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M Endo

Publications and source records attributed to M Endo.

At least 307 records · Page 17Linked to original sources
PubMed1997

Effective cross-circulation technique of venoarterial bypass for differential hypoxia condition.

We examined a new technique of cross-circulation (CC) venoarterial bypass (VAB) with femoral arterial perfusion and superior vena cava drainage through a long femoral venous cannula. Six adult mongrel dogs weighing 15 to 20 kg underwent the CC-VAB with oxygenation after introduction of respiratory failure (RF). The flow of the CC-VAB was maintained at half the level of the control cardiac output, and the hemodynamic parameters were monitored. To evaluate hypoxia in the upper body, the arterial partial pressure of oxygen (PaO2 [mm Hg]) in the carotid artery and the venous saturation of oxygen (SvO2 [%]) in the pulmonary artery were measured during control, RF, standard VAB, and CC-VAB conditions. The PaO2 decreased significantly after the introduction of RF (41.7 +/- 12.4), and it returned to normal levels only after CC-VAB (151.2 +/- 24.5, p < 0.05). The SvO2 during CC-VAB (98.6 +/- 2.1) was significantly higher than that during VAB without CC (53.5 +/- 3.4, p < 0.05). These results suggest that this cross-circulation technique could be applied to patients with differential hypoxia during femoral VAB with oxygenation or percutaneous cardiopulmonary support (PCPS).

Analysis of Variance↗
PubMed1997

Significant left ventricular unloading with transaortic catheter venting during venoarterial bypass.

Insufficient unloading of the left ventricle with blood stagnation is a main cause of unsuccessful left ventricular (LV) recovery during percutaneous cardiopulmonary support (PCPS). The purpose of this investigation was to evaluate the effectiveness of transaortic catheter venting (TACV) for LV unloading. Six adult mongrel dogs (mean weight 16.3 kg, range 14-20 kg) underwent venoarterial bypass (VAB) with TACV. Bypass flow ranged from 0.8-1.2 L/min, and TACV flow ranged from 160-240 ml/min. In addition to monitoring the standard hemodynamic parameters, the slope of the LV end-systolic pressure-volume relation (Emax) during transient occlusion of the inferior vena cava, the slope of the LV end-systolic pressure-stroke-volume relation (Ea), the stroke work (SW), the LV pressure-volume area (PVA), and the slope of the SW end-diastolic volume relation, the preload recruitable stroke work (PRSW) were assessed by means of a microtip manometer and a conductance catheter. The LV contractility (Emax) and aortic elastance (Ea) were equivalent in the 2 groups with or without TACV (7.7 +/- 1.1 versus 8.4 +/- 1.5 mm Hg/ml and 8.2 +/- 1.4 versus 7.6 +/- 1.3 mm Hg/ml). Comparing the measurements for the baseline to those for VAB with TACV, the SW was significantly reduced, and the PVA/SW was increased by TACV (1,685 +/- 309 versus 867 +/- 188 x 10(-4) J, p < 0.05 and 1.32 +/- 0.03 versus 1.58 +/- 0.11, p < 0.05, respectively). Furthermore, the PRSW was gradually decreased from the baseline value to the value resulting from VAB with TACV (75 +/- 8 versus 44 +/- 3 x 10(-4) J/ml, p < 0.01). In comparison, the percent reduction of SW between VAB and VAB with TACV tended to be increased by TACV (23.2 +/- 7.2% versus 46.9 +/- 7.7%, p = 0.05). These results suggest that TACV might reduce LV work (SW and PRSW) and might increase the LV energetic charge. In conclusion, TACV would be an adjunctive technique to VAB or PCPS for patients with LV failure.

Angioplasty, Balloon, Coronary↗
PubMed1997

Clinical evaluation of pulsatile flow mode of Terumo Capiox centrifugal pump.

The Terumo Capiox centrifugal pump system possesses an automatic priming function in which the motor repeatedly stops and runs intermittently to eliminate air bubbles in the circuit through the micropores of the hollow-fiber membrane oxygenator. By modifying this mechanism, we have developed a pulsatile flow mode. In this mode, maximum and minimum pump rotational speeds can be independently set every 20 rpm in the range of 0 to 3,000 rpm. The duration of the pump run at maximum and minimum speeds can also be independently set every 0.1 s in the range of 0.2 to 15 s. In a clinical trial, after obtaining the desired flow rate, 2.4 L/min/m2 in nonpulsatile flow mode, a pulsatile flow mode of 60 cycles/min (with 1 cycle being maximum speed for 0.4 s and minimum speed for 0.6 s) was obtained by adding and subtracting 500 rpm to and from the rotational speed in nonpulsatile flow mode. Pulse pressures in the femoral artery and in the circuit just proximal to the perfusion cannula (6.5 mm Sarns high flow cannula with metal tip) were measured in 5 patients who underwent pulsatile cardiopulmonary bypass (CPB) for a coronary artery bypass graft (CABG), and compared to pulse pressures obtained by intraaortic balloon pumping (IABP) in 3 patients and by the pulsatile mode of the 3M Delphin pump in 3 patients. The platelet count, free hemoglobin, and beta-thromboglobulin (beta-TG) were measured and compared with measurements from another 5 patients who underwent nonpulsatile CPB. Although the pulse pressure measured in the circuit was 180 mm Hg on average, the pressure in the femoral artery was only 15 to 40 mm Hg with a mean of 20 mm Hg. In the same patients, 60 to 80 mm Hg pulse pressure was obtained with IABP. The pulse pressure obtained with the Delphin pump was not more than that obtained with the Terumo pump. There were no significant differences in percents of preoperative levels of platelet counts (pulsatile, 87.6 +/- 15.8% and nonpulsatile, 72.4 +/- 40.6%), free hemoglobin (pulsatile, 18 +/- 8 mg/dl and nonpulsatile, 25 = 7 mg/dl), and beta-TG (pulsatile 298 +/- 28 ng/ml and nonpulsatile, 312 +/- 143 ng/ml). In conclusion, although the pulsatile mode of the Terumo centrifugal pump did not exhibit any adverse effects hematologically, the pulse pressure obtained was unsatisfactorily small, mainly because of dumping caused by the perfusion cannula.

Angina Pectoris↗
PubMed1997

Fungicidal action of aureobasidin A, a cyclic depsipeptide antifungal antibiotic, against Saccharomyces cerevisiae.

Aureobasidin A, an antifungal antibiotic inhibiting a wide range of pathogenic fungi, is lethal for growing cells of susceptible fungi. We did cytological studies on the mechanism of its fungicidal action against Saccharomyces cerevisiae. When cultures were treated with 5.0 micrograms of aureobasidin A per ml, the numbers of viable cells started to decrease after 2 to 3 h of incubation, and most cells had lost viability after 5 to 6 h. When cell death in the treated cultures began, amino acids released by the cells could be detected, indicating disruption of the cell membrane. The proportion of cells with a single small bud or two or more buds increased as the population of viable cells decreased. Most such cells had the DNA content of cells in the G2 phase of the cell cycle, suggesting that the drug inhibited some cellular process involved in normal bud growth but did not affect DNA replication. Disruption of actin assembly was found in many cells treated for 2 to 3 h, as was chitin delocalization. The results suggest that aureobasidin A has a previously unknown mechanism of fungicidal action toward S. cerevisiae. It causes aberrant actin assembly, inhibiting the normal budding process and leading to cell death, probably through destruction of membrane integrity.

Actins↗
PubMed1997

Endoscopic treatment of early oesophageal or gastric cancer.

BACKGROUND AND AIMS: Endoscopic treatment has become increasingly popular in recent years as an alternative to surgical treatment with the hope of offering superior quality of life (QOL) for the patient. The results of endoscopic treatment of mucosal lesions of mostly early oesophageal or gastric cancer performed in 145 patients (155 lesions) over the past eight years were reviewed from the standpoint of QOL. RESULTS: In 56 patients who underwent radical resection of the oesophageal mucosa, no serious complications and symptoms occurred, with epithelialisation completed within about a month. Patients also showed good results regarding dietary intake and performance status (PS), and all are currently alive without any sign of recurrence. One time fractionated endoscopic resection was carried out in about 40% of the 57 patients who underwent gastric mucosal resection. In these 57 patients, an artificial ulcer measuring 3 cm or more was formed, resulting in a favourable outcome after healing. An overwhelming proportion of these subjects had no symptoms and good PS after the treatment. CONCLUSIONS: The introduction of this method, endoscopic mucosal resection using a cap fitted panendoscope, is expected to permit additional indications for endoscopic treatment. Endoscopic Nd-YAG laser irradiation was applied mainly to early gastric cancer lesions (32 patients), usually for relative indications for endoscopic treatment. This procedure is safe and advantageous in that it requires no hospitalisation, permits fractionated irradiation, and secures good QOL.

Endoscopy↗
PubMed1997

Staging of esophageal carcinoma in vitro with 4.7-T MR imaging.

PURPOSE: To determine the accuracy of 4.7-T magnetic resonance (MR) imaging for evaluating the mural invasion of esophageal carcinoma. MATERIALS AND METHODS: Sixty-seven esophageal specimens containing 70 squamous cell carcinomas were studied with a 4.7-T MR system with a 4-cm-diameter surface coil. Spin-echo MR images were obtained with a field of view of 4-6 cm, matrix size of 256 x 256, and section thickness of 3 mm, which resulted in a voxel size of 0.08-0.16 mm3. MR findings were compared with histopathologic findings, which served as the standard of reference. Tumor invasion on MR images was determined by consensus of two radiologists. RESULTS: T2-weighted images depicted six to eight layers of the normal esophageal wall; these correlated well with layers identified with histologic examination. In 66 (94%) of 70 cases of esophageal carcinoma, the depth of mural invasion visualized with MR imaging correlated well with that determined with histopathologic examination. The stage determined with MR imaging, however, was higher in two (3%) and lower in two (3%) cases than that determined with histopathologic examination. MR imaging enabled visualization of the gross features of tumor growth pattern, tumor ulceration, and adjacent lymph node involvement. CONCLUSION: MR imaging in vitro allows accurate assessment of the mural invasion of esophageal carcinoma and thus potentially enables preoperative histopathologic staging.

Carcinoma, Squamous Cell↗
PubMed1997

Different grades of medial hypertrophy and intimal changes in small pulmonary arteries among various types of congenital heart disease with pulmonary hypertension.

Morphometric analysis of small pulmonary arterial changes was performed in three patients with different congenital heart disease with pulmonary hypertension: congenital mitral stenosis (MS), ventricular septal defect (VSD) and transposition of the great arteries (TGA). The material was biopsy or autopsy lung specimens, all having the same degree of elevated pulmonary arterial pressure. Medial thickness was determined by the method of Suwa and Takahashi, and the degree of intimal changes was quantified using the index of pulmonary vascular disease (IPVD) by Yamaki and Tezuka. It was demonstrated that the medial thickening of the small pulmonary arteries was the strongest in the patient with congenital MS, moderate in VSD, and the weakest in TGA, with statistically significant differences between each pair of these three conditions. Interestingly, the order of severity for intimal changes was reversed: it was the severest in TGA and the mildest in congenital MS. We surmise that in patients with TGA, medial hypertrophy is suppressed by sustained vasodilation resulting from the high oxygen saturation of pulmonary arterial blood, while in congenital MS, the media undergoes the severest hypertrophy because of the low oxygen saturation. We also conclude that in TGA intimal changes readily develop in the presence of attenuated media, while in congenital MS, the thickened media seems to prevent intimal changes. From a clinical viewpoint, these results urge us to recommend early surgical intervention in TGA and VSD where severe intimal changes can develop in the absence of extreme medial thickening. It may not be appropriate to extend operation on patients with congenital MS, since strongly thickened media can trigger vasospasms and medial necrosis.

Adolescent↗
PubMed1997

A left atrial myxoma complicated with acute myocardial infarction.

A 43-year-old female, admitted because of acute infero-posterior myocardial infarction, showed angiographic findings of 100% occlusion of left circumflex artery. Echocardiographic findings showed inferior hypokinesis, while a large left intraatrial tumor was also observed. The coronary angiography on the 17th hospital day showed complete reperfusion of the culprit lesion without stenosis. On the 21st hospital day, the removal operation of the tumor was performed. Pathological findings showed typical cardiac myxoma, and the etiology of the occlusion at the culprit vessel was presumed to be closely related to the existence of the left atrial tumor.

Adult↗
PubMed1997

Correlation between venous stump pressure and brain damage after cortical vein occlusion: an experimental study.

A canine model of cortical vein occlusion was used to evaluate whether data obtained from monitoring venous stump pressure could help predict cerebral infarction after venous obstruction. Following bilateral parasagittal craniotomy, the cortical vein in each hemisphere was temporarily occluded and the increase in pressure was directly measured. Permanent venous obstruction was subsequently produced, and parenchymal brain damage 24 hours later was classified as: Stage 0, no parenchymal damage; Stage I, mild edema; Stage II, moderate parenchymal edema and/or ischemic changes in neurons; and Stage III, moderate-to-severe hemorrhage. The histological stages correlated closely with the rise in venous pressure: mean pressure increases (+/- standard deviation) were 5.5 +/- 2.9 mm Hg in hemispheres graded as Stage 0 (12 hemispheres), 7.7 +/- 3.2 mm Hg in those graded as Stage I (five), 11.2 +/- 4.1 mm Hg in those classed as Stage II (five), and 16.4 +/- 5 in those categorized as Stage III (seven). There were significant differences between Stages 0 and II (p < 0.01) and between Stages 0 and III (p < 0.001). Disruption of the blood-brain barrier as indicated by extravasation of Evans blue dye correlated well with the pressure increment. These results may indicate the threshold for injury after cortical venous occlusion. Venous stump pressure measurements obtained during a test occlusion may be a useful adjunct in predicting brain damage and may be helpful for intraoperative vessel selection for venous resection.

Animals↗
PubMed1997

Laboratory evaluation of a new membrane oxygenator with a built-in hemoconcentrator.

In order to facilitate the handling of cardiopulmonary bypass (CPB) and simplify the circuit, we have developed a new membrane oxygenator with a hemofiltration function. The hollow fiber units for gas exchange and hemofiltration were combined in concentric circles in a cylindrical housing. The total priming volume was 190 ml. Because we used a silicon-coated hollow fiber membrane for gas exchange, this oxygenator was completely resistant to serum leakage. The gas exchange and hemofiltration sections both have a blood-outside flow configuration. All blood flows in a radial direction from around the central core to the surrounding hollow fiber units, first to the hemofiltration portion and then to the gas exchange section. Filtered fluid was easily collected through a stopcock mechanism. The oxygen transfer rate was 312 ml/min at a blood flow rate of 6 L/min, and the ultrafiltration rate was 3.5 L/hour at a blood flow rate of 4 L/min with 25% hematocrit and 200 mmHg transmembrane pressure in an in vitro study. The pressure drop was 62 mmHg at a blood flow rate of 4 L/min. We found no adverse effects in an in vivo study using a mongrel dog. In conclusion, this durable combined device could achieve excellent and simplified hemoconcentration by having all the blood in the unit flow through the hemofiltration portion, and may be useful not only in CPB during open heart surgery, but also in extracorporeal membrane oxygenation.

Animals↗
PubMed1997

A prospective, randomized clinical trial of preoperative bowel preparation for elective colorectal surgery--comparison among oral, systemic, and intraoperative luminal antibacterial preparations.

During a one year and six month period, 137 patients undergoing elective colorectal surgery for carcinoma were randomly allocated to three groups. Patients in group A received oral tobramycin and metronidazole for three days prior to surgery. Patients in groups B and C received systemic antibiotic, a second generation cephem cefmetazole, every 3 hours during surgery. Patients in group C also received a luminal preparation of tobramycin during surgery. All patients received mechanical bowel preparation in the same manner. The incidence of postoperative wound sepsis was 10.9% in group A, 9.8% in group B, and 10.0% in group C. There were no significant differences in postoperative wound sepsis among the three groups. The oral antibiotic regimen induced a greater change in intestinal flora and was associated with more frequent postoperative diarrhea. Although the preoperative bowel preparation taken for patients in group A could not sufficiently reduce the intestinal bacterial count, systemic antibiotic prophylaxis was simple and cost-effective. There was no additional advantage in combining the systemic and luminal antibiotic preparations. Therefore, for elective colorectal surgery, we recommend intravenous infusion of second generation cephem cephmetazole with mechanical bowel preparation.

Administration, Oral↗
PubMed1997

[False positive FDP test associated with malignant lymphoma].

We present a man with non-Hodgkin's lymphoma who had false positive FDP test results and who had monoclonal IgM and IgG. At admission, laboratory examinations showed elevated FDP levels and prolonged PT and APTT, which did not improve by anti-coagulation therapy. Although coagulation system data returned to normal levels after steroid pulse therapy, the FDP level increased. Positive pregnancy test and results of dilution analyses on FDP assay yielded a diagnosis of false positive FDP test results due to serum latex agglutinin. The addition of anti-immunoglobulin antibody inhibited latex agglutination by serum. FDP levels positively correlated with serum IgM concentrations. These data suggest that the false positive FDP test in this case was due to latex agglutination by monoclonal IgM.

Connectin↗
PubMed1997

Role of nitric oxide in tumor microcirculation. Blood flow, vascular permeability, and leukocyte-endothelial interactions.

The present study was designed to define the role of nitric oxide (NO) in tumor microcirculation, through the direct intravital microcirculatory observations after administration of NO synthase (NOS) inhibitor and NO donor both regionally and systemically. More specifically, we tested the following hypotheses: 1) endogenous NO derived from tumor vascular endothelium and/or tumor cells increases and/or maintains tumor blood flow, decreases leukocyte-endothelial interactions, and increases vascular permeability, 2) exogenous NO can increase tumor blood flow via vessel dilatation and decrease leukocyte-endothelial interactions, and 3) NO production and tissue responses to NO are tumor dependent. To this end, a murine mammary adenocarcinoma (MCaIV) and a human colon adenocarcinoma (LS174T) were implanted in the dorsal skinfold chamber in C3H and severe combined immunodeficient mice, respectively, and observed by means of intravital fluorescence microscopy. Both regional and systemic inhibition of endogenous NO by N omega-nitro-L-arginine methyl ester (L-NAME; 100 mumol/L superfusion or 10 mg/kg intravenously) significantly decreased vessel diameter and local blood flow rate. The diameter change was dominant on the arteriolar side. Superfusion of NO donor (spermine NO, 100 mumol/L) increased tumor vessel diameter and flow rate, whereas systemic injection of spermine NO (2.62 mg/kg) had no significant effect on these parameters. Rolling and stable adhesion of leukocytes were significantly increased by intravenous injection of L-NAME. In untreated animals, both MCaIV and LS174T tumor vessels were leaky to albumin. Systemic NO inhibition significantly attenuated tumor vascular permeability of MCaIV but not of LS174T tumor. Immunohistochemical studies, using polyclonal antibodies to endothelial NOS and inducible NOS, revealed a diffuse pattern of positive labeling in both MCaIV and LS174T tumors. Nitrite and nitrate levels in tumor interstitial fluid of MCaIV but not of LS174T were significantly higher than that in normal subcutaneous interstitial fluid. These results support our hypotheses regarding the microcirculatory response to NO in tumors. Modulation of NO level in tumors is a potential strategy for altering tumor hemodynamics and thus improving oxygen, drug, gene vector, and effector cell delivery to solid tumors.

Adenocarcinoma↗
PubMed1997

[A case of Ellis-van Creveld syndrome with partial atrioventricular septal defect and double orifice mitral valve].

Ellis-van Creveld Syndrome (ECS) is characterized by chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital cardiac defects. As congenital cardiac defects, single atrium and endocardial cusion defect are frequent in literatures. We described a case, a 68-year-old woman, presenting with ECS with partial atrioventricular septal defect and double orifice mitral valve. The partial atrioventricular septal defect was repaired by closure with a Dacron patch. The accessory orifice was located at the anterior cusp of the mitral valve, which was left, untouched, because no regurgitation had been detected preoperatively. Her postoperative course was uneventful, and the patient was discharged on 25th postoperative day.

Aged↗
PubMed1997

[A randomized comparative study of surgical adjuvant chemotherapy using 5-fluorouracil and dl-leucovorin with CDDP 5-FU and dl-leucovorin for colorectal cancer].

A randomized comparative study of surgical adjuvant chemotherapy using dl-leucovorin (dl-LV) and 5-fluorouracil (5-FU) (FL-therapy) with CDDP, 5-FU, and dl-LV (PFL-therapy) was conducted. The following were the administration schedules: Arm A was 13 mg/m2 of CDDP, 300 mg/m2 of 5-FU, and 30 mg/body of dl-LV for 5 consecutive days and arm B was 300 mg/m2 of 5-FU and 30 mg/body of dl-LV for 5 consecutive days. Both regimens were followed by biweekly administration of the same dose of dl-LV and 5-FU in outpatients. Arm A was started at the 26th postoperative day and arm B at the 21st day on average. Some 26 cases composed of 11 cases of arm A and 15 cases of arm B completed the administration schedules. Only one case in arm A was complicated by local recurrence around 35 months after operation. Major toxicities were anorexia and neutropenia. Both toxicities were seen more in arm A than in arm B, showing complete recovery in all cases. These data suggest that PFL-therapy and FL-therapy seem to be possible and promising surgical adjuvant therapies for advanced colorectal carcinoma.

Adenocarcinoma↗
PubMed1997

[Clinical evaluation of 2-mg granisetron tablet for nausea and vomiting induced by anticancer drugs including cisplatin].

The antiemetic effects on nausea and vomiting induced by anticancer drugs and safety of a 2-mg granisetron tablet were studied in cancer patients, particularly in the field of gynecology, who had been treated with anticancer drugs including cisplatin (CDDP) at 50 mg/m2 or more. The 1-mg granisetron tablet is already commercially available and used widely in clinical practice by oral administration of two tablets per dosage. In this investigation, the clinical efficacy, safety and usefulness of a 2-mg tablet, which can be taken more easily, were studied. The 2-mg granisetron tablet was judged to be "remarkably effective" or "effective" for nausea and vomiting in 22 (66.7%) of 33 patients. For safety, neither adverse experiences nor abnormal laboratory values were judged to be of clinical significance. The 2-mg granisetron tablet was considered "extremely useful" or "useful" in 22 (66.7%) of 33 patients. The above results confirmed the excellent antiemetic effect on nausea and vomiting induced by anticancer drugs including CDDP and the high degree of safety of a 2-mg granisetron tablet.

Adult↗