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Biomedical subjects

K Mitsui

Publications and source records attributed to K Mitsui.

At least 127 records · Page 7Linked to original sources
PubMed1993

Encapsulated type II pneumocyte adenoma: a case report and review of the literature.

An unusual benign lung neoplasm, a papillary adenoma of type II pneumocytes, was resected from a 26-year-old man who showed no clinical symptoms. The tumor was 2.0 cm in diameter and was localized in the subpleural region of S7 of the right lung; the cut surface showed a spherical medullary mass encapsulated by a thin layer of connective tissue. Histologically, there were cuboidal to columnar epithelial cells with a little nuclear atypia showing a monotonous papillary pattern with a delicate stroma in most parts of the tumor. There was neither capsular invasion nor metastasis of tumor cells. Nuclear DNA analysis of the tumor cells showed a diploid pattern and a low S-phase fraction. The immunohistochemical study revealed that most tumor cells contained a large amount of surfactant apoprotein in the cytoplasm. Osmiophilic lamellar bodies characteristic of type II pneumocytes were frequently found by electron microscopy. These findings indicate that this was a benign adenoma of the lung arising from type II pneumocytes.

Adenoma↗
PubMed1993

Flow characteristics of hepatic tumors at color Doppler sonography: correlation with arteriographic findings.

OBJECTIVE: We studied benign and malignant hepatic tumors with color Doppler sonography and arteriography in order to correlate color Doppler flow characteristics with tumor hemodynamics (vascularity, arteriovenous shunting, and portal vein involvement) shown by arteriography. We also evaluated the usefulness of color Doppler flow characteristics in discriminating between tumor types. SUBJECTS AND METHODS: We performed color Doppler sonography and hepatic arteriography in 58 patients with 72 hepatic lesions larger than 2.0 cm in diameter. Differences in pulsatile flow (peritumoral or intratumoral) and the highest systolic peak flow velocities reached were evaluated on color Doppler sonograms and compared with arteriographic findings. RESULTS: Color flow sonograms were obtained in 43 of 45 hepatocellular carcinomas, 15 of 16 cholangiocellular carcinomas or hepatic metastases, and six of 11 hemangiomas. Mixed peritumoral and intratumoral pulsatile flow was shown by arteriography in highly vascular tumors. The mean peak systolic flow velocity seen in hepatocellular carcinomas (0.52 m/sec) significantly exceeded the velocity seen in hemangiomas (0.16 m/sec), but not the velocity seen in other malignant hepatic tumors (0.51 m/sec). Six hepatocellular carcinomas, one cholangiocellular carcinoma, and two hepatic metastases with peak systolic flow velocities greater than 0.80 m/sec were each proved arteriographically to have arteriovenous shunting or portal vein involvement. CONCLUSION: Color Doppler sonography was useful for evaluating hepatic tumor hemodynamics as seen at arteriography, and peak systolic velocity may be useful in differentiating malignant hepatic tumors from hemangiomas.

Adult↗
PubMed1993

Increased hepatic arterial blood flow in acute viral hepatitis: assessment by color Doppler sonography.

To evaluate the effect of acute viral hepatitis on hepatic arterial blood flow, we performed color Doppler sonography with point-spectral analysis in 15 patients with acute viral hepatitis and compared the results with those in 15 normal volunteers. During the acute phase of hepatitis, the peak-systolic and end-diastolic velocity of the hepatic artery were significantly larger than those in normal arteries (p < 0.01). During the recovery phase, these indexes of the hepatic artery decreased significantly to the control levels (p < 0.01). The resistive indexes related to vascular resistance in the hepatic artery during the acute phase were significantly less than those in normal arteries (p < 0.01), and they increased significantly to the control levels during the recovery phase (p < 0.01). No significant correlation was found between these indexes of the hepatic artery and conventional liver function parameters. However, the interval between the acute phase and the recovery phase did correlate negatively with the peak-systolic velocity of the hepatic artery in the acute phase (r = -0.630, p < 0.05) and with the end-diastolic velocity (r = -0.514, p < 0.05). We conclude that color Doppler sonography is useful for imaging increased hepatic arterial blood flow in patients with acute viral hepatitis. We believe that increased hepatic arterial blood flow during the acute phase may provide a marker for earlier recovery from hepatitis-induced damage.

Acute Disease↗
PubMed1993

[A case report of graft replacement of the ascending and transverse aorta without homologous red blood cell transfusion].

A 28-year-old man of DeBakey type I dissecting aneurysm was received graft replacement of the ascending and transverse aorta under the deep hypothermic circulatory arrest and continuous retrograde cerebral perfusion for cerebral protection during circulatory arrest. From 3 weeks before operation, autologous blood was collected from the patient with the intravenous administration of a recombinant human erythropoietin (rHuEPO) and was subsequently used in the operation. As result, the graft replacement of the ascending and transverse aorta was performed without homologous red blood cell transfusion and postoperative neurological complications. We believe autologous blood transfusion with rHuEPO and circulatory arrest with CRCP contributes operations of aortic aneurysms without homologous blood transfusion.

Adult↗
PubMed1993

[A case of right ventricular outflow reconstruction surgery using an autologous pericardial non-valved conduit to treat pulmonary atresia with uncommon systemic-pulmonary collateral artery].

A 11-year-old girl diagnosed as having pulmonary atresia with uncommon systemic-pulmonary artery underwent on March 6, 1991. The collateral artery was derived from the left subclavian artery and divided from the descending aorta. Right ventricular outflow reconstruction was performed using a non-valved conduit of the autologous pericardium, and anastomosis of the conduit and pulmonary artery was successfully performed prior to extracorporeal circulation, because of the conduit's flexibility. Thus, we could reduce extracorporeal circulation time. Postoperative course was excellent, and patient is free from the morbidity associated with prosthetic valve. It is considered that a non-valved conduit of the autologous pericardium may be effective, but will require a long term follow-up.

Blood Vessel Prosthesis↗
PubMed1993

[Cardiac hemangioma of the interventricular septum and right ventricle: a case report].

A 52-year-old man who had been pointed out cardiac tumor on echocardiography, CT, MRI and coronary angiography was admitted to our hospital. He was asymptomatic. The surgical excision of the tumor was performed under extracorporal circulation and the postoperative period was free of event. It was not certain whether it originated from interventricular septum or right ventricle. The histology was mixed hemangioma composed of capillary and cavernous type.

Heart Neoplasms↗
PubMed1993

A case of spontaneous recanalization following renal infarction.

A 30-year-old-male was admitted to our hospital with a tentative diagnosis of appendicitis. We found no signs of peritonitis, and therefore suspected urinary tract calculi. Intravenous pyelography revealed his right kidney to be nonfunctional, while retrograde pyelography was normal. Angiography revealed right renal infarction. Renovascular hypertension was present, and treatment with captopril was prescribed. Two years later without medication he had normal blood pressure and plasma renin activity. Intravenous pyelography revealed a right kidney functioning well, and digital subtraction angiography (DSA) revealed spontaneous recanalization of his right renal artery.

Adult↗
PubMed1993

[Pulmonary artery reconstruction for extreme tetralogy of Fallot and similar complex heart diseases before cardiopulmonary bypass].

It is sometimes difficult to repair the pulmonary artery in extreme tetralogy of Fallot and other similar complex heart diseases, such as pulmonary atresia with major aorto-pulmonary collateral arteries, because of their complexity. Therefore, cardiopulmonary bypass takes longer in these patients than in those with usual tetralogy of Fallot. We undertook reconstruction of the pulmonary artery in 4 cases of extreme tetralogy of Fallot and other similar complex heart diseases before cardiopulmonary bypass. We investigated the cardiopulmonary bypass time in these patients and compared it with that in patients with usual tetralogy of Fallot. There was no significant difference in cardiopulmonary bypass time between the two groups. In the 4 extreme cases, the postoperative course was uneventful. We conclude that this attempt reduced the cardiopulmonary bypass time and facilitated the surgical correction.

Adolescent↗
PubMed1993

[Clinical experience with extracorporeal shock wave lithotripsy using Dornier MFL 5000-(U) for urinary stone].

Our hospital recently installed one of the newest types of extracorporeal shock wave lithotripters, a Dornier MFL 5000-(U). We conducted preliminary clinical trials with the apparatus from April to June 1991. In this report we discuss our experience with the first 40 patients (52 stones) treated in a total of 52 extracorporeal shock wave lithotripsy (ESWL) sessions. Follow up observation was conducted for three months. Except in one case, invasive anesthesia was not used. A double J-catheter was inserted in 13 cases, a ureteral catheter in 7 cases, and percutaneous nephrolithotripsy (PNL) was used after ESWL in one case. After one month of follow-up, 27 patients (67.5%) were completely free from stone fragments, while at 3 months after treatment, 34 patients (85.0%) were free from stone fragments. No serious complications were observed after ESWL. We concluded that the Dornier MFL-5000-(U) apparatus is effective for renal and ureteral stones and generates no serious complications.

Adult↗
PubMed1992

Effects of endothelin-1 and conversion of big endothelin-1 in the isolated perfused rabbit lung.

We examined the effects of endothelin-1 (ET-1) on pulmonary hemodynamic and transvascular fluid filtration and the conversion of big endothelin-1 (big ET-1), a precursor of ET-1, in isolated perfused rabbit lungs at constant vascular and airway pressures. Furthermore we examined whether ET-1 contributes to cyclooxygenase metabolism. The perfusate flow decreased significantly after bolus administration of 1 or 0.1 nmol of ET-1. Lung weight did not increase throughout the experimental period. Big ET-1- (1 nmol) induced decrease in the flow was slow in developing, although the maximum response was comparable to that induced by the same dose of ET-1. The concentration of bit ET-1 in the perfusate progressively decreased, while that of ET-1 increased in a time-dependent manner. Phosphoramidon, an inhibitor of metalloproteinase, suppressed the pressor effect of big ET-1 (P less than 0.01) and the increase in the concentration of ET-1 in the perfusate (P less than 0.05). The present findings provide the first evidence suggesting that the potent vasocontractile effect of big ET-1 in pulmonary circulation can be attributed to the production of ET-1 by the conversion from big ET-1 in the vascular bed. ET-1-induced perfusate flow changes were not affected by indomethacin, and the concentration of 6-ketoprostaglandin F1 alpha, a metabolite of prostacyclin, did not increase after ET-1 administration.

Animals↗
PubMed1992

Outbreaks of group A beta-hemolytic streptococcal pharyngitis in children: correlation of serotype T4 with scarlet fever.

We evaluated the clinical features of 121 children who had group A beta-hemolytic streptococcal (GABHS) pharyngitis during 2 outbreaks in the Chikuhou district, Fukuoka, Japan, with respect to T types. During the first outbreak (November 1989-February 1990), T12 (50%) and T22 (27%) were the dominant T types isolated. During the second outbreak (January-April 1991), 64% of the typable strains were T4. Pus on the tonsils was less common and strawberry tongue more common in patients with eruptions than in those without. Skin eruptions were much more common in the patients infected with T4 than with other T types (p < 0.001). Despite a 10-day regimen of amoxicillin, 12/69 patients (17.4%) had evidence of GABHS on repeat cultures. The results suggest that T4 may be associated with a high incidence of scarlet fever. Serotyping should be performed to identify disease carriers and patterns of GABHS infection.

Adolescent↗
PubMed1992

[Gianturco expandable metallic stents in the treatment of superior vena cava syndrome caused by lung cancer].

Treatment of superior vena cava syndrome (SVCS) caused by advanced lung cancer is still controversial. We inserted Gianturco expandable metallic stents (GEMS) in 5 patients with SVCS due to the extension of lung cancer. GEMSs were introduced intravenously through the catheter after intraluminal balloon dilation of the stenotic sites. SVCS was successfully and easily relieved by this method without any significant complication. GEMS placement seems to be a useful alternative to bypass grafting procedure for the treatment of SVCS.

Adult↗
PubMed1992

[Annual changes of bacteria isolated from urinary tract infections and their susceptibility to new quinolone agents].

Statistical analyses were conducted on bacterial strains isolated from the urine of patients with urinary tract infections (UTI) in the Department of Urology at Aichi Medical University from January 1988 through December 1991. The drug sensitivity of the bacterial strains isolated from patients with complicated UTI between 1988 and 1991 was analyzed and compared. Among the outpatients with uncomplicated UTI, a total of 352 strains were isolated. E. coli was isolated the most frequently (90.1%). Among the outpatients with complicated UTI, a total of 829 strains were isolated. Enterococcus sp. was isolated the most frequently (21.2%). P. aeruginosa and S. aureus showed a tendency to increase. Among the inpatients with complicated UTI, a total of 671 strains were isolated. Enterococcus sp. was isolated the most frequently (22.5%). P. aeruginosa and S. aureus showed a tendency to increase, while E. coli and Enterobacter sp. showed a tendency to decrease. E. coli was highly sensitive to all drugs except ampicillin (ABPC). Proteus sp. and Klebsiella sp. were highly sensitive to norfloxacin (NFLX). P. aeruginosa was highly sensitive to gentamicin (GM). The frequency of NFLX-sensitive P. aeruginosa significantly dropped from 84.6% to 40.9% among the outpatients (P < 0.01), and from 75.0% to 44.4% among inpatients (P < 0.05). S. aureus was highly sensitive only to minocycline (MINO). The frequency of NFLX-sensitive S. aureus significantly dropped from 66.6% to 23.3% among inpatients (P < 0.05). Enterococcus sp. was highly sensitive to ABPC and MINO. Of the new quinolones, tosufloxacin (TFLX) had the strongest antimicrobial activity followed by (ciprofloxacin) CPFX on all the bacterial strains tested.

Bacteria↗
PubMed1992

Endothelin-1 mediates regional blood flow during and after pulmonary operations.

To investigate the role of endothelin-1, a potent vasoconstrictor peptide produced by vascular endothelial cells, in the physiologic response to surgical stress, we measured plasma endothelin-1 concentrations by a sandwich-enzyme immunoassay in patients with lung cancer undergoing pulmonary operations (n = 12). In the first group (n = 6), we measured plasma endothelin-1 concentrations at multiple sampling sites (median cubital vein, pulmonary artery, and left atrium). Plasma endothelin-1 levels were significantly increased at all sampling sites at the end of the operation. Although there was no difference between the increased plasma levels of endothelin-1 in the pulmonary artery and in the left atrium, the increased level in the median cubital vein (peripheral venous blood) was significantly higher than that in the pulmonary artery (mixed venous blood). This result suggests that the production of endothelin-1 might differ between various organs under surgical stress. In the second group (n = 6), we measured plasma endothelin-1 concentrations both in the median cubital vein and in the ipsilateral radial artery, and also measured cardiac output and forearm blood flow. The increase in endothelin-1 levels in the median cubital vein was significantly higher than that in the radial artery after the operation. The endothelin-1 output from the forearm, calculated by the forearm blood flow and the arteriovenous difference of endothelin-1 concentrations, significantly increased after the operation. Although the cardiac output significantly increased after the operation, the forearm blood flow significantly decreased. The present findings provide a novel hypothesis that the preferential release of endothelin-1 from the peripheral vasculature of the forearm may partly contribute to a compensatory response to surgical stress, for example, the reduction of local blood flow in nonvital organs so as to increase the blood flow in vital organs.

Adult↗
PubMed1992

[Evaluation of postoperative pulmonary complications and remaining pulmonary arterial flow of lobectomized lung cancer patients using pulmonary digital subtraction angiography].

Postoperative pulmonary complications cause the decrease of the flow of remaining pulmonary circulation. We examined the effects of the difference of resected lobes on the postoperative course and remaining pulmonary circulation of the lobectomized lung cancer patients using a pulmonary digital subtraction angiography. In all cases with preoperative pulmonary complications, circulatory flow of the remaining lung on the operated side significantly decreased. In the cases without preoperative pulmonary complications, only the cases performed left upper lobectomy developed the decrease of the circulatory flow on the operated side. This seemed to be chiefly caused by a postoperative continual atelectasis of the remaining lower lobe due to kinking of the bronchus. On the other hand, the postoperative decrease of the residual pulmonary circulatory flow on the operated side was not developed in the cases undergoing a segmentectomy, even with pulmonary complications. Therefore, for any case requiring a left upper lobectomy or the case with an impaired lung requiring any type of lobectomy, contralateral pulmonary function should be exactly evaluated preoperatively.

Aged↗
PubMed1992

[MRSA pyothorax due to bronchopleural fistula after grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta--a successful treatment by open drainage and omentopexy].

Treatment of postpneumonectomy pyothorax due to bronchopleural fistula (BPF) is troublesome, especially with methicillin-resistant staphylococcus aureus (MRSA) infection. Moreover, in a bypass-grafting case, the management becomes more complicated. We reported a successful treated case of MRSA pyothorax due to BPF after grafting and pneumonectomy. In a 48-year-old woman performed grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta, MRSA pyothorax due to BPF occurred. BPF was successfully closed by fibrin-glueing under bronchofiberscopy. However pyothorax was not improved by thoracic irrigation for a month. Therefore, open pleural drainage underwent. At the same time, bronchial stump and graft surface was covered with the omental pedicle flap. The open wound had become sterile in two months, and the thoracic window was closed three months after the open drainage.

Aorta, Thoracic↗