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Biomedical subjects

H Makuuchi

Publications and source records attributed to H Makuuchi.

At least 163 records · Page 9Linked to original sources
PubMed1990

[The effect of a protein-bound polysaccharide (PSK) on lymphocyte subsets of peripheral venous blood and thoracic duct lymph].

To study the effects of a protein bound polysaccharide (PSK) on the immune system in normal animal, lymphocytes subsets of both peripheral (PBL) and thoracic duct lymphocytes (TDL) were analyzed in 6 week old male SPF Wistar-Imamichi rats before and after free feeding of forage which contained 2% of PSK. PBL and TDL were obtained at the time before, 4 weeks after and 8 weeks after administration of PSK. Age matched rats without administration of PSK were used as a control. Following the peripheral blood cell counts were carried out, lymphocytes subsets such as ratio of total T cells helper/inducer T (Th) cell, suppressor/cytotoxic T (Ts) cell and B cell were assayed using W3/13, W3/25, 0 X 8 and 0 X 4 monoclonal antibodies with laser flow cytometric technique (Orthospectrum III Orthodiagnostics). In terms of the PBL, number of total T cells and Th cells in PSK treated group were significantly lower than that of controls. However no statistical different could be obtained between these two groups in relation to the number of Ts cells and B cells. On the other hand, the number of T cells and Th cells in TDL of PSK treated groups were significantly higher than that of controls while Ts cell and B cell number did not show no apparent differences between these two groups. These findings indicate that oral administration of PSK have a potency to accelerate the transport of T cells from blood stream to lymphatic channel and also regulate their distribution in a normal healthy animals.

Animals↗
PubMed1990

Superficial esophageal carcinoma. With special reference to basaloid features.

A total of 200 surgically resected esophageal carcinomas were reviewed and 50 cases (25.0%) were identified as "superficial esophageal carcinoma" (depth of invasion limited to mucosa or submucosa). The age, sex, location, tumor size, histological features, and prognosis were studied in 49 of these cases. The carcinomas were classified into four histological groups: 1) squamous cell carcinoma (SCC), 2) squamous cell carcinoma with basaloid features and expansive growth (BE), 3) squamous cell carcinoma partially mixed with the basaloid type (mixed), and 4) other types of tumors. There were 25 cases (51.0%) of SCC, 14 BE cases (28.6%), 8 mixed cases (16.3%), and 2 (4.1%) other tumors (malignant melanoma, adenoacanthoma). Among 133 advanced cancers (invasion into and beyond the muscularis propria), there were 123 cases (92.4%) of SCC, 9 (6.8%) mixed cases, and one (0.8%) adenoacanthoma. No BE lesions were identified. In superficial carcinoma there was a statistically significant difference between BE and mixed carcinoma by the chi-square test (p less than 0.05) with regard to the maximum longitudinal diameter. None of the BE carcinoma showed nodal metastasis, while 3 (12.0%) of SCC and 5 (62.5%) of mixed lesions had nodal metastases. The difference in cumulative survival rate between BE and mixed carcinoma was statistically significant by the Z and Wilcoxon tests (p less than 0.05). We conclude that the BE type of superficial esophageal carcinoma had a better prognosis, and should be separated from the ordinary SCC with infiltrative growth from a clinicopathological view point.

Age Factors↗
PubMed1990

[Treatment of coronary artery disease with poor left ventricular function: comparison of medical and surgical treatments in relation to the numbers of the diseased vessel].

The operative mortality and short-term (average 20 months) survival of 100 surgically or medically treated patients, who had coronary artery disease with poor left ventricular function, were examined. One hundred patients with myocardial infarction and radionuclide-documented left ventricular dysfunction (LVEF at rest less than or equal to 40%) were subjects of this study; 85 patients among them underwent simultaneous coronary arteriography. Fifty-six patients whose average age was 59.7 years, and an average LVEF was 30.0%, were treated medically; 44 patients with an average age of 56.0 years, and an average LVEF of 30.9%, were treated surgically, 41 with bypass grafts, two with left ventricular surgery, and one with both these procedures. The medically treated patients consisted of four groups. Group I comprised 15 patients, in whom coronary angiography was contraindicated. Their average age was 67.1 and an average LVEF was 26.2%, Group II, included six patients, who had no indication for surgery because of severely diseased distal coronary arteries. This group had an average age of 57.5 years and an average LVEF of 22.5%. There were one with two-vessel disease and five with three-vessel disease. Group III included five surgical candidates who refused surgery. Their average age and an LVEF were 67.0 and 35.0%, respectively. In this group, there were one with two-vessel disease and four with three-vessel disease. Group IV, comprised 22 patients who did not need surgical therapy. Their average age was 55.3 and average LVEF was 32.5%. They included 22 with one-vessel disease, seven with two-vessel disease and one with three-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Successful resection of mediastinal and abdominal recurrent tumors of esophageal leiomyosarcoma 12 years after surgery].

A 57-year-old woman admitted to our hospital in October, 1988 because of the tumor of the abdominal wall and abnormal shadows of right chest wall and right upper mediastinum. Her esophagus had been resected and reconstructed by the stomach roll because of the esophageal leiomyosarcoma in May, 1976. Clinical examinations revealed that the abdominal mass and chest shadows were the recurrence of the leiomyosarcoma. The abdominal tumor was resected on 17th October, 1988. On 14th December, 1988 right thoracotomy was performed. Chest wall tumor (40 x 30 x 20 mm) and mediastinal tumor (45 x 40 x 35 mm) were resected completely. The mediastinal tumor was adhered to the remnant esophageal muscle layer. Microscopic section of the tumor showed spindle cell sarcoma with fine calcification, and it was diagnosed as the metastatic leiomyosarcoma.

Abdominal Muscles↗
PubMed1990

[Malignant fibrous histiocytoma of the rib: a case report of repetitive extensive resections and reconstruction of the chest wall].

A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.

Bone Neoplasms↗
PubMed1990

[Hamilton's operation in Bland-White-Garland syndrome].

A 14-year-old boy, who had been treated medically for mitral regurgitation, underwent cardiac catheterization which revealed not only mitral regurgitation but also anomalous origin of the left coronary artery from the pulmonary artery. Thus he was diagnosed as Bland-White-Garland syndrome which was repaired by Hamilton's operation. Under cardiopulmonary bypass, the pulmonary trunk was opened longitudinally. After aorto-pulmonary window (A-P window) was created, a heterogenous pericardial baffle was attached to the posterior wall of the pulmonary trunk connecting A-P window and the ostium of left coronary artery. Thereafter the pulmonary trunk was enlarged with a patch of the same material. He did well postoperatively. Postoperative angiogram demonstrated satisfactory reconstruction of two-coronary-artery system.

Adolescent↗
PubMed1989

[Basic studies on oral administration of lentinan (I)--influence on lymphocyte subsets in peripheral venous blood].

The effect of oral administration of lentinan (LTN), a biological response modifier, in the control of systemic immune function was studied in 6-week old male Wistar-Imamichi SPF rats. In the LTN group, 1 mg LTN dissolved in 1 ml physiological saline was administration forcibly into the stomach twice weekly. Physiological saline alone was administered in a similar fashion to the control group. Blood samples were obtained prior to and after four and eight weeks of administration. White blood cells and lymphocyte counts were obtained and lymphocyte subsets were measured using monoclonal antibodies W3/13, W3/25 and 0 X 8 (Sera-Lab), and a laser flow cytometry system (Orthospectrum III, Orthodiagnostic System). The T cell ratio, helper/inducer T (Th) cell ratio, and suppressor/cytotoxic T (Ts) cell ratio were measured. The peripheral white blood cell count and lymphocyte count were not significantly different between the control and LTN groups. After four weeks of LTN administration, however, the LTN group showed a significantly higher T cell ratio, Th cell ratio and Th/Ts cell ratio than did the control group, and the Ts cell ratio was significantly lower. In the groups undergoing administration for eight weeks, no difference was noted in the lymphocyte subsets between the two groups. Oral administration of LTN apparently modulates the systemic immune function through T cell stimulation, especially Th cells, but continued administration may induce a tolerance to the effect of LTN.

Administration, Oral↗
PubMed1989

Mosaicism in the expression of tumor-associated carbohydrate antigens in human colonic and gastric cancers.

Serial sequential sections from a single tumor were examined by immunohistological staining with several monoclonal antibodies directed, respectively, to different tumor-associated carbohydrate epitopes. Staining patterns were compared with those of conventional staining with hematoxylin-eosin or periodate/Schiff's reagent. Each tumor showed different areas of staining with different antibodies, and the combined staining map shows a clear mosaicism of antigen expression within the same tumor. For example, some areas of a given tumor were stained by FH4 (defining dimeric Le(x)), while other complementary areas were strongly stained, in a mutually exclusive manner, by SH1 (defining Le(x)), AH6 (defining Le(y)), FH6 (defining sialosyl dimeric (Le(x)), or TKH2 (defining sialosyl-Tn). Some areas were stained by two or three of these antibodies. Comparisons of the mosaic-staining patterns with cytohistological properties of tumor cells within specific areas suggested that the pattern of antigen expression is correlated with degree of differentiation; e.g., poorly-differentiated cells with severe dysplasia did not express high levels of Le(x) or Le(y) but did express sialyl-Le(x) or dimeric Le(x); on the other hand, moderately or well-differentiated tumor cells in some areas expressed high levels of Le(x) or Le(y) but lower levels of sialyl-Le(x). Areas showing strong expression of sialyl-Tn in their secretions were consistently correlated with presence of well-differentiated tumor cells, whereas secretions from normal mucosae were consistently characterized by lack of sialyl-Tn expression. It is postulated that the original in situ tumors (which had homogeneous glycosylation patterns) evolved into several spatially discrete cell populations displaying different degrees of glycosylation, reflecting stages of tumor cell differentiation and progression.

Antibodies, Monoclonal↗
PubMed1989

[advantages and disadvantages of three regional lymph node dissection of thoracic esophageal carcinoma and the lymph node dissection by thoraco-abdomino-midsternal approach].

The 117 cases of two regional (thoraco-abdominal) lymph node dissection were compared to the 56 cases of three regional (with neck area in addition) lymph node dissection for esophageal carcinoma. As for operative death and postoperative complications, there were no difference between these two groups. The prognosis of three regional dissecting group was better than that of two regional dissecting group concerning about the cases that lymph node metastases were less than 1 or 2, the depth of invasion was limited to just near adventitia (a1) and the locations were in upper or midthoracic esophagus. But also the rate of postoperative recurrence to the neck and uppermediastinal lymph nodes were high in spite of three regional dissection. Putting together with all cases, significant improvement of prognosis were not obtained in the three regional group compared to two regional group. So we thought the usual three regional lymph node dissection might not be sufficient. Recently we added midsternotomy and made the lymph node dissection in neck-thoracic junction more complete. This procedure did not make the operative death and postoperative complications increase and the improvement of prognosis was expected by it.

Abdomen↗
PubMed1989

[Anaerobic threshold and oxygen uptake in patients with mitral stenosis].

The exercise stress test with a bicycle ergometer was performed for 31 patients with mitral stenosis and for 10 normal subjects. The patients were categorized in two groups. Group 1 consisted of 16 patients having indication for surgical intervention and Group 2 consisted of 15 patients without such surgical indications. Oxygen uptakes at the anaerobic threshold and at peak exercise (MAX) were assessed by percent attainment of the predicted normal value from Posner's equation. Heart rates during exercise did not differ between the two groups. However, Group 1 had significantly smaller values of percent attainment of oxygen uptake both at the anerobic threshold and peak exercise than the controls and Group 2. Oxygen pulses in Group 1 were also significantly less than in the controls or Group 2. Seven cases were reassessed six months or more after surgery including open mitral commissurotomy in two and mitral valve replacements in five. The improvement of oxygen pulse showed a statistical significance. Percent oxygen uptake attainment was also significantly improved both at the anaerobic threshold and at peak exercise. Percent attainment of oxygen uptake in mitral stenosis differed significantly according to the NYHA class both at the anaerobic threshold and peak exercise. These values are considered useful for making decisions for surgical treatment in borderline cases.

Adult↗
PubMed1989

[Coronary artery bypass surgery in hemodialysis-dependent patients].

Coronary artery bypass surgery was performed in three cases of hemodialysis-dependent patients. Extracorporeal ultrafiltration method (ECUM) during cardiopulmonary bypass was useful to control water and electrolyte balance. Partial blood reperfusion (PBR) method was employed in post-operative hemodialysis, which proved to be effective not only to minimize hemodynamic deterioration but also to prevent the induction of bleeding tendency. Hemofiltration on the first post-operative day would be recommendable in poor-risk patients to eliminate excessive intravascular fluid which is returned from the third space.

Aged↗
PubMed1988

Coronary artery spasm during coronary artery bypass surgery: its diagnosis, treatment and prevention.

Between 1982 and 1983, we experienced four cases of hemodynamic collapse accompanied by an ST-segment depression in the ECG lead II, shortly after the cessation of cardiopulmonary bypass. The bypass graft flows monitored in these patients during the hemodynamic collapse episodes were remarkably low. In three cases, nitroglycerin (0.5-1 mg) was injected directly into the vein graft, which increased the graft flow suddenly, returned the ST-segment to the baseline, and improved the circulatory condition. Since 1984, however, diltiazem has been used in the cardioplegic solution and postoperative drip infusion. Due to the introduction of this drug, coronary artery spasm has not been seen in any of our patients since. These findings show that the monitoring of ST-segment changes and bypass graft flows are useful in the early diagnosis of coronary artery spasm after myocardial revascularization. Direct infusion of nitroglycerin into the vein graft is effective for the treatment of spasm, while diltiazem is useful in the prevention of coronary artery spasm incidental to myocardial revascularization.

Coronary Artery Bypass↗
PubMed1988

Paget's extension of esophageal carcinoma. Immunohistochemical and mucin histochemical evidence of Paget's cells in the esophageal mucosa.

A 68-year-old male with Paget's disease of the esophagus is reported. The underlying primary esophageal carcinoma was diagnosed as adenosquamous cell carcinoma on the basis of the presence of both adenocarcinoma and epidermoid carcinoma components. There was invasive growth of clear Paget's cells in the esophageal epithelium. Mucin histochemistry disclosed common characteristics of mucin between Paget's cells and adenosquamous cell carcinoma. It was histochemically confirmed that the existence of mucin was a general feature of extramammary Paget's disease. In 13 control esophageal carcinomas including three with adenocarcinomatous elements, Paget's cells were not found in the epithelium. To date only one case of Paget's disease of the esophagus has been described in the literature.

Aged↗
PubMed1988

Early and late results of coronary artery bypass grafting in the elderly.

This study is a review of our experience with elderly patients, who have undergone coronary artery bypass grafting (CABG). Of 357 patients who underwent elective CABG from April 1982 to May 1986, 50 patients (14.0%) were 65 years old or older. The incidence of preoperative cardiac conditions in the elderly was almost the same as that in patients less than 65 years of age. The incidence of noncardiac preoperative conditions in the older patients, such as diabetes mellitus, renal dysfunction, concomitant malignant disease, atherosclerotic lesion of the ascending aorta, was significantly higher than that in the younger age group. Early surgical mortality was 4.0% (2 cases) in the older group, and 1.3% (4 cases) in the younger group. There was no significant difference in statistics. The incidence of major postoperative complications was not significantly different between the two age groups, except that of cerebral infarction, which was significantly higher in the elderly group (6.0% vs 0.3%, p less than 0.001). The rate of a long postoperative hospital stay was also significantly higher in the older group (43.8% vs 30.0%, p less than 0.05). Long-term results, such as late mortality, symptom-free rate and graft patency, showed no significant differences between the two age groups. It is concluded that CABG can be performed in selected older patients with relatively low mortality and morbidity. Special attention should be paid to prevent perioperative cerebral infarction.

Aged↗
PubMed1988

[A case of A-V fistula with severe hemolysis following internal jugular venipuncture].

Severe hemoglobinuria was observed in a case with abdominal aortic aneurysm on the 23rd postoperative day. The typical continuous murmur was heard on the right upper chest, and IADSA revealed an A-V fistula connecting between the right subclavian artery and the internal jugular vein. This A-V fistula was thought to have been caused by an inadvertent arteriopuncture during the central venous cannulation at the time of the operation. Poloxamer 188 (a non-ionic surfactant) and haptoglobin were given intravenously, and they proved to be quite effective in improving intravascular mechanical hemolysis and hemoglobinuria. A division of the A-V fistula was done successfully, which was facilitated by the median sternotomy combined with the extension of the skin incision to the neck. It cannot be overemphasized that utmost care should be taken to prevent any complication at the time of the central venous cannulation.

Anemia, Hemolytic↗