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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 703 records · Page 39Linked to original sources
PubMed1990

Clinical studies of early gastric cancer.

Three hundred and seventy-four cases of early gastric cancer in which invasion was limited to within the submucosa have been resected in our hospital during the past 15 years. The incidence of early gastric cancer was 31% among the total of 1,214 cases of gastric cancer operated on. There were 37 cases with multiple lesions and 5 cases with insufficient data. In this series, clinical investigations were performed in 332 cases excluding the above 42 cases.

Adenocarcinoma↗
PubMed1990

[A case of pancreatic carcinoma coexist with pancreatic pseudocyst].

Report of Pancreatic carcinoma coexist with Pancreatic pseudocyst is rare. We have experienced a case of pancreatic carcinoma which was diagnosed and resected by coexisted pancreatic pseudocyst. The patient aged 53 years, complained of epigastric distension and visited our hospital. There was no past history of abdominal injuries and he didn't drink much. A cyst 7cm in diameter was found at pancreatic tail lesion by our examination. By blood chemistry tumor marker CA19.9 was 310 and he complicated diabetes mellitus. We suspected pancreatic carcinoma coexist with pancreatic pseudocyst, so distal pancreatectomy and splenectomy was performed. We found a solid tumor sized about 3cm in diameter at just proximal of pancreatic cyst. Since perioperative histological examination revealed adenocarcinoma, we performed lymph node dissection. The tumor was highly differentiated adenocarcinoma which invaded retroperitoneum in some lesion. The patient died 10 months later by recurrence. We concluded that we must take into account not only laboratory finding but their clinical course in such cases.

Adenocarcinoma↗
PubMed1990

[Aortic valve replacement in a patient with von Willebrand's disease--a case report].

A 38-year-old man was admitted to our hospital with complaints of palpitation and shortness of breath. On auscultation, presence of severe aortic regurgitation was found. Seven years prior to admission, he had undergone rectal polypectomy complicated by postoperative serious hemorrhage which had led to the diagnosis of von Willebrand's disease. Aortic valve replacement with a Björk-Shiley prosthesis was performed under routine cardio-pulmonary bypass. He received Confact-F as a replacement therapy of factor VIII throughout the perioperative period. His operative and postoperative courses were uneventful without difficulties in hemostasis. The patient was placed on a regimen of anticoagulation (Warfarin sodium) without increase in the bleeding tendency. He is asymptomatic and doing well six months after the operation.

Adult↗
PubMed1990

[Surgical salvage of cardiac rupture: a case report].

A 39-year-old man suffered from acute myocardial infarction. Echo cardiography showed the presence of intra-pericardial fluid. We had emergent operation. We successfully salvaged cardiac rupture with fibrin glue and oxy-cellulose without cardiopulmonary bypass. His post-operative course was uneventful. The patient was discharged on the seventh week after the operation. The problems of acute cardiac rupture were discussed.

Adult↗
PubMed1990

DNA analysis of periampullary cancers.

The nuclear DNA content in 71 cases of periampullary cancer (27, cancer of the head of the pancreas (Ph); 24, cancer of the ampulla of Vater (A); and 20, cancer of the inferior common bile duct (Bi] was measured cytofluorometrically using the archival paraffin-embedded specimens of the primary lesions. They were analyzed in relation to prognosis, tumor size, histological differentiation, lymph node metastasis, lymphatic invasion, venous invasion, perineural invasion, and growth pattern. The results show that "Ph" has more unfavorable prognosis compared with the other two and it has more DNA content under the same conditions such as tumor from 2.1 to 4 cm in its greatest dimension, well differentiated adenocarcinoma, with or without lymph node metastasis, with or without venous invasion, with lymphatic invasion, with perineural invasion, and in the intermediate growth pattern between expansive and infiltrative. In conclusion, this study demonstrates a close correlation between the DNA content and prognosis and the significant clinical value of DNA analysis for predicting the prognosis in patients of periampullary cancer.

Adenocarcinoma↗
PubMed1990

Comparison of arteriosclerosis obliterans of lower limbs between China and Japan.

Clinical data on 50 patients with arteriosclerosis obliterans (ASO) in China (Group A) and Japan (Group B) respectively were studied for better understanding of these changing trends. The results showed that the incidence of ASO peaked in Group A in the 50 to 69 age range (88%) and in Group B in the 55 to 74 age range (78%). Group A had a lower ratio of smokers and cases of diabetes mellitus than Group B but a higher ratio of hypertension and a higher total cholesterol level. Angiography showed that the prevalence of atherosclerotic lesions in the lower extremities as a whole was similar for both groups. They were different in location, extent and severity of the arteries involved between the two groups. We believe that this study has shown various differences between the two groups but that the causes are probably multifactorial.

Age Factors↗
PubMed1990

[A case of right ventricular failure after CABG successfully supported by right heart bypass with a centrifugal pump].

A 67-year-old woman underwent CABG because of severe triple vessel disease. She could not wean from CPB in spite of full inotropic drugs and IABP support due to right ventricular failure probably caused by the perioperative right ventricular infarction. Right heart bypass (RHB) with a centrifugal pump was used. Finally she could wean from CPB and took an uneventful postoperative course except mediastinitis. During 5 days of RHB operation ACT was maintained between 180s and 200s by systemic heparinization. RHB with a centrifugal pump is a reliable method to assist a failing right ventricle.

Aged↗
PubMed1990

[Coronary-coronary bypass (C-C bypass) in 2 cases].

A left IMA graft to LAD associated with c-c graftings using saphenous vein were simultaneously performed in 70-year old man and 44-year-old man with multiple coronary disease. Postoperative catheterization showed patency in both cases. It is advisable to perform c-c bypass for patients with calcification of ascending aorta or stenosis of distal RCA such as 4-PD or 4-AV.

Adult↗
PubMed1990

[Measurement of myocardial blood flow using N-13 ammonia dynamic PET-theory and methodology].

Positron emission tomography (PET) offers the potential capability of noninvasive measurement of regional myocardial blood flow (RMBF) in man. Because N-13 ammonia exhibits properties which to some extent resemble those of the radioactive microsphere, we developed a first-pass flow method for noninvasive measurement of RMBF. In the present method, RMBF was determined by dividing myocardial activity at time T by arterial input integrated from the injection start to that time, where time T is the endpoint of first circulation of N-13 ammonia. Also in the present method a time-activity curve of left atrium was used as the arterial input function to make the procedure totally noninvasive. To validate the present method, we compared it with the compartment analysis. 5 patients with hypertrophic cardiomyopathy (HCM) and with a considerably thickened ventricular wall, were selected for the comparison between the first-pass flow method and the compartment analysis. The relationship of RMBFs by the two methods was y = 1.8 + 1.097x-0.002037x2 (n = 30, SEE = 5.5), where x (ml/min/100 g) was obtained by the compartment analysis, while y (ml/min/100 g) by the first-pass flow method. The result indicated that both were almost identical in physiological flow range (less than 100 ml/min/100 g), but that the first-pass flow method underestimated RMBF in the higher flow range due to venous leakage of N-13 ammonia. As the conclusion, we could at least measure RMBF of HCM patient in the physiological flow range by the present method. The future extension of the method was discussed.

Ammonia↗
PubMed1990

[Laser ablation in the treatment of ventricular tachycardia: problems in the clinical case].

I. Experimental Studies We examined if laser ablation could make the same characteristic lesion as cryolesion to canine myocardium. Nine mongrel dogs were used in this experiment. Right lateral thoracotomy was performed and Nd:YAG laser was delivered onto the epicardial surface of both ventricles. Laser power of between 10 and 50 W was used with the various duration of 3 and 20 s, keeping the lasing distance 5 mm above the cardiac surface. Histologically, the lesion showed a well-demarcated area consisted of coagulation necrosis and contraction band necrosis in the acute phase, which changed to a fibrous scar in the chronic phase. There was a good correlation (r = 0.79; n = 52, p less than 0.01) between the lasing energy and the depth of the denaturation zone. II. A Case Report A 45-year-old male with ventricular tachycardia (VT) after aortic valve replacement was operated upon with Nd; YAG laser delivery. An antero-lateral thoracotomy through 4th and 6th inter-costal space was performed. The intraoperative mapping showed the three origins of VTs to be near the apex of left ventricle. With cardiopulmonary bypass, Nd; YAG laser was delivered onto the endocardial surface adjacent to arrhythmogenic foci. The lasing power was 10-30 W with the duration of 5.0-9.9 s. One hundred twenty seven trials were done with the total lasing energy to be 12490 J. Subsequently cryoablation was added on this area. Though VT remained in acute phase, 2 weeks later, all of tachyarrhythmia was abolished spontaneously.

Animals↗
PubMed1990

[Technical considerations for the epicardial approach in Wolff-Parkinson-White syndrome].

Epicardial approach consists of meticulous dissection of the annular fat pad of the Kent bundle site and subsequent cryocoagulation from the epicardial side. This technique obviates the need of atriotomy and makes ablation without cardiopulmonary bypass possible. In performing this approach for patients with the left parietal or posteroseptal pathway through median sternotomy, special technical strategies are necessary to keep hemodynamic status stable during dissection and cryoablation procedures, because in these cases apex of the heart has to be retracted upward to approach the Kent bundle site. For this purpose, the use of an ultrasonic surgical aspirator for dissection of the annular fat pad is required. With this instrument fat tissue is emulsified and aspirated by stroking the fat pad gently, easy dissection is possible without injury to major coronary vessels, even through a narrow operative field. Another point is to dissect the annulus fat below the coronary sinus (i.e., at the space between the coronary sinus and circumflex coronary artery), not above it. By doing this extensive retraction of the apex is no longer necessary. In performing cryocoagulation care has to be taken not to involve the coronary artery into the lesion. However, too tight retraction of the coronary artery may cause another risk of thrombosis. Sometimes moderate systemic heparinization should be performed during coronary retraction and cryocoagulation procedure.

Heart Conduction System↗
PubMed1990

[DBMP-85 was effective at diagnosis and LVP was effective at relapse in a case of acute mixed leukemia].

A 16 year-old boy was admitted to our hospital in April 1985, because of bilateral submandibular swellings. Hematological examination revealed Hb was 7.3 g/dl, WBC was 89,000/microliters (76% blast), and platelet was 154,000/microliters. His bone marrow was hypercellular and consisted with 91% blasts. Myeloperoxidase staining was positive for 38% of blasts. Auer rods were seen in some of blasts. Thus, the diagnosis was M1 according to FAB classification. Cytogenetic studies of 20 marrow cells were performed and all cells had 46, XY, -1, -7, 3q-, 7q-, 17q+, +2mar. Eighty five percent of blasts expressed HLA-DR and 43% of blasts expressed CD2 and CD13 simultaneously. Thus, this leukemia was considered as the hybrid type of acute mixed leukemia by surface marker analysis. DBMP-85 regimen, the chemotherapy for AML, was started after admission and complete remission (CR) was attained in June 1985. After 4 courses of post remission chemotherapy, he discharged in December 1985 and was followed at our outpatient clinic without chemotherapy. His disease was relapsed in June 1986, and the combination chemotherapy with mitoxantrone, etoposide and Ara-C was applied to him but failed to attain CR. Then, LVP protocol, the chemotherapy for ALL, was started and CR was achieved. The blasts at relapse had morphologically myeloid features, and expressed HLA-DR, CD2 and CD13 as well as at diagnosis. Cytogenetic studies at relapse showed some karyotype except gaining 12p- anomaly. Therefore, same blasts were considered to emerge at relapse. Our case suggests that LVP therapy may be effective for AML expressing myeloid and lymphoid surface markers.

Adolescent↗
PubMed1990

[Femoral artery pseudoaneurysm by intraaortic balloon pumping].

Femoral artery pseudoaneurysm is one of multiple vascular complications with intra aortic balloon pumping (IABP). In a series of 815 cases, the incidence of pseudoaneurysm formation was 0.61 percent. Six patients with this complication who underwent successful surgical repair were reviewed. Three cases in our series were obviously due to the unsuitable technique of balloon removal. Especially a patient who underwent IABP insertion after exposure of the femoral artery should undergo open removal of the balloon with reconstruction of the femoral artery. In conclusion, femoral artery pseudoaneurysms are expected to diminish by the appropriate technique of balloon removal.

Adult↗