Okitsugu Nishimura

Bone disorder following partial and total gastrectomy with reference to bone mineral content

To study post-gastrectomy metabolic bone disorders, we measured the radial bone mineral content (BMC), serum levels of calcium, inorganic phosphorus, alkaline phosphatase, and 25-hydroxyvitamin D(25-OH-D) in 59 patients with partial- and 39 patients with total gastrectomy. Total gastrectomy patients manifested a higher incidence of decreased BMC levels than did partial gastrectomy patients (56 per centvs. 25 per cent). Patients subjected to the Billroth II procedure, especially females, manifested abnormally low BMC values. The decline in BMC was age-related; it was pronounced in females. At 10 years postoperatively, many of the partial gastrectomy patients manifested markedly low BMC levels; in totally gastrectomized patients this finding was made at less than 5 years postoperatively. Approximately 30 per cent of our patients showed abnormalities in serum minerals, alkaline phosphatase or 25-OH-D.

Clinical evaluation of long-term srvival after total gastrectomy

Twenty-seven cases of long-term survival after total gastrectomy were clinically evaluated. From the standpoint of general nutrition and rehabilitation, the patients appeared to be in satisfactory condition. However, hyperchromic anemia, serum vitamin B12 deficiency, and osteoporosis were noted in some patients.

Early cancer of duodenal duplication a case report

SummaryA case which presented with early cancer of the duodenal duplication in addition to a gallbladder defect is reported. This may be the first case of its kind reported in the literature.

Pulmonary function before and after abdominal surgery in the aged

AbstractIn patients 70 years or older, pulmonary function tests were performed before and after abdominal surgery to correlated the results with the development of postoperative pulmonary complications which developed in 48% of these patients, compared to 15% in the control group. To predict the development of PPC, preoperative analysis of the flow-volume curve is useful and

The effects of diet on the residual small intestine following massive resection

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Thermochemotherapy Using a Radiofrequency Capacitive Heating System in the Treatment of Unresectable Bile Duct and Pancreatic Cancers

vital capacity is a valuable parameter for the analysis of the flow-volume curve. Postoperatively, pulmonary function was reduced and there was a delay in the restoration of pulmonary function in cases with postoperative pulmonary complications. The administration of appropriate analgesics may be useful to improve postoperative ventilatory disturbances.

Transumbilical portal vein catheterization and insulin analysis in an infant with hypoglycemia

Serum zinc and copper levels were evaluated in patients with gastric cancer who had undergone gastrectomy. These patients were divided into two age categories; namely, the aged group, comprising 39 patients over the age of 70 years, and the younger group, comprising 23 patients younger than 50 years. The data before and after surgery were compared between the two groups. Serum zinc levels in the aged group were significantly lower than those in the younger group, both before and after surgery. Serum copper levels, however, did not differ significantly between the two groups. The serum Cu/Zn ratio was also analyzed according to the histological stages of cancer (stages I to IV), and compared between the two ageclassified groups. The aged group showed a higher Cu/Zn ratio at all stages, whereas in the younger group, the ratio was significantly higher at stage IV than in the earlier stages. Preoperative serum zinc, copper, and the Cu/Zn ratio were studied in relation to the complication of anastomotic leak after surgery. The Cu/Zn ratio in the aged patients with this complication was significantly higher than that in the aged patients without it. These results suggest that the Cu/Zn ratio may be an important factor in determining nutritional parameters in the aged.

PULMONALY FUNCTIONS, BEFORE AND AFTER ABDOMINAL SURGERY OF AGED PATIENTS

The midportions of rat small intestines were resected by 90 per cent, and the residual intestines studied for the effects of diet on mucosal morphology, nutrition and gastrointestinal hormones. Groups of rats were fed chow, an elemental diet (ED), or an ED+dietary fiber (EDF) for 1 or 3 weeks. Nonresected rats which were fed chow or ED for 3 weeks were used as controls. Nutritional parameters, such as concentrations of serum total protein, albumin and transferrin were favorable but gain in body weight was not. The parameters indicated that resected rats fed EDF fared better than resected rats fed ED. Mucosal villous height in the residual jejunum, similar in all the resected groups after 1 week, was significantly increased in the resected rats fed chow or EDF after 3 weeks, but did not differ between 1 and 3 weeks in the resected rats fed ED. Changes in the number of villous epithelial cells and villous width were also examined. The level of plasma enteroglucagon was high in the rats fed chow or EDF after both 1 and 3 weeks, and was positively correlated with the increases in villous height. Levels of serum gastrin were not affected by dietary change. Luminal nutrients were significantly associated with the adaptive changes in the mucosa of the residual intestine, and mucosal morphology was also considerably influenced by dietary change.