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Biomedical subjects

H Matsuda

Publications and source records attributed to H Matsuda.

At least 1,045 records · Page 58Linked to original sources
PubMed1994

[Aortic valve replacement in a kidney transplant recipient].

A 62-year-old man with chronic renal failure, who had been treated with hemodialysis, received a kidney transplant from his son in December 1989. He kept good renal function without any episode of graft rejection under the immunosuppressive therapy with Cyclosporine A (CyA), Predonine (PRD), and Mizoribine. In 1990 he started to have exertional dyspnea, and was diagnosed to have aortic valve regurgitation. He underwent aortic valve replacement in September, 1991. He was treated with continuous infusion of CyA and bolus injection of methylprednisolone from the start of the operation, and returned under the preoperative immunosuppressive therapy after oral intake became possible. On the third post-operative day, the level of serum creatinine elevated. Although we couldn't detect significant changes in subpopulations of peripheral blood lymphocytes, steroid pulse therapy was performed as the possibility of acute rejection was underiable. Serum creatinine returned to normal level in a few days and the postoperative course after that was uneventful. He was discharged on the 30th post-operative day.

Aortic Valve↗
PubMed1994

[Pregnancy and delivery in patients with lupus nephritis].

To investigate some of the problems associated with pregnancy and delivery in lupus nephritis, 13 pregnancies in 7 patients with inactive lupus nephritis and 5 pregnancies in one patient with primary antiphospholipid syndrome (PAPS) were compared with 36 pregnancies in 22 patients with primary nephrotic syndrome (NS). Furthermore, a follow-up survey during 0-8 years was made with 12 babies born to mothers with lupus nephritis. Some pregnancies during lupus nephritis were accompanied by disease exacerbation and worsening of renal function. There was a higher incidence of babies born with a low birth weight, and the incidences of fetal loss or premature birth and toxemia were higher in lupus nephritis than in NS. The number of babies with a low birth weight was significantly higher in patients with pregnancy-induced hypertension or skin lesion due to lupus erythematosus. The presence of antibodies against SSA/RO in the mother was associated with the occurrence of congenital heart block. Birth weight of babies born to mothers with lupus nephritis was low, but there were no statistical differences in the growth of babies after 6 months of age compared with babies born to normal women.

Adult↗
PubMed1994

[Development of direct phlebography for surgical intervention of the varix cruris].

To determine the appropriate treatment for patients with varix cruris, we performed three different methods of phlebography including direct phlebography, and compared their findings by each phlebography. Conventional ascending phlebography was taken routinely and initially in all limbs (n = 120). "Direct phlebography" developed by us was then indicated, when the visualization of the deep vein system was unclear by conventional ascending phlebography. This method was useful for the clear opacification of the deep vein system, and also was able to visualize the deep femoral vein clearly. After the precise diagnosis of varix cruris, descending phlebography under the Valsalva maneuver at supine position was carried out for the evaluation of the deep vein insufficiency. According to these phlebographic findings, conventional stripping with or without sub- or suprafascial ligation of communicating vein was indicated to saphenous typed varix cruris. The valvuloplasty to the highest valve in superficial femoral vein was carefully added in eight limbs which showed the significant reflux by added in eight limbs which showed the significant reflux by the descending phlebography. This valvuloplasty was remarkably contributed to the immediate healing of the stasis ulcer without recurrence. And compression sclerotherapy was selected to some patients with branch typed varix cruris.

Adolescent↗
PubMed1994

Right ventricular dysfunction after major pulmonary resection.

Right ventricular performance was assessed by thermodilution in 20 patients at rest and during exercise before and after lobectomy or pneumonectomy. The right ventricular ejection fraction was significantly decreased on the first postoperative day (0.36 +/- 0.34), the second postoperative day (0.34 +/- 0.04), and the third postoperative week (0.37 +/- 0.06) relative to the preoperative right ventricular ejection fraction value (0.43 +/- 0.07, p < 0.05). The right ventricular end-diastolic volume index was significantly increased by the second postoperative day (130 +/- 24 ml/m2) compared with the preoperative value (112 +/- 20 ml/m2). A significant decrease in the right ventricular stroke volume index was observed after operation, with a significant increase in heart rate considered necessary to maintain cardiac output. Pulmonary arterial pressure, the pulmonary vascular resistance index, and central venous pressure were unaltered over time. Indices of left ventricular function (that is, cardiac index, arterial pressure, and pulmonary arterial wedge pressure) were also preserved throughout the postoperative period. To explain the right ventricular dysfunction, ergometric exercise values were compared and the heart rate, pulmonary arterial pressure, central venous pressure, pulmonary vascular resistance index, and right ventricular end-diastolic volume index were all higher and the right ventricular ejection fraction lower during exercise after the operation. However, indices of left ventricular function remained unchanged. Significant elevations in pulmonary arterial pressure and the pulmonary vascular resistance index only during exercise occurred. These findings indicate that changes in right ventricular function at rest compensate for the increase in right ventricular volume, but adequate compensation does not occur during exercise, with a resultant increase in pulmonary arterial pressure and the pulmonary vascular resistance index. This suggests that a change in afterload may be the main determinant of the deterioration in right ventricular pump performance during exercise. We speculate that the main cause of right ventricular dysfunction after major pulmonary resection might be the changes in right ventricular afterload. The right ventricle may play an important role serving as a "reservoir" for afterload.

Aged↗
PubMed1994

[Electronmicroscopic study on the vitreous membrane of the Stickler syndrome].

The vitreous membrane obtained from a patient with Stickler syndrome, an 8 year-old female, was investigated electronmicroscopically. The cells found in the membrane had cilia, microvilli and cytoplasmic filaments. Gap junctions and basement membrane-like structures were also found. Several of the cells had phagosomes containing crystalline materials. Thus, these cells seemed to be glial cells.

Abnormalities, Multiple↗
PubMed1994

[New approaches to the regulation of autoimmune disease].

Recent advancement in immunology has revealed that autoimmune diseases occur when T lymphocytes become activated on recognizing a self-antigen linked to the autologous class II molecule of the major histocompatibility complex (MHC). The resulting complex of antigen, MHC, and T cell receptor could be a target for treatment of autoimmune disease. This approach is now being studied in animal models. Experimental autoimmune uveoretinitis is a T cell mediated autoimmune disease directed against retinal proteins and has been studied as a model for human uveitis. In Lewis rats, uveitogenic peptides and uveitogenic T cell receptor families have been detected. It is a first step toward developing specific immunotherapy. This paper describes a general outline of the steps of T cell activation and ways of suppression of autoimmune diseases by the modulation of these steps, especially in experimental autoimmune uveoretinitis.

Amino Acid Sequence↗
PubMed1994

[Ureteral polyps: three case reports].

We observed recently three cases of ureteral polyps including a case of multiple polyps. The first patient was a 33-year-old man with multiple polyps at the left upper ureter. The second patient was a 51-year-old man and the third 49-year-old man, and both cases were complicated with ureteral stones. We divided 88 ureteral polyps reported in Japan from 1970 to 1990 into polyps in children and those in adults. We further divided the individual polyps into single and multiple polyps and examined them clinically. Characteristic findings were obtained in polyps in children; namely, multiple polyps were dominant, almost all of them occurred at the left upper ureter and no cases were complicated with ureteral stones. Furthermore, many of the multiple polyps in adults occurred at the left upper ureter and few were complicated with stones as in the children. In conclusion, the ureteral polyps in children and multiple ureteral polyps in adults were similar in character and we presumed that some congenital factors might be involved in their occurrence.

Adult↗
PubMed1994

[A case of primitive neuroectodermal tumor in the chest wall ("Askin's tumor")].

We report a case of Askin's tumor, primitive neuroectodermal tumor (PNET) in the chest wall, with review of reported cases of PNET. Our case was the ninth of Askin's tumor and the 36th of PNET in Japan. A 12-year-old girl was hospitalized because of a large right intrathoracic mass. The serum neuron-specific enolase (NSE) was 11.4 ng/ml, slightly increased, and the urinary excretion of catecholamine metabolites was normal. The needle biopsy specimens were diagnosed as small round cell sarcoma. At surgery we found an encapsulated multilobular mass in the region. The chest wall was resected partially to extirpate it completely. Its macroscopic and microscopic features were almost similar to the description of Askin et al. The immunohistochemical staining of the cells was positive for NSE, strongly suggesting the neurogenic origin. After surgery, intensive chemotherapy with autologous bone marrow transplant was performed, and she has been living without sign of recurrence for two years.

Child↗
PubMed1994

Effect of omentopexy on wound healing of the extensively detached and anastomosed canine trachea.

BACKGROUND: To examine the beneficial effect of omentopexy for tracheal anastomosis after extensive detachment that may cause impairment of the blood supply, the time course of tracheal wound healing was studied experimentally. METHODS: Circumferential resection of the trachea for three cartilage rings (nos. 11, 12, 13) and end-to-end anastomosis of the trachea were performed in 66 mongrel dogs, which were allocated to three groups (n = 22 in each). In the detached group, the trachea was entirely mobilized and isolated from the surrounding tissue for a length of 25 cartilage rings. In the wrapped group, omentopexy was added for the anastomosed site. In the control group, the same anastomosis was performed without omentopexy or detachment. The tracheal tissue blood flow was measured with a laser Doppler flow meter at the anastomosed site, and the tensile strength was determined with a tensiometer. RESULTS: All groups showed significant decreases in the blood flow on day 3, compared with the preoperative values, and increases stepwise from day 7 to day 21. On days 3, 7, and 14 the tissue blood flow was significantly (p < 0.01) higher in the wrapped group than in the detached group, although on day 21 it did not differ significantly among the three groups. The tensile strengths of the cartilaginous and membranous portions were significantly (p < 0.05) higher in the wrapped and control groups than in the detached group. On day 21, no significant intergroup differences were observed for this parameter. In the wrapped group and in the control group, the capillary network at the anastomosed site was well developed on day 7, and the tracheal mucosal epithelium was well regenerated on day 21 without granulation formation. CONCLUSIONS: This study showed that omentopexy at the anastomosed site of an extensively detached trachea provided adequate wound healing caused by rapid recovery of the tissue blood flow.

Anastomosis, Surgical↗
PubMed1994

[Reoperation for valvular heart diseases].

To elucidate the limitation of mitral valve reconstruction, 53 mitral disease patients (Mitral stenosis: 29, Mitral regurgitation: 24) undergoing reoperation late after valve reconstruction were studied, taking account of valvular lesions at initial operation. Reoperation rate after open mitral commissurotomy for mitral stenosis was higher in the patients with valvular regurgitation at initial operation than in those with severe subvalvular lesions or calcified valve. Reoperation rate for mitral regurgitation after mitral valvuloplasty was higher in the patients with stenotic fibrous degeneration or dilated annulus at initial operation than in those with torn chorda. Thus, these findings suggest that combined lesion of stenosis and regurgitation at initial operation may affect the reoperation rate in patients undergoing mitral valve reconstruction for either mitral stenosis or mitral regurgitation. Different approaches to the mitral valve through the left atrium and various techniques of the atriotomy have been practiced according to the need for a particular patients. The left atrium and the mitral valve can be exposed through median sternotomy followed by biatrial atriotomy or transplant approach. A correct approach and good exposure plays a key role in the success of redo surgical procedure for mitral valve disease.

Humans↗
PubMed1994

[Effects of subcutaneous administration of erythropoietin on autologous blood predonation in open heart surgery: Japanese multicenter double-blinded dose-study].

The effects of subcutaneous administration of recombinant human erythropoietin (EPO) on harvesting autologous blood predonation (ABP) and decreasing homologous blood transfusion (HBT) in open-heart surgery were examined prospectively in 132 patients treated in a 32-institute multicenter study. Single doses of 6000, 12,000, 18,000 and 24,000 unit (IU) of EPO with intravenous iron (40 mg) were administered once a week for 3 weeks with ABP (400 ml/week) before surgery. ABP volume (ml), change of blood hemoglobin level (C-Hb), preoperative net blood hemoglobin increase (delta Hb [g/dl] including ABP, perioperative blood loss (ml), and HBT rate, were as follows; [table: see text] Preoperative reduction of Hb (C-Hb) was less in administration dose of 18,000 IU and 24,000 IU than 6000 IU (p < 0.05). The increase of delta Hb was highest in 18,000 IU and HBT rate was lowest in administration dose of 24,000 IU, however, there was no statistical difference. In conclusion, both 18,000 IU and 24,000 IU of EPO treatment is effective to minimize the progression of anemia according to ABP for open heart surgery.

Blood Transfusion, Autologous↗
PubMed1993

Binding of membrane-anchored macrophage colony-stimulating factor (M-CSF) to its receptor mediates specific adhesion between stromal cells and M-CSF receptor-bearing hematopoietic cells.

To explore the biologic significance of the membrane-anchored form of macrophage colony-stimulating factor (M-CSF), we examined whether interaction between membrane-bound M-CSF and its receptor mediates intercellular adhesion as well as cell proliferation and differentiation. Human M-CSF receptors were expressed on a murine interleukin-2 (IL-3)-dependent cell line, FDC-P2, by DNA transfection with the c-fms gene (FDC-P2-MCSFR). A human bone marrow-derived stromal cell line, KM102, was used in the cell adhesion assay. The expression of membrane-bound M-CSF on KM102 cells was demonstrated by flow cytometry and immunoblot analysis. After the incubation of parent and transformed FDC-P2 cells on confluent KM102 cells, nonadherent cells were removed and the cells attached to KM102 cells were examined microscopically. Almost all parent FDC-P2 cells were nonadherent, whereas a significant number of FDC-P2-MCSFR cells bound to KM102 cells. The addition of anti-M-CSF or anti-M-CSF receptor neutralizing antibodies dose-dependently inhibited the binding of [3H]-thymidine-labeled FDC-P2-MCSFR cells to KM102 cells. An excess amount of M-CSF also inhibited the binding. On the other hand, the addition of antibodies against some representative adhesion molecules (vitronectin receptor, Pgp-1/CD44, and VLA-4) did not inhibit the adhesion between FDC-P2-MCSFR cells and KM102 cells. These results support the idea that membrane-anchored M-CSF and its receptor may function as mediators of cell-cell adhesion.

Animals↗
PubMed1993

Characterization of CD4+ single positive cells that lack CD3 in the human thymus.

In the thymus of experimental animals, single positive cells that lack surface CD3 expression (CD3-CD4+CD8- or CD3-CD4-CD8+) have been reported to have intermediate characteristics between the CD4-CD8- cells and CD4+CD8+ cells. Here we show the presence of single positive cells in the human thymus that lack CD3 by means of three-color flow cytometric analysis. CD3- cells constitute 12 +/- 7.5% of CD4 single positive cells in 10 normal thymus samples. CD8 single positive cells, on the other hand, contained only 1.5 +/- 2.2% CD3- cells. Seventeen percent of these CD3-4+8- thymocytes were in S+G2/M phase, while only 4.3% of CD4+CD8- thymocytes were in S+G2/M. The surface antigen phenotype of CD3-CD4+CD8- thymocytes was CD1(low), CD2+, alpha beta TCR-, CD29(high), LFA-1+, ICAM-1-, IL-2R-, CD45common (low), CD45RA-, and CD45R0(low). They expressed cytoplasmic CD3+ and 28% of them expressed cytoplasmic CD3 and cytoplasmic alpha beta TCR. The levels of CD2, CD29, CD45R0, cytoplasmic CD3, and cytoplasmic alpha beta TCR expression were intermediate between the CD3-4-8- and CD4+8+ populations. These results indicate that CD3-CD4+CD8- thymocytes constitute a minor but significant population in the human thymus. Their surface antigen phenotype and the high incidence of dividing cells suggest that they are immature and probably on their way to the CD4+8+ double positive thymocytes.

Adolescent↗