[Case of myosarcoma of the ileum causing septicemia].
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Adult↗
Biomedical subjects
M Kawamoto
Publications and source records attributed to M Kawamoto.
Contrasting effect of isoflurane on drug metabolism: decreased type I and increased type II substrate metabolism in guinea pig liver microsomes.
Inhalation anaesthetics might affect perioperative drug elimination by altering drug distribution, hepatic blood flow or drug metabolism. The in vitro effects of isoflurane on aniline hydroxylation and aminopyrine N-demethylation were investigated with guinea pig liver microsomes to assess the role of isoflurane on oxidative drug metabolism through the hepatic mixed-function oxidase system. p-Aminophenol and formaldehyde were measured spectrophotometrically as metabolic products of aniline hydroxylation and aminopyrine N-demethylation, respectively, where the reaction mixture consisted of a microsomal suspension, NADPH, aminopyrine or aniline, with or without isoflurane. The rate of cytochrome P-450 reduction by NADPH affected in the presence of isoflurane was investigated by spectrometric measurement of the CO-cytochrome P-450 complex formation at various times. Due to the addition of isoflurane, the Vmax values for aniline hydroxylation evidently increased except in high isoflurane concentration (3.33 mM) and for aminopyrine N-demethylation the value was significantly low only in the presence of a high isoflurane concentration, whereas the K(m) values significantly decreased in aniline hydroxylation and increased in aminopyrine N-demethylation, and isoflurane also accelerated the rate of cytochrome P-450 reduction by NADPH. These results reflect the inhibition of aminopyrine N-demethylation and activation of aniline hydroxylation in the presence of isoflurane as a consequence of isoflurane-accelerated cytochrome P-450 reduction by NADPH and/or drug-enzyme binding properties, and may have implications on the metabolism of perioperatively administered drugs during isoflurane anaesthesia.
Aminopyrine N-Demethylase↗
Bilio-enteric anastomosis as a risk factor for postembolic hepatic abscesses.
In 2 patients who had undergone pancreatoduodenectomy with choledochojejunostomy, a subsequently detected metastatic tumor of the liver was treated with transcatheter arterial embolization. Weeks later intrahepatic abscesses developed. Pathophysiologic processes that may lead to this complication of hepatic embolization are discussed.
Adult↗
Significance of myocardial uptake of iodine 123-labeled beta-methyl iodophenyl pentadecanoic acid: comparison with kinetics of carbon 11-labeled palmitate in positron emission tomography.
BACKGROUND: A radioactively labeled beta-methyl branched fatty acid analog, 123I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP), has been developed to probe regional myocardial fatty acid metabolism. However, the significance of BMIPP uptake in the myocardium remains unclear. METHODS AND RESULTS: To evaluate the significance of BMIPP uptake, single-photon emission computed tomography was performed 30 minutes after injection of BMIPP, and 201Tl-labeled single-photon emission computed tomography was taken on a separate day in 10 patients. Findings of BMIPP and 201Tl-labeled imaging were compared with the data obtained from positron emission tomography with 11C-labeled palmitate. The BMIPP uptake (percent of maximum) was significantly correlated with the early uptake (percent) and delayed uptake (percent) of 11C-labeled palmitate (r = 0.659 and r = 0.687, respectively) (p < 0.01 each), whereas it was not significantly correlated with the residual fraction (r = 0.205) or the clearance half-time of the early component (r = 0.138) of 11C-labeled palmitate as a marker of beta-oxidation of the fatty acid. CONCLUSIONS: These data indicate that, although the myocardial uptake of BMIPP may not directly reflect beta-oxidation of fatty acids, its uptake may reflect both regional myocardial blood flow and fatty acid extraction.
Adult↗
Combined assessment of regional perfusion and wall motion in patients with coronary artery disease with technetium 99m tetrofosmin.
BACKGROUND: Technetium 99m tetrofosmin is a new 99mTc-labeled myocardial perfusion agent that can be labeled easily and provides excellent myocardial perfusion images. In addition, bolus administration of the tracer allows first-pass radionuclide ventriculography. METHODS AND RESULTS: This study examined the diagnostic value of combined assessment of regional perfusion by tetrofosmin tomography and wall motion by first-pass radionuclide ventriculography both at rest and during stress in 24 patients suspected of having coronary artery disease. All patients underwent stress-rest tetrofosmin tomography, stress-delayed thallium 201 tomography, and coronary angiography. Stress tetrofosmin tomography showed abnormal perfusion in all 23 patients with angiographic evidence of coronary artery disease, whereas stress 201Tl tomography showed abnormal perfusion in 22 of the 23 patients. For detection of significant (> or = 50% diameter stenosis) stenotic coronary arteries, the two perfusion studies showed similar sensitivities (62% with 201Tl and 69% with tetrofosmin) and specificities (88% and 100%, respectively). When analysis of regional wall motion was combined with perfusion study, a slightly higher sensitivity was obtained (77%), with similar specificity. The regional wall motion score was concordant with the regional perfusion score in only 42% of the segments at rest and 50% during exercise. CONCLUSIONS: These results suggest that stress tetrofosmin perfusion tomography and stress 201Tl tomography provided similar diagnostic accuracy for detection of coronary artery disease. The combined assessment of perfusion and function that is feasible with tetrofosmin may enhance diagnostic accuracy in patients with coronary artery disease.
Aged↗
The use of iodinated free fatty acids for assessing fatty acid metabolism.
Free fatty acid is a major substrate fuel for normal myocardium. Cardiovascular disease is frequently associated with impairment of fatty acid oxidation. Therefore assessment of fatty acid metabolism may be an important tool for the early detection of myocardial abnormalities and may provide insight into pathologic heart conditions. Although carbon 11-labeled palmitate is a well-established tracer for probing myocardial fatty acid metabolism, a variety of iodinated fatty acid compounds have been introduced for assessing fatty acid metabolism, including straight-chain and branched-chain fatty acid compounds. Straight-chain fatty acid has advantages for measuring fatty acid oxidation on the basis of tracer clearance from the myocardium. Branched-chain fatty acid can be trapped in the myocardium without further washout and uptake in the myocardium may reflect fatty acid retention and some aspect of fatty acid metabolism. A long tracer retention period makes feasible the acquisition of single-photon emission computed tomographic images. This review examines the characteristics of both types of tracers and our recent clinical experience with beta-methyliodophenyl pentadecanoic acid, which has potential for detecting and characterizing both ischemic heart disease and cardiomyopathy.
Fatty Acids↗
Myofascial pain in patients with postthoracotomy pain syndrome.
OBJECTIVE: Postthoracotomy pain syndrome is generally considered to be neuropathic pain due to intercostal nerve injury. However, nonneuropathic pain can also occur following thoracic surgery. We present a series of cases with postthoracotomy pain syndrome in which myofascial pain was thought to be a causative component of postthoracotomy pain syndrome. CASE REPORT: Twenty-seven patients (17 men and 10 women) were treated with trigger point injections, intercostal nerve blocks, and/or epidural blocks. Clinical criteria were used to diagnose the myofascial pain. A visual analogue scale was used, and sensory disturbances were recorded before and after treatment. A trigger point in a taut muscular band within the scapular region, which we diagnosed as myofascial pain, was observed in 67% of the patients. The existence of this trigger point significantly increased the rate of success for the treatments. CONCLUSIONS: Postthoracotomy pain may result, at least in part, from a nonneuropathic origin (myofascial pain). It is recommended that each patient be examined in detail to determine whether there is a trigger point in a taut muscular band within the scapular region. If found, this point is suggested as a good area for anesthetic injection.
Aged↗
Infantile hemangiopericytoma--case report and literature review.
Infantile hemangiopericytoma is a rare soft tissue neoplasm of pericytic origin and is almost always benign, despite its worrisome pathologic features. We describe a 2-month-old male infant with a soft tissue mass on his right thigh. Histologically, the lesion showed a characteristic hemangiopericytoma-like vascular pattern, multilobulation, and moderate mitotic activity. These morphologic features were prediagnosed as infantile hemangiopericytoma. However, immunohistochemical and ultrastructural studies revealed a heterogeneous cellular composition, primarily pericytes and endothelial cells, similar to that observed in infantile myofibromatosis.
Diagnosis, Differential↗
Evaluation of the T&T olfactometer by mapping c-fos protein in an olfactory bulb.
OBJECTIVES: Although in Japan the T&T olfactometer is most commonly used in patients suffering from smelling disorders, no scientific analysis has been performed so far. The objective of this study was to clarify whether the five odorants used in the T&T olfactometer are suitable or not. We mapped the glomeruli activated by the five test odorants employed in the T&T olfactometer. The expression of c-fos protein as a marker of neuronal excitation was monitored using an immunohistochemical technique. STUDY DESIGN: The expression of c-fos protein in the rat olfactory bulb was investigated to determine what part of the olfactory system is activated by five odorants used in the T&T olfactometer. METHODS: Each rat was isolated in a clean cage for 120 min to reduce the basal expression of c-fos protein. Each rat was fixed in the cage and exposed to one of five test odorants for 90 min. The expression of c-fos protein was measured using an immunohistochemical technique. RESULTS: Each odorant activated numerous glomeruli and the patterns of distribution of activated glomeruli were specific to each odorant. Glomeruli in most regions of the bulb were activated by all five test odorants. CONCLUSION: We assume that in the T&T olfactometer the optimal ((five)) odorants are employed, because the glomeruli activated by those odorants showed unique patterns in the immunohistochemical assay.
Animals↗
Prediction of accelerated Ca-induced Ca release rate by clinical findings in malignant hyperthermia susceptible subjects.
BACKGROUND: An abnormally accelerated Ca-induced Ca release (CICR) rate is known to be correlated with malignant hyperthermia susceptibility (MHS). OBJECTIVE: To analyze significant clinical findings concerning CICR rate and develop a computer program for its prediction in human MHS. PATIENTS AND METHOD: Using data from 146 subjects who had received a muscle biopsy for the determination of CICR rate, because of their anesthesia-related MHS history, we analyzed 23 different clinical features. There were 71 subjects with an abnormally accelerated CICR rate and 75 with a normal rate. Accelerated CICR rate was used as the objective variable whilst clinical findings and ages were used as independent variables and control variables, respectively. A multiple logistic regression model was employed for the analyses and the most suitable formulae for prediction were determined for use in the development of a computer program. RESULTS: The following 8 clinical findings were determined to be the most significant: the presence of muscle rigidity, the most serious PaCO2 reading (mmHg), peak body temperature (degree C), body temperature rate of increase over 15 minutes (degree C/15 minutes), most serious arterial pH reading, administration of dantrolene, improvement of acidosis with dantrolene, and time elapsed to peak body temperature after administration of anesthetics (minutes). By ranking the subject ages into 14 groups, we were able to minimize the prediction error rate with each corresponding formula. The computer program developed for prediction whilst consisted of these formulae yielded a sensitivity of 80% and a specificity of 86%. CONCLUSION: This method of prediction may contribute to the accurate prediction of CICR rate at the bedside. For clinical convenience, we will distribute the computer program upon request.
Acidosis↗
Depression factors of neutrophil bactericidal activity with nitroblue tetrazolium reduction test in surgical patients.
In this study, background factors were determined in 108 surgical patients who showed depression in phagocytic and bacteriocidal activity with nitroblue tetrazolium reduction test. Control subjects consisted of 4 healthy males and 4 healthy females whose age ranged from 25 to 38 years. The background factors associated with the depressed neutrophil phagocytic and bacteriocidal activity in surgical patients were renal insufficiency, liver cirrhosis, hypoproteinemia, diabetes mellitus, long-term administration of steroids and immunosuppressants, obesity, anemia, aging and malignant tumors. These depression factors closely resembled those generally considered to be involved in increased susceptibility to infections.
Adult↗