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Biomedical subjects

I Murata

Publications and source records attributed to I Murata.

At least 55 records · Page 3Linked to original sources
PubMed1999

A chronic, massive thrombus in the right main pulmonary artery: a case report and echocardiographic analysis.

A chronic, large thrombus in the right main pulmonary artery (PA) was detected in a 54-year-old woman with a history of surgical repair of atrial septal defect. Color flow imaging revealed a prominent red signal along the right border of the markedly dilated PA. Pulsed Doppler echocardiography showed that the red signal was caused by flow reversal occurring during systole. According to the physics of blood flow, flow reversal probably represents secondary, helical flow, which may be related to thrombus formation.

Echocardiography↗
PubMed1998

Clinical studies on three cases of the interval form of carbon monoxide poisoning: serial proton magnetic resonance spectroscopy as a prognostic predictor.

Three patients with the interval form of carbon monoxide (CO) poisoning were studied for associations between their clinical courses and serial changes on: (1) MRI; (2) EEG; (3) single photon emission computed tomography with N-isopropyl-p-[123I]iodoamphetamine ([123I]IMP SPECT); and (4) proton magnetic resonance spectroscopy ([1HIMRS) to evaluate their usefulness as prognostic predictors. A hyperintense area on MRI T2-weighted images and a hypointense area on T1-weighted images, appearing in the deep white matter, persisted for a prolonged period even after improvement of the clinical symptoms, and did not become an accurate indicator of clinical evaluation or prognosis. [1H]MRS studies with the volume of interest set in the frontal lobe white matter revealed increases in choline-containing compounds, and reductions of N-acetylaspartate in all cases. These findings normalized in one subclinical case over time. Distinctive findings in the severe cases included increased lactate in two cases showing akinetic mutism, with a difference in prognosis noted according to the degree and period of persistence of this increase. EEG findings were relatively well correlated with clinical symptoms in the early period, with a good correlation no longer consistent after a certain period was exceeded. [123I]IMP SPECT findings did not always reflectclinical symptomatology either. These results indicate that [1H]MRS is the most useful indicator in the clinical evaluation of patients with the interval form of CO poisoning.

Adult↗
PubMed1998

Diversity of myocardial involvement in systemic sclerosis: an 8-year study of 95 Japanese patients.

BACKGROUND: Myocardial fibrosis has been reported to be an important complication of systemic sclerosis (SSc). Left ventricular (LV) hypertrophy has also been reported, but its significance is unclear. Correlations between cardiac complications and clinical or serologic subsets of SSc have not been previously evaluated by long-term observational studies. METHODS: We correlated the findings of echocardiography, electrocardiography, and autopsy with clinical and serologic features in 95 patients with SSc who were monitored for up to 8 years. RESULTS: Septal thickness determined by echocardiography was significantly greater in patients with anti-nuclear ribonucleoprotein (nRNP) antibodies than in patients with anti-Scl70 or anticentromere antibodies. Fractional shortening was reduced in patients with diffuse cutaneous involvement or anti-Scl70 antibodies. Ten patients had cor pulmonale, which was confirmed by echocardiography. Four of them had diffuse cutaneous involvement and advanced pulmonary fibrosis, whereas four had anti-nRNP antibodies and mild or no fibrosis. Septal hypertrophy was detected in 12 patients, 10 of whom had limited cutaneous involvement and six had anti-nRNP antibodies. Diffuse or regional LV wall hypokinesia was seen in seven patients, of whom six had anti-Scl70 antibodies and five had diffuse cutaneous involvement. Six patients with cor pulmonale, five with abnormal LV wall motion, and three with septal hypertrophy died during the follow-up period. Autopsy revealed LV hypertrophy in three with septal hypertrophy, disarray and irregular hypertrophy of myocytes in one of them, and extensive myocardial fibrosis in one with diffuse LV wall hypokinesia. CONCLUSIONS: Septal hypertrophy and cor pulmonale caused by pulmonary vasculopathy were associated with limited cutaneous involvement or anti-nRNP antibodies, whereas abnormal LV wall motion and cor pulmonale caused by advanced pulmonary fibrosis were mostly seen in patients with diffuse cutaneous involvement or anti-Scl70 antibodies.

Adult↗
PubMed1998

Carcinoma of the stomach with hyperkeratosis palmaris et plantaris and acanthosis of the esophagus.

A 59-yr-old man with carcinoma of the stomach, concurrent acquired hyperkeratosis (tylosis) of the palms and soles, and acanthosis of the esophageal mucosa is reported. He presented the tylosis and esophageal lesions when the carcinoma was evident. Resection of the stomach resulted in diminution of the skin and esophageal lesions. The association of sporadic tylosis and carcinoma of the stomach is extremely rare. This is the first case report documenting the association of gastric cancer, tylosis, and acanthosis of the esophageal mucosa.

Adenocarcinoma↗
PubMed1998

Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow.

OBJECTIVE: Portal hypertensive gastropathy (PHG) has been recognized recently as a potential cause of upper gastrointestinal tract bleeding and is associated with a change in gastric hemodynamic indices in cirrhotic patients with portal hypertension. Endoscopic variceal ligation (EVL) is the treatment of choice for esophageal varices. We investigated the early effect of EVL on PHG and gastric mucosal blood flow (GMBF). METHODS: We examined 35 cirrhotic patients who were treated by EVL. PHG was evaluated endoscopically and GMBF was measured by laser Doppler flowmetry before and 1 or 2 wk after EVL. RESULTS: After EVL, only two patients (5.7%) developed severe PHG, 6 (17.1%) developed mild PHG, and 27 (77.1%) showed no change in endoscopic appearance of PHG. In those patients who developed PHG, EVL significantly decreased GMBF at the corpus (p < .05). However, no significant changes of GMBF at the corpus were noted after EVL in those patients who had no worsening of endoscopic features. EVL had no effect on GMBF at the antrum in any patients. CONCLUSIONS: Endoscopic variceal ligation is safe and does not lead, at least within 1-2 wk, to worsening of gastropathy in most cases. Our finding that gastropathy developed in the presence of reduced GMBF may suggest that PHG develops as a result of congestion caused by blockade of gastric blood drainage rather than by hyperemia.

Adult↗
PubMed1997

Clinical evaluation of pulmonary hypertension in systemic sclerosis and related disorders. A Doppler echocardiographic study of 135 Japanese patients.

BACKGROUND: Previous studies on pulmonary hypertension (PH) in systemic sclerosis and related disorders used differing patient populations, and defined PH according to different criteria. We have attempted to determine the prevalence and cause of PH in these disorders using a mainly noninvasive cardiopulmonary evaluation. PATIENTS AND METHODS: One-hundred thirty-five Japanese patients with systemic sclerosis and related disorders were divided into proximal and distal scleroderma groups, with or without overlapping features of systemic lupus erythematosus (SLE) and polymyositis. They underwent multiple cardiopulmonary tests, including chest radiography, pulmonary function tests, and echocardiography to screen for pulmonary fibrosis and PH. RESULTS: The pulmonary artery systolic pressure was estimated by Doppler echocardiography in 80 patients (59%). PH (systolic pressure > or = 40 mm Hg) was diagnosed in 28 patients by the Doppler method and in two patients by right heart catheterization (mean pressure > or = 20 mm Hg). Doppler-estimated pulmonary artery pressures were significantly higher in patients with proximal scleroderma (p < 0.05), and in those with an SLE/polymyositis overlap (p < 0.01). The FVC was significantly reduced in the proximal scleroderma group (p < 0.0005), but not in the overlap group. PH was attributable to pulmonary fibrosis in nine patients who had proximal scleroderma without overlap. Pulmonary arteriopathy was the probable cause of PH in seven patients with overlap and in four patients who had proximal scleroderma without overlap. CONCLUSIONS: These findings suggest that proximal scleroderma predisposes patients to PH mainly because of pulmonary fibrosis, but occasionally because of pulmonary arteriopathy. An overlap of SLE/polymyositis predisposes patients to PH due to the occurrence of arteriopathy.

Asian People↗
PubMed1996

Varioliform gastritis and duodenitis associated with protein-losing gastroenteropathy, treated with omeprazole.

A 44-year-old female with varioliform gastritis and duodenitis had gastrointestinal protein loss revealed by 111indium chloride scintigraphy. Treatment with omeprazole, a proton pump inhibitor, for 2 months, followed by famotidine, resulted in clinical improvement with resolution of the gastroduodenal lesions and protein loss. Colonization of the stomach with Helicobacter pylori was found before and after the treatment. The results in this patient suggest that omeprazole can be of value for the treatment of varioliform gastritis associated with protein-losing gastroenteropathy. The role of Helicobacter pylori in the pathogenesis of this disease is unclear.

Adult↗
PubMed1996

Case report: primary CD30 (Ki-1)-positive anaplastic large cell lymphoma of the duodenum.

As recently described, Ki-1 anaplastic large cell lymphoma is a distinctive subtype of non-Hodgkin's lymphoma. We report a Ki-1 anaplastic large cell lymphoma of the duodenum in a 62-year-old man. He received modified CHOP therapy and was in complete remission at 18 months. To our knowledge, this is the first report of primary Ki-1 anaplastic large cell lymphoma of the duodenum.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Acute appendicitis immediately after colonoscopy.

In a 69-yr-old man we treated, acute appendicitis occurred immediately after colonoscopy was performed. There were no signs or symptoms of appendicitis before colonoscopy, including in the colonoscopic findings around the cecal end and appendicular orifice. Because appendicitis is a rare complication of colonoscopy, prompt recognition should lead to early and effective treatment.

Acute Disease↗
PubMed1995

Quantitative EEG in never-treated schizophrenic patients.

To clarify whether patients with schizophrenia still show EEG slowing in the absence of psychopharmacological treatment, EEG was analyzed in 20 acute never-treated schizophrenics and 20 age-matched healthy controls using the computerized wave-form recognition method. Compared to controls, schizophrenics had more fast theta (6-8 Hz) and slow alpha (8-9 Hz) activity, and less fast alpha activity (9-13 Hz). The average EEG frequency at O1 correlated negatively with total and positive symptom scores on the BPRS in the schizophrenic group. These findings confirm that the frequency of alpha rhythm is slowed in schizophrenia and that this slowing is possibly related to the expression of psychopathology in this disorder.

Adult↗
PubMed1995

Pericardiac metastasis from advanced gastric cancer.

A 64-year-old man complaining of anterior chest pain, weight loss, and neck tumors was found to have advanced gastric cancer with pleuritis carcinomatosa and multiple lymph node and bone metastases. The patient was treated with combination chemotherapy consisting of mitomycin C (MMC), tegafur (UFT), and lentinan, and then with MMC and 5-fluorouracil (5FU) instillation into the pleural spaces after pleural drainage. With these treatments, the primary tumors and cancerous ulcers of the stomach improved markedly, and the lymph node enlargement and pleural effusion disappeared completely. Afterwards pericardiac metastasis complicated by cardiac tamponade occurred, but repeated pericardiocentesis and administration of MMC into the pericardiac cavity effectively eliminated the effusion. These treatments appeared potentially useful for advanced gastric cancer with generalized metastases including pericardiac involvement. However, the patient died of cardiac tamponade with massive pericardiac bleeding, probably due to the repeated pericardiocentesis and/or the administration of anticancer drugs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

A case of mesenteric venous thrombosis after endoscopic variceal band ligation.

A rare case of isolated superior mesenteric venous thrombosis (MVT) after endoscopic variceal band ligation (EVL) is reported. A 64-year-old woman with a history of idiopathic portal hypertension presented at the emergency room with vomiting, increasing cramping abdominal pain, and low-grade fever. She had undergone EVL for esophageal varices 4 months before and had had intermittent attacks of mild abdominal pain after the EVL. Ultrasonogram of the abdomen demonstrated marked concentric wall thickening of the ileal loop. Enhanced computed tomographic (CT) scan revealed a central lucency in the lumen of the superior mesenteric vein, surrounded by a high-density vein wall, corresponding to a thrombus. An isolated MVT and venous collateral network in the splanchnic area were confirmed by angiography. Supportive therapy, i.e., water and electrolyte replacement, and anticoagulation improved the clinical condition and radiologic status. This case of MVT after EVL suggests a possible relationship between EVL and MVT. It is necessary for clinicians to be aware of this relationship for the early diagnosis of MVT.

Endoscopy↗
PubMed1995

Serial proton magnetic resonance spectroscopy in a patient with the interval form of carbon monoxide poisoning.

Serial proton magnetic resonance spectroscopy (1H-MRS) studies were performed from immediately after the appearance of sequelae in a patient with the interval form of carbon monoxide (CO) poisoning. The volume of interest was set over the frontal lobe white matter. In the early period a persistent increase in choline was found, which was thought to reflect the course of progressive demyelination. The appearance of lactate and decrease in N-acetylaspartate reflected the point at which neuron injury became irreversible. These were followed later by the finding of irreversible changes on MRI and single photon emission computed tomography. The findings suggest that 1H-MRS may be a useful modality to determine neuron viability and prognosis early in the course of the interval form of CO poisoning.

Brain Diseases↗
PubMed1994

[Significance of a mass survey for colorectal cancer at the workplace].

Two thousand four hundred and forty workers from 2 plants were enrolled in a mass survey for colorectal cancer using a single immunological fecal occult blood test as screening. The occult blood test was positive in 71 (4.0%) out of 1,759 subjects in whom the test was conducted. A further investigation, including total colonoscopy or barium enema, was performed on 52 (73.2%) of the 71. Colon cancer was detected in 5 cases: 1 with advanced cancer and 4 with early cancer (cancer in the adenoma). The advanced cancer was successfully resected by surgery and the early cancers were removed by endoscopic polypectomy. Adenomas were found in 21 cases, 11 of which were polypectomized. From these results, it can be seen that a survey for colorectal cancer at the workplace is important, and by expanding the number of subjects for the survey in the workplace we can expect more and earlier detections of colorectal cancer.

Adenoma↗