Search PubMed⌕ Search

Biomedical subjects

M Tsukamoto

Publications and source records attributed to M Tsukamoto.

At least 163 records · Page 9Linked to original sources

[A case report of emergency thoracotomy and aortic cross clamp for massive abdominal hemorrhage due to the rupture of a pancreatic pseudocyst].

The authors present a rare case of a 58-year-old female who had cardiac arrest due to massive abdominal hemorrhage because of the rupture of pancreatic pseudocyst during an emergency operation. We succeeded in resuscitation by performing emergency thoracotomy and internal cardiac compression. Thoracic aortic cross clamping was employed to control bleeding, and we could perform the operation. She recovered without any neurological deficits. Thoracic descending aortic cross clamping should be always considered both before and during operation for the control of massive abdominal hemorrhage to avoid circulatory collapse.

Abdomen↗

[Diagnosing the depth of esophageal carcinoma invasion by esophagography scoring].

In patients with an esophageal carcinoma, it was important to determine the depth of the carcinomatous involvement so as to decide on its resectability and prognosis. Thus four measurements of the esophagography findings involving ninety five post-esophagectomy patients were categorized into four grades and scored from point 1 to point 4, depending on the degree of severity, the measurements being the size of the tumor, the circumferential carcinomatous invasion, the degree of stenosis, and the depth of the ulcer. The sum total scores of these four esophagography findings were found to correlate well (P less than 0.01) with the depth of the invasion (submucosa, muscularis propria, adventitia, and the adjacent structures).

Adult↗

[The treatment of accompanied organ failure after thoracic and cardiovascular surgery with mechanical organ-supports].

Five hundred and thirty-three patients have been treated after thoracic and cardiovascular surgery in our ICU during the last four years. Cardiac failure was shown in 150 cases, respiratory failure in 132 cases, renal failure in 76 cases, and hepatic failure in 84 cases. The appropriate mechanical organ-supports (MOS) were applied in the following cases: intra-aortic balloon pumping (IABP) in 48 cases, veno-arterial bypass (VAB) in 18 cases, left ventricular assist device (LVAD) in 1 case, respirator in 132 cases, continuous hemofiltration (CHF) in 44 cases, hemodialysis (HD) in 13 cases, peritoneal dialysis (PD) in 21 cases, Continuous intensive peritoneal dialysis (CIPD) in 7 cases, and plasma exchange (PEx) in 22 cases. The results of MOS6 which required exocorporeal circulation were not satisfactory, especially CHF (mortality rate 75.0%), HD (76.9%), and VAB (100%). Though, the results of IABP (35.4%) and CIPD (14.3%) were significantly better. The main cause of early death (within 6 post-operative days) was low output syndrome (LOS) (63.6%). However, that of late death (beyond 14 post-operative days) was sepsis (66.7%). Therefore, it is important for the survival of these patients to control LOS during the early post operative period and then to concentrate on the prevention of infection.

Arteriovenous Shunt, Surgical↗

[Pulmonary dirofilariasis found unexpectedly during thymectomy].

A 56-year-old woman in Kitakyushu City was operated on after diagnosis of mediastinal tumor with myasthenia gravis. Besides the thymoma, a small nodule was palpated in the lower lobe of the left lung and biopsied. A segmented worm was found in sections of this granulomatous nodule. A cross section of the degenerated worm (400 X 310 micron) showed a 3-layered tegument and internal cuticular ridges with high lateral chords. The muscle layer consisted of high and polymyarian muscles. Based on these characteristics, this worm was identified as an immature dog heartworm, Dirofilaria immitis. The recent sharp increase of dirofilariasis cases reported in Japan is discussed.

Dirofilariasis↗

[A case report of nasal infestation by the leech, Dinobdella ferox].

A 55-year-old man in Okagaki Town, Fukuoka Prefecture, pulled a nasal leech from his nostril in July 1987, after suffering from nosebleed, copious running snivels as well as unpleasant foreign body sensation in the nasal cavity. Except for nasal septum deviation, no abnormality in the ears and mouth cavity nor bleeding, ulcerous and erosive changes in the nasal cavity were found. The formalin-fixed specimen of the leech was nearly black with no definite stripes or spots, and measured 3.5 cm in length and 1.2 cm in width. Because of these and the following characteristics, viz. 1) auricles on the posterior segment were absent, 2) five pairs of eyes were present in the anterior segments with the eye pairs 3 and 4 separated by an annulus, and 3) teeth were not observed, this specimen was identified as Dinobdella ferox. This nasal leech is found widely in Southeast Asia. In Japan, some human cases of its infestation have also been reported, mainly from southern Kyushu. The leech seemed to have entered the nasal passage of the present case from a stream at a hot spring in northern Kyushu. Attention should be given to nasal leech infestation especially now that many people in Japan are eager to visit isolated hot spring resorts.

Animals↗

[Three recent cases of ascariasis in northern Kyushu].

Ascariasis is considered to be one of the rare infectious diseases in Japan, but recently it has been slightly increasing. This paper reports three ascariasis cases who seemed to be infected recently in the Kitakyushu area, Japan. Case 1: A 59-year-old woman in Kitakyushu City passed a round worm after continuous abdominal pain. The patient was discharged from the hospital because of no further abnormal intestinal symptoms and findings. Case 2: An 85-year-old woman in Nakama City, who suffered from cerebral infarction, vomited a round worm before hospitalization. Many ascarid eggs were detected after admission, and after treatment with pyrantel pamoate (Combantrin) two round worms were passed and egg detection became negative. Case 3: A 77-year-old man in Saikawa Town vomited 3 round worms after gastrectomy due to early gastric cancer. Many unfertilized eggs were also detected from the stool together with hook worm eggs, but no eggs were found after administration of pyrantel pamoate. Morphological examination was made by a scanning electron microscope on the denticles on the dentigerous lip ridges of the worms to differentiate from possible infection with a pig parasite, Ascaris suum. The three cases were diagnosed as ascariasis due to human Ascaris lumbricoides based on the following evidences that the expelled worms had 1) less pointed tips of the denticles and shallower or wider interdenticle notches, and 2) far more denticles of smaller size along the dentigerous ridges, compared with Ascaris suum. The necessity of differentiating pig- from human-ascarids, when considering human infection with Ascaris suum, is discussed.

Aged↗

Isolation and identification of prostaglandin I 2 stimulating factor from human plasma.

To isolate and identify the plasma factor which stimulates prostaglandin I 2 production by rat aortic ring, a human plasma fraction which showed a major stimulating activity on prostaglandin I 2 production was purified by ultrafiltrate, Sephadex G-10 gel filtration and QAE-Sephadex column chromatography. The purified plasma factor was identified as uric acid by its ultraviolet and infrared absorption spectroscopy, and 1H nmr and 13C nmr spectroscopy. The stimulating activity of the purified plasma factor and that of authentic uric acid coincided with each other. The stimulating potency of uric acid at its physiological concentration in human plasma (about 50 micrograms/ml) was half of the deproteinized human plasma, and was about 30 fold stronger than that of L-tryptophan, a cofactor of prostaglandin hydroperoxidase.

Adult↗

[A case of small cell carcinoma of the esophagus].

The case of a 51-year-old man, complaining of a sense of pressure on his chest, is reported. Tests led to a diagnosis of a cancer in the midesophagus and a subtotal esophagectomy was performed. The tumor was found to be a protruded type, 8.5 X 7.0 cm in size. A histologic diagnosis revealed it to be a small cell anaplastic carcinoma. The tumor cells were found negative in a Grimelius staining and did not contain hormones such as ACTH. Some cytokeratins, however, were detected by an immunohistochemical examination, Cancer invasion into the adventitia was seen, though no lymph node metastasis or a distant metastasis was shown. Six months after operation, a recurrence in the mediastinum and in the distant lymph nodes was found. Chemotherapy and irradiation were found to be useful, and the postoperative survival period was 25 months.

Carcinoma, Small Cell↗

[Cooperative research on post-operative adjuvant therapy of breast cancer. Tohoku Society of Adjuvant Chemo-endocrine Therapy of Breast Cancer].

A randomized trial was carried out in 55 institutes in the Tohoku district to examine the significance of breast cancer post-operative adjuvant chemo-endocrine therapy in stage II and IIIa patients for possible radical mastectomy. A total of 619 patients were entered from November 1982 to November 1984, of whom 554 were eligible. Patients were administered MMC 13 mg/m2 after surgery, and randomized using the envelope method into either group A, treated with Tegafur 400 mg/m2 alone (275 patients), or group B, treated with Tegafur 400 mg/m2 and Tamoxifen 20 mg/daily (279 patients), for a year from the 7th day after operation. There was no significant difference between the two groups in the background factors of age, menopausal status, operation methods, stage or number of positive lymph nodes, but there were more patients of ER(+) in group B. A Kaplan-Meier method comparison showed no significant difference between the two groups in 3-year disease-free survival rates. There was no significant difference between the two groups compared by ER or menopausal status. However, patients with 4 or more positive lymph nodes showed a significant benefit in group B. Group B also marked a higher disease-free survival rate for ER(+) patients with 4 or more positive lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗

[A human case of pulmonary dirofilariasis suspected to be lung cancer].

A 50-year-old man in Kitakyushu City visited a hospital for evaluation of an opacity in a routine chest X-ray film. After examinations by bronchoscopy and chest roentgenography, a clear coin lesion was found in the middle lobe of the right lung and was suspected to be a lung cancer. A right thoracotomy was performed to remove it. The lesion (10.6 X 9.8 mm) was a well-defined ellipsoid granuloma due to a foreign body with a central zone of necrosis surrounded entirely by a fibrous wall. In a cross section of the dissected granuloma two degenerated worm-like structures were revealed. The sections of the worm (216-240 X 296 mu m at the greatest diameter) had at least a 3-layered cuticle and prominent internal longitudinal cuticular ridges but no external cuticular ridges. The lateral chords were as high as the muscle layer which consisted of abundant somatic muscle (more than 30 muscle cells/quadrant). Judging from these morphological characteristics, the pulmonary granulomatosis was diagnosed to be due to an immature dog heartworm, Dirofilaria immitis. This identification was further supported by results from immunological methods. The present case is the 56th human case of dirofilariasis (the 39th as a pulmonary case only) in Japan.

Diagnostic Errors↗

[Fifty-six cases of human dirofilariasis reported in Japan--a complied table].

Since the first reported case of human dirofilariasis in 1964, a total of 56 cases have been recorded from Japan, including 39 pulmonary and 16 extra-pulmonary cases. The difference in case number between pulmonary and extre-pulmonary sites is statistically highly significant (P = 0.001). Distribution of the lesion in pulmonary dirofilariasis is mainly concentrated in the right lung (P less than 0.001). The rapid increase of human dirofilariasis within the last 5 years indicates that this disease is one of the important anthropozoonoses.

Adolescent↗

[Gliomatosis peritonei].

Gliomatosis peritonei, the miliary implants of mature glial tissues on the peritoneum or omentum, is a rare complication of solid ovarian teratoma. Our case is reported and 38 previously reported cases are reviewed. The grade of the primary tumors varied from grade 0 to grade 3. Only five cases were composed entirely of mature tissues. Five of the 39 patients died. Despite of varied therapy, the rest of the patients were alive from 3 months to 38 years later. Inspite of intraperitoneal implants, the prognosis in patients with these tumors is good, irrespective of the mode of therapy. On the basis of this study, we recommended a conservative therapy for the primary tumor and therapy for the implants is not required.

Adolescent↗

[The correlation between the productive capacity of carcinoembryonic antigen (CEA) and prognosis in gastric cancer].

In 130 resected specimens of gastric cancer, CEA was stained by the enzyme labeled antibody method. The positive rate of CEA stain was 74.6% and higher in well differentiated adenocarcinoma, mucinous adenocarcinoma, and signet ring cell carcinoma. The positive rate was lower in poorly differentiated adenocarcinoma. The 5-year survival rate was higher in the CEA (-) group in stage II, and higher in the CEA (+) group in stage III (p less than 0.05) and stage IV. This suggests that the correlation of the CEA stain and the prognosis varies with the stage of cancer.

Carcinoembryonic Antigen↗