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Biomedical subjects

H Inoue

Publications and source records attributed to H Inoue.

At least 397 records · Page 22Linked to original sources
PubMed2000

[Efficacy of cibenzoline for chest oppression and ventricular arrhythmia during effort and alcohol consumption in a patient with hypertrophic obstructive cardiomyopathy: a case report].

A 67-year-old man presented with chest oppression and palpitation during effort and alcohol consumption. Echocardiography demonstrated asymmetric septal hypertrophy and systolic anterior motion of the anterior mitral leaflet with a pressure gradient of 80 mmHg across the left ventricular outflow tract (LVOT), leading to the diagnosis of hypertrophic obstructive cardiomyopathy. During the treadmill exercise test, blood pressure decreased with electrocardiographic ST-segment depression and subsequent frequent premature ventricular contractions. Holter-electrocardiographic monitoring also showed ST-segment depression with premature ventricular contractions during effort and alcohol consumption. Coronary angiography showed no abnormalities and cardiac catheterization at baseline showed a systolic pressure gradient of only 2 mmHg across the LVOT. However, the gradient increased to 33 mmHg after premature ventricular contraction, 27 mmHg at Valsalva maneuver and 75 mmHg with dobutamine infusion (5 micrograms/kg/min) and disappeared with 70 mg of intravenous cibenzoline. Medication with cibenzoline (300 mg/day) for one month reduced the LVOT gradient at rest to 53 mmHg and strikingly improved symptoms and exercise tolerance and also suppressed premature ventricular contractions during exercise and alcohol consumption. We conclude that cibenzoline was effective for reduction of LVOT gradient both at rest and during exercise and alcohol consumption.

Administration, Oral↗
PubMed2000

Non-surgical therapy of primary aldosteronism: transcatheter arterial infusion of ethanol into an aldosteronoma.

Primary aldosteronism due to an adrenocortical adenoma can be cured by ablation of the adenoma, which produces an excess of aldosterone (aldosteronoma). This has traditionally been performed by surgical removal of the adenoma. However, some patients with aldosteronomas refuse surgical removal. Therefore, we developed a therapeutic method to ablate an aldosteronoma by transcatheter arterial infusion of ethanol. This method ablated the aldosteronoma in 27 (82%) of 33 treated cases and produced no serious complications, and may be one of the therapeutic choices for aldosteronomas.

Humans↗
PubMed2000

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (1998)].

The bacteria isolated from the patients with lower respiratory tract infections were collected by institutions located throughout Japan, since 1981. Ikemoto et al. have been investigating susceptibilities of these isolates to various antibacterial agents and antibiotics, and analyzed some characteristics of the patients and isolates from them each year. Results obtained from these investigations are discussed. In these 18 institutions around the entire Japan, 532 strains of presumably etiological bacteria were isolated mainly from the sputa of 438 patients with lower respiratory tract infections during the period from October in 1998 to September in 1999. MICs of various antibacterial agents and antibiotics were determined against 85 strains of Staphylococcus aureus, 100 strains of Streptococcus pneumoniae, 96 strains of Haemophilus influenzae, 75 strains of Pseudomonas aeruginosa (non-mucoid strains), 6 strains of Pseudomonas aeruginosa (mucoid strains), 38 strains of Moraxella subgenus Branhamella catarrhalis, 26 strains of Klebsiella pneumoniae etc., and the susceptibilities of 517 strains were assessed except for those strains that died during transportation. S. aureus strains for which MICs of oxacillin (MPIPC) were higher than 4 micrograms/ml (methicillin-resistant S. aureus: MRSA) accounted for 60.0%. Vancomycin (VCM) and arbekacin (ABK) showed the most potent activities against MRSA. But one of MRSA showed resistance to ABK with the MIC of 64 micrograms/ml. The sensitive strains of MRSA to VCM have decreased. The frequency of penicillin (PC)-intermediate S. pneumoniae (PISP) + PC-resistant S. pneumoniae (PRSP) have increased in 46.0% for 1998 comparatively from 30.9% of 1997's. But PRSP decreased, and PISP increased into 39.0% of 1998 years from 19.8% of 1997's. Panipenem (PAPM), imipenem (IPM) and faropenem (FRPM) showed the most potent activities against S. pneumoniae with MIC80s of 0.125 microgram/ml or below. Against H. influenzae and M. (B.) catarrhalis, almost all the drugs showed good activities. The sensitive strains of them against ceftazidime (CAZ) decreased in 1997, but those have increased in 1998. Inversely, the susceptibility of them against cefotiam (CTM) had been higher in 1997, but those have been lower in 1998. Tobramycin (TOB) showed the most potent activity against P. aeruginosa (both mucoid and nonmucoid strains). All drugs except ampicillin (ABPC) were active against K. pneumoniae. A quite few of K. pneumoniae showed low susceptibilities. Also, we investigated year to year changes in the characteristics of patients, their respiratory infectious diseases, and the etiology. The examination of age distribution indicated that the proportion of patients with ages over 70 years was 48.6% of all the patients showing a slight increase in every year. About the proportion of diagnosed diseases as follows: Bacterial pneumonia was the most frequent with 40.2%. The ratio of it has increased slightly, and the increased rate was 10% in patients with ages over 70 years compared with the results in 1997. Chronic bronchitis have decreased slightly with 27.6% in 1998. Number of strains isolated from patients before administration of antibiotics were more than those after administration of them in chronic bronchitis, but these were almost same number in bacterial pneumonia. Administration of antibiotics has changed the results of the frequency of isolation of bacterial species. Bacterial isolations before administration of antibiotics were as follows: S. pneumoniae 26.7%, H. influenzae 23.8%, S. aureus 13.3% and M. (B.) catarrhalis 10.8%. The frequencies of S. aureus decreased after antibiotics administration over 15 days, but the frequencies of P. aeruginosa (both mucoid and non-mucoid) was not affected. The frequencies of P. aeruginosa was 45.5% after administration over 15 days. The frequencies of S. pneumoniae decreased upon administration of antibiotics, these were only 4.5% over 15 days. The frequencies of H. (

Anti-Bacterial Agents↗
PubMed2000

Potentiation of penile tumescence by T-1032, a new potent and specific phosphodiesterase type V inhibitor, in dogs.

We examined the mechanism underlying the potentiation of penile tumescence by methyl 2-(4-aminophenyl)-1, 2dihydro-1-oxo-7-(2-pyridinylmethoxy)-4-(3,4, 5-trimethoxyphenyl)3-isoquinoline carboxylate sulfate (T-1032), a new potent and selective phosphodiesterase type V inhibitor. In vivo, pelvic nerve stimulation induced a penile tumescence together with increase of total nitric oxide metabolite levels within the corpus cavernosa of anesthetized dogs. Intravenous (1-100 microg/kg) and intraduodenal (3, 30, 300 microg/kg) treatment with T-1032 dose dependently potentiated the tumescence. The potency of T-1032 was equivalent to that of sildenafil. T-1032 did not influence the intracavernous pressure when the pelvic nerve stimulation was absent. The potentiation of tumescence was more pronounced by intracavernous than i.v. injection. Intracavernous N(G)-nitro-L-arginine, a nitric-oxide synthase inhibitor, but not N(G)-nitro-D-arginine diminished the effects of T-1032 on the tumescence. Furthermore, i.v. T-1032 augmented the tumescence induced by sodium nitroprusside (SNP) but not by vasoactive intestinal polypeptide (VIP). In vitro, in isolated preparations of canine corpus cavernosum precontracted with phenylephrine, SNP (0. 01-100 microM) and VIP (0.01-1 microM) produced a dose-dependent relaxation accompanied by an increase in cGMP and cAMP levels, respectively. T-1032 augmented the relaxation induced by SNP but not by VIP. These data suggest that oral treatment with T-1032 has potential to improve erectile dysfunction through the inhibition of phosphodiesterase type V in the smooth muscles of corpus cavernosa.

Animals↗
PubMed2000

[Primary transitional cell carcinoma of prostate: a case report].

A 67-year-old male was admitted with a three-month history of voiding difficulty. Prostate specific antigen remained within the normal limit. Under the diagnosis of benign prostatic hypertrophy, transurethral resection of prostate was performed. Pathological examination of the resected specimens of the prostate revealed transitional cell carcinoma. Two courses of systemic M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) chemotherapy were performed, followed by cystoprostatourethrectomy, pelvic lymphadenectomy, and ileal conduit construction. Now one year has elapsed, with no clinical signs of recurrence.

Aged↗
PubMed2000

Hemodialysis-related subacromial lesion: diagnostic imaging and minimally invasive treatment.

BACKGROUND: In an attempt to refine the diagnosis and surgical treatment system for spontaneous shoulder pain in supine position (SPSP) in long-term hemodialysis (LTHD) patients we reviewed shoulders of patients during a 4-year period. PATIENTS AND METHODS: Clinical findings, imaging findings and operative results (average duration of follow-up was 39 months) on both shoulders of 110 patients (Shigei Hospital, Okayama, Japan) were analyzed to identify the cause of SPSP in order to accurately differentiate it from other shoulder pains, and to select the proper treatment method. RESULTS: As the hemodialysis period lengthened, increase in the incidence and severity of bone and soft tissue changes (radiolucency, joint destruction, increase of thickness of subacromial bursa and rotator cuff, and synovial proliferation) in the shoulder induced by dialysis-related amyloidosis were noted in roentgenography, ultrasonography and magnetic resonance imaging. SPSP occurred in the LTHD patients. An increase in subacromial bursa and rotator cuff thickness correlated with SPSP. A decrease in subacromial space correlated with change in position and SPSP. An increase of subacromial pressure was judged to be the cause of SPSP, and subacromial decompression by coraco-acromial ligament release was effective for relieving SPSP. When massive synovial proliferation or invasion of granulation tissues was observed in the glenohumeral joint, arthroscopic debridement was necessary. CONCLUSION: SPSP is a sensitive indicator of a distinct subacromial lesion frequently found in LTHD patients. These lesions can be treated by minimally invasive endoscopic coraco-acromial ligament release, resulting in marked pain relief.

Arthroscopy↗
PubMed2000

[Endoscopic extirpation for benign breast tumor].

Endoscopic extirpation using a fine endoscope and related devices via the extramammary approach (mainly the transaxillary approach) has been applied for benign breast tumors since 1997 in the Second Department of Surgery, Kyushu University. The operative procedures, morbidity, and mortality are presented here. We have treated 37 patients with a mean age of 27.6 years, whose tumors had been diagnosed as benign; average tumor diameter was 3.6 cm. Seven patients had multiple tumors, including 4 with bilateral lesions. The transaxillary approach was chosen in 35 patients and the inframammary approach, which was a procedure in the early phase, was chosen in the remaining 2 patients. Patients with benign tumors can thus avoid direct incision on the breast by endoscopic extirpation via the extramammary approach. We recommend this procedure as a new option instead of direct excisional biopsy for benign breast tumors.

Adult↗
PubMed2000

Is it permissible to omit mediastinal dissection for peripheral non-small-cell lung cancers with tumor diameters less than 1.5 cm?

BACKGROUND: Recently the pros and cons of limited surgery for small-sized peripheral non-small-cell lung cancers (PNSCLCs), such as omission of mediastinal dissection, etc., have been vigorously debated. We analyzed whether hilar/mediastinal lymph node metastases were present in 30 small-sized PNSCLCs. MATERIAL AND METHODS: In the nine years from 1990 to 1998, 294 lung cancer patients underwent lobectomy or pneumonectomy combined with hilar/mediastinal dissection in the Tokai University Hospital. Thirty of these patients diagnosed as having cT1N0M0 PNSCLC with tumor diameters of 1.5 cm or less by computed tomography, are evaluated in this article. RESULTS: The 30 PNSCLC patients consisted of 14 males and 16 females with a mean age of 61 +/- 9 years. Twenty six patients (87%) had no hilar nor mediastinal lymph node metastases (pN0), one patient (3%) had a hilar lymph node metastasis (pN1), and three patients (10%) had mediastinal lymph node metastases (pN2). CONCLUSIONS: Mediastinal lymph node metastases were histologically observed in 3 (10%) of 30 PNSCLC patients with tumor diameters of 1.5 cm or less. Our results show that mediastinal dissection is still necessary even for small-sized lung cancers.

Carcinoma, Non-Small-Cell Lung↗
PubMed2000

Endoscopic mucosal resection. Current concepts.

Recent advances in endoscopic mucosal resection of superficial early digestive tract cancers are truly remarkable. The extraordinary long-term outcomes of patients who have been treated with endoscopic mucosal resection have encouraged the widespread practice of endoscopic mucosal resection in Japan. These minimally invasive techniques allow safe and effective treatment of diseases that would otherwise require major surgery. This article provides an overview of endoscopic mucosal resection techniques, their associated outcomes, and other potential applications of endoscopic mucosal resection.

Colonic Neoplasms↗
PubMed2000

[A successful case of post operative management using nitrogen gas inhalation for a one-month old infant with high pulmonary blood flow].

We report a successful case of post operative management by inhaling nitrogen gas for a one-month old infant with high pulmonary blood flow after Blalock-Taussig shunt and plasty of the pulmonary artery. The operation was performed under extracorporial circulation. Nitrogen gas inhalation was dramatically effective for this infant to stabilize his post operative hemodynamic state. This therapy appears to be a very useful and easy handling technique in postoperative management for a patient with high pulmonary blood flow.

Abnormalities, Multiple↗
PubMed2000

[Hepatic arterial infusion chemotherapy for liver metastasis from esophageal squamous cell carcinoma].

Since 1993, we have treated 9 patients with liver metastases from esophageal squamous cell carcinoma using hepatic arterial infusion chemotherapy (HAI). These patients underwent esophagectomy and reconstruction with a stomach roll, and without preoperative chemotherapy and/or radiotherapy, HAI was effective in 5 patients (56%) with a CR in 2 patients. Preceding systemic chemotherapy was done with 7 patients, and was effective in 3 of them. HAI was also effective in all of them. In 3 patients with hepatic arterial anomalies, the right gastroepiploic artery and right gastric artery feeding the stomach roll could be preserved after changing the hepatic arterial flow. Two stomach roll ulcers and one hepatic arterial stenosis were experienced due to the toxicity of HAI. However, the nausea, vomiting, diarrhea, and/or myelosuppression seen with the preceding systemic chemotherapy were not experienced. In spite of the technical difficulties in catheterization and toxicities to stomach roll, HAI is considered to be more effective and feasible than systemic chemotherapy.

Aged↗
PubMed2000

Gamma knife surgery for epilepsy related to hypothalamic hamartomas.

OBJECTIVE: Drug-resistant epilepsy associated with hypothalamic hamartomas (HHs) can be cured by microsurgical resection of the lesions. Morbidity and mortality rates for microsurgery in this area are significant. Gamma knife surgery (GKS) is less invasive and seems to be well adapted for this indication. METHODS: To evaluate the safety and efficacy of GKS to treat this uncommon pathological condition, we organized a multicenter retrospective study. Ten patients were treated in seven different centers. The follow-up periods were more than 12 months for eight patients, with a median follow-up period of 28 months (mean, 35 mo; range, 12-71 mo). All patients had severe drug-resistant epilepsy, including frequent gelastic and generalized tonic or tonicoclonic attacks. The median age was 13.5 years (range, 1-32 yr; mean, 14 yr) at the time of GKS. Three patients experienced precocious puberty. All patients had sessile HHs. The median marginal dose was 15.25 Gy (range, 12-20 Gy). Two patients were treated two times (at 19 and 49 mo) because of insufficient efficacy. RESULTS: All patients exhibited improvement. Four patients were seizure-free, one experienced rare nocturnal seizures, one experienced some rare partial seizures but no more generalized attacks, and two exhibited only improvement, with reductions in the frequency of seizures but persistence of some rare generalized seizures. Two patients, now seizure-free, were considered to exhibit insufficient improvement after the first GKS procedure and were treated a second time. A clear correlation between efficacy and dose was observed in this series. The marginal dose was more than 17 Gy for all patients in the successful group and less than 13 Gy for all patients in the "improved" group. No side effects were reported, except for poikilothermia in one patient. Behavior was clearly improved for two patients (with only slight improvements in their epilepsy). Complete coverage of the HHs did not seem to be mandatory, because the dosimetry spared a significant part of the lesions for two patients in the successful group. CONCLUSION: We report the first series demonstrating that GKS can be a safe and effective treatment for epilepsy related to HHs. We advocate marginal doses greater than or equal to 17 Gy and partial dose-planning when necessary, for avoidance of critical surrounding structures.

Adolescent↗
PubMed2000

Hand-assisted laparoscopic surgery for the abdominal phase in endoscopic esophagectomy for esophageal cancer: an alteration on the site of minilaparotomy.

The authors present an alteration at the site of a minilaparotomy in the abdominal phase of endoscopic esophagectomy and reconstruction by means of hand-assisted laparoscopic surgery. In the first case, a minilaparotomy was performed in the lower right side of the abdomen during laparoscopic construction of a gastric tube using hand-assisted laparoscopic surgery. However, this technique was not always feasible because an elaborate technique was necessary, even with the use of the surgeon's hand, which was inserted in the abdomen through the mini-incision. After the second case, the authors performed a minilaparotomy slightly above the stomach. The upper abdominal incision allowed easier and safer management of the gastric tube. This technique was also helpful in the Kocher maneuver and in the construction of the retrosternal route. The site of the minilaparotomy in the upper abdomen reduced the stress of this procedure, and, therefore, became the standard procedure for select patients at the First Department of Surgery, Tokyo Medical and Dental University.

Biopsy↗
PubMed2000

[A case of latex allergy with bronchial asthma].

A 26-year-old nurse consulted our department because of shortness of breath, wheezing and skin eruption after eating lunch several days before. At the consultation, the symptoms had disappeared, pulmonary function showed no abnormality, and there were no abnormal findings on chest auscultation. Latex allergy was suspected because of a history of wheezing and skin eruption after wearing latex gloves and an elevated serum IgE level specific to latex antigen. After a usage test of medical latex gloves, wheezing, skin eruption, and a decrease of FEV1.0 on pulmonary function testing were observed. The case was therefore diagnosed as latex allergy with bronchial asthma. Her symptoms were not observed after polymer coated gloves were substituted. Latex allergy is apt to complicate food allergy, an initial symptom of the present case. Specific IgE for several kinds of food was also elevated.

Adult↗