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Biomedical subjects

M Hamaji

Publications and source records attributed to M Hamaji.

At least 37 records · Page 2Linked to original sources
PubMed1986

Removal of mesenteric gastrinoma: a case report.

A 37-year-old man with a primary mesenteric gastrinoma is reported. A parathyroid adenoma had been removed 13 years ago. Six years earlier the patient underwent an emergency distal gastrectomy because of massive bleeding from a duodenal ulcer. Two months later stomal ulcers developed associated with hypergastrinemia. No gastrinoma was detected and total gastrectomy was performed. The fasting plasma level of gastrin was stable in the range from 580 to 920 pg/ml for the following 5 years. However, the level was found to abruptly increase to 4125 pg/ml. The level increased progressively to 11383 pg/ml within 1 year. A gastrinoma was identified in the jejunal mesenterium, and it was completely removed. After surgery the plasma level of gastrin decreased below the limit of the assay, and the paradoxical response to secretin was no longer observed.

Adult↗
PubMed1985

A study of the vascular arrangement in the rat adrenal gland using non-radioactive microspheres.

The intra-glandular vascular arrangement in the adrenal has been studied using non-radioactive microspheres injected by three different routes: in-vivo injection into the left ventricle under pentobarbital anesthesia, postmortem orthograde, and postmortem retrograde injection. The doses of microspheres were 10(5) (average size 24.7 micrometers), 10(6) (15.8 micrometers) and 10(7) (9.9 micrometers). The entrapment rate of microspheres by the medulla as compared with the whole gland was measured in the serially sectioned tissue (section thickness 60 micrometers). The entrapment rates of 25-micrometers microspheres differed between the orthograde and retrograde injections, while the entrapment rates for 15-micrometers microspheres were essentially similar irrespective of the route of injection. Our results support the conclusion from previous microangiographic studies that the adrenal cortex and medulla are supplied by different arteries but have a common venous outflow, and that direct communication between cortical and medullary sinusoids is not likely. The medullary blood flow per gram tissue weight is estimated to be larger than cortical blood flow.

Adrenal Cortex↗
PubMed1985

Blood glucose control by an artificial endocrine pancreas in a patient with phaeochromocytoma.

In a patient with phaeochromocytoma who presented with unstable diabetes mellitus, an artificial endocrine pancreas was used intraoperatively. Anaesthetic agents included enflurane, nitrous oxide and oxygen. Nicardipine was used to control hypertensive episodes. The initial blood glucose concentration was 173 mg X dl-1 and it decreased to 110 mg X dl-1 in response to insulin infusion, but plasma catecholamines were markedly increased. Seventy minutes later, the glucose concentration increased progressively to 249 mg X dl-1 despite massive insulin infusion, maximally 5.64 mU X kg-1 X min-1. The blood glucose concentration reached a peak at the time of the ligation of the venous drainage from the tumour and the peak was coincident with that of plasma catecholamine levels (epinephrine: 20.8 ng X ml-1, norepinephrine 16.4 ng X ml-1). Both glucose and catecholamine concentrations decreased promptly after removal of the tumour and hypotension followed likely because of a persistent vasodilatatory effect of nicardipine. The profiles of blood glucose, insulin and glucose infusion rates provided by the artificial endocrine pancreas suggested that the insulin resistance began to be reversed shortly after removal of the phaeochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1985

Central role for angiotensin in control of adrenal catecholamine secretion.

Angiotensin II (ANG II) is required for unimpaired adrenal reflex secretion of catecholamines after hemorrhage in the dog. To test if ANG II acts centrally, experiments were performed under general anesthesia on bilaterally or sham-nephrectomized dogs hemorrhaged at 25 ml/kg. Ventriculocisternal perfusion of ANG II or its antagonist saralasin was accomplished via needles inserted in the left lateral cerebral ventricle and cisterna magna. Mean arterial pressure and adrenal secretion of catecholamines were measured before and after hemorrhage. Nephrectomized dogs receiving only artificial cerebrospinal fluid (CSF) by ventriculocisternal perfusion had a very small adrenal response to hemorrhage compared with animals receiving ANG II intraventricularly (IVT) (at 10 and 100 pg . kg-1 . min-1). This effect of ANG II IVT also depended on the rate of IVT infusion. Peripheral infusion of ANG II (10 pg . kg-1 . min-1) had no effect on adrenal catecholamine secretion. Animals with intact kidneys given saralasin IVT (0.06 ng/min) responded similarly to nephrectomized dogs receiving only CSF IVT. Intravenous saralasin did not blunt the response to hemorrhage. Thus ANG II appears to support catecholamine secretion via a central mechanism. This mechanism is physiologically significant because either nephrectomy or functional elimination of ANG II by saralasin greatly attenuates the adrenal medullary response to hemorrhage in vivo.

Adrenal Glands↗
PubMed1985

Angiotensin II restoration of reflex adrenal medullary secretion to anephric dogs is physiologically dose dependent.

Acute nephrectomy seriously impairs hypovolemic adrenal epinephrine (E) release in the anesthetized dog. That systemically delivered angiotensin II totally restores E release to acutely anephric dogs is equally clear, but the dose-response relationship of this angiotensin II effect is not known. Adrenal secretion rates and arterial plasma E, norepinephrine (NE), and dopamine levels were studied in nine groups of mongrel dogs (n = 5 in each group) under pentobarbital anesthesia: 1) resting animals; 2) hemorrhage (25 ml/kg); 3) hemorrhage after acute nephrectomy; 4-7) hemorrhage, acute nephrectomy, plus iv angiotensin II at a) 0.01 ng/kg X min, b) 0.10 ng/kg X min, c) 1.00 ng/kg X min, or d) 10.00 ng/kg X min; 8) no hemorrhage, acute nephrectomy, angiotensin II (10.00 ng/kg X min); and 9) hemorrhage, kidneys intact, iv angiotensin II (10.00 ng/kg X min). Arterial and adrenal blood were sampled during a baseline prehemorrhage period and 15, 30, 60, and 90 min after hemorrhage. We confirm blunting of reflex E release by acute nephrectomy in the anesthetized dog and show that angiotensin II restores E (P less than 0.01), NE (P less than 0.01), and dopamine (P less than 0.01) release in acutely anephric dogs. Aortic plasma E and NE were also restored to normal by angiotensin II (P less than 0.01 for each). Dogs with intact kidneys show a blunted hemorrhage response of arterial plasma E (P less than 0.01), NE (P less than 0.01), and DM (P less than 0.05) to our largest angiotensin II infusion rate (10 ng/kg X min). The study demonstrates that in acutely anephric conditions, angiotensin II support of reflex catecholamine release is sensitively dose dependent to physiological infusion rates of systemic angiotensin II and suggests further that this angiotensin II effect is restrained by the kidneys.

Adrenal Glands↗
PubMed1985

Release of gastric inhibitory polypeptide in totally pancreatectomized patients.

The role of insulin in controlling gastric inhibitory polypeptide (GIP) release was assessed in seven totally pancreatectomized patients, in whom inhibitory effects of endogenous pancreatic hormones on GIP secretion were excluded. In these patients, glucose was ingested on two occasions, once alone and once during insulin infusion using an artificial endocrine pancreas to maintain blood glucose at levels similar to those in normal subjects. Plasma levels of GIP, the maximum response of plasma GIP, and the integrated incremental GIP for 180 min were similar. We conclude that insulin does not alter the secretion of GIP in response to oral glucose when the influence of endogenous pancreatic hormones is excluded.

Adult↗
PubMed1984

Anaesthetic management with morphine in phaeochromocytoma.

Morphine was used as the principal anaesthetic agent for five patients undergoing resection of phaeochromocytoma, and changes in plasma catecholamines were monitored. Phenoxygenzamine (0.5 mg X kg-1 X day-1) was orally given one week before operation. After premedication with hyoscine (0.4 mg) and diazepam (20 mg) of meperidine (50 mg), anaesthesia was induced with an infusion of morphine (1 mg X kg-1) over 30 min and maintained with diazepam, nitrous oxide and oxygen. Pancuronium was used as the muscle relaxant. In three of the five patients, blood pressure transiently rose (ranging from 15 to 60 mg) following orotracheal intubation, but vasodilators were not required. In two of the three, plasma norepinephrine increases were 1.1 and 1.3 ng X ml-1. In the other two patients, whose blood pressure was stable, the change in plasma norepinephrine was 0.1 and 0.7 ng X ml-1. After reaching a peak at the time of ligation of drainage vein from the tumour, plasma catecholamines rapidly decreased to the preoperative levels, but the blood pressure was well maintained in all cases. Ventricular arrhythmias did not occur despite the increased levels of endogenous catecholamines. These findings suggest that morphine can be used as an alternative anaesthetic agent during operation for phaeochromocytoma and that exaggerated pressor responses to morphine (when given slowly) seem not to occur in phaeochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1984

Gastric inhibitory polypeptide secretion after radical pancreatoduodenectomy.

To elucidate the role of gastric inhibitory polypeptide (GIP) in the alteration of insulin secretion following pancreatoduodenal resection, in which the main sources of GIP are removed, plasma levels of GIP were measured for 180 minutes after oral glucose administration, both before and after radical pancreatoduodenectomy in nine patients with periampullary cancer. Fasting plasma levels of GIP remained much the same before and after surgery, and were not different from those in normal controls. The levels of GIP after glucose ingestion were significantly greater in the preoperative patients than in normal controls throughout 180 minutes. After pancreatoduodenectomy, the postglucose levels significantly diminished but remained within normal limits. Changes in plasma levels of insulin early after glucose ingestion in these patients, however, were significantly less both before and after surgery than in normal controls, and were not concomitant with the initial increase in plasma GIP. On the other hand, plasma levels of insulin greatly increased immediately after glucose ingestion in accordance with a rapid elevation of plasma GIP in 11 gastrectomized patients in whom the duodenum and the pancreas were preserved intact and who served as the control group. Thus, the diminution in GIP secretion following pancreatoduodenectomy may relate to the lack of main sources of this gut hormone and not to factors involved in the reconstruction of the alimentary tract. We conclude that the impaired insulin secretion following oral glucose ingestion in patients before and after pancreatoduodenectomy does not relate to the secretion of GIP.

Administration, Oral↗
PubMed1984

Characterization of monoclonal antibodies against etiological agents of Weil's disease.

Monoclonal antibodies against etiological agents of Weil's disease were produced by cell fusion technology. Twenty hybridomas were produced through the fusion of P3X63Ag8 .653 cells with spleen cells from BALB/c mice immunized against Leptospira interrogans serovar icterohaemorrhagiae RGA strain and serovar copenhageni Shiromizu and M20 strains. Reactivities of the antibodies produced by the hybridomas were determined by the microscopic agglutination test. Among the five hybridoma antibodies to the RGA strain, two reacted specifically to serovar icterohaemorrhagiae, two reacted to serovar icterohaemorrhagiae at a high titer and serovar copenhageni at a low titer, and one reacted to serovars icterohaemorrhagiae, copenhageni, pyrogens, and canicola. Of the ten hybridoma antibodies to the Shiromizu strain, one reacted specifically to serovar copenhageni, seven reacted to both serovars copenhageni and icterohaemorrhagiae at almost the same titer, and two exhibited intermediate properties. Of the five hybridoma antibodies to the M20 strain, three reacted to both serovars copenhageni and icterohaemorrhagiae at almost the same titer, one reacted to serovar copenhageni at a low titer and serovar icterohaemorrhagiae at a high titer, and one reacted to serovars copenhageni, icterohaemorrhagiae, and pyrogens. The results revealed that each serovar has its own antigen(s) and their common antigens. In addition, 20 strains of leptospires were recently isolated and tested with three monoclonal antibodies characterized by different reactivities. Twenty strains were clearly identified by their antibodies, i.e., 16 strains were identified as serovar icterohaemorrhagiae and three strains were identified as serovar copenhageni. The remaining strain, which was not agglutinated by three antibodies, was identified as serovar autumnalis by an agglutination test with immune rabbit sera.

Agglutination↗
PubMed1983

Diagnostic monitoring of plasma levels of glucose and insulin during surgery for insulinoma.

With serial measurement of blood sugar levels during surgery in three patients with solitary insulinoma, we confirmed the location, then later, the complete elimination of the insulin-secreting tumor. Following vigorous massage of the tumor, blood sugar levels decreased while the levels progressively increased within 20 min following removal of the tumor. Subsequent measurement of simultaneous plasma insulin levels provided further confirmation. Plasma levels of insulin increased in accordance with massage of the tumor. Prior to removal of the tumor, the levels progressively decreased to less than the preoperative levels. For success in detecting slight changes in blood sugar levels secondary to increase or decrease of insulin secretion during surgery for insulinoma, (1) controlled infusion of glucose to keep blood sugar levels around 80 mg/dl and (2) frequent rapid determination of blood sugar levels are considered to be important.

Adenoma, Islet Cell↗
PubMed1980

An appraisal of radical pancreatoduodenectomy based on glucagon secretion.

In an attempt to elucidate changes in endocrine functions of the pancreas associated with radical pancreatectomy for periampullary cancer, plasma levels of insulin (IRI) and pancreatic glucagon (IRG) were measured during arginine infusion in ten patients with periampullary cancer both before and after pancreatoduodenectomy. The response of plasma IRI to arginine which was impaired before the surgery showed further impairment after the surgery. This finding is consistent with the previous results obtained in such patients by oral glucose tolerance testing. Also, the response of plasma IRG was subnormal preoperatively and was found to be impaired postoperatively. Both maximum and integrated secretion of IRG during arginine infusion decreased after the surgery in all instances. From these findings, it is concluded that pancreatoduodenectomy aggravates the already disordered pancreatic endocrine functions, as indicated by arginine infusion in patients with periampullary cancer.

Adult↗
PubMed1979

Estimation of catecholamines in human plasma by ion-exchange chromatography coupled with fluorimetry.

Estimation of catecholamines in human plasma was made by ion-exchange chromatography coupled with fluorimetry. Catecholamines in deproteinized plasma were adsorbed onto Amberlite CG-50 (pH 6.5, buffered with 0.4 M phosphate buffer) and selectively eluted by 0.66 M boric acid. The catecholamine fraction was separated further on a column of Amberlite IRC-50 which was coupled with a device for the automated performance of the trihydroxyindole method (epinephrine and norepinephrine) or the 4-aminobenzoic acid-oxidation method (dopamine). One sample could be analysed within 25 min with either method. The lower detection limits were 0.02 ng for epinephrine and dopamine, and 0.04 ng for norepinephrine. Plasma catecholamine contents of healthy adults at rest were epinephrine 0.07 +/- 0.01 ng/ml (n = 19), norepinephrine 0.27 +/- 0.03 ng/ml (n = 19) and dopamine 0.22 +/- 0.03 ng/ml (n = 26). The procedure of adsorption and elution of the plasma catecholamines by ion-exchange resin was simple, the simplicity contributing to constant recovery. The catecholamine fraction could be analysed without evaporation of the eluate. The analytical column could be used for the analysis of more than 1000 samples before excessive back-pressure developed. Our method of continuous measurement of plasma catecholamine fulfils clinical requirements.

Catecholamines↗