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Biomedical subjects

M Tsuru

Publications and source records attributed to M Tsuru.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Changes in the liver weight in the elderly].

To elucidate the effect of aging on liver weight in the elderly, 582 elderly cases (male 291, female 291), were selected from 2000 elderly autopsied cases on the basis of being free from pathological findings affecting liver weight. Both liver weight and its ratio to body weight decreased with age, and influenced by obesity; the former increased and the latter decreased in obese cases. Analysis according to the degree of obesity also showed decrease of liver weight and is ratio to body weight with age. Comparison between males and females of the same decade revealed the tendency that in females the liver weight was low, while liver weight.body weight ratio was high. The same results were obtained by analysis based on the degree of obesity.

Aged↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; the detection of impaired vasodilatory capacity with 133Xe SPECT and acetazolamide (Diamox) test].

To evaluate the efficacy of 133Xe SPECT and Diamox test, for selecting patients with hemodynamic compromise, tests using 133Xe inhalation method and single photon emission computed tomography (SPECT) with acetazolamide (Diamox) were performed in twenty-three patients with chronic cerebral ischemia, before and after extracranial-intracranial bypass surgery or carotid-endarterectomy. All patients complained of TIA, RIND, or minor completed stroke, and cerebral angiography of all patients demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery. Cerebral blood flow (CBF) was also measured 15 minutes after intravenous administration of 10-12 mg/kg Diamox, which is known as a cerebral vasodilatory agent (Diamox test). Our results revealed that all patients could be divided into four types according to the findings of their resting rCBF and Diamox reactivity. The patients who had normal resting rCBF and normal Diamox reactivity (type 1) were considered to have well-developed collateral circulation and normal cerebral perfusion pressure (CPP) in spite of severe occlusive lesions in the carotid system. Moderate vasodilatation due to reduced CPP was considered to occur in patients who had normal resting rCBF and decreased Diamox reactivity (type 2). The resting rCBF remained unchanged, but Diamox reactivity improved to the normal range after surgery in the patients of type 2 (p less than 0.01), which indicated the improvement of CPP and the resolution of the autoregulatory vasodilatation. Maximum vasodilatation or dysautoregulation was considered to occur due to the inadequate collateral flow and the severely reduced CPP in patients whose findings revealed decrease in the resting rCBF and impaired Diamox reactivity (type 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetazolamide↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; measurement of cerebral blood volume (CBV) with 99mTc-RBC SPECT].

To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with 99mTc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by 133Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor complete stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with 99mTc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with 133Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r = -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with 133Xe SPECT and 99mTc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease.

Acetazolamide↗
PubMed1989

Clinical pharmacology of dilevalol (I). Comparison of the pharmacokinetic and pharmacodynamic properties of dilevalol and labetalol after a single oral administration in healthy subjects.

Dilevalol (25 mg----50 mg----100 mg) or labetalol (100 mg) was given orally in six healthy subjects. The study was carried out on four occasions with a week interval. Blood samples for plasma drug concentrations were taken for a 24-hour post-drug period. Blood pressure (BP) as well as heart rate (HR) at supine position, during 50 degrees tilting and during a submaximal exercise were measured after each treatment. The mean maximum plasma concentration (Cmax) as well as the mean area under the plasma concentration-time curve (AUC) increased in a dose-dependent manner after dilevalol. These parameters after dilevalol 100 mg were significantly lower than after labetalol 100 mg. No significant differences were observed in the time to maximum concentration (tmax), the distribution half-life (t1/2 alpha) or the elimination half-life (t1/2 beta) between dilevalol and labetalol. There were no significant differences in BP at supine position or during 50 degrees tilting among the dosages. Postural changes in HR during 50 degrees tilting was significantly smaller after dilevalol 100 mg than following labetalol 100 mg. The suppressing effect of dilevalol 100 mg on an increase in HR during a submaximal exercise was significantly greater than during labetalol 100 mg. These data indicate that although plasma drug concentrations are lower after dilevalol than following labetalol, the beta-blocking activity of dilevalol is more potent than labetalol.

Administration, Oral↗
PubMed1989

Clinical pharmacology of dilevalol (II). The pharmacokinetic, pharmacodynamic, and tolerance studies of dilevalol during repeated administration in healthy subjects.

Dilevalol (50 mg) was given orally twice daily for eight days in six healthy subjects. All parameters were obtained following 1st (on day 1) and 15th (on day 8) dosages. Blood samples for plasma drug concentrations were taken for a 12-hour (after 1st dosage) or a 24-hour (after 15th dosage) post-drug period. Blood pressure (BP) as well as heart rate (HR) at supine position, during 50 degrees tilting and during a submaximal exercise were measured after each dosage. The mean time to maximum concentration (tmax) was faster, and the mean area under the plasma concentration-time curve (AUC) was greater after 15th dosage than following 1st dosage. No significant differences were observed in the maximum plasma concentration (Cmax), the distribution half-life (t 1/2 alpha) or the elimination half-life (t 1/2 beta) between the two dosages. BP at supine position as well as during 50 degrees tilting decreased significantly after each dosage, and did not differ between 1st and 15th dosages. Postural changes in BP or HR during 50 degrees tilting were not induced following 1st or 15th dosage. The suppressing effects (%R) on an increase in HR during a submaximal exercise were significantly larger after 15th dosage than after 1st dosage. A significant correlation was observed between plasma dilevalol concentration and %R in HR. These data indicate that the hypotensive effect of dilevalol is not altered during the repeated administration of the drug for 8 days. However, the beta-blocking activity of dilevalol might be enhanced during the repeated dosages, which is, in part, attributed to dosage-dependent elevation in plasma drug concentrations.

Administration, Oral↗
PubMed1989

[Basal plasma cholecystokinin levels in digestive diseases--comparison between CCK-8 like bioactivity by bioassay and CCK immunoreactivity by radioimmunoassay].

Basal plasma cholecystokinin levels were measured by a bioassay using dispersed rat pancreatic acini in various digestive diseases and compared with corresponding values by CCK-8 specific radioimmunoassay. The mean basal level in healthy volunteers was 0.40 +/- 0.06 pM. The basal level in liver cirrhosis was significantly elevated to 0.92 +/- 0.14 pM. The patients with cholestasis, that is, primary biliary cirrhosis and obstructive jaundice due to choledocholithiasis, bile duct cancer or lymph node metastasis , had markedly increased basal plasma CCK-8 like bioactivities from 1.88 pM to more than 25 pM. These CCK bioactivities were not correlative with CCK immunoreactivities. It was concluded not only that basal plasma CCK in patients with bile flow disturbance were truly increased, but also that interfering substances of the bioassay might appear in the plasma of these patients.

Adult↗
PubMed1987

Diuretic and uricosuric effects of traxanox sodium in healthy subjects. Single dose study.

A new compound, 9-chloro-5-oxo-7-(1H-tetrazol-5-yl)-5H-[1]-benzopyrano[2,3- b]pyridine sodium salt pentahydrate (traxanox sodium, Y-12141) has been shown to exert uricosuric effect in animal experiments. This study was performed to investigate the pharmacokinetics and pharmacological effects of this compound in healthy subjects by double-blind, cross-over comparison with placebo. The urine volume and urinary electrolytes increased significantly after single oral doses of 120 and 360 mg. Urinary excretion of uric acid tended to increase and serum uric acid decreased significantly. Traxanox sodium did not induce any significant change in blood pressure and pulse rate. These results suggest that traxanox sodium is a useful diuretic agent with uricosuric effect.

Administration, Oral↗
PubMed1985

Anomalous atlantoaxial portions of vertebral and posterior inferior cerebellar arteries.

In a review of the vertebral angiograms of 300 patients free from disease at the craniovertebral junction, we found atlantoaxial arterial anomalies in 2,3%. These were: 2 cases in which the vertebral artery ran in the spinal canal below C1, 3 cases of duplication of the vertebral artery above and below C1, and 2 cases of origin of the posterior inferior cerebellar artery at C2. Although these arteries ran in the spinal canal between C1 and C2, they never encroached upon the posterior third of the canal. From the survey of another 21 patients having bony abnormalities at the craniovertebral junction, the first type of arterial anomaly described above was seen in 4 patients and associated with failure of segmentation of the embryonic sclerotome such as occipitalization of the atlas or Klippel-Feil syndrome. It is possible to relate the development of these anomalous vessels to malarrangement of the embryonic segmental arteries. Our results indicate that one must be cautious with lateral C1/2 puncture or surgical exposure of the region.

Adult↗
PubMed1985

Functional prognosis of surgical treatment of craniosynostosis.

Twenty-three cases of craniosynostosis were studied with regard to age at operation, symptoms, operative methods, and long-term results. Long-term results of 20 cases that were followed up for more than 1 year after surgery showed that mental retardation remained in 8 cases; a slight improvement in mental function was observed in only 2 cases. Of the 8 patients with mental retardation, 7 were operated on more than 6 months after birth, 7 showed striking digital impression on skull X-ray films and 5 were suffering from oxycephaly. Of the 8 patients with mental retardation, 5 had suffered from perinatal asphyxia or had seizures during delivery and subsequent past history. From these observations, factors affecting prognosis are: (1) age at operation; (2) the degree and duration of increased intracranial pressure; (3) the extent and degree of suture closures; (4) perinatal asphyxia and seizure disorders.

Child↗
PubMed1985

Intraoperative sonography for brain tumor surgery.

Intraoperative ultrasonography was performed during craniotomies for nine cases of primary brain tumor. B-mode real-time linear scanner with a small probe head has proven to be extremely useful for detecting and localizing subcortical or deep seated brain tumors. The sonography clearly showed the tumors as hyperechogenic mass except in one case, calcifications as more echogenic particles, cyst as hypoechogenic area. Physical principles of echogenicity are discussed, and major advantages and disadvantages of intraoperative ultrasonography in neurosurgery are mentioned.

Adult↗
PubMed1985

[Transoral anterior approach to foramen magnum meningioma--a case report and review].

A case of an anteriorly located meningioma in the region of the foramen magnum, successfully treated by a transoral approach, is reported. A 60-year-old woman was admitted to the author's department on January 19th, 1983. Six years before admission, she began to experience the gradual cold dysesthesia in the both palms, and then developed gait disturbance, clumsiness of the right hand and a stiffneck. She was found to have atrophied hands, mild spastic tetraparesis, ataxia and hypalgesia under the bilateral C2 spinal levels. A CT scan disclosed a patchy hyperdense lesion, which was enhanced homogenously with contrast medium, occupying almost all the intradural extramedullary space at the foramen magnum. The transoral approach was employed following preliminary tracheostomy. The tumor, extending about one centimeter superiorly to the basion and inferiorly to the upper border of C2 body, was removed completely, and then the dural defect was covered with a piece of fascia and gelform. An anterior occipitocervical fusion was performed extending to C2 using a block of an antogenous iliac bone. Post-operatively immobilization was secured by a Halo-Vest. But unexpectedly, CSF leakage was disclosed several days after the surgery without neurological deterioration. On the 17th day following first surgery, a re-operation was performed. The dural defect was successfully repaired with a piece of fascia by interrupted sutures in an illustrated fashion (Fig. 5). A piece of muscle was then placed in the epidural space created by bone removal. A fusion of the atlanto-axial joint not extending to the basiocciput was employed.(ABSTRACT TRUNCATED AT 250 WORDS)

Dura Mater↗
PubMed1985

[Surgical treatment of trigeminal neuralgia--neurovascular decompression established by Jannetta].

The etiology of trigeminal neuralgia has been unknown. However, recently, trigeminal neuralgia is believed to be caused by vascular cross compression at the root entry zone of the trigeminal nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al. They emphasized that the pain was relieved by surgery. In this report, we will discuss the operative findings and results in a series of 8 patients who have undergone neurovascular decompression. The postoperative progress in all of these patients was excellent and relieved of the pain. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia.

Adult↗
PubMed1985

[Surgical results and clinical analysis of 19 cases of acromegaly].

The authors have been analyzed the results from 19 patients who underwent transsphenoidal microsurgery for their pituitary adenomas. All of the patients showed some degree of clinical improvement after surgery. Surgical complications seemed to be negligible except one patient who had suffered from persistent diabetes insipidus postoperatively. The results in terms of postoperative GH levels were almost good in 17 patients in whom preoperative GH levels had been below 100 ng/ml. There was no relationship between postoperative GH values and tumor grades or types (in Hardy's classification) in this group of patients. In 12 of them, postoperative GH values fell and remained below 5 ng/ml, although abnormal GH responses to dynamic testing were still noted. On the other hand, the results were particularly poor in the remaining 2 patients in whom preoperative GH levels had been higher than 100 ng/ml. Postsurgical radiation therapy was applied to 5 cases. Postirradiation GH values decreased in all 5 cases, but did not reach to the normal level (below 5 ng/ml) in 3 of them.

Acromegaly↗
PubMed1985

[Two cases of giant fusiform aneurysm presenting ischemic attacks].

It is said that major clinical sign of giant fusiform aneurysm is so-called mass sign compressing surrounding tissues and ischemic attack caused by the aneurysm is very rare. The authors experienced such uncommon two patients with partially thrombosed fusiform aneurysm who developed ischemic attack. Case 1: A 68-year-old man was admitted to our hospital in semicomatous state with ocular bobbing and decorticate posture of sudden onset. Enhanced CT scans taken at admission showed a presence of homogenously enhanced mass continuing to bilateral posterior cerebral arteries, which compressed the pons from right ventro-lateral side (Fig. 1 a,b). Plain CT scan taken 10 days after admission demonstrated extensive low density area in the pons (Fig. 1c). Basilar artery and P1 segment of the right posterior cerebral artery are ectatic, tortuous and elongated (Fig. 2a). The ectatic basilar artery was displaced upward and posteriorly (Fig. 2b). He developed locked-in syndrome and died of pneumonia six months after admission. At autopsy, large aneurysm measuring 3.5 X 2.0 X 1.9 cm was verified in the basilar artery (Fig. 3a). Cross section of the basilar artery aneurysm showed that laminated thrombosis nearly occupied the lumen with partially unobstructed portion (Fig. 3b). Also, horizontal section of the pons demonstrated a presence of old infarction located in the perforating arteries territory (Fig. 3c). Case 2: A 42-year-old man was initially hospitalized in 1978 because of multiple intracranial meningiomas and subtotal removal of meningiomas located in the tuberculum sellae and the foramen magnum was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗