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Biomedical subjects

K Matsuba

Publications and source records attributed to K Matsuba.

At least 37 records · Page 2Linked to original sources
PubMed1991

[The CT diagnosis of emphysema and correlation with pathologic findings].

It is difficult to diagnose clinically silent or mild emphysema. The efficacy of CT scans for the diagnosis of emphysema has attracted attention and comparisons have been made between CT images and the pathological grade of emphysema in resected lungs. With a view to determine to what extent high resolution CT images are accurate concerning the diagnosis of mild emphysema, we conducted an extensive comparative study on CT scores of emphysema, based on high resolution CT, the pathology score derived from the cut surface of the lung identical in its plane with that of the CT and destructive index (DI) which is said to be instrumental in representing the degree of deterioration of alveolar walls in the same regions of the lungs. In this study, 42 patients who underwent thoracotomy and their lung specimens including a solitary nodule of considerable size have been employed. The CT scores and pathology scores depend on the picture grading system developed by Thurlbeck and coworkers for the basis of counting. The findings were such that with 1 mm collimation, the CT scores ranged between 12 and 57 with a mean +/- SD of 22.1 +/- 9.6 (n = 35) while with 5 mm collimation, the CT scores ranged between 7 and 46 with a mean +/- SD of 16.5 +/- 8.3 (n = 33). The pathology scores stood at 10 to 57 with a mean +/- SD of 23.2 +/- 9.8 (n = 42).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Evaluation of pulmonary emphysema with high resolution computed tomography and the effect of smoking].

Cigarette smoking is thought to play an important part in the development of pulmonary emphysema. The authors previously reported on the correlation of high resolution computed tomography (CT) with the pathology grade of emphysema and the destructive index of lung specimens from 42 patients undergoing thoracotomy for a solitary pulmonary nodule. High resolution CT was effective to identify the presence and grade of mild emphysema. The mean per cent predicted FEV1 was 97 per cent. There were 28 smokers and 14 nonsmokers. In this report, the correlation of smoking history with pathology score and high resolution CT was analyzed. There was significant correlation among these indices. These results further support the relationship between smoking and pulmonary emphysema. High resolution CT scan may help in the understanding of the role of cigarette smoking in the development of early pulmonary emphysema.

Adult↗
PubMed1990

Efficacy of cyclosporin A for idiopathic pulmonary fibrosis.

In an 11-year-old girl with severe dyspnoea and cyanosis, idiopathic pulmonary fibrosis (IPF) was diagnosed. The PaO2 of blood could be maintained between 50 mm Hg and 70 mm Hg with a high dose pulse corticosteroid therapy, although this dose could not be reduced. Azathioprine in addition to prednisolone provoked deterioration. Twelve weeks after admission, cyclosporin A (Cs A), a known immunosuppressant, was started together with prednisolone. The PaO2 reverted to normal within 1 month and prednisolone could be tapered off within 6 months. Two years after admission, the patient is free of symptoms on continuous Cs A therapy. This case seems to be the first case successfully treated with Cs A.

Administration, Oral↗
PubMed1990

The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores.

Early and accurate diagnosis of emphysema is said to be invaluable for identification of clinically silent and mild emphysema. Recently, computed tomography (CT) has been much advocated for its efficacy in detailed diagnosis of emphysema, and the results have been compared with the pathology grade of emphysema in resected lung specimens. To assess the ability of high resolution CT scan in detecting and grading mild emphysema, we correlated the high resolution CT scan with the pathology grade of emphysema and the destructive index (DI) of lung specimens from 42 patients undergoing thoracotomy for a solitary pulmonary nodule. The high resolution CT scan and the cut surface of the lung, corresponding exactly to the same plane of the CT scan image, were assessed using the picture-grading system of Thurlbeck and coworkers on a scale of zero to 100. The CT scores for all patients ranged from 12 to 57, with a mean +/- SD of 22.1 +/- 9.6 using 1-mm collimation (n = 35), and from 7 to 46 with a mean +/- SD of 16.5 +/- 8.3 using 5-mm collimation (n = 33). The pathology scores ranged from 10 to 57, with a mean +/- SD of 23.2 +/- 9.8 (n = 42). The DI ranged from 15.4 to 67.1, with a mean +/- SD of 31.4 +/- 10.8 (n = 42). The CT scores using 1-mm and 5-mm collimation correlated significantly with the pathology scores (r = 0.68 and 0.76, respectively, p less than 0.001), and with the DI (r = 0.62 and 0.74, respectively, p less than 0.001). The pathology scores correlated significantly with the DI (r = 0.72, p less than 0.001). We therefore concluded that high resolution CT can help to identify the presence and grading of mild emphysema.

Adult↗
PubMed1990

Abnormal lipoprotein composition in normolipidemic diabetic patients.

To see whether there are any lipoprotein abnormalities in diabetic patients without hyperlipidemia, lipoprotein composition was examined in 75 strictly normolipidemic diabetic patients. Their plasma cholesterol (chol) and triglyceride (TG) were limited to less than 6.0 and less than 1.7 mM, respectively. Body-weight- and age-adjusted normolipidemic healthy subjects served as the control group. Plasma total chol and TG and low-density lipoprotein (LDL-) and high-density lipoprotein (HDL-) chol were identical in the diabetic and control subjects. Total apolipoprotein B (apoB) in the plasma of the diabetic subjects was significantly elevated. The chol-apoB ratio in the TG-rich (very-low-density + intermediate-density) lipoprotein fraction (Sf12-400) of the diabetic subjects was significantly higher than the control value, whereas LDL-apoB levels were increased and chol-apoB ratio in the LDL fraction was significantly suppressed in the diabetic subjects. Because each LDL particle contains only one apoB molecule, apoB and chol-apoB ratio in this fraction can represent particle number and chol loading of the LDL particles, respectively. Thus, these data suggest that LDL particle number is increased, and the particles are chol depleted in diabetic subjects even if they are normolipidemic.

Apolipoproteins↗
PubMed1990

[The relationship between alveolar apertures and alveolar size and smoking history in humans, and experimental studies on air pollutants].

Using surgical specimens from patients with lung tumor, alveolar apertures and alveolar sizes were quantitatively assessed using scanning electron microscopy. Compared with smoking habits, increased apertures, defined as alveolar destruction were observed in patients smoking more than 35 years, whereas alveolar size was increased in patients, with a 15-year smoking history. Experimental studies with exposure to NO2, O3 and H2SO4 mist showed that exposure of NO2 and H2SO4 could induce epithelial injury such as disappearance of cilia in the central airways.

Adult↗
PubMed1990

[Membranous and respiratory bronchiole disease in patients with normal air-flow and mild air-flow limitation].

In order to evaluate the role of membranous (MB) and respiratory bronchioles (RB) in patients with normal and mild airflow limitation, we quantitatively assessed the pathological change of MB, RB and alveoli in the pathological specimens of 42 patients who required surgery for removal of a solitary pulmonary nodule. We also measured the destructive index (DI), to evaluate the destruction of alveolar walls. High resolution CT scan and pulmonary function tests were performed within 1 month of resection. Results of the pulmonary function tests correlated with pathological changes of RB better than with MB. Significant correlation between the emphysema score of resected lung and the pathological change of MB and RB was observed. There was also significant correlations between the CT score or DI and RB changes. However, there was no significant correlation between the CT score or DI and the change of MB. There were significant differences between smokers and nonsmokers in the results of pulmonary function test, pathological changes of RB and severity of emphysema. We postulate that RB is responsible for subtle functional abnormalities in the early stages of chronic obstructive pulmonary disease.

Adult↗
PubMed1990

[The changes in airway structure associated with reduced FEV1].

The purpose of this study is to clarify the changes in the small airways associated with reduced forced expiratory volume in one second (FEV1). We compared the structure of the membranous and respiratory bronchioles of resected lungs from 111 patients with a normal predicted FEV1 to the structure of these airways from 45 patients with an FEV1 reduced below the 95% confidence limits for height and age. Membranous and respiratory bronchioles of less than 2 mm in internal diameter were counted and their diameter and wall thickness were measured. The data show that there were more membranous bronchioles of internal diameter less than 0.4 mm in patients with reduced FEV1. The walls of membranous bronchioles were not increased in thickness but there was an increase in the ratio of wall thickness to lumen diameter. The wall thickness of respiratory bronchioles was increased in the obstructed group and there was also an increase in the ratio of wall thickness to lumen diameter in these airways. We conclude that the patients with obstructive lung disease have a greater increase in wall thickness than can be explained by a reduction in airway support due to emphysema and suggest that the airways obstruction in these patients is due to thickening of the wall and narrowing of the lumen by a chronic inflammatory process.

Adult↗
PubMed1989

Protective effect of probucol on alloxan diabetes in rats.

The diabetogenic action of alloxan is known to be attenuated by several oxygen radical scavengers. The present study was conducted to see if probucol, a drug with strong free radical scavenger action, can reduce pancreatic B-cell damage induced by alloxan in male Wistar rats. After 2 weeks of a 1% probucol diet, 50 mg/kg alloxan was intravenously injected in rats (group PA, n = 34). Urine glucose of most of the injected rats not pretreated with probucol (group A, n = 22) was positive, while more than half of the rats of group PA failed to show urine glucose. The blood glucose level in group PA was significantly lower than that in group A (326 +/- 25 vs. 487 +/- 28 mg/dl, P less than 0.001). Histological examination revealed that most of the pancreatic islets of group A were degranulated, whereas a lot of islets remained unaffected in group PA. Thus, the in vivo diabetogenic action of alloxan was reduced by pretreatment with probucol, although the effect was incomplete. This effect can be explained by probucol's strong free radical scavenger action. Since accumulation of free radicals can be an initial step of B-cell damage in animal models of type 1 (insulin-dependent) diabetes, the drug can be useful for the prevention of type 1 diabetes with its long-term clinical history of safety.

Alloxan↗
PubMed1989

Estimation of cholesterol loading of the low-density lipoprotein fraction in diabetic subjects without ultracentrifugation.

We report here a new formula for estimating apolipoprotein (apo) B concentration in the low-density lipoprotein (LDL) fraction from measurements of plasma triglyceride and apoB. ApoB in plasma and in the triglyceride-rich lipoprotein fraction (VLDL, d less than 1.019) and plasma triglyceride were measured in 112 subjects, including 56 diabetics. There was a significant correlation between VLDL-apoB and plasma triglyceride (Y = 0.07X + 1, r = 0.73, P less than 0.001). We calculated LDL-apoB according to this formula: LDL-apoB = total apoB - (0.07 x total triglyceride + 1). We found an excellent relationship between LDL-apoB (total apoB - VLDL-apoB) and calculated LDL-apoB (Y = 1.0X + 1, r = 0.96, P less than 0.001). This new formula will enable us to estimate the apoB concentration in the LDL fraction without ultracentrifugation.

Apolipoproteins B↗
PubMed1989

Surgical treatment of pulmonary aspergilloma and Aspergillus empyema.

Twenty-four patients, 16 male and 8 female, underwent a total of 35 operations for pulmonary aspergillosis. Intrapulmonary aspergilloma was detected in 19, and Aspergillus empyema was present in 5. The major operative procedures performed were pneumonectomy in 2 patients, lobectomy in 8, segmentectomy in 1, cavernostomy in 4, and open-window thoracostomy in 5. The surgical results in 5 patients 70 years old or older were excellent. Empyema developed postoperatively in 2 patients who had undergone wedge resection of the lung or segmentectomy. Although resection involving the minimum extent possible is desirable in the treatment of intrapulmonary aspergilloma so as not to decrease lung function, it is dangerous to perform a limited procedure in the case of aspergilloma with an invasive character. In patients in poor general condition, cavernostomy followed by muscle flap plombage is recommended. For Aspergillus empyema, the primary procedure was open-window thoracostomy followed by plombage using chest wall muscle or omentum. We consider omental flap plombage to be superior to thoracoplasty in some respects for mycotic empyema, especially because it is a less extensive surgical procedure.

Adult↗
PubMed1989

Effect of dietary fructose on triglyceride turnover in streptozotocin-diabetic rats.

The effects of fructose or glucose on plasma triglyceride kinetics in streptozotocin (40 mg/kg) diabetic rats were studied using Triton WR1339. To separate groups of diabetic rats fructose or glucose was supplied at 10% in drinking water. Diabetic rats without sugar supplementation (diabetic control) had significantly suppressed triglyceride secretion compared to non-diabetic controls. Neither fructose nor glucose supplementation increased the triglyceride secretion rate in diabetic rats. However, despite reduced secretion rates, plasma triglyceride levels in glucose-supplemented diabetic rats, diabetic controls and non-diabetic controls were essentially identical. This suggested that removal of triglyceride from the circulation was impaired in the diabetic rats. In contrast, fructose supplementation resulted in a more than 150% (significant) increase in the mean plasma triglyceride of diabetic rats. The observation of significant hypertriglyceridemia in spite of low triglyceride secretion rate in fructose-supplemented diabetic rats suggests that dietary fructose, but not glucose, interferes with triglyceride removal from the circulation of streptozotocin-diabetic rats. This impairment by dietary fructose is in addition to the impaired triglyceride removal associated with diabetes alone.

Animals↗
PubMed1989

Long-term treatment of hypercholesterolemic non-insulin dependent diabetics (NIDDM) with pravastatin (CS-514).

We examined the long-term effect of pravastatin, a new potent inhibitor of endogenous cholesterol biosynthesis, on glucose and lipid metabolism in hyperlipidemic NIDDM. Ten patients (5 on sulfonylurea, 5 on diet) were studied over 12 months. Five were WHO type IIa and 5 were type IIb. Blood was taken before and then 1, 6 and 12 months after initiating 10 or 20 mg daily of pravastatin. The cholesterol concentration in whole plasma and very low density lipoprotein (VLDL), plasma triglyceride and apolipoprotein (apo) B were all significantly decreased within the first month. These changes lasted for 1 year. High density lipoprotein (HDL)-cholesterol increased in the first month but returned to base line thereafter. Low density lipoprotein (LDL)-cholesterol tended to decrease in the first month, and was suppressed significantly from the 6th month (11%) to the 12th month (16%). The effect of pravastatin on LDL-cholesterol in NIDDM was slower and weaker than that published for non-diabetic hypercholesterolemia. Therefore, the mechanism by which pravastatin suppresses plasma cholesterol levels in these two conditions may differ. After 1 year, no adverse effects were noted on hematopoietic, hepatic or renal function. Blood glucose level, hemoglobin A1c and the insulin response to oral glucose were unchanged. In addition, serum creatine phosphokinase showed no abnormal increase. Careful ophthalmological examinations before and after pravastatin treatment revealed no development of new lenticular opacities. Thus, pravastatin appears to be a safe and effective drug for the long-term treatment of NIDDM with hypercholesterolemia.

Adult↗
PubMed1989

The role of insulin in triglyceride turnover in rats.

Exogenously induced hyperinsulinemia can increase in vivo triglyceride production in rats receiving dietary fructose, either as monosaccharide or as sucrose, but not in those receiving only glucose. Thus, in the presence of fructose, but not glucose, insulin stimulates triglyceride production. Dietary fructose can also impair the removal of circulating triglyceride. Exogenous insulin overcomes this fructose-associated impairment of triglyceride removal. On the other hand, streptozotocin-diabetic rats showed a suppressed triglyceride secretion rate (TgSR) but their plasma triglyceride level was unchanged. Therefore, insulin deficiency may result in not only decreased production of triglyceride but also impaired triglyceride removal from the circulation. Fructose-fed diabetic rats showed higher plasma triglyceride levels than chow-fed diabetic rats without a concomitant increase in TgSR, suggesting impaired triglyceride removal from the circulation induced by fructose in diabetic rats. Glucose-fed diabetic rats did not differ in TgSR or plasma triglyceride level from chow-fed diabetic rats. These observations indicate that circulating insulin and dietary fructose, but not glucose, have a key role in very-low-density lipoprotein triglyceride turnover in rats.

Animals↗
PubMed1989

Results of resection for bronchogenic carcinoma in patients over the age of 80.

Thirty three patients aged over 80 years underwent resection for bronchogenic carcinoma. The operations performed were: lobectomy (21), segmentectomy (4), wedge resection (2), pneumonectomy (3), carinal resection (1). In two patients no resection was feasible. Three patients died within two months of surgery. The cumulative five year survival rate was 55%, 79% for patients with stage I carcinoma and 31% for stage III. It is considered that resection has an acceptable outcome in patients over 80 years.

Aged↗
PubMed1989

The National Institutes of Health Intermittent Positive-Pressure Breathing Trial: pathology studies. IV. The Destructive index.

A Destructive Index (DI) was recently devised by Saetta and coworkers (7), and their data suggest that the DI may be a better assessment of emphysema than the traditional indexes. We have applied the DI as well as conventional assessments of emphysema-panel grading (emphysema score), mean linear intercept (Lm), and internal surface area at a volume of 5 L (ISA5) - to the lungs of patients in the National Institutes of Health Intermittent Positive Pressure Breathing Trial, which admitted patients with moderate to severe chronic airflow obstruction. In the 41 patients with satisfactory morphologic material who died and were autopsied, the DI was significantly correlated with emphysema score (p less than 0.001), Lm (p less than 0.001), and ISA5 (p less than 0.001). There was a rapid increase in the DI between emphysema scores of 30 and 60; when the DI reached a score of about 90, it did not increase much further. A wide spread of the DI from 23.7 to 86.5 was present in lungs with a Lm of less than 0.55 mm. The DI was well related to the diffusing capacity for carbon monoxide (DLCO) (p less than 0.001) and %TLC (p less than 0.01), but not to %FEV1, slope of phase III (phase III), nor recoil pressure at 90% of TLC (P90). The correlations between emphysema score and either DLCO or %TLC were about the same as for the DI. Also, correlations were significant for %FEV1, phase III, and P90. Lesions of bronchioles had no correlation with the DI. We therefore conclude that the DI is related to conventional assessments of emphysema, but beyond an emphysema score of 55 or a Lm of 0.55 mm, it does not discriminate emphysema severity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗