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Biomedical subjects

H Kuroda

Publications and source records attributed to H Kuroda.

At least 199 records · Page 11Linked to original sources
PubMed1993

[A case of infective endocarditis with subaortic-valve aneurysm].

We report a 64-year-old female patient with a subaortic-valve aneurysm due to infective endocarditis, in whom the aneurysm and its perforation was detected by Doppler color flow imaging. She had severe aortic and mitral valve regurgitation, and underwent aortic valve replacement with plication of the aneurysm. Transthoracic echocardiography doesn't have enough usefulness to clarify periaortic-annular changes, but combination with Doppler color flow imaging is supposed to be informative for subaortic-valve changes same as transesophageal echocardiography especially in the cases with abnormal flow.

Aortic Aneurysm↗
PubMed1993

[Efficacy of 48-hour infusion of 5-fluorouracil for gall bladder cancer].

Usefulness of an adjuvant chemotherapy for 23 patients who had undergone "non-curative" resection for adenocarcinomas of the gallbladder was investigated. Patients were divided into two groups: Group A (16 patients) was given MF (mitomycin C 6 mg/m2, 5-fluorouracil 250 mg/body) by injection on the 2nd and 9th postoperative day and received orally Tegafur 600 mg/day and PSK 3 g/day. Group B(7 patients) was treated weekly with a 48-hour infusion of 5-FU (1,000 mg/m2/24 hours), for 6 weeks and leucovorin (30 mg/body) was given for 2 hours prior to 5-FU infusion. The results were evaluated by the Kaplan-Meier method. Response rate of anti-tumor was 0% in Group A and 14.3% in Group B, including: PR, 1 and NC, 6 cases. The 50% survival time was 230 days in group A and 471 days in group B (p = 0.0008). The results suggest that treatment with 5-FU and LV is effective for gallbladder cancer.

Adenocarcinoma↗
PubMed1993

[A case of surgical treatment of patent ductus arteriosus using left heart bypass in an adult].

This paper describes a new operative method for patent ductus arteriosus using left heart bypass. A 57-year-old woman with patent ductus arteriosus associated with severe pulmonary hypertension was successfully operated upon. Because of aneurysmal dilatation and calcification of the aortic side of the ductus, PDA was divided under left heart bypass with centrifugal pump. Postoperative course was uneventful, and is now well.

Ductus Arteriosus, Patent↗
PubMed1993

[A case of verrucous carcinoma of the penis with detection of human papillomavirus using the in situ hybridization method].

A case of penile verrucous carcinoma is reported. The patient had a previous history of condyloma acuminatum of the penis. No signs of squamous cell carcinomas were observed in the histopathological findings. We also detected the histologic evidence of human papilloma virus (HPV) infection in the result of the study by in situ hybridization. The local positive reaction of HPV infection for type 6/11 was seen, and was related to the koliocytosis. However other types of HPV (16/18, 31/33, 51) were negative.

Adult↗
PubMed1993

[Propranolol for prophylaxis of first hemorrhage in cirrhotic patients with esophageal varices--a controlled study comparing with sclerotherapy].

To compare the efficacy of oral propranolol and sclerotherapy in the prevention of first hemorrhage from esophageal varices, 65 cirrhotic patients with moderate to large esophageal varices and no history of bleeding were included in the prospective controlled trial. After randomization, 33 patients received propranolol at a does reducing the heart rate by 25%; 32 patients were treated with intra-variceal and extra-variceal injection of ethanolamine oleate. On entry to the trial, the two groups were comparable in terms of clinical and biological parameters. The patients were observed for up to 60 months, with an average of 31 months. Nine patients bled (5 in propranolol and 4 in sclerotherapy) during follow-up. No significant difference were observed between propranolol and sclerotherapy in the cumulative bleeding rate and survival. The multivariate Cox model indicated that drug compliance in the propranolol group and high portal pressure in the sclerotherapy group were factors predictive of the first hemorrhage. These data support that propranolol and sclerotherapy are of comparable value in preventing the first hemorrhage in cirrhotic patients with esophageal varices.

Aged↗
PubMed1993

[A case of left atrial plication for mitral valvular disease with giant left atrium].

A case of plication of giant left atrium complicating mitral valvular disease is reported. The patient was a 44-year-old female with mitral stenosis and regurgitation, whose respiratory function was severely disturbed. Chest X-ray showed severe stenosis of the left main bronchus and widening of the tracheal bifurcation secondary to compression by the left atrium. Mitral valve replacement and left atrial plication was performed. Postoperative respiratory weaning was uneventful and respiratory function was improved. We concluded that plication is very beneficial in patients with giant left atrium who have signs of compression of the bronchus and lungs.

Adult↗
PubMed1993

[A case report of graft-versus-host disease caused by using stored blood after aortic valve replacement].

A 61-year-old man underwent aortic valve replacement and received transfusion of 8 units of stored blood. Erythema appeared on the entire body the 12th day after operation, and was followed by high fever, elevation of liver enzymes, progressive pancytopenia, aplastic bone marrow and diarrhea. He died due to septic shock on the 19th postoperative day. Skin biopsy showed the typical features observed in graft-versus-host disease (GVHD). Based on the clinical course, skin and bone marrow biopsy, we diagnosed as post-transfusion GVHD. Therefore, even when stored blood or stored red blood cells are used, these should be irradiated and transfused through the leukocyte removal filter.

Aortic Valve↗
PubMed1993

[Surgical treatment of patent ductus arteriosus in the adult].

Ten patients over the age of 30 were operated on for isolated patent ductus arteriosus (PDA). Division was performed in 9 patients and ligation in only one. In two cases, the aorta had to be cross-clamped above and below the level of the ductus under normothermia because of massive bleeding. In another two patients with aneurysmal dilatation and calcification of the aortic side of the ductus, PDA was closed by aortic cross-clamping under LA-to-femoral-artery bypass with a centrifugal pump. Postoperatively, all patients are well and in NYHA class I. Therefore, in the adult, if the conventional method of division between ductus clamps is considered dangerous due to increased friability and atheromatous changes of the ductus and surrounding tissues, the ductus should be closed during aortic cross-clamping under assist circulation. In such a case, LA bypass is considered quite useful and safe.

Adult↗
PubMed1993

[Surgical treatment of total left anomalous pulmonary venous connection to the coronary sinus without atrial septal defect].

Surgical repair of total left anomalous pulmonary venous connection to coronary sinus without atrial septal defect (ASD), a very rare situation, was recently conducted. A 13-year-old girl was diagnosed as ASD. Two-dimensional echocardiography, however, indicated enlarged coronary sinus preoperatively. During operation the absence of ASD and drainage of total left pulmonary veins into the coronary sinus were observed. The operation was conducted by the method of Van-Praagh. The coronary sinus was closed to divert pulmonary venous blood to the left atrium, while maintaining coronary venous return to the right atrium. The postoperative course was uneventful and cardiac catheterization showed satisfactory results.

Adolescent↗
PubMed1992

[Identification of a 3' splice site mutation in the thyroglobulin gene in a case of congenital familial goiter].

A case of congenital familial goiter with impaired thyroglobulin (Tg) synthesis has been reported. The patient is the fifth in a family of six children, three of whom have a goiter. The parents are cousins. The patient's thyroid function tests showed low T4 (1.0 microgram g/dl) and free T4 (0.2 ng/dl), normal or slightly increased T3 (1.8 ng/ml) and free T3 (7.4 pg/ml), and high TSH (57 micrograms U/ml). Serum Tg was 5.1 ng/ml (normal less than 30). The thyroidal 123I-uptake was 59.8% before and 54.5% after perchlorate test. Gel filtration with Bio-Gel A 5m demonstrated the presence of albumin-like protein probably iodinated as a major protein in the thyroid and very low content of Tg which was smaller than the normal 19S Tg. Histologically microfollicular adenoma and negative Tg immunostaining were the dominant findings. Segregation of Tg alleles in the family was studied by Southern blotting with a probe revealing a diallelic RFLP. The results demonstrated that the affected siblings had received the same alleles from both parents and were homozygous for the RFLP. Northern blotting analysis of the goiter RNA with a Tg probe revealed that, whereas the amount of Tg mRNA was normal, its size seemed slightly reduced. PCR amplification of Tg mRNA as six overlapping cDNA fragments demonstrated that a 200bp fragment was missing from the 5' region of the goiter mRNA. Subcloning and sequencing of the cDNA fragments, and of the patient's genomic DNA amplified from this region, revealed that this aberrant splicing is due to a cytosine to guanine transversion at position minus 3 in the acceptor splice site of intron 3. The presence in exon 4 of a putative donor tyrosine residue (tyr 130) involved in thyroid hormone formation provides a coherent explanation of the hypothyroid status of the patient. To our knowledge, this is the first identified mutation responsible for congenital familial goiter in humans.

Adult↗
PubMed1992

The effect of dopamine on rat gastric motility.

The inhibitory mechanism of dopamine (DA) on rat gastric motility was investigated in association with DA receptors. Gastric movement was assessed according to the method of Jacoby et al and was expressed with the system of Ludwick et al. (1968). DA inhibited gastric movement in both the corpus and antrum in a dose-dependent manner. Domperidone, a specific antagonist of DA2 receptor, suppressed DA-induced inhibition of gastric movement in a dose-dependent manner. SCH23390, a specific antagonist of DA1 receptor did not affect DA-induced inhibition of gastric movement. LY171555, a specific agonist of DA2 receptor, inhibited gastric movement in both the corpus and antrum in a dose-dependent manner. SKF38393, a specific agonist of DA1 receptor, did not affect gastric movement. These results indicate that DA plays an important role in the inhibitory regulation of gastric motility, through DA2 receptor but not DA1 receptor.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed1992

Possible involvement of Na(+)-H+ exchange in the early phase of reperfusion in myocardial stunning.

Calcium overload during reperfusion after prolonged ischemia has been associated with the Na(+)-Ca2+ exchange system. It has been proposed that the promotion of Na(+)-Ca2+ exchange at reperfusion may be mediated by Na(+)-H+ exchange. To evaluate whether this hypothesis is applicable for stunned myocardium, we examined the influence of temporary suppression of Na(+)-H+ and/or Na(+)-Ca2+ exchange during early reperfusion in isolated rat hearts. Myocardial stunning was produced by global ischemia for 15 min at 37 degrees C. The initial reperfusate was given during the subsequent 10 min after ischemia, and followed by reperfusion with normal Krebs-Henseleit buffer solution for 40 min. Hemodynamic indices, creatine kinase in coronary effluent, and myocardial water content were measured during reperfusion. The functional recovery of stunned myocardium was improved with higher extracellular Na+ concentration and/or lower Ca2+ concentration of the initial reperfusate. Aortic flow recovery of group II (135 mM Na(+)-0.5 mM Ca2+) was 77.0 +/- 3.4%, which was substantially greater (P < 0.05) than that of other groups: group I (control, 135 mM Na(+)-1.5 mM Ca2+), 68.2 +/- 2.4%; group III (25 mM Na(+)-0.5 mM Ca2+), 48.7 +/- 2.9%; group IV (25 mM Na(+)-1.5 mM Ca2+), 21.6 +/- 1.5%. Administration of amiloride, an inhibitor of Na(+)-H+ exchange, in the initial reperfusate ameliorates cardiac damage and improved aortic flow recovery in a dose-dependent manner (10(-6) M, 70.1 +/- 3.7%; 10(-5) M, 77.3 +/- 1.7%; 10(-4) M, 82.0 +/- 2.1% vs control 68.2 +/- 2.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Amiloride↗
PubMed1992

Sequence analysis of the 3'-terminal halves of RNA 1 of two strains of barley mild mosaic virus.

DNA complementary to the 3'-terminal halves of RNA 1 of two strains of barley mild mosaic virus (BaMMV) from Japan, BaMMV-Ka1 and BaMMV-Na1, was cloned and sequenced. The sequences start within a single long open reading frame (ORF), and are followed by 337 and 338 3' non-coding nucleotides, for BaMMV-Ka1 and BaMMV-Na1 respectively. The two strains have 88% nucleotide identity in the ORFs and 92% identity in the non-coding regions. The putative ORF products contain the capsid proteins at the C termini, as indicated by amino acid sequence analysis, and two putative non-structural proteins are arranged in the same manner as in RNA 1 of barley yellow mosaic virus (BaYMV). The deduced capsid proteins of BaMMV-Ka1 and BaMMV-Na1 each contain 251 amino acids and have 94% sequence identity, which is compatible with their close serological relationship. Most of the sequence differences between the two capsid proteins are found in the N-terminal region, and might explain their serological differences. Significant sequence similarities of the capsid proteins of the two BaMMV strains (37 and 35% respectively) with that of BaYMV, and their marginal similarities (21 to 26%) to the capsid proteins of aphid-borne or mite-borne potyviruses support the classification of BaMMV and BaYMV as distinct members of the same virus group, which is separate from the group(s) containing aphidborne or mite-borne potyviruses.

Amino Acid Sequence↗
PubMed1992

Unexpected racemization of proline or hydroxy-proline phenacyl ester during coupling reactions with Boc-amino acids.

When L-proline or O-benzyl-trans-4-hydroxy-L-proline phenacyl ester was coupled with Boc-amino acids in dimethylformamide using water-soluble carbodiimide (WSCI) in the presence of anhydrous 1-hydroxybenzotriazole (HOBt) as coupling reagents, extensive racemization was observed at the C alpha of the proline or hydroxy-proline residue. The extent of racemization was measured by HPLC after the coupling with Boc-L-Leu-OH in the presence or absence of HOBt. The extent of racemization increased when HOBt was added to the reaction mixture, but greatly decreased when it was not, indicating that HOBt was needed for inducing racemization. Almost no racemization was observed when the coupling reaction was carried out by the mixed anhydride procedure in tetrahydrofuran or by the carbodiimide method in dichloromethane without using HOBt. In the case of coupling reactions with ordinary L-amino acid phenacyl esters, no racemization was observed. Examination of some model systems yielded sufficient evidence to prove that HOBt is an efficient catalyst for racemizing proline or hydroxy-proline phenacyl ester not only in the stage of cyclic intermediate formation but also in the opening of the ring structure. Thus, the racemization reaction was found to be closely related to the formation of the cyclic carbinol-amine derivative.

Acetophenones↗
PubMed1992

[Retroperitoneal giant malignant fibrous histiocytoma: report of a case].

A case of histiocytoma in a 63-year-old woman with general fatigue is described. Ultrasonography and radiological examination revealed a large mass at the retroperitoneum displacing the right kidney to medial anterior abdomen. Exploration of the tumor with right kidney was done via a transperitoneal approach because the tumor had invaded the hilar fat tissue of the right kidney. The total resected weight was 3,200 g. Histological study showed malignant fibrous histiocytoma, storiform-pleomorphic type. Post-operative chemotherapy consisting of cyclophosphamide, vincristine, adriamycin, dimethyl triazeno-imidazole carboxamide (CYVADIC) was performed and the patient is doing well without any evidence of recurrence or metastasis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Mitral valve surgery for patients after undergoing percutaneous transvenous mitral commissurotomy (PTMC)--investigation on indication of PTMC based on the intraoperative findings].

Ten patients underwent open heart surgery for mitral valve after PTMC because of post PTMC MS (n = 4) and MR (n = 6) out of 150 patients undergoing PTMC in our hospital between June 1987 and October 1991. Intraoperative findings of 4 patients with residual mitral stenosis included severe thickening, stiffening and calcification on anterior and posterior leaflets, commissures and subvalvular apparatus. Mitral valve repair was possible in 2 and mitral valve replacement (MVR) was necessary in the other 2. In all 6 cases who massive mitral regurgitation after PTMC, in repairable tears in the mitral leaflets necessitated MVR. Since in these cases changes in the leaflets were less severe than those of the commissures or subvalvular apparatus, surgical repair could have been possible if open mitral commissurotomy (OMC) was done primarily. Patients selection for PTMC versus OMC based on precise morphological evaluation of mitral valve would reduce occurrence of massive MR resulting in surgical replacement.

Adult↗