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Biomedical subjects

H Kishimoto

Publications and source records attributed to H Kishimoto.

At least 127 records · Page 7Linked to original sources
PubMed1995

Extent of aortopulmonary collateral blood flow as a risk factor for Fontan operations.

Between November 1987 and January 1990, 33 patients (tricuspid atresia, 9 patients; mitral atresia, 3; single ventricle, 15; others, 6) underwent Fontan operations. The rate of blood flow returning to the heart during aortic cross-clamping was measured as an indication of the extent of development of aortopulmonary collateral arteries. Percent cardiac return (calculated by dividing the blood flow rate returning to the heart by the cardiopulmonary bypass blood flow rate and expressing the value as a percentage), were 1% to 9%, 7 patients; 10% to 19%, 11; 20% to 29%, 9; 30% to 39%, 4; 40% to 49%, 1; and 50% to 59%, 1 patient. Percent cardiac return showed a significant correlation with postoperative mean systemic venous pressure (r = 0.6, p < 0.01). In those patients in whom percent cardiac return was more than 33%, the mean systemic venous pressure after operation was high (more than 17 mm Hg), and none of these patients survived. To predict percent cardiac return preoperatively, the conventional indices of systemic ventricular volume, pulmonary artery area index, arterial blood oxygen saturation, pulmonary blood flow index, and pulmonary vascular resistance were analyzed. None of these showed significant correlation with percent cardiac return. However, all the patients who had a high percent cardiac return (more than 30%) also had both high arterial blood oxygen saturation (more than 75% in room air) and small pulmonary artery area index (less than 55%). In addition, the age at operation showed good correlation (r = 0.6, p < 0.01) to percent cardiac return.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Leukemic erythroderma with elevated plasma IL-3 and hyperhistaminemia: in situ expression of IL-3 mRNA in leukemic cells.

We report a case of chronic myelogenous leukemia (CML) with pruritic erythroderma. Hyperhistaminemia, elevated level of plasma interleukin-3 (IL-3), and moderate basophilia were noted in this case. His skin manifestation was resistant to topical corticosteroid therapy and exacerbated in parallel with leukocyte count, plasma histamine and IL-3 levels. To identify localization and production of IL-3 in our case, we performed in situ hybridization on peripheral blood cells and skin biopsy specimen, and detected IL-3 mRNA in myelogenic cells in both specimens.

Dermatitis, Exfoliative↗
PubMed1995

Spontaneous aortic thrombosis in a neonate with multiple thrombi in the main branches of the abdominal aorta.

Spontaneous aortic thrombosis in the neonate is a rare entity with a high mortality rate. The present patient, who was diagnosed after showing haematuria and cyanosis, underwent aortic thrombectomy with a Fogarty catheter through a left thoracotomy, but died of sepsis, disseminated intravascular coagulation and multiple organ failure. Autopsy revealed multiple residual thrombi in the main branches of the abdominal aorta and necrosis of the abdominal organs despite a patent thoracoabdominal aorta. In patients with no blood flow in the main branches of the abdominal aorta on preoperative examination, removal of thrombi, including those in the main branches of the abdominal aorta, might be performed in a single, early and aggressive procedure.

Aorta, Abdominal↗
PubMed1995

Biventricular repair in cardiac isomerism. Report of seventeen cases.

Ninety-three patients with cardiac isomerism were treated surgically from July 1985 to June 1991. Among them, three patients with right and 14 with left isomerism underwent biventricular repair. Ages ranged from 4 months to 41 years (mean 4.8 years). Anatomic repair was accomplished in 15 patients and functional repair with the right ventricle used as the systemic ventricle in two patients. Methods of atrial septation to separate pulmonary venous flow from systemic venous flow included atrial partition with a straight patch in seven patients, intraatrial rerouting with a tailored baffle in five, and a Mustard-type atrial switch in five. One hospital death (5.8%) and two late deaths (12%) occurred. Two patients required reoperation (12%), one reconstruction of a stenotic systemic venous connection and one mitral valve replacement because of incompetence. Surgically induced complete atrioventricular block was not observed in any of the patients. Optimal atrial septation offers the possibility of biventricular repair for patients with acceptable intraventricular structure.

Abnormalities, Multiple↗
PubMed1995

Anesthetic management of a 656-g neonate undergoing pulmonary valvotomy.

We describe the successful management of a 656-g preterm infant of 29 weeks' postconceptional age undergoing closed transventricular pulmonary valvotomy. The patient had a critical pulmonary stenosis and was treated with an infusion of prostaglandin E1, which resulted in excessive pulmonary blood flow through the ductus arteriosus. The key points in anaesthetic management were maintaining an optimum balance between the systemic and pulmonary circulation and preparing for the abrupt haemodynamic change caused by valvotomy.

Anesthesia↗
PubMed1995

[Combined effect of bleomycin and SDB-ethylenediamine, a synthetic isoprenoid, on oral squamous carcinoma cell lines and transplantable nude mouse tumors].

Combined effect of bleomycin (BLM) and N-solanyl-N, N'-bis (3, 4-di-methoxy-benzyl)-ethylenediamine (SDB-ethylenediamine), a synthetic isoprenoid was studied on 3 oral squamous carcinoma cell lines (SCCTF, SCCKN, SCCRY) and clonal cell lines from SCCRY in vitro and on transplantable nude mouse tumors. The cytotoxicity of SDB-ethylenediamine varied among those cell lines in vitro. SDB-ethylenediamine potentiated more than 2-fold the cytotoxic effect of BLM in 6 cell lines, but no distinct correlation was found between cytotoxicity of SDB-ethylenediamine and potentiation by BLM. Compared with verapamil, the cytotoxic effect of BLM was potentiated 3.9-fold by SDB-ethylenediamine in SCCTF. The growth of the transplantable nude mouse tumors (SCCRY and SCCTF) was strongly suppressed when BLM was combined with SDB-ethylenediamine. Correlation between BLM resistance and potentiation of BLM by SDB-ethylenediamine was not observed in this experiment.

Animals↗
PubMed1995

Implication of parathyroid hormone for the development of hypertension in young spontaneously hypertensive rats.

The purpose of this study is to elucidate the role of parathyroid hormone (PTH) in the development of hypertension in young spontaneously hypertensive rats (SHR). Parathyroidectomy (PTX) or sham surgery was performed on 6-week-old male SHR, and 3 weeks later human PTH (hPTH) or saline was infused subcutaneously over 2 weeks using a minipump. PTX significantly attenuated the development of hypertension and reduced serum vitamin-D concentrations. PTX also augmented the depressor response to acetylcholine before N-nitro-L-arginine (L-NNA), although it remained unchanged after L-NNA. The cardiovascular reactivity to exogenous noradrenaline and angiotensin II was not affected by PTX. The chronic administration of hPTH reversed these effects. We conclude that PTH plays an important role in the development of hypertension, through modulating the release of endothelium-derived relaxing factor, in young SHR.

Acetylcholine↗
PubMed1995

[Detectability of hypervascular small hepatocellular carcinoma by dynamic spiral CT].

Thirty-one cases of small hepatocellular carcinoma (HCC) under 3 cm in diameter underwent Spiral CT with bolus injection of contrast medium (Dynamic Spiral CT). Dynamic Spiral CT was compared with CT after intra-arterial injection of iodized oil (Lipiodol-CT). The detectability of 79 nodules of small HCC on early phase images of Dynamic Spiral CT was 49.4% (32.6% for those under 1 cm in diameter, 58.3% for 1-2 cm, 91.7% for 2-3 cm). The detectability of small HCCs above the hilum of the liver was better than that below the hilum. Five lesions were detected only on delayed CT images, but not on early phase CT images. Dynamic Spiral CT is useful for detecting hypervascular small HCCs, and both early phase and delayed CT images must be obtained.

Adult↗
PubMed1995

Endoscopic aspiration lumpectomy of esophageal leiomyomas derived from the muscularis mucosae.

OBJECTIVES: There is still much debate about the indications and best technique for endoscopy for the treatment of esophageal leiomyomas. We developed a novel technique for endoscopic aspiration lumpectomy and used it in patients with esophageal leiomyomas derived from the muscularis mucosae. METHODS: Nine patients with esophageal leiomyomas were treated with informed consent. The indication for intervention was based on the endosonographic confirmation of a tumor originating from the 2nd layer of the esophagus. We attached a transparent cylinder to the tip of an endoscope and a snare-guide tube to the outer axis of the scope. After endoscopic suction of the tumor into the cylinder, the snare was pushed open. The tumor was grabbed at its base with the entire surrounding mucosa, and removed. RESULTS: The overall procedure time averaged 18 minutes, and there were no complications in any of the subjects. The resected specimens were elliptical with a mean long diameter of 22 +/- 4 mm and a mean short diameter of 17 +/- 4 mm. Complete resection was possible in eight of the nine tumors that were under 2 cm in diameter. After a follow-up period of 4 to 27 months (mean 11 months), no recurrence was found in any of the completely resected cases. CONCLUSIONS: Endoscopic aspiration lumpectomy has been proven to be a safe, effective, and less invasive procedure for small esophageal leiomyomas derived from the muscularis mucosae.

Esophageal Neoplasms↗
PubMed1995

[Dynamic change of serum UFT concentration in a patient with tongue cancer complicating chronic renal failure].

To evaluate the effect of UFT as a postoperative adjuvant chemotherapeutic agent for a patient with tongue cancer complicating chronic renal failure, we measured a dynamic change of serum tegafur (FT), 5-FU and uracil concentrations in hemodialysis. When the patient administered 200 mg of UFT orally one hr before hemodialysis, serum 5 FU concentration was 0.051 micrograms/ml at the beginning of hemodialysis, then rapidly increased to 0.396 micrograms/ml at maximum one hr later and thereafter decreased to the initial level after 4 hrs, the end of hemodialysis. Even after hemodialysis, however, 5-FU maintained the effective serum concentration. On the other hand, serum FT and uracil levels showed a slight change during hemodialysis. The maximum concentrations of FT and uracil were 3.154 micrograms/ml and 0.540 micrograms/ml respectively, after 3 hrs of dialysis. We next measured serum levels of 5-FU, FT and uracil during two days without hemodialysis treatment. Although their serum levels were increased after UFT administration, those were decreased to the initial level on the next day, indicating no drug accumulation. These results suggest that UFT was safe and useful as a postoperative adjuvant chemotherapeutic agent in a cancer patient being performed hemodialysis.

Administration, Oral↗
PubMed1994

Determination of a new immunosuppressant, mycophenolate mofetil, and its active metabolite, mycophenolic acid, in rat and human body fluids by high-performance liquid chromatography.

Mycophenolate mofetil, a new immunosuppressant, is a morpholinoethyl ester of mycophenolic acid. A new selective, sensitive and simple high-performance liquid chromatographic method was developed for the determination of mycophenolic acid and mycophenolate mofetil in biological samples. The preparation of samples was based on liquid-liquid extraction. The compounds were separated on a CN column using acetonitrile-0.01 M phosphate buffer (1:4, v/v) as the mobile phase. UV detection was used at wavelengths 215 and 304 nm. The detection limit was 5 ng per injection volume. This method enabled pharmacokinetic and pharmacodynamic studies in humans and rats.

Animals↗
PubMed1994

Effective cases of transcatheter arterioportal chemoembolization with high-dose iodized oil for hepatocellular carcinoma.

By administering an excessive amount of iodized oil via the hepatic artery, anticancer drugs in the iodized oil flow into the portal vein through the arterioportal communication. This phenomenon permits chemotherapy against extracapsular infiltration by a hepatocellular carcinoma (HCC) nourished by the portal blood flow. From May 1983 through July 1992, 240 cases of HCC underwent transcatheter arterioportal chemoembolization (TAPCE) with more than 5 ml of iodized oil (mean, 15 ml) in our hospital. In all, 32 patients survived for more than 3 years, and the factors favoring the efficacy of TAPCE therapy were investigated. Doxorubicin (mean, 46 mg) was given to 31 patients and 20 mg mitomycin C was given to 1 patient. The patients included one Stage 1 case, 13 Stage 2 cases, 17 Stage 3 cases, and one Stage 4 case. The mean tumor size was 5.0 cm, and portal invasion was suggested in 8 cases by angiography. The tumors were divided into 5 types: 13 cases of the single nodular type (SN), 7 cases of the single nodular type with proliferation (SN-P), 3 cases of the multinodular fused type (MN-F), 5 cases of the multinodular type (MN), and 4 cases of the massive type. A complication of liver dysfunction was detected in 14 cases, and half of them were Child's class C. In all, 7 patients underwent hepatectomy and 6 received percutaneous ethanol injection after TAPCE. The treated area of TAPCE was classified as segmental, lobar, or total. Segmental and lobar administration of TAPCE yielded statistically effective results, and their tumor response rate was 86%. All of the MN-F and massive types showed a good tumor response. The incidence of intrahepatic distant metastasis was higher in the localized TAPCE group than in the total TAPCE group. Segmental and lobar TAPCE should be applied for localized infiltrating HCCs, even in cases associated with liver cirrhosis, but these methods have a limited capacity to prevent distant intrahepatic metastasis.

Adult↗
PubMed1994

Open heart operation in a young child with spherocytosis.

Open heart operations on patients with hereditary spherocytosis have been reported rarely. Young children who have not yet undergone splenectomy have a high risk of intraoperative hemolysis because of the heart-lung machine and secondary renal failure. We report the case of a 15-month-old child with spherocytosis who underwent an open heart operation without serious complications as a result of careful and appropriate perioperative management.

Ductus Arteriosus, Patent↗
PubMed1994

Induction of bleomycin resistance in a human oral squamous carcinoma cell line and characterisation of bleomycin-resistant and -sensitive clones.

We examined the change of sensitivity to antitumour agents by repeated treatment with bleomycin (BLM) using two oral squamous carcinoma cell lines, SCCTF and SCCKN. SCCTF exhibited minimal sensitivity to BLM and strong heterogeneity in BLM sensitivity, whereas SCCKN was highly sensitive to BLM and showed weak heterogeneity. When SCCTF was treated continuously with low-dose BLM (0.1 microgram/ml) but not intermittently with high-dose BLM (1 microgram/ml), the BLM sensitivity was rapidly decreased to acquire drug resistance. On the other hand, SCCKN was completely killed by the same treatments. To investigate the mechanism of induction of resistance in SCCTF, BLM-sensitive and -resistant clones, TF-S and TF-R, were isolated and analysed. Consequently, TF-R showed decreased cellular accumulation and retention of BLM, increased BLM hydrolase activity and elevated DNA repair activity concomitant with increased poly(ADP-ribose) polymerase activity as compared with TF-S. Therefore, it was suggested that antitumour drug-resistant clones were selectively grown from heterogeneous tumour cell population.

Antineoplastic Agents↗
PubMed1994

A novel form of self tolerance dictated in the thymus of transgenic mice with autoreactive TCR alpha and beta chain genes.

Transgenic (TG) mice with TCR alpha and beta chain genes from a CD4-dependent auto-I-Ak reactive T cell clone were generated. H-2k TG mice had a large number of thymic and splenic CD4 T cells expressing the autoreactive TCR without manifestation of autoimmunity. The cells were not anergic, as they could respond to autologous antigen presenting cells and anti-TCR antibodies in vitro to proliferate and to produce interleukins. Various degrees of down-regulation of CD2 and CD44 was observed in TG mice, indicating the presence of a defective co-stimulatory process in TG T cells. These features indicate that the self tolerance in autoreactive TCR TG mice is due not to clonal deletion and anergy but to a novel mechanism where T cells cannot sufficiently respond to normally existing self ligand in vivo. That such an in vivo unresponsiveness of autoreactive T cells is dictated in the thymus during CD4 T cell differentiation atypical form of positive selection of autoreactive T cells was suggested by the abnormal surface expression of CD69 and HSA.

Animals↗
PubMed1994

Extraserosal invasion in advanced gastric cancer: evaluation with MR imaging.

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging in the diagnosis of extraserosal invasion in advanced gastric cancer. MATERIALS AND METHODS: MR imaging was performed in 48 patients with advanced gastric cancer, and the results were correlated with the histopathologic findings. Images perpendicular to the gastric wall with cancer were obtained with spoiled gradient-recalled acquisition in the steady state (GRASS). The degree of serosal invasion was classified on the basis of the appearance of a low-signal-intensity band around the lesion. RESULTS: Advanced gastric cancer appeared as a thickened wall of high signal intensity after the administration of contrast material. A low-signal-intensity band disappeared or showed irregularity in the area of extraserosal invasion by the gastric cancer. The MR imaging-determined grade correlated with the histopathologic findings for 11 of 14 (79%) pT2 tumors, 23 of 24 (96%) pT3 tumors, and eight of 10 (80%) pT4 tumors. The overall accuracy was 88%. CONCLUSION: Presence of a low-signal-intensity band at MR imaging is useful for the preoperative evaluation of serosal invasion.

Adult↗