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Biomedical subjects

K Azuma

Publications and source records attributed to K Azuma.

At least 37 records · Page 2Linked to original sources
PubMed1996

Accumulation of Tc-99m HMDP in hepatic metastasis from colon carcinoma without detectable calcification.

A 51-year-old man was found to have hepatic metastasis from colon carcinoma. Bone scintigraphy with 99mTc-hydroxymethylene diphosphonate showed a ringlike accumulation corresponding to the hepatic mass, which was without calcification on computed tomography. Treatment with chemotherapeutic agents was started. After 4 months, computed tomography showed that the mass was smaller than before and that the margin was calcified. The extraosseous accumulation of the radionuclide may be evidence supporting earlier speculation on calcification that could not yet be detected by computed tomography.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Coronary artery fistula to bronchial artery on contralateral side of coronary atherosclerosis and myocardial insufficiency. A case report.

Among coronary vessels anomalies is the rare coronary artery fistula. Myocardial insufficiency resulting from fistula steal phenomenon can not be clinically distinguished from that of coronary atherosclerosis, if these conditions coexists in the same patient. The authors present a case of extracardiac left coronary artery fistula connecting the circumflex branch and left bronchial artery, with inferior wall myocardial insufficiency attributable to the right coronary artery atherosclerosis.

Aged↗
PubMed1996

[Cesarean section under spinal anesthesia for a patient with chronic renal failure].

A 37-year-old primipara was scheduled for cesarean section under spinal anesthesia in the 38th gestational week because of cephalo-pelvic disproportion. She had suffered from chronic renal failure since 27 years of age, and had been undergoing hemodialysis three times per week. The frequency of hemodialysis was increased to 4-6 times per week during pregnancy to maintain blood urea nitrogen and serum creatinine concentration below 60 mg.dl-1 and 6.0 mg.dl-1, respectively. Since she had no bleeding tendency, spinal anesthesia with 8 mg of tetracaine was successfully performed after hemodialysis eliminating only solute but not water in the morning of surgery and after infusion of 500 ml of acetated Ringer solution. Blood pressure and heart rate were stable during surgery. Monitoring of central venous pressure was useful for fluid management. A baby weighing 2,575 g with an Apgar Score of 8 at one minute and 9 at five minutes was delivered five minutes after the beginning the surgery. The mother recovered uneventfully and returned to regular hemodialysis on the first postoperative day. These findings suggest that with careful fluid management, spinal anesthesia can be safely performed for cesarean section, for patients undergoing hemodialysis.

Adult↗
PubMed1996

[Matured mediastinal teratoma with high levels of tumor markers in cystic fluid].

A 42-year-old woman was admitted to Gifu Municipal Hospital because of an abnormal mediastinal shadow on a chest X-ray film. The serum CA125 level was slightly high 38 U/L, normal: < 35 U/L. Preoperative examination of fluid from a cyst revealed a high level of carcinoembryonic antigen (550 ng/ ml). The tumor resected was 11 x 9 x 5 cm. Microscopic examination revealed a matured teratoma containing pancreatic cells, collagenous tissues, squamous epithelia, and hair follicle-like tissues. Biochemical analysis of the cystic fluid revealed high levels of eight tumor markers: carcinoembryonic antigen, CA125, CA19-9, SLX, Ferritin, NSE TPA, and elastase 1. Samples stained positively for the tumor markers carcinoembryonic antigen CA125, CA19-9, and NSE by ABC immunohistochemical staining. The serum carcinoembryonic antigen levels had decreased to the normal level within two weeks after the surgery. The high levels of tumor markers and materials in the cystic fluid may have been related to the biological characteristics of the various cell components in this matured teratoma.

Adult↗
PubMed1995

[Experimental study on early detection of alloxan-induced pulmonary injury by magnetic resonance imaging].

We studied the early detection of alloxan-induced pulmonary injury by magnetic resonance imaging in vivo. Permeability edema was induced in ten rats by intravenous injection of alloxan at 100 mg/kg. T1-and T2-weighted images were acquired in five rats every 30 min for 120 min after alloxan injection. Five rats served as controls. The rats were sacrificed immediately after imaging and examined microscopically. CT images were also acquired in five rats every 30 min for 120 min after alloxan injection. Five rats served as controls. The rats were sacrificed immediately after imaging, and the wet-to-dry ratio of the lung was measured. In T1-weighted images, relative signal intensity from the lung with permeability edema rose from 30 min to 120 min, and was greater than that from normal lung every time. In T2-weighted images, there was no statistically significant difference in relative signal intensity of the lung between permeability edema and the control during 120 min. In CT images, there was also no statistically significant difference in lung density between permeability edema and the control during 120 min. There was no statistically significant difference in the wet-to-dry lung ratio between edematous lung and normal lung. In histological study, mild congestion and interstitial edema were observed in edematous lung. These results suggest the potential capability of MR imaging in detecting the early phase of permeability pulmonary edema.

Alloxan↗
PubMed1995

[Coronary artery bypass grafting in cases with the atherosclerotic ascending aorta].

Among 172 cases of coronary artery bypass grafting, 9 cases (5%) revealed severely atherosclerotic ascending aorta. In 3 of the 9 cases, total aortic cross-clamping in the distal anastomoses of saphenous vein graft (SVG) and partial aortic clamp in the proximal anastomoses of SVG were performed. In 1 case with this technique, cerebral infarction was occurred. In 4 cases, total aortic cross-clamping in the distal and proximal anastomoses of SVG was performed. In 2 of these cases with this technique, cerebral infarctions were occurred. Hypothermic circulatory arrest was performed in 2 of the rest. In one case that was predicted to have atherosclerosis of ascending aorta prior to operation, the left internal thoracic artery was anastomosed to the left anterior descending, and SVG to the right coronary artery with hypothermia and ventricular fibrillation. And during the proximal anastomoses of SVG, hypothermic circulatory arrest without aortic clamping was initiated. In another case, atherosclerosis of ascending aorta was noted after aortic cross-clamping. Then the aorta was declamped, hypothermic circulatory arrest was established, the aorta was opened, the diseased segment was resected, and proximal anastomoses of SVG was performed to Dacron patch which was implanted for aortic wall. There were no cerebral infarction in last two patients.

Aged↗
PubMed1995

Screening of patients with ischemic heart disease by transesophageal atrial pacing and the selection of surgical therapy: in patients with arteriosclerosis obliterans and aortic aneurysm.

This study evaluated (1) a screening method for ischemic heart disease (IHD) using transesophageal atrial pacing (TEP), and (2) the appropriate surgical therapy for patients with concomitant IHD which was evaluated on the basis of the coronary score (CS) by Leaman. Thirty-nine patients with arteriosclerosis obliterans of the lower extremities (ASO) and 35 with aortic aneurysm underwent TEP and coronary angiography (CAG). Coexistent IHD was diagnosed in 25 patients (64%) with ASO and in 14 (40%) with aortic aneurysm. Screening for IHD by TEP was 96% sensitive, 71% specific, and 87% accurate in patients with ASO, and 79% sensitive, 90% specific, and 86% accurate in patients with aortic aneurysm. Coronary artery bypass grafting (CABG) and peripheral arterial revascularization (PAR) were performed by one stage surgery in 3 patients with a CS of 16 or more. In 18 patients with a CS of 5.5 or less, only PAR was performed. One stage surgery was performed in 6 patients with aortic aneurysm. Four patients had a CS of 9.5 or more, and 2 patients with coexistent stenosis of the left anterior descending branch (LAD) had CS of 3.5 and 8, respectively. Repair of the aneurysm was undertaken in 5 patients with a CS of 8 or less without LAD disease. In patients with ASO showing a CS of 5.5 or less and in those with aortic aneurysm showing a CS of 8 or less (and without LAD disease), the only surgical procedure performed was either PAR or repair of the aneurysm. There were no complications attributable to IHD observed in these patients during the perioperative period.

Adult↗
PubMed1995

Evidence for an immunological pathogenesis of thrombocytopenia in chronic liver disease.

OBJECTIVES: To elucidate the role of platelet-associated IgG (PA-IgG) in the mechanism of thrombocytopenia associated with chronic liver disease. METHODS: Platelet count in blood, PA-IgG, and scintigraphic spleen/liver ratio as a marker of splenomegaly was examined in 214 individuals, including 16 controls showing nonspecific reactive change in liver biopsy and 198 patients with chronic liver disease. RESULTS: The mean blood platelet count decreased significantly according to severity of liver disease, from control to liver cirrhosis. PA-IgG levels increased significantly in relation to severity of liver disease, as did spleen/liver ratio. In chronic hepatitis or liver cirrhosis, an inverse correlation was found between platelet counts and PA-IgG levels. An inverse correlation was also observed between platelet count and spleen/liver ratio in liver cirrhosis. The splenic embolization resulted in a significant rise in platelet count and a significant fall in PA-IgG in the 14 cirrhotic patients. CONCLUSIONS: These results may give support to evidence for an immunological mechanism mediated by PA-IgG for the thrombocytopenia occurring in chronic liver disease. In the case of liver cirrhosis, this mechanism would act in addition to platelet pooling in the spleen on thrombocytopenia. PA-IgG may also have an important role in thrombocytopenia associated with chronic hepatitis, in which splenic platelet pooling is less marked.

Adult↗
PubMed1995

[Intratumoral LPD deposition within hepatocellular carcinoma without arterial tumor staining].

The dissociation of intratumoral LPD deposition and arterial tumor staining was investigated in 20 cases of hepatocellular carcinoma (HCC) without arterial tumor staining. The intratumoral deposition of LPD injected from the hepatic artery was observed in nine cases of HCC and coincided with the decrease in tumor vascular bed evaluated by photomicroscopic study and arterial portography. LPD deposition was not observed within the 11 other tumors, which were diagnosed as well differentiated HCC. Infusion angiographic CT revealed that the arterial and portal vascular beds were separated from each other. Therefore, arterial tumor staining was insufficient for accurate evaluation of the tumor vascular bed. The vascular bed in cancerous and noncancerous tissue was accurately evaluated by the addition of the contrast enhancements from the hepatic artery and the portal vein.

Carcinoma, Hepatocellular↗
PubMed1994

Diffusion anisotropy of cerebral ischaemia.

Focal cerebral ischemia was produced by occlusion of the middle cerebral artery with a silicone cylinder in Wistar rats. Diffusion-weighted echo-planar images (DW-EPIs) using the motion-probing gradient (MPG) method were acquired at 1-3 hours and 24-48 hours after occlusion. Apparent diffusion coefficients (ADCs) were calculated from these images in ischemic lesions and in normal unoccluded regions. Results were as follows. 1. Ischemic lesions could be detected on the DW-EPIs at 1 hour after occlusion. 2. The ADC of water in the brain tissue was smaller than that of free water as a result of restricted diffusion. 3. Anisotropic diffusion that probably can be attributed to the myelin sheath was observed in the normal deep white matter. 4. In the ischemic lesions, the ADC decreased rapidly within 1-3 hours after occlusion and then slightly further declined after 24-48 hours. In the ischemic deep white matter, diffusion anisotropy disappeared at 24-48 hours after occlusion. Diffusion-weighted imaging may have applications in the examination of pathophysiological mechanisms in cerebral ischemia by means of evaluation of ADC and diffusion anisotropy.

Animals↗
PubMed1994

Another approach for aortic valve replacement through left thoracotomy.

We report a 54-year-old man with a history of esophagectomy and retrosternal esophagogastric anastomosis for esophageal cancer through right thoracotomy in whom cardiac failure developed due to aortic regurgitation. He underwent aortic valve replacement through a left thoracotomy with division of two great arteries and their strong traction toward the surgeon by stay sutures. He has been well for 3 years postoperatively in New York Heart Association class I.

Anastomosis, Surgical↗
PubMed1994

Mechanism of anovulation in hyperprolactinemic amenorrhea determined by pulsatile gonadotropin-releasing hormone injection combined with human chorionic gonadotropin.

OBJECTIVE: To clarify the mechanism of anovulation in hyperprolactinemic anovulatory women by subcutaneous (SC) pulsatile GnRH injection. DESIGN: Prospective clinical study. SETTING: Studies were made on at the Department of Obstetrics and Gynecology, the University of Tokushima, School of Medicine. PATIENTS: Six hyperprolactinemic (group 1) and 7 normoprolactinemic (group 2) anovulatory patients were studied. INTERVENTIONS: After examinations of pulsatile secretion of LH, the GnRH test, thyrotropin-releasing hormone test and estrogen test, pulsatile GnRH treatment (20 micrograms/2 hours SC) was performed. Two protocols were tested on each patient. In the non-hCG protocol, GnRH treatment was continued until ovulation. In the hCG protocol, 5,000 IU of hCG was injected to induce ovulation when follicles were fully mature. MAIN OUTCOME MEASURE: The rates of follicular maturation and ovulation, serum E2 and P in the two groups. RESULTS: Pulsatile LH secretion was impaired in both groups. LH release 48 hours after estrogen injection was impaired in group 1 but not in group 2. Follicles matured on pulsatile GnRH treatment in all cycles in both groups. However, with the non-hCG protocol, ovulation occurred in only 17% of group 1, but in 89% of group 2. With the hCG protocol ovulation occurred in all cycles in both groups. CONCLUSIONS: The main cause of anovulation is impaired gonadotropin pulsatility and derangement of the estrogen-positive feedback effect on LH secretion in hyperprolactinemic patients, their ovarian response to gonadotropin being well maintained. Subcutaneous pulsatile GnRH therapy combined with hCG can be used as an alternative to bromocriptine treatment for induction of ovulation in these patients.

Adult↗
PubMed1994

Efficacy of a rinse solution for the prevention of reperfusion injury in canine preserved lungs.

To evaluate the efficacy of a perflurocarbon emulsion (Fluosol: FC-43) for protecting preserved lungs from ischemic reperfusion injuries, we employed an isolated canine left lung reperfusion model. The left lung from 15 mongrel dogs was flushed and preserved in Euro-Collins solution for 24 hrs at 4 degrees C. The preserved lungs were rinsed through the pulmonary artery with a perflurocarbon emulsion (perfluorotributylamine: FC-43) or Carolina rinse solution II (CRS-II) and then reperfused with whole blood for 120 minutes. The lungs were divided into three groups; lungs reperfused without rinse (Group 1: n = 5), and lungs rinsed with oxygenated FC-43 (Group 2: n = 6) or CRS-II (Group 3: n = 4). Reperfusion was with whole blood warmed to 37 degrees C. The pulmonary vascular resistance was lower in the lungs in Group 1 than in those in Groups 2 and 3 (84.2 +/- 33.3 v.s. 322.3 +/- 190.5 and 474.1 +/- 219.0 mmHg/L/min, p < 0.01). There was no significant difference in the PaO2 among the 3 groups at the end of reperfusion. The extravascular lung water (dry/wet ratio) was lower in the lungs in Group 2 than Groups 1 and 3 (90.5 +/- 0.7% v.s. 86.8 +/- 2.1% and 92.1 +/- 2.1% p < 0.01). These data demonstrated that pulmonary function and structure were maintained well in lungs reperfused with FC-43. We conclude that a perfluorocarbon emulsion (FC-43) is useful for protecting ischemic canine lungs from reperfusion injury, but Carolina rinse solution II is not effective for minimizing reperfusion injury in canine lungs.

Animals↗
PubMed1994

[Invasive thymoma].

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Diagnosis, Differential↗
PubMed1994

[FIO2 and SpO2 during cardiac surgery in neonates and infants].

Fractional inspired oxygen (FIO2) applied before and after a repair or palliative procedure for cardiac defects along with SpO2 measured by pulse oximeter were reviewed from anesthetic records of 62 neonates and infants. Fentanyl was used for anesthesia, except in cases without i.v. route in which sevoflurane with nitrous oxide in oxygen was used for induction of anesthesia. FIO2 was adjusted using air and oxygen. The lower FIO2 was applied to the patients for a closure of ventricular septal defect, a reconstruction of coarctation or interrupted aortic arch, and pulmonary artery banding, while the higher FIO2 was used for systemic-to-pulmonary artery shunts and the repair of tetralogy of Fallot. In the congenital heart disease with the intracardiac shunt, the magnitude of the shunt flow and hemodynamics can be altered by changing systemic and pulmonary vascular resistance which could be induced by various ways. Since alveolar oxygen tension is a known determinant of pulmonary vascular resistance, an appropriate FIO2 should be applied to each patient with different pathophysiology. A low FIO2 should be set for the cases with nonrestrictive left-to-right shunting, since a high FIO2 may cause a torrential pulmonary blood flow. A high FIO2 is preferable for the cases with right-to-left shunting and a concomitant decreased pulmonary blood flow.

Anesthesia↗
PubMed1994

Electrical responses and K+ activity changes to light in the ocellus of the planarian Dugesia japonica.

The extracellular electrical response (ocellar potential, OP) and K+ activity changes to light were measured in the planarian ocellus by conventional and double-barreled ion-selective microelectrodes. The OP evoked by a 0.5 sec light flash is a simple monophasic potential, which is sustained during long-term illumination. The spectral sensitivity of the OP has the characteristics of a rhodopsin with lambda max 505 nm. K+ activity in the extracellular space of the ocellus in the dark was 1.1 +/- 0.2 mM (mean +/- SE, n = 6). A 0.5 sec light flash and a 120 sec long-term illumination evoked increases in the K+ activity. The maximum K+ activity change occurred at 503 nm. These results suggest that the efflux of K+ from the planarian photoreceptor into the extracellular space is caused by light, and that the OP and the increase of K+ activity are mediated by a rhodopsin.

Animals↗
PubMed1994

[Catheter intervention to venous system using expandable metallic stents].

Superior vena cava syndrome mainly associated with malignant tumors, is usually resistant to any therapy. Although mechanical dilation of narrowed lumen is ideal for relief of symptoms, conventional balloon angioplasty has not been effective method. Surgical intervention is not a good choice in patients with advanced malignant tumors. Recently developed expandable metallic stents have been adopted to superior vena cava syndrome with good results. In this article, characteristics of expandable metallic stents is reviewed, and our experience of expandable metallic stents (Gianturco stent and Wallstent) in venous system is indicated. In addition, percutaneous insertion of inferior vena cava filter (Greenfield filter) is also mentioned.

Adult↗