Biomedical subjects

Y Atomi

Publications and source records attributed to Y Atomi.

At least 91 records · Page 5Linked to original sources

PubMed1996

Endoscopic transpapillary bile duct biopsy without sphincterotomy for diagnosing biliary strictures: a prospective comparative study with bile and brush cytology.

OBJECTIVES: Endoscopic transpapillary bile duct biopsy has a high sensitivity for detection of malignant biliary strictures, but is commonly performed after endoscopic sphincterotomy. We performed transpapillary biopsy without sphincterotomy, using a recently developed, malleable biopsy forceps, and prospectively studied the usefulness of this diagnostic procedure, compared with that of bile and brush cytology. METHODS: We succeeded in transpapillary biopsy without sphincterotomy in 45 (87%) of 52 patients. In 43 patients with biliary strictures (31 malignant, 12 benign) who successfully underwent all endoscopic samplings by bile aspiration, brushing, and biopsy, the diagnostic value of these three sampling methods was compared. RESULTS: Transpapillary biopsy (81%) had a significantly higher level of sensitivity for malignancy than bile (32%) and brush (48%) cytology. Transpapillary biopsy was more sensitive for bile duct cancer (88%) than for pancreatic cancer (71%), as were cytology techniques. No false positives were found in any of the three sampling methods. No complications accompanied the endoscopic procedures. CONCLUSIONS: Transpapillary bile duct biopsy without sphincterotomy is a simple, safe, and effective technique for diagnosing biliary stricture. We recommend that this technique be performed routinely at initial endoscopic retrograde cholangiopancreatography for patients with a stricture or filling defect of the extrahepatic bile duct.

Adult↗

PubMed1996

[Development of quality of life questionnaire for patients with colorectal cancer in surgical area--a study of reliability and validity of Tokyo Yamabuki Forum Version].

We developed a new questionnaire in the surgical area based on a core quality of life (QOL) questionnaire for patients with gastrointestinal cancer. In this study, we investigated the validity and reliability of a QOL questionnaire (Tokyo Yamabuki Forum Version) for patients with colorectal cancer. The questionnaire was composed of 17 items including 5 scales (basic sensory scale, psychological scale, physiological scale, defection-related scale and active scale) and a face scale as an global scale. The time needed to answer questionnaires was expected to be around 7 minutes and the questionnaires should basically be answered by the patients themselves everyday in the hospital. The study was performed in 10 hospitals in the Tokyo area, and 394 samples collected from 21 patients with rectal and colonic cancers were analyzed. A number of respondents failed to answer the question "Do you feel your foods tasty?", so we judged this item inappropriate and deleted it from the analysis. Fifteen items, including 5 scales showed satisfactory internal consistency and construct validity in correlation and factor analyses. Performance status showed a low correlation between each item, each scale and the global scale, while SDS and STAI showed an inordinately negative correlation with the fundamental and physical scales. Especially, SDS revealed an extremely close correlation with the active scale, and STAI showed an excessive correlation with the psychological scale. In the time course of QOL under chemotherapy, reductions (aggravations) were observed in both the total score of 15 items and global scale within one week postoperatively, but after that recovered to preoperative levels at 2 weeks postoperatively. A tendency to QOL improvement was observed 2 weeks after starting chemotherapy or chemoimmunotherapy. QOL of 13 patients was measured over 3 months, and the longest term was 8 months. The results suggested that this QOL questionnaire has sufficient reliability and validity to be usable for patients with colorectal cancer in the surgical area and that this model is applicable for long-term QOL surveys and frequent measurement.

Adult↗

PubMed1995

Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US.

PURPOSE: To identify ultrasonographic (US) features of large cholesterol polyps (> 10 mm in diameter) of the gallbladder in the differential diagnosis of polypoid lesions. MATERIALS AND METHODS: Sixty-seven patients underwent US (n = 67) and endoscopic US (n = 33). Fourteen patients had large cholesterol polyps. Findings in these patients were compared with those in patients with small cholesterol polyps (< or = 10 mm in diameter; n = 34) or other polypoid lesions (n = 19). RESULTS: US demonstrated the large cholesterol polyps as pedunculated masses with granular surfaces. In 94% of patients, all small cholesterol polyps were echogenic whereas the large cholesterol polyps tended to have decreased echogenicity. Endoscopic US showed complete or partial aggregation of echogenic spots in all cholesterol polyps-but not in other polypoid lesions, which included carcinomas. CONCLUSION: Aggregation of echogenic spots seems to be a US feature characteristic of both large and small cholesterol polyps. Routine use of endoscopic US is recommended for differential diagnosis of polypoid lesions because of its high resolution.

Adenocarcinoma↗

PubMed1995

Diagnosis of acute pancreatitis: value of endoscopic sonography.

OBJECTIVE: The aim of this study is to assess the diagnostic usefulness of endoscopic sonography in acute pancreatitis. SUBJECTS AND METHODS: Twenty-three patients with clinically diagnosed acute pancreatitis (edematous pancreatitis in 16 and necrotizing pancreatitis with heterogeneous enhancement of the pancreas on contrast-enhanced CT scans in seven) prospectively underwent endoscopic sonography. We studied visualization of the pancreas and the extrahepatic bile duct, capability of differentiation between edematous and necrotizing pancreatitis, and detectability of common bile duct stones and compared the results of endoscopic sonography with those of conventional sonography, CT, and ERCP. In 25 normal subjects, we performed endoscopic sonography to determine the size of the pancreas. RESULTS: Endoscopic sonography could be performed at the bedside noninvasively and repeatedly. Normal pancreas size was defined from the results of normal subjects. Endoscopic sonography adequately showed the whole length of the pancreas and the extrahepatic bile duct in all cases. On endoscopic sonography, the pancreas was enlarged in 10 of 16 patients with edematous pancreatitis and in all seven patients with necrotizing pancreatitis. In edematous pancreatitis, the echogenicity of the pancreas was normal (four patients) or diffusely hypoechoic (12 patients). In all seven patients with necrotizing pancreatitis, endoscopic sonography showed a pancreatic focal hypoechoic mass with or without interspersed echogenic spots. Endoscopic sonography could differentiate edematous and necrotizing pancreatitis as well as CT could. Conventional sonography depicted the pancreas in only 61% of patients. Endoscopic sonography was highly sensitive in depicting inflammatory peripancreatic spread compared with CT. Endoscopic sonography was more sensitive (100%) than conventional sonography (43%) and CT (57%) for detecting bile duct stones in biliary pancreatitis. CONCLUSION: This study suggests that endoscopic sonography may be useful for the diagnosis of acute pancreatitis, particularly in cases of biliary pancreatitis.

Acute Disease↗

PubMed1994

Pancreatic carcinoma accompanied by pseudocyst: report of two cases.

Two cases of pancreatic cancer accompanied by pseudocyst are reported. Case 1 was a 60-year-old man who was admitted to our hospital complaining of left lower abdominal discomfort. A cystic lesion, about 3 cm in diameter, was found in the pancreatic tail by ultrasonography (US) and computed tomography (CT). No signs of chronic pancreatitis were found. At operation, an elastic, hard, white tumor, about 1 cm in diameter, was felt adjacent to the cystic lesion on the duodenal side. Histologically, this tumor was a duct cell carcinoma with an adjacent pseudocyst upstream of the pancreas. Case 2 was a 57-year-old man who complained of back pain and loss of body weight. US and CT examination revealed a cystic lesion, 11 x 7 cm in size, in the tail of the pancreas. Histological examination of the resected specimen revealed both a duct cell carcinoma, 3 cm in size, in the body of the pancreas and a pseudocyst, 9 cm in size. Pseudocysts accompanying carcinoma are thought to develop from obstruction of the pancreatic duct by the carcinoma, followed by intraductal high pressure and disruption of ductules upstream of the pancreas. Thus, we should pay careful attention to pseudocyst of the pancreas, especially when signs of diffuse chronic inflammation cannot be found, to help identify duct cell carcinoma in the early stage. Further detailed examinations of the cyst fluid or pancreatic juice, such as cytology, tumor marker determinations, or establishment of K-ras codon 12 mutation, are needed.

Carcinoma, Ductal, Breast↗

PubMed1994

Intracellular action of an exogenous low-molecular-weight synthetic protease inhibitor, E3123, in cerulein-induced acute pancreatitis in rats.

The intracellular distribution and action of a new synthetic protease inhibitor, E3123, were studied in cerulein-induced acute pancreatitis in rats. Acute pancreatitis was induced by a 4-h iv infusion of a supramaximal dose of cerulein, and was treated by prophylactic (pretreatment) or therapeutic (posttreatment) continuous administration of E3123. Pancreatic edema and hyperamylasemia were ameriolated only by prophylactic treatment. A subcellular fractionation study showed that the activities of cathepsin-B and trypsin in the zymogen granule-enriched fraction of the cerulein-pancreatitis group were remarkably increased. Both prophylactic and therapeutic treatment significantly prevented the elevation of these enzyme activities. These effects were accompanied by amelioration of pancreatic histopathological features, including intracellular vacuolization and fat necrosis. A microscopic autoradiographic study using 3H-labeled E3123 showed diffuse intracellular distribution of E3123, and the radioactivity of 3H-E3123 in the posttreatment group was three times greater than that in the pretreatment group. This study provides the first experimental evidence that, even when administered therapeutically, exogenous protease inhibitors are transported into pancreatic acinar cells, thereby reducing the severity of early intracellular alterations in cerulein-induced acute pancreatitis.

Acute Disease↗

PubMed1993

Transendothelial migration activity of lymphokine-activated killer (LAK) cells.

With an in vitro static system using HUVEC (human umbilical vein-derived endothelial cells) cultured on type I collagen gel, we investigated the transendothelial migration activities of I1-2 activated killer (LAK) cells. Our results indicate that in comparison with unstimulated T cells, LAK cells exhibit strong transendothelial migration activity, as well as increased adhesiveness to HUVEC. Pretreatment of HUVEC for 24 h with rINF-gamma, rTNF-alpha and rIL-1 beta enhanced the LAK cell migration. The increase in the percentage of migration of LAK cells was greater than that of the percentage of adhesion but significantly less than the increase in the percentage of migration of resting T cells. The results of blocking studies using mAb strongly suggest that the enhanced migration of LAK cell was probably attributed to nonspecifically increased binding to HUVEC and markedly enhanced chemokinetic activity that was dependent primarily on the LFA-1 molecule. Among LAK cells, there were considerable differences in the migration activities of the various phenotypes. CD8+T-LAK migrated preferentially to CD4+T-LAK. CD16+ NK-LAK showed increased adhesion but somewhat decreased migration activities. However, rINF-gamma treatment of HUVEC for 24 h promoted vigorous migration of CD16+ NK-LAK, which suggests that endothelium regulate the migration of LAK cells. Based on these observations, we proposed that LAK cells, if transferred into tumor feeding vessels, can migrate into tumor tissue in considerable numbers and efficiently make contact with individual tumor cells to produce preferable clinical effects.

Cell Adhesion↗

PubMed1993

Treatment of choledocholithiasis in patients with liver cirrhosis. Surgical treatment or endoscopic sphincterotomy?

OBJECTIVE: The clinical features of choledocholithiasis were analyzed in cirrhotic patients. The outcomes of surgical treatment and endoscopic sphincterotomy (EST) in this situation were compared and the risk factors predictive of an increased mortality rate were identified. SUMMARY BACKGROUND DATA: In cirrhotic patients, high risk for gallbladder stones in cholecystectomy has been established. Common bile duct stones can often exacerbate liver dysfunction and might be more difficult to treat. METHODS: Among 16 cirrhotic patients with choledocholithiasis, 9 underwent choledocholithotomy and T-tube placement (surgery group) and 7 underwent EST (EST group). Pretreatment clinical data were comparable between groups. RESULTS: Among 16 patients, 15 had biliary tract symptoms and 7 had cholangitis. The surgery group had excessive intraoperative hemorrhage (1576 mL) and a high morbidity rate (66.7%). The mortality rate was 44.4%: 0% in Child A or B classification patients and 80% in Child C patients. The common causes of death were liver failure, postoperative hemorrhage, and sepsis. The EST group had no complications related to procedures, but there was one death (14.3%) due to preexisting liver failure. Hepatic dysfunction, coagulopathy, and cholangitis were factors predictive of an increased mortality rate. CONCLUSIONS: Choledocholithiasis in cirrhotic patients should be treated by EST after liver function and general condition are improved by medical management, except in emergency cases.

Adult↗

PubMed1993

Functional analysis of TCR gamma delta+ T cells in tumour-infiltrating lymphocytes (TIL) of human pancreatic cancer.

In six patients with advanced pancreatic carcinoma, TIL and tumour-draining lymphocytes (TDL) were isolated from primary pancreatic tumour and regional lymph nodes. In comparison with TDL and peripheral blood lymphocytes (PBL), TIL contained a comparatively higher percentage of TCR gamma delta+ cells, although they were still a small fraction. By 2 weeks culture with rIL-2 and immobilized OKT-3 antibody, the TCR gamma delta+ cells in TIL were preferentially expanded at the early culture periods, although it was temporary. In four cases, the TCR gamma delta+ and CD8+ TCR alpha beta+ TIL were separated by negative sorting using flowcytometry. All the TCR gamma delta+ TIL were CD4-, CD8- (double negative), and one of the TIL lines was mostly composed of delta TCS1+ cells, while the others were delta TCS1-. In comparison with CD8+ TCR alpha beta+ TIL, all the TCR gamma delta+ TIL exhibited much stronger lytic activity against freshly isolated autologous pancreatic cancer cells. However, all the gamma delta+ TIL also exhibited a strong non-MHC-restricted cytotoxicity, and there was no correlation between the lytic pattern and the percentage of delta TCS1+ cells. These data suggest that the TCR gamma delta+ T cells can proliferate vigorously in a certain condition, and if successfully expanded in vitro they might be helpful material for effective adoptive immunotherapy.

Aged↗

PubMed1993

Cystopancreaticostomy and longitudinal pancreaticojejunostomy as a simpler technique of combined drainage operation for chronic pancreatitis with pancreatitis with pancreatic pseudocyst causing persistent cholestasis.

A simpler combined drainage operation for a patient with chronic pancreatitis and chronic pseudocyst is described in the following conditions: the pancreatic duct was markedly dilated, the cyst was located directly behind the main pancreatic duct in the head of the pancreas and separate from the duodenum and the cyst caused persistent CBD stricture and cholestasis mainly by its compressive effect. The pancreatic duct was opened anteriorly throughout its length. A second incision was made in the posterior wall of the main pancreatic duct into the cyst and the edge of the opening was sutured for hemostasis. The opened pancreas was anastomosed to a Roux-en-Y jejunal limb according to the ordinary method of longitudinal pancreaticojejunostomy. This technique, cystopancreaticostomy and pancreaticojejunostomy, may provide a simpler and effective operative strategy for patients with chronic pancreatitis and pseudocyst in similar conditions.

Cholestasis↗

PubMed1993

[Extracorporeal shock wave lithotripsy].

Extracorporeal shock wave lithotripsy (ESWL) was performed in 84 patients with gallbladder stones. The gallstones completely disappeared within 12 months after ESWL, in 31% of the patients with one to three radiolucent stones not larger than 3 cm in diameter and in 57% of the patients with a solitary stone up to 2 cm with the ultrasonographic gallstone pattern of I a or I b. There was no major complication. ESWL is a safe and effective treatment in selected patients with a solitary radiolucent stone not larger than 2 cm with I a or I b pattern.

Adult↗

PubMed1993

Clinicopathological characteristics of hepatic hilar bile duct carcinoma.

We reviewed thirty cases of hepatic hilar bile duct carcinoma found in 5,800 consecutive autopsy cases, mainly of the aged, and analysed their clinicopathological characteristics. Eleven cases had a record of tumor resection (8 men, 3 women, mean age 75.1 years). At operation, the gross type was mainly infiltrative in all eleven cases, and the stage was II, III or IV in as many as ten cases. Cholecystectomy and bile duct resection were performed in all cases except one in whom additional hepatic lobectomy was performed. In none of the cases was the operation curative. The main cause of non-curability was residual carcinoma on the surgical cut or ablated surface due to longitudinal or lateral cancerous interstitial spread. This was confirmed by the fact that local relapse of carcinoma, either in the hepatic hilus or hepatoduodenal ligament, was found in all the cases at autopsy. This fact also indicates the difficulty in achieving complete resection of carcinoma in this part. On the other hand, a relatively "benign" aspect of hepatic hilar bile duct carcinoma was suggested as follows: 1. Most of the cases were well-differentiated adenocarcinoma. 2. Although there was no case of curative resection, three out of of nine cases (excluding the cases of death during operation) survived more than two years. 3. Distant metastasis found at autopsy was relatively rare, being seen in four of these eleven cases. In the light of these data an operation, even though palliative, is considered to be justified.

Adenocarcinoma↗

PubMed1992

[Surgical and non-surgical treatments of gallstones].

Comparisons were made of therapeutic modalities for gallstones. Four-hundred thirty-five patients with gallstones were operated on with the mortality rate of 0.7%. Extracorporeal shock-wave lithotripsy (ESWL) was performed in 84 patients with gallbladder stones. Complete stone disappearance rate at 1 year was 31% in patients with one to three radio-lucent stones not larger than 3cm in diameter and 57% in solitary stones up to 2cm with the US pattern of Ia or Ib. There was no major complication. Endoscopic sphincterotomy (EST) was performed in 131 patients with common bile duct stones. The success rate was for stone extraction, was 97%. Immediate complications occurred in 8% cases, yielding the mortality rate of 0.8%. Common bile duct stones recurred in 2 of 113 patients (3%). Acute cholecystitis was experienced in 2 of 43 patients with the gallbladder left in situ; 2 of 12 with and none of 31 without gallbladder stones. In conclusion, ESWL is a safe and effective treatment in selected patients. EST can be the first-choice modality in the treatment of not only the post-cholecystectomy cases but also the patients with the gallbladder without stones.

Adult↗

PubMed1992

Canine pancreatic kallikrein: enzyme isolation and characterization.

Two forms of canine pancreatic kallikrein, designated as canine pancreatic kallikrein A and B, were separately isolated by ion-exchange, affinity and hydrophobic chromatographies. These enzymes had similar apparent molecular masses, substrate specificities and pH optima. However, kallikrein B was inhibited by soybean trypsin inhibitor, while kallikrein A was not. Both kallikrein A and B were shown by sodium dodecyl sulfate-polyacryl amide gel electrophoresis to consist of two polypeptide chains, designated alpha and beta chains, and binding by disulfide bond(s). The N-terminal amino acid sequences of each alpha and beta chains of kallikrein A and B were determined.

Amino Acid Sequence↗

PubMed1991

Early changes of alpha B-crystallin mRNA in rat skeletal muscle to mechanical tension and denervation.

alpha B-Crystallin specifically decreases in atrophied rat soleus muscle with hindlimb suspension (HS). alpha B-Crystallin cDNA was cloned from rat heart cDNA library using oligonucleotide probe, and its complete coding and partial non-coding regions were sequenced. Northern blot analysis revealed that alpha B-crystallin mRNA in slow muscle decreases at 36 hour after HS but recovered at 24 hour after HS stopped. Denervation decreased the expression of alpha B-crystallin mRNA in slow muscle but increased it in fast muscles, which hardly expressed in normal condition. Passive tension increased the expression of alpha B-crystallin mRNA in both muscle types. Based upon these Northern blot analysis of alpha B-crystallin, nerve innervation and external load on muscle are essential regulatory factors on the expression of the mRNA of alpha B-crystallin in rat skeletal muscle.

Actins↗

PubMed1991

Effect of dichloroacetate on oxidative removal of lactate in mice after supramaximal exercise.

1. The effect of dichloroacetate (DCA), which activates substrate oxidation on oxidative removal of lactate in mice after supramaximal exercise was investigated. 2. DCA significantly decreased the blood lactate concentration and increased the oxidative removal of lactate during prolonged exercise. 3. No significant differences were found in the removal of the blood lactate concentration, in oxidative removal of lactate after supramaximal exercise. 4. It is concluded that DCA administration which activates lactate oxidation during exercise does not activate lactate oxidation in mice after supramaximal exercise.

Animals↗

PubMed1991

Alpha B-crystallin in skeletal muscle: purification and localization.

Atrophy of rat soleus muscles by hindlimb suspension is characterized by an early dramatic decrease in a soluble 22-kDa protein. The 22-kDa protein was purified from rat red skeletal muscle and rat lens by three different methods of chromatography. The partial amino acid sequence (65% of total amino acids) determined for muscle 22-kDa protein was identical with that of rat lens crystallin. The HPLC elution patterns of lysylendopeptidase fragments of 22-kDa protein from the two sources were identical. Polyclonal antibodies to rat muscle and bovine lens alpha B-crystallin with the two proteins on immunoblotting. alpha B-Crystallin protein was expressed and synthesized efficiently in slow skeletal muscle and poorly in fast muscle. Thus, the decreased 22-kDa protein of slow muscle in the suspension treatment was confirmed to be alpha B-crystallin. Immunoblotting confirmed that most of the alpha B-crystallin was solubilized, though some was tightly bound to myofibrils. This bound portion was localized in Z-bands of isolated myofibrils by immunocytochemical light and electron microscopy. Muscle alpha B-crystallin is tentatively proposed to be a myofibril-stabilizing protein, based upon its extraction characteristics, localization, and amino acid sequence.

Amino Acid Sequence↗

PubMed1990

Effect of physical training on the responses of serum adrenocorticotropic hormone during prolonged exhausting exercise.

The purpose of this study was to investigate the effects of physical training on the responses of serum adrenocorticotropic hormone (ACTH) and cortisol concentration during low-intensity prolonged exercise. Five subjects who had fasted for 12 h cycled at the same absolute intensity that elicited 50% of pre-training maximal oxygen uptake (VO2max), either until exhaustion or for up to 3 h, before and after 7 weeks of vigorous physical training [mean daily energy consumption during training exercise, 531 kcal (2230 kJ)]. In the pretraining test, serum ACTH and cortisol concentrations did not increase during the early part of the exercise. Increases in concentrations of both hormones occurred in all subjects when blood glucose concentration decreased during the later phase of the exercise. The mean values and SEM of serum ACTH and cortisol concentrations at the end of the exercise were 356 ng.l-1, SEM 79 and 438 micrograms.l-1, SEM 36, respectively. After the physical training, VO2max of the subjects improved significantly from the mean value of 50.2 ml.kg-1.min-1, SEM 2.5 to 57.3 ml.kg-1.min-1, SEM 2.0 (P less than 0.05). In the post-training test, exercise time to exhaustion was prolonged in three subjects. Comparing the pre- and post training values observed after the same length of time that the subjects had exercised in the pre-training test, the post-training values of serum ACTH (44 ng.l-1, SEM 3) and cortisol (167 micrograms.l-1, SEM 30) concentration were less than the pre-training value (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗