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Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

At least 1,369 records · Page 76Linked to original sources
PubMedDate not supplied

Midazolam for continuous sedation in Japanese patients in the critical care setting: phase II study.

This prospective, phase II study was carried out to evaluate the efficacy and safety of midazolam as a sedative agent in nine critically ill Japanese patients without coma who had been admitted to an intensive care unit. An adequate level of sedation (sedative score [SS] 4-6) was induced by midazolam 0.14 - 0.39 mg/kg and maintained with a dose range of 0.08 - 0.24 mg/kg per h. One patient was excluded from the efficacy analysis since optimum sedation was not maintained by continuous infusion. The percentage of time during which SS 5 was achieved varied among the patients. The most frequent adverse events were hypotension, partial pressure of carbon dioxide elevation and premature ventricular contraction. Population pharmacokinetic analysis suggested that lower drug clearance rates were correlated with the presence of complications. The 50% of effective concentration values of SS 5, estimated by logistic regression analysis, varied greatly (mean, 251 ng/ml). In conclusion, midazolam infusion achieved successful sedation in this critical care setting. The optimum dose differed among the patients, however, and was influenced by the presence of complications.

Adult↗
PubMedDate not supplied

Measurements of the effect of dipyridamole on regional myocardial blood flow with positron emission tomography and the first-pass flow model.

We assessed percent changes of regional myocardial blood flow (RMBF) after infusion of dipyridamole (0.56 mg/kg) with dynamic N-13 ammonia PET and the first-pass flow model. Positron emission tomography (PET) was performed at rest and after infusion of dipyridamole in 17 participants [five normal subjects, five patients with hypertrophic cardiomyopathy (HCM), and seven patients with coronary artery disease]. Dipyridamole increased RMBF 126 +/- 69% (mean +/- SD) in normal subjects and 55 +/- 43% in the patients with HCM. In the cases of coronary artery disease, the percent changes of RMBF were +19 +/- 19% in ischemic areas and +76 +/- 23% in nonischemic areas. These results demonstrate that N-13 ammonia dynamic PET study is useful in assessing the percent changes of RMBF induced by dipyridamole infusion.

Adult↗
PubMedDate not supplied

A new treatment for ischemic ulcers: foot bath therapy using high oxygen soluble fluid.

We devised a new treatment for ischemic ulcer in which the diseased foot is soaked in perfluorodecalin, a fluorocarbon. Pure oxygen bubbles emerge from the perfluorodecalin, and dissolved oxygen levels reach 35% by volume within 60 minutes. The solution is placed in a bath once or twice a day for 2-3 hours and pure oxygen is allowed to bubble through it (3-5 1/min). Nine patients were treated by this technique. Drugs which seemed to have an effect on ischemic ulcers were not used during the treatment. Ischemic ulcers in three patients (5 X 5 mm, 23 X 6 mm and 10 X 5 mm) healed completely within two weeks and there were no recurrences. In six patients, the ulcers showed 30-70% reductions in size within 4 to 14 days. Four of them later underwent arterial reconstruction, which resulted in complete healing of the ulcers. In two patients, the ulcers reverted to their former size 6 to 12 months after the cessation of perfluorodecalin bath therapy.

Adult↗
PubMedDate not supplied

Experience with the EEA stapler for esophagojejunostomy.

From January 1979 through December 1986, 239 patients underwent total gastrectomy for gastric cancer. In 94 patients esophagojejunostomy was performed with the EEA stapler and in 145 patients hand sutures were employed. Operating time (mean +/- SD) was 288 +/- 60 minutes in the stapled group and 306 +/- 75 minutes in the sutured group (p less than 0.05). The length of the resected esophagus (mean +/- SD) was 19 +/- 17 mm in the former and 14 +/- 14 mm in the latter (p less than 0.01). The rate of leakage was 7.4% in the former and 13.8% in the latter with no significant difference. Five patients (3.4%) died within 30 days after sutured anastomosis and in two of them death was caused by anastomotic leakage. There was no operative death in the stapled group. It seemed that the stapler was able to simplify and facilitate esophagojejunostomy after total gastrectomy and that anastomosis with the stapler was at least as reliable as that with hand sutures.

Anastomosis, Surgical↗
PubMedDate not supplied

Rotation-induced Taylor vortex enhances filtrate flux in plasma separation.

Techniques of plasma filtration with rotating flat membranes are capable of producing a Taylor vortex and concomitantly reducing concentration polarization by formed elements. The present study describes filtration characteristics of a small-sized rotating filter that is superior to a capillary filter in terms of filtrate flux. The rotating filter with a surface area of 60 cm2 was composed of two concentric cylinders, with the inner cylinder mobile, with a flat polycarbonate membrane (pore diameter: 0.8 micron), and the outer cylinder fixed. Filtration experiments were performed using bovine blood to determine filtrate flux at rotational speeds from 600 to 4,500 rpm. Photographic observations using aluminum powder revealed that many Taylor vortices were present in the radial gap (0.6 mm). Filtrate flux increased with transmembrane pressure until a maximum filtrate flux of 0.02 cm/min at 600 rpm, 0.42 cm/min at 1,800 rpm, 0.60 cm/min at 3,600 rpm, and 0.69 cm/min at 4,500 rpm were reached at a blood flow rate of 100 ml/min. Based on the filtration resistance model, values for fractional filtration resistance of the red blood cell polarization layer ranged from 0.25 to 0.80 at a rotational speed of 3,600 rpm, whereas those of a capillary filter range from 0.80 to 0.90. This indicates that Taylor vortices promote back diffusion of red blood cells accumulated on membrane surfaces. Thus, the filtrate flux of a rotating filter is two orders of magnitude higher than that of a capillary filter because of the back diffusion of red blood cells facilitated by Taylor vortices.

Animals↗
PubMedDate not supplied

An application of film dosimetry for helium ion radiotherapy.

Clinical dosimetry of complex dose distribution associated with charged particle radiotherapy requires a rapid and convenient technique with a spatial resolution of 3 mm or better. Radiographic film stacks have been evaluated for three-dimensional dosimetry of charged particle beams. Sheets of Cronex 4 film are placed between lucite spacers in a light-tight box and the beam is directed perpendicularly to the film surface. Optical densities on each sheet are digitized with a video digitizer and corrected for density-dose nonlinearity and LET effects. A three-dimensional matrix of the measured dose is constructed and compared with calculated values. Both transverse and depth dose data recorded by film have been compared with diode measurements and generally shown agreement within 5%. The present technique appears to be an effective method to generate experimentally measured dose distributions.

Film Dosimetry↗
PubMedDate not supplied

Quality of postoperative life in gastric cancer patients seventy years of age and over.

A questionnaire on health and daily life was mailed to patients who had undergone gastrectomy between 1976 and 1985. Replies came from 66 patients aged 70 and over at the time of operation (the elderly group), and 189 who were under 70 at the time of the questionnaire (the controls). Fifty-two percent of the elderly group were under medical treatment, whereas only 37% of the controls were (p less than 0.01). Preoperatively, 79% of the elderly group "could go out and do work", but at the time of the questionnaire only 56% (p less than 0.01) could. Forty percent of the elderly group who had worked before the operation retired after surgery. Employment of the males was: under 60 (98%), 60-64 (84%), 65-69 (58%), 70-74 (45%), 75-79 (57%), 80 and over (27%). These percentages were similar to the employment rates of male citizens of the same age groups in Tokyo.

Activities of Daily Living↗
PubMedDate not supplied

Lymph node metastasis in early gastric cancer.

From 1969 through 1984, 304 case of early gastric cancer (EGC) were resected. Nodal status was studied in 272 cases in which lymph node dissection was performed. The lymph nodes were negative for metastasis in 90% of the cases. In 7%, metastasis was noted in the Group 1 lymph nodes alone and in 3%, as far as the Group 2 nodes. But in no case were the Group 3 involved. The 10-year survival rate was poorer in patients with positive nodes than in those with negative nodes (52.8% vs. 94.1%). Cancer recurred more often in patients who had no lymph node dissection than in those with node dissection (9.4% vs. 1.5%). Lymph node metastasis was more frequent in the following EGC types: macroscopically combined type, over 5 cm, and with submucosal invasion. Dissection as far as the Group 2 nodes should be routinely performed even in EGC, especially in cases with the above-mentioned characteristics.

Follow-Up Studies↗
PubMedDate not supplied

A new phantom for evaluation of low-contrast detectability of X-ray CT scanner.

It is possible to produce Xyron (styrene grafted polyphenylene ether) having different electron densities but virtually the same effective atomic number. The difference between the CT numbers obtained with two Xyron types of different electron densities was shown both theoretically and experimentally to be constant, regardless of the effective photon energy. A phantom for evaluation of low-contrast detectability of X-ray CT scanners was produced from these two types of Xyron and was shown to be effective for both comparative studies and daily quality assurance.

Humans↗
PubMedDate not supplied

Clinical evaluation of ten-year survival cases after operation for upper and mid-thoracic esophageal cancer.

From 1946 to 1976, we examined 1,329 patients who had undergone radical resection for upper and mid-thoracic cancer. Seven patients had a postoperative survival of more than twenty years, 58 more than ten and 137 more than five. Histological and pathological tests were performed: it was thus possible, particularly in patients with a survival of more than ten years, to grade the malignancy according to the classification for histologic malignancy proposed by us for several years (cellular atypism, structural atypism and infiltration). These pathological alterations were closely linked with the prognosis and survival time.

Aged↗
PubMedDate not supplied

Clinicopathological stages and pyrimidine nucleotide synthesis in human mammary carcinomas.

The object of this study was to evaluate activities of thymidylate synthetase (TS) and thymidine kinase (TK) in relation to histopathological features of human mammary carcinomas, as well as clinical classification of patients. The TS and TK are key enzymes on the de novo and salvage pathways, respectively, for pyrimidine nucleotide synthesis. High TS and TK activities have been found in rapidly proliferating tissues. Clinical stage and TNM post-surgical histopathological classification of 20 patients with mammary carcinomas, during the period of 1988-1991, and TS and TK activities in each carcinoma were determined. Elevated TS and TK activities in mammary carcinomas corresponded to progressively worse clinical stages. Papillotubular carcinomas showed lower enzyme activity than that of solid-tubular and scirrhous types. TS activities continued to rise as the malignant invasion became more severe. The clinical prognosis of patients with mammary carcinomas appears to depend on the de novo synthesis of DNA in carcinomas.

Adult↗
PubMedDate not supplied

[Histopathological findings of coronary artery lesions resected by directional coronary atherectomy].

Eleven directional coronary atherectomy procedures were performed in seven patients with angina pectoris and four patients with myocardial infarction, 10 men and 1 woman aged 41 to 69 years (mean 57 +/- 7 years). The onset of angina pectoris or myocardial infarction had occurred 2 months to 17 years previously. The preoperative mean diameter of stenosis was 80 +/- 8%, and the mean residual diameter of stenosis was 6 +/- 9% (p < 0.01). Seven left anterior descending arteries and four right coronary arteries were treated. Five of the 11 patients received partial-thickness resections of medial tissue and two of the five patients received full-thickness resections of the media with adventitial tissue. No lesions showed aneurysms or perforations during coronary arteriography after the procedure. The resected tissue was examined microscopically. Intimal tissues stained with Masson's trichrome were classified into four groups according to the characteristics fibrous tissue and the amount of proliferative cells: Type I was old dense fibrous tissue, type II was relatively old fibrous tissue containing many proliferative cells, type III was new loose fibrous tissue containing many proliferative cells, and type IV was atheromatous plaque. The intimal tissues were type I in 48.0%; type II in 35.5%; type III in 14.8%; and type IV in 1.7%. Resected lesions without prior treatment (primary lesions) from five patients with histories of 3 months or less were characterized by much type II and type III tissue; (type I tissue, 33.8%; type II tissue, 51.1%; type III tissue, 14.5%; type IV tissue, 0.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Radiology of lung cancer.

It is of vital importance not only to prevent lung cancer but also to detect and treat it as early as possible. Plain chest X-ray examination often provides preliminary data useful for the early detection of lung cancer, and multiple diagnostic modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) are used to obtain more accurate information. The authors describe the clinical utility of imaging diagnosis by computed radiography (CR), advanced multiple beam equalization radiography (AMBER), CT, and MRI in term of the imaging-pathologic correlation. We would like to emphasize that these modalities are not competitive but supplementary. It should be anticipated that, as technological improvements continue to be made, each modality will assume an increasingly important role in the imaging of lung cancer.

Diagnostic Imaging↗
PubMedDate not supplied

Aqueductal blood clot as a cause of acute hydrocephalus in subarachnoid hemorrhage.

We describe two patients with acute hydrocephalus, in whom CT scans did not show intraventricular hemorrhage unequivocally. Midline sagittal MR imaging revealed a blood clot plugging the aqueduct. MR imaging is useful for detecting sub-acute clots within the aqueduct and for differentiating them from other entities.

Caudate Nucleus↗
PubMedDate not supplied

Hassab operation with intraoperative endoscopic injection sclerotherapy ("Hassab-EIS") for esophagogastric varices: with an autopsied case after excessive gastric vascular damage.

BACKGROUND/AIMS: Endoscopic injection sclerotherapy (EIS) does not always treat advanced esophagogastric varices completely. Moreover, it may cause deterioration of gastric varices and may result in gastric hemorrhages. We would like to emphasize a combination treatment of the obliteration therapy of intramural varices by EIS and the transabdominal devascularization with splenectomy by Hassab's operation for such advanced esophagogastric varices. The purpose of this study is to develop an effective, less-painful procedure, having the fewest operational risks and a minimum number of treatment days. MATERIALS AND METHODS: We tried both therapies simultaneously (Hassab+EIS) on four patients with esophagogastric varices. RESULTS: Excessive vessel damage occurred in one patient which resulted in postoperative bleeding. He subsequently fell into sepsis/DIC and eventually died on the 9th POD. The three other patients are doing well and required less hospitalization time and a fewer number of additional EIS treatments than the esophageal transection group or the Hassab's operation group. CONCLUSION: From the reconsideration of the autopsied case, it is important to limit the distribution of the sclerosant only in the varicose veins of the lower esophagus and the upper stomach.

Adult↗
PubMedDate not supplied

Procedures of simultaneous radical resection indicated for primary synchronous esophageal and liver cancers--from the personal experience of three cases.

Primary double cancers of the liver and esophagus are extremely rare. Only 7 cases, both cancers resected, were reported. A 2 stage surgical procedure has been recommended for such a case. We experienced 3 consecutive patients who underwent successful simultaneous radical resection with a good outcome. Case 1 with an advanced esophageal cancer (EC) and hepatocellular carcinoma (HCC) without liver dysfunction received subtotal esophagectomy and posterior segmentectomy of the liver under a thoraco-laparotomy. Case 2, with an early stage EC and HCC with Child A cirrhosis, received the same surgical procedures as case 1 to complete stanching under good visibility for esophagectomy, because of his bleeding tendency due to liver dysfunction. But post operative bleeding from the thoracic cavity continued for 5 consecutive postoperative days. Case 3, with an early stage EC and cholangiocellular carcinoma (CCC), underwent transhiatal esophagectomy and right hepatic lobectomy under laparotomy. All cases received active enteral nutritional (EN) support from the early postoperative day with good outcomes. In conclusion, simultaneous radical resection for synchronous cancers of the esophagus and liver might be a possible indication for patients who have little or slight liver dysfunction. In the case with liver dysfunction, esophagectomy should be performed under thoracotomy, but transhiatal resection, for complete stanching, even in the early stage EC. Post-operative EN support is essential for these patients to obtain a good outcome.

Aged↗