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Biomedical subjects

M Kado

Publications and source records attributed to M Kado.

At least 55 records · Page 3Linked to original sources
PubMed1992

[An experience of rapid, two-stage arterial switch operation for transposition of the great arteries and intact ventricular septum beyond the neonatal period].

A 2-month-old girl with transposition of the great arteries and intact ventricular septum was successfully repaired by rapid, two-stage arterial switch operation. Balloon atrioseptostomy and ligation of the ductus arteriosus was done elsewhere on 14th and 29th day after birth. On her first admission to our hospital at 2 months of age, left ventricular-right ventricular pressure ratio (LVp/RVp) was almost 0.5 and left ventricular posterior wall thickness (LVPWT) by echo cardiography was 3.5 mm. Because of these date, we selected rapid, two-stage arterial switch operation. On 74 days, the first-stage preparatory operation (pulmonary arterial banding and right modified Blalock-Taussig shunt) was undergone with the resultant LVp/RVp of 0.97. During a few days after the first-stage operation, left ventricular ejection fraction (LVEF) by echocardiography was reduced to nearly 30%. But after this phase left ventricular function recovered rapidly and LVp/RVp, LVPWT and LVEF was 1.18, 6.3 mm and 66% on the 7th day. On the 9th day, the second-stage arterial switch operation was undergone as usual as in neonatal period without hard adhesion. Her postoperative course was uneventful.

Cardiac Surgical Procedures↗
PubMed1991

[A pilot study of etoposide, split-dose cisplatin and THP in small cell lung cancer].

Sixteen untreated patients with small cell lung cancer were treated with a combination of Etoposide (70 mg/m2 i.v., day 3-5), Cisplatin (40 mg/m2 i.v., days 1 and 8) and THP (20 mg/m2 i.v., days 1 and 8). Cycles were repeated every 4 weeks and 15 patients received more than two cycles. The objective response rate was 80% (12 of 15) in complete cases, 91% (10 of 11) in limited disease and 50% (2 of 4) in extensive disease. CR rate was 33% in complete cases, 46% in limited disease. The median duration of response was 22.6 weeks. The median survival was more than 12 months in complete cases. Toxicity was primarily myelosuppression. Three of 15 patients had leukopenia of grade 4, 3 of 15 of grade 3, and 7 of 15 of grade 2. Nausea and vomiting were well tolerated by metoclopromide and methylprednisolone. The renal toxicity was minimal. There were no chemotherapy-related lethal complications. This schedule of Etoposide, split-dose Cisplatin and THP is effective and safe for patients with small cell lung cancer. However, the advantage of THP is still controversial.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Role of the vitreous in posterior segment neovascularization in central retinal vein occlusion.

We retrospectively studied the relationship between the vitreous condition and the development of retinal or optic disc neovascularization in 60 eyes with central retinal vein occlusion associated with extensive retinal ischemia. At initial examination, 24 of 60 eyes (40%) with central retinal vein occlusion had complete posterior vitreous detachment, a prevalence significantly higher than in the fellow eyes. During a mean follow-up period of 43 months, 13 of 34 eyes (38%) without posterior vitreous detachment developed retinal or disc neovascularization, or both, but none of the 24 eyes with complete posterior vitreous detachment developed neovascularization (P less than .001). Our results suggest that central retinal vein occlusion may induce the development of posterior vitreous detachment, and that posterior vitreous detachment may play a role in protecting eyes with central retinal vein occlusion from posterior segment neovascularization.

Adult↗
PubMed1991

[Absent pulmonary valve syndrome: surgical approach for the worst group included in symptomatic neonates].

Absent pulmonary valve syndrome (APVS) has been classified to two groups. One is severely symptomatic infant group and the other no or slightly symptomatic. But we think that severely symptomatic group should be divided into the worst neonate group and the other. This worst group, that contains neonates who can not be weaned from the respirator after surgical intervention including corrective surgery because of severe bronchomalacia and/or peripheral bronchial stenosis, has already severe respiratory distress and needs ventilatory support while high pulmonary vascular resistance is maintained. Three patients of this group were operated on at 2, 13 and 2 days of age and there were two late hospital death. The last patient underwent ligation of main pulmonary artery (mPA) and left modified Blalock-Taussig shunt (MBTS) with phi 4 mm polytetrafluoroethylene graft and was extubated on the next day. The management of this group should aim at controlling the pulmonary regurgitation as early as possible to decrease the progressive airway obstruction and minimize pulmonary tissue damage. Ligation of mPA and MBTS can be performed without cardiopulmonary bypass and eliminates pulmonary regurgitation and controls the pulmonary blood flow less than the total correction. In the point of protecting bronchi and lung and reducing the risk of surgical intervention in critical neonatal period, ligation of mPA and MBTS can be safer and more effective operation for the worst APVS neonate than the total correction with insertion of artificial valve.

Blood Vessel Prosthesis↗
PubMed1990

Posterior vitreous detachment following panretinal laser photocoagulation.

A total of 30 eyes of 19 patients with type I diabetes, varying severity of retinopathy, and no posterior vitreous detachment (PVD) were studied clinically, and vitreous examination was performed by preset lens biomicroscopy. Follow-up was 4.0-7.5 years. A total of 15 eyes underwent panretinal laser photocoagulation (PRP) and 15 eyes were left untreated. The incidence of PVD was 8 of 15 353%) after PRP and 1 of 15 (7%) in untreated eyes (P less than 0.02). Minimal vitreous hemorrhage occurred in 4 of 7 treated eyes (57%) that did not develop PVD and in only 2 of 8 (25%) that did. In treated eyes with no history of vitreous hemorrhage, the incidence of PVD was 6/9 (67%); in treated eyes with minimal vitreous hemorrhage at any time, it was 2/6 (33%). In treated eyes, the presence of Diabetic Retinopathy Study (DRS) high-risk characteristics was equally frequent in eyes that developed PVD as in those that did not. These data suggest that PVD occurs following PRP, independent of the severity of diabetic retinopathy or prior vitreous hemorrhage.

Adult↗
PubMed1990

Vitreous changes and macular edema in central retinal vein occlusion.

The condition of the posterior vitreous was determined in 56 eyes with central retinal vein occlusion (CRVO). Using a life-table analysis, it was studied in 56 eyes. The incidence of posterior vitreous detachment (PVD) in the CRVO eyes at the first vitreous examination did not differ significantly from that in 64 age-matched control eyes. However, the incidence of PVD in CRVO eyes increased from 39.3% at the first vitreous examination to 58.5% after 6 months, and to 69.6% 1 year from the examination. The incidence of PVD in CRVO eyes during follow-up was statistically higher than that of the controls (P = .009). The incidence of PVD after the first vitreous examination was significantly higher in eyes with hemorrhagic retinopathy than in eyes with venous stasis retinopathy (P = .04). In the 34 eyes with macular edema, the edema lasted significantly longer in those with vitreomacular attachment (VMA) at the first examination than in those without VMA at this time (P = .02). VMA may play an important role in the pathogenesis and chronicity of macular edema in CRVO.

Adult↗
PubMed1990

[Effect of erythromycin on the generation of neutrophil chemiluminescence in vitro].

In order to elucidate the therapeutic mechanisms of low dose-long term erythromycin (EM) therapy in patients with diffuse panbronchiolitis (DPB), the authors evaluated the effect of in vitro EM treatment on neutrophil (PMN) oxygen radicals production. EM has potent capacity to suppress PMN chemiluminescence (CL) induced by the N-formyl Met-leu-phe (FMLP), opsonized zymosan, and calcium ionophore A23187 stimulation. In marked contrast, phorbol myristate acetate (PMA)-induced PMN CL were much less affected by EM treatment. The suppressive activity of EM was dependent on the EM concentration and at a EM concentration of 25 micrograms/ml, FMLP-induced PMN CL were suppressed by 45.3 +/- 5.6% (n = 7), but PMA-induced CL were suppressed only marginally, 11.9 +/- 3.7% (n = 7). The onset of inhibitory activity of EM is rapid and at 5 min., 60.1% of the maximum suppression at 60 min. was observed. This EM-induced suppression was found to be reversible and dependent on the EM-pretreatment temperature since the suppressive activity of EM were observed only at 37 degrees C but not at 0 degrees C. These results suggest that actively transported intracellular EM exerts its suppressive activity by inhibiting the process of Ca++ transfer or Ca++ utilization by cells. In addition, these results were consistent with the concept that EM might act as an anti-inflammatory agent in chronic bacterial airway infections such as bronchiectasis and DPB where the PMN appear to play an important role in the generation of airway destruction.

Erythromycin↗
PubMed1990

[Role of the vitreous in idiopathic preretinal macular fibrosis indicated by visual acuity in follow-up cases].

The vitreous and visual acuity in 103 eyes with idiopathic preretinal macular fibrosis were examined. The vitreous was studied biomicroscopically and the follow-up course was 6 months or more. Twenty-two eyes had no posterior vitreous detachment (group 1), 4 eyes had partial posterior vitreous detachment without traction to the macula (group 2), 17 eyes had partial posterior vitreous detachment with traction to the macula (group 3), and 60 eyes had complete posterior vitreous detachment (group 4). There were significantly more eyes with a visual acuity of 0.4 or worse, decreased acuity, or macular fluorescein leakage in group 3 than in groups 1 or 4. Decreased visual acuity was found in 41% of eyes with macular fluorescein leakage, but in only 11% of eyes without macular fluorescein leakage. It is presumed that the vitreous traction to the macula and macular fluorescein leakage are closely related to the outcome of visual acuity in cases with idiopathic preretinal macular fibrosis.

Adolescent↗
PubMed1989

Biomicroscopic evaluation and photography of ocular toxoplasmosis.

The vitreous of 39 eyes with ocular toxoplasmosis was studied and photographed using an El Bayadi-Kajiura preset lens. In active cases of toxoplasmosis, the vitreous showed inflammatory opacities and gel shrinkage. In inactive cases, the vitreous was often liquefied. Compared with 39 normal eyes of age- and sex-matched controls, the prevalence of partial posterior vitreous detachment was significantly higher in toxoplasmosis (P less than .001). A higher prevalence of posterior vitreous detachment was found in eyes with the major chorioretinal lesion outside the temporal vascular arcade than in those with lesions inside the temporal vascular arcade (P less than .05). Our results indicated that various vitreous changes may cause posterior vitreous detachment and that location of the inflammatory focus may influence the vitreous condition.

Adolescent↗
PubMed1989

[Role of the vitreous in retinal neovascularization evaluated by a comparison of central retinal vein occlusion and branch retinal vein occlusion].

Thirty three patients (33 eyes) with central retinal vein occlusion (CRVO) and 80 patients (81 eyes) with branch retinal vein occlusion (BRVO) were studied in an attempt to investigate the role of the vitreous in the formation of retinal neovascularization. All these eyes had some areas of capillary nonperfusion confirmed by fluorescein angiography and no scatter photocoagulation before the first examination. The incidence of new vessels at the optic disc (NVD) in CRVO was not significantly different from that in BRVO. However, the incidence of new vessels elsewhere (NVE) in CRVO was significantly less than that in BRVO. Follow-up vitreous examination of 36 cases while they had not developed NVD and/or NVE showed a higher incidence of posterior vitreous detachment from the mid-peripheral retina (MP-PVD) in CRVO than in BRVO. On the other hand, there was no statistically significant difference in the incidence of posterior vitreous detachment from the optic disk (D-PVD) between CRVO and BRVO. The high incidence of MP-PVD in CRVO may explain the low incidence of NVE in CRVO.

Adult↗
PubMed1988

A review of 324 cases of idiopathic premacular gliosis.

We reviewed the records of 324 patients (395 eyes) seen between 1973 and 1987 with a diagnosis of idiopathic premacular gliosis. Mean age of onset was 64.6 years, 189 (58.3%) were women, and all but six patients were white. Initial visual acuity was 20/40 or better in 214 eyes (54.2%), 20/50 to 20/100 in 136 eyes (34.4%), and poorer than 20/100 in 45 eyes (11.4%). Follow-up examinations were made in 214 eyes. After a mean follow-up period of 33.6 months, 106 (49.5%) of the 214 eyes maintained a visual acuity within one line of initial visual acuity, 28 (13.1%) were more than one line better, and 80 (37.4%) were poorer. Partial or complete posterior vitreous detachment was present in 303 (84.9%) of the 357 eyes undergoing vitreous study; 43 (14.2%) of these 303 eyes had partial vitreous detachment with vitreous adhesion to the macula. Cystoid macular edema was present on angiography in 77 (20.6%) of 373 eyes undergoing fluorescein angiography; 20 (26.0%) of these 77 eyes had partial posterior vitreous detachment with vitreous adhesion to the macula, whereas only 23 (7.8%) of the 296 eyes without cystoid macular edema had such vitreous adhesion (P less than .001). Other findings were myopia in 116 of 367 eyes (31.6%) (103, or 88.8%, of the myopic eyes had posterior vitreous detachment), and increased intraocular pressure in 56 of 324 eyes (17.3%).

Adolescent↗
PubMed1988

Role of the vitreous in branch retinal vein occlusion.

We analyzed the vitreous findings in 62 patients (62 eyes) with major branch retinal vein occlusion to determine whether vitreous examination was useful in predicting the development of retinal or disk neovascularization, or both. In 18 eyes with no or partial posterior vitreous detachment and large areas of capillary nonperfusion (5 disk diameters or more), ten eyes (55.6%) eventually developed neovascularization. Only three of the remaining 44 eyes (6.8%) developed neovascularization. The probability of this development was greater in eyes with no partial posterior vitreous detachment at the initial vitreous examination (P = .0177, Cox's regression analysis), and in those with large areas of nonperfusion (P = .0097, Cox's regression analysis).

Aged↗
PubMed1988

The role of the vitreous in diabetic macular edema.

The authors assessed retrospectively clinical records of 76 patients (125 eyes) 60 years of age or older with diabetic retinopathy who had undergone a vitreous examination. The groups consisted of 105 eyes (63 patients) with macular edema and 20 eyes (13 patients) without macular edema. Vitreous studies were done using the El Bayadi-Kajiura lens to determine whether or not the posterior vitreous was attached to the retina in the macula. Twenty-one of 105 eyes (20.0%) in the edema group and 11 of 20 eyes (55.0%) in the no-edema group had a detached posterior vitreous. This difference was found to be statistically significant, indicating that diabetic cases without macular edema have a significantly higher rate of posterior vitreous detachment than those with macular edema. This study demonstrates that the vitreous may play a role in diabetic macular edema.

Aged↗
PubMed1987

Phase II study of oral VP-16-213 in small cell lung cancer.

The soft, gelatin capsule of VP-16-213 (etoposide) was given orally and evaluated in a Phase II study of 56 patients with histologically confirmed small cell lung cancer. The drug was given in a dose of 200 mg/body/day orally for 5 consecutive days, and the courses were repeated every 3 to 4 weeks depending upon the individual patient recovery from myelosuppression. An overall objective response was obtained in 17 patients (30%), five previously treated (23%) and 12 untreated (35%). The median days for response after the start of treatment was 14 d (range, 5 to 64), and the median duration of response was 62 days (range, 28 to 278). The dose-limiting factor was leukopenia, while thrombocytopenia was also experienced. Gastrointestinal reactions to toxicity and alopecia were also observed, but they were not overwhelming. The study demonstrated that the VP-16-213 soft gelatin capsule given orally is effective against small cell lung cancer without clinical cross-resistance to other cytotoxic agents. Its usefulness in combination chemotherapy is thus suggested.

Administration, Oral↗
PubMed1986

[A phase II study of etoposide (VP-16) injection in primary lung cancer by cooperative study group].

A Phase II Study of VP-16 was performed in 58 patients with primary lung cancer. VP-16 was administered via infusion at a dosage of 60-100 mg/m2 daily for 5 days, and repeated every 3 to 4 weeks. Of the 58 patients who entered into the study, 38 were evaluable. Partial response was observed in 6 patients who had been diagnosed as having small cell carcinoma of the lung. Response rates were 15.8% for all evaluated patients and 33.3% for the patients with small cell carcinoma of the lung. As for dose-limiting toxicity, leukopenia (less than 3,000/mm3) was observed in 53.1% of cases. Other major adverse reactions were hematologic toxicities such as anemia and thrombocytopenia, gastrointestinal toxicities and alopecia, but these were all well tolerated.

Adenocarcinoma↗