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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 199 records · Page 11Linked to original sources
PubMed1999

Treatment of esophageal and gastric tumors.

Endoscopic mucosal resection (EMR) has gained increasing popularity in the treatment of esophageal and gastric mucosal cancers in Japan, for complete local resection of the cancer-bearing mucosa. In Western countries, the concept of mucosal cancer and the necessity of treating it are gradually but steadily coming to be accepted. As a treatment for inoperable cases of advanced cancer, on the other hand, intubation with self-expanding metal stents has been widely accepted as a less invasive form of palliation for malignant obstruction of the upper gastrointestinal tract. Tumor ingrowth into the stent can be mechanically avoided by adding a membrane coating to it. In the last two years, applications for therapeutic endoscopy in the treatment of esophageal and gastric tumors have continued to widen.

Adenocarcinoma↗
PubMed1999

Interaction between collagens and glycosaminoglycans investigated using a surface plasmon resonance biosensor.

The interactions of glycosaminoglycans with collagens and other glycoproteins in extracellular matrix play important roles in cell adhesion and extracellular matrix assembly. In order to clarify the chemical bases for these interactions, glycosaminoglycan solutions were injected onto sensor surfaces on which collagens, fibronectin, laminin, and vitronectin were immobilized. Heparin bound to type V collagen, type IX collagen, fibronectin, laminin, and vitronectin; and chondroitin sulfate E bound to type II, type V, and type VII collagen. Heparin showed a higher affinity for type IX collagen than for type V collagen. On the other hand, chondroitin sulfate E showed the highest affinity for type V collagen. The binding of chondroitin sulfate E to type V collagen showed higher affinity than that of heparin to type V collagen. These data suggest that a novel characteristic sequence included in chondroitin sulfate E is involved in binding to type V collagen.

Animals↗
PubMed1999

Intestinal metaplasia at the esophagogastric junction in Japanese patients without clinical Barrett's esophagus.

OBJECTIVE: The significance of intestinal metaplasia found in biopsy specimens taken from healthy appearing squamocolumnar junction is unclear. The aim of the present study was to investigate the prevalence of intestinal metaplasia at the esophagogastric junction in Japanese patients with no clinical diagnosis of Barrett's esophagus. METHODS: A total of 103 specimens from consecutive surgeries were studied. All subjects underwent surgical resection for squamous carcinoma of the esophagus. Microscopic examination was performed from the squamocolumnar junction to 4 cm distal to the squamocolumnar junction. The extent of intestinal metaplasia was investigated in detail. Microscopic columnar-lined esophagus was defined as columnar epithelium with esophageal-type submucosal glands. RESULTS: The extent of intestinal metaplasia varied and was usually identified at intervals. Intestinal metaplasia exactly at the squamocolumnar junction was identified in 29 of 103 specimens (28%). Microscopic columnar-lined esophagus was identified in five of the 103 (5%), four of which had intestinal metaplasia in the columnar-lined esophagus. CONCLUSION: Intestinal metaplasia occurs frequently in the region of the esophagogastric junction in Japanese patients with squamous cell cancer of the esophagus.

Adult↗
PubMed1999

Patient position verification using CT images.

The use of ions in the radiotherapy of cancer patients requires an accurate patient positioning in order to exploit its potential benefits. Using CT images as the basis for the setup verification offers the advantage of a high in-plane resolution in combination with a geometrically accurate, volumetric information. Before each fraction a single CT slice is acquired at the isocenter level after the positioning procedure. This single slice is registered to the planning CT cube using automated image registration algorithms. Thus any erreonous translation or rotation can be detected and quantified. The registration process involves the interpolation of the volumetric data, the calculation of an energy function, and the minimization of this energy function. Several data interpolation functions as well as minimization algorithms were compared. CT studies with a head phantom were performed in which defined translations and rotations were simulated by moving a motor-driven treatment chair. Different slice thicknesses and anatomical sites were studied to investigate their potential influence on the registration accuracy. The accuracy of the registration was found to be a fraction of a voxel size for suitable combinations of algorithms (typically better than 0.16 mm/deg). A significant dependancy of the registration accuracy on the CT slice thickness and the anatomical site was found (the accuracy ranges from 0.05 mm/deg to 0.16 mm/deg depending on the site). The calculation time is dependant on the used algorithms and the magnitude of the setup error. For the standard combination of algorithms as proposed by the authors (Downhill Simplex minimization with Trilinear interpolation) the typical calculation time is about 20 s for a Sun UltraSPARC processor. Taking into account the mechanical accuracy of the setup device (motor-driven chair) the registration of CT images is thus a useful tool for detecting and quantifying any significant error in the patient position.

Algorithms↗
PubMed1999

Complement activation accelerates glomerular injury in diabetic rats.

A known inhibitor of the complement cascade (K-76 COONa) was administered to an inbred diabetic rat model to investigate whether the complement system may play a role in the progression of diabetic glomerulosclerosis. Drinking water containing K-76 COONa was available continuously to inbred diabetic rats (Otsuka Long-Evans Tokushima Fatty, OLETF) from the age of 25 to 55 weeks (Group L). Drinking water without K-76 COONa was similarly available to OLETF rats (Group H) and nondiabetic control rats (Long-Evans Tokushima Otsuka, LETO) (Group C). The levels of plasma glucose (mg/dl) at the 55th week were 156 +/- 16 in Group C, 252 +/- 18 in Group L and 349 +/- 93 in Group H. There was no significant difference in the degree of diabetes between Group L and Group H. The levels of urinary protein at 55 weeks of age (mg/day) were 2.1 +/- 0.4 in Group C, 11. 6 +/- 1.5 in Group L and 18.0 +/- 2.8 in Group H. The level of urinary protein was significantly decreased by the administration of K-76 COONa. Histological examination of renal specimens from the sacrificed rats at 55 weeks of age revealed diffuse mesangial expansion in almost all glomeruli in Group H, exudative lesions in 30% of glomeruli in Group H, and only mild mesangial expansion was recognized in Group L. Immunofluorescence study revealed brilliant staining of C3 and immunoglobulins (Ig) in Group H; trace staining of Ig and no staining of C3 were recognized in Group L. The incubation study with guinea pig serum and glomeruli from rats revealed that Ig and complement components also bound to injured glomeruli in vitro. These data indicate that the complement cascade is activated by injured glomeruli and this activation exacerbates diabetic glomerulosclerosis.

Animals↗
PubMed1999

Cone-beam CT angiography of the thorax: an experimental study.

The authors recently developed a cone-beam computed tomography (CT) scanner and this report presents their evaluation of its potential for thoracic vascular imaging. An X-ray tube and a video-fluoroscopic system were rotated around the objects and 360 projected images were collected in a 12-s scan. Each image was digitized and a 3 dimensional (D) image (256x256x256 voxel volume with a voxel dimension of 0.9x0.9x0.9 mm) was reconstructed. Two different 3D-CT angiographies were investigated in 2 pigs: right atriography and thoracic aortography. Each pig was anesthetized, mechanically ventilated and positioned within the scanner. Contrast agent was infused through the right atrium or the aortic root at a rate of 3 ml/s during the scan. The right atriography scan clearly delineated the anatomy of the pulmonary artery, heart chambers and thoracic aorta. The thoracic aortography scan also clearly delineated the aortic anatomy including the internal thoracic and intercostal arteries. In conclusion, cone-beam CT angiography is potentially useful for thoracic vascular imaging.

Angiography↗
PubMed1999

Effect of cysteine protease of Porphyromonas gingivalis on adhesion molecules in gingival epithelial cells.

We examined the effect of cysteine protease of Porphyromonas gingivalis (P. gingivalis) on cell adhesion molecules including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and very late antigen-4 (VLA-4) of human gingival epithelial cells. The cells were incubated for 48 hr with or without P. gingivalis protease. Their cell adhesion molecule expression levels were increased at 12 hr, but decreased at 18-48 hr. This result suggests that protease degrades cell adhesion molecules. After the stimulation with protease for 12 hr, P. gingivalis fimbrial binding to a monolayer of the cells was effectively inhibited by the addition of the cell adhesion molecules, suggesting the fimbrial binding to the cells occurred through cell surface adhesion molecules.

Bacterial Adhesion↗
PubMed1999

Assessment of long-distance running performance in elite male runners using onset of blood lactate accumulation.

The purpose of this study was to evaluate the relationship between onset of blood lactate accumulation (OBLA) and long-distance running performance in order to examine whether OBLA can be a good predictor of long-distance running performance even in elite male runners with similar performance levels. Eleven highly-trained male long-distance runners participated in this study. The average running velocities of the individuals' running performance were 5.918 +/- 0.084 m.s-1 and 5.672 +/- 0.095 m.s-1 for 5000 m (V5000) and 10,000 m (V10000), respectively. The blood lactate concentrations and heart rate responses were measured immediately after field running, and the average value of running velocity corresponding to OBLA (VOBLA) was 5.447 +/- 0.132 m.s-1. Variations of these three velocities expressed as a coefficient of variance (CV) ranged from 1.4 to 2.4%. A strong inverse relationship between heart rate corresponding to OBLA (HROBLA) and performance was observed (r = -0.709, p < 0.02 for V5000 and r = -0.830, p < 0.01 for V10000), while there was a lack of significant relationship between VOBLA and performance (r = 0.293, NS for V5000 and r = 0.130, NS for V10000). Furthermore, the average value of HROBLA obtained in this study (174.5 +/- 8.2 b.min-1) was quite similar to that of the heart rate threshold reported by some previous researchers. In conclusion, VOBLA alone could not explain the small variation of long-distance running performance, and HROBLA should be used in place of VOBLA for evaluating long-distance running performance in elite runners with quite similar performance levels.

Adult↗
PubMed1999

Transition of polycythemia vera to chronic neutrophilic leukemia.

Two cases of polycythemia vera (PV) had transition to a hematological condition compatible with chronic neutrophilic leukemia (CNL) 17 and 8 years after diagnosis, respectively. One patient was treated with carboquone followed by hydroxyurea (HU) and the other with HU during PV phase. On transition, both had neutrophilia with white blood cell count above 40,000/microl, elevated neutrophil alkaline phosphatase activity, splenomegaly, normal karyotype without bcr-abl rearrangement. Busulfan was temporally effective in controlling the neutrophil count. However, one patient progressed to the so-called spent phase and the other subsequently had multiple transitions between PV and CNL. These cases may represent a form of uncommon evolution of PV and support the contention that CNL is a type of myeloproliferative disorder and that at least some CNL cases have derangement at the hematopoietic stem cell level.

Busulfan↗
PubMed1999

[Acquired pulmonary stenosis caused by mediastinal mature teratoma: a case report].

A 13-year-old girl was admitted with a sudden onset of chest oppression. Mediastinal teratoma was suspected on chest X-ray and CT scan. A grade 2/6 systolic murmur was heard at the upper left sternal area and cardiac catheterization showed mild pulmonary stenosis. After resection of the tumor, the murmur disappeared and histopathological diagnosis was mature teratoma. This is a rare case report of pulmonary stenosis caused by mediastinal mature teratoma.

Adolescent↗
PubMed1999

[Combined chronic subdural and acute epidural hematoma secondary to metastatic hepatocellular cancer: case report].

We report a case of combined chronic subdural and acute epidural hematoma caused by metastatic hepatocellular cancer of the dura mater. A 44-year-old woman, who had been under treatment for hepatic cancer for one year, presented with right hemiparesis. MRI revealed a chronic subdural hematoma on the left fronto-parietal region with subgaleal and epidural metastasis. The patient was found comatose 7 days later. A huge epidural hematoma in the left parietal region was disclosed with CT scan. She died of hepatic failure despite the evacuation of the hematoma. This is the first reported case with a combined subdural and epidural hematoma secondary to metastatic brain tumor of the dura mater.

Acute Disease↗
PubMed1999

[A case report of a coronary fistula from left coronary artery to left ventricle].

The patient is a 44-year-old man. He has had chest pain on effort since 1994, diagnosed as unstable angina in 1996. He was found to have three vessel disease on coronary angiography and was sent to TWMC for operation. CABG was performed for the right and left anterior descending arteries, and TMLR for the posteroinferior region because the left circumflex artery was fine and ungraftable. Both the grafts were patent and there was improved LV function. Interestingly, we found a coronary fistula running from the left coronary artery to the left ventricle. As far as we can tell from our literature searches, this is the first time that a coronary fistula has been found after TMLR.

Adult↗
PubMed1999

Inhibitory effect of free sialic acid on complement activation and its significance in hypocomplementemic glomerulonephritis.

The role of free sialic acid on complement activation was investigated. The serum levels of free sialic acid and total sialic acid were measured by previously described methods in 16 patients with acute post-infectious glomerulonephritis (AGN), 27 patients with systemic lupus erythematosus (SLE), 15 patients with persistent hypocomplementemic membranoproliferative glomerulonephritis (MPGN), and 13 healthy controls. A statistical study demonstrated an increased level of free sialic acid in patients with AGN and SLE in which the hypocomplementemia improved throughout the course and a decreased level of free sialic acid in patients with MPGN and SLE in which hypocomplementemia continued throughout the course. The levels of total sialic acid were significantly increased in patients with AGN and SLE and were significantly decreased in patients with MPGN. There was no correlation between the levels of free sialic acid and total sialic acid in patients with AGN, in whom the levels of both total and free sialic acids were increased. To examine the effect of free sialic acid on the complement cascade, lipopolysaccharide (LPS) was incubated with normal human serum (NHS) in the various concentrations of N-acetyl neuraminic acid (NANA), a member of the sialic acid group. The incubation mixtures were examined by enzyme immunoassay using monoclonal anti-iC3b antibody or anti-Bb antibody. Native C3 or Factor B in NHS broke down less following the addition of NANA. To elucidate the role of NANA on the hemolytic function of C3, a rabbit erythrocyte (Ra E) hemolytic assay was carried out. Ra E lysed completely in the presence of R3 with native C3. However, hemolysis occurred to a lesser degree in C3-depleted serum (R3) or R3 with NANA-treated C3. To investigate the influence of NANA on complement components, the levels of complement components were measured in the incubation mixture with various doses of NANA and NHS. The levels of C3 and C5 were significantly decreased after the addition of NANA, even though the levels of Factor H and Factor I were not markedly changed. These data indicate that NANA exerts an influence on the complement components even though it has no effect on the regulatory proteins of complement. Our in vitro findings, together with the in vivo data, suggest that free sialic acid might have an inhibitory effect on the activation of C3 and the following complement cascade, and might also have been responsible for the improvement of hypocomplementemia.

Animals↗
PubMed1999

[Complete arterial revascularization in emergency CABG].

Between August 1987 and November 1998, 137 patients underwent emergency CABG within 24 hours from the notification of cardiologist. Among them, 37 patients (27%) (34 men, 3 women) with a mean age of 59.9 (range, 39-76) underwent multiple CABG with exclusive use of arterial conduits. Preoperative diagnosis was acute myocardial infarction in 20 patients and unstable angina in 17 patients. Twenty-nine patients (78%) had either triple vessel or left main disease. There were 3 redo CABG and 3 patients were on hemodialysis. Postoperative follow-up averaged 44 months. Twenty-nine patients (78%) were under IABP support preoperatively. The mean number of anastomoses was 2.65 (range, 2-5). One patient (2.7%) died of persistent heart failure 54 days postoperatively. The patency was confirmed angiographically in 33 patients 3-4 weeks after surgery. Overall patency was 90.6% (LITA: 93.0%, RGEA: 76.2%, RITA, radial: 100%). There were no late deaths or redo CABG, and 2 patients sustained myocardial infarction and 3 patients underwent PTCA during follow-up. Five-year actuarial survival rate was 97.1% and cardiac event-free rate was 75.7%. These excellent early and long-term results suggest that complete arterial grafting for emergency CABG should be considered as a primary treatment in patients who have multivessel or left main disease, and no ongoing profound cardiogenic shock or rapid deterioration.

Adult↗
PubMed1999

[Three cases of pregnancy in primary glomerulonephritis with successful outcomes in spite of severe histological findings].

When women with kidney disease wish to have children, concerns are raised about the adverse effect on their renal function. Although the situation is less clear in regard to the effects, there is general agreement that a moderately severe decrease in renal function, especially in the presence of significant hypertension, reduces the chance of conception, and a successful outcome of gestation. On the other hand, several reports maintain that in most patients, pregnancy does not change the natural history of glomerular disease. Accordingly, we reported successful cases in whom renal function remained preserved. The three cases suffered from different types of glomerulonephritis (GN) and percutaneous renal biopsies were conducted before pregnancy. All biopsy specimens were examined by light and immunofluorescence microscopy, and were diagnosed as IgA nephropathy, sclerosing GN and membranoproliferative GN, respectively. Since severe histological findings were found and their data worsened (serum creatinine > 1.3 mg/dl, 24-hr creatinine clearance < 70 ml/min), their chance of having children appeared low. However, as we did not observe deterioration of clinical findings and hypertension over the ten-year follow-up, we allowed conception resulting in the birth of normal children. Thus we should mention the relatively favourable courses of nephropathy in some patients with GN, particularly in patients with stable renal disease and normal blood pressure, it should not be considered an indication for termination. It is important to observe the status of glomerular disease for as long as possible.

Adult↗
PubMed1999

New graft holder for coronary artery bypass using arterial conduits.

An arterial graft holder was designed to facilitate coronary artery bypass surgery. It can be used to open the heel of arterial conduits and it immobilizes the graft with a spring clamp. The tip of the holder is made from flexible, silicon-coated vinyl chloride tubing, so that it can be inserted into the arterial lumen without causing endothelial injury.

Anastomosis, Surgical↗
PubMed1999

[A case report of total aortic reconstruction and choice of staged operation in Marfan syndrome].

A 37-year-old man with Marfan syndrome underwent four operations for extensive cardiovascular disease. He was diagnosed as having AAE, AR and DeBakey type I aortic dissection. First, Bentall operation using Piehler procedure and total aortic arch replacement using retrograde cerebral perfusion and profound hypothermia at 18 degrees C were performed on May 11, 1994. Second, repair of leakage of the right coronary artery anastomosis and grafting for the descending thoracic aortic aneurysm were performed on December 3, 1994. Y-type grafting for the AAA was performed on December 21, 1996. Last, grafting for TAAA was performed under hypothermia at a rectal temperature of 20 degrees C on November 17, 1997. This surgical strategy of staged operation for extensive cardiovascular disease in Marfan syndrome is an effective method. Regular follow-up by CT is necessary for deciding the time and method of reoperation.

Adult↗