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Biomedical subjects

H Matsuda

Publications and source records attributed to H Matsuda.

At least 1,153 records · Page 64Linked to original sources
PubMed1993

The evaluation of submucosal carcinoma of the esophagus as a more advanced carcinoma.

Of 75 patients with superficial esophageal carcinoma, there were 16 cases with epithelial or mucosal, and 59 cases with submucosal, lesions. The incidence of nodal metastasis in patients with epithelial or mucosal carcinoma was zero, and the 5-year survival rate was 100%. However, 13 out of 59 cases (22.0%) with submucosal carcinoma were accompanied by nodal involvement, and the rate of vessel invasion was 27.1% (16/59). Even in 46 cases of submucosal carcinoma without nodal involvement, there were 13 cases (22.1%) with vessel invasion. The 5-year survival rate of the 26 submucosal cases with either nodal metastasis or vessel invasion was 37.6%, and even that of the 33 cases with neither lymph node metastasis nor vessel invasion was 60.0%. On the other hand, of the 74 patients with carcinoma invading the muscularis propria, there were 35 cases (47.3%) without nodal metastasis and 27 cases (36.5%) which were also free of vessel invasion. The 5-year survival rate of the former was 32.6%, and of the latter 33.1%. On the basis of these findings, we wish to emphasize that submucosal carcinoma should be classified as an advanced carcinoma.

Adult↗
PubMed1993

[Heart failure in valvular heart disease].

The clinical manifestations of heart failure depend importantly on the rate at which the syndrome develops and specifically on whether sufficient time has elapsed for compensatory mechanisms to become operative and for fluid to accumulate in the interstitial space. In most cases of the valvular heart diseases, patients survive the acute insult, and anatomical and functional abnormalities of the valves develop gradually, so that a host of compensatory mechanisms develop, especially cardiac hypertrophy. These allow the patient to adjust to and tolerate not only the anatomical abnormalities, but also a reduction in cardiac output or changes in loading condition, with less difficulties. The most important goal of treatment for the patients with chronic heart failure is to improve prognosis and the quality of life. Surgical correction is one of the best way to obtain good results in the treatment of the valvular heart diseases. We have been evaluated left ventricular pump function and contractile function before and after surgery for valvular diseases using the method for estimating myocardial contractility, that is, the relationship between ejection fraction and end-systolic volume or a ratio of end-systolic wall stress to end-systolic volume (ESS/ESVI), estimated the reversibility of the left ventricular systolic function after surgery, and determined the timing of operation. To make precise evaluation for the heart failure in patients with chronic valvular heart diseases, particularly during compensatory period, reduced pump function and myocardial contractility rather than clinical symptoms should be assessed and considered as an indicator for severity of the heart failure.

Aortic Valve Insufficiency↗
PubMed1993

[Quantitative analysis of brain perfusion using radionuclide angiography with 99mTc-HMPAO].

A noninvasive simple method for quantitative radionuclide angiography with 99mTc-dl-hexamethyl propylene amine oxime (99mTc-HMPAO). The method of graphical analysis was employed for the evaluation of the unidirectional influx constant (Ku) from the blood to the brain for the tracer. The Ku values were standardized to represent objective and comparable values, brain perfusion indices (BPI), among studied subjects by setting the ratio of ROIbrain size to ROIaorta size to 10. The mean +/- SD of the whole-brain BPI values for the 41 normal controls was 11.15 +/- 2.61, and biphasic reduction with advancing age was observed. The mean of the whole-brain BPI of 7.95 with SD of 2.35 in 103 patients with cerebrovascular disorders was significantly lower than that in normal controls. The right to left ratio of BPI showed wider dynamic range than that of the total counts of SPECT. This technique is quite easy to apply as an adjunct to SPECT and may be helpful in the quantitative evaluation of brain perfusion in routine clinical studies.

Adult↗
PubMed1993

Biventricular repair of cardiac isomerism with common atrioventricular canal with the aid of an endocardial cushion prosthesis.

Between 1983 and 1990, six patients with atrial isomerism associated with common atrioventricular canal and double-outlet right ventricle were operated on with the aid of an endocardial cushion prosthesis. This prosthesis, which has been used for the repair of common atrioventricular canal since 1975, is composed of a vertical Dacron patch and "wings" constructed from the patient's own pericardium, which are attached to both sides of the patch to compensate for the defective atrioventricular valve tissue. The ventricular portion of the patch was extended anteriorly to construct the route for blood flow from the left ventricle to the aorta. Intraventricular repair was performed through the common atrioventricular orifice in all patients and also through an additional right ventriculotomy in one patient. The complex systemic and pulmonary venous return was separated by use of the atrial part of the endocardial cushion prosthesis together with additional prosthetic materials. All patients survived the operation and were followed up from 1 to 9 years. All of them are doing well, although one patient has a significant interventricular residual shunt. Repair of atrial isomerism with common atrioventricular canal and double-outlet right ventricle with an endocardial cushion prosthesis was performed with satisfactory immediate and intermediate-term postoperative results.

Blood Vessel Prosthesis↗
PubMed1993

[Hormone therapy of tamoxifen in resected carcinoma of the pancreas].

Greenway et al reported estrogen receptor existed in the carcinoma of the exocrine pancreas in 1981. We followed the study by using immunohistochemical method with monoclonal antibody ER-D5 (Amersham) and found high levels of estrogen receptor in 21 cases out of 27 carcinomas of the pancreas (77.8%). Furthermore, we gave randomly the hormone therapy by Tamoxifen 20 mg per day adding to immuno-chemotherapy (Tegaful, Mitomycin, Krestin, OK-432) to the patients with resected carcinoma of the pancreas. There was no significant difference of the survival rate of pancreatic carcinoma without hormone therapy between 10 cases with estrogen receptor and 4 cases without estrogen receptor at the 6th month and 12th month. However, in cases treated by Tamoxifen, remarkable high survival rate at 12 months of 11 cases with estrogen receptor was obtained to be 85.7% according to Kaplan-Meier method. Two cases without estrogen receptor died within 5 months. One year survival rate of Tamoxifen group (13 cases) was 78.6% and that of non Tamoxifen group (14 cases) was 21.4%. These findings indicated that estrogen receptor existed at the high level in the carcinoma tissues of the pancreas and anti-estrogen treatment might offer a new approach to the treatment of pancreatic carcinomas.

Adult↗
PubMed1993

[Central type benzodiazepine receptor and cerebral blood flow in experimental chronic brain infarction--evaluation using a double-tracer autoradiography technique].

Double tracer autoradiography was performed to measure regional cerebral blood flow (rCBF) and the binding of central type benzodiazepine receptors (BZR) in infarction by means of permanent occlusion of the unilateral middle cerebral arteries (MCA) in rat. Iodine-125 Iomazenil and 99mTc-HMPAO was used to label BZR and rCBF respectively. In the chronic phase of infarction 21 to 28 days after occlusion (5 rats), rCBF in the left MCA territory was decreased to 62% of the sham control (4 rats), while BZR was more decreased to 45% of the control. In remote areas from the MCA lesion, the ipsilateral thalamus showed 28% decrease of BZR as compared to the control, though the decrease of rCBF was not significant. Iomazenil distribution may represent neuron density or BZR density on a neuron, since central type BZR is reported to be located on neurons. These results suggest that central type BZR imaging is more useful tool for the evaluation of brain tissue viability and transneuronal degeneration than rCBF imaging in brain infarction.

Animals↗
PubMed1993

Long-term results of entry closure and aneurysmal wall plication with axillofemoral bypass: a new procedure for repair of DeBakey type 3 dissecting aneurysm.

To prevent aneurysm rupture, avoid pseudoaneurysm formation, and preserve intercostal arteries, a new procedure for repair of DeBakey type 3 dissecting aneurysm was developed. Since January 1977, 28 patients have undergone repair of type 3 dissecting aneurysm. Fifteen patients with type 3b underwent this new procedure (group 1) and 13 patients with type 3a dissecting aneurysm underwent segmental graft replacement (group 2). In group 1 a permanent axillofemoral bypass was placed on the right side. Next the intrathoracic false lumen was opened longitudinally, the entry was closed, and the aneurysmal wall was sutured around the true lumen as tightly as possible. The operative mortality rate was 20% in group 1 and 31% in group 2. One of 15 patients in group 1 died of operation-related causes, whereas three patients in group 2 died. There were six late deaths: three in group 1 and three in group 2. Paraplegia occurred in neither group 1 nor group 2. The mean diameter of the plicated descending aorta was 24.0 +/- 2.7 mm 3 months after surgery. No recurrence was detected in group 1. These results suggested that this new surgical technique for repair of type 3 dissection reduces the incidence of paraplegia and pseudoaneurysm formation.

Adult↗
PubMed1993

Long-term performance of beta-propiolactone-treated nonviable homograft for aortic valve replacement and right ventricular outflow tract reconstruction.

The long-term performance of beta-propiolactone-treated homografts was clearly different between operative survivors of aortic valve replacement (n = 27) and those of right ventricular outflow tract reconstruction (n = 11). The reoperation-free survival rate at 20 years was 14.8 +/- 6.8 (standard error)% in the former and 77.8 +/- 13.9% in the latter. Even a nonviable aortic homograft can be favorably accepted as a material for right ventricular outflow tract reconstruction in contrast to the aortic position.

Adult↗
PubMed1993

Probable cerebellar abnormality on 123I-IMP SPECT scans in epileptic patients with long-term high-dose phenytoin therapy. Based on observation of multiple cases.

Quantitative assessment of regional cerebral blood flow (rCBF) in the bilateral cerebral and cerebellar cortices was performed in 13 epileptic patients receiving long-term high-dose phenytoin (PHT) therapy, using single photon emission computed tomography (SPECT) with N-isopropyl-(iodine 123) p-iodoamphetamine. In 4 of the 13 patients, both the cerebellar to frontal rCBF ratio and cerebellar to cerebral rCBF ratio showed low values as compared with those in 22 normal subjects matched for sex and age, probably reflecting abnormal relative cerebellar hypoperfusion. None of the 4 patients showed any abnormal findings on X-ray computed tomography or magnetic resonance brain imaging. The patients with a history of acute PHT intoxication tended to show the abnormal relative cerebellar hypoperfusion. These results suggest the utility of SPECT scans for early detection of cerebellar abnormalities known to be often present in epileptic patients, and imply a risk of long-term high-dose PHT therapy.

Adult↗
PubMed1993

Quantitative assessment of regional cerebral blood flow with 123I-IMP in normal adult subjects.

Quantitative assessment of regional cerebral blood flow (rCBF) in the bilateral cerebral and cerebellar cortices was performed in 22 normal adult subjects consisting of an early twenties group (5 men and 9 women, 20-22 years) and middle age group (3 men and 5 women, 41-52 years), using single photon emission computed tomography (SPECT) with N-isopropyl-(iodine 123) p-iodoamphetamine. Absolute rCBF values in each region in the 22 subjects ranged from 46 to 102 ml/100 g/min (mean 69.1, standard deviation 13.7 ml/100 g/min). The absolute rCBF values were significantly higher in women than in men, and in the early twenties group than in the middle age group. In addition, based on each absolute rCBF value, the interhemispheric asymmetry, anterior to posterior ratio and cerebellar to frontal ratio in rCBF were calculated. These results may be useful as indexes for detecting organic and functional brain abnormalities in various neuropsychiatric diseases.

Adult↗
PubMed1993

Secondary early carcinoma in a reconstructed gastric tube after subtotal esophagectomy for early carcinoma of the esophagus.

A 70-year-old man was found to have a moderately differentiated squamous cell carcinoma in the mid-esophagus on X-ray and endoscopy. These examinations revealed no lesion in the stomach at that time. Ten days after termination of preoperative hyperthermo-chemo-radiotherapy (HCR), a subtotal esophagectomy and gastric tube reconstruction via the retrosternal route were performed (pTNM stage I). Seven months later, another early cancer was detected in the reconstructed gastric tube. Via a median sternotomy, a wedge resection of the gastric tube was performed, and histopathological studies revealed a well-differentiated adenocarcinoma, which was limited to the submucosa (pTNM stage I). The patient has since done well with no signs of recurrence for the twenty-two months that have elapsed since the second operation was performed. Since the incidence of double cancer in the esophagus and stomach is high, and cases such as that described here will be detected more and more frequently in the future, not only a thorough investigation of a stomach intended for use in the reconstruction of the esophagus, but also strict postoperative checkups of the gastric tube when the esophagus has been reconstructed using the stomach must be considered of great importance.

Adenocarcinoma↗
PubMed1993

Intraventricular repair for Taussig-Bing anomaly.

Among 41 patients with Taussig-Bing anomaly who underwent intracardiac repair, 10 patients were treated by intraventricular rerouting repair. The ages at operation ranged form 1 month to 8 years (average 2 years 3 months). Primary repair was done in four (average age 2 years 7 months), and repair was done after pulmonary artery banding in six patients (average age 2 years 2 months). The relationship of the great arteries was side by side in nine patients and oblique in one. After extensive resection of the infundibular septum, a distance of 8 to 18 mm from the tricuspid ring or chordae to the pulmonary valve was obtained (24% to 71% of total circumference for the subaortic route). The subaortic route was created to obtain an internal diameter at least equal to that of the aortic route. Tricuspid chordal or papillary muscle reattachment was performed in two patients. There were no early or late deaths. Follow-up ranged from 1 year 4 months to 22 years 3 months (average 5 years 8 months), and reoperation was required in one patient for residual pulmonary stenosis. The intraoperative pressure gradient between the left ventricle and aorta was 0 to 24 mm Hg (average 10.3 mm Hg), and postoperative study showed the gradients to be less than 19 mm Hg (n = 8). The age at operation, left ventricular-aortic pressure gradient, and postoperative tricuspid regurgitation were not significantly affected by the presence of severe hypertrophy of the infundibular septum (n = 4). These results indicate that intraventricular rerouting may be feasible in most patients who have the Taussig-Bing anomaly with side-by-side or similar relationships of the great arteries, and the age and conal anatomic variations do not appear to be significant limiting factors.

Cardiac Catheterization↗
PubMed1993

[Participation of non-major histocompatibility complex gene in experimental autoimmune uveitis].

It is known that the susceptibility of experimental autoimmune uveitis (EAU) is controlled by both major histocompatibility antigen complex (MHC) and non-MHC genes. In this report, we studied the role of non-MHC gene in the induction of EAU. LEW, WKAH, (LEW x WKAH) F1 and (LEW x WKAH) F2 rats were examined for their incidence and severity to develop EAU by immunization with bovine S-antigen (S-Ag). We found that all LEW rats developed severe EAU within 2 weeks after immunization, but no WKAH rat did. Most F1 rats developed mild inflammation in 3-4 weeks after immunization. A quarter of F2 rats developed EAU within 2 weeks, half of them developed it in 3-6 weeks after immunization, and the others did not. These findings suggest that only one non-MHC gene controls the susceptibility to S-Ag induced EAU in rats.

Animals↗
PubMed1993

[The effect of LDL-apheresis on the long-term prognosis of hypercholesterolemic patients with coronary artery bypass grafts: a multicenter study].

Hypercholesterolemia is well known as a risk factor which had been shown to affect the long-term prognosis after coronary artery bypass grafting (CABG). The data were collected from multi-institutions documenting the long-term results of CABG in 61 hypercholesterolemic patients who received LDL-apheresis. Mean post-CABG period was 50 +/- 34 (+/- SD) months. Mean period of therapy by LDL-apheresis using Liposorber system after CABG was 25 +/- 17 months with a frequency of once per 2.6 +/- 1.3 weeks. Before initiating LDL-apheresis mean serum cholesterol (TC) and LDL-cholesterol (LDL-C) were 327 mg/dl and 261 mg/dl, respectively. With combined LDL-apheresis and lipid-lowering drug therapy mean TC and LDL-C were reduced to 247 mg/dl and 177 mg/dl immediately pre-apheresis and 106 mg/dl and 60 mg/dl immediately post-apheresis, respectively. Two of 61 patients had PTCA post CABG. Percent free from cardiac event during the long-term period post CABG as calculated by the life-table method was 97% at 3 years and 94% at 4 years and thereafter. While number of the patients is still small, the aggressive cholesterol-lowering therapy by LDL-apheresis is suggested to improve the prognosis of hypercholesterolemic patients with bypass grafts.

Adult↗
PubMed1993

Demonstration of focal brain ischemia induced by hyperventilation using Tc-99m HMPAO SPECT.

A case with vasospasm of the right anterior cerebral artery induced by hyperventilation is presented. Consecutive Tc-99m HMPAO brain SPECT studies at rest and during hyperventilation greatly contributed to the quantitative evaluation of focal perfusion decrease in conjunction with contrast angiography. This technique seems to be useful for the detection of alterations in regional brain perfusion during short duration intervention.

Adult↗