Biomedical subjects

H Matsuda

Publications and source records attributed to H Matsuda.

At least 1,243 records · Page 69Linked to original sources

PubMed1992

Hyperthermo-chemo-radiotherapy as a definitive treatment for patients with early esophageal carcinoma.

Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery.

Aged↗

PubMed1992

[Basic and clinical studies on cefprozil in pediatrics].

1. Serum levels of cefprozil (CFPZ, BMY-28100) after single oral administration of 7.5 mg/kg were 2.9-5.5 micrograms/ml at 1 hour and trace at 6 hours. 2. Urinary excretion rates of CFPZ were 45.7-102.3% within 6 hours (HPLC). 3. CFPZ was administered at doses ranging 19-47.3 mg/kg/day to 17 cases of pediatric infections including 16 cases with respiratory infections and 1 case with external otitis. Good clinical and bacteriological responses were obtained in all cases. 4. As side effect, diarrhea was observed in 1 case. As abnormal laboratory test results, eosinophilia was observed in 5 cases.

Administration, Oral↗

PubMed1992

Effect of intra-aortic balloon pumping after cardiac surgery: comparative study of use in coronary bypass and valve replacement.

To compare the effects of intra-aortic balloon pumping (IABP) between use for coronary artery bypass grafting (CABG) and for valve replacement, the results were reviewed in 513 patients who underwent CABG (n = 215) or valve replacement (n = 298). The rate of weaning from IABP and in-hospital survival after IABP support were excellent in CABG patients, where all 21 CABG patients (100%) and 17 out of 25 valve replacement patients (68%) could be weaned from IABP, and 19 out of 21 CABG patients (90%) and 14 out of 25 valve replacement patients (56%) survived for a long period. From comparative studies of pre- and postoperative data, the duration of IABP support in patients who could be weaned from IABP or who achieved in-hospital survival tended to be more prolonged in patients with valve replacement than in those with CABG. Among patients having IABP postoperatively, 4 CABG patients and 8 valve replacement patients had definite indications for IABP support. In the other 34 patients, preoperatively depressed cardiac function was observed in 12 patients where most of them were patients with valve replacement. Postoperative improvements in cardiac index were not as marked in patients undergoing valve replacement with IABP. The outcome for patients who had definite causes of post-operative cardiac failure, which were more numerous in the valve replacement group, was poor even if they could be weaned from much longer IABP support. In conclusion, the IABP was more effective in patients with CABG compared with those with valve replacement, because the number of patients who had a depressed cardiac function during the pre- and postoperative periods was lower in the CABG group and the incidence of serious perioperative complications was less frequent in these patients.

Adult↗

PubMed1992

[Neurophysiologic and histopathologic studies in a case of congenital sensory neuropathy with anhidrosis].

A three year-old boy with congenital sensory neuropathy with anhidrosis (CSNA) was described. Sural nerve biopsy specimens revealed an almost complete absence of unmyelinated fibers and a marked decrease of the density of small myelinated fibers with preservation of the density of large myelinated fibers. No evidence of active degeneration of unmyelinated or myelinated fibers was found. Skin biopsy specimens revealed the absence of nerve terminals and fibers innervating sweat glands, although sweat glands seemed to be apparently normal in their morphological findings. Therefore, it was concluded that the absence of pain and temperature sensations with preservation of touch sensation in our patient was compatible with the morphometric findings of nerve fibers of the sural nerve described. Similarly anhidrosis was concluded to be well explained by the absence of the innervation of sweat glands and the vessels around them. On the other hand, electrophysiologic studies, such as motor and sensory nerve conduction, short latency somatosensory evoked potential and auditory brainstem response, in which the function of the large myelinated fibers is presumably tested, were all normal. Therefore, the structure and function of such large myelinated fibers were spared in this case. From clinical viewpoints, electrophysiologic studies described above are useful to differentiate CSNA from other types of congenital sensory neuropathies, in which large myelinated fibers are affected.

Electrophysiology↗

PubMed1992

[Phrenic nerve palsy after open heart surgery--problems in post-operative respiratory management].

We clarified the problems in respiratory management in patients with phrenic nerve palsy (PNP) after open heart surgery. From December 1988 to March 1991, 248 adult patients underwent open heart surgery with topical myocardial cooling. In these patients PNP was diagnosed in 17 patients (6.9%). Age of these patients at operation ranged from 25 to 76 years with a mean age of 57 years. 9 patients were valvular heart disease (7 were reoperation), 7 were coronary artery disease, and one patient was aortic aneurysm. PNP was diagnosed by chest roentgenogram or percutaneous phrenic nerve stimulation test (PNST). Frequency of long-term intubation (> 14 days) was higher in complete PNP patients than incomplete PNP patients. 2 patients, who were observed effort dyspnea at the time of respiratory weaning, were extubated followed by respiratory and circulatory deterioration, and were reintubated. PNP were confirmed after reintubation by PNST. These patients died of pneumonia. Another 2 patients were observed effort dyspnea during respiratory weaning, and were doubted of PNP. PNP were confirmed by PNST before extubation. After hemodynamic stabilization and respiratory physiotherapy, these patients were extubated without any trouble. One patient, who required repeated intubation, was diagnosed PNP by PNST. This patient was extubated after confirmation of improvement of PNP by follow-up PNST. The incidence of PNP was higher in patients with previous open heart surgery than without previous operation. We supposed that the dissection around the heart might be one of major cause of postoperative PNP. So, in recent 4 cases of mitral reoperation, we attempted to reach mitral valve through atrial septum with minimum dissection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[A surgical case of thoracic aortic aneurysm due to Takayasu's aortitis associated with ulcerative colitis].

We experienced a case of thoracic aortic aneurysm due to Takayasu's aortitis associated with ulcerative colitis. Steroid was medicated to control inflammation and operation was performed. The ascending aorta, aortic arch, brachiocephalic artery, and left carotid artery were replaced by artificial graft. We made elephant trunk type anastomosis at the distal side of the graft to provide for growth of the aneurysm after operation. This was a rare case considered autoimmune overlapping syndrome, and its background was complicated by HLA-Bw52 and parasitic Metagonimus Yokogawai. Relationship between steroid medication and progression of the disease is not certain yet. Postoperative course is uneventful, no recurrence of inflammation is seen and the aneurysm is not enlarged until now.

Adult↗

PubMed1992

Effect of repeated oral doses of a novel immunosuppressive macrolide lactone on hepatic mixed-function oxidase system in the rat. Comparative study with ciclosporin.

Effect of pretreatment of rats with FK506((-)-(1R,9S,12S,13R,14S,17R,18E,21S,23S,24R,25S,27R)-17-allyl-1,14- dihydroxy-12-[(E)-2-[(1R,3R,4R)-4-hydroxy-3methoxycyclohexyl]-1- methylvinyl]-23,25-dimethoxy-13,19,21,27-tetramethyl-11,28-dioxa-4- azatricyclo-[22.3.1.0(4.9)]octacos-18-ene-2,3,10,16-tetrone hydrate, CAS 104987-11-3) on microsomal cytochrome P-450 system and oxidations of the administered drug and other model substrates were studied and compared with those of a pharmacologically related drug, ciclosporin (cyclosporin A). Oral treatment of male Sprague-Dawley rats with FK506 (0.4, 2 or 10 mg/kg/d) for 7 days did not decrease microsomal content of total cytochrome P-450 in livers, but rather increased the content in groups with the dose of 0.4 or 10 mg/kg to the levels of 126-130% of the control. Microsomal NADPH-cytochrome c reductase activities were decreased up to 67% of the control with the increasing dose of FK506 and to 62% in a group treated orally with cyclosporin A (25 mg/kg/d for 7 days), although another microsomal electron-transport component, cytochrome b5, was rather increased in all the treated groups. Treatment with FK506 or cyclosporin A did not reduce but slightly increased microsomal activities of aniline hydroxylation, p-nitroanisole O-demethylation and O-ethoxyresorufin O-deethylation. Microsomal depropylation of 7-propoxycoumarin, a typical P-450IIIA-substrate, was also not reduced in all dose groups of FK506, while it was decreased by the treatment with 25 mg/kg cyclosporin A.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

Single lung transplantation in rats with fatal pulmonary hypertension.

Effects of single lung transplantation on fatal pulmonary hypertension were evaluated in rats receiving a lethal dose of monocrotaline. Inbred rats treated with monocrotaline (80 mg/kg) received a left lung isograft at 4 weeks (n = 9) and at 6 weeks (n = 6), when moderate and severe pulmonary hypertension, respectively, had developed. Medicated (n = 12) and nonmedicated rats (n = 12) served as control animals. Each rat was tested weekly with treadmill for exercise tolerance and oxygen consumption during a 10-week period after medication and after they were killed. Medicated control rats lost exercise tolerance and highest oxygen consumption per unit time consistently to the range of resting value (or 45% of nonmedicated control rats), and all died from severe pulmonary vascular occlusive disease with right ventricular hypertrophy before 10 weeks (right ventricular/left ventricular weight ratio of 1.16). All rats receiving a left lung isograft at 4 weeks survived and regained highest oxygen consumption per unit time (87% of nonmedicated control rats), with the lung transplant receiving 65% (nonmedicated control rats, 39%) of cardiac output and milder right ventricular hypertrophy (right ventricular/left ventricular weight ratio of 0.46). Except for one, all rats that received a left lung isograft at 6 weeks tolerated single lung transplantation, but they died soon after reperfusion because of pulmonary edema in the graft that received 58% of cardiac output with right ventricular/left ventricular weight ratio of 0.79. Results of single lung transplantation in rats were dependent on severity of pulmonary hypertension. In rats with moderate pulmonary hypertension, single lung transplantation was successful in reversing exercise intolerance and right ventricular hypertrophy. Single lung transplantation was unsuccessful when pulmonary hypertension was severe in the rat model because increased flow toward the lung transplant resulted in graft pulmonary edema.

Animals↗

PubMed1992

[Unilateral persistent hyperhidrosis after ischemic stroke].

A 64-year-old right hemiplegic woman, who had been treated for hypertension for 15 years, was admitted to our hospital. Neurologic examination on admission disclosed right hemiplegia and motor aphasia; however, ophthalmoparesis, pupillary abnormality, and blepharoptosis were not evident. Excessive sweating on the right side of the body, which was most marked on the face, was observed. Amount of sweating on the left side of the body was normal. Unilateral hyperhidrosis persisted for more than 2 months. MRI revealed hemorrhagic infarctions in the left basal ganglia, internal capsule, thalamus, hypothalamus, and medial part of the cerebral peduncle. 123I-IMP SPECT disclosed hypoperfusion in the left striatum, thalamus, occipital cortex, and right cerebellar hemisphere. Cerebral angiography revealed arteriosclerotic changes in the basilar artery, but that the left posterior cerebral artery and its branches were not occluded. Unilateral persistent hyperhidrosis is rare after ischemic stroke. Hypothalamic lesion was thought to be responsible for the hyperhidrosis in this patient. As the hypothalamus receives its blood supply from the posterior cerebral artery, unilateral persistent hyperhidrosis may be an important sign of cerebral infarction in the posterior cerebral artery region.

Cerebral Infarction↗

PubMed1992

[Pulsed Doppler echocardiographic observation of left ventricular filling dynamics after aortic valve replacement in patients with chronic aortic regurgitation].

The 23 patients who underwent aortic valve replacement (AVR) for aortic regurgitation (AR) from 1977 to 1990 were studied with pulsed Doppler echocardiography. The patients were divided into two groups. The A group consisted of 5 patients whose end-systolic volume index (ESVI) were more than 200 ml/m2 and/or left ventricular ejection fraction (EF) were less than 0.35 before AVR. The B group consisted of 18 patients whose ESVI were less than 200 ml/m2 and EF were more than 0.35 before AVR. A Doppler volume sampler was placed at the center of mitral orifice to measure the transmitral inflow velocity after AVR (mean 28 months). Left ventricular filling dynamics were assessed by the peak velocity in the rapid filling phase (R), the peak velocity in the atrial contraction phase (A) and the ratio of A by R (A/R ratio) of mitral flow velocity pattern. The deceleration rate of early diastolic rapid inflow (DeR) determined as the slope a straight line drawn between the peak of early diastolic inflow and a point at half peak velocity on the fall side of the envelope. Result was as follows; 1) The DeR showed significant correlation with the EF (r = 0.56, p < 0.01). The DeR showed significant inverse correlation with the ESVI (r = -0.52, p < 0.05). 2) The R velocity (mean 43.9 +/- 7.9 cm/sec) in group A was significantly lower than in group B (mean 61.4 +/- 18.6 cm/sec), (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Assessment of regional and transmural myocardial perfusion by means of intraoperative myocardial contrast echocardiography during coronary artery bypass grafting.

By using intraoperative myocardial contrast echocardiography, we assessed regional myocardial perfusion and transmural blood flow distribution immediately after myocardial revascularization. A total of 62 revascularized myocardial areas were studied in 31 patients undergoing coronary artery bypass grafting. The revascularized areas were divided into three different areas: S area, supplied by significantly stenosed coronary arteries (43 areas); C area, supplied by coronary collateral situation associated with totally occluded coronary arteries (12 areas); MI area, preexisting transmural myocardial infarction (7 areas). Myocardial contrast echocardiography was obtained by direct injection of 2 ml of sonicated 5% human albumin into the saphenous vein grafts at rest and during atrial pacing. Each area was divided into two layers of endocardial and epicardial halves, and myocardial enhancement of peak intensity was measured for each half and endocardial/epicardial gray level ratio was calculated: (1) The peak intensity of myocardial enhancement in S area and C area was significantly higher than that in MI area at rest as well as during pacing after myocardial revascularization. There was no significant difference in the peak intensity between S area and C area both at rest and during pacing. In S area the peak intensity significantly increased during pacing (p < 0.01), whereas it did not change in C area and MI area. (2) S area demonstrated no significant change in endocardial/epicardial intensity ratio during pacing. In contrast, the ratio in C area significantly decreased during pacing. (3) In S area with preoperative percent increase of segmental wall thickening lower than 25%, there was a significant correlation (r = 0.84, p < 0.001) between the peak intensity of myocardial enhancement and the postoperative changes of percent increase of segmental wall thickening in the revascularized areas. Thus, immediately after myocardial revascularization, intraoperative myocardial contrast echocardiography could provide a quantitative assessment of regional myocardial perfusion as well as blood flow distribution in the areas with myocardial infarction and with coronary collateral situation and in the areas supplied by stenosed coronary arteries.

Cardiac Pacing, Artificial↗

PubMed1992

Evaluation of right ventricular function by regional wall motion analysis in patients after correction of tetralogy of Fallot. Comparison of transventricular and nontransventricular repairs.

Right ventricular function was assessed by regional wall motion analysis and by global function in 62 patients after repair for tetralogy of Fallot. Its relation to surgical procedures, with special attention to right ventriculotomy, was investigated. Patients were classified as follows: group Ia (n = 17), transpulmonary-transatrial repair without right ventriculotomy; group Ib (n = 22), transpulmonary-transatrial repair with minimal right ventriculotomy and small transannular patch; and group II (n = 23), transventricular repair with or without transannular patch. For regional wall motion analysis, fractional area change was used for three anterior parts obtained from hemiaxis area analysis of the lateral right ventriculogram. Ejection fractions were used for global right ventricular function. Functional assessment was done both at rest and during isoproterenol infusion, which is a stress test to evaluate cardiac functional reserve. At rest, group Ia showed better right ventricular anterior wall motion as well as global ejection fraction than did group II. Group Ib showed a global ejection fraction comparable to group Ia, with better regional wall motion in the middle anterior part of the right ventricle despite the depressed upper and lower anterior parts of the right ventricle. Group II showed depressed wall motion of the middle anterior part and the resultant impaired global ejection fraction. During isoproterenol infusion, group Ia showed significant increase in fractional area change of all anterior parts and in global ejection fraction. Group Ib showed significant increases in fractional area change at the middle and lower parts and in global ejection fraction comparable with group Ia. Otherwise, group II showed no significant change in fractional area change, or in global ejection fraction, at the upper and middle parts. These results indicated that transpulmonary-transatrial repair for tetralogy of Fallot provided better postoperative global right ventricular function and its reserve, with less impaired regional wall motion, than did the transventricular repair.

Cardiac Catheterization↗

PubMed1992

[The first case of infantile type neuronal ceroid-lipofuscinosis in Japan].

We reported the first case of typical infantile-type neuronal ceroid-lipofuscinosis (INCL) in Japan. The patient was a 1-year-old girl presenting with rapidly progressive psychomotor deterioration and blindness. Muscular hypotonia, microcephaly and myoclonic jerks became marked with the progression of her disease. Diminution in amplitude of EEG, VEP and ERG was prominent in the initial stage, but ABR was normal. MRI showed progressive brain atrophy. Electron microscopic examination of the biopsied skin revealed granular matrix, the specific inclusion bodies, in the epithelial cell of sweet glands. Many sea-blue histiocytes were demonstrated in her bone marrow samples. INCL is a common progressive encephalopathy in the Scandinavian countries, but a typical case had not yet been fully reported in Japan. This prompted us to report our case. Future reports are need for the study of INCL in Japan.

Biopsy↗

PubMed1992

Global left ventricular performance and regional systolic function after suture annuloplasty for chronic mitral regurgitation.

BACKGROUND: In surgery for chronic mitral regurgitation, the mitral subvalvular apparatus, including annulus, may play an important role in preserving left ventricular (LV) performance. The suture annuloplasty for mitral regurgitation allows annular contraction of the mitral valve. The potential effects of suture annuloplasty on the postoperative LV performance have not been fully defined. METHODS AND RESULTS: Global and regional LV function in 12 patients with suture annuloplasty were compared with 12 patients with conventional mitral valve replacement (MVR). Cineangiography and echocardiography were obtained before and 10.8 months after surgery. End-diastolic volume index and end-systolic volume index decreased significantly in both groups after surgery (p < 0.01). Ejection fraction remained unchanged in the suture annuloplasty group, whereas it decreased significantly in the MVR group after surgery (p < 0.01). There was a significant inverse relation between ejection fraction and end-systolic wall stress in the two groups after surgery (suture annuloplasty group, r = -0.69, p = 0.01; MVR group, r = -0.60, p = 0.04). The intercept on the y axis was significantly (p < 0.005) higher in the suture annuloplasty group than in the MVR group. In the suture annuloplasty group, cross-sectional area ejection fraction at the mitral valve level and at the papillary muscle level by LV two-dimensional echocardiography remained unchanged after surgery. In the MVR group, they decreased significantly after surgery (p < 0.01). There was a significant correlation between the cross-sectional area ejection fraction and the global ejection fraction at both levels after surgery. Therefore, the improvement of the regional wall motion can be attributed to the improvement of the global LV performance after suture annuloplasty. CONCLUSIONS: These data suggest that suture annuloplasty can provide more desirable postoperative LV systolic performance than conventional MVR by preserving both the contraction of the mitral annulus and the mitral valvular-ventricular interaction.

Echocardiography↗

PubMed1992

[The utility of quantitative 99mTc-GSA liver scintigraphy in the evaluation of hepatic functional reserve: comparison with 99mTc-PMT and 99mTc-Sn colloid].

Using data from 17 patients with liver cirrhosis and 3 patients with fatty liver, we have compared the utility of 3 hepatic imaging agents in the evaluation of hepatic functional reserve. Evaluated here were 99mTc-galactosyl human serum albumin (GSA) which is a new ligand for hepatic binding protein, 99mTc-N-pyridoxyl-5-methyl tryptophan (PMT) of a hepatobiliary agent, and 99mTc-Sn colloid. In each patient, we performed these 3 imaging studies within a week and also examined hepatic function tests (indocyanine green test, hepaplastin test, choline-esterase, etc). In each imaging study, serial images and dynamic data were obtained after the injection of 99mTc-GSA (185 MBq/3 mg), 99mTc-PMT (185 MBq), or 99mTc-Sn colloid (185 MBq). Using the obtained dynamic data, we analyzed the liver kinetics of the 3 agents based on 1 compartment model with 3 parameters (hepatic clearance, hepatic excretion rate, non-specific volume of distribution). From fitting the liver and heart data to this model, three unknown parameters were determined. Patlak plot was also applied in order to estimate liver uptake rate. Both curve fitting and Patlak plot could determine appropriate parameters in every study. In 99mTc-GSA, a nonlinear 3 compartment model was also applied in order to estimate hepatic blood flow, liver receptor density, and affinity of receptor-GSA binding separately. Using the obtained parameters, we analyzed the correlations between the parameters and the results of hepatic function tests. In all of the parameters, those obtained from 99mTc-GSA imaging showed the most significant statistical correlation with the results of hepatic function tests. From the present results, 99mTc-GSA imaging was concluded to be the best for evaluation of hepatic functional reserve.

Adult↗

PubMed1992

[A clinical study of tuberculous pleurisy].

Forty-eight cases of tuberculous pleurisy were examined and the following results were obtained. (1) Most of the patients were male, and there was no significant age and underlying diseases. (2) Fever and chest pain were observed mainly in younger patients, and sputum and dyspnea in older patients. (3) All of the cases examined had exudative pleural effusion, and increased ADA activity was frequently observed. (4) Mycobacterium tuberculosis was detected in the sputum of 65%, and also in the pleural effusion of 28% of the patients. The pathological diagnosis of tuberculosis was made by pleural biopsy in 83% of the patients, suggesting that pleural biopsy is very useful in the diagnosis of tuberculosis pleurisy. (5) The prognosis of the patients with tuberculosis pleurisy was good. Steroid therapy was generally ineffective.

Adolescent↗

PubMed1992

[Low dose cyclosporin treatment for ocular lesions of Behçet's disease].

Cyclosporin is an immunosuppressant that has recently been used for the treatment of Behçet's disease. We evaluated the clinical effect of low doses of cyclosporin (5 mg/kg/day) on 20 patients of Behçet's disease with refractory ocular involvement. The therapeutic effect of cyclosporin was judged by the frequency of ocular inflammatory attacks. It was effective in more than 70% of the patients. On the other hand, it had some adverse side effects such as renal dysfunction, indigestion, and neurological disorders. Most side effects were mild with low dose treatment, but neurological side effects were similar in frequency and severity to those seen with 10 mg/kg/day usage. These findings indicate that low dose cyclosporin (5 mg/kg/day) administration may be acceptable as a standard plan for treatment of Behçet's disease, but that we have to use cyclosporin with great attention to its side effects, especially neurological symptoms.

Adult↗

PubMed1992

[Progress and application of multiple-parameter flow cytometric analysis].

Multiple-parameter flow cytometric analysis for the expression of cell surface markers has been generally used in various clinical and fundamental fields. This was made possible by the development of many monoclonal antibodies and new fluorescence dyes coordinately with the progress in hardwares. Especially, the development of new fluorescence dyes enabled us simultaneously analysis of more than two markers, not only surface markers but also intracellular events, such as Ca2+ concentration and cell cycle. As a result, fine characterization of cells of interest is now possible even with a limited number of cells within a shorter time. The high resolution and sensitivity of current multiple-parameter flow cytometer make possible the isolation of diverse and unique cell populations that can be obtained by no other way.

Antibodies, Monoclonal↗