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Biomedical subjects

M Kudo

Publications and source records attributed to M Kudo.

At least 235 records · Page 13Linked to original sources
PubMed1994

[Anesthetic management of a multiallergic patient scheduled for cholecystectomy].

A 64-year-old woman was scheduled for cholecystectomy. Her past history revealed that serious anaphylactic reactions including generalized flushing and urticaria, severe hypotension and unconsciousness which occurred after eating crab four years ago. Puncture and/or intradermal skin test and subsequent lymphocyte stimulation test to several drugs commonly used in perioperative period were performed prior to anesthesia. Positive reactions to intravenous anesthetics and muscle relaxants, and negative reactions to inhalational and local anesthetics were found. Famotidine and ketotifen fumarate were given to prevent histamine release for four days before operation. After premedication with scopolamine, a catheter was inserted into epidural space at Th9-T10 level and 2% lidocaine 2 ml was administered initially into the epidural space. Anesthesia was induced with inhalation of nitrous oxide and oxygen, and deepened gradually by the increments of sevoflurane. Tracheal intubation was performed smoothly without adjunct muscle relaxant. Anesthesia was maintained with sevoflurane and epidural anesthesia with intermittent lidocaine administration. No adverse responses were noted at the time of iopamidol injection for intraoperative cholangiography. The anesthesia and postoperative course of this patient were uneventful.

Anaphylaxis↗
PubMed1994

The role of Helicobacter pylori infection in the pathogenesis of gastritis.

We conducted a prospective study to evaluate the relationship between H. pylori infection and gastritis in a Japanese population. The study population consisted of 92 patients with endoscopically proven gastritis. Biopsy specimens were taken from the gastric mucosa from the corpus and antrum according to the Sydney system for the new classification of gastritis. H. pylori was histologically found in 84.3% of patients for mononuclear (MN) cell infiltration and in 88.1% of those positive for polymorphonuclear (PMN) cells. H. pylori was not found in any of nine patients without MN cell infiltration (P < 0.001), while 68.8% of patients without PMN cell infiltration were positive for H. pylori (P < 0.03). The frequency of MN cell infiltration in H. pylori-positive patients was significantly higher than that in H. pylori-negative patients (100% vs 65.4%; P < 0.001). The frequency of PMN cell infiltration in H. pylori-positive patients was also significantly higher than that in H. pylori-negative patients (54.5% vs 23.1%; P < 0.01). The incidence of MN cell infiltration in the antrum was significantly higher than that in the gastric corpus in H. pylori-positive gastritis patients (93.2% vs 65.1%; P < 0.001). The incidence of PMN cell infiltration was also higher in the antrum than in the corpus in H. pylori-positive gastritis patients, although the difference was not significant (42.0% vs 31.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Gastric Mucosa↗
PubMed1994

Causal role of Helicobacter pylori in peptic ulcer relapse.

Helicobacter pylori has been shown to infect the gastric mucous layer of almost all patients with duodenal ulcer disease, as well as that of most patients with gastric ulcer disease. Recent studies have suggested that the eradication of H. pylori affects the natural history of duodenal ulcer disease such that the rate of relapse decreases markedly. We evaluated the relationship between H. pylori infection and peptic ulcer relapse in a Japanese population following a prospective study. Seven of 18 (38.9%) gastric ulcer patients positive for H. pylori relapsed by the end of 1 year, whereas only 1 of 9 (11.1%) gastric ulcer patients without H. pylori developed ulcer relapse (P < 0.05). Relapse rates of duodenal ulcer patients negative for H. pylori were significantly lower than those positive for H. pylori within 1 year (0% vs 66.7%; P < 0.01). The effects of anti-H. pylori drugs on the eradication of H. pylori were examined in 50 patients with peptic ulcers. Eradication rates with a proton pump inhibitor (PPI) alone (omeprazole 20 mg) showed the lowest values (4 of 13; 30.8%). The rates were: 44.4% for amoxicillin alone (4 of 9); 70% for triple therapy consisting of amoxicillin, metronidazole, and bismuth subnitrate (14 of 20); and 87.5% for concomitant therapy of the PPI plus amoxicillin (7 of 8). Reinfection rates of H. pylori within 1 year after eradication of this organism were distinctly higher in the PPI alone group (80%) than in other groups (18.2%-32.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Non-selective reinnervation by regenerating facial motoneurons after peripheral nerve crush in the developing rat.

To study the regeneration process after the facial nerve crush in the neonatal period, the location of cranial motoneurons supplying the posterior belly of the digastric muscle (PDG) and the vibrissae follicular muscles was examined using retrograde tracing methods in the rat with facial nerves that had been surgically injured 1-2 day(s) after birth. In different stages after the induced facial palsy was functionally recovered, i.e. 4-20 weeks after the surgical operation, Fluoro-Gold (FG) was injected into the PDG, while wheat germ-agglutinated horseradish peroxidase (WGA-HRP) was injected into the vibrissae follicular muscles. Distribution of neurons retrogradely labeled with FG and/or WGA-HRP was then examined in the brainstem. On the intact side, used as a control, FG-positive neurons were restrictedly seen within the accessory facial nucleus (Acs7), while HRP-positive neurons were found in the main facial nucleus (FMN) proper. On the injured sides with any survival periods: 1) FG-positive neurons were diffusely seen not only in the Acs7 but also in the FMN, where the normal myotopical representation seemed to be no longer maintained. 2) HRP-positive neurons were also seen scattered not only in the FMN but in the Acs7. 3) The volume and cell number in both the Acs7 and the FMN were notably reduced. Thus, the present results indicate: 1) that the misdirectional regeneration of nerve fibers occurs widely across the facial motoneuron pools, and 2) that the non-selective distribution can never be restored to the selective one when severely damaged even in the neonatal periods.

Animals↗
PubMed1994

[Plasma catecholamine levels in patients during surgical removal of pheochromocytoma under sevoflurane anesthesia].

We measured plasma catecholamine levels and hemodynamics in 5 patients during surgical removal of pheochromocytoma under sevoflurane anesthesia. Plasma catecholamine levels were unchanged with sevoflurane anesthesia. Plasma epinephrine, norepinephrine and dopamine levels increased 149 folds, 7.8 folds and 2.9 folds respectively as compared with preanesthetic values during surgical manipulation of the tumor, and then declined in magnitude but still remained 15 folds, 2.7 folds and 1.8 folds higher respectively as compared with the preanesthetic levels after removal of the tumor. These catecholamine levels finally reached 180%, 20% and 60% of the preanesthetic values respectively after the emergence from anesthesia in the recovery room. Mean systolic and diastolic arterial blood pressures were 127/82 mmHg before anesthetic induction and increased to 211/71 mmHg during manipulation of the tumor. Then they decreased to 75/52 mmHg immediately after removal of the tumor but recovered up to 126/71 mmHg on recovery from anesthesia. Alpha and beta adrenal blockers were administered if necessary to control hypertension and tachycardia during manipulation of the tumor. Hypotension after removal of the tumor was treated with volume replacement, vasopressor and/or catecholamines. No correlation was found between plasma catecholamine levels and arterial blood pressure in our study except during manipulation of the tumor. No arrhythmias were observed during anesthesia and surgery in our cases even though plasma catecholamines increased extremely with surgical intervention. We conclude that sevoflurane anesthesia is a better choice for surgery for pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1994

[Small nodular lesions of the pancreas: differential diagnosis with ultrasound angiography].

Ultrasound angiography (USAG), sonographic imaging of the blood flow in an organ or tissue obtained by carbon dioxide infusion into the supplying artery, was performed on 28 pancreatic nodular lesions less than 3 cm in diameter. The hemodynamics of tumors observed with USAG were divided into three groups: hypovascular, isovascular, and hypervascular, compared with the adjacent pancreatic tissue. Most of hypovascular nodules were duct cell carcinoma (sensitivity 94.1%, specificity 90.4%), while isovascular lesion was the characteristic of inflammatory masses (sensitivity 100%, specificity 95.8%). Hypervascular cases included all of the mucin producing tumors and islet cell tumors but only one case of duct cell carcinoma. So you can almost exclude duct cell carcinoma as an diagnosis in vascular rich tumors (negative predictive value 83.6%). These results were compared with those on conventional x-ray angiograms and incremental CT scans. Ultrasound angiography enabled us to detect more slight differences of tumor vascularity than the other modalities. Thus we conclude that USAG can be a useful diagnostic aid in small mass lesions of the pancreas.

Adenocarcinoma, Mucinous↗
PubMed1994

A case of cerebellar neuroectomesenchymoma in an infant.

This case report concerns a congenital cerebellar tumor in an infant. The tumor consisted of small, immature lymphocyte-like cells, medium-sized, rhabdoid cell-like cells, and large, polymorphic gemistocytic astrocyte-like cells, which were admixed in motley form on a background of neuronal matrix and dural and collagen fibrous tissues. Immunohistochemical studies revealed that the cytoplasm of rhabdoid cells had conspicuous structures, resembling weakly eosinophilic homogeneously amorphous inclusion bodies, and that the strongly eosinophilic cytoplasm, seen abundantly in the gemistocytic astrocyte-like cells, was a mixture of components that were positive for glial fibrillary acidic protein (GFAP) and vimentin and of components positive for myoglobin. Because of the simultaneous expression of both, neuroectodermal and mesenchymal characteristics the reported tumor was not a mixed tumor of independent neuroectodermal and mesenchymal tumor components, but a very rare neuroectomesenchymoma derived from immature cells with pluripotential differentiating capabilities.

Biomarkers, Tumor↗
PubMed1993

Neurogenetical segregation of the vestibulospinal neurons in the rat.

The time of origin of the vestibulospinal projection neurons was determined by a double-labeling method using 5-bromodeoxyuridine (BrdU), the thymidine analogue, and Fluoro-Gold (FG), a retrograde fluorescent tracer. Rat fetuses were exposed to BrdU in utero to label the vestibular neurons on one of the embryonic (E) days between E12 and E15. Upon reaching adulthood, the rats were given unilateral injections of FG into the cervical cord to identify the spinal projection neurons. Brainstem sections were immunohistochemically processed for BrdU and then examined for neurons that were both BrdU-positive and FG-positive in the vestibular nuclei. In the lateral vestibular nucleus (LVe), most of the vestibulospinal neurons were generated on E12. In the inferior vestibular nucleus (IVe), the vestibulospinal neurons were produced almost equally on both E12 and E13. In the medial vestibular nucleus (MVe), the vestibulospinal neurons were generated consistently on days between E12 and E14 with a mild peak on E13. The present results thus demonstrate that genesis of the vestibulospinal neurons occurs sequentially in the following order: firstly in the LVe, secondly in the IVe, and finally in the MVe. The different sequential generation of vestibulospinal neurons among the LVe, MVe and IVe may reflect the fact that the vestibulospinal projections are differentially organized depending on the nature of each subnucleus.

Animals↗
PubMed1993

Measurement of functioning hepatocyte mass via [99mTc]galactosyl-neoglycoalbumin.

Technetium-99m-galactosyl-neoglycoalbumin (TcNGA) is a synthetic radiolabeled ligand specific for hepatic binding protein (HBP), a receptor that resides exclusively on hepatocytes. In vivo measurement of receptor concentration was obtained via kinetic analysis of liver and blood time-activity data obtained during the hepatic clearance of intravenously administered TcNGA. The purpose of this study was to assess receptor concentration as a measure of the functioning hepatocyte mass. Therefore, TcNGA and dual-injection indocyanine green maximal removal rate (ICG Rmax) studies were performed on nine patients with hepatic cirrhosis associated or not with hepatocellular carcinoma. Receptor concentration was compared with ICG Rmax, which is a validated method for the estimation of the functioning hepatocyte mass. The correlation coefficient was 0.76 (P = 0.017). It is concluded that HBP concentration ([HPB]o) as measured by functional imaging is a measure of functioning hepatocyte mass. This implies that measurement of an individual's receptor concentration by using nuclear medicine techniques provides an objective index of hepatic functional mass and supports attempts to rigorously evaluate [HBP]o for its clinical efficacy.

Aged↗
PubMed1993

The role of Helicobacter pylori in peptic ulcer disease.

The linking of relapse of duodenal as well as gastric ulcers with Helicobacter pylori (H. pylori) has been a considerable advance in managing patients with peptic ulcer disease. However, pathogenetic role of H. pylori in peptic ulcer still remains unclear. The aim of this study was to assess the relationship between H. pylori infection and inflammatory cell infiltration in gastric mucosa in peptic ulcer disease. Sixty-four patients with endoscopically proven gastric ulcer and 26 patients with duodenal ulcer were evaluated by prospective study. Biopsy specimens were taken from the ulcer margin, corpus and antrum. Eradication of H. pylori was attempted by concomitant administration of amoxycillin 500 mg, metronidazole 250 mg and bismuth subnitrate 1 g twice daily for 2 weeks. H. pylori positive rates in clinical stages of gastric and duodenal ulcer showed almost the same values of more than 90%. The prevalence of H. pylori at the antrum and corpus was almost the same as that between gastric and duodenal ulcer patients, whereas a dramatic difference in the positive rates at the ulcer margin was observed between gastric and duodenal ulcer patients (83.9% and 35.0%, respectively). The prevalence of polymorphonuclear (PMN) cell infiltration at the ulcer margin was still high even at the scarring stage of gastric and duodenal ulcer with positive H. pylori, whereas a dramatic decrease of PMN cell infiltration was observed at the ulcer margin after successful eradication of H. pylori. These results suggest that H. pylori may play an important role in the pathogenesis of gastric and duodenal ulcer by inducing inflammatory cells such as PMN cells in gastric mocosa.

Amoxicillin↗
PubMed1993

Concentration of orally administered antimicrobial agent in burn scar tissue, granulation tissue, normal skin and serum.

Tissue and serum concentrations of orally administered ofloxacin were measured using high performance liquid chromatography. From 56 patients who received 200 mg of ofloxacin prior to surgery, 103 specimens including 48 of serum, 32 of scar tissue, 18 of normal skin and five of granulation tissue were harvested between 2 and 3 h after administration. The ofloxacin values were 1798.6 +/- 1125.5 ng/g in the granulation tissue followed by 1525.5 +/- 1002.7 ng/ml in the serum, 1450.0 +/- 1011.3 ng/g in the scar tissue and 1092.8 +/- 593.3 ng/g in normal skin. There was no statistically significant difference between the ofloxacin concentrations in those four specimens by ANOVA test.

Administration, Oral↗
PubMed1993

Syntheses and biological activities of chemically stable prostacyclin mimics with cis-bicyclo[4.3.0]nonene ring system: the novel homoisocarbacyclin analogues.

The synthetic studies concerning a series of homoisocarbacyclin analogues, which are homologous compounds of isocarbacyclin, with cis-bicyclo[4.3.0]non-2-ene or cis-bicyclo[4.3.0]non-3-ene as a nucleus have been carried out. The general synthetic methods of homoisocarbacyclin analogues have been accomplished starting with the versatile Corey lactone. Among the analogues synthesized in the present studies, a promising compound (TY-11223) exhibiting a good selectivity in biological actions was found to be studied further.

Animals↗
PubMed1993

[Seroepidemiological study on hepatitis C virus infection in an endemic area of hepatitis C virus].

To clarify the prevalence of hepatitis C virus infection in a rural area with high incidence of chronic liver disease in Japan, sera from 412 inhabitants, aged 20-89 years, collected in 1989-1990 and sera from 483 inhabitants in the same area, collected in 1982 were tested for anti-HCV (antibody to C100-3) with the first-generation enzyme-linked-immunosorbent-assay (ELISA). In addition, sera from 118 inhabitants, aged 20-49 years, collected in 1989-1990 were tested for HCV-RNA with the polymerase chain reaction technique, with use of primers from the 5'-untranslated region of the HCV genome. Anti-HCV was positive in 175 out of 412 sera collected in 1989-1990 (42.5%): prevalence was higher in male (54.0%) than in female (34.9%). The prevalence rates in the 20-29, 30-39, 40-49, 50-59, 60-69, and 70-89 year-old group were 0%, 14.3%, 51.9%, 41.7%, 49.1%, and 53.1%, respectively. On the other hand, in sera collected in 1982, the overall prevalence of anti-HCV was 42.5% (175 of 412). The prevalence rates in the 20-29, 30-39, 40-49, 50-59, 60-69, and 70-89 year-old group were 12.5%, 43.3%, 51.5%, 50.3%, 60.7%, and 68.9%, respectively. The prevalence rate of young adults less than 40 years old in 1982 were higher than that in 1989-1990. In short, the prevalence of hepatitis C virus infection in this area had altered a great deal. HCV-RAN was detected in 42 of 118 (35.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Cerebral aneurysm associated with multiple endocrine neoplasia, type 1--case report.

Cerebral aneurysm associated with pituitary adenoma and other endocrine dysfunctions occurred in a 45-year-old female suffering from multiple endocrine neoplasia, type 1 (Wermer's syndrome). She died of subarachnoid hemorrhage secondary to rupture of the aneurysm. Pituitary adenoma and/or other endocrine dysfunctions associated with multiple endocrine neoplasia, type 1 may be a factor in the aneurysm formation.

Adenoma↗