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Biomedical subjects

M Terada

Publications and source records attributed to M Terada.

At least 199 records · Page 11Linked to original sources
PubMed1997

Fate of trileaflet equine pericardial extracardiac conduit used for the correction of anomalies having pulmonic ventricle-pulmonary arterial discontinuity.

BACKGROUND: External conduits used for the repair of congenital heart diseases having discontinuity between the pulmonic ventricle and the pulmonary artery still carries a high risk of reoperation. Between June 1983 and June 1992, handmade equine pericardial conduit with fabricated trileaflet valve had been the conduit of choice in our institute. The aim of this study is to clarify the temporal sequence of conduit obstruction in this material and to formulate the optimal surgical strategies for this disease entity. METHODS: One hundred forty-three patients have undergone extracardiac conduit repair using this conduit. Postoperative catheterization performed within 2 months showed pulmonary to systemic ventricular systolic pressure ratio of 0.57 +/- 0.17 with the pressure gradient between pulmonic ventricle and pulmonary artery of 21.1 +/- 17.2 mm Hg. In 63 patients among the survivors, a series of Doppler two-dimensional echocardiographic images could be clearly obtained. RESULTS: Moderate-to-severe degree of pulmonary insufficiency represented only 3.2% of all cases within 3 months, which rapidly increased to 14.3% at 1 to 3 years and 32.8% at 3 to 5 years. However, the rate of increase of pulmonary insufficiency diminished beyond 5 years with 34.9% at 5 to 7 years and 40.0% at 7 to 9 years. Estimated pressure gradient calculated by Bernoulli's equation applied in the same patient subset was 4.1 +/- 7.9 mm Hg within 3 months, which progressively increased to 7.1 +/- 11.8 mm Hg at 1 to 3 years, 21.0 +/- 24.0 mm Hg at 3 to 5 years, 40.2 +/- 25.9 mm Hg at 5 to 7 years, and 71.3 +/- 34.0 mm Hg at 7 to 9 years. Among patients with a pressure gradient across the conduit of more than 40 mm Hg at follow-up catheterization, the primary cause of the obstruction was attributed to degeneration of the valve in 7 patients, whereas sternal compression was strongly suspected as the primary cause in the other 8 patients. Intimal peel was not obvious in the excised specimens. CONCLUSIONS: Degeneration of the valve in the equine pericardial conduit became prominent at 3 to 5 years after the operation, whereas the pressure gradient across the conduit continued to progress thereafter. A thick and hardened valve from degeneration and varying degrees of external compression by the sternum were delineated at the site of stenosis.

Animals↗
PubMed1997

Ventricular hypertrophy as a risk factor in ventricular septation for double-inlet left ventricle.

BACKGROUND: Ventricular septation is an option for surgical correlation of double-inlet or common-inlet left ventricle. However, the surgical risk factors of ventricular septation remain unknown. METHODS: Twenty-three patients with double-inlet or common-inlet left ventricle underwent ventricular septation. Preoperative data were compared between the survivors (n = 18) and the nonsurvivors (n = 5) to assess surgical risk factors. RESULTS: There were two early deaths (9.5%) and three late deaths (14.3%). Nonsurvivors of ventricular septation were significantly older at the time of operation (14.0 +/- 6.0 versus 7.0 +/- 5.4 years; p < 0.05) and had greater left ventricular mass (383% +/- 100% versus 206% +/- 57% of normal predicted value; p < 0.005) and greater left ventricular mass to left ventricular end-diastolic volume ratio (1.84% +/- 1.18% versus 0.77% +/- 0.17%/% of normal predicted value; p < 0.005). Univariate logistic regression analysis also revealed age at operation (p < 0.05) and mass/end-diastolic volume ratio (p < 0.05) as significant risk factors for death after operation. Multivariate regression analysis revealed that age at operation positively influenced increased mass/end-diastolic volume ratio (p < 0.001). These findings indicated that ventricular hypertrophy was one of the risk factors for ventricular septation, which had a tendency to progress with age. CONCLUSIONS: Early operation before progression of ventricular hypertrophy is recommended in patients with double-inlet or common-inlet left ventricle who have suitable anatomy for the ventricular septation procedure.

Adolescent↗
PubMed1997

Duodenal atresia in dizygotic twins.

The authors report duodenal atresia occurring in both members of dizygotic twins who showed no signs of Down's syndrome, and both had normal chromosomal constitutions. They both had the two unlinked end type of atresia in the second portion of the duodenum, and direct end-to-end duodenoduodenostomy was carried out. Their postoperative courses were smooth, and both babies were discharged 32 days after birth. Their mother underwent pituitary adenoma removal and partial parathyroidectomy for multiple endocrine neoplasia (MEN-type I). She had been given hormonal supplement therapy after surgery and became pregnant after exogenous gonadotropin therapy. Environmental factors may be responsible for some cases of duodenal atresia.

Diseases in Twins↗
PubMed1997

The role of subfractionation of alpha-fetoprotein in the treatment of pediatric surgical patients.

Subfractionation of serum alpha-fetoprotein (AFP) is a useful method to discriminate between yolk sac tumors, hepatic malignancies, and benign liver diseases in adults but has not been validated in infants and children. AFP subfractionation was performed on AFP-positive sera from 73 infants and children. AFP subfraction profiles were classified into three common types: (1) yolk sac type, (2) hepatoblastoma type, and (3) benign hepatic type, according to the reactivity of individual AFP samples to lectins. In 68 of 73 samples (93.2%), AFP subfraction profiles were accurately classified into these three types, and an atypical AFP subfraction profile resembling the hepatoblastoma type was found in sera from five infants (6.8%). Differentiation between hepatoblastoma and hepatitis when patients are very young can be difficult. Subfractionation is more accurate when patients are older. This technique was found to be useful in the diagnosis of neonatal ovarian tumors, in recurrent hepatoblastoma/ yolk sac tumor with low serum AFP, and in the differential diagnosis of hepatic mass (malignancy versus hyperplastic nodule) in the liver with long-standing cholestasis. Estimation of serum AFP subfraction profiles facilitates the differential diagnosis of various AFP-positive pediatric diseases, such as hepatoblastoma, hepatoma, hepatitis or germ cell tumors. This test is inexpensive, can be carried out within 48 hours, and should be performed for the differential diagnosis of pediatric liver disease.

Adolescent↗
PubMed1997

Modified Fontan procedure in ninety-nine cases of atrioventricular valve regurgitation.

Between January 1985 and August 1995, among 242 patients who underwent a modified Fontan procedure, 99 had atrioventricular valve regurgitation ranging in degree from 1 to 4, for which concomitant repair of the atrioventricular valve regurgitation was done in the majority of cases. In all but 4 cases the atrioventricular valve was repaired mainly by circular annuloplasty and valve replacement was not done in any case. Although the hospital mortality rate was significantly higher in cases with atrioventricular valve regurgitation (12/99, 12%) than in cases without (4/143, 3%; p < 0.0037, chi 2 test), actuarial survival in atrioventricular valve regurgitation was 84% for years 5 through 10. The degree of atrioventricular valve regurgitation before operation was 1.6 +/- 0.7 on average: in 49 cases with higher than grade 2 regurgitation before operation there was a significant decrease to 0.4 +/- 0.49 (p < 0.0001) after operation in short-term survivors. Patients with atrioventricular valve regurgitation can be treated with reasonable risk, provided proper repair of the valve is done. Circular annuloplasty is a simple and uniformly effective method to control regurgitation even in cases of common atrioventricular valve.

Adolescent↗
PubMed1997

Clinical study of esophageal foreign bodies attributable to PTP material.

Retrospective survey of patients with esophageal foreign bodies who were treated in the Osaka Medical College over the past 21 years, and the patients with esophageal foreign bodies attributed to press through package (PTP) who were treated at the Osaka Central Emergency Clinic, a representative holiday emergency institution in Japan, was carried out. The incidence of foreign bodies attributed to PTP material tends to increase throughout the period reviewed. The patients over 60 years of age accounted for 25/28 (89%) of all PTP patients in Osaka Medical College and 27/32 (84%) in Osaka Central Emergency Clinic, strongly suggesting that PTP dysphagia is most common in elderly patients. Diagnostic methods and preventive measures against PTP foreign bodies were discussed.

Adolescent↗
PubMed1997

Scoop biopsy of intracaval tumor thrombi: a preliminary report of a minimally invasive technique to obtain large samples.

PURPOSE: The purpose of this study is to safely improve the yield of intracaval biopsy. MATERIALS AND METHOD: A co-axial system was composed of an inner catheter with a smoothly tapered tip with a shark jaw, and an outer sheath. The biopsy procedure consisted of four steps: (1) the tip was stuck into the target thrombi; (2) the inner sheath was advanced deeply into the target and the jaw was opened within the mass; (3) the outer sheath was advanced to envelope the inner cather; (4) then the system was withdrawn. After simulation experiments seven patients underwent this scoop biopsy. RESULTS: A simulation experiment proved that this technique brought much larger samples with minimal damage of the target surface. Seven patients who had been suspected of intracaval tumor thrombi underwent this procedure and confidential pathological examination without any complications. CONCLUSION: This scoop biopsy procedure was thought to be helpful in obtaining large samples safely.

Aged↗
PubMed1997

Axonal contact regulates expression of alpha2 and beta2 isoforms of Na+, K+-ATPase in Schwann cells: adhesion molecules and nerve regeneration.

Three isoforms of catalytic alpha subunits and two isoforms of beta subunits of Na+,K+-ATPase were detected in rat sciatic nerves by western blotting. Unlike the enzyme in brain, sciatic nerve Na+,K+-ATPase was highly resistant to ouabain. The ouabain-resistant alpha1 isoform was demonstrated to be the predominant form in rat intact sciatic nerve by quantitative densitometric analysis and is mainly responsible for sciatic nerve Na+,K+-ATPase activity. After sciatic nerve injury, the alpha3 and beta1 isoforms completely disappeared from the distal segment owing to Wallerian degeneration. In contrast, alpha2 and beta2 isoform expression and Na+,K+-ATPase activity sensitive to pyrithiamine (a specific inhibitor of the alpha2 isoform) were markedly increased in Schwann cells in the distal segment of the injured sciatic nerve. These latter levels returned to baseline with nerve regeneration. Our results suggest that alpha3 and beta1 isoforms are exclusive for the axon and alpha2 and beta2 isoforms are exclusive for the Schwann cell, although axonal contact regulates alpha2 and beta2 isoform expressions. Because the beta2 isoform of Na+,K+-ATPase is known as an adhesion molecule on glia (AMOG), increased expression of AMOG/beta2 on Schwann cells in the segment distal to sciatic nerve injury suggests that AMOG/beta2 may act as an adhesion molecule in peripheral nerve regeneration.

Animals↗
PubMed1997

Absence of human papillomavirus-16 and -18 DNA and Epstein-Barr virus DNA in esophageal squamous cell carcinoma.

To elucidate the association of human papillomavirus (HPV) and Epstein-Barr virus (EBV) with carcinogenesis of the esophagus, 41 surgically resected specimens and 12 cell lines of esophageal squamous cell carcinoma were examined for the presence of HPV DNA and EBV DNA by polymerase chain reaction using primers for the E6 regions of HPV-16 and -18 and for the EBNA 1 region of EBV. We designed the reaction condition to amplify HPV and EBV DNA specifically and detected by gel electrophoresis. In ethidium bromide staining, no band was detected either for the HPV E6 region of for the EBV EBNA 1 gene in any of the surgically resected specimens and the cell lines, although the HPV sequence was detectable by Southern blot hybridization, which is a more sensitive detection method than staining; three out of 41 surgically resected specimens were positive for HPV-18 by Southern blot hybridization of polymerase chain reaction products. However, the number of viral genomes has been estimated as lower than 1 x 10(-3) copies per cell based on the intensity of the hybridization signals. Moreover, the DNA samples extracted from the corresponding non-cancerous esophageal mucosa were also positive for HPV-18, and the intensities of the hybridization signals were almost the same as those of the tumors. The results of our study indicate that HPV-16, HPV-18 and EBV are not generally associated with esophageal carcinogenesis.

Carcinoma, Squamous Cell↗
PubMed1997

Pharmacological properties of YM17E, an acyl-CoA:cholesterol acyltransferase inhibitor, and diarrheal effect in beagle dogs.

YM17E (1,3-bis[[1-cycloheptyl-3-(p-dimethylaminophenyl)ureido]methyl]ben zene dihydrochloride) was found to be a potent inhibitor of acyl-CoA:cholesterol acyltransferase (ACAT) in rabbit liver and intestine microsomes. Dixon plot analysis revealed that YM17E inhibited microsomal ACAT in a non-competitive manner. YM17E induced a marked decrease in serum cholesterol, especially in non-high-density lipoprotein (HDL) fractions, in cholesterol-fed rats and rats fed normal chow. Measurement of bile secretion after oral administration of YM17E in cholesterol-fed rats showed that the drug markedly accelerated the secretion of bile acids and neutral sterols. Furthermore, absorption of [3H]cholesterol from the gut of cholesterol-fed rats was significantly inhibited by YM17E. From these results, the hypocholesterolemic activity of YM17E in these animals resulted from both a decrease in cholesterol absorption from the gut and the stimulation of excretion of cholesterol from the liver into bile. However, YM17E caused secretory diarrhea in beagle dogs at near lipid lowering doses. When YM17E was administered at the same total dosage but divided into 5 daily administrations, the incidence of diarrhea was significantly reduced while its cholesterol lowering effect became stronger. These results suggest that the inhibition of intestinal and/or liver ACAT increases the risk of diarrhea development which, however, can be avoided by controlled drug administration in beagle dogs.

Animals↗
PubMed1997

[Comparison of Gore-tex covered Ultraflex stent and bare Ultraflex stent: preliminary clinical results].

We clinically compared the covered Ultraflex stent and the bare Ultraflex stent for malignant esophageal strictures. Materials were 6 cases with esophageal carcinomas. We placed the Gore-tex covered stents (A group) in 4 cases including 2 cases of esophagorespiratory fistulae, and the bare stents (B group) in 2 cases. The stents were well-expanded in all cases. After stenting, dysphagia was improved in all cases. Fistulae were obstructed by the cover in 2 cases in A group. Mean survival term was 123 days in A group and 45 days in B group. Complications were fistulation of bare portion of the covered stent in one case in A group, and tumor bleeding in one case in B group. Considering of the risk of fistula or tumor bleeding, the cover is necessary to increase the safety and efficacy of the esophageal stent.

Aged↗
PubMed1997

[A long-term histological prognosis after IFN therapy for chronic hepatitis C].

In 72 chronic hepatitis C patients treated with IFN, liver biopsies were performed before and after IFN treatment, and histological changes were examined. In complete responders, the grading score improved significantly since 6-mo after IFN treatment, and the staging score improved significantly since 12-mo after IFN treatment. In long-term responders underwent a following liver biopsy 4-5 yr after IFN treatments; 5 had normal liver histology. In partial responders, both the grading and staging score did not improve significantly. But, in the cases who had sustained normalization of ALT levels after IFN treatment, both the grading and staging score improved after treatment. In non-responders, both the grading and staging score did not improve significantly.

Biopsy↗
PubMed1997

Factors associated with survival exceeding 5 years after transcatheter arterial embolization for hepatocellular carcinoma.

During the period between April 1981 and March 1988, 232 consecutive patients underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma at the Department of Radiology, Wakayama Medical College. A > or = 5-year course calculated from the time of the initial TAE was able to be confirmed in 216 patients, who became the subjects of this study. Five-year survival rates were calculated by the direct method, while the clinical features existing at the time of the initial therapy and the clinical course of patients surviving > or = 5 years were studied. The 5-year survival rate was 6.0%. Comparison of the patients dying within 1 year and the patients surviving for > or = 5 years revealed differences in the severity of liver cirrhosis and the tumor type. The long-term survivors tended to have low serum alpha-fetoprotein values. The clinical picture of the patients surviving > or = 5 years after TAE was characterized by relatively mild liver cirrhosis (Child's class A or B), a serum alpha-fetoprotein value of < or = 1,500 ng/dL, relatively small nodular-type tumors with a maximum main tumor diameter of < or = 5.5 cm, a tumor-occupying rate of less than 20%, and absence of portal vein involvement by the tumor. There were patients in whom a relatively small number of TAE sessions was effective in controlling the tumor for a prolonged period, with the patients then dying of causes unrelated to the tumor, as well as patients in whom proliferation of the tumor was controlled by numerous applications of transcatheter therapy, resulting in > or = 5-year survival but with eventual death due to the tumor. Transcatheter arterial embolization makes a major contribution to achieving long-term survival of > or = 5 years in patients with hepatocellular carcinoma.

Adult↗
PubMed1997

[Evaluation of hepatic encephalopathy and portal hemodynamics by Doppler ultrasonography after a transjugular intrahepatic portosystemic shunt].

TIPS (transjugular intrahepatic portosystemic shunt) is an efficacious treatment for esophagogastric varices, ascites and hypertensive gastrointestinal vasculopathy associated with portal hypertension. The main complication after the procedure is hepatic encephalopathy. We tried to elucidate the correlation between hepatic encephalopathy and changes in portal hemodynamics after TIPS, based on observation by Doppler ultrasonography. We carried out Doppler ultrasonography in 28 cases of TIPS to assess hepatopetal and hepatofugal blood flow in the right and left portal branches. Hepatic encephalopathy occurred after TIPS in 9 cases out of 28 (32%), and new onset of disease was observed in 6 of 9. Doppler ultrasonography revealed hepatofugal blood flow in both right and left portal branches in 6 cases, 5 of which showed encephalopathy. Hepatopetal blood flow of the right and left portal branches was observed in 17 of 28 cases after TIPS. Hepatic encephalopathy occurred in only 2 of 17 cases. The changes in portal vein hemodynamics after TIPS were investigated by color Doppler ultrasonography, which were considered to be very useful for prediction of hepatic encephalopathy and indication of medical treatment to prevent the occurrence of this disease.

Adult↗
PubMed1997

[A suicidal case of electrocution with hypnotic drug poisoning: an autopsy report].

A 28-year-old male was found dead on a bed in a hotel. He had two electric wires, the ends of which were fastened to each coin (50 and 100 yen); the coins were attached to a left hypochondrial region and a left side of the chest. The other ends of the wires were connected to a time switch, which had been connected to a plug top (100 V, 60 Hz alternating current). An empty box of a commercially available hypnotic (bromvalerylurea), a suicide note and a manual book for suicide were found at the spot. As autopsy findings, both burns on the left hypochondrial region and on the left side of the chest were carbonized at their central parts and erythemas were also noted around them. Histological findings were consistent with electric marks and the burns showed vital reactions. Copper stain was slightly positive; iron stain was negative. Bromvalerylurea concentrations in blood, urine, brain, liver and kidney samples were 14.5, 37.7, 5.8, 5.2 and 6.2 micrograms/ml or g, respectively. The blood level showed that he had been moderately intoxicated by the drug, but not fatal. The cause of death was thus judged to be suicidal electrocution. It seems that suicide was influenced by a "Manual Book of Suicide", which was found in his bag.

Adult↗
PubMed1997

Effective prevention of thrombocytopenia using adenovirus-mediated transfer of HST-11FGF-4 gene: in vivo and in vitro studies.

A novel biological function of HST-1 protein (FGF-4) was investigated by constructing an adenovirus vector containing the HST-1 cDNA and applied for thrombocytopenia as a gene therapy. A single intraperitoneal injection of the replication-deficient adenovirus containing the HST-1 gene (Adex1HST-1) into mice caused a two-fold increase in peripheral platelet count for 30 days, and effectively prevented experimentally induced thrombocytopenia. Studies of Adex1HST-1-infected or HST-1 protein-treated megakaryocytic Dami cells suggested that HST-1 protein promotes megakaryocyte maturation, and increases cytokine secretion from megakaryocyte and adhesive interactions between megakaryocyte and endothelial cells. Colony assay revealed that HST-1 protein stimulated CFU-MK (colony-forming unit of megakaryocyte) not alone but synergistically with early-acting cytokines such as IL-3 or Tpo (c-mpl ligand) as a megakaryocyte potentiating factor. These results have important implications for clinical application of the Adex1HST-1 for thrombocytopenia.

Adenoviridae↗