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T Takayasu

Publications and source records attributed to T Takayasu.

At least 55 records · Page 3Linked to original sources
PubMed1992

Bone metastases of hepatocellular carcinoma after liver resection.

Between January 1985 and July 1990, 323 cases of hepatocellular carcinoma underwent liver resection in our department. Bone metastases were found in 12 of these cases (3.7%). Bone metastases were mainly found in vertebral bone (58.3%) and pelvic bone (41.7%). The time interval to the development of bone metastasis after liver resection was closely related to the presence of intrahepatic metastasis and the stage at operation. In all cases, the initial clinical symptom was pain and/or motor disturbance. Radiotherapy was performed in 10 cases and transcatheter arterial embolization or surgery was performed in 4 cases. The pain or neurological symptoms improved with these therapies in all cases. Cumulative survival was 1 year in 74%, 2 years in 34%, and 3 years in 17%, respectively.

Adult↗
PubMed1992

An autopsy case of infant death due to heat stroke.

We report an autopsy case of infant death due to heat stroke. On a winter day, a 52-day-old female baby was placed under a Japanese electric foot warmer with a coverlet (kotatsu) on an electric carpet warmer in a heated room at home. After about 5 h, the mother noticed that the baby was unconscious and took her to a hospital. Spontaneous respiration, however, was already absent, and the pupils were dilated. The trunk was hot; body temperature was 41.3 degrees C. The skin of the whole body was dry. Autopsy revealed second-degree burn injuries on the left side of the face and the dorsum of the left hand. Numerous marked petechiae and ecchymoses were found in the thymus (capsule and parenchyma), pleurae (visceral and parietal), pericardial cavity (internal and external surfaces), epicardium, and beneath the serosa at the origin of the aorta. In addition, there was congestion in various organs, edema in the brain and lungs, and hemorrhage in the lungs. Histopathologically, macrophages without hemosiderin granules were present in the alveoli. When the heating conditions at the accident were reproduced experimentally, the temperature in the electric kotatsu warmer rose to 50-60 degrees C. Thus, we concluded that misuse of the electric kotatsu caused heat stroke in this infant.

Autopsy↗
PubMed1992

Application of hemoglobin analysis by CO-oximeter to medico-legal practice with special reference to diagnosis of asphyxia.

Hemoglobin analysis by CO-oximeter is more easily and rapidly available method than other spectrophotometric or GC methods. In the present study, the possibility of diagnosis of asphyxia by CO-oximeter was examined experimentally using rabbits. When measured value of oxyhemoglobin (O2Hb) was lower than about 20% and that of deoxyhemoglobin (HHb) was, on the other hand, higher than about 80%, being accompanied by low measured values of both methemoglobin (MetHb) and CO-hemoglobin (COHb) (< 5%), asphyxia should be firstly considered as the cause of death. To the corpses found at the scene of fire, three chief factors causing death such as burns, suffocation due to oxygen deficiency and intoxication by poisonous gases may have occurred simultaneously, and through measuring the values of O2Hb, COHb, MetHb and HHb, the main lethal factor could be selected out among these three factors above and the cause of death could be examined much more closely. Because of easy and rapid analysis, it could be considered that CO-oximeter was useful for forensic practices and police activities.

Animals↗
PubMed1992

[An autopsy case of fatal nicotine poisoning].

A fatal case of nicotine poisoning is reported in which a 44-year-old female committed suicide in a short time by taking orally the eluate from tobacco. External examination showed no abnormal findings except for markedly dark red-purple postmortem lividity, and internal examination demonstrated no pathological changes but the signs of sudden death. Through the toxicological investigation by GC and GC-MS, however, nicotine was detected in the solution which she had taken orally and in the blood, urine and the contents of the stomach and small intestine. The nicotine concentrations of the blood, urine and contents of stomach and small intestine were 6.3 micrograms/ml, 1.5 micrograms/ml, 30 micrograms/ml and 71 micrograms/g respectively, and enough to be lethal.

Adult↗
PubMed1991

Experience with 225 hepatic resections for hepatocellular carcinoma over a 4-year period.

During the past 4 1/2 years, we have performed hepatic resection on 225 patients with hepatocellular carcinoma (HCC). These patients included 171 men and 54 women, whose ages ranged from 29 to 84 years with an average of 60 years. Underlying cirrhosis of the liver was found in 67% of the patients and chronic hepatitis in 27%. Patients undergoing hepatic resection were classified into five groups according to curability as follows: Group A, resection of the tumor-bearing segment and one additional segment; Group B, complete resection of the tumor with more than 1.0 cm free surgical margin; Group C, complete resection of the tumor with less than 1.0 cm free surgical margin; Group D, incomplete resection of the tumor; Group E, surgical approach for advanced HCC with tumor thrombi in the main trunk or the first branch of the portal vein and/or the inferior vena cava, with multiple daughter nodules in both lobes and with tumor recurrence. The number of patients in Groups A, B, C, D, and E was 12 (5%), 83 (37%), 58 (26%), 14 (6%) and 58, (26%), respectively. There were 4 deaths (2.4%) among the 167 patients in Groups A to D within 30 days after operation and 12 deaths (20.7%) in Group E. The 3-year survival rate of Groups A, B, C, D, and E was 100%, 74%, 21%, 0%, and 35%, respectively.

Adult↗
PubMed1991

Seventy-two-hour preservation of porcine liver by continuous hypothermic perfusion with UW solution in comparison with simple cold storage.

Porcine livers preserved for 72 hr using continuous hypothermic perfusion (CHP) were studied in order to compare the effects of CHP on energy metabolism with those of simple cold storage (SCS). The livers of the CHP group were perfused in situ for 72 hr at 7 degrees C with University of Wisconsin (UW) solution and FC-43 as an oxygen carrier, while those of the S1 group were stored ex situ for 48 hr at 4 degrees C in UW solution, and those of the S2 group for 72 hr. They were then recirculated with human blood at 37 degrees C for 2 hr for the evaluation of their viability. At the end of preservation, significantly higher levels of total adenine nucleotides (TAN) and energy charge (EC) were observed in the CHP group compared with the S1 and S2 groups. At 2 hr recirculation, the level of TAN was significantly higher in the CHP group than in the S1 and S2 groups. The EC level was also higher in the CHP group than in the S2 group. During recirculation, the ketone body ratio (acetoacetate/beta-hydroxybutyrate) was higher in the CHP group than in the S2 group. The values in the CHP group were above 1.0 after 45 min recirculation. There were no significant differences in the pyruvate/lactate ratio and lactate level between the CHP and S1 groups. However, these values were significantly different from those in the S2 group. The present findings demonstrate that CHP using UW solution and the oxygen carrier was better able to preserve the energy metabolism of the porcine liver for 72 hr than 48-hr SCS in UW solution.

Adenine Nucleotides↗
PubMed1991

Energy metabolism of porcine liver during a 72-hour hypothermic perfusion with UW solution.

Porcine livers were preserved for 72 h using continuous hypothermic perfusion with UW solution and fluorocarbon emulsion (FC-43). They were then recirculated with human blood for 2 h at 37 degrees C for the evaluation of their viability. During hypothermic perfusion and recirculation, the main metabolites of the perfusate and adenine nucleotide concentrations were measured in order to examine the energy metabolism of the livers. This study revealed that hypothermically perfused livers, which mainly utilize endogenous fatty acids as an energy substrate during this time were adequately preserved for 72 h. In terms of energy metabolism, it is suggested that when using the method of continuous hypothermic perfusion with UW solution and FC-43, the administration of adequate amounts of certain fatty acids might prolong the preservation period.

Adenine Nucleotides↗
PubMed1991

[Extensive liver resection according to redox theory].

Postoperative mortality and morbidity are determined by intraoperative stress calculated by changes in arterial ketone body ratio (AKBR) during hepatectomy. In this report, we introduced two types of operative procedure which aims not to decrease AKBR during operation. One is total vascular exclusion (HVE) for liver resection using venovenous bypass which improved the deleterious effects of portal pooling and decreased return of blood to heart. The other is the hepatic resection applying the technique used in the transplantation from the living related donor. In this procedure, the remnant liver works for decreasing the intraoperative stress. The tumor involving lobe is removed under cold perfusion and the tumor is removed on the back table. Then, the tumor free liver is transplanted to the same position.

Carcinoma, Hepatocellular↗
PubMed1990

The outcomes of the operated hepatocellular carcinoma patients.

During the past 5 1/3 years, we have performed 521 hepatic resections, of which 308 cases were hepatocellular carcinomas (HCC). Two hundreds and sixty cases of the 308 HCC patients were studied on their outcomes. These patients included 198 males and 62 females, whose ages ranged from 29 to 84 years. Underlying cirrhosis of the liver was found in 66% of the patients. Hepatectomized patients were classified into 5 groups according to the curability as follows; Group A, the resection of the tumor-bearing segment and additional segment; Group B, the complete resection of the tumor with more than 1.0 cm free surgical margin; Group C, the complete resection of the tumor with less than 1.0 cm free surgical margin; Group D, the incomplete resection of the tumor; Group E, the surgical approach for advanced HCC with tumor thrombi in the main trunk or the 1st branch of the portal vein and/or the inferior vena cava, with multiple daughter nodules in both lobes and with tumor recurrence. The number of patients in Groups A, B, C, D and E was 14 (5.4%), 105 (40.4%), 61 (23.4%), 14 (5.4%) and 66 (25.4%), respectively. There were 5 death (2.6%) among the 194 patients of Group A-D within 30 days after operation and 12 death (18.2%) in Group E. The overall 5-year survival rate of all 249 patients except for 11 surgical death cases was 32%. Whereas, 5-year survival rate for Group A and B were 100% and 47%, 4-year rate for Group C was 44%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Clinical investigation of hepatectomies for hepatocellular carcinoma--significance of extended hepatectomy for advanced hepatocellular carcinoma].

Although the diagnostic methods for hepatocellular carcinoma (HCC) are now being improved, there are still many cases detected at advanced stage. We, based on the Redox theory and using a technique of vascular surgery and liver transplantation, made it possible to perform the extended hepatectomy more actively even in the advanced cases which were previously considered to be in-operable. We report these extended hepatectomies in this paper. From January 1985 to August 1989, we performed 263 hepatectomies for HCC. Out of these 263 cases, we examined 208 cases which had an interval more than three months from the time of the operation and had exact follow-up data at the end of August 1989. There are 57 extended hepatectomies and they consist of 4 groups as follows. 1) Multiple group (14 cases): the operation for the cases with multiple daughter nodules in both lobes besides the main tumor. 2) Thrombus group (30 cases): the operation for the cases with portal tumor thrombus in the first branch or the main trunk of portal vein. 3) IVC group (4 cases): the operation adding resection and reconstruction of IVC because tumor was hardly fixed to the wall of IVC. 4) Recurrence group (9 cases): the operation for hepatic recurrence. Six cases of the Multiple group survived more than one year and one case is still alive more than two years after surgery. The 6-months, 1-year and 2-year cumulative survival rates of the Multiple group are 50.5%, 38.3%, and 8.5% respectively and these results are better than other reports. Forty-three hepatic recurrences were observed in 138 cases whose tumor was completely resected macroscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Cytochrome c oxidase activity in human liver specimens. An index of prognosis for hepatic resection.

Cytochrome c oxidase activity, measured as Vmax (nanomoles of cytochrome c oxidized per second per milligram of protein) and Michaelis constant (Km) (micromoles per liter), was measured spectrophotometrically in human liver specimens obtained by needle biopsy from 43 patients. In 16 normal livers, the Vmax and Km values ranged from 1.26 to 2.25 nmol/s per milligram of protein and from 2.78 to 3.95 mumol/L, respectively. In 27 patients with liver cirrhosis or chronic hepatitis, these values ranged from 1.60 to 3.80 nmol/s per milligram of protein and from 2.80 to 6.50 mumol/L, respectively. Patients with Vmax above 2.5 nmol/s per milligram of protein or Km above 5.0 mumol/L had a high incidence of postoperative complications even after minor hepatic resection. By contrast, even patients with liver cirrhosis or chronic hepatitis could tolerate major hepatic resection as long as their Vmax and Km values were within the normal range. These findings indicate that the cytochrome c oxidase activity in liver specimens can serve as a prognostic sign in hepatic resection even in patients with liver cirrhosis or chronic hepatitis.

Adult↗
PubMed1990

Changes in arterial ketone body ratio in the phase immediately after hepatectomy. Prognostic implications.

Postoperative fluctuations of the ketone body ratio in arterial blood (acetoacetate/3-hydroxybutyrate), reflecting hepatic mitochondrial redox potential, were analyzed in 266 hepatectomized patients in relation to their prognosis. Changes in ketone body ratio were classified into the following two types: a primary decrease at the end of operation and a secondary decrease after transient recovery. Patients were classified into three groups by the primary decrease of ketone body ratio: group 1 (183 cases) with ketone body ratio above 0.7, group 2 (49 cases) between 0.7 and 0.4, and group 3 (34 cases) below 0.4 Ketone body ratio was restored to above 0.7 in 2.5 +/- 0.2 days (mean +/- SE) in all group 2 patients. However, though it was restored within 4.5 +/- 0.4 days in 26 group 3 patients, the other 8 died of multiple organ system failure in 7.4 +/- 2.8 days without recovery of ketone body ratio. This was followed by a secondary decrease in ketone body ratio to below 0.7 in 94 patients, concomitant with complications. The degree of the secondary decrease was positively correlated with that of the primary decrease. In the secondary decrease, of 42 patients with ketone body ratio below 0.4, 28 died of multiple organ failure. Total mortality was 7% in group 1, 12% in group 2, and 50% in group 3. It is suggested that the primary decrease in ketone body ratio at the end of operation is a decisive factor in the prognosis for hepatectomized patients.

Adult↗
PubMed1990

Waste of ATP for tension development in myocardial acidosis: chemomechanical uncoupling at myofibrillar level.

The precise mechanism responsible for the early contractile failure after the onset of myocardial ischemia remains unclear. Physiological studies have reported that intracellular accumulation of inorganic phosphate and intracellular acidosis are the main factors of contractile failure. In contrast, biochemical experiments have shown that the Ca2+ sensitivity of myofibrillar ATPase became less as incubation pH reduces, but the maximal myofibrillar ATPase activity did not change.

Acidosis↗
PubMed1990

Hepatic resection for advanced hepatocellular carcinoma with removal of portal vein tumor thrombi.

In 13 of 398 patients who underwent hepatectomy, tumor thrombi of the remnant portal vein was concomitantly removed by the balloon catheter method in 8, an open method under hepatic vascular exclusion in 1, and resection of the occlusive portal segment followed by portal reconstruction in 4. In 8 of these patients the liver was cirrhotic. The mode of hepatectomy consisted of bisegmetectomy or trisegmentectomy in 11, segmentectomy in one, and partial resection in one patient. Two patients died of portal thrombosis or hepatic failure in the hospital. The mean survival in four patients was 12 months. Seven are still alive (mean, 16 months). In the corresponding period, nine patients with occlusive tumor thrombi of the portal confluence were hospitalized without operation and survived up to 4 months (mean, 64 days) after detection of the tumoral occlusion. The causes of death of the nine patients were bleeding esophageal varices, rupture of the tumor, or hepatic failure. It was revealed that removal of tumor thrombi in the remnant portal vein contributes to (1) portal decompression, (2) feasibility of arterial embolization, and (3) increase in resectability of the main tumor. At present, this procedure might be regarded as an emergency procedure for the avoidance of the above lethal impendence, but it may open the door to an adjuvant therapy.

Aged↗
PubMed1990

[An autopsy case of sudden death due to hyperthyroidism].

A rare autopsy case of death due to thyroid crisis is reported. A 45-year-old lean woman with pigmentation of the skin was found dead at the seaside. The autopsy findings were as follows: The enlarged thyroid gland (35.5 g) had a histological finding of diffuse hyperplastic goiter (hyperthyroidism). The thymus (28.5 g) was enlarged and parenchymatous. The lymphocytes in the thymus and spleen were conspicuously proliferated, probably due to secondary adrenal cortex insufficiency. The adrenal cortex was slightly atrophic. Hemosiderin-laden macrophages in the lung, and centrilobular necrosis, microscopic bleeding, fibrosis, and nodular regenerative hyperplasia of the liver indicated the persisted heart failure. A small pericardial scar was found at the right ventricle of the heart (280 g), and the histological finding of the heart was only congestion. Acetone was detected in a relatively high concentration in the blood (72 micrograms/ml), urine (139 micrograms/ml), bile (32 micrograms/ml) and gastric contents (38 micrograms/g), probably due to metabolic disorder from thyroid crisis. In conclusion, the cause of death was diagnosed as sudden death due to thyroid crisis from hyperthyroidism.

Death, Sudden↗
PubMed1990

Reduced arterial ketone body ratio during laparotomy: an evaluation of operative stress through the changes in hepatic mitochondrial redox potential.

The present article discusses the evaluation of surgical stress on the basis of the hepatic functional capacity of each patient. The changes in arterial blood ketone body ratio (KBR; acetoacetate/beta-hydroxybutyrate), which reflects hepatic mitochondrial redox potential, following intraoperative procedures were investigated in 60 laparotomy cases, including 30 cases with partial hepatectomy. The time course of changes in KBR was obtained by serial measurement during operation. The total area below the KBR level of 0.7 was defined as the hepatic stress score (HSS). HSS was significantly greater in the cases with hepatectomy (43.5 +/- 9.1; mean +/- SE) than in others (16.5 +/- 4.2; p less than 0.01). HSS in 13 patients accompanied by postoperative complications (60.4 +/- 17.7) was also significantly greater than that in the patients with uneventful postoperative courses (22.1 +/- 4.3; p less than 0.05). The former was also accompanied by significantly larger postoperative catabolic response preceding the clinical onset of complications (p less than 0.001). In the cases with uneventful postoperative courses, analysis of variance revealed that nitrogen balance and catabolic index in the first postoperative week were dependent on HSS negatively and positively, respectively (p less than 0.005), indicating a causative relationship between the suppression of hepatic energy metabolism during operation and the enhanced postoperative catabolic response. These results suggest that total surgical stress in major laparotomy can be quantitated and evaluated through the magnitude of decrease in hepatic mitochondrial redox potential, and that this evaluation may provide valuable information for intraoperative and postoperative patient care.

3-Hydroxybutyric Acid↗
PubMed1989

A new method for the determination of ethanol in the blood and urine by pulse heating.

We have established a new method for the determination of ethanol and other gaseous substances in even minute amounts of biological material by utilizing a Curie-point pyrolyzer (Model JHP 3, Japan Analytical Industry) connected to GC or GC-MS. No pretreatment of the biological material is needed and the procedure is based on the principle that volatile or gaseous substances can be evaporated from biological materials by pulse heating and introduced for analysis directly to a GC or GC-MS. The blood from rats that had been administered ethanol-d6 orally, as well as blood and urine collected from healthy volunteers that had ingested alcoholic drinks and blood and tissue specimens taken from autopsied cadavers were examined for ethanol concentrations by both this new method and by the usual head space-GC method. To test this new method, one microliter of the blood or urine was injected into a tubularly folded ferromagnetic alloy (Pyrofoil) and heated pulsatively five times at 160 degrees C (pulse heating). The vapor that evaporated from the sample then was directly introduced to the GC or GC-MS, and the time required to complete the analysis took approximately 5 min. In parallel, for comparison purposes, portions of the same samples (0.2-0.5 g) were examined by means of the head space method as well. The measured values of ethanol-d6 and ethanol in the rat blood and in the human whole blood, blood plasma, and urine that were obtained by this pulse heating procedure correlated almost perfectly with those obtained by head space method. These results show the accuracy and reproducibility of this new method.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗