Biomedical subjects

H Saitoh

Publications and source records attributed to H Saitoh.

At least 325 records · Page 18Linked to original sources

PubMed1991

Ataxic hemiparesis due to small semioval center infarction--consideration of the neuroanatomical disruptions responsible for ataxic hemiparesis.

A 63-year-old man with clinical features of typical ataxic hemiparesis is reported. CT scan and magnetic resonance imaging showed a small infarction in the contralateral semioval center near the parietal cortex. Of note is the previously unreported site of the lesion relative to this syndrome. The neuroanatomical basis for the ataxic hemiparesis syndrome is discussed.

Ataxia↗

PubMed1991

Neuroradiological findings of paretic neurosyphilis, a case report.

Neuroradiological findings of a patient with paretic neurosyphilis are described. A 50-year-old male patient showed personality changes, severe dementia and some neurological deficits. Serological analysis of serum and cerebrospinal fluid demonstrated the presence of antibodies to Treponema pallidum. Computed tomography showed diffuse cerebral cortical atrophy and ventricular dilatation, and magnetic resonance (MR) imaging revealed some small abnormal signals in the white matter. Single photon emission tomography using [123I] N-isopropyl-p-iodoamphetamine (IMP-SPECT) indicated decreased activities, most markedly in the right frontal and bitemporal cortices. Although the neuroradiological findings were nonspecific, the MR imaging and IMP-SPECT findings were interesting because they have not been described previously to our knowledge.

Antibodies, Bacterial↗

PubMed1991

[Vertebral dissecting aneurysm treated with trapping and bilateral posterior inferior cerebellar artery side-to side anastomosis; case report].

A case is reported of ruptured dissecting aneurysm of the intracranial vertebral artery (VA) operated on with VA trapping and bilateral posterior inferior cerebellar artery (PICA) side-to-side anastomosis. A 42-year-old male suddenly developed severe headache and vomiting. On admission, 3 hours later, he was in a state of moderate confusion (Japan Coma Scale 3) and had neck stiffness. Computed tomography (CT) revealed diffuse subarachnoid hemorrhage, especially thick in the posterior fossa with right side dominance. Right vertebral angiography disclosed a fusiform dilatation with proximal narrowing of the right VA which originated just proximal to the VA-PICA junction. Lateral suboccipital craniectomy was undertaken with the patient in a left park bench position. Right VA was dilated and discolored black, and right PICA arose from the proximal portion of this aneurysmal dilatation. Since it was impossible to clip the VA distal to the PICA for the proximal clip-occlusion, the VA including the VA-PICA junction was trapped. Considering the risk of developing infarction at the PICA territory, bilateral PICA was anastomosed at their posterior medullary segment in a side-to-side fashion because the occipital artery (OA) had been cut at the skin incision and could not be used for the OA-PICA anastomosis. The postoperative course was benign, but a mild lateral medullary syndrome developed. CT revealed no abnormal low density area and left vertebral angiography demonstrated the patency of the bypass. Thereafter, the deficit subsided gradually and the patient was discharged. He is presently working without neurological deficit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[Radiographic visualization of pleural space under negative pleural pressure].

Although many imaging modalities have developed in the area of pulmonary medicine, information about the condition of pleural surface is limited. In this study, we carried out contrast pleurography under negative pleural pressure in dogs and humans to evaluate the condition of the pleural space including adhesion between the two pleural layers, incomplete fissure and features of the pleural surface. After insertion of a flower-type catheter into the pleural space under ultrasonic guidance, contrast material (60% Meglumine iotalamate, Conray 60, 0.5-1.0 ml/kg) was injected into the pleural space through the catheter. In dogs with intact pleura, contrast material distributed to the pulmonary surface, including interlobar spaces, rapidly. In dogs with pleural adhesion which was induced artificially with talc, affected areas were visualized as defects of contrast material. In humans, this contrast pleurography provided information about pleural adhesion, pulmonary lobulation, extent of cancer to neighbouring lobes, irregular pleural surface due to bullae formation and pleural indentation by cancerous lesion. There was no serious complication in dogs and human studies. This contrast pleurography is unique because it is possible to evaluate the pleural space physiologically under negative pressure condition. It may be concluded that this method of pleurography is useful for the clinical evaluation of the condition of the pleura in various lung diseases.

Adult↗

PubMed1991

[Prospective controlled study of elective sclerotherapy plus oral propranolol for prevention of recurrent bleeding in cirrhotics with recent variceal hemorrhage].

In a prospective, randomized controlled trial, 43 patients with cirrhosis and variceal hemorrhage were allocated after control of the bleeding to treat by elective sclerotherapy alone (n = 23) or by oral propranolol after elective sclerotherapy (n = 20). The dose of oral propranolol was based on a reduction of the resting pulse rate by 25%. The end points of the study were rebleeding or death. Both treatment groups were comparable with respect to origin and severity of liver disease, size of esophageal varices and portal pressure at entry. The mean follow up was 27 +/- 19 months for all patients. Patients treated sclerotherapy alone had more rebleeding (n = 11) did than those in the sclerotherapy plus propranolol (n = 3). The cumulative percentages of patients free of rebleeding 1 and 2 years after inclusion were 77 and 66% in sclerotherapy alone, and 100 and 85% in sclerotherapy plus propranolol; the difference between the two groups was significant. No statistically significant effect on mortality was seen. These data support that oral propranolol after sclerotherapy reduces the risk of recurrent bleeding in cirrhotics treated elective sclerotherapy.

Administration, Oral↗

PubMed1991

[Intra-arterial infusion chemotherapy using an implantable reservoir in the treatment of hepatic metastases in colorectal cancer].

With colorectal cancer, the therapeutic outcome for multiple hepatic metastasis extending to the bilateral lobe, even when various chemotherapies are administered, is extremely poor. For multiple hepatic metastases at our clinic, from November, 1985, through February, 1991, we used an implantable reservoir to administer intra-arterial infusion chemotherapy and reviewed the results. We treated 16 patients with hepatic metastases of colorectal cancer, H2 in 3 cases and H3 in 13 cases. When we used the reduction rate of the tumor diameter as seen by CT scan as a criteria for antitumor effectiveness, 1 case was CR and 3 cases were PR, for an efficacy rate of 25.0%. Changes in the serum CEA level were related to antitumor effectiveness. Among the evaluable cases, the 1-year survival rate was 60.0%, which was significantly more favorable than the 20.0% obtained in the systemic chemotherapy group (p less than 0.05). Given the above, although there are a few problems such as the kind and dose of drugs, the use of intra-arterial infusion chemotherapy with an implantable reservoir to treat hepatic metastases of colorectal cancer permits a form of chemotherapy providing a better QOL out of hospital.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1991

Protein-losing gastroenteropathy detected by technetium-99m-labeled human serum albumin.

Gastric and fecal clearance of alpha 1-antitrypsin were measured in three cases of protein-losing gastroenteropathy and in two control cases. Abdominal scintigraphy using 99mTc-labeled human serum albumin was performed in all five subjects. All three cases of protein-losing gastroenteropathy showed 99mTc activity in the gastrointestinal tract. In the patient with hypertrophic gastropathy, the activity was seen initially in the stomach and duodenum. In the patients with intestinal lymphangiectasia, the activities were initially in the small bowel. We conclude that 99mTc scintigraphy was useful, not only in diagnosing protein-losing enteropathy, but, also, in detecting the responsible region of the gastrointestinal tract.

Feces↗

PubMed1991

[Cardioplegic arrest and intermittent aortic clamping: comparison in coronary artery bypass graft].

427 randomized patients undergoing coronary artery bypass graft (CABG) were divided into two groups. In Group A (269 patients), myocardial protection was achieved using cardioplegic solution (Bretschneider). Group B (158 patients) was operated with intermittent aortic cross-clamping. Between both groups there was no significant difference in early postoperative mortality rates, incidence of postoperative low output syndrome, perioperative myocardial infarctions, length of ICU-stay, length of intubation, incidence of arrhythmia, and inotropic requirements. The ratio of reperfusion time divided by aortic cross-clamping time (R/C-ratio) in Group B (1.06 + 1.17) was larger than in Group A (0.49 + 0.17), which could explain this result. In Group A significantly larger incidence of postoperative arrhythmia was recognized, if reperfusion time was shorter than 20 minutes. Also in Group A, longer postoperative intubation was required with R/C-ratio under 0.60. In Group B longer intubation was needed postoperatively with aortic cross-clamping time longer than 30 minutes, reperfusion time shorter than 30 minutes, or R/C-ratio under 0.80. In conclusion, reperfusion should be continued at least for 20 minutes and if possible, for the length equivalent to R/C-ratio over 0.60 in CABG with presently widely used cardioplegic arrest.

Adult↗

PubMed1991

Hepatic hemodynamics and functions in extrahepatic portal obstruction in the rat with liver cirrhosis.

Portal vein obstruction due to a thrombus may be encountered in liver cirrhosis. However, the effect of portal vein obstruction on hepatic hemodynamics and functions, and on collateral formation has not been clear in liver cirrhosis. To rectify this, the cirrhotic rat model with portal vein ligation was evaluated. In addition to the early recovery of hepatic blood flow, the reduction in hepatic blood flow after portal vein ligation was less in the cirrhotic rat than in the normal rat. The portogram showed that, in addition to hepato-fugal collaterals, hepato-petal collaterals developed well and early in the cirrhotic rat as compared with the normal rat. Although mitochondrial functions before portal vein ligation deteriorated in the cirrhotic rat, the decrease after portal vein ligation was less, and the recovery of function was earlier in the cirrhotic than the normal rat. The influence of portal vein obstruction on hepatic hemodynamics and functions in the cirrhotic rat was less than in the normal rat, due to earlier and significant formation of hepato-petal collaterals.

Animals↗

PubMed1991

[Stab wounds of the spinal cord by a kitchen knife: report of a case].

A case of spinal cord injury due to stab wounds by a kitchen knife is presented. A 41-year-old male was hospitalized because of spinal cord injury resulting from stab wounds inflicted with a kitchen knife in the posterior cervical area. Neurological examination on admission showed paraplegia, disappearance of deep tendon reflex in both lower extremities, sensory disturbance below T1 level, left Horner's syndrome and urinary disturbance. In addition to these symptoms cerebrospinal fluid was leaking from the wounds. An emergency operation was performed. After laminectomy of C7 and T1, we found that the spinal cord was almost completely split at C7/T1 level. Dural plasty was performed. Neurologically, sensory disturbance was slightly improved at 4 months after the injury. Initial MRI (TR: 200 msec, TE: 20 msec) revealed high intensity at C7/T1 level which was damaged by the kitchen knife. MRI 5 months after the injury revealed low intensity on T1 weighted imaged, high intensity on T2 and proton weighted image. The occurrence of the spinal cord injury due to stab wounds by a kitchen knife is very rare in Japan. MRI is useful in the diagnosis of stab wounds of the spinal cord.

Adult↗

PubMed1991

[Results of noncurative resection of primary lung cancer].

Out of 1099 cases of primary lung cancer patients who underwent surgical treatment in our department from 1952 to 1988, 374 cases were divided as noncurative by the post surgical examination. We divided the causes of noncurative resection as follows; I) absolute noncurative resection 1) tumor rest in a) lymph nodes (Ly rest), b) chest wall or diaphragma (Ch + Dia rest), c) bronchial stump (Bro rest) 2) intra-pulmonary metastasis (pm), 3) dissemination or pleuritis carcinomatosa (Dis + pl) II) relative noncurative 1) incomplete dissection of lymph nodes (Ro) 2) group 2b lymph node metastasis (2b Ly). Ly rest was the commonnest (103 cases 27.5%) in noncurative resection and Ch + Dia rest (94 cases, 25.1%) and p.m. (54 cases 14.4%) followed thereafter. Two thirds of the noncurative cases were classified into these 3 groups, and the rest of the causes were Dis + pl, Bro rest. RO and 2b Ly groups. p.m. and Ly rest groups were the most common causes of noncurative resection in adenocarcinoma cases whereas Ly rest and Ch + Dia rest groups were common in squamous cell carcinoma cases. Five year survival rate of the total noncurative cases was 12.1% although those of Dis + pl groups was 22.9% and those of p.m. group was 18.8%. Five year survival rate of the other groups were around 10%. A slightly better survival rate was observed when relative noncurative resection was performed in RO (19.7%) and 2b Ly (18.7%) groups.

Female↗

PubMed1990

Two different lymph node metastatic patterns of a prostatic cancer.

Among 753 autopsy prostatic cancer cases with a metastasis, 476 (63%) had a lymph node metastasis, whereas 277 (37%) did not. Two different lymph node metastatic patterns were observed: Type 1, combined metastasis involving the pelvic and paraaortic lymph nodes; and Type 2, metastasis to the paraaortic lymph nodes, but not to the pelvic lymph nodes. Type 1 metastasis cases showed a significantly more frequent metastasis to the bladder and rectum, and a less frequent metastasis to the lungs and liver. Hydronephrosis occurred more frequently (P less than 0.01) in the Type 1. Furthermore, in the Type 1 cases the lymph node metastasis appeared to be continuously invasive, but in the Type 2 cases, metastasis appeared to be the skip type or some metastases may have spread via the vertebral vein bypass route and may have been associated with a hematogenous metastasis.

Aorta↗

PubMed1990

Target cell of leukemic transformation in acute megakaryoblastic leukemia.

Acute megakaryoblastic leukemia (AMkL) is a newly defined acute leukemia in which the differentiation of proliferating blasts is arrested at the megakaryocytic precursor stage. In order to clarify whether a target cell of leukemic transformation in AMkL is a cell committed to megakaryocytic lineage, or a multipotential stem cell, we examined AMkL patients with regard to: a) the presence of myelodyplastic features in residual erythroid and granulocytic cells, b) coexistence of myeloperoxidase (MPO)-positive blasts with megakaryoblasts, and c) the presence of the same chromosomal abnormality in erythroid and granuloid colony-forming cells as seen in megakaryoblasts. Regarding the former two items, results were compared with those from megakaryoblastic crisis of chronic myelocytic leukemia (CML-MkBC) and transient myeloproliferative disorder in Down syndrome (DS-TMD), which are thought to be multipotential stem cell disorders. Among 18 patients with AMkL, three, all complicating myelofibrosis, had marked myelodysplastic changes of erythroid series and/or granulocytic series. In 4 out of 7 patients with CML-MkBC, 5 out of 8 patients with DS-TMD, and 7 out of 18 patients with AMkL, MPO-positive blasts, even though rare, were observed in addition to PPO-positive blasts. All except one of these patients with AMkL also showed complicating myelofibrosis. In one case of AMkL with myelofibrosis, chromosomal analysis of cultured cells of individual colonies revealed that all the analysable metaphases from both CFU-GM and BFU-E had the same chromosomal abnormality as megakaryoblasts. This study has clarified that a considerable proportion of AMkL cases, particularly those with complicating myelofibrosis or showing acute myelofibrosis, arise against the background of a multipotential stem cell disorder, even if blasts are exclusively megakaryocytic in phenotype.

Cell Transformation, Neoplastic↗

PubMed1990

Upshaw-Schulman syndrome in two siblings.

Upshaw-Schulman syndrome is a rare disease, and familial occurrence has not been reported. In this paper, two Japanese brothers, aged 2 and 6 years, with microangiopathic hemolytic anemia, thrombocytopenia and fragmented red cells from the newborn period are reported. Unusually large von Willebrand factor (vWF) multimers were found in the plasma samples from both cases during remission, while the quantities of the unusually large vWF multimers decreased greatly at a low platelet count. They were temporarily relieved from hemolytic anemia and thrombocytopenia by infusions of plasma from normal donors. It appears that our patients lack an unidentified plasma factor, which is genetically determined.

Anemia, Hemolytic, Congenital↗

PubMed1990

Correlation between structures of organic cations and their binding behaviours to brush border membrane isolated from rat small intestine.

We have investigated the correlation between the molecular structures of various organic cations and their binding to rat small intestinal brush border membrane. The binding of small quaternary ammonium compounds such as tetramethylammonium and choline to brush border membrane was not sufficient to inhibit methylchlorpromazine binding. However, lauryltrimethylammonium and cetyltrimethylammonium, both quaternary amines with a long carbon chain, inhibited binding significantly. The inhibition was competitive. When the unbranched hydrocarbon chain of the quaternary amines was extended in steps from C1 (methyl) to C16 (cetyl), the inhibitory effect increased sharply with length from C7 (heptyl) to C16. These results suggest that the size of the hydrophobic part of the molecule is an important factor in binding of quaternary ammonium compounds to the brush border membrane. The structure of the hydrophilic part was another factor. In imipramine-related compounds, the order of binding was N-didesmethylimipramine (primary amine) greater than desipramine (secondary) greater than imipramine (tertiary) greater than methylimipramine (quaternary). However, with the small molecular ethylamine-related compounds, binding properties did not reflect differences in the hydrophilic component. Therefore, the effect of the hydrophilic part may be secondary and may depend on the size of the hydrophobic part. We suggest that organic cations which are amphiphilic can bind to a common binding site on brush border membrane through hydrophobic and/or hydrophilic interactions.

Animals↗

PubMed1990

Contribution of passive transport mechanisms to the intestinal absorption of beta-lactam antibiotics.

The transport characteristics of aminopenicillins (ampicillin and amoxicillin), aminocephalosporins (cephalexin, cephradine and cefadroxil) and cefazolin have been compared with those of an actively transported substance (D-glucose) and a passively transported substance (L-glucose). Although the initial uptake of the aminocephalosporins was stimulated in the presence of an inward H+ gradient, there was no overshoot in the uptake of any of the drugs tested, even in the presence of an H+ gradient. Also, the time course and the degree of uptake of these drugs were similar to those of L-glucose, especially in the absence of an H+ gradient. These results suggest that the beta-lactam antibiotics tested, like L-glucose, pass through the rat intestinal brush border membrane mainly by passive diffusion. However, the differences in absorption between these drugs, like the differences in their disappearance from a proximal loop of rat intestine, cannot be explained by a simple permeation process alone.

Animals↗

PubMed1990

[Intestinal absorption and urinary excretion of triethylenetetramine for Wilson's disease in rat].

Triethylenetetramine.2.HCl (trientine, TE) is an orphan drug for the treatment of Wilson's disease. There has been no reports regarding the absorption, distribution, metabolism, and excretion in the body. In the current study, the absorption and excretion of TE in rats were examined. The observed mean percentage amount of TE absorbed at the jejunum and ileum with the loop method for 1 h was 42.0% and 22.5%, respectively. Tight junction blocking agent inhibited the absorption of TE from the jejunum loop with 27%, but the absorption of TE from the ileum loop was not affected by this blocking agent. Therefore, the main absorption route for TE might be permeation across the plasma membrane of intestinal epithelial cells. TE and amikacin, a polycationic compound like TE, bound to the brush border membrane (BBM) of rat small intestine in the absence of inorganic ions such as Na+, K+, Ca2+, Mg2+ and Cu2+. But the binding of TE to BBM was inhibited markedly under the physiological concentration of these ions. The bioavailability of TE was below 10% and the plasma levels of TE in non-fasted rats were significantly lower than that observed in fasted rats. The urinary excretion of unchanged TE during 24 h was only 3.5% of the orally administered dose. However, the urinary excretion of total TE including metabolites, though they have not been identified, was 35.7%. These results suggest that low bioavailability of TE might be due to the rapid metabolism in the body after absorption from the gastrointestinal tract.

Administration, Oral↗

PubMed1990

[Gamma-ray spectra of 201Tl-radiopharmaceuticals with a scintillation camera--crosstalk of contaminating nuclides of 200Tl and/or 202Tl onto 201Tl-photopeaks].

In cardiac imaging with 201Tl, the collimator for low energy high resolution is generally used, and also the energy window, which is set on the spectral display of a pulse height analyzer of a scintillation camera, is chosen 70 +/- 12.5 keV. The purpose of this study is to discuss those conditions in 201Tl imaging with the scintillation camera. Two types of collimators for HR (high resolution) and ME (medium energy) were used in this experiment, and we measured the pulse height spectra of 201TlCl radiopharmaceuticals in air and in a cuboid phantom, connecting a multi-channel pulse height analyzer to the scintillation camera. As a result of measuring of the pulse height spectra, two different energies of gamma rays which are not supposed to emit from 201Tl nuclide were observed, and we also identified the presence of a small amount of 202Tl (with 439 keV) and/or 200Tl (with 368 keV) from their half-life measurements. Thus, the use of the HR-collimator with 201Tl imaging is not suitable, because the shielding effects of its septa is poor to 439 keV gamma-rays, and the scattered radiation produced by the Compton interaction contributes to the principal photopeak on the pulse height spectrum. Here, we recommend the use ME-collimator instead of the HR-one, and of the window width of 76 +/- 25 keV for increasing the count rate.

Humans↗