Biomedical subjects

M Endo

Publications and source records attributed to M Endo.

1,377 records · Page 77Linked to original sources

PubMedDate not supplied

Atherosclerotic abdominal aorta saccular protrusion.

Fourteen saccular abdominal aortic protrusion patients (ages ranged from 55 to 84, mean age 69.1 years) were reported. Their lesions were pathologically or bacteriologically suggested to be of atherosclerotic origin. Other origins were eliminated by using the patients past history or physical and diagnostic examination. All patients were classified into 1 of 3 types; solitary, adjacent to fusiform AAA, and independent of fusiform AAA. Diagnosis and surgical techniques were complicated when coexisting with a fusiform abdominal aortic aneurysm (AAA) and located in the AAA neck. The treatment of choice for 13 patients was surgery. Postoperatively two patients died of hepatic failure at 5 weeks, and from apoplexia at four months, after surgery, respectively. The remaining patients' prognosis is good after a 3-month to 6-year follow-up with a mean period of 2.9 years except 1 medically treated patient. Accordingly, atherosclerotic abdominal aorta saccular protrusion should be carefully diagnosed and be surgically treated in the usual AAA manner. Only juxtarenal saccular protrusions require careful reconstruction, preserving the renal or visceral function.

Aged↗

PubMedDate not supplied

Technical devices in jejunal pouch reconstruction following total gastrectomy, including postoperative results.

BACKGROUND/AIMS: Either straight Roux-en-Y anastomosis or jejunal interposition used to be adopted following total gastrectomy. However, dissatisfaction with regard to postoperative quality of life has prompted the development of new techniques. The purpose of this study is to describe and assess the authors' technical devices in jejunal pouch (J-pouch) reconstruction following total gastrectomy and the results of these operations. PATIENTS AND METHODS: A prospective study of 17 patients with malignant gastric disease (nine with J-pouch interposition, eight with J-pouch Roux-en-Y reconstruction) was performed. To facilitate the side-to-side anastomosis of the jejunal loop, the authors used an autosuture instrument. The anastomosis was then checked for hemostasis using a vaginoscope. RESULTS: An Endo GIA with a 60-mm long white cartridge (closed height of staples, 1.0 mm) is the instrument of choice to create the J-pouch. This autosuture instrument fires triple staggered staple lines, which minimizes bleeding from the anastomosed site and reduces operative time. No anastomotic leaks were associated with the autosuture instrument. The vaginoscope facilitates a direct observation of the staple lines internally and if necessary, enables secure hemostasis with sutures. Bowel motility was satisfactory for both surgical procedures, as measured by the percentage of radiopaque markers which were expelled from the pouch. There were no serious complications, and all patients have currently survived, a maximum of 5 years and 6 months after surgery, except for one patient who died from recurrent disease. CONCLUSION: The authors' procedures for J-pouch reconstruction are advantageous due to a favorable postoperative quality of life, with low complication rates.

Adult↗

PubMedDate not supplied

Effect of transaortic catheter venting on left ventricular function during venoarterial bypass.

Although venoarterial bypass (VAB) or percutaneous cardiopulmonary support (PCPS) can improve hemodynamics in patients with serious cardiac decompression, some cannot be weaned from circulatory support. Insufficient unloading of the left ventricle (LV) with blood stagnation is a main cause of unsuccessful LV recovery during PCPS. This investigation was undertaken to evaluate the effectiveness of transaortic catheter venting (TACV) for LV unloading. Eight mongrel dogs (mean weight 16.3 kg, range 14-20 kg) underwent VAB with TACV. In addition to monitoring standard hemodynamic parameters, the slope of the LV end systolic pressure-volume relationship (Emax) during transient occlusion of the inferior vena cava, the slope of LV end systolic pressure-stroke-volume (Ea), external stroke work (SW), LV pressure-volume area (PVA), and slope of the SW-end diastolic volume relationship (preload recruitable stroke work: PRSW) were assessed by means of a micro-tip manometer and a conductance catheter. We measured data under the following four conditions; before circulatory support (baseline), during isolated VAB, VAB with TACV, and VAB with TACV plus intra-aortic balloon pumping (IABP). The LV contractility (Emax) and LV elastance (Ea) were equivalent for the four conditions. By comparison with baseline and VAB with TACV, LV energy (PVA) and work (SW, PRSW) were significantly reduced by TACV (1283.9 +/- 197.1 vs. 793.3 +/- 124.8 x 10(-4) J, 897.1 +/- 147.2 vs. 474.2 +/- 83.0 x 10(-4) J and 35.6 +/- 2.7 vs. 25.7 +/- 1.7 x 10(-4) J/ml, respectively), and the PE/PVA increased with TACV (30.4 +/- 2.6 vs. 40.8 +/- 1.8%). In contrast, there was no significant difference in PVA, SW, PRSW, and PE/PVA between baseline and isolated VAB. These results suggest that TACV might be an adjunctive technique to VAB or PCPS for patients with LV failure.

Animals↗

PubMedDate not supplied

A new method of endoscopic mucosal resection of neoplastic lesions in the stomach: its technical features and results.

BACKGROUND/AIMS: In gastric cancer, endoscopic treatment can be expected to provide an absolute cure only if the lesion is mucosal and not accompanied by metastatic lymph nodes. To further evaluate such possibly curable lesions, we retrospectively reviewed 208 cases of early gastric cancer surgically resected over the past 20 years. METHODOLOGY: Our new method of endoscopic mucosal resection using a cap-fitted panendoscope, which is called EMRC, has been employed in the treatment of 73 gastric neoplastic lesions. RESULTS: It was found that curable lesions would, as the primary condition, be histologically well-differentiated carcinomas and measure 2 cm or less of the elevated type and less than 1 cm of the depressed type. The lesions were consequently identified as 49 early cancers (46 mucosal, 3 submucosal), 23 adenomas and 1 carcinoid. Although resection was completed in a single session of EMRC treatment in all cases, approximately 40% of them required fractionated resection, leaving an ulcer measuring 3 cm or more in approximately 30%. Bleeding or muscle resection occurred in 7 patients, in whom conservative treatment was effective. No recurrence has been found in any of the 73 lesions, demonstrating a favorable outcome. CONCLUSIONS: This method is advantageous in that it is simple and relatively easily applied at almost any location within the stomach. In addition, the size of the specimen obtained by en bloc resection is approximately 2 cm. The method is thus fairly likely to come into widespread use.

Aged↗

PubMedDate not supplied

Doxorubicin and vincristine with methionine depletion contributed to survival in the Yoshida sarcoma bearing rats.

Several anti-cancer agents show increased toxicity if administered with methionine-depleting total parenteral nutrition (Met-deplete TPN). Changes in the cell cycle due to Met-deplete TPN were investigated, and then the enhancement of the anti-tumor effects of serial combinations of doxorubicin (ADM), a drug acting on late S-G2 phase and vincristine (VCR), an antimitotic drug, under Met-deplete TPN was also examined in the tumor-bearing rats. According to the fraction of labeled mitosis, within 3 to 4 days after the introduction of Met-deplete TPN in the ascites type Yoshida sarcoma (YS) -bearing rats, the cell cycle of the tumor cells showed marked delay and the fraction of labeled mitosis decreased to less than 70%. However, this delay was recovered immediately after methionine infusion, with on increase in the labeled mitotic cell population. In the experiment using solid type YS-bearing rats, ADM was administered intraperitoneally under Met-deplete TPN for 8 days, followed by intraperitoneal VCR administration with methionine-containing TPN for 3 days, and then fed on solid food and water ad libitum until death. This serial combination of Met-deplete TPN with ADM and VCR resulted in marked suppression of the tumor and prolonged survival in comparison to the control groups with a significant difference (p < 0.001) (generalized Wilcoxon test).

Animals↗

PubMedDate not supplied

Development of a 3D CT-scanner using a cone beam and video-fluoroscopic system.

We describe the design and implementation of a system that acquires three-dimensional (3D) data of high-contrast objects such as bone, lung, and blood vessels (enhanced by contrast agent). This 3D computed tomography (CT) system is based on a cone beam and video-fluoroscopic system and yields data that is amenable to 3D image processing. An X-ray tube and a large area two-dimensional detector were mounted on a single frame and rotated around objects in 12 seconds. The large area detector consisted of a fluorescent plate and a charge coupled device (CCD) video camera. While the X-ray tube was rotated around the object, a pulsed X-ray was generated (30 pulses per second) and 360 projected images were collected in a 12-second scan. A 256 x 256 x 256 matrix image was reconstructed using a high-speed parallel processor. Reconstruction required approximately 6 minutes. Two volunteers underwent scans of the head or chest. High-contrast objects such as bronchial, vascular, and mediastinal structures in the thorax, or bones and air cavities in the head were delineated in a "real" 3D format. Our 3D CT-scanner appears to produce data useful for clinical imaging and 3D image processing.

Equipment Design↗

PubMedDate not supplied

Purpuric lichen nitidus.

We report the case of a patient in whom lichen nitidus with hemorrhage was found on the palm and the thigh. Histopathologically, the small vessels in the lesions showed extensive changes and were increased in number. The capillary walls revealed degenerative changes with extravasation of erythrocytes. On electron microscopy, amorphous, electron-dense deposits were observed along the outside of the endothelial cells. These findings can explain the presence of the hemorrhagic changes. We describe this as a case of purpuric lichen nitidus.

Hand Dermatoses↗

PubMedDate not supplied

Multiple basal cell carcinoma developing two years after 60Co irradiation.

A 66-year-old Japanese man developed multiple basal cell carcinoma 2 years after receiving 60Co irradiation for oropharyngeal tumors. All of the tumors were located within the radiation fields where the skin was atrophied and telangiectatic. In the present case, the total dose (112 Gy) of 60Co radiation received by the patient had been large and the latent period was much shorter than in previously reported cases. It is suggested that the reasons for the short latency in our case were 1) the total radiation dose and 2) the fact that the area irradiated was a frequently sun-exposed area.

Aged↗

PubMedDate not supplied

Angiolymphoid hyperplasia with eosinophilia.

We report a case of angiolymphoid hyperplasia with eosinophilia (ALHE). Histologically, some vessels were lined with plump endothelial cells. Infiltration by lymphocytes, histiocytes and eosinophils was marked. An arteriovenous malformation and vessels occluded by endothelial cell hyperplasia were present. PCNA staining gave positive results for the nuclei of many of the plump endothelial cells. Electron-microscopic findings disclosed increased metabolic activity in the cells. These observations suggest that the plump endothelial cells, characteristic of ALHE, have high metabolic activity. These results suggest that blood flow is increased by arteriovenous malformations and that blood pressure is elevated by occlusion, resulting in hyperplasia of plump endothelial cells and accelerated neovascularization.

Adult↗