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Biomedical subjects

J Suzuki

Publications and source records attributed to J Suzuki.

At least 613 records · Page 34Linked to original sources
PubMed1987

[Chemical embolization using conjugated estrogen--a clinical study of 40 cases].

For the treatment of dural arteriovenous malformation (AVM), meningioma and other external carotid lesions, a method of chemical embolization using a conjugated estrogen is reported. A total of 40 cases were treated, including 11 cases of dural AVM, 20 cases of meningioma and 9 other cases such as of skull tumor, aneurysmal bone cyst, nasopharyngeal tumor, traumatic AV fistula, scalp AVM and venous angioma of the scalp. The conjugated estrogen was administered continuously through a cannula inserted into the external carotid artery. For venous angioma of the scalp, it was injected directly into the lesion. Disappearance or reduction of the abnormal vasculature of the lesion and/or the feeding arteries was confirmed on angiograms in 9 of 11 cases (81.9%) of dural AVM, in 17 of 20 cases (85%) of meningioma and in all cases of other external carotid lesions. Diminution of enhancement on CT scan was obtained in 8 of 20 cases (40%) of meningioma and in 6 of 7 cases (85.7%) of other external carotid lesions. There has been no recurrence of the dural AVM as long as 10 years. Eighteen cases of meningioma were operated on, and in 16 cases the lesion was totally removed without massive hemorrhage. In 2 cases of skull tumor and a case of nasopharyngeal tumor as well, the lesions were totally removed. Complications in 40 cases were as follows: parotitis in 17 cases, liver dysfunction in 3 cases, and each of gynecomastia, facial palsy, trismus and convulsion in one case. All of them cleared up after the interruption or reduction of administration of the conjugated estrogen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[An experimental study of chemical embolization using conjugated estrogen--ultrastructural observations on rat mesenteric vessels].

We previously reported a new embolization method using conjugated estrogen and also a basic study which demonstrated that conjugated estrogen produced microcirculatory disturbance. To clarify the mechanism of this microcirculatory disturbance following the administration of conjugated estrogen, the changes of vascular endothelial cells and red blood cells were studied. After intra-arterial infusion of conjugated estrogen into rat mesenteric arteries, microcirculatory changes were observed with a biomicroscope, and also ultrastructural changes of vascular endothelial cells and red blood cells were examined. As a result, biomicroscopically, mesenteric microcirculatory disturbance in proportion to the doses of conjugated estrogens was seen and stasis of the microcirculation was finally observed in all rats. Ultrastructural observations revealed an appearance of spherocytes soon after the infusion and injury of vascular endothelial cells perfused with conjugated estrogen. Vascular endothelial cells were injured remarkably, including their plasma membrane, cytoplasm, and nuclei when mesenteric microcirculation showed sludging under the biomicroscope. At the stage of stasis, endothelial cells were severely injured and most of the vessels were filled with spherocytes. From these results, it was presumed that vascular endothelial injury and alterations of red blood cells into spherocytes induced by conjugated estrogen were the major factors of embolization effect of the conjugated estrogen. Furthermore, conjugated estrogen was considered as an effective embolic material because not only main arteries but microcirculations could be occluded by its intraarterial infusion.

Animals↗
PubMed1987

[Results of combined radiochemotherapy of intracranial ependymoma].

Thirty patients with intracranial ependymoma were treated in our clinic from 1965 through 1984. They were 13 children and 17 adults. As for the location of tumor, 9 were in the lateral ventricle, 8 in the cerebral hemisphere, 12 in the fourth ventricle and one in the third ventricle. Histologically, 18 were benign and 12 were anaplastic. The clinical course was analyzed in 24 cases. Out of the 24 cases, surgical treatment with postoperative radiation therapy was done in 16 cases, surgical treatment with postoperative radiochemotherapy in 6, and radiochemotherapy alone in two. Five-year survival rate of patients treated by surgery with radiation therapy and with radiochemotherapy was 35.7% and 66.7%, respectively. Patients treated by surgery not only with radiation therapy but also with chemotherapy took a better outcome. Recurrence was observed in 9 cases. Four cases of the 9 were benign ependymoma. The recurrence was observed within 3 years after the initial treatment in all cases. Even if histologically benign, the recurrence occurred in a relatively high rate as reported in the past literature. It should, therefore, be stressed that the initial treatment is important not only for a malignant ependymoma but also for a benign one, and the postoperative radiochemotherapy is useful for the improvement of the results.

Adolescent↗
PubMed1987

[Results of supratentorial low-grade astrocytoma--effects of combined radiochemotherapy].

The retrospective analysis of 53 cases with supratentorial low-grade (grade 1 or 2 due to WHO grading) astrocytomas included the years 1965-84. The 5-year and 10-year survival rates were 61.9% and 52.1%, respectively. The recurrence of tumors occurred in 15 cases (28.3%), almost within 3 years after the initial treatment, and early recurrent cases indicated poor results. Among them, 6 cases were noticed increasing malignancy of histological findings. According to our investigations, the factors which influence to the survival rate were age of patients, duration of symptoms before treatment, presence of neurological deficits and degree of surgical removal of tumor. The patients with good prognosis were under 20-year old, over 6 months of duration, with no neurological signs and with total or subtotal removal. But, 5-year survival rate was not so improved by postoperative radiation therapy. Analysis on the effects of chemotherapy for low-grade astrocytoma was little reported. We treated 26 patients with RAFP therapy (Radiation + ACNU + FT-207 + PSK). Only 2 cases out of 26 showed the recurrence till now. The rate of reduction of their tumors was 46.2% by CT scan. So, it was considered that RAFP therapy was effective for supratentorial low-grade astrocytoma.

Adolescent↗
PubMed1987

[The protective effect of mannitol, vitamin E, and glucocorticoid in experimental cerebral ischemia--influence on lipid peroxidation, energy metabolism and brain edema].

At present we apply the three-drug-combination therapy consisting of mannitol, vitamin E and glucocorticoid (betamethasone) in the treatment of cerebral infarction at acute stage with favorable results. However, much of the action mechanism of these drugs remains unelucidated. For the purpose to elucidate the mechanism by which they exert actions and moreover to evaluate the efficacy of this therapy, we conducted experiments using highly ischemic whole brain models of rats. In this model, chemiluminescence value, energy metabolism, water content and concentrations of Na+, K+ were determined with time. During ischemic period chemiluminescence level increased with time, and more remarkable increase was seen after recirculation of the blood flow. However, in the group with administration of the three drugs combination increase in chemiluminescence was inhibited remarkably. In the analysis of intensity of chemiluminescence by wavelengths, the peaks were observed at 480, 520 - 530, 570, 620 - 640 and 680 - 700 nm. These wavelengths were taken to suggest the release of energy (luminescence) associated with the transition of singlet oxygen to the grounded state during the breakdown of the lipid hydroperoxide. By addition of vitamin E or beta-carotene (quencher of singlet oxygen) on the brain homogenate in vitro, luminescence was remarkably inhibited over whole ranges of wavelength. Determination of adenine nucleotide and carbohydrate revealed that these three drugs combination promoted their recovery at the period of recirculation of the blood flow after ischemia. In particular, increase in lactate was inhibited from the period of ischemia with prevention of progression of lactic acidosis. Moreover, in the group with administration of the three drugs combination and the group with administration of 20% or isotonic mannitol the increase in the cortical water content following recirculation of the blood flow was inhibited. From these result it is considered that each of the three drugs shows not only inhibition of lipid peroxidation as radical scavengers but also protective effect on lowering of activities of ion channel (Na+, K+-ATPase, etc.) by the free radicals.

Animals↗
PubMed1987

[Aneurysm of the extracranial internal carotid artery treated by neck resection and end-to-end anastomosis under the administration of brain protective substances].

A case of aneurysm of the extracranial internal carotid artery treated by aneurysmal neck resection and end-to-end anastomosis of the internal carotid artery under the administration of Sendai Cocktail, which is composed of 20% mannitol solution, dexamethasone and vitamin E and has brain protective effects from ischemia. The patient, a 55-year-old man, was admitted to Yonezawa City Hospital on October 11, 1984, with chief complaints of transient consciousness disturbance and left hemiparesis. On admission, no neurological deficit was found but pulsatile fixed mass was found in the right submandibular region. CT scan revealed multiple low density areas in the right cerebral hemisphere and right upper cervical mass, which was enhanced in a part. Right carotid angiography revealed aneurysm of the extracranial internal carotid artery. On October 31, 1984, operation was performed. In the operative procedure, it needed temporary occlusion of the right carotid artery for 143 minutes and 14 minutes, because the aneurysm severely adhered to surrounding tissue and extended to the skull base. Collateral circulation through the circle of Willis was poor in this case but ischemic complication was not found. On November 20, 1984, he discharged without neurological deficit. Postoperative angiography, one year after the operation, showed good flow through the site the primary end-to-end anastomosis.

Anastomosis, Surgical↗
PubMed1987

[A case of prolactinoma in close association with Rathke's cleft cyst].

We report a case of Rathke's cleft cyst in pituitary tumor. A 31-year-old woman admitted to our hospital complained of visual disturbance, headache, amenorrhea and galactorrhea. Serum prolactin level was 3,060 ng/ml. By means of CT scan and MRI, we found suprasellar-extending tumor to have cystic component in the center of the tumor. Transsphenoidal surgery revealed grayish jelly-like content in the cyst. Histologically tumor cells were composed of chromophobic, basophilic and eosinophilic cells. The cyst wall in the pituitary adenoma was composed of ciliated or non-ciliated columnar epithelium intermingled with goblet cells, being similar to Rathke's cleft cyst. Except for the cells of the cyst wall, most of the tumor cells were immunoreactive for prolactin. As for intermediate filament, tumor cells in both solid and cystic portions showed positive immunoreactivity for cytokeratin and GFAP, and not for vimentin and neurofilament. These results suggest that the nature of the intracytoplasmic filament in the pituitary tumor with Rathke's cleft cyst may be not only keratin but also GFAP.

Adenoma↗
PubMed1987

[Two cases of intracranial fibromuscular dysplasia whose repeated angiography disclosed progression of the lesion].

Fibromuscular dysplasia (FMD) is well known owing to the characteristic angiographical finding of a "string of beads" appearance, but intracranial involvement with this disease is extremely rare. Moreover, to our knowledge, only seven cases that had repeated angiograms disclosed progression of FMD lesion in the literature. Such cases of intracranial FMD which showed progression in the follow-up angiography are reported. Case 1: A 8-year-old boy was referred to our hospital because of aphasia and right hemiplegia following right hemiconvulsion. Left carotid angiography on the 7th day from the onset revealed a "string of beads" appearance involving the left middle cerebral artery from M1 to M2 portion. He was treated with low molecular dextran, urokinase and steroid. After these drugs were administered, his speech was normalized. A repeat left angiogram performed two months later disclosed definite increase in the degree of stenosis associated with FMD. Perivascular sympathectomy around common and internal carotid artery and superior cervical ganglionectomy on the left side carried out on the 70th day from the onset. Postoperative left carotid angiogram showed improvement of the stenosis markedly, and the motor disturbance was improved gradually. Case 2: A 34-year-old woman presented with head dullness and disorientation suddenly. Left carotid angiogram on the third day from the onset showed a "string of beads" appearance from C1 to M1 portion. Follow-up angiography three days later revealed some progression of the stenosis. Furthermore a repeat left angiogram disclosed occlusion of left internal carotid artery at the C2 portion. Left STA-MCA bypass surgery was performed on the 61st day from the onset.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Histological localization of 4-S-cysteinylphenol in melanoma-bearing mice.

4-S-cysteinylphenol (4-S-CP), the S-homologue of tyrosine, has been recently synthesized as a selective chemotherapeutic agent against malignant melanoma and has been shown to be a specific substrate for tyrosinase in vitro. In vivo incorporation of 4-S-CP into the B16 and Harding Passey (HP) melanomas and the systemic organs have been evaluated by the autoradiographic method. The distribution of the silver grains indicated that 4-S-CP was selectively incorporated into both the B16 and HP melanomas. 4-S-CP was excreted mainly from the kidneys and there was an accumulation of 4-S-CP in the reticulo-endothelial system. These results seemed to contribute to the utilization of 4-S-CP and other related compounds as chemotherapeutic agents against malignant melanoma.

Animals↗
PubMed1987

[Left ventricular short-axis plane for magnetic resonance imaging: its clinical importance and applications].

Left ventricular short-axis images were obtained by ECG-gated magnetic resonance imaging (MRI) in nine patients with hypertrophic cardiomyopathy and seven patients with chest pain, all of whom had diagnostic cardiac catheterization including angiography. The accuracy and usefulness of the short-axis image in MRI for measuring wall thickness and dimension and for calculating ejection fraction were evaluated. All patients were examined on an examination couch in the right anterior oblique position in optimal positions to obtain the left ventricular long-axis images in the Z-X plane (conventional coronal plane). Next, the paraxial mode was used to obtain the short-axis images by rotating the Y-Z plane (conventional sagittal plane) around the Y axis. The intervals between the trigger on the middle point of the upstroke of the R wave and the 90 degree pulse of saturation recovery spin echo sequence were 40 msec and 340 msec with a 34 msec echo delay time for the end-diastolic and end-systolic images, respectively. Short-axis images in MRI in end-diastole were utilized to measure wall thickness and dimension in patients with hypertrophic cardiomyopathy and the measurements obtained were compared with those of echocardiography. As for calculating ejection fraction in patients with chest pain, the length of the left ventricular long axis (L) was measured using the MRI long-axis image. The intraventricular sectional area at four levels (S1, S2, S3, S4) were measured using the MRI short-axis image in end-diastole and in end-systole. Left ventricular end-diastolic and end-systolic volumes were calculated using the following formula: V = 1/2 X (L -4.5) X S1 + 1.5 X (S1 + S2 + S3) + 1/3 X 1/2 X (L -4.5) X S4. Ejection fraction by MRI was compared with that by cardiac catheterization (single plane, area-length method). The measurements of wall thickness and dimension by MRI correlated well with those by echocardiography (r = 0.97, p less than 0.01). Ejection fraction calculated by MRI correlated significantly with that by cardiac catheterization (r = 0.82, p less than 0.05). We concluded that the left ventricular short-axis image in MRI is satisfactorily accurate for measuring wall thickness and dimension, and useful for evaluating the left ventricular ejection fraction.

Angina Pectoris↗
PubMed1987

[A case of cerebral embolism caused by atrial myxoma--superselective fibrinolytic therapy].

A 37-year-old man was admitted to our clinic 3 hours after the onset of cerebrovascular accident with right hemiparesis and total aphasia. On admission, we started combined administration of mannitol, vitamin E, phenytoin (Sendai Cocktail) and perfluorochemicals to protect ischemic brain. Left cerebral angiography revealed occlusion of the left middle cerebral artery involving its perforating arteries. Following the performance of angiography, vascular balloon catheter was introduced into the embolus, and fibrinolytic agent (urokinase) was continuously injected. Soon after the injection of 240,000 unit urokinase, recanalization of left middle cerebral artery was shown by repeated cerebral angiography performed 5.5 hours after the onset. On his clinical course, left hemiparesis and aphasia were improved step by step, and 1 week later, he could walk by himself with minor neurological deficits. Further examination revealed that myxoma was located on left atrium by echocardiography. Within 1 week, the patient was transferred to cardio-surgical unit, and myxoma was successfully removed. Now he is in good health and has returned to his job. Usually cerebral embolisms result from atrial myxoma cause severe cerebral infarction. Here we reported a case of cerebral embolism by myxoma and recanalized using fibrinolytic agent by balloon catheter injection. The damage will be reduced if the duration of occlusion is limited, so this method will be helpful to treat cerebral embolism.

Adult↗
PubMed1987

[Aortic regurgitation in hypertrophic cardiomyopathy as detected by color Doppler echocardiography].

Aortic regurgitation (AR) in patients with hypertrophic cardiomyopathy (HCM) has rarely been reported. Using color Doppler echocardiography, we assessed the incidence and the cause of AR in patients with HCM. There were 86 patients with HCM (M:F = 66: 20, 57 +/- 12 years, mean +/- SD) and 43 control subjects (M: F = 33: 10, 57 +/- 8 years). HCM was diagnosed by echocardiography; the thickness of the interventricular septum (IVS) was more than 15 mm and the ratio to the thickness of the left ventricular free wall (LVPW) was more than 1.3. The rate and degree of aortic regurgitation were observed by color Doppler echocardiography, and aortic regurgitant murmurs were recorded by phonocardiography. Echocardiographic measurements were made using standard techniques. In the M-mode echocardiograms, the aortic diameter, the thicknesses of the IVS and LVPW were measured. In the 2DE, calcification of the aortic valve and systolic anterior movement of the mitral valve (SAM) were evaluated. In the early systolic 2DE image, the distance from the point of the greatest bulging of the upper IVS to the aortic root (D1) and the distance from the point of the greatest bulging to the line which is parallel to the long axis of the aorta (D2) were measured. Results were as follows: 1. Color Doppler echocardiography revealed aortic regurgitation in 17 (21%) patients with HCM; whereas it was observed in only three (7%) of the control subjects. 2. The aortic regurgitant signals were limited to the left ventricular outflow tract both in patients with HCM and in the control subjects. 3. Aortic regurgitant murmurs were recorded in only two patients with HCM and in none of the control subjects. 4. There was no difference between the patients with and without AR as to age (59 vs 56 years), blood pressure (141/84 vs 136/80 mmHg), aortic diameter (34 vs 33 mm), aortic valve calcification (12% vs 9%) and SAM (53% vs 52%). 5. In the patients with HCM, D1 was shorter (9.9 vs 14 mm, p less than 0.001) and D2 was longer (16 vs 10 mm, p less than 0.001) in the patients with AR than in those without AR. That is, the basal septum of the patients with AR protruded more deeply into the outflow tract, and the distance to the aortic valve was significantly shorter than in those without AR.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1987

[Evaluation of changes in brain tissues surrounding cerebral arteriovenous malformations using NMR-CT].

Patients with cerebral arteriovenous malformation (AVM) show various clinical symptoms, but they can be divided into two groups; one resulting from rupture of AVM and another derived from chronic ischemia in surrounding tissues of AVM. Intracerebral or subarachnoid hemorrhages due to rupture of AVM can be detected by X-ray CT scan, however, it is difficult to obtain three dimensional image of changes in the surrounding area of AVM that has never experienced hemorrhagic attacks. We are using 0.15 Tesla NMR-CT (resistive type) produced by Bruker Company in West Germany and its pulse sequence is Carr-Purcell-Meiboom-Gill (CPMG) method which is best reformed type of spin echo. With this machine, we observed images of AVM and its surrounding tissue, made calculated images of T1 and T2 relaxation time and measured T1 and T2 values of ROI. On images of NMR, nidus and many dilated vessels were distinctly revealed as low or no signal intensity area in all cases without contrast media. And it is noteworthy that surrounding areas of AVM on calculated T1 and T2 images were observed as tissues showing elongated relaxation time in all cases. These tendencies were confirmed by measurement of T1 and T2 in ROI compared with contralateral side. We think elongations of T1 and T2 in surrounding tissues mean ischemic or necrotic changes in these areas induced by steal phenomena due to arteriovenous shunting.

Adult↗