Biomedical subjects

M Ueda

Publications and source records attributed to M Ueda.

At least 1,045 records · Page 58Linked to original sources

PubMed1990

[A study of ultrasonic scaling in combination with povidone-iodine solution. (1)].

The effects of ultrasonic scaling in combination with povidone-iodine solution were examined clinically. The results obtained were as follows: 1. Three days after instrumentation, significant improvement was found in all experimental groups. Thereafter the improvement was at the same level and backing in each group. 2. Clinical findings, with exception of plaque index, showed improvement with ultrasonic scaling in combination with povidone-iodine solution in comparison with ultrasonic scaling alone and root planing.

Combined Modality Therapy↗

PubMed1990

Distributional and developmental variations of multiple forms of calpastatin in mouse brain.

DEAE-cellulose chromatography of mouse brain extract demonstrated the occurrence of two calpastatin fractions, CS-0.1 and CS-0.2, with distinctly higher content of the latter. CS-0.1 emerged from the column at 0.1 M NaCl, inhibited calpain II more strongly than calpain I, and identified also immunologically with hitherto known calpastatin. CS-0.2 emerged at 0.2 M NaCl, inhibited calpain I more strongly than calpain II, and did not crossreact with anti-calpastatin antibody used. Fairly consistent amounts of CS-0.2 and calpain II were found in the brain of mice from 10 days to 10 weeks after birth, while CS-0.1 became measurable only after 4-week growth. In adult mice, CS-0.1 was highest in specific activity in brainstem, lower in cerebellum, and not detectable in cerebral hemisphere. Physiological significance of multiple forms of calpastatin and their variations found is not known.

Aging↗

PubMed1990

[A clinical study of the renal pelvis and ureteral cancer].

During the 13 years from 1976 to 1988, 160 patients with renal pelvic and ureteral cancer were reviewed based on a new general rule for clinical and pathological studies on renal pelvic and ureteral cancer of Japanese Urological Association. There were 71 renal pelvic cancers, 80 ureteral cancers, and 9 cancers in both regions. Patients ranged in age from 35 to 91 years old (average: 63). The involved side was right in 63 and left in 97. The most frequent symptom was hematuria, which was seen in 81.1%. IVP revealed the findings of filling defects, hydronephrosis, and non-visualized kidney in 99.7% of the patients. Total nephroureterectomy with bladder cuff resection was performed in 123 cases, nephroureterectomy in 16 cases, nephrectomy in 5 cases, partial ureterectomy in 10 case, and biopsy in 6 cases. As adjuvant therapies, irradiation was performed in 32 and chemotherapy in 123. Histologically, 156 were with transitional cell carcinoma, one squamous cell carcinoma, one adenocarcinoma and 2 unclear, the over-all survival rate of this study at 1, 3, 5 and 10 years were 86.8%, 73.0%, 65.3% and 45.6%, respectively. No patient with lymph-node metastasis (N+) survived longer than 5 years. All patients with M(1) died within one year. There were no difference of prognosis between renal pelvic cancer and ureteral cancer. Regarding various prognostic factors, our series gave the same results as previous reports. However, it should be stressed that pathological grading was the most important prognostic factor.

Adult↗

PubMed1990

[A case of advanced thoracic esophageal cancer with marked response to bleomycin absorbed on activated carbon particles (BLM-CH44), methotrexate, and cisplatin].

A 67-year-old women, who suffered from advanced esophageal cancer with left main bronchus and azygous vein involvement, was treated by combined administration of bleomycin absorbed on activated carbon particles (BLM-CH44, 10 mg/body), methotrexate (30 mg/body i.m.), and cisplatin (75 mg/body i.v.). BLM-CH44 was injected around tumor and total dose of BLM was 120 mg, that of MTX was 180 mg, and that of CDDP was 225 mg. After therapy, the sign of extra-esophageal spread disappeared and a radical operation was performed. Microscopically, the lesion of the esophagus was almost disappeared, and CH44 staining lymph node involvement was completely disappeared.

Aged↗

PubMed1990

Widespread thrombosis and necrotizing arteritis of the liver in a 69-year-old woman with symptoms simulating those of temporal arteritis.

Autopsy findings of widespread thrombosis and necrotizing arteritis of the liver in a 69-year-old woman who had clinical symptoms suggesting those of temporal (giant cell) arteritis were presented. The lesion of the temporal artery was not of temporal arteritis but of thrombosis, part of widespread thrombosis, which occurred in the small arteries having hypertensive arteriolopathy. This case also had an arteritis of the liver resembling polyarteritis nodosa (PN). The pathologic processes demonstrated in this case suggested that the temporal arteritis-like symptoms may be brought about by occlusion of the temporal artery. Temporal arteritis is a nonfatal and self-limited disease and little information has been obtained from autopsy material. Accordingly, it is necessary to collect autopsy cases of temporal arteritis to investigate this disease through observations of whole bodies. Recently we examined a case which appeared clinically having symptoms of temporal arteritis, but the autopsy revealed that the symptoms were not brought about by temporal arteritis but by thrombosis of the temporal artery. It is the purpose of this paper to present this case and to discuss some problems concerning genesis of symptoms of temporal arteritis.

Aged↗

PubMed1990

Characteristics of cerebral glucose utilization in dementia.

To make clear the characteristics of cerebral glucose uterization in dementia, PET studies with 18F-FDG were carried out. Taking the pattern of 18F-FDG uterization, dementia can be subdivided into two types. One type shows a simultaneous and symmetrical reduction glucose uterization in the posterior part of neocortex covering the temporal, parietal and occipital association cortices. This is referred to as type I. Although this type constitutes only about 1/5 of all dementia patients, it is considered the fundamental type of dementia. Aside from this, there is type wherein a simultaneous and symmetrical reduction in glucose uterization of the neocortex. This is type II. It constitutes about 4/5 of all dementia patients which is far more type I. There are no essential difference in the characteristics of cerebral glucose uterization in AD and MID. However, with regards the mean, AD is lower than MID. Various organic defect in neocortex do not correlate with the global reduction in glucose uterization in dementia patients. These results suggest that the reduction in glucose uterization in dementia may be functional disorder.

Aged↗

PubMed1990

Severe atrophy of amygdala and hippocampus in both Alzheimer's disease and multi-infarct dementia.

Alzheimer's disease and multi-infarct dementia are the two main diseases entirely different from each other producing almost the same abnormalities as dementia syndrome. With magnetic resonance imaging, severe atrophy of amygdala and hippocampus in both Alzheimer's disease and multi-infarct dementia was observed. There was no essential difference on the atrophic findings between Alzheimer's disease and multi-infarct dementia. This result therefore suggest that the quantitative measurement of amygdaloid and hippocampal atrophy predicts dementia.

Aged↗

PubMed1990

[Aneurysm of the diverticulum of the ductus arteriosus in the adult].

Aneurysm of the diverticulum of the ductus arteriosus is a rarely reported entry in adult. To our knowledge, only two previous patients underwent successful aneurysmectomy in Japan. Three new cases of aneurysm of the ductus arteriosus diverticulum in the adult, all diagnosed preoperatively and successfully repaired, are presented. All three patients are alive 17 to 44 months postoperatively. Our experience with these patients suggests several important features of these aneurysms: (1) CT scanning with contrast enhancement will almost invariably confirm the diagnosis of these aneurysms. (2) Exposure through a median sternotomy is generally good and carries less operative morbidity from rupture than a posterolateral thoracotomy. (3) Because of their critical location and the high incidence of rupture in reported cases, aneurysms producing symptoms, or those showing progressive enlargement should be surgically resected. (4) When a succular aneurysm of the aortic arch is demonstrated expanding toward the aortopulmonary window with adhesion to the pulmonary artery, the possibility of its origin from the ductus arteriosus must be investigated.

Age Factors↗

PubMed1990

[The study on salivary clearance in children. 3. The volume of saliva in the mouth before and after swallowing].

Several kinds of substances such as acids and bacterial toxins diffuse from dental plaque into the salivary film which moves slowly between the plaque on the teeth and oral mucosa. The volume of saliva retained in the mouth before and after swallowing seem to be very important with respect to clearance of such substances from plaque. In 30 subjects, five-year-old children of each gender, the volume of saliva in the mouth after swallowing (X) could be computed by measuring the potassium concentration in unstimulated saliva and in the expectorate after a five-second rinse with 3 ml of water immediately following a swallow. The volume of saliva normally swallowed was calculated from the unstimulated salivary flow rate and the normal swallowing frequency. The volume of saliva before swallowing (Y) was calculated as the total of (X) plus the volume normally swallowed. The unstimulated salivary flow-rate was 0.22 +/- 0.14 ml/min, the mean values of (X) and (Y) were 0.38 +/- 0.11 ml and 0.50 +/- 0.15 ml, respectively, and there were no significant differences in these values based on gender. These values were about half the values of those parameters in adults (Lagerlöf and Dawes, 1985), and insertion in the computer program (Dawes, 1983) of these values suggested that sugar clearance in the five-year-old children would be slightly faster than in adults.

Child, Preschool↗

PubMed1990

[An interesting case of pituitary apoplexy showing abnormality in water-electrolyte before and after surgery].

Cases which present abnormality in water-electrolyte before and after operation of pituitary adenoma are occasionally reported. The authors have encountered a case in which neurological symptoms became aggravated abruptly with pituitary apoplexy after admission, hyponatremia was noted before operation and polyuria, not hypotonic urine was observed after operation. As a result of an endocrinological examination which may have an influence on water-electrolyte (ADH, aldosterone, ANP, etc.) the ADH level in hyponatremia before operation was high at 6.8 pg/ml; so, it was taken as SIADH. According to a study at the time of polyuria after operation, the ADH level was normal at 2.4 pg/ml, the ANP level was abnormally high at 140 pg/ml and the specific gravity of the urine was kept at 1.010 or more. So, polyuria was considered due to abnormally increased content of serum ANP. In polyuria due to abnormally increased content of serum ANP, the osmotic pressure of the urine is maintained relatively well, which is a clinical feature evidently different from diabetes insipidus. After operation for pituitary adenoma, water-electrolyte should be controlled with polyuria due to abnormally increased content of serum ANP in addition to diabetes insipidus taken into consideration.

Atrial Natriuretic Factor↗

PubMed1990

Disseminated intravascular coagulation after hepatic resection.

Disseminated intravascular coagulation (DIC) after hepatic resection is a serious complication that leads to a fatal outcome unless prompt treatment is instituted. Between April 1973 and June 1988, DIC occurred postoperatively in 18 of 192 patients who underwent hepatic resection because of a variety of diseases of the liver and biliary tract. The diagnosis was made on the basis of changes in platelet count, fibrinogen level, serum level of fibrin degradation product (FDP), and protamine sulfate test. Heparin was used in an earlier series but has been discontinued because of difficulty in determining the optimal dose in patients undergoing liver resection. Instead, we now use gabexate mesilate, which blocks the coagulation cascade without the aid of antithrombin III and works as an anticoagulant. Fifteen patients had uneventful recoveries, but three died. Two died of aggravation of DIC, which was a result of reoperation performed under the diagnosis of surgical bleeding. The other patient died of liver failure after fever of unknown cause persisted for 4 months. The rationale for the diagnosis and treatment of DIC after liver resection is documented, and the problems involved are discussed.

Anticoagulants↗

PubMed1990

Hepatic resection for hepatocellular carcinoma.

Between July 1973 and September 1988, 119 patients with hepatocellular carcinoma underwent hepatic resection at Keio University Hospital, Tokyo. Hepatic resection was performed not only for patients with liver cirrhosis and obstructive jaundice but also for patients with advanced disease. Eighty (67.2%) of the 119 patients had liver cirrhosis and four patients had obstructive jaundice. Two or more segments of the liver were resected in 56 (47.0%) patients, 29 of whom had liver cirrhosis. Eleven patients died within 30 days after surgery, an operative mortality rate of 9.2%. Seven additional patients could not be discharged from the hospital, resulting in a hospital death rate of 5.9%. Seventeen of these 18 patients had cirrhosis. Selection of patients with sufficient reserve function of the remaining liver portion, caused a great reduction of the incidence of postoperative death. The 5-year actuarial survival rate for the 101 patients who were discharged from the hospital was 39%, and 13 patients lived longer than 5 years, the longest survival period being 13 years 10 months. Hepatocellular carcinoma is amenable to hepatic resection if patients with sufficient reserve function of the liver are selected.

Adolescent↗

PubMed1990

[Subacute subdural hematoma--report of 4 cases and a review of the literature].

Subdural hematoma is divided roughly into two types acute and chronic. The two show an entirely different mode of illness. The authors have encountered 4 cases of subacute subdural hematoma in which characteristics of both types coexisted. These cases are characterized by the following. 1) The disease develops in the elderly persons with a history of trauma unknown or after minor head injury. 2) There is a relatively long period of clear consciousness and they visit a hospital when they are in the subacute stage, 3) They have a history of drinking alcohol heavily as a habit and there is a high risk of hypertension and diabetes. 4) Brain CT findings sometimes reveals mixed density hematoma. 5) Hemorrhage from the cortical artery is occasionally noted as the operative findings. Hematoma membrane is absent. 6) The outcome is generally poor because of systemic complications. As described above subacute subdural hematoma was similar to chronic subdural hematoma in the clinical course and CT findings. But operative findings of this disease indicated acute subdural hematoma. Repeated minor hemorrhage, related to coagulation disorder and brain atrophy would be important as the mechanism of subacute subdural hematoma. The effectiveness of perforation craniotomy as radical operation was low and removal of hematoma by major craniotomy was needed. The concept of subacute subdural hematoma is considered important in deciding on a therapeutic policy.

Acute Disease↗

PubMed1990

[Infarction in the territory of the anterior choroidal artery due to embolic occlusion of the internal carotid artery--report of two cases].

A case with infarction in the territory of the anterior choroidal artery (AChA) due to embolic occlusion of the internal carotid artery (ICA) is rare. We described two cases and investigated the mechanism of the territory of the AChA. Case 1 was a 69-year-old man. Case 2 was a 71-year-old woman. The neurological examination in both cases showed left homonymous hemianopsia, left facial palsy, left hemiparesis and left hemisensory disturbance. CT scan in these cases showed infarctions of the right uncus, amygdaloid nucleus, genu and posterior limb of the internal capsule, globus pallidus, lateral geniculate body and tail of the caudate nucleus. The right common carotid angiogram showed a complete occlusion of the ICA at its cervical segment in case 1 and at its carotid siphon in case 2. In both cases, the left carotid injection visualized the right anterior cerebral artery and right middle cerebral artery via the anterior communicating artery well, but the right AChA was not visualized. In case 1, the collateral pathways from the right external carotid artery (ECA) and the right posterior communicating artery (PCoA) to the right ICA were not supplied and the precommunicating segment of the right posterior cerebral artery was hypoplastic. In case 2, the collateral pathway from the right ECA to the right ICA was not supplied.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1990

[The effects of ulinastatin on the release of granulocyte elastase during pancreas surgery].

During a major abdominal surgery, intraoperative manipulation may cause circulatory changes, which lead to release of granulocyte elastase. Twenty one patients were studied to elucidate the release of granulocyte elastase and the inhibitory effect of a protease inhibitor (ulinastatin) on lysosomal enzyme release during pancreas surgery. Patients were divided into 3 groups. Patients in group A served as control. Patients in group B were given ulinastatin 10,000 units.kg-1 intravenously prior to surgery. Patients in group C were given ulinastatin 5,000 units.kg-1 intravenously twice prior to surgery and 3 hours after the start of surgery. The granulocyte elastase was measured by commercially available kits, at 7 points: prior to induction of anesthesia, immediately after tracheal intubation, 30, 60, 120, 180 min after the start of surgery and 30 min after surgery. The plasma level of elastase increased markedly during the operation in group A, it did not increase in groups B and C during the operation. Thirty min after the operation, the plasma level of elastase increased markedly in group A (354 +/- 63 micrograms.l-1), and in group B (396 +/- 167 micrograms.l-1). The plasma level of elastase was restored to normal levels 30 min after the operation in group C. These results indicate that granulocyte elastase values were maintained at significantly higher levels during and after pancreas surgery, and suggest that ulinastatin inhibits the release of granulocyte elastase during pancreas surgery.

Aged↗

PubMed1990

[Successful surgical treatment of ruptured thoracic aortic aneurysm into the lung].

A 62-year-old man was admitted to the hospital because of massive hemoptysis. Chest X-ray film, CT scan and IADSA demonstrated a large aneurysm of the thoracic aorta, extending from the ascending aorta to the descending aorta. Bronchoscopy revealed bleeding from left B1+2. Six days after the onset, replacement of the thoracic aorta with woven Dacron prosthetic graft, autoclaved after immersion in albumin, was performed with cardiopulmonary bypass and separate cerebral perfusion (700 ml/min) under moderate hypothermia (25 degrees C). Left upper lobe of the lung, adherent tightly to the posterior and medial wall of the aneurysm, was not dissected because bleeding from left bronchus was trivial even after systemic heparinization. Because of the cardiac dilatation, delayed chest closure was needed. Postoperative cardiac failure, necessitating much catecholamine support, was seen with gradual improvement and no neurological deficit was recognized. He was discharged from the hospital without any sequelae 2 months after the onset. Pathologic diagnosis was an atherosclerotic aneurysm.

Aorta, Thoracic↗

PubMed1990

[A simplified method for the assessment of C1 esterase inhibitor function].

From the result that the activated form of C1-s(C1-s) prolonged the kinetics of hemolysis via complement, this assay was applied to assess C1 esterase inhibitor (C1INH) function. In the kinetic assay, the complement hemolytic activity was evaluated by the time which required to cause 50% reduction of the initial turbidity of sensitized sheep erythrocytes, and was expressed as T1/2. (1) T1/2 of pooled normal human sera (p-NHS) showed dose-dependent prolongation by the addition of various amounts of C1-s. (2) Preincubation of various amounts of functionally pure C1INH with the constant amounts of C1-s inhibited dose-dependently the prolongation of T1/2 by C1-s. (3) The C1INH activity of NHS was 840 +/- 80 units/ml (n = 6) and that of the C1INH deficient serum was 80 units/ml, which were calculated from the standard curve established by the addition of various amounts of purified C1INH. This test requiring only C1-s and sensitized sheep erythrocytes is simple technically and high in sensitivity, and seems to be useful for the routine assay for C1INH function of human sera.

Animals↗

PubMed1990

[Surgical treatment of syphilitic ascending aortic aneurysm: a case report].

A 67-year-old man with positive serum reaction for syphilis had been followed by cardiologist for his moderate-sized saccular ascending aortic aneurysm and small-sized abdominal aortic aneurysm. Because of his transient ischemic attack probably secondary to the thrombo-embolism of the aneurysm and rapid growing of its size, surgical treatment was recommended. Resection of the saccular aneurysm with patch plasty of the ascending aorta was performed under the cardiopulmonary bypass associated with right side cerebral perfusion. At the time of operation, the mildly dilated ascending aorta and arch with multiple intimal ulceration were noted. Although his postoperative hemodynamic condition was stable, he suffered from multiple cerebral infarction, probably due to embolism migrated from the fragile aortic intima. His neurological condition was improved promptly, trivial hemi-paralysis was remained. The specimen of resected aneurysmal wall revealed syphilitic changes microscopically. We concluded that the extent of the aortic replacement with prosthetic graft should be deceived not only with its external appearance, but also with the changes of its inside.

Aged↗