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Biomedical subjects

H Sugimoto

Publications and source records attributed to H Sugimoto.

At least 235 records · Page 13Linked to original sources
PubMed1994

Unilateral hyperlucent thorax on plain chest radiographs after neck dissection: importance of atrophy of the trapezius muscle.

OBJECTIVE: A hyperlucent thorax on plain chest radiography indicates a decrease in the radiographic density of the thorax, which can be caused by intra- or extrapulmonary diseases. The purpose of this study was to assess the prevalence and mechanisms that may be responsible for unilateral hyperlucency of the thorax after neck dissection and to determine if atrophy of the trapezius due to the transection of the accessory nerve is a cause of hyperlucent thorax. MATERIALS AND METHODS: Differences in the radiographic density between the right and left lung were evaluated and correlated with transection of the accessory nerve in 21 patients who had had a radical or a modified neck dissection for a malignant tumor of the head and neck. Twenty-eight neck dissections were performed on these 21 patients (seven had a simultaneous bilateral neck dissection). In 14 of the 21 patients, the accessory nerve had been severed during the neck surgery. In six patients, mechanisms responsible for a hyperlucent thorax were investigated with follow-up thoracic CT scans. RESULTS: In the radiographs, eight patients had a hyperlucent thorax on the side of the neck dissection. In all of these cases, the accessory nerve on the side of this neck dissection had been severed during a radical or a modified neck dissection. Prior to surgery, no such hyperlucency was noted. CT scans showed atrophy of the denervated trapezius muscle. CONCLUSION: Our findings show that atrophy of the denervated trapezius muscle after neck dissection is a cause of unilateral hyperlucent thorax on plain chest radiographs. Therefore, this finding should be anticipated as a postoperative change in patients who have had this surgery.

Accessory Nerve↗
PubMed1994

[Adrenocortical function in children with near fatal asthma].

The adrenal function of children with near fatal asthma was evaluated by a modified rapid ACTH test. The rapid ACTH tests, which were performed within six months of each life-threatening asthmatic episode, showed extremely low responsiveness. The response in the subjects was significantly lower than that of patients who had received high dose of corticosteroid therapy. It was suggested that the adrenocortical function of children with near fatal asthma had been already suppressed and that adrenal suppression could easily occur in such patients. We advocate the following measures: (1) environmental control, education of patients and their families, physical training accurate medication should be supplied to reduce the use of corticosteroids, (2) sufficient doses of corticosteroids should, however be given to patients with acute exacerbation, (3) not only lung function tests or allergic examinations, but also adrenocortical function tests should be performed on severe asthmatic patients.

Adolescent↗
PubMed1994

[A case of scleroderma renal crisis with acute interstitial pneumonia, microangiopathic hemolytic anemia and refractory thrombocytopenia].

A 46-year-old woman who noticed tightness of the skin in September, 1993, was admitted to a local hospital due to hypertension, congestive heart failure and renal dysfunction on the 2nd of November. After admission, renal function deteriorated progressively. A diagnosis of scleroderma renal crisis (SRC) was suspected from her skin biopsy and clinical course. She was referred to our hospital for further evaluation and maintenance of hemodialysis. Her blood pressure was kept normal by anti-hypertensive drugs including cilazapril. Acute interstitial pneumonia, microangiopathic hemolytic anemia and thrombocytopenia appeared during her clinical course. Corticosteroid therapy was effective for acute interstitial pneumonia, but in-effective for thrombocytopenia. Plasma exchange was not effective for thrombocytopenia, which was successfully treated with intravenous gamma-globulin therapy. She died of cytomegaloviral encephalitis, which might have resulted from immunodeficiency caused by prolonged corticosteroid therapy and uremia. Complications other than SRC might have appeared during the clinical course based on the immune disorder of progressive systemic sclerosis itself. In order to improve the prognosis of patients with SRC such complications should be detected promptly and treated correctly.

Acute Disease↗
PubMed1994

[A case of paragonimiasis with a tumor of the intrathoracic chest wall].

A case of paragonimiasis with a tumor of intrathoracic chest wall was reported. The patient was a 46-year-old male who complained of cough and showed abnormal findings on chest X-ray. After performing various examinations, the patient was diagnosis as having a tumor of the intrathoracic chest wall. On surgery, the tumor was enveloped in a thick capsule and its lumen was filled with yellow-white atheromatous material. Calcification was not found. Pathologically, an egg-like structure of a parasite was confirmed inside the sequestrum attached to the lining of the inner surface of the capsule. Past history of pleuritis and ingestion of freshwater crabs confirmed the diagnosis of paragonimiasis.

Humans↗
PubMed1994

[A case of cardiac angiosarcoma with a pseudoaneurysm formed in the right coronary artery].

A case of superficially infiltrating cardiac angiosarcoma damaging the right coronary artery and forming a pseudoaneurysm was studied. The patient was a 25-year-old male who had undergone cardiac tamponade twice in the past six months. Since heart murmur was audible in auscultation, thorough examination was performed. Cardioechography and cardiac angiography revealed a pseudoaneurysm of hen egg size involving the proximal right coronary artery. Although the pseudoaneurysm and right atrium ruptured during operation, a coronary bypass was placed and the right atrium was repaired with an equine pericardium. Angiosarcoma was identified by pathological examination of the excised specimen. The patient died two months after operation due to lung metastasis.

Adult↗
PubMed1994

[Hyperbaric oxygen therapy in the Hokkaido University Hospital].

We surveyed the hyperbaric oxygen therapy during the past seven years in the Hokkaido University Hospital. The mean number of patients was 27 per year. The average number of the therapy was 328 per year. There were neither complications nor accidents attributable to the hyperbaric oxygen therapy. Three representative diseased states hypoxic brain damage, sudden deafness and occlusion of retinal arteries, showed remarkable recovery by this therapeutic modality. A safety standard has been revised in 1991. We have been operating the hyperbaric oxygen therapy according to the revised standard. The inter-departmental approach in this therapeutic modality is mandatory in order to achieve effective outcome.

Female↗
PubMed1993

[Ankylosing spondylitis with acute anterior uveitis--correlation between HLA-B27 and clinical and radiologic findings].

Six cases of ankylosing spondylitis (AS) complicated with acute anterior uveitis (AAU) were reviewed. Clinical and radiologic findings of these cases were correlated with HLA-B27. All the patients were men; four of them were HLA-B27 positive, and two were B27 negative. The average age of onset was younger in B27+ patients than in B27- patients. Ophthalmologic study showed no definite difference in inflammatory change of AAU between B27+ patients and B27- patients. AAU in B27+ patients was completely cured in three months. A history of low back pain was more apparent in B27+ than in B27- patients. Three out of four B27+ patients showed complete bony ankylosis in sacroiliac joints, whereas no ankylosis was seen in B27- patients. CT scan was useful to demonstrate sacroilitis in cases with equivocal radiologic findings. Spondylitic changes were more extensive in B27+ than in B27- patients. The results support the concept that HLA-B27+ AS and B27- AS are different entities with similar phenotypic expression, and HLA-B27 is an arthritogenic gene in the Japanese population as well.

Acute Disease↗
PubMed1993

Recovery from postoperative hypothermia predicts survival in extensively burned patients.

To clarify the cause of postoperative hypothermia in extensively burned patients, factors affecting postoperative hypothermia were studied in 16 extensively burned adult patients (8 survivors and 8 nonsurvivors) with a burn index greater than 35. Body temperature was monitored continuously in either the urinary bladder or rectum. Hypothermia of less than 35 degrees C occurred in 89% (66 of 74) of the total operations performed in these 16 patients. The rate of temperature rise (RTR) was significantly lower in nonsurvivors (0.4 +/- 0.2 degrees C/h) than in survivors (1.7 +/- 0.9 degrees C/h; p < 0.001). Continuous indirect calorimetry performed in seven patients (four survivors and three nonsurvivors) demonstrated that RTR was determined primarily by heat production. The measured energy expenditure reached only 1.7 +/- 0.2 times the basal energy expenditure during rewarming in nonsurvivors, whereas it was 2.7 +/- 0.9 times the basal energy expenditure in survivors (p < 0.01). Surprisingly, in nonsurvivors, the RTR was significantly decreased even during the first 2 weeks. These findings suggest that those who cannot generate heat well in postoperative hypothermia are unable to produce the additional energy required to overcome sepsis.

Adult↗
PubMed1993

Molecular cloning and heterogeneity of the human hepatitis C virus (HCV) genome.

The Japanese variant of the hepatitis C virus (HCV-N) genome, consisting of 9440 nucleotides in length, was cloned from a small amount (2 ml) of plasma from a single Japanese carrier by using RT-PCR and modified RT-PCR. The HCV-N genome has a long open reading frame that encodes a 3014 amino acid polyprotein with 340 and 57 bases of 5' and 3' non-coding sequences, respectively. HCV-N has a 4-amino-acid insertion in the NS5 region as compared to other HCV isolates, but this insertion is found to be very rare upon direct sequencing of that region. Comparative sequence analysis of all the complete and partial HCV sequences that were reported indicates that HCV can be subdivided into at least 4 groups. The HCV-N isolate has a high homology with HCV-J and HCV-BK (> 90%) and so belongs to group II, but shows less similarity to HCV-1 (> 78%, group I) and least to HC-J6 (> 67%, group III). Among these HCV isolates, the 5' non-coding region was the most conserved (> 93%) since it plays an important role in replication. The RT-PCR assay to detect HCV-RNA, using the primers deduced from this region, was very sensitive and specific. The putative core protein could become an important target for immunoassay because of a high degree of amino acid sequence similarity in that region. A high degree of diversity and a low similarity between each HCV isolate in the putative envelope protein play an important role in the chronicity of HCV infection and development of immunopreventive agents, such as immunoglobulin and vaccine for that infection.

Base Sequence↗
PubMed1993

Susceptibility effects of bone trabeculae. Quantification in vivo using an asymmetric spin-echo technique.

RATIONALE AND OBJECTIVES: The authors assessed the capability of magnetic resonance imaging in measuring bone mineral density in vivo. METHODS: Using the in-phase asymmetric spin-echo technique, the susceptibility effect (T2*susceptibility) was measured in lumbar vertebrae in vivo. Calcium density was measured with single energy quantitative computed tomography scan. The values of the susceptibility effect were correlated with calcium density. RESULTS: A statistically significant positive correlation was observed between signal loss due to susceptibility-induced inhomogeneity and the calcium density in the region of interest. The change in 1/T2*susceptibility per unit change in density was 0.114 seconds-1/mg/cm3. T2*susceptibility was 14.3 mseconds in volunteers and 17.4 mseconds in postoophorectomy patients. CONCLUSIONS: To some extent, quantification of bone density is possible using magnetic resonance imaging; however, the relatively wide dispersion of the susceptibility effect, plotted against the calcium density in the axial skeleton, indicates that other factors, such as the three-dimensional structure of bone trabeculae, may play important roles in determining magnetic resonance parameters.

Adult↗
PubMed1993

Extramedullary plasmacytoma: cytological and genotypic studies.

A 62-year-old woman had multiple plasmacytomas in the skin and lymph nodes, without Bence-Jones protein or a monoclonal peak of serum immunoglobulins. Infiltrating plasmacytoid cells expressed cytoplasmic IgG (lambda) and surface CD38, without any B-cell markers. There was no visceral or bone marrow involvement suggestive of multiple myeloma. Southern blot analysis of extracted DNA from the cutaneous lesions showed two rearranged bands with an immunoglobulin, but not a T-cell receptor, gene probe. The patient showed a poor response to chemotherapy, and died of bronchopneumonia. The clinical course and cytological features differentiate multiple cutaneous extramedullary plasmacytomas from solitary cutaneous extramedullary plasmacytoma and cutaneous lesions associated with multiple myeloma.

Female↗
PubMed1993

Transient and repetitive rises in blood pressure synchronized with plasma catecholamine increases after head injury. Report of two cases.

The authors report two patients with repetitive episodes of acute transient rise in blood pressure synchronized with increases in plasma catecholamine after severe head injury. In both cases, the paroxysmal hypertension occurred suddenly on the 2nd day posttrauma, and its frequency declined gradually, disappearing with time. The pathophysiological basis of this peculiar clinical manifestation is discussed.

Brain Injuries↗
PubMed1993

Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury.

Recent experimental studies have demonstrated that mild hypothermia at about 34 degrees C can be effective in the control of intracranial hypertension. A randomized controlled study of mild hypothermia was carried out in 33 severely head-injured patients. All patients fulfilled the following criteria: 1) persistent intracranial pressure (ICP) greater than 20 mm Hg despite fluid restriction, hyperventilation, and high-dose barbiturate therapy; 2) an ICP lower than the mean arterial blood pressure; and 3) a Glasgow Coma Scale score of 8 or less. The patients were divided into two groups: one received mild hypothermia (16 patients) and one served as a control group (17 patients). Mild hypothermia significantly reduced the ICP and increased the cerebral perfusion pressure. Eight patients (50%) in the hypothermia group and three (18%) in the control group survived (p < 0.05), while five (31%) in the hypothermia group and 12 (71%) in the control group died of uncontrollable intracranial hypertension (p < 0.05). In five patients in the hypothermia group, cerebral blood flow was measured by the hydrogen clearance method and arteriojugular venous oxygen difference was evaluated before and during mild hypothermia. Mild hypothermia significantly decreased the cerebral blood flow, arteriojugular venous oxygen difference, and cerebral metabolic rate of oxygen (p < 0.01). The results of this preliminary investigation suggest that mild hypothermia is a safe and effective method to control traumatic intracranial hypertension and to improve mortality and morbidity rates.

Adult↗
PubMed1993

[A case of non-IgA mesangioproliferative glomerulonephritis with huge paramesangial hemispherical deposits].

A 16-year-old female was admitted to our hospital because of chance proteinuria. On admission, mild proteinuria (0.6g/day) was observed, but microhematuria was not detected during the observation period. All the values of the renal function tests were within the normal range. Her renal biopsy demonstrated a prominent increase in the mesangial area by light microscopy and showed marked paramesangial hemispherical deposits by electron microscopy. Though IgM, IgG, Clq, C3, and fibrinogen were localized in the mesangial region, IgA was not detected by immunofluorescence study. It has been reported that paramesangial hemispherical deposits are strongly indicative of IgA glomerulonephritis. We conclude that this patient is a rare case of non-IgA glomerulonephritis with huge paramesangial hemispherical deposits.

Adolescent↗