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Biomedical subjects

M Masuda

Publications and source records attributed to M Masuda.

At least 469 records · Page 26Linked to original sources

[A case report of hypertrophic obstructive cardiomyopathy after the correction of atrioventricular septal defect].

A 47-year-old woman who had closure of an atrioventricular septal defect and repair of mitral cleft developed severe dyspnea on effort 6 years after surgery. An echocardiography showed asymmetric left ventricular hypertrophy and a left cardiac catheterization revealed marked intraventricular pressure gradient and moderately severe mitral regurgitation. The patient underwent mitral valve replacement through transseptal approach during empty beating heart. Symptomatic relief was obtained and marked reduction of intraventricular systolic pressure gradient was noted in postoperative cardiac catheterization about 40 days after the operation. Mitral valve replacement should be considered for the treatment of hypertrophic obstructive cardiomyopathy in severe cases with associated morphological abnormality of mitral leaflet or severe mitral regurgitation.

Cardiomyopathy, Hypertrophic↗

[Adult T-cell leukemia with massive melena due to marked gastrointestinal involvement].

A 60-year-old man born in Okinawa was admitted to our hospital because of epigastralgia. Physical examination revealed general lymphadenopathy, mild hepatomegaly and skin eruption. The peripheral blood leukocyte count was 168,600/microliters, with 93% abnormal lymphocytes showing convoluted or lobulated nuclei. Anti HTLV-1 antibody was positive with titer of 1: 1280 (PA). Leukemic cells had typical ATL cells' surface markers (OKT3; 97.2%, T4; 93.3%, T8; 2.8%, OKIA1; 39.6%, IL-2R; 41.8%) and complete monoclonal HTLV-1 provirus DNA. Endoscopic examination with biopsy revealed massive involvement of ATL cells into gastric mucosa. In the course of the treatment, he had extremely massive melena, and was saved by emergency operation. Multiple ulcers were found in the resected colon. Histological examination showed the marked infiltration of the ATL cells into the mucous or submucous membrane. Thereafter, he was treated well with ALG (Anti Lymphocyte Globulin), until hypercalcemia occurred. He died of acute renal failure after hypercalcemia.

Gastrointestinal Neoplasms↗

[A case of cystitis cystica and glandularis suspected of submucosal tumor of urinary bladder].

A case of cystitis cystica and glandularis is reported. The patient visited our hospital with the complaint of terminal miction pain. Cystoscopic examination showed a walnut-sized, well-defined mass in the retrotrigone. The surface of the mass was nodular and partially cystic. Computer tomography showed a mass protruding inside and outside of the bladder. Transurethral biopsies of the mass revealed cystitis cystica and glandularis.

Adult↗

[Psychogenic urinary retention: report of two cases].

Case 1 was a 24-year-old woman, with a broken heart who complained of urinary retention. Cystometry revealed a hypoactive bladder without detrusor contraction. Case 2 was a 30-year-old man, who thought that he had renal failure. Urodynamic study showed hypoactive bladder without detrusor contraction. External sphincter electromyograph revealed no evidense of detrusor sphincter dyssynergia. These 2 cases were treated by psychotherapy, administration of diazepam and bethanechole, and intermittent self catheterization. The Japanese literature on the psychogenic urinary retention is briefly discussed.

Adult↗

[Transurethral resection of bladder outlet obstruction from carcinoma of the prostate].

Transurethral resection (TUR) in combination with endocrine therapy was performed on 30 patients who were on initial treatment for carcinoma of the prostate and 6 patients who had previously been treated for this disease, 5 of whom were suffering from relapse after a satisfactory response to endocrine therapy. This paper reports the results viewed from potential promoting of metastasis and improvement in bladder outlet obstruction. Prior to TUR, urinary retention was present in 11 of initially treated patients (36.7%) and in three of the previously treated patients (50.0%). The average duration of postoperative indwelling catheter was 3.9 +/- 1.6 days in the initially treated group and 5.2 +/- 3.1 days in the previously treated group. Among the initially treated group, two patients with poorly differentiated adenocarcinoma advancing from Stage C to Stage D (15.4%) developed postoperative metastases which demonstrated at 14 and 42 months; the timing of their occurrence, however, was thought to preclude relating the metastases to TUR. Although metastasis occurred early in two patients among the previously treated group (33.3%), it was considered a natural disease course in relapse cases. Obstructive voiding symptoms recurred postoperatively in three patients of the initially treated group (10.0%) and three patients of the previously treated group (50.0%) during 6 months or more of follow-up periods. UR performed for carcinoma of the prostate proved to be fully safe and effective in the initially treated patients, while admitting that a considerable number of relapses seen in the previously treated patients degraded its benefit to some extent. We conclude that TUR contributed to the better quality of life in both initially and previously treated groups of patients with carcinoma of the prostate.

Adenocarcinoma↗

[Clinical assessment of prosthetic valve replacement of the right-sided cardiac valves: mechanical or bioprosthesis?].

Clinical results with mechanical and bioprosthetic valve replacements for tricuspid and/or pulmonary positions were reviewed. Between February 1975 and December 1985, 34 bioprostheses (B) (22 Hancock, 9 Ionescu-Shiley and 3 Carpentier-Edwards pericardial) and 18 mechanical prostheses (M) (St. Jude Medical) were implanted in our institute excluding hospital death. Group with B included 29 tricuspid valve replacements and 5 pulmonary valve replacements. Group with M included 9 tricuspid valve replacements, 7 pulmonary valve replacements and 1 both valve replacements. The cumulative follow-up period was 207.2 patient-years (p-t) in group B and 55.0 p-y in group M. The incidence of valve failure was 0.48 +/- 0.48% per p-y in group B and 7.27 +/- 3.64% per p-y in group M (p less than 0.001). The incidence of valve-related events was 1.93 +/- 0.97% per p-y in group B and 9.09 +/- 4.07% per p-y in group M (p less than 0.001). At 3 years, the percent free of valve failure was 100 +/- 0% in group B and 76.8 +/- 10.2% in group M (p less than 0.05). Fourteen bioprosthetic valves (B') and 10 mechanical valves (M') were implanted at the right-sided cardiac valve position alone. The cumulative follow-up period was 94.2 p-y in group B' and 32.3 p-y in group M'. The incidence of valve-related events was 1.06 +/- 1.06% per p-y in group B' and 12.4 +/- 6.19% per p-y in group M' (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Effect of recombinant GM-CSF and recombinant G-CSF on colony formation of blast progenitors in acute myeloblastic leukemia.

The colony-promoting activities of recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) and recombinant granulocyte colony-stimulating factor (rG-CSF) on primary and secondary colony formation by blast progenitors (leukemic colony-forming units [L-CFU]) from 21 patients with acute myeloblastic leukemia (AML) were examined using blast colony assay and compared to colony promotion stimulated by phytohemagglutinin-stimulated leukocyte-conditioned medium (PHA-LCM). Recombinant GM-CSF stimulated blast colonies in 13 out of 20 cases examined (1 case not done). The magnitude of stimulation by rGM-CSF varied significantly according to the type of AML, but in general was lower than that of PHA-LCM. Blast cells of type M1 did not form any colonies with rGM-CSF, although numerous colonies were produced with PHA-LCM. Type M4 blasts formed fairly large numbers of colonies, though slightly less than those stimulated by PHA-LCM. Blasts of type M2 and M5 formed colonies with the stimulation of rGM-CSF, but the numbers were considerably smaller than type M4 and those stimulated with PHA-LCM. Recombinant G-CSF stimulated blast colonies in only 5 out of 21 cases, 3 of them being type M2. The number of cases responding to rG-CSF was significantly smaller than that responding to rGM-CSF, and even in cases in which colonies were formed, the magnitude of stimulation was minimal. From these results it seems likely that blast cells of different types of AML require a different kind of CSF for their optimal growth; type M4 blasts responded to the stimulation of rGM-CSF well, but blasts of other types of AML responded poorly. Thus, except for type M4, CSF(s) other than rGM-CSF seems to be required for the sufficient growth of L-CFU. Recombinant G-CSF is not likely to play an essential role in the proliferation of leukemic blasts of most types. Previous exposure to rGM-CSF and rG-CSF did not alter the self-renewal capacity, cellular phenotype, and morphology of colony cells, indicating that the direction and degree of differentiation of L-CFU stimulated by rGM-CSF or rG-CSF were not different from those stimulated with PHA-LCM.

Colony-Stimulating Factors↗

[A new trial assessment of left ventricular function before and after aorto coronary bypass surgery--application of ejection vector (E.V.)].

In 34 patients underwent aorto coronary bypass, left ventriculography was analyzed and ejection indexes (E.F. 100, E.F. 50, E.V. = 2 X E.F. 50/E.F. 100) were calculated. There was not difference in ejection indexes of patients between who had been complicated with preoperative myocardial infarction and not. E.F. 100 was not changed postoperatively, otherwise, E.F. 50 and E.V. showed significant increase. In 15 patients whose quality of life remarkably was improved postoperative period, E.F. 100 was not changed but E.F. 50 and E.V. were significantly increased. Four patients could not perform exercise test to full dose because of intractable ischemic calf pain. In twelve patients, whose left ventricular function was improved at postoperative exercise test, their E.F. 100 was found to be unchanged, but in contrast, E.F. 50 and E.V. were increased significantly. In conclusion, we found that E.V. could become to be more sensitive indicator of left ventricular function compared with E.F. 100 before and after aorto coronary bypass surgery.

Adult↗

Simple enzymatic method for determining 1,5-anhydro-D-glucitol in plasma for diagnosis of diabetes mellitus.

We have developed a simple method for determination of 1,5-anhydro-D-glucitol in plasma, based on use of pyranose oxidase (EC 1.1.3.10), an enzyme with specificity toward pyranoid compounds such as 1,5-anhydro-D-glucitol and glucose. Plasma samples deproteinized with trichloroacetic acid are passed through a two-layer mini-column packed with strongly basic anion (OH- form, the upper layer) and strongly acidic cation (H+ form, the lower layer) exchange resins. 1,5-Anhydro-D-glucitol is efficiently recovered in the flow-through fraction, which is almost devoid of other sugars that are sensitive to pyranose oxidase. The hydrogen peroxide formed in the enzymatic oxidation of 1,5-anhydro-D-glucitol is detected by a standard method utilizing an enzymatic color-developing system. The overall assay system is highly specific for 1,5-anhydro-D-glucitol. The correlation between results obtained in the present method (x) and in the gas-liquid chromatographic (GLC) method (y) was: y = 1.062x-0.293 mg/L (r = 0.997, n = 49, Sxy = 10.78 mg/L). Compared with GLC, our method is simpler in the sample treatment step and quicker in the measuring step. The precisions of the two methods are comparable.

Benzothiazoles↗

[Surgical aspect of active infective endocarditis].

Twenty patients with active infective endocarditis, 11 with native valve endocarditis (NVE) and 9 with prosthetic valve endocarditis (PVE), were treated surgically from 1975 through April 1987 at Kyushu University Hospital. The operative indications were congestive heart failure mainly due to massive aortic regurgitation in 18, periannular abscess in 6, major embolism in 5 and severe hemolysis in 3 patients. In the group of NVE, single aortic valve replacement was performed in 4 patients and multiple valve replacement in the remainder. One patient died early postoperatively from LOS. Two patients with recurrent infective endocarditis, which occurred within 60 days after previous prosthetic valve replacement, were operated subsequently as early PVE. All other patients became NYHA class I postoperatively except for one patient who died from thrombosed valve. In the group PVE, re-AVR was done in 3, re-MVR in five, double valve replacement in two and re-fixation of the prosthesis to the aortic annulus in one patient. Two patients with early PVE died from recurrent endocarditis late postoperatively. One of 7 patients with late PVE, who had suffered from myocardial and cerebral infarction before reoperation, died from multiple organ failure. There were 3 patients with perivalvular leakage due to late active PVE, whose preoperative signs of inflammation were negative or minimum. As recurrent perivalvular leakage due to persistent infective endocarditis might frequently occur in such cases, complete resection and debridement of infected foci should be emphasized.

Adolescent↗

Comparison of serum assays for TAG-72, CA19-9 and CEA in gastrointestinal carcinoma patients.

Tumor-associated glycoprotein (TAG-72) has been shown to be expressed in a wide variety of epithelial malignant tissues. We have investigated serum levels of TAG-72 antigen in patients with gastrointestinal cancer with a solid phase radioimmunometric assay (RIA), CA72-4, utilizing murine monoclonal antibodies CC49 and B72.3 which recognize the TAG-72 antigen. Elevated levels of serum TAG-72 antigen were found in 48% of 56 gastric carcinoma patients and 67% of 45 colorectal carcinoma patients. The serum concentrations of TAG-72 were compared to those of CA19-9 and CEA. The positive rates of CA19-9 in gastric carcinoma and colorectal carcinoma patients were 29% and 54%, and those of CEA were 52% and 60%, respectively. Elevated serum levels of TAG-72, CA19-9 and CEA were observed in 7%, 14% and 24%, respectively, of patients with benign disease, thus indicating a preferential expression of TAG-72, compared to CA19-9 and CEA, in gastrointestinal carcinoma patients versus in patients with benign disorder. A cocktail of CA72-4, CA19-9 and CEA RIAs increased positive rates to 68% in sera of gastric cancer patients and 84% in sera of colorectal cancer patients. Combination assays using CA72-4, CEA and CA19-9 RIAs for patients with benign gastrointestinal disorder, however, also increased the positive rate to 31%. These results indicate that CA72-4, CA19-9 and CEA RIAs may be complementary in detecting circulating tumor-associated antigens. It must be emphasized, however, that interpretation of the data provided by the combination serum assays requires careful consideration.

Antibodies, Monoclonal↗

Upstream region of hepatitis B virus S gene responsible for transcriptional stimulation by dexamethasone.

Transcriptional regulation of hepatitis B virus (HBV) surface antigen (HBs Ag) gene was studied in human hepatoma-derived cell lines. Treatment with dexamethasone (Dex; 1 microM) induced an increase in the smaller HBs-mRNA initiated within Pre-S region encoding S and Pre-S2 proteins, but not the larger HBs-mRNA initiated in the further upstream encoding Pre-S1 protein. The Bg1II-MstII fragment (map position 2425-3201) in the upstream of the S gene was used as a transcriptional promoter of chloramphenicol acetyltransferase (CAT) gene. The CAT activity brought about by this construct in the transient assay was elevated by 5-fold in the presence of Dex. Deletion analysis localized the sequence required for the full response to Dex within a 590-base pair fragment in the upstream of the transcriptional initiation site of the smaller HBs-mRNA. And this fragment contained the binding site for the nuclear factor I (NF-I), which might have some role in Dex-dependent transcriptional stimulation.

CCAAT-Enhancer-Binding Proteins↗

Miconazole and amphotericin B alter polymorphonuclear leukocyte functions and membrane fluidity in similar fashions.

The influence of miconazole on polymorphonuclear leukocytes (PMN) was investigated and compared with that of amphotericin B (AmB). Human PMN were preincubated in vitro with miconazole or AmB at therapeutically attainable concentrations in plasma, and their chemotactic functions were assessed with the synthetic chemotactic peptide N-formylmethionyl-leucyl-phenylalanine (FMLP). Changes in membrane fluidity of PMN were examined by an excimer-forming lipid technique. Adherence of PMN was measured by a nylon fiber column method. Miconazole and AmB pretreatment irreversibly depressed PMN random migration and chemotaxis under agarose but did not influence superoxide anion production. Both miconazole and AmB increased PMN adherence. Miconazole and AmB lowered the binding affinity of FMLP receptors on PMN and decreased the membrane fluidity in a similar manner. These results demonstrate that miconazole and AmB alter selected in vitro membrane properties of human PMN.

Amphotericin B↗

Abnormal membrane fluidity as a cause of impaired functional dynamics of chemoattractant receptors on neonatal polymorphonuclear leukocytes: lack of modulation of the receptors by a membrane fluidizer.

Membrane properties associated with chemoattractant-mediated cellular responsiveness of neonatal polymorphonuclear leukocytes (PMN) were analyzed using n-formylmethionyl-leucyl-phenylalanine. Inasmuch as aliphatic alcohols as a membrane fluidizer can enhance the chemoattractant binding and affect subsequent cellular responsiveness in adult PMN, neonatal PMN were studied for such properties by their treatment with iso-propyl alcohol, an aliphatic alcohol. The alcohol (less than 2.5%) treatment enhanced the N-formylmethionyl-leucyl-phenylalanine binding to adult PMN, but there were no changes in the N-formylmethionyl-leucyl-phenylalanine binding to neonatal PMN. Although the N-formylmethionyl-leucyl-phenylalanine-induced subsequent responsiveness including migration, lysosomal enzyme release and superoxide anion production were modulated by the alcohol treatment in adult PMN, there was no such modulation in neonatal PMN. Because membrane fluidity is largely involved in the regulation of the receptor functions, the membrane fluidity of neonatal PMN was next measured by an excimer-forming lipid technique in flow cytometry. The membrane fluidity value (0.45 +/- 0.037) of neonatal PMN was lower than that (0.74 +/- 0.072) of adult PMN (p less than 0.01). Although the aliphatic alcohol enhanced the membrane fluidity of adult PMN, it did not affect the membrane fluidity of neonatal PMN. We conclude that there is abnormal membrane fluidity as a cause of impaired functional dynamics of the chemoattractant receptors, which appears to underlie the defective modulation of cell functions by the membrane fluidizer in neonatal PMN.

1-Propanol↗