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Biomedical subjects

Y Ku

Publications and source records attributed to Y Ku.

At least 163 records · Page 9Linked to original sources
PubMed1992

[Morphometrical analysis of non-cancerous liver tissue with special reference to clinicopathological features of hepatocellular carcinoma].

This study was undertaken to investigate the relationship between morphometrical characteristics of noncancerous liver tissues and clinicopathological features of hepatocellular carcinoma (HCC) in 89 cases which underwent either hepatectomy (n = 56) or autopsy (n = 33). Using Automatic Image Analyzer (IBAS-2), we determined interstitial ratio (IR) of the non-cancerous liver tissues as a morphological parameter in all cases. In addition, mean values of area (MA), maximal diameter, and shape factor of pseudolobules were determined in the cirrhotic patients. IR in cases with main tumors smaller than 3 cm was higher than that in cases with tumors larger than 3 cm (23.5 +/- 6.7% vs 18.5 +/- 8.9% mean +/- SD: p less than 0.01), and IR in cases with histologically proven intrahepatic metastases (im positive) was also higher as compared to im negative cases (17.5 +/- 9.0% vs 21.3 +/- 8.0%; p less than 0.05). Among the other parameters determined in the cirrhotics, MA was higher in cases with tumors larger than 3 cm than in cases with smaller tumors (2.54 +/- 1.87 mm2 vs 1.78 +/- 1.01 mm2; p less than 0.05), and MA was higher in im positive cases as compared to im negatives (2.67 +/- 1.91 mm2 vs 1.67 +/- 0.96 mm2; p less than 0.01). These data indicated that non-cancerous liver tissue has a close relation not only to the carcinogenesis but to subsequent tumor growth and progression of HCC.

Adult↗
PubMed1992

Serum bile acid monitoring as an early indicator of allograft function in canine orthotopic liver transplantation.

This study was undertaken to elucidate the correlation between early graft function and serum bile acids profile in canine orthotopic liver transplantation (OLT). The recipient dogs were categorized into four groups: group A (n = 5); bile output over 10 ml during initial 6 hours, group B (n = 4); bile output less than 1 ml during the same period, group C (n = 5); transplanted immediately after graft harvesting, and group D (n = 5); transplanted after 7-hour ice-cold preservation in lactated Ringer's solution. In all cases serum total bile acid (TBA) was markedly elevated during anhepatic phase, the value being 49.4 +/- 48.5 mumol/L. However, in group A, TBA decreased promptly after revascularization, the value at 4-hour being 14.7 +/- 12.7 mumol/L. In contrast, the corresponding TBA level in group B was 62.3 +/- 27.5 mumol/L 4 hours later (p < 0.01 vs group A). In group C, TBA also decreased immediately after reperfusion. Furthermore, in comparison between groups C and D, TBA level was significantly different 4 and 6 hours after reperfusion (p < 0.01). In the reduction rate of TBA (value at each time point after reperfusion the value immediately before reperfusion), the significant difference was observed after 2 hours between groups A and B (p < 0.05). In addition, significant difference was recognized at 30 minutes between groups C and D (p < 0.05). Although the changes of most bile acid fractions were proportional to the changes of TBA in all four groups, the detection of lithocolic acid at 6 hours was characteristic of both groups B and D. In conclusion, there was strong correlation between the TBA level and the graft function during early postoperative period. Therefore, TBA will be a specific and early indicator to differentiate the quality of the transplanted grafts in OLT.

Animals↗
PubMed1992

[The direct hemodynamic effects of dopamine on hepatic blood flow in the dog--use of direct hemoperfusion (DHP) under hepatic venous isolation (HVI)].

We studied the direct effects of dopamine on hepatic blood flow using DHP under HVI. Dopamine was given to mongrel dogs through either the right antecubital vein (group I: n = 3), the hepatic artery-HA (group II: n = 7) or the portal vein-PV (group III: n = 6). In groups II and III, DHP under HVI was performed to eliminate the cardiovascular influence caused by the extraregional distribution of dopamine. In group I, HA/AO decreased from 2 +/- 10 to 29 +/- 9% with infusions of dopamine from 1 to 10 micrograms/kg/min. The peak increase in PV/AO was only 14 +/- 11%. In groups II and III, plasma concentrations of dopamine in the hepatic venous blood were reduced to as low as 2.7 +/- 1.6% after DHP, and AO flow remained unaltered. Dopamine infusions in doses from 0.25 to 10 micrograms/kg/min through HA and PV resulted in dose dependent reductions of HA/AO from 4 +/- 14 and 10 +/- 9% to 42 +/- 12 and 51 +/- 11%, respectively. In contrast, PV/AO remained unchanged. Although alpha 1 antagonist reversed these hemodynamic effects, no remarkable change was observed with DA1-antagonist. In conclusion, dopamine seems to act at the site of either sinusoidal or post-sinusoidal level probably as an alpha-agonist. In addition to dopamine's effect on PV flow, our study indicates that increased attention should be given to its activity in reducing HA flow.

Animals↗
PubMed1991

Correlation between high adenosine triphosphate tissue concentration and good posttransplant outcome for the canine pancreas graft after preservation by the two-layer cold storage method.

Assessment of viability of a pancreas graft during preservation is very important to avoid transplantation of a nonfunctioning allograft. In the present report the correlation between adenosine triphosphate tissue concentration at the end of cold preservation by the two-layer method and viability a of canine pancreas graft following transplantation was studied. After preservation by an original two-layer (Euro-Collins' solution/perfluorochemical) method (group 1) and a modified two-layer (University of Wisconsin solution/PFC) method (group 2) for 24, 48, 72, 96, and 120 hr (subgroups A, B, C, D, and E), the tissue concentration of ATP was determined using high-performance liquid chromatography, and the viability of the pancreas graft was tested in the canine model of segmental pancreas autotransplantation. Maintenance of normoglycemia for at least five days after transplantation was considered to indicate a viable pancreas graft. In group 1, functional success rates were A: 5/5, (100%), B: 4/4 (100%), C: 4/4, (100%), and D: 0/4 (0%), respectively. The ATP tissue concentrations were 7.47 +/- 0.47 (n = 5), 7.91 +/- 1.21 (n = 4), 8.29 +/- 0.21 (n = 4), and 4.94 +/- 1.11 (n = 4) mumol/g dry weight in groups 1A, 1B, 1C, and 1D, respectively. There was a statistically significant difference between viable groups (groups 1A, 1B, and 1C, 7.86 +/- 0.77 mumol/g dry weight [n = 13]) and the nonviable group (group D, 4.94 +/- 1.11 mumol/g dry weight (n = 4) (P less than 0.01). On the other hand, the functional success rates were 3/3 (100%), 3/3 (100%), 3/3 (100%), 5/7 (71%), and 0/3 (0%) in groups 2A, 2B, 2C, 2D, and 2E, respectively. Two of seven dogs died of causes related to the grafts (pancreatitis and thrombosis). The ATP tissue concentrations were 8.53 +/- 1.45 (n = 3), 9.64 +/- 1.77 (n = 3), 13.81 +/- 2.09 (n = 3), and 12.49 +/- 2.52 (n = 5) mumol/g dry weight in groups 2A, 2B, and 2C and in viable grafts in group 2D, respectively, but the ATP tissue concentration of nonviable grafts in group 2D and group E were 3.51 +/- 0.81 (n = 2) and 3.98 +/- 1.34 (n = 3) mumol/g dry weight, respectively. There was a statistically significant difference between viable groups (groups 2A, 2B, 2C and viable grafts in group 2D, 11.03 +/- 2.72 mumol/g dry weight [n = 14]) and nonviable groups (group E and nonviable grafts in group 2D, 3.79 +/- 1.06 mumol/g dry weight [n = 5]) (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphate↗
PubMed1991

[A new method of intraarterial high dose chemotherapy for unresectable hepatomas using direct hemoperfusion under hepatic venous isolation (HVI.DVP)].

We have recently developed a simple method of high dose chemotherapy using HVI.DHP. The effect of HVI.DHP was evaluated in the elimination of anticancer drugs. Adriamycin (ADR: 3mg/kg), mitomycin C (MMC:1mg/kg) and cisplatin (CDDP: 2mg/kg) were given to mongrel dogs through the hepatic artery with or without HVI.DHP. The drug removal rates were similar in three drugs. Area under the curve and peak systemic level of each drug were substantially reduced by means of HVI.DHP, the values of ADR, MMC and CDDP being 17.4 and 6.2%, 4.5 and 5.9%, and 24.6 and 23.1%, respectively, of the corresponding values of simple hepatic artery infusions. Ten patients with unresectable hepatomas were treated by intraarterial high dose ADR (100-150mg/m2) using HVI.DHP. All except for two patients with catheter related complications recovered uneventfully and showed marked reductions of serum alpha-fetoprotein. Complete response was observed in one and partial response in five patients, for an overall response rate of 60%. Systemic toxicities of ADR were minimized: no cardiotoxicity, leucopenia less than 1000 cells/mm3 in one and mild hair loss in six patients. On the basis of these results, we consider this method to be an attractive therapeutic option for hepatic tumors.

Animals↗
PubMed1990

Extracorporeal removal of anticancer drugs in hepatic artery infusion: the effect of direct hemoperfusion combined with venovenous bypass.

The effect of a new extracorporeal system combining direct hemoperfusion (DHP) with venovenous bypass was evaluated in the elimination of anticancer drugs in hepatic artery infusion. Adriamycin (3 mg/kg) and mitomycin C (1 mg/kg) were given to mongrel dogs through the hepatic artery with three different durations of 1, 10, and 20 minutes. Plasma drug levels were determined at the inlet and outlet of DHP and right external jugular vein (systemic level). Blood flow through DHP averaged 200 ml/min. In dogs without DHP (group I; n = 4), systemic levels of adriamycin and mitomycin C increased rapidly with 1-minute infusion, reaching the peak values of 6.61 +/- 2.44 (mean +/- SD) and 2.20 +/- 1.05 micrograms/ml, respectively. With DHP under single venous bypass (group II; n = 5), the peak values were reduced to 1.25 +/- 1.02 and 0.79 +/- 0.52 microgram/ml. Moreover, the peak levels were markedly reduced by DHP under hepatic venous isolation (group III; n = 6), the values being 0.41 +/- 0.15 and 0.13 +/- 0.07 microgram/ml with 1-minute infusion. The drug-removal rates were improved substantially in group III compared with group II. The longer the duration of infusion, the higher the removal rates tended to be in group III. These results indicate that effective elimination of anticancer drugs can be accomplished by this system during intraarterial chemotherapy of the liver.

Absorption↗
PubMed1990

[A new method of intraarterial high dose chemotherapy for unresectable hepatocellular carcinoma--the effect of direct hemoperfusion under hepatic venous isolation].

We undertook hepatic artery infusion of high dose adriamycin (ADR) in three patients with unresectable hepatocellular carcinoma utilizing direct hemoperfusion (DHP) under hepatic venous isolation (HVI). 5 minutes continuous infusion of ADR at dosages of 100 and 150 mg/m2 was combined with DHP of 20 and 30 minutes, respectively. HVI was established by occlusions of suprahepatic and retrohepatic vena cava using a tourniquet tape and a cuff-cannula. During HVI, hepatic venous outflow was directed toward DHP and joined with the rest of the intra-caval blood before the centrifugal pump connected to a return cannula to the left axillary vein. Systemic levels of ADR were maintained less than 2 micrograms/ml during the treatments in three patients. The estimated drug removal rates were 72.3%, 51.2% and 31.1% respectively. Hematologic changes due to DHP were tolerable and transient. Highest values of serum transaminases were demonstrated on day 2 and rapidly recovered to the pretreatment levels within a week. Postoperative CT studies revealed also marked reduction in tumor size. We consider this method an attractive therapeutic option for patients with advanced hepatocellular carcinoma.

Aged↗
PubMed1989

[Extracorporeal adriamycin-removal following hepatic artery infusion: use of direct hemoperfusion combined with veno-venous bypass].

Systemic toxicity of adriamycin (ADR) has limited its high dosage application in hepatic artery infusion. We developed a new extracorporeal device combining direct hemoperfusion (DHP) and veno-venous bypass to eliminate ADR following hepatic artery infusion. Mongrel dogs were divided into three group, I: controls without DHP (n = 3), II: DHP under single venous bypass from IVC to left external jugular vein (n = 3) and III: DHP under hepatic venous isolation using veno-venous bypass (n = 5). Blood specimens were obtained to determine plasma drug levels until 60 min after ADR injection (3 mg/kg body weight, 1 min). Blood flow through DHP, which was averaged 200 ml/min in both groups II and III, was monitored with ultrasonic flowmeter. In groups I and II, peripheral ADR levels rapidly increased, reaching the peak values of 5.61 +/- 2.42 and 1.17 +/- 0.31 micrograms/ml respectively at 1 min after injection. The peak level in group III was markedly reduced, the value being 0.42 +/- 0.17 microgram/ml, which was 7.5% of the peak value of group I. The removal rates in groups II and III were 10.9 and 27.5% respectively. In conclusion, DHP under hepatic venous isolation can be an useful method to reduce systemic distribution of ADR during hepatic artery infusion.

Animals↗
PubMed1989

Hemodynamic study of occlusion of the splenic vein caused by carcinoma of the pancreas.

The most common cause of occlusion of the splenic vein is pancreatic disease, such as pancreatitis or carcinoma of the pancreas. As compared with benign causes, carcinoma of the pancreatic body or tail may readily involve not only the splenic vein, but also, eventually, the splenic artery. Therefore, the clinical features of occlusion of the splenic vein may be profoundly altered according to the nature of the underlying causes. In an attempt to clarify the pathophysiologic findings and hemodynamic mechanism of occlusion of the splenic vein associated with carcinoma of the pancreas, three patient reports were selected from our past experience. Upon analyzing the clinical course of these patients, three consecutive phases may be distinguished. Phase 1 is the insidious or latent phase represented by Patient No. 1. The splenic vein is partially occluded and gastric varices or splenomegaly has not developed. Phase 2, the collateral developing phase, is represented by Patient No. 2. The splenic vein is completely occluded while the splenic artery is patent, resulting in marked gastric varices and splenomegaly. Phase 3 is the vanishing phase and is represented by Patient No. 3. The occlusion of the splenic artery is superimposed on the occlusion of the splenic vein, causing gastric varices to vanish and the enlarged spleen to shrink.

Aged↗
PubMed1989

[Splenic vein occlusion due to pancreatic disease: regional portal hypertension from hemodynamic points of view].

The purpose of this study is to clarify the clinicopathophysiology of splenic vein occlusion due to pancreatic disease from hemodynamic points of view. We reviewed the angiographic findings and medical records of 82 patients who had pancreatitis, pancreatic cyst or pancreatic cancer in the pancreatic body and tail. According to the site of occlusion in 16 patients with complete splenic vein occlusion, this entity may be divided into two categories: Type A, an occlusion close to the spleen in which short-gastric system seems to be major collateral, and Type B, an occlusion distant from splenic hilum in which gastroepiploic system becomes prominent as collateral. As compared to 7 patients with incomplete splenic vein occlusion, gastric varices and splenomegaly were frequently observed with the patients having complete occlusion. Among these 16 patients, splenic arterial occlusion was superimposed in 3 patients with pancreatic cancer in whom gastric varices were not detected. Thus, clinical features of this entity must be carefully assessed according to the nature of the underlying disease. Based on these observations, three consecutive phases: Phase 1 Insiduous or latent phase, Phase 2 Collateral developing phase, Phase 3 Vanishing phase may be distinguished for splenic vein occlusion secondary to pancreatic disease.

Adult↗