Satoaki Kamiya

THE EFFECTS OF INTRAVENOUSLY INFUSED CATECHOLAMINES ON HEPATIC BLOOD FLOW IN CONSCIOUS DOGS WITH EXPERIMENTAL OBSTRUCTIVE JAUNDICE

This study was conducted to examine how the effects of dopamine and dobutamine on hepatic blood flow were influenced by obstructive jaundice in a conscious canine model. Prior to biliary obstruction, portal venous blood flow (PVF) increased in response to the infusion of either dopamine or dobutamine: dopamine infused at 8 μg/kg per min produced an increase of 19±0% in PVF, while dobutamine infused at 16 μg/kg per min produced an increase of 30±2%. Although hepatic arterial blood flow (HAF) decreased dose-dependently in response to the infusion of dopamine, no significant change was observed in HAF in response to any dose of dobutamine. Obstructive jaundice attenuated or completely abolished the PVF-increasing effect of dopamine, whereas it did not significantly alter the effect of dobutamine on hepatic blood flow. In dogs with obstructive jaundice, dopamine at 16 μg/kg per min produced a decrease of 17±3% in PVF. These findings suggest that dobutamine is more effective than dopamine for increasing hepatic blood flow in patients with obstructive jaundice.

Effects of Prostaglandin E1 on Hepatic Blood Flow in Conscious Dogs with Chronic Biliary Obstruction

To evaluate the effects of prostaglandin E₁ (PGE₁) on the hepatic circulation in cholestasis, hepatic arterial blood flow (HAF), portal venous blood flow (PVF), cardiac output, and heart rate during PGE₁ infusions were investigated before and 2 weeks after biliary obstruction in conscious dogs by a transit-time ultrasonic flowmeter. In the control period, HAF and PVF increased dose dependently with the infusion of PGE₁ from 0.05 to 0.5 µg/kg/min. During the biliary obstruction period, a lower dose of PGE₁ increased HAF and PVF. The plasma concentration level of PGE₁ during the infusion of PGE₁ was significantly higher at each dose in the cholestatic animals. These results suggest that the metabolism of PGE₁ is attenuated by cholestasis. Plasma PGE₁ concentrations should be useful in deciding the optimal dose of PGE₁.

Primary Malignant Lymphoma of the appendix. A Case Report.

症例は61歳の男性. 平成11年6月右下腹部痛を主訴に近医より当院紹介受診した. 右下腹部に有痛性の腫瘤を触知し急性虫垂炎の術前診断にて同日虫垂切除術を施行した. 病理組織学的には悪性リンパ腫 (diffuse large cell type) であった.腫大した体表リンパ節は触知せず術前の胸部単純X線写真, 他の消化管精査, 腹部CTにても異常所見認めず, 虫垂原発悪性リンパ腫と診断された. 術後化学療法追加した.虫垂原発悪性リンパ腫の本邦報告例は自験例を含め32例で, 文献的考察を含め報告する.