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Biomedical subjects

M Masuzawa

Publications and source records attributed to M Masuzawa.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Parenteral and enteral nutritional support for patients with liver cirrhosis].

In liver cirrhosis, metabolic processes deteriorate, and serum amino acid imbalances may develop. Aromatic amino acids accumulate and branched-chain amino acids (BCAA) deficiencies develop, leading to hepatic encephalopathy and malnutrition. According to Fischer's reports, parenteral nutritional support with BCAA rich solution (Aminoleban (Otsuka), Morihepamin (Morishita)) is useful in patients with hepatic encephalopathy. Enteral nutritional support with BCAA rich solution (Aminoleban EN (Otsuka), Hepan-ED (Morishita)), together with low protein diet, may correct the specific metabolic abnormalities in patients with chronic hepatic failure and contribute to regain the quality of life and survival.

Amino Acids↗
PubMed1993

Clinical applications of ICG Finger Monitor in patients with liver disease.

The indocyanine green (ICG) Finger Monitor system is a non-invasive indication of ICG concentrations in the blood. In this study, significant correlation was found between the sensor signal voltage and plasma ICG concentrations ranging from 0.04 mg/dl to 1.0 mg/dl (r = 0.998, P < 0.001) in vivo. The ICG clearance curve showed an initial sharp rise 20-30 s after bolus injection, followed by a small rise. The concentration then deceased exponentially. In 196 patients with chronic liver disease, there was a close correlation between the KICG (plasma disappearance rate) and R15 (blood retention ratio at 15 min) (r = 0.886, P < 0.001, r = 0.912, P < 0.001) and corresponding values calculated by the conventional ICG method. In 263 cases with chronic liver disease, the plasma disappearance rates calculated using this monitor (mean +/- S.D.) were 0.156 +/- 0.064 (n = 20) in the control group, 0.129 +/- 0.060 (n = 92) in the chronic hepatitis group, 0.048 +/- 0.025 (n = 59) in the cirrhosis group and 0.059 +/- 0.03, (n = 92) in the group with hepatocellular carcinoma. A significant difference in the plasma disappearance rate and blood retention ratios 15 min after injection of ICG using this system was observed between control cases and the chronic hepatitis and cirrhosis groups (P < 0.0001). In 36 cases, the time from injection to the appearance of ICG in the fingertip significantly decreased in the cirrhosis group (P < 0.01). The ICG Finger Monitor system was shown to be useful clinically as well as for research due to its accuracy and non-invasive nature.

Adult↗
PubMed1993

Erythroderma, hair loss, and sinus histiocytosis with massive lymphadenopathy in a XYY-male.

This paper presents a case of sinus histiocytosis with massive lymphadenopathy (SHML) presenting as erythroderma in an XYY-male aged 27. The patient had little or no scalp, axillary, or pubic hair. Histologically, lymph nodes indicated dilatation of the sinuses with proliferation of benign-appearing histiocytes possessing abundant clear cytoplasm, admixed with giant cells and pericapsular fibrosis. Infiltrating histiocytes in the lymph nodes were OKM-1 (CD11b) positive, which is characteristic of monocyte-granulocyte lineages. In the present case, the abnormal presence of erythroderma, hair loss, SHML, and a chromosomal abnormality, XYY, were thought to be incidental features.

Adult↗
PubMed1993

[Chemotherapy for the treatment of angiosarcoma].

A common type of angiosarcoma in the dermatological field is Wilson-Jones type angiosarcoma arising on the head and neck of elderly. It is called malignant hemangioendothelioma (MHE) and its prognosis is extremely poor, even though treated with the present state of the art: surgical excision, radiation, chemotherapy, and immunotherapy. Recently, chemotherapy has been done with CYVADIC (CPM, VCR, ADM, DTIC), and in some cases intraarterial fusion of ADM and 5-FU has been tried in combination therapy. But older patients are particularly intolerant of this chemotherapy, because of its severe toxic effects. Unfortunately, there is no evidence that these chemotherapeutic trials have helped to improve the prognosis.

Aged↗
PubMed1992

Analysis of prognostic factors in patients with hepatocellular carcinoma treated by transcatheter arterial embolization.

We studied 240 cases of unresected hepatocellular carcinoma (HCC) using Cox's proportional hazard model to elucidate which factors would be closely related with the survival period after treatment by transcatheter arterial embolization (TAE) in the presence or absence of iodized oil. The results were as follows. The cumulative survival values obtained after TAE were 67.5% for 1 year, 32.0% for 2 years, and 20.5% for 3 years. The most significant prognostic factor was the degree of extension of tumor embolus in the portal vein or its branch. The tumor extension and the tumor type were also important factors. Age, sex, and AFP, HBsAg, and HCV Ab values were not useful as prognostic factors. This study provides a rational background for the selection of treatment for HCC. Furthermore, knowledge of the prognostic factors is useful for the management of patients, particularly in maintaining their good quality of life.

Adult↗
PubMed1992

Unusual cutaneous lesions associated with chronic myelomonocytic leukaemia.

A 69-year-old man presented with unusual nodular cutaneous lesions of 3 years duration predominantly involving the chest, upper back and scalp. Histopathological changes in biopsy specimens from affected skin resembled those seen with granuloma annulare even though there was a lack of epithelioid cells. Based on the sluggish course of the condition, leukocytosis with monocytosis in peripheral blood and the findings on electron microscopic examination of peripheral blood cells, he was diagnosed as having chronic myelomonocytic leukaemia (CMMoL). At lower magnification under the electron microscope, the nodular skin lesions showed pleomorphic cell features with monocytes and histiocytic cells of abnormal appearance. The skin lesions were thus considered to be an unusual type of leukaemia cutis.

Aged↗
PubMed1991

Two-dimensional flow cytometric analysis of intrahepatic lymphocyte subsets from patients with chronic hepatitis.

Peripheral and intrahepatic lymphocyte subsets were analyzed in 22 patients with chronic hepatitis by two-dimensional flow cytometry. Activated T cells in the liver significantly increased compared with those in the peripheral blood. Helper T cells increased, but the CD4+ cells decreased due to a marked decrease of suppressor inducer T cells. CD8+ cells increased due to a increase of both cytotoxic T and suppressor T cells. Fc-receptor-positive cells, which increased significantly, were not NK cells but Fc-receptor-bearing T cells. In comparison with immunohistochemical methods, flow cytometric analysis enables more objective quantitation and simpler two-color staining of intrahepatic lymphocytes. Our findings using this method suggest that activated T cells and helper T cells have important roles in hepatitis and that hepatocellular injury may be generated not only by cytotoxic T cells but also by Fc-receptor-bearing T cells.

Adult↗
PubMed1991

Renal kinin and kallikrein excretion in cirrhotic patients.

Urinary kinin and urinary kallikrein activity were measured in 33 liver cirrhotics, and the values were correlated with the severity of the liver disease. A significant relationship was observed between urinary kinin excretion and urinary kallikrein excretion (r = 0.53; p less than 0.01). Both urinary kinin and kallikrein excretion were significantly lower in Child's group C than in Child's groups A and B (p less than 0.05) and showed positive correlations with serum albumin (r = 0.47, p less than 0.01 and r = 0.46, p less than 0.01, respectively). Increases in urinary kinin and kallikrein excretion after endoscopic variceal sclerotherapy were observed in 18 patients (p less than 0.01 and p less than 0.05, respectively). These results suggest that the renal kallikrein-kinin system in suppressed in severe liver disease in proportion to the severity of the underlying liver disease. In this study possible activation of this system after sclerotherapy was also demonstrated.

Esophageal and Gastric Varices↗
PubMed1991

[A dramatic effect of continuous intra-arterial injected recombinant interleukin-2 immunotherapy on malignant hemangioendothelioma].

A malignant hemangioendothelioma (MHE) developed on the frontal scalp of an 83-year-old woman was treated with intralesional injection of recombinant interleukin-2 (rIL-2, TGP-3, Takeda Chemical Industries LTD, Osaka) which had lead the lesion to complete remission for 2 years and 9 months. After the period of the complete remission, the patient developed MHE lesion on the occipital scalp which rapidly enlarged to more than 10 cm in diameter within 7 days, though there was no recurrence of MHE on the frontal scalp at that time. Intra-arterial rIL-2 injection was conducted through the occipital artery which circulates around the tumor lesion, but resulted unsuccessful because of the obstruction of the artery. Continuous intra-arterial rIL-2 injection through bilateral superficial temporal arteries was conducted, and then the tumor lesion came to complete remission on both clinical and histological data. So far, the patient has been showing no local recurrence or metastasis for the period of 8 months. We conclude that continuous intra-arterial rIL-2 injection immunotherapy through superficial temporal arteries is the best way of all the treatment in cases with recurrent MHE located on occipital scalp.

Aged↗
PubMed1990

Urinary neutral glycosphingolipid analysis of patients with Fabry's disease; rapid isocratic elution from high-performance liquid chromatography as per-o-benzoyl derivatives.

Neutral glycosphingolipids from urinary sediments of six patients with Fabry's disease and 11 members of the family of one propositus were analyzed using high-performance liquid chromatography. Per-o-benzoyl derivatives of GlcCer, LacCer, GbOse3Cer and GbOse4Cer were clearly resolved by a solvent mixture of hexane/dioxane/isopropanol (75:25:1, v/v) on a normal-phase silica column. Using our isocratic solvent system, the analysis was completed within 15 min. The smallest amount of glycolipid that could be detected by HPLC was 50 pmol and a linear response was shown at 230 nm up to 400 pmol. The calculated peak area of GbOse4Cer was higher than those of GlcCer, LacCer and GbOse3Cer. The molar ratios of GbOse3Cer to monohexosyl ceramide (CMH) in the urinary sediments were: Fabry hemizygotes, 36.33 +/- 25.54 (n = 6); heterozygotes, 0.94 +/- 0.50 (n = 4); and controls, 0.11 +/- 0.06 (n = 5). The molar ratio CDH/CMH was also higher in patients (8.42 +/- 6.23) than in controls (0.77 +/- 0.23). The female H was a rare example of a carrier with typical clinical manifestations. From the urinary sediment analysis, females E, G and J were suspected to be Fabry heterozygotes, although no clinical signs were observed at the time of examination.

Chromatography, High Pressure Liquid↗
PubMed1990

Effects of endoscopic variceal sclerotherapy using GT XIII on blood coagulation tests and the renal kallikrein-kinin system.

Forty-six sclerotherapy sessions were performed on liver cirrhotics with high-risk esophageal varices using GT XIII, a sclerosant composed of gelatin, thrombin and coagulation factor XIII. GT XIII was effective for the prevention of temporary symptoms and transient hypotension observed in 55 sclerotherapy sessions using thrombin. In 42 (91%) sessions, patients underwent sclerotherapy with no symptoms, and in the other four (9%) sessions, only slight symptoms of general fatigue and headache were observed. Changes in the mean arterial pressure were significantly smaller in sessions using GT XIII than in those using thrombin (-12.3 +/- 13.6 vs. -26.8 +/- 20.7 mmHg, P less than 0.01). Changes in coagulation tests, similar to those of disseminated intravascular coagulation (DIC), were also reduced in sessions using GT XIII. Urinary kallikrein and kinin excretion significantly increased after the procedure (P less than 0.01), indicating activation of the renal kallikrein-kinin system. Increases in urinary kallikrein and kinin excretion showed a significant relationship with the consumed plasma fibrinogen levels (r = -0.51, P less than 0.01 and r = -0.58, P less than 0.01, respectively), and it was suggested that activation of the glandular kallikrein-kinin system caused by abrupt DIC-like changes in the hemostatic system might play a role in manifestations of temporary complications occurring with the use of hemostatic agents containing thrombin.

Blood Coagulation↗
PubMed1990

[Lipiodol transcatheter arterial chemoembolization for non-resectable hepatocellular carcinoma--multicenter cooperative study].

A cooperative group study was carried out on the effect of Lipiodol transcatheter arterial chemo-embolization (L-TACE) for non-resectable hepatocellular carcinoma (HCC). Thirty-seven hospitals in Japan participated in this study and a total of 157 eligible patients included 138 males and 19 females with an average age of 60.3 y.o. In the chemo-embolization, Lipiodol mixed with 20-50 mg/m2 of doxorubicin (adriamycin) was given through a catheter, and this was followed by embolization with gelatin sponge. Effect of additional oral 5-FU (150-200 mg/day) was also studied as an open trial. Levels of serum alpha-feto protein decreased at 10 days after L-TACE, and this decrease lasted for 5 weeks. CR was observed in one patient, PR in 33, MR in 24, NC in 66 and PD in 16. The response rate was 24.3%. Cumulative one-year, two-year and three-year survival rates were 56.0%, 30.8% and 26.4%, respectively. It was concluded that higher survival rates after L-TACE were observed when (1) patients had better functional reserves of the liver, (2) HCC was in the less advanced stage and (3) L-TACE was carried out more than twice. A reduction of the tumor size after L-TACE did not necessarily mean a good prognosis for the patients. There was no significant difference in the survival rate between the patients taking or not taking 5-FU.

Adult↗