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Biomedical subjects

M Matsutani

Publications and source records attributed to M Matsutani.

At least 73 records · Page 4Linked to original sources
PubMed1990

Effect of propranolol on diastolic time during exercise.

To evaluate the effect of propranolol on diastolic time (DT) during uninterrupted upright exercise, 11 men with normal coronary arteries receiving oral propranolol and 10 men with coronary artery disease (CAD) were studied by ear densitography. The DT-heart rate (HR) regression equation during exercise obtained from persons without CAD receiving propranolol was DT = e(6.923-0.014 X HR), which was not statistically different compared to that of normal volunteers with no medication. All 10 men with CAD had ischemic electrocardiographic responses at peak exercise with no medication but had no signs of ischemia during exercise after receiving oral propranolol therapy. Although propranolol caused no significant difference in the DT-HR relation in patients with CAD at 1-min exercise, a significant difference in the DT-HR relation was observed after propranolol therapy at peak exercise. In addition to negative chronotropic action (leftward shift along the DT-HR curve), prevention of disproportionate DT shortening at peak exercise (upward shift of the DT-HR curve) with propranolol through its beneficial action on myocardial ischemia tends to increase myocardial perfusion in patients who, when off propranolol, had ischemic response to exercise.

Adult↗
PubMed1990

Factors associated with pericardial effusion in acute Q wave myocardial infarction.

To elucidate the clinical characteristics associated with pericardial effusion in the early phase of myocardial infarction, 330 patients with acute Q wave infarction were studied. According to echocardiography, 83 patients had pericardial effusion on the third day of hospitalization, and careful auscultation revealed that a pericardial rub was absent in 45 patients and was present in 38 patients. Based on seven clinical variables, multivariate analysis was performed to determine the important variables related to the occurrence of pericardial effusion with and without pericardial rub. Pulmonary capillary wedge pressure and left ventricular segments with advanced asynergy were the significant factors related to the occurrence of pericardial effusion without a pericardial rub. The presence of ventricular aneurysmal motion, left ventricular segments with advanced asynergy, and alveolar arterial oxygen difference were related to pericardial effusion with a pericardial rub. Therefore, a hemodynamic factor was the major mechanism associated with the increase in extravascular myocardial fluid and the consequent occurrence of hydropericardia in the absence of a pericardial rub, whereas an increase in the microvascular permeability in the myocardium with excessive fluid exudating through the irritated epicardial surface was the mechanism related to pericardial effusion with a pericardial rub in the early phase of acute myocardial infarction.

Capillary Permeability↗
PubMed1990

Diastolic time during static and dynamic exercise in myocardial infarction.

To evaluate the difference in the response of DT in the early phase of static (sustained weight load) and dynamic (treadmill) exercise, the relation of DT and HR was studied by ear densitography in 11 patients with myocardial infarction. None of the patients had an ischemic electrocardiographic response during exercise. Despite an increase in HR and the pressure-HR product with both types of exercise, the pressure-HR product was significantly higher at three minutes of dynamic exercise, which was associated with a significant lengthening of left ventricular ejection time. Diastolic blood pressure rose significantly during static exercise, but it remained unchanged with dynamic exercise. Electromechanical systole and HR had a linear inverse relation at three minutes of exercise, and DT and HR had a nonlinear inverse relation (DT = e7.29-0.0156 x HR, and DT = e7.07-0.0142 x HR for static and dynamic exercises, respectively). A significant prolongation of QS2 with a consequent shortening of DT (p less than 0.05) was observed in dynamic exercise. In addition to a higher pressure-HR product, the disproportionate shortening of diastole in the early phase of dynamic exercise has a potential for initiating imbalance of myocardial oxygen supply and demand.

Blood Pressure↗
PubMed1990

[Drug sensitivity test against malignant gliomas].

In treating brain tumors with chemotherapy, the choice of drug is most important since human tumors have different drug sensitivities and growth rates. We have been studying the therapeutic effect of anticancer drugs against malignant brain tumors in the following in vivo models. 1) Human glioma-bearing nude mice. 2) Methylcholantrene-induced 203Gl mouse glioma-bearing immunocompetent C57BL/6 mice. 3) Human gliomas transplanted into the chorioallantoic membrane of chick embryos. We evaluated the advantages of each model for anti-cancer drug sensitivity tests. 1) Human glioma-bearing nude mice were found to be most useful in predicting the direct effects of anticancer drugs. We evaluated the effects of several drugs such as ACNU or interferons in six glioma strains transplanted into nude mice. 2) Immunocompetent C57BL/6 mice models were found useful in predicting the therapeutic effects of biological response modifiers. In this model, we can also evaluate changes in immunological parameters such as NK activities or T cell subsets. 3) In the drug sensitivity test using the CAM of chick embryos, various kinds of gliomas could be grafted with a high rate of success. The tumor reduction rate of the sensitivity test using this system tended to agree with that using nude mice. This test was found to be useful in predicting the effect of drugs against gliomas directly resected from individual patients.

Animals↗
PubMed1990

[Clinical diagnosis of gliomatosis cerebri by radioimages].

Gliomatosis cerebri (GC) is a rare clinical entity characterized by diffuse and infiltrative overgrowth of the tumor cells. Most of the previously reported cases of GC were autopsy cases because the clinical diagnosis of GC has been difficult. The authors report four cases diagnosed clinically as GC. Cases 1 and 2 are females aged 19 and 69. Cases 3 and 4 are males aged 47 and 50. In the first three cases, CT findings were almost normal. MRI study, especially on its T2 weighted image (T2W1), clearly demonstrated the wide extent of the infiltration of the tumor cells along the white matter. The last case occurred in the pre-MRI era, but contrast enhanced CT showed a bilateral periventricular high density area accompanied by diffuse low density white matter. Three of them underwent echo-guided needle biopsy, and one underwent partial excision of the lesion. Histological diagnosis was glioblastoma in Cases 1 and 4, and anaplastic astrocytoma in Cases 2 and 3. Difficulty in the clinical diagnosis of GC has been based on the fact that traditional imaging studies, including CT, can not clearly show the extent of tumor cell infiltration. MRI study is a very sensitive imaging technique which can easily demonstrate the area infiltrated by glioma cells. So we may be able to make clinical diagnosis of GC, coupling the data from MRI study and brain biopsy. The authors expect that accumulation of clinical experiences of GC may give useful information for the investigation of "invasion", which is one of the major problems in the treatment of malignant gliomas.

Adult↗
PubMed1989

Establishment of a human malignant meningioma cell line with amplified c-myc oncogene.

A new cell line (KT21-MG1) has been established from a human malignant meningioma transplanted into nude mice. The cultured cells showed epithelial cell-like morphology and were positive immunohistochemically for vimentin as the original tumor. They have been grown continuously in vitro for more than 2 years. The population doubling time was about 24 hours at the 30th passage. The cells are capable of proliferating in soft agar medium and produced tumors in nude mice, the histologies of which were similar to the original patient-derived tumor. Analysis of cellular oncogenes showed that myc and fps were amplified approximately tenfold and threefold, respectively, in this cell line, whereas N-myc, L-myc, N-ras, K-ras, H-ras, abl, erbB2, Blym, src, raf-1, myb, and sis were not changed significantly. The amplification of myc was accompanied by an enhanced expression. Chromosome studies of cultured cells showed the monosomy of chromosome 22 that has been reported to be a specific abnormality in meningiomas.

Animals↗
PubMed1989

Subacute brain atrophy after radiation therapy for malignant brain tumor.

Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed.

Aged↗
PubMed1989

Factors associated with persistent and transient fascicular blocks in anterior wall acute myocardial infarction.

To determine the factors associated with persistent and transient fascicular blocks, 144 patients with Q-wave anterior wall acute myocardial infarction (AMI) were studied. Thirty-three patients had new onset of fascicular block considered to be a consequence of AMI. Multivariate analysis using 16 clinical variables revealed that the number of asynergic segments, serum potassium level and pericardial rub were significant factors related to the occurrence of fascicular block. Among the 33 patients with fascicular block, 18 had persistent (group 1) and 15 had transient (group 2) fascicular blocks. When the 2 groups with fascicular block were compared, group 1 had significantly more asynergic segments than group 2 (4.7 +/- 1.2 vs 3.7 +/- 1.6, respectively), whereas pericardial rubs were observed significantly more in group 2 (67%) than in group 1 (28%). Therefore, the inflammatory process of AMI was 1 of the mechanisms related to the occurrence of a transient fascicular block and a more extensive myocardial necrosis was associated with a persistent fascicular block.

Aged↗
PubMed1989

So-called intracranial germ cell tumours: personal experiences and a theory of their pathogenesis.

We investigated 110 cases of intracranial germ cell tumours (up to the end of 1986), 56% of which showed monotypic histological patterns and 44% were shown to be mixed tumours. All these cases underwent surgery followed by radiation and/or chemotherapy. All cases of choriocarcinoma and embryonal carcinoma died within 2 yr: cases of endodermal sinus tumour also showed poor results (4 yr survival rate was 12.5%). Mature teratoma had a 5 yr survival rate (5YSR) and a 10 yr survival rate (10YSR) of 78.3% each: immature teratoma showed a 5YSR of 44.9%. Two-cell pattern tumours (PTC) showed a 5YSR of 85.8% and a 10YSR of 82.4%. They (PTC) can be divided into two groups (i) germinoma and (ii) pinealoma of pineal parenchyma origin (pineocytoma with lymphocytic infiltration) on the basis of the difference in the tumour cell-stroma relationship and also placental alkaline phosphatase stain. In the pineal region, 70% of PTC belonged to the category of pinealoma and in the suprasellar region, 92% of PTC were germinoma. Germinoma showed a 5YSR of 91.4% and a 10YSR of 91.4%, whereas those of the pinealoma were 78.2% and 68.4% respectively. This suggests that the biological characteristics of germinoma and pinealoma may be different. All these results may bring into question the validity of the germ cell theory, since germinoma, which should be the most undifferentiated according to the theory, was the most benign and choriocarcinoma and endodermal sinus tumour, which should be the most differentiated, were the most malignant in the follow-up study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Successful combination chemotherapy (cisplatinum, vinblastine, and bleomycin) in the treatment of medulloblastoma disseminated by cerebrospinal fluid: case report.

A case of successful combination chemotherapy using cisplatinum, vinblastine, and bleomycin (PVB therapy) to treat medulloblastoma disseminated by cerebrospinal fluid is presented. In this case, a locally recurrent tumor and several disseminated tumors were seen to decrease in size on CT examinations. Pain in the lower extremities and urinary incontinence improved during three courses of PVB therapy administered during a period of 9 weeks. These results suggest that combination PVB therapy may offer one of the treatments of choice for recurrent or disseminated medulloblastoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Multiple saccular cerebral aneurysms associated with systemic lupus erythematosus--case report.

A rare case of multiple saccular cerebral aneurysms in a patient with systemic lupus erythematosus (SLE) is presented. The aneurysms were located at the junction of the left internal carotid artery (ICA) and the posterior communicating artery (PComA), at the anterior communicating artery, at the middle cerebral artery, at the junction of the right ICA and the PComA, and at the top of the basilar artery. All the aneurysms, except for the one on the basilar artery, which was unruptured, were successfully clipped. Histopathological examination of one resected aneurysmal dome confirmed the diagnosis of transmural arteritis secondary to SLE. Postoperatively, she died of a massive hemorrhage from a rectal ulcer. The etiology and prognosis of cerebral aneurysms in SLE are discussed.

Arteritis↗
PubMed1989

[Regrowth pattern of glioblastoma multiforme after radiotherapy].

We investigated the correlation between the technique of radiation therapy used and the regrowth pattern of recurrent glioblastoma multiformes of 48 patients who received initial radiation therapy in our clinic from April, 1974 to March, 1988. Three different techniques have been applied to patients with brain tumors: whole brain irradiation, generous local irradiation (the parallel opposing technique or three field technique, in which the treatment field fully covers the peritumoral low density area on CT images), and restricted local irradiation (the rotation technique, in which the treatment field is restricted to within about 2 cm of the tumor margin on CT images). Radiation dose of the treatment field was over 45 Gy in every case. The regrowth pattern was defined as being one of the followings: inside of the treatment field, outside of the treatment field (this includes the boundary zone between the treatment and the non-treatment field), and remote from the treatment field-which mostly due to the tumor spreading through ventricular systems. In all 7 cases that received whole brain irradiation, tumor recurred inside of the treatment field. Two of these 7 cases showed remote recurrence at the same time. Mean duration time to recurrence was 36.3 weeks. In 27 (90%) of 30 cases that received the generous local irradiation, tumor recurred within the treatment field. Only one showed outside recurrence, and two other cases showed remote recurrence. The mean duration time to recurrence in this group was 32.2 weeks. Of 11 cases that received restricted local irradiation, 3 cases (27%) showed recurrence outside of the treatment field, one showed recurrence in a remote area. The mean duration time to recurrence in this group was 38.3 weeks, but was not significantly longer than that of other two groups. These results indicate that restricted local irradiation sometimes fails to cover the tumor invaded area, and that the results of treatment using generous local irradiation are almost the same as those using whole brain irradiation. This suggests that generous local irradiation is advantageous to patients with brain tumors since the incidence of subacute side effects such as mental deterioration is much lower in local irradiation as compared with whole brain irradiation.

Brain Neoplasms↗
PubMed1989

[Radiation-induced brain atrophy].

Clinico-pathologic characteristics of radiation-induced brain atrophy were reviewed. Radiation-induced brain atrophy becomes obvious 2 to 3 months after radiation therapy in more than half of the patients who have been irradiated to the brain. Mental and neurologic deterioration were well correlated with the severeness of brain atrophy. Pathologically, demyelinating process secondary to direct neurotoxicity of irradiation seemed to be responsible for the entity. A large target field or whole brain irradiation and the senility of patients were major risk factors. The most important differential diagnosis is normal pressure hydrocephalus which is basically curable. The prognosis of radiation-induced brain atrophy is poor. The only possible method to protect the brain from this pathologic entity is to minimize target field as much as possible.

Age Factors↗
PubMed1989

[Response to antitumoral agents of a human medulloblastoma implanted into the chorioallantoic membrane of a chick embryo].

In a previous study the authors have reported on a correlation between the effects of drugs on gliomas grown in the eggs and in the nude mice, and in this study, they have observed the antineoplastic effects of ACNU or combined chemotherapy (CAP-cyclophosphamide, adriamycin, cisplatin) against a medulloblastoma applied onto the chorioallantoic membrane (CAM) of a chick embryo. In this model, ACNU was thought to be ineffective because of an intracerebral dissemination that occurred in spite of the administration of ACNU. ACNU also proved ineffective against the medulloblastoma that grew on the CAM. There seemed to be correlation between the results of this test and the clinical course of this model. Thus this sensitivity test is thought to be useful in the screening of drugs against gliomas.

Adolescent↗
PubMed1989

[The treatment of brain metastasis from breast cancer].

From 1975 through 1988, 25 patients with a brain metastasis from a breast cancer received treatments that varied, according to their systemic condition. Of this number, 13 patients were selected for a surgical removal followed by radiation and inoperable patients (3 of this number had meningeal carcinomatosis) with a serious widespread metastasis were treated by radiation only. The median survival time in the former group was 12 months with a 1-year survival rate of 58.3% and that of the latter group (excluding the meningeal carcinomatous cases) was 7 months with a 1-year survival rate of 20%. The median survival of all 25 patients was 7 months with a 1-year survival rate of 33%. At the diagnosis of the brain metastasis, 88% had metastasis to organs other than intracranial sites and most patients died because of the progression of the metastasis at these other sites. Thus, surgical removal of the brain metastasis, followed by radiation therapy, should be considered for patients without a widespread systemic metastasis. Survival for such cases would be more than 1 year.

Adult↗
PubMed1989

[Histopathology of radiation injury of the brain with special reference to intraoperative radiotherapy].

Histological changes of intraoperative radiation therapy (IORT) induced brain injury are rather localized, but generally similar to those caused by external radiation therapy. The CT findings of radiation necrosis which are mistakenly diagnosed as a recurrent tumor might be due to the progression of necrosis and surrounding edema. IORT is a very effective treatment for gliomas, but enlargement of the treatment field size of IORT could increase the potential hazard of radiation to the normal brain tissue.

Adult↗
PubMed1989

[Surgical treatment on survival and quality of life in patients with supratentorial glioblastoma:].

One hundred one patients with glioblastoma were studied to evaluate the effect of the extent of surgical resection on the length and quality of life. Extensive removal of tumor was performed for 45 patients, while the remaining 56 patients underwent partial removal or biopsy of tumor. The median time to tumor progression and the median survival in the former patients were 18.0 months and 23.0 months, respectively, and, in the latter patients, 6.0 months and 10.0 months, respectively. More than 80% of Karnofsky rating was observed in 69% of the former patients. Extensive removal of glioblastoma would be associated with longer and better survival when compared to partial removal.

Adult↗