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Biomedical subjects

Y Nimura

Publications and source records attributed to Y Nimura.

At least 217 records · Page 12Linked to original sources
PubMed1995

Disseminated intravascular coagulation after liver resection: retrospective study in patients with biliary tract carcinoma.

BACKGROUND: Disseminated intravascular coagulation (DIC) after hepatectomy is not well understood. The objective of this retrospective study was to evaluate hemostatic changes after extensive liver resection and to elucidate the frequency of posthepatectomy DIC. METHODS: In 100 patients without cirrhosis who underwent resection of two or more segments of the liver for biliary tract carcinoma, various hemostatic parameters were measured before and after resection, and the liver function of each patient was assessed. RESULTS: In patients with posthepatectomy liver failure, platelet count, fibrinogen concentrations, and prothrombin time were significantly lower than in those without such failure. Serum levels of fibrin degradation product did not differ significantly between the two groups. The minimum platelet count was significantly negatively correlated with serum total bilirubin level. Posthepatectomy DIC occurred in 2.0% of the patients. CONCLUSIONS: After extensive liver resection patients exhibited a decreased platelet count with hepatic dysfunction. However, this condition rarely resulted in DIC, at least in patients without cirrhosis and serious postoperative complications.

Adult↗
PubMed1995

Right or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma.

BACKGROUND: Percutaneous transhepatic embolization of the right portal vein plus the left medial portal branch (R3-PE) and the left portal vein plus the right anterior portal branch (L3-PE) is not well described. METHODS: Four patients with far advanced carcinoma of the hepatic hilus underwent R3-PE (n = 1) or L3-PE (n = 3) as preoperative management for right hepatic trisegmentectomy or left hepatic trisegmentectomy. The portal vein embolization was performed with the ipsilateral approach through the right anterior portal branch. RESULTS: In all patients the embolizations were successful without complications. Volumetric study with computed tomography showed sufficient hypertrophy of the nonembolized hepatic segments. Three of the four patients eventually underwent trisegmentectomy. The postoperative courses in two of the patients were uneventful. The remaining patient suffered from posthepatectomy liver failure but recovered. CONCLUSIONS: R3-PE or L3-PE is advisable as preoperative management for trisegmentectomy and appears effective for increasing the safety of the operation. This embolization is achievable only through the ipsilateral approach.

Adult↗
PubMed1995

Effects of in vivo administration of anti-IL-10 monoclonal antibody on the host defence mechanism against murine Salmonella infection.

Interleukin-10 (IL-10) is a cytokine that regulates various macrophage functions. To elucidate the involvement of endogenous IL-10 in the early stage of murine salmonellosis, we examined the effect of anti-IL-10 monoclonal antibody (mAb) administration on the host defence mechanism against Salmonella choleraesuis infection. The in vivo administration of anti-IL-10 mAb significantly enhanced host resistance at the early stage of Salmonella infection, as assessed by bacterial growth in the peritoneal cavity and the liver. Enhanced levels of monokine mRNA, including IL-1 alpha, tumour necrosis factor-alpha (TNF-alpha) and IL-12, were observed from day 1 after infection in the peritoneal macrophages in anti-IL-10 mAb-treated mice compared with those in control mAb-treated mice. Mice treated with anti-IL-10 mAb exhibited significantly higher levels of interferon-gamma (IFN-gamma) in the peritoneal exudates and major histocompatibility complex (MHC) class II expression on the peritoneal macrophages on days 3 and 5 after infection. Notably, in vivo anti-IL-10 mAb brought about an increment of gamma delta T cells in the peritoneal cavity at the early phase of infection, which was correlated with the expression of endogenous heat-shock protein 60 (HSP60), which is implicated as a potential ligand for gamma delta T cells, in the infected macrophages. Our results suggest that the neutralization of endogenous IL-10 accelerates some macrophage functions and, consequently, the activation of immunocompetent cells, including gamma delta T cells, at the early stage of infection, resulting in an enhanced host defence against Salmonella infection.

Animals↗
PubMed1995

Congenital absence of portal venous system associated with a large inferior mesenteric-caval shunt: a case report.

We encountered a 30-year-old man with congenital absence of the portal venous system associated with a large inferior mesenteric-caval shunt via the internal iliac veins, which was revealed by angiography and liver biopsy. He had experienced refractory hemorrhoidal bleeding and occasional dyspneic attacks, but no episode of portal encephalopathy. The serum ammonia level in peripheral blood was within normal limits, which suggests the presence of a homeostatic control mechanism. The clinical profile of this extremely rare case, including liver function, is described.

Adult↗
PubMed1995

Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization.

Changes in lobar volume of the liver and in total hepatic function were studied in 19 patients with biliary tract cancer who underwent right portal vein embolization as preoperative management for extensive liver resection. Computed tomography (CT) was performed to estimate liver volume before and approximately 11 days after embolization. An indocyanine green (ICG) test was performed before and 11 to 13 days after embolization. The calculated volume of the right lobe decreased from 761 +/- 181 cm3 to 625 +/- 110 cm3 11 days after embolization (P < .0001), whereas the volume of the left lobe increased from 420 +/- 94 cm3 to 555 +/- 110 cm3 (P < .0001). Thus, portal embolization produced a gain in left lobe volume of 136 +/- 62 cm3 and an almost equivalent loss in right lobe volume. The hypertrophy ratio of the left lobe, expressed as percentage of postembolization volume of the left lobe to preembolization size, of the 5 patients with diabetes mellitus (DM) was lower than that of the 14 patients without diabetes (116.7 +/- 6.3% vs. 140.4 +/- 18.4%; P < .005). The ICG disappearance rate in 16 patients improved from 0.163 +/- 0.034 to 0.177 +/- 0.027 (P < .05). The improvement was especially evident in 9 of 14 post-jaundice patients, although the rate decreased slightly in 2 patients without jaundice. We conclude that right portal vein embolization can produce a compensatory hypertrophy of the left lobe within 11 days without seriously affecting hepatic function. In diabetic patients, however, a longer interval between embolization and operation may be needed to achieve sufficient hypertrophy of the left lobe.

Adult↗
PubMed1995

[A case of carcinoma of the pancreas head associated with celiac axis compression syndrome].

We report a 51-year-old woman with pancreas head cancer associated with celiac axis compression syndrome (CACS). Angiography demonstrated that the inferior pancreatico-duodenal artery and the posterior superior pancreaticoduodenal artery dilated significantly. The lateral view of aortography showed compression of the celiac axis. We performed pancreatoduodenectomy safely with cutting the median arcuate ligament. Postoperative course was uneventful. Postoperative angiography demonstrated improvement of the compression. In CACS, celiac axis is compressed by the median arcuate ligament (seichu kyujo jintai in Japanese), not by the medial arcuate ligament (naisoku kyujo jintai in Japanese).

Abdominal Pain↗
PubMed1994

Kupffer cells cytotoxicity against hepatoma cells is related to nitric oxide.

We have previously demonstrated that rat resting macrophages have cytotoxicity against tumor cells. In the current study we have performed an in vitro experiment to explore the mechanism of Kupffer cells-mediated cytotoxicity against hepatomas. The coculture of tumor cells with Kupffer cells (derived from rat livers) stimulated syngeneic and allogeneic Kupffer cells to produce nitric oxide. Kupffer cell-mediated cytotoxicity was paralleled to the amount of nitric oxide and was abolished by the addition of NG-monomethyl-L-arginine. The ability to stimulate Kupffer cells to produce nitric oxide resided on the membranous fragment of tumor cells.

Animals↗
PubMed1994

Ca2+/calmodulin-dependent protein kinase V and I may form a family of isoforms.

We reported that polyclonal antibody against Ca2+/calmodulin-dependent protein kinase V (CaM kinase V) reacted to two proteins of rat cerebrum with a molecular mass of 40 and 41 kDa. This antibody revealed the immunoreactivity with CaM kinase I expressed in E. coli (recombinant CaM kinase I), of which molecular mass was 40 kDa, whereas 41 kDa mainly with purified CaM kinase V. The immunoreactive bands of recombinant CaM kinase I and CaM kinase V did not shift by phosphorylation or dephosphorylation. These results suggest that CaM kinase V and CaM kinase I may form a family of isoforms.

Animals↗
PubMed1994

Purification and characterization of nuclear phospholipase C specific for phosphoinositides.

A phosphoinositide-specific phospholipase C (PLC) was solubilized from the isolated nuclei of rat ascites hepatoma AH7974 cells by ultrasonication in 2 M KCl. The extract was then subjected to five steps of column chromatographies in the order of Sephacryl S-300, phosphocellulose, Mono Q, Mono S, and Superose 6. Four forms of PLC (tentatively designated as N1, N2, N3, and N4) were purified 440-1400-fold. N1, N2, N3, and N4 showed apparent molecular masses of 85, 83, 80, and 88 kDa, respectively, on SDS-polyacrylamide gel electrophoresis. N1 cross-reacted with the antibody against the delta 1 isoform, while the other three forms did not cross-react with any of the antibodies against PLC-delta 1, -gamma 1, -gamma 2, and -beta 1. They hydrolyzed phosphatidylinositol (PI), phosphatidylinositol 4-monophosphate (PIP), and phosphatidylinositol 4,5-bisphosphate (PIP2) but did not show any activities against phosphatidylcholine and phosphatidylethanolamine. They showed the same optimal pH:pH 6.5 for PI hydrolysis and pH 7.0 for both PIP and PIP2 hydrolyses. They absolutely required Ca2+ for activity, with optimal concentrations of 10(-3)-10(-5) M for PIP and 10(-4)-10(-5) M for PIP2. For PI hydrolysis, N1, N2, and N3 required a Ca2+ concentration higher than 10(-2) M whereas N4 revealed significant activity even at 10(-5) M Ca2+ concentrations. Two forms of plasma membrane PLC and three forms of cytosolic PLC were purified from AH7974 cells by the same procedure as for nuclear PLC. Comparative study with these three groups revealed that all of the purified PLC isoforms shared similar enzymological properties except N4, which showed an exceptionally high affinity to Mono S column and was active at low concentrations of Ca2+ for PI as substrate. Furthermore, when PLC isoforms of nuclei from adult resting rat liver were compared with those from regenerating rat liver after partial hepatectomy, a PLC isoform corresponding to N4 of AH7974 cells was found only in regenerating liver nuclei. From these results, it was suggested that the nuclei of growing liver cells possessed a unique form of PLC (N4).

Animals↗
PubMed1994

Angiographic changes in the hepatic artery after skeletonization resection for biliary tract cancer.

Using preoperative and postoperative arteriography, angiographic changes in the hepatic artery were studied after skeletonization of the hepatoduodenal ligament and hepatic resection for biliary tract carcinoma. Of 52 patients evaluated (32 with carcinoma of the bile duct, 20 with gallbladder cancer), no angiographic changes were apparent after operation in 30 (58 per cent) and there were pathological findings in 22 (42 per cent; smooth stenosis in five patients, irregular stenosis in seven, a beaded appearance in four, dilatation in two, obstruction in four). Based on angiographic findings, patients were classified into three subgroups (no change, 30 patients; irregular form, 18; obstructed, four). Postoperative liver function was also evaluated. No definite correlation was evident between angiographic findings and the incidence of hepatic failure or liver dysfunction in the first month after operation. Given that connective tissue and lymph node dissection in the hepatoduodenal ligament is essential for curative resection of biliary tract carcinoma, these findings suggest that skeletonization is an acceptable operative procedure.

Adolescent↗
PubMed1994

Ca2+/calmodulin-dependent protein kinase V: tissue distribution and immunohistochemical localization in rat brain.

Polyclonal antibody against Ca2+/calmodulin-dependent protein kinase V (CaM kinase V) was prepared from guinea pigs immunized with synthetic polypeptide, based on the partial amino acid sequence of the rat brain enzyme. Immunoblot analysis of purified CaM kinase V revealed two immunoreactive bands with a molecular mass of 41 kDa and minor 40 kDa, respectively. Tissue distribution of CaM kinase V and immunohistochemical localization in rat brain were also investigated. Immunoblotting revealed the presence of immunoreactive proteins with the same molecular mass of 40 and 41 kDa, in the cerebrum, cerebellum, brain stem, pituitary gland, lung, adrenal gland, spleen, liver, colon, heart, stomach, ovary, spinal cord, and thymus. Immunohistochemistry revealed strong staining in the neuronal somata and weak staining in the nuclei. Densely stained regions included the cerebral cortex, the hippocampal formation, the caudatoputamen, the globus pallidus, the hypothalamus, the substantia nigra, the medial geniculate body, the olfactory bulb, the cerebellar cortex and the choroid plexus. CaM kinase V revealed different substrate specificity compared with CaM kinase II. These results lead to the notion that CaM kinase V may exist in 40- and 41-kDa isoforms, is widely distributed in various tissues, and may play an important role in the control of a wide variety of calcium regulated processes in the respective tissues.

Amino Acid Sequence↗
PubMed1994

Evaluation of tracheal mucosal blood flow during an extended radical operation for esophageal carcinoma: clinical and experimental studies.

Using the hydrogen gas clearance method, a plate-type probe was attached to the surface of the cuff of an endotracheal tube in order to measure the ischemic changes in the tracheal mucosa produced by peritracheal lymph node dissection. In eight human subjects with intrathoracic esophageal carcinoma, the tracheal mucosal blood flow was 40.1 ml/100 g per minute after they had undergone a right thoracotomy and then decreased to 13.0 ml/100 g per minute after they had further received an extended radical operation preserving the right bronchial artery. No tracheal ulcers were seen. The same ischemic changes in the tracheal mucosa were also measured in dogs. The right bronchial artery contributes about one-third of the total blood flow to the trachea and this was thus calculated to be about 10-14 ml/100 g per minute.

Animals↗
PubMed1994

A new method of anterior mediastinal tracheostomy following resection of cervical esophagus and the larynx: report of a case.

We report herein the case of a 52-year-old man for whom a split pectoralis major myocutaneous flap was applied at the time of extended radical surgery for esophageal carcinoma with tracheal involvement, to avoid the postoperative complications of anterior tracheostomy such as tracheal necrosis and rupture of the major vessels. Laryngopharyngectomy and extended resection of the proximal trachea was performed through a manubrectomy, leaving the tracheal remnant only 4 cm above the carina. A pectoralis major myocutaneous flap was split into two with one piece being wrapped around the trachea at the anterior mediastinal tracheostomy site, and the other being placed between the trachea and brachiocephalic artery. The postoperative course was uneventful and the patient was discharged from hospital on the 34th postoperative day. A split pectoralis major myocutaneous flap may be effective not only for filling the dead space between the trachea and brachiocephalic artery, but also for reducing tension at the tracheocutaneous anastomosis and protecting against circulatory damage at the mediastinal tracheostomy site to minimize stomal retraction.

Carcinoma, Squamous Cell↗
PubMed1994

Sphincter of Oddi motility in patients with bile duct stones. A comparative study using percutaneous transhepatic manometry.

The motility of the sphincter of Oddi was measured by percutaneous transhepatic manometry of the sphincter of Oddi (PTMSO) in three groups of 57 patients with bile duct stones. The three groups were: (1) cholecystectomy group (N = 10)--patients with common bile duct stones (CBDS) who had already undergone cholecystectomy; (2) noncholecystectomy group (N = 37)--patients with CBDS who had not undergone cholecystectomy; and (3) intrahepatic stone (IHS) group (N = 10). The basal pressure, amplitude, frequency, and propagation direction of contraction waves and the response to cerulein injection or dried egg yolk ingestion were analyzed and compared among these groups. No significant differences in the basal pressure, amplitude, frequency, and propagation direction of the contraction waves were found among the three groups. There were also no differences in the response to cerulein or dried egg yolk ingestion. The frequency and duration of the burst contractions occurring in duodenal phase III of the migrating motor complex were significantly higher (P < 0.05) in the cholecystectomy group than in the other two groups. These two differences in the burst contractions may be ascribed to the absence of the gallbladder.

Adult↗
PubMed1994

Advanced primary non-Hodgkin's lymphoma of the small intestine in childhood: report of four cases.

Primary non-Hodgkin's lymphoma of the small intestine (PLI) is an uncommon malignancy in childhood which carries a poor prognosis. Consideration of the possible diagnosis of PLI is important when children have vague abdominal symptoms, since thoughtful multidisciplinary treatment can result in a better prognosis. This paper reports the cases of four children who have presented to our hospital since 1985 with advanced stage III or IV PLI. All the children had a huge abdominal mass but none of them had complete intestinal obstruction. Regarding the diagnosis, ultrasonography frequently reveals a hypoechoic thickening of the intestinal wall with dilated intestinal loops. A delayed primary or second-look operation may be the treatment of choice following adequate chemotherapy, while total parenteral nutritional support may prevent gastrointestinal complications. Three of the four patients have been in complete remission for 2 to 4 1/2 years since their initial treatment.

Child↗