Biomedical subjects

S Fujisaki

Publications and source records attributed to S Fujisaki.

134 records · Page 8Linked to original sources

PubMedDate not supplied

Physiological studies on nitric oxide in the right sided colon of patients with diverticular disease.

BACKGROUND/AIMS: Previously, we reported that non-adrenergic non-cholinergic (NANC) inhibitory nerves are decreased in the left-sided colon of patients with diverticular disease, contributing to their intraluminal high pressure by segmentation (1). It is established that nitric oxide (NO) is released by stimulation of NANC inhibitory nerves. Among Oriental people, including the Japanese, right-sided diverticular disease has predominated more frequently than among Western people. In order to evaluate the function of NO in the right-sided colon of patients with diverticular disease, we examined the enteric nerve responses in colonic materials from patients with this disease, using the right-sided normal colon as a control. METHODOLOGY: Colonic tissue specimens were obtained from 8 patients with diverticular disease of the right-sided colon, and normal segments of the right-sided colon were obtained from 11 patients with localized diseases. A mechanograph was used to evaluate in vitro colonic responses to electrical field stimulation (EFS) of adrenergic and cholinergic nerves before and after treatment with various autonomic nerve blockers, N(G)-nitro-L-arginine (L-NNA), and L-arginine. RESULTS: 1) Cholinergic nerves were more dominant in the diverticular colon than in the normal colon (p<0.01). 2) NANC inhibitory nerves were found to act on the normal colon and to a lesser extent in the diverticular colon (p<0.05). 3) NO mediates the relaxation reaction of NANC inhibitory nerves in the normal colon and to a lesser extent in the diverticular colon. CONCLUSIONS: The intrinsic intestinal innervation contains excitatory and inhibitory nerves and the former, especially cholinergic nerves, are dominant in the right-sided colon with diverticula. In addition, reduction of the action of NANC inhibitory nerves by substances such as NO may be largely related to the tight intraluminal pressure by colonic segmentation observed in the right-sided colon with diverticula.

Adrenergic Fibers↗

PubMedDate not supplied

The role of nitric oxide (NO) in the human pyloric sphincter.

BACKGROUND/AIMS: Nitric oxide (NO) has recently been shown to be a neurotransmitter in non-adrenergic non-cholinergic (NANC) inhibitory nerves in the gastrointestinal tract. To clarify the role of NO in the human pyloric sphincter, enteric nerve responses in pyloric tissue specimens obtained from patients with gastric cancer were investigated. METHODOLOGY: Fresh specimens of normal pylorus obtained from 18 patients with gastric cancer were used. The subjects consisted of 12 men and 6 women, aged from 45-74 years (average: 60.1 years). A mechanograph was used to evaluate in vitro pyloric sphincter muscle responses to electrical field stimulation (EFS) of adrenergic and cholinergic nerves before and after treatment with various autonomic nerve blockers, and N(G)-nitro-L-arginine (L-NNA) and L-arginine. RESULTS: Cholinergic nerves were mainly involved in the regulation of enteric nerve responses to EFS in the basal condition of the study, and NANC inhibitory nerves acted on human pylorus. L-NNA concentration dependently inhibited the relaxation in response to EFS in the human pylorus, and this inhibitory effect in the pylorus was reversed by L-arginine. CONCLUSIONS: These findings suggest that the cholinergic/adrenergic and NANC inhibitory nerves play important roles in regulating contraction and relaxation of the human pylorus, and that NO plays an important role as a neurotransmitter in NANC inhibitory nerves of the human pylorus.

Adrenergic Fibers↗

PubMedDate not supplied

Peptidergic nerves in the colon of patients with ulcerative colitis.

BACKGROUND/AIMS: The cause of impaired motility, such as diarrhea and toxic megacolon, in patients with ulcerative colitis is unknown. Neuropeptides have recently been shown to be a neurotransmitter in the non-adrenergic non-cholinergic inhibitory and excitatory nerves in the human gut. To clarify the physiological significance of vasoactive intestinal polypeptide, substance P and neurotensin in the colon of patients with ulcerative colitis, we investigated the enteric nerve responses on lesional and normal bowel segments derived from patients with ulcerative colitis and patients who underwent colon resection for colonic cancers. METHODOLOGY: Twenty-four specimens were obtained from the lesional colon of 6 patients with ulcerative colitis (4 male, 2 female; ages 14-51 years, mean: 40.3 years). The patients with ulcerative colitis had chronic disease (4 with moderate disease, 2 with severe disease). Seventy-two specimens were obtained from the normal colon of 10 patients with colonic cancer (8 men and 2 women; ages 40-56 years, mean: 51.2 years). A mechanographic technique was used to evaluate in vitro muscle responses to these peptides of adrenergic and cholinergic nerves before and after treatment with various autonomic nerve blockers. RESULTS: (1) Peptidergic nerves such as vasoactive intestinal polypeptide, substance P, and neurotensin nerves were found to act on both normal colon and ulcerative colitis colon; (2) the colon with ulcerative colitis was more strongly innervated by vasoactive intestinal polypeptide nerves than the normal colon; (3) Substance P and neurotensin nerves act more weakly in the UC colon that the normal colon. CONCLUSIONS: These findings suggest that peptidergic nerves play an important role in the impaired motility observed in patients with UC.

Adolescent↗

PubMedDate not supplied

Role of nitric oxide in the left-sided colon of patients with diverticular disease.

BACKGROUND/AIMS: Non-adrenergic non-cholinergic inhibitory nerves are the most important nerves in the enteric nervous system of the human gut. Recently, it has been established that nitric oxide is released by stimulation of non-adrenergic non-cholinergic inhibitory nerves. Therefore, in order to evaluate the function of nitric oxide in the left-sided colon of patients with diverticular disease, we examined the enteric nerve responses in colonic tissues from patients with this disease, and also used the left-sided normal colon as a control. METHODOLOGY: Colonic tissue specimens (the diverticular bearing segments) were obtained from 9 patients with diverticular disease of the left-sided colon, and normal segments of the left-sided colon were obtained from 16 patients with ascending colon cancer. A mechanograph was used to evaluate in vitro colonic responses to electrical field stimulation of adrenergic and cholinergic nerve before and after treatments with various autonomic nerve blockers, NG-nitro-L-arginine, and L-arginine. RESULTS: 1) The diverticular colon was more strongly innervated by cholinergic nerves than the normal colon (P < 0.01); 2) Non-adrenergic non-cholinergic inhibitory nerves were found to act on the normal colon and to a lesser extent in the diverticular colon (P < 0.05). 3) Nitric oxide mediates the relaxation reaction of non-adrenergic non-cholinergic inhibitory nerves in the normal colon and to a lesser extent in the diverticular colon. CONCLUSIONS: These findings suggest that the intrinsic intestinal innervation contains excitatory and inhibitory nerves and that the former, especially cholinergic nerves, are dominant in the left-sided colon with diverticula. In addition, diminution of action of non-adrenergic non-cholinergic inhibitory nerves by substances such as nitric oxide may be largely related to the high intraluminal pressure by colonic segmentation observed in the left-sided colon with diverticula.

Adult↗

PubMedDate not supplied

Relationship between gastroduodenal interdigestive migrating motor complex and quality of life in patients with distal subtotal gastrectomy for early gastric cancer.

A total of 40 patients (28 males, 12 females; mean age, 56.6 years; range, 41-72 years), 1-1.5 years (mean, 1.4 years) after subtotal gastrectomy for early gastric cancer (Billroth I, D2 lymph node dissection, curability A) were divided into 2 groups according to the occurrence of interdigestive migrating motor complex (IMMC), phase III from the duodenum, and their postoperative quality of life was compared. Results were as follows: (i) patients in the IMMC, phase III positive group (28 patients) had evidently more appetite and ate more food, with less decrease in body weight compared with the IMMC, phase III negative group (12 patients); and (ii) patients in the IMMC, phase III positive group had clearly less symptoms, such as early dumping symptoms (systemic symptoms), symptoms of reflux esophagitis (e.g. heartburn, feeling of regurgitation, difficult swallowing), nausea, abdominal pain, diarrhea, abdominal distention, and borborygmus, compared with the negative group. These results showed more satisfactory quality of life in the IMMC, phase III positive group compared with the negative group.

Adult↗

PubMedDate not supplied

Prognostic studies on gastric cancer with concomitant liver metastases.

BACKGROUND/AIMS: The aim of this study was to clarify prognostic factors after surgical treatments in gastric cancer patients having synchronous liver metastases. METHODOLOGY: Clinicopathological features and prognosis were retrospectively reviewed in 43 surgical patients with gastric cancer with concomitant liver metastases from 1984 to 1998. RESULTS: More than half of the patients (51.2%) had numerous liver metastases (H3). Rates of peritoneal metastases (P1, P2, P3: 34.9%), tumor serosal invasion (T3 or T4: 73.8%) and widespread lymph node metastases (N3, N4: 69.8%) were also high. Although the gastric resection was performed in 29 patients (67.5%), concomitant hepatectomy resection was performed in only 3 patients (7.0%). Univariate analysis revealed that the grade of liver metastases (H1, H2, H3) was only a statistically significant prognostic factor (P = 0.008). Concerning surgical treatments, the resection group had tendency to better survival than the nonresection group (P = 0.074). Eight cases survived more than 1 year. Seven of the 8 cases (87.5%) were patients with gastrectomy. All of the 5 two-year survivors were patients with gastrectomy. CONCLUSIONS: In patients with gastric cancer with concomitant liver metastases, the grade of liver metastases indicate prognosis. In addition, there is possibility of palliative gastrectomy increasing the survival rare to more than one year.

Adult↗

PubMedDate not supplied

A novel operative technique on proximal gastrectomy reconstructed by interposition of a jejunal J pouch with preservation of the vagal nerve and lower esophageal sphincter.

BACKGROUND/AIMS: This article describes the surgical techniques and postoperative status for proximal gastrectomy reconstructed by interposition of a jejunal J pouch with preservation of the vagal nerve and lower esophageal sphincter. METHODOLOGY: We have performed a new technique for reducing postgastrectomy sequelae such as reflux esophagitis, early dumping syndrome, and microgastria in early gastric cancer located in the proximal third of the stomach. The technique consists of proximal gastrectomy with preservation of the hepatic, pyloric, celiac branch of the vagal nerve, and abdominal esophagus (lower esophageal sphincter), and reconstruction by interposition of a jejunal J pouch. To reserve pyloric function, pyloroplasty can be omitted by preservation of the pyloric branch from the vagal nerve. To restore loss of reservoir function, the reconstruction is performed with an interposed jejunal J pouch. Sacrifice of the mesenteric arcades is kept to a minimum to preserve the autonomic nerve and blood flow in the mesentery. RESULTS: All of the patients who underwent this operation were able to eat an adequate amount of food at 6 months after surgery and they were satisfied with their postoperative status. And that, we have not experienced postgastrectomy disorders such the dumping syndrome and reflux esophagitis. CONCLUSIONS: Therefore, this method is useful for preventing the postoperative disorders in patients with early gastric cancer located in the proximal third of the stomach.

Adult↗

PubMedDate not supplied

Hepatectomy for metastatic renal cell carcinoma.

The experience with hepatectomy for metastatic renal cell carcinoma (RCC) has been very rarely reported, because multiple organ metastases ordinarily coexist when hepatic metastases are found out. Three patients who underwent hepatectomy for metastatic RCC are presented here. Radical nephrectomy was performed for the primary renal lesions in all the patients, and their hepatic metastases were resected simultaneously in one of them with a solitary tumor, and about one month later in two of them with multiple (3 and 6) tumors. These operations produced no distinct complications. The patients with 1 and 3 hepatic metastatic lesions survived without tumor recurrence for 12 and 21 months, respectively, while the patient with 6 hepatic metastatic lesions had tumor-free interval of only 2 months and died 10 months after hepatectomy due to lung metastasis. Hepatectomy may be the only promising treatment for hepatic metastases from RCC, but the indication for surgery should be evaluated according to the number of hepatic metastases.

Carcinoma, Renal Cell↗