Search PubMed⌕ Search

Biomedical subjects

M Kawamura

Publications and source records attributed to M Kawamura.

At least 559 records · Page 31Linked to original sources
PubMed1991

[Releasing phenomenon of well learned praxis with right hand].

We report a case with "releasing phenomenon of well learned praxis" with right hand caused by cerebral infarction in the territory of left anterior cerebral artery. A 71-year-old right-handed woman suddenly developed motor paralysis in right lower and upper limbs associated with mutism. Motor paralysis of the right upper limb and speech disturbance improved gradually. At this period it was noted that she grasped and used an object in front of her with right hand against her own will. The neurological findings about one month after the onset of the disease revealed very mild weakness of the right upper extremity and severe motor paralysis of the right lower limb. In addition, tendon reflex was exaggerated in the right lower limb and sensory disturbance was noted in the region distal from the right knee. Neuropsychologically, ideomotor apraxia was observed in the left hand. Pathological gasping of the right hand was also noted. When the patient saw and touched an object, she used it with her right hand against her own will, and her left hand voluntarily hindered the right hand. This behavior is apparently similar with the "compulsive manipulation of tools" reported previously. However, the following hitherto unknown phenomena were observed in the present patient: Her right hand performed pantomimic movement for the use of objects orally described by the examiner without visually presenting them. The right hand also tended to imitate the gestures of the examiner automatically, even if the patient was not asked for imitating the gestures. These behavioral abnormalities of the right hand was thought to be liberated from the inhibition system.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Surgical treatment of advanced thyroid carcinoma invading the trachea.

Operative methods, in relation to the completeness of resection and surgical results, and postoperative complications, in relation to operative methods, were discussed in 60 patients with advanced thyroid carcinoma in whom tumor invading the trachea was resected along with thyroid carcinoma. Laryngotracheal anastomosis was performed in 41 patients and tracheotracheal anastomosis in 19 patients. Complete resection was performed in 22 patients in the former group and in 12 patients in the latter group. Three-, 5-, and 10-year survival rates in patients undergoing complete resection were 87.0%, 78.1%, and 78.1%, respectively. Those for patients undergoing incomplete resection were 64.9%, 43.7%, and 24.3%, respectively. The locations of remaining tumor were the tracheal stump in patients in whom resection was incomplete. In four patients with esophageal invasion, the muscular layer of the esophagus was resected. Three of these patients had good postoperative results. Postoperative complications consisted of stenosis at the anastomosis in two patients, temporary mis-swallowing in three patients, temporary lower pharyngeal stenosis in one patient, temporary vocal cord edema in one patient, and tetany in two patients.

Anastomosis, Surgical↗
PubMed1991

[Histochemical changes of islet cells of Langerhans after hepatectomy and effect of glucagon and insulin].

It has been made by a number of studies that after hepatic resection, portal factors such as insulin and glucagon play an important role in liver regeneration. We have reported hypertrophy of Langerhans islands of dogs after partial hepatectomy. In the present study we attempted to clarify the mechanism of this hypertrophy. In a control group, a forty-percent hepatectomy was carried out. One and four weeks after surgery, 0.5g/kg of glucose was administered intravenously followed by a blood sampling from the portal vein to measure the changes of glucose, insulin and glucagon respectively. In addition area changes of the islets of Langerhans after the operation were measured with PAP technique. In a GI group, the same experiment as in the control group was done and 1mg of glucagon and 2IU/kg of insulin were administered every morning after the operation. The following results were obtained. In the GI group, there were no decrease in portal plasma insulin level and no enlargement of the sizes of the islets four weeks after surgery.

Animals↗
PubMed1991

[Tracheal surgery to preserve or improve pulmonary and laryngeal functions].

One hundred and two patients underwent tracheal surgery to preserve or improve pulmonary and laryngeal functions. For pre- and post-operative functional examinations of tracheal stenotic patients, the flow volume curve and frequency analysis of tracheal stenotic sounds were very useful. As a results of tracheal surgery in 76 malignant cases, vocal cord stenosis due to bilateral laryngeal nerve paralysis was occurred in 21 patients. For vocal cord stenosis, T tube insertion was very effective and we were able to close the orifice of tracheostomy in 11 out of 15 cases by this method.

Adolescent↗
PubMed1991

[The early changes in bone mineral metabolism due to radiation--measurement of bone mineral density in lumbar vertebra by quantitative computed tomography].

Osteosclerosis, osteonecrosis and compression fracture are commonly observed several years after radiation. Since lumbago usually occurs several months after radiation, the possibility that bone mineral metabolism is disturbed during and immediately after radiation cannot be ruled out. However, there have been no reports concerning early changes in bone mineral metabolism due to radiation. The bone mineral density was measured by QCT (Quantitative Computed Tomography) in 30 normal non-radiated cases and 14 radiated cases to investigate the changes in bone mineral metabolism due to radiation. The bone mineral density (QCT-Value: QCT-V) in the 3rd lumbar vertebra (L3) of normal non-radiated subjects decreased linearly with age (Y = 291.114447-3.01473X). The QCT-V of the 5th lumbar vertebra (L5) of normal cases also decreased linearly with age (Y = 309.641397-3.03986X), resembling that of L3. The ratio of the QCT-V of L5 to L3 (L5/L3, expressed as a percentage) definitely increased with age (Y = 86.5657441 + 0.58885064X). In radiated cases, the QCT-V of L3 in the non-radiated field did not change appreciably. The QCT-V of L5 in the radiated field was decreased from 20GY and reached 53.08 +/- 17.37% of the pre-radiation value after 50GY. The L5/L3 ratio was also decreased from 20GY and reached 55.47 +/- 15.32% of the pre-radiation value after 50GY. It becomes apparent that the QCT-V of the radiated lumbar vertebra is decreased during radiation. It is suggested that bone mineral metabolism may be disturbed in the early phase of radiation.

Bone Density↗
PubMed1991

[Reconstruction and its prognosis in patients undergoing resection of tracheal bifurcation].

Seventeen resections of tracheal bifurcation were performed: 12 for bronchogenic carcinoma, 2 for primary neoplasm of the trachea, one each for pulmonary sarcoma, inflammatory lesion and metastatic thyroid carcinoma. We performed carinal reconstruction in eight patients, sleeve pneumonectomy in eight patients and wedge pneumonectomy in one. In patients undergoing carinal reconstruction, there were 2 operative deaths and six patients survived over five years after the operation. However, in patients undergoing sleeve (wedge) pneumonectomy, there were 3 operative deaths, four patients died from 3 months to 7 months, and only two patients survived 5 years after the operation. Carinal resection with pneumonectomy had poorer prognosis than carinal reconstruction.

Adult↗
PubMed1990

[Combined treatment in patients with carcinoma in situ of the urinary bladder using intravesical pirarubicin, irradiation and hyperthermia].

The treatment with hyperthermia in combination with radiation and intravesical pirarubicin (THP-ADM) was preliminary investigated in 5 patients with urinary bladder carcinoma in situ. Following intravesical administration of 30 mg THP-ADM, external irradiation of 3.0 Gy was delivered to the urinary bladder. Immediately then, hyperthermia using Thermotron RF-8 was performed for 50 min (intravesical temperature: 42-43 degrees C for 35 min). After five courses of the treatment, complete response has been maintained for 6, 8, and 9 months in 3 patients. However, in a patient with complete response, urinary cytology became positive in the 6th month after the treatment. In the remaining patient treatment was interrupted after only 3 courses due to urinary irritation, urinary cytology didn't become negative. The side effects of the combined treatment were limited to the transient symptoms of bladder irritation in all patients and thermal burn in 2 patients. These preliminary results suggest that this combined treatment may represent an effective conservative therapy for patients with urinary bladder carcinoma in situ.

Administration, Intravesical↗
PubMed1990

[A case of prolonged jaundice after surgical treatment of obstructive jaundice caused by a carcinoma of the head of the pancreas relieved with dibutyryl cyclic AMP].

Recently, we experienced a case of obstructive jaundice caused by a carcinoma of the head of the pancreas which could not be relieved by reduction surgery. The operation performed was a cholecystectomy and supraduodenal choledochotomy with T-tube insertion. Glucagon and insulin were, therefore, administered with the aim towards the recovery of the liver function to be induced by the enhancement of the liver regeneration. The treatment, however, was not effective. Then, dibutyryl cyclic AMP was administered to the case by intravenous drip infusions at the rate of 5 micrograms/kg/min. Thereafter, the value of serum total bilirubin was reduced remarkably. A prolonged and intense obstructive jaundice is generally accompanied by damage to the liver function, and the condition carries a high risk of postoperative complication. In this paper, the effectiveness of dibutyryl cyclic AMP on liver cell damage caused by prolonged obstructive jaundice are reported.

Aged↗
PubMed1990

A possible role of the beta-subunit of (Na,K)-ATPase in facilitating correct assembly of the alpha-subunit into the membrane.

mRNAs from the alpha- and beta-subunits (mRNA alpha and mRNA beta, respectively) of Torpedo californica (Na,K)-ATPase were injected into Xenopus laevis oocytes either separately or in combination, and the properties of the two subunits synthesized were studied. The alpha-subunit synthesized in oocytes injected with mRNA alpha alone was recovered in both the membrane and cytosol fractions and was susceptible to tryptic attack. When mRNA beta was coinjected with mRNA alpha, almost all the alpha-subunit was found in the membrane fraction and was resistant to trypsin. In all cases, essentially all of the beta-subunit was recovered in the membrane fraction and was resistant to trypsin. As the amount of mRNA beta coinjected increased, the amounts of both the alpha- and beta-subunits as well as (Na,K)-ATPase activity of the membrane fraction increased. These results suggest that the beta-subunit facilitates the correct assembly of the alpha-subunit into the membrane probably by forming a stable complex with the nascent alpha-subunit.

Animals↗
PubMed1990

[Radiation therapy for unresected gastric lymphoma].

Six consecutive patients with unresected gastric lymphoma which were treated by radiation therapy between November, 1976 and March 1989 were reviewed. Radiation therapy was performed using involved fields, total radiation dosages of which ranged from 25.2 to 36 Gy (mean, 29.3 Gy). Five out of the 6 patients were treated with chemotherapy combined with radiation. Regimen of the chemotherapy was CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) in most cases. Three out of the 6 underwent probe laparotomy, but the tumors were diagnosed as unresectable due to locally invading the adjacent structures. They were treated by chemo-radiotherapy and 2 of them are surviving as of the present study (40 and 116 months). The other 3 patients were diagnosed as with clinical stage IV disease and 2 of them were successfully treated with chemo-radiotherapy (21 and 66 months, surviving). These data suggest that unresected gastric lymphomas, which are locally advanced or stage IV disease, are treated by chemoradiotherapy with high curability without any serious complications.

Adult↗
PubMed1990

Effect of glucagon on bile acid metabolism after resection of liver cancer in patients with cirrhosis.

After hepatectomy patients with cirrhosis and liver cancer may develop progressive hepatic dysfunction and eventually hepatic failure. Insulin and glucagon are often used to treat certain kinds of hepatic dysfunction and hepatic insufficiency. We investigated the effect of glucagon on bile acid metabolism and pancreatic endocrine function. In 7 patients with severe cirrhosis and cancer of the liver, 1 mg of glucagon was injected intravenously pre- and post-operatively, and total bile acids, C-AMP, and bile acid fractions were determined. In the pre-operative glucagon tolerance test, the C-AMP level rose from a baseline of 14 +/- 0.8 PMol/ml to 362 +/- 94 PMol/ml 30 min after the injection of glucagon (p less than 0.01); and the level of total bile acids decreased from a baseline of 28 +/- 9 microMol/ml to 11 +/- 3 microMol/ml 60 min after the injection of glucagon. The post-operative C-AMP level increased from a baseline of 13 +/- 1 PMol/ml to 192 +/- 58 PMol/ml level of 30 min after the injection of glucagon (p less than 0.01), and the post-operative level of total bile acids decreased from a baseline of 64 +/- 20 microMol/ml to 26 +/- 7 microMol/ml 60 min after the injection of glucagon. There was a significant correlation between the 5-min increment ratio of C-AMP and the decrement ratio of total bile acids (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Acids and Salts↗
PubMed1990

Assessment of antimicrobial penetration into the pancreatic juice in dogs.

The pancreatic ductal penetration of piperacillin, cefuzonam, fosfomycin and netilmicin, injected intravenously, was studied in four dogs with chronic pancreatic fistula. Serum and pancreatic juice were collected simultaneously, frozen, and later assayed for antibiotic concentration. Each antibiotic achieved its therapeutic serum level. The pancreatic ductal levels of piperacillin and cefuzonam were therapeutic, in contrast, the fosfomycin and netilmicin levels were subtherapeutic. These results are considered to be of interest in prevention and treatment of pancreatic infections.

Animals↗
PubMed1990

[Clinical studies on hypercreatine phosphokinasemia in emergency diseases].

Unexplained serum creatine phosphokinase (CPK) elevation is not a rare clinical problem, especially in emergency diseases. We studied hypercreatine phosphokinasemia (hyper-CPK-emia) in 161 cases of emergency diseases. Correlations between CPK and various laboratory data, various conditions were investigated. The hyper-CPK-emia was found to obtain no correlations with GPT, GOT, LDH, creatinine and body temperature. For this reason, we could not discover the unknown factors of which contributed to elevate the serum CPK. The sources of the serum CPK in these diseases were concluded to be the skeletal muscle. This is based on the facts that CPK MM (muscle type) is specifically increased among the CPK isozymes. The elevation of serum CPK activity in emergency diseases was considered to result from muscle hypoxia due to severe stress and general circulatory failure.

Adolescent↗
PubMed1990

[Role of CT and ultrasonography in acute blunt trauma of the abdomen].

From March 1985 to April 1989, one hundred thirty-one patients were examined using computed tomography (CT) and/or ultrasonography (US) in the evaluation of acute blunt trauma of the abdomen (CT and US in 36 patients, CT in 25 US in 70). Twenty-three out of the 131 cases (17.6%) showed positive findings of abdominal trauma on CT and/or US. Sixteen of the 23 patients with positive findings underwent therapeutic laparotomy, while all of the other 108 patients with negative findings were successfully managed conservatively. This fact suggests that one of the roles of CT and/or US is to pick up patients with negative findings who do not have any laparotomy. Free fluid collection was demonstrated in all of the 23 patients with positive findings in: all 22 on CT (100%), and 13 of 14 on US (92.9%). In all of the 23 patients but one with an injured mesenterium, injured organ was demonstrated by CT and/or US in: 21 of 22 by CT (95.5%), and 11 of 14 by US (78.6%). In one of the 11 patients, not an immediate US but a follow-up on the next day revealed an injured organ. In 6 out of the 12 patients who underwent both plain and contrast enhancement (CE), CT, CE-CT demonstrated the injured organ more clearly than plain CT. US with sector probe was also useful for demonstrating the injured lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries↗
PubMed1990

Assembly of the alpha-subunit of Torpedo californica Na+/K(+)-ATPase with its pre-existing beta-subunit in Xenopus oocytes.

The alpha- and beta-subunits of Torpedo californica Na+/K(+)-ATPase were expressed in turn in single oocytes by alternately microinjecting the specific mRNAs for the alpha- and beta-subunits. The mRNA first injected was degraded prior to the injection of the second mRNA by injecting the antisense oligonucleotide specific for the first mRNA. The pre-existing beta-subunit, which had been synthesized by injecting mRNA for the beta-subunit, could assemble with the alpha-subunit expressed later in the single oocytes and the resulting alpha beta complex acquired both ouabain-binding and Na+/K(+)-ATPase activities. On the other hand, formation of the alpha beta complex was not detected when the alpha-subunit was expressed first, followed by the beta-subunit. These data suggest that the beta-subunit acts as a receptor or a stabilizer for the alpha-subunit upon the biogenesis of Na+/K(+)-ATPase.

Animals↗
PubMed1990

[A possible role of the beta subunit of (Na, K)ATPase on the biogenesis of the enzyme].

(Na, K)ATPase is composed of two heterologus subunits; a catalytic alpha subunit and a glycosylated beta subunit whose role remains unclear. To elucidate a possible role of the beta subunit, the alpha and beta subunits of Torpedo californica (Na, K)ATPase were expressed in the Xenopus oocytes system which allows the specific programmed synthesis of different subunits in a cell by alternately injecting individual mRNA. When oocytes were injected with mRNA alpha alone, no significant increase in (Na, K)ATPase activity was observed, whereas a slight increase was detected in oocytes injected with mRNA beta alone. The pre-existing beta subunit, which had been synthesized by injecting mRNA beta, could assemble with the alpha subunit, expressed later in the single oocytes and the resulting alpha beta acquired both ouabain-binding and (Na, K)ATPase activities. The results reported in this paper strongly indicate that the beta subunit plays an essential role, at least in the biogenesis of the enzyme.

Animals↗