomosis. However, a response was seen in patients with interposed jejunal anastomosis, even though it was less than that for those in the Billroth I group and in normal persons. We conclude that the impairment of endogenous secretin release may be an important factor in pancreatic dysfunction after gastrectomy, and we suggest that a Billroth I operation after subtotal gastrectomy and interposed jejunal anastomosis after total gastrectomy are better procedures than the Billroth II or Roux-en-Y anastomoses to obtain endogenous secretin release.

Duodenum↗
PubMed1982

Radioimmunoreactive serum elastase levels and histologic changes during experimental pancreatitis in rats.

A radioimmunoassay system showed elastase levels of 128 to 232 ng/mL in normal rat serum. The average normal value was approximately 64-fold greater than the minimal detectable amount. No cross-immunoreactivity was found with human elastase 1, porcine elastase, and trypsin. The elastase and amylase levels in rat serum were measured during pancreatitis induced by trypsin (group 1) and normal saline solution (group 2). Within 15 minutes the serum elastase and amylase levels increased significantly and remained elevated. The serum elastase levels in group 1 were significantly higher than in group 2. Hemorrhagic pancreatitis was found in group 1 and edematous pancreatitis was found in group 2 five hours after induction of pancreatitis. Elastase levels in these tissues were significantly lower than those in normal tissue. The levels in ascitic fluid were higher than those found in serum.

Acute Disease↗
PubMed1982

Alpha-fetoprotein and carcinoembryonic antigen in pancreatobiliary disease with and without jaundice.

A comparative study of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in serum was made by radioimmunoassay in 66 patients with pancreatobiliary disease with and without obstructive jaundice. biliary concentrations of these proteins were assayed in 12 patients with benign and 7 patients with malignant disease. There was no statistical difference in serum AFP between these two groups but there was a difference in serum CEA. Although CEA and AFP in bile in both groups were higher than in serum there was no statistical difference in serum CEA and AFP in patients with and without obstructive jaundice in either benign or malignant disease. In benign disease, patients with inflammation had higher serum CEA than normal. Although there was no statistical difference in serum CEA in patients with a without liver metastases, the serum CEA in liver metastases was significantly higher than in benign disease. We concluded that AFP is unlikely to be important in the assessment or management of patients with cancers other than those derived from the liver or yolk sac, and that the elevation of serum CEA in patients with malignant pancreatobiliary disease either with or without obstructive jaundice occurs mainly in the presence of widespread malignancy, especially in liver metastases.

Adult↗
PubMed1982

Serum elastase I levels in pancreatic disease.

The radioimmunoassay for human elastase I used in this study is accurate, sensitive, and specific, which we have confirmed. The assay can be done within 4 hours, which is important for clinical purposes. A total o 103 subjects were examined, and levels of 99 to 370 ng/dl (mean 200) in normal human sera were determined. The serum elastase levels in acute, acute relapsing, and chronic relapsing pancreatitis were significantly higher than normal. Although serial determinations returned to normal within 5 days after the onset of the attack, they decreased gradually and remained high on the 7th, 10th, and 11th days in patients who still had residual signs of pancreatitis. The values in patients with chronic pancreatitis and various other diseases were normal. The values in patients with acute pancreatitis were significantly higher than in those with hyperamylasemia of nonpancreatic origin. Twelve of 19 patients with pancreatic cancer had abnormal serum elastase levels; this was especially true in patients with cancer of the pancreatic head. We believe that the measurement of serum elastase levels by radioimmunoassay will become a useful diagnostic method for pancreatic disease in the future.

Amylases↗
PubMed1982

Idiopathic portal hypertension associated with progressive systemic sclerosis.

Herein we describe the clinical course of a case of idiopathic portal hypertension accompanied by splenomegaly, portal hypertension, and pancytopenia in addition to progressive systemic sclerosis. Immunological studies revealed positive antinuclear antibodies, hypergammaglobulinemia with increases in IgG and IgA, a decrease in peripheral T lymphocytes, and a decrease in the rate of lymphocyte blast transformation induced with phytohemagglutinin. The spleen weighed 1070 g, and the portal pressure was 270 nm H2O. Esophageal varices were also noted. These findings suggest the possibility of association of some immunological abnormalities with the etiology of idiopathic portal hypertension.

Adult↗
PubMed1981

Serum beta 2--microglobulin and carcinoembryonic antigen in patients with gastric disorders.

A comparative study of carcinoembryonic antigen (CEA) and beta 2-microglobulin in serum was made by radioimmunoassay in 121 patients with gastric disease. There was no statistical difference in serum CEA and beta 2-microglobulin in patients with benign gastric disease, early gastric carcinoma, and advanced gastric carcinoma. However, CEA levels in patients with advanced gastric carcinoma were higher than those in benign gastric disease and in early gastric carcinoma but beta 2-microglobulin did not show and differences. Furthermore, after total removal of the tumor, the elevated CEA levels decreased but beta 2-microglobulin remained unchanged. We concluded that CEA appeared to predict tumor behavior more accurately in patients with gastric carcinoma than beta 2-microglobulin.

Adult↗
PubMed1981

The effects upon blood coagulation in dogs of experimentally induced pancreatitis and the infusion of pancreatic juice.

The coagulation changes observed in acute experimental pancreatitis were compared with those after the intravenous infusion of pancreatic juice and ascitic fluid exudate obtained from bile-induced pancreatitis in dogs. The coagulation changes after acute pancreatitis was induced by the intraductal injection of autologous bile, trypsin or elastase showed decreased platelet counts, decreased plasma fibrinogen levels, prolonged partial thromboplastin and prothrombin times, shortened euglobulin clot lysis time and increased fibrin degradation products. Multiple microemboli were observed in the lung and, occasionally, in the kidney, an indication of consumption coagulopathy. The effects upon blood coagulation after the intravenous injection of pancreatic juice included decreased platelet counts, decreased plasma fibrinogen levels and prolonged partial thromboplastin and prothrombin times. The intravenous injection of pancreatic exudate produced greater changes than did those of an equal amount of pancreatic juice. There was a shortening of euglobulin clot lysis time and a marked increase in fibrin degradation products. Pancreatic exudate which accumulates during acute pancreatitis may contain a toxic substance or substances which contribute to the consumption of coagulation factors during acute pancreatitis.

Acute Disease↗
PubMed1981

Evaluation of cholangeographic procedures in diagnosis of obstructive jaundice.

Endoscopic retrograde cholangiography, percutaneous transhepatic cholangiography with external bile drainage and a combined method utilizing both procedures were evaluated in 187 patients with obstructive jaundice. Ductal obstructive regions were located in 90 per cent of cases by endoscopic retrograde cholangiography, and 55 per cent of these were correctly diagnosed. Complications were observed in 7.9 per cent with a mortality rate of 2.9 per cent. The most serious complication was cholangitic sepsis. By percutaneous transhepatic cholangiography with external bile drainage, ductal obstructive regions were correctly located in 82 per cent, 37 per cent of these patients were correctly diagnosed. Complications occurred in 9.2 per cent with a mortality rate of 1.5 per cent. The most serious complication was massive bleeding. Successful external bile drainage could be obtained in most cases. The combined method overcomes the disadvantages of the single methods and the cause of obstructive jaundice can be diagnosed more precisely. The surgeon has a better knowledge of the type and the extent of the lesion prior to definitive surgery and can operate more safely on patients with obstructive jaundiced when the serum total bilirubin, has decreased to a level below 5 mg/dl.

Adult↗
PubMed1980

Carcinoembryonic antigen-like activity in gastric juice and plasma in patients with gastric disorders.

Carcinoembryonic antigen (CEA)-like activity in gastric juice and plasma was examined in patients with gastric disease. There was no statistical difference in plasma CEA in normal subjects and in patients with benign gastric cancer. However, four patients with advanced gastric cancer, one with stage III and three with stage IV disease had a very high plasma CEA level. There was significant differences in CEA-like activity in gastric juice in patients with benign gastric disease and early gastric cancer (p less than 0.01) and patients wih benign and advanced gastric cancer (p less than 0.001). These results suggest that measurement of CEA-like activity in gastric juice is a useful adjunct to the diagnosis of early malignant changes in the stomach.

Adult↗
PubMed1980

Pancreatography with contrast medium containing polyethylene hydrogenated castor oil.

A new contrast medium has been used for endoscopic pancreatography. Good visualization of the pancreas was obtained by this method. No side-effects of this method were observed by clinical and histologic examination, either in clinical or experimental studies. Clinically, the new method provided more detailed information regarding pancreatic changes in chronic pancreatitis. It is suggested that this method may make detection of a small tumor of the pancreas in the parenchyma and permit earlier diagnosis of carcinoma of the pancreas.

Amylases↗