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Biomedical subjects

Y Kamiyama

Publications and source records attributed to Y Kamiyama.

At least 19 recordsLinked to original sources
PubMed1992

Clinical application of arterialization of portal vein in living related donor partial liver transplantation.

Arterialization of the portal vein was employed during hepatic arterial reconstruction in our first few clinical experiences of partial liver transplantation using liver grafts obtained from living related donors. This procedure reduced the time required for revascularization of the grafts to about 25 min, and could in fact reduce the ischemic phase of the grafts. Repeated practice of the clinical transplantation technique has shortened the time needed to complete vascular reconstruction, eliminating the need for this procedure in most of our subsequent cases. In many clinical cases, however, there may be emergency situations which require vascular reconstruction, resulting in a prolongation of ischemic phase and the deterioration of the cellular viability of the graft. In such situations, arterialization of the portal vein can be a useful way to prevent the prolongation of the ischemic phase and to rescue the graft.

Arteriovenous Shunt, Surgical↗
PubMed1992

[Disappearance of lung metastases from hepatocellular carcinoma following bronchial arterial infusion of CDDP and MMC].

A 58-year-old man was admitted to our department because he had been diagnosed as hepatocellular carcinoma, which was located at S6 segment, and posterior segmentectomy was performed. After 6 months, right lung metastases of HCC were found and right bronchial arterial infusion of CDDP and MMC was performed twice. Dramatic effects were obtained such as disappearance of lung metastases. We emphasize the useful effect of CDDP and MMC for metastases of HCC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Metabolic correction of plasma aminogram by pig or baboon liver cross-hemodialysis with an interposed membrane.

Our previous reports have shown that the patients with both grade 4 hepatic coma and arterial blood ketone body ratio (BKBR) of over 0.25 became fully alert after treatment by pig or baboon liver cross-hemodialysis, while those with BKBR below 0.25 died of hepatic coma without increase of BKBR. The present study shows the changes in plasma amino acids (AA) in 8 patients after treatment by cross-hemodialysis and itnravenous infusion of Fisher's solution. In all patients, the ratio of tyrosine plus phenylalanine to total AA concentration decreased (p = 0.012), and the AA molar ratio increased significantly (p = 0.007). In unrecovered patients, total AA and branched chain AA increased after cross-hemodialysis, while in the recovered patients total AA did not increase significantly. It is suggested that this metabolic support is effective in reducing the plasma levels of aromatic AA mainly oxidized in the liver, as long as BKBR remained over 0.25.

Aged↗
PubMed1991

[Long-term follow-up study after pylorus-preserving gastrectomy for gastric ulcer].

The long-term follow-up study of pylorus-preserving gastrectomy (PPG) for benign gastric ulcer was described in terms of postoperative subjective symptoms related to gastrectomy and recurrent ulceration. Of 134 patients who underwent PPG, 5 patients died within one month after operation, 33 patients died in the follow-up period and 22 patients have not been traced. Seventy-four patients were available for a 3-24 year follow-up (mean 16.6 years) Recurrent ulcer developed in 4 patients, 1, 2, 9 and 11 years after surgery at the greater curvature of pre-pyloric region in all cases. Two patients underwent reoperation. These patients revealed higher gastric acid secretion as compared with that of one month after primary operation. But gastrin hypersecretion and G-cell hyperplasia were not recognized in these patients. According to detailed questionnaires, no patient showed the symptoms of dumping syndrome. The results indicate that PPG is preferable for the surgical treatment of gastric ulcer.

Adult↗
PubMed1991

[Effect of total biliary diversion (cholecysto-jejuno-cystostomy) on gut hormone release and pancreatic structure in dogs].

In order to elucidate the effect to total biliary diversion (TBD) on gut hormone release and pancreatic structure, we performed cholecysto-jejuno-cystostomy (CJC) in 6 mongrel dogs using a small interposed intestinal segment between the gallbladder and the urinary bladder with ligation of the common bile duct. Twelve weeks after CJC, CJC was converted into cholecysto-jejuno-duodenostomy (CJD) to normalize luminal bile flow. Fat rich meal loading tests were carried out before and after these procedures. Plasma concentrations of GI hormones (CCK, PP, GIP) were measured by radioimmunoassay and morphological changes of the pancreas were evaluated by light and electron microscopic study. CJC significantly enhanced the basal levels and fat-stimulated release of both CCK and PP, however after CJD, these changes returned to the normal levels. Following CJC, fat-stimulated GIP release was completely inhibited, but recovered after CJD. Following CJC, hypertrophy of pancreatic acinar cells with profuse and dilated rough endoplasmic reticulum was observed, while after CJD this change returned to the pre-operative state. These results suggest that a feedback regulation may exist between luminal bile flow and CCK secretion, and pancreatic hypertrophy after TBD is, at least partly, due to the increased plasma CCK levels.

Animals↗
PubMed1991

[Surgical results in Crohn's disease--an analysis in view of cumulative risk or recurrence and reoperation].

Forty nine cases with Crohn's disease operated at our department were analyzed in view of cumulative risk of reoperation and recurrence. Cumulative risk of reoperation was 22% at five years and 40% at ten years. Cumulative risk of recurrence after "curative" resection in thirty four cases was 53% at five years and 73% at ten years. Both risks were the highest in ileal type and the lowest in colonic type. Cumulative risk of relapse in ileocolic type after non-"curative" resection was 67% at five and ten years, which showed no significant difference with cumulative risk of recurrence after "curative" resection. Cumulative risk of recurrence after "curative" resection with proximal resection margin longer than 10 cm had no significant difference from the group with shorter margin. Cumulative risk of recurrence and reoperation after reoperation was a little higher than after initial operation, but they showed no statistical difference. In conclusion, there is no need to stick to "curative" resection, and it is enough to have the resection margin no longer than 10 cm. It is essential not to spoil the quality of life by excessive resection.

Adult↗
PubMed1991

Effect of short-term essential amino acid-containing dialysate in young children on CAPD.

In young children on CAPD, hypoproteinemia and malnutrition are often observed. We used essential amino acid-containing dialysate (EAAD) to assess short-term effectiveness on serum amino acid concentrations in young children undergoing CAPD. EAAD consisted of a 540 ml, 1.5% glucose-containing dialysate and 100 ml of 7.4% essential amino acid (EAA) solution. Aside from methionine, all serum EAA rose during the 6 hour peritoneal dialysis cycle using EAAD, peaking at about 200% of pre-treatment level one hour after start of treatment. They then returned to near pre-treatment levels at the end of the cycle. However, serum methionine increased 680% of pre-treatment level, one hour after start and 390% at the end of the cycle. In the serum non-EAA tyrosine, which showed low levels in patients with chronic renal failure, increased after EAAD treatment. Other non-EAA, most of which showed increased levels in patients with chronic renal failure, decreased after EAAD treatment. These changes in serum amino acids suggest that EAA, absorbed from EAAD, may have increased uptake of non-EAA in protein synthesis. This may improve the nutritional status of young children on CAPD.

Amino Acids, Essential↗
PubMed1990

[Effect of obstructive jaundice on the electrophysiological characteristics of the gastric mucosa and gastric acid secretion in rats].

To elucidate the effect of jaundice on the electrophysiological characteristics of the gastric mucosa and gastric acid secretion, gastric mucosal potential difference (PD) and gastric acid secretion were measured in rats with obstructive jaundice. Also transepithelial potential difference (TEPD), short circuit current (Isc) and transepithelial electrical resistance (Rt) were measured in the isolated gastric mucosa of rats with obstructive jaundice. Secondly, to confirm whether the alteration of these parameters were induced by jaundice and increased serum bile acids in the jaundiced rats, the effects of biliary drainage on the electrophysiological characteristics and gastric acid secretion, and the effects of bile acid (TCA) on TEPD, Isc, Rt were evaluated. PD, TEPD, Isc and gastric acid secretion were reduced in the jaundiced rats, and tended to recover after biliary drainage. TEPD and Isc were reduced significantly by TCA administration. These results suggest that active ion transport in the gastric mucosal cells and gastric acid secretion are impaired in jaundiced rats and the increased serum bile acid in jaundiced rats may cause these dysfunctions and the impaired active ionic transport function is improved by biliary drainage.

Animals↗
PubMed1989

Pyridine nucleotide fluorometry in preserved porcine liver with fluorocarbon emulsion.

Oxidation-reduction changes in pyridine nucleotide fluorescence were investigated in perfused and preserved porcine liver. A fluorocarbon emulsion (FC-43) was administered to the perfusate as an oxygen carrier to obtain full oxidation level by portal perfusion at a physiological low flow rate. A satisfactory reading was obtained by portal perfusion with EuroCollins' solution containing 10% v/v FC-43 at a rate of 0.5 ml/min/g liver. The amplitude (R x A) and the changing velocity (R x V) from full oxidation to full reduction were determined in the resultant trace curve. Both R x A and R x V decreased in inverse proportion to the duration of preservation period (3, 6, 12 hr). Adenine nucleotide content, hepatic energy charge level, and ketone body ratio in the tissue were simultaneously measured, and they also decreased proportionally to the duration of preservation. There were close positive correlations between R x A and total adenine nucleotide concentration (r = 0.841, P less than 0.01), between R x V and energy charge (r = 0.787, P less than 0.01), and between R x V and tissue ketone body ratio (r = 0.881, P less than 0.01). These results suggest that pyridine nucleotide fluorometry can accurately follow the cellular function of isolated porcine liver by administration of FC-43 in perfusate. This fluorometry may also have potential application in evaluating viability of a large organ like the human liver graft.

Adenine Nucleotides↗
PubMed1989

The effects of PGI2 analog (OP-41483) on perfused porcine liver.

The effects of a prostacyclin analog OP-41483 on energy metabolism were studied in an isolated porcine liver perfused with human blood for 8 h. OP-41483 was administered intravenously at a rate of 0.3 microgram/kg/min during the procurement and into the perfusate at a rate of 1.0 microgram/min during perfusion. Acetoacetate, beta-hydroxybutyrate, lactate, and pyruvate were measured before perfusion and at 1, 2, 3, 5, and 8 h after perfusion, from which values the ketone body ration (acetoacetate/beta-hydroxybutyrate, KBR), reflecting the redox state of liver mitochondria, was calculated. In the OP-41483 group, KBR increased rapidly from 0.34 to 0.95, 1.61, 1.51, 2.35, and 2.04, and lactate decreased rapidly from 9.81 to 6.30, 4.51, 3.22, 2.39, and 1.33 mmol/L at the respective hours after perfusion. There were significant differences after 3 h of perfusion as compared with the control group (p less than 0.05). These results suggest that administration of OP-41483 causes an increase in mitochondrial NAD+/NADH ratio (oxidized and reduced forms of free nicotinamide-adenine dinucleotides), leading to an enhancement of the metabolic capacity of the perfused liver.

3-Hydroxybutyric Acid↗
PubMed1989

Effects of partial deprivation of portal blood on arterial blood ketone body ratio in rabbits.

To examine the effects of portal blood deprivation on energy metabolism of the liver, we studied: (1) the ketone body ratio (acetoacetate/beta-hydroxybutyrate) in liver tissue, which is in equilibrium with the free NAD+/NADH ratio in liver mitochondria, in the ligated lobe (LL) and nonligated lobe (NLL), (2) the hepatic energy charge [EC = (ATP + 1/2 ADP)/(ATP + ADP + AMP)] in both LL and NLL, and (3) the arterial blood ketone body ratio (BKBR) after left portal vein branch ligation (PBL) in rabbits. As found in LL after PBL, portal blood deprivation decreased the tissue ketone body ratio. The EC in LL significantly decreased after PBL, but recovered 7 days after PBL since the LL became atrophic. The BKBR remained within the normal range, even when 60% of the total liver was deprived of portal blood.

Animals↗
PubMed1989

Changes in serum bile acid composition in relation to histological findings after liver transplantation in piglets.

Changes in the composition of serum bile acids were investigated after orthotopic liver transplantation in piglets. Serum levels of all bile acid components rapidly increased during the anhepatic phase and then quickly decreased, returning to the preoperative state within 6 h of revascularization of the allograft. In the animals in which extrahepatic biliary stenosis was a complication, serum total bile acids (TBA) increased remarkably. A marked increase of hyocholic acid and marked decrease of hyodeoxycholic acid were noted; as percentages of TBA, the average levels per day were 91.3 +/- 1.3 and 5.0 +/- 1.3%, respectively. No change in chenodeoxycholic acid (CDCA) was observed. In the animals suffering acute rejection without extrahepatic biliary stenosis, serum TBA increased slightly and the percentage of CDCA rose, the average level being 29.6 +/- 1.5%. These results suggest that the measurement of the composition of serum bile acids may serve as a useful means of assessing allograft function after liver transplantation.

Animals↗
PubMed1989

Taurocholate-induced gastric damage in rats with obstructive jaundice.

We examined the severity of taurocholate-induced gastric mucosal damage in rats with obstructive jaundice. Oral administration of 100 mM taurocholate induced severer gastric mucosal damage in rats with jaundice than in intact rats. Pretreatment with 5 mM taurocholate significantly protected the gastric mucosa against 100 mM taurocholate-induced damage, suggesting adaptive cytoprotection in rats with jaundice. The reductions in the gastric mucosal potential difference and hexosamine contents in the gastric mucosa in response to 100 mM taurocholate were significantly attenuated by prior administration of 5 mM taurocholate in both intact rats and rats with jaundice.

Animals↗
PubMed1989

[The effect of celiac plexus block on splanchnic circulation; changes in systemic hemodynamics and tissue blood flow of the liver and kidney in rabbits].

The effects of the celiac plexus block (CPB) on the hepatic and renal tissue blood flow (TBF) were investigated in 45 rabbits. Together with this, the effects of drugs (phenylephrine: PE, norepinephrine: NE, dopamine: DA, 6% hydroxyethyl starch: HES) used to increase mean blood pressure (MBP) up to control level were also investigated. TBF was measured by the hydrogen clearance method. Following CPB, MBP and heart rate decreased significantly. TBF of the liver and kidney both decreased significantly for 14.3% and 25.9% respectively. A correlation was observed between the decreases of MBP and renal TBF. An increase in hepatic TBF beyond the control level was observed in DA group, and in both hepatic and renal TBF in the HES group after adjustment of MBP. In other groups, both hepatic and renal TBF tended to decrease. It was concluded that hepatic and renal TBF decreased because of hemodynamic suppression following CPB. The results also suggest that both TBFs would have increased if systemic hemodynamic change was not so great.

Animals↗
PubMed1988

Determination of cytochromes in human liver contaminated with hemoglobin.

A spectrophotometric method was developed to determine cytochromes in human liver mitochondria contaminated with hemoglobin. The influence of hemoglobin on the measurement was canceled by keeping hemoglobin in the carbon monoxide bound form throughout determination. Mitochondria were solubilized by 2% sodium cholate, and cytochromes were reduced enzymatically with glutamate and succinate as substrates to the maximal extent. The amount of cytochromes determined spectrophotometrically was linearly correlated with mitochondrial protein at least up to the extent of 8 mg/ml.

Aged↗