Biomedical subjects

M Uematsu

Publications and source records attributed to M Uematsu.

At least 127 records · Page 7Linked to original sources

PubMed1992

Primary non-AIDS related brain lymphoma. Patterns of failure following radiotherapy.

Thirteen patients with primary brain lymphoma (PBL) were treated with radiotherapy. Three patients also had ocular involvement with retinal masses at initial presentation. All but one patient received conventional whole brain irradiation and, in addition, spinal irradiation, intrathecal methotrexate or orbital irradiation were given in two, two and four patients respectively. The radiation doses for involved sites ranged from 40 to 65 Gy, and for prophylactic sites from 30 to 50 Gy. After radiotherapy, all patients had complete regression of the tumor on computed tomography. Nine patients relapsed, 5 of them with brain recurrence. Two patients had ocular recurrence exclusively as their first relapse. The remaining two relapsing patients had bone lesions. One patient died intercurrently. As a result, only three patients are alive and free of disease after 16 to 36 months and all three received some adjuvant treatment in addition to whole brain irradiation.

Adult↗

PubMed1992

[Long-term results of the Blalock-Taussig shunts].

One-hundred and thirty-six patients received the classical Blalock-Taussig shunts between 1980 and 1990. Their age range at operation was 4 days to 12.8 years and their median age was 13 months. The operative mortality rate was 0.7% (1/136). The survivors were followed up from 1 month to 11.5 years, 5.4 years in average. Twenty-five patients required another shunt and the mean interval to that procedure was 2.4 years (modified Blalock-Taussig 23, classical Blalock-Taussig 2, Glenn 1, internal mammary artery-pulmonary artery shunt 1). Forty-five patients received corrective operations, there were four operative deaths (Fontan 2, Rastelli 2). There were 15 late deaths of which three deaths were not cardiogenic. One year after operation, 91.0% of patients remained in well-palliated condition. At three years after operation, 76.4% of patients continued to be in well-palliated condition. There were twelve neonates in this series. Their age range was 4 to 26 days and their median age was 13 days. There was no operative death. Five patients required second shunt. There were two late deaths. At present, six patients continue to be in well-palliated condition 8 months to 9 years after first operation. Angiographic findings showed the stenotic change of the vascular anastomoses in 49.3% (35/71) of patients. This study suggests that polydioxanone suture (PDS) will be useful for the growth of the anastomoses in Blalock-Taussig operation.

Anastomosis, Surgical↗

PubMed1992

[Evaluation of left ventricular relaxation by mitral regurgitant curve].

To examine whether left ventricular (LV) isovolumic relaxation can be assessed noninvasively using a continuous-wave Doppler technique, we compared Doppler-determined parameters derived from mitral regurgitation (MR) velocity curve with micromanometer-derived indices of LV relaxation, peak negative dP/dt and tau, in 9 patients with MR (5 with dilated cardiomyopathy, 2 with old myocardial infarction and 2 with rheumatic MR). The rate of LV pressure decay (delta P/delta t) at aortic valve closure was calculated from the recordings of MR jet velocities based on the simplified Bernoulli equation. The time constant of LV pressure decay (tD) was determined as the time from the aortic valve closure to the point where the velocity declined by (1/e)1/2. Doppler-determined delta P/delta t correlated well with hemodynamic peak negative dP/dt (r = 0.97, p < 0.001), and tD with hemodynamic tau (r = 0.89, p < 0.005). Thus, we concluded that left ventricular isovolumic relaxation can be noninvasively assessed with a continuous-wave Doppler technique in the presence of mitral regurgitation.

Blood Flow Velocity↗

PubMed1991

[Limited chemotherapy and radiotherapy for stage I-II intermediate or high grade lymphoma of nodal sites or Waldeyer's ring].

Between 1982 and 1988, forty-four patients with stage I-II intermediate or high grade lymphoma of nodal sites or Waldeyer's ring were treated with the protocol of full dose CHOP and irradiation. Two of these patients had B symptoms. Because the early results of the initial standard treatment with 6 cycles of CHOP and 40 Gy of irradiation were excellent with no relapses, the number of cycles of CHOP and total doses of irradiation were gradually reduced in order to make treatment safer. Since 1987, 3 cycles of CHOP and irradiation of 30 Gy has become the new standard treatment for patients without bulky tumor. All but a few of the 44 patients were treated within the range of these two standards. The follow-up period of 44 patients ranged from 20 to 94 months with median of 56 months. Two patients relapsed and died of disease, both of whom had B symptoms at the initial presentation. Another patient with a prior history of liver dysfunction died of complications of CHOP. The remaining 41 patients are currently alive and free of disease. Fifteen of these patients received the new standard treatment with median follow-up of 28 months, and all are alive and well. In the same period, thirteen patients with the same stage, histology and primary sites were treated outside the protocol mainly with radiation alone because of old age or very small lesion. Five of them died of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Molecular identification and comparison of the starch synthase bound to starch granules between endosperm and leaf blades in rice plants.

Normal (nonglutinous) rice plants (Oryza sativa and O. glaberrima) contain more than 18% amylose in endosperm starch, while waxy (glutinous) plants lack it in this starch. In contrast, leaf starch contained more than 3.6% amylose even in waxy plants. SDS-PAGE analysis of proteins bound to endosperm starch granules in the normal plants revealed a single band with a Mr of 60 kd, whereas waxy plants did not exhibit a similar band. The activity of starch synthase (NDP-glucose-starch glucosyltransferase) was completely inhibited by antibody against the 60-kd protein. Thus, we conclude that the 60-kd protein is the waxy protein encoded by the Wx allele, which also plays a role in the synthesis of nonglutinous starch in endosperm tissue. In leaf blades, the proteins bound to starch granules separated into five bands with Mr's of 53.6 to 64.9 kd on SDS-PAGE. Analysis of these proteins by immunoblotting using antiserum against Wx protein and inhibition of starch synthase activity by the synthase antibody revealed that none of these proteins was homologous to Wx protein. We suggest that the synthesis of amylose in leaf blades is brought about by a protein encoded by a gene(s) different from the Wx gene expressed in the endosperm.

Amylose↗

PubMed1991

[A case of left main bronchial rupture due to bronchocath tube].

A 68-year-old woman underwent a right upper lobectomy for lung cancer. After resection, we noticed the left main bronchial rupture due to bronchocath tube (polyvinyl chloride double lumen tube). The lesion of the rupture was repaired by interrupted sutures with 4-0 prolene. Subsequent course of the patient was uneventful. Tracheobronchial rupture is rare complication of intubation with polyvinyl chloride double lumen tube. There are 6 cases of this complication last five years in Japan. The cause and prevention of this complications are described. It is important to use an adequate tube size, to prevent malposition of the tube and overinflation of the bronchial balloon.

Aged↗

PubMed1991

Recovery of circadian rhythm of plasma cortisol levels after a 3-day trip between Tokyo and San Francisco.

The objective of the present study is to investigate the change in the circadian rhythm of plasma cortisol levels following a 3-d trip and a westbound return flight from San Francisco (SFO) to Tokyo. Six healthy male students volunteered for the project. Plasma cortisol levels were monitored 4 times daily for 13 d during the experimental period. In Tokyo, the baseline pattern of cortisol concentrations showed the classical diurnal profile. During the 50-h stay in SFO, phase advancement of 8 h was observed for the initial 32 h. This was followed by a disturbance in the profile for the remaining 18-h period. After returning to Tokyo, the subjects exhibited the original diurnal pattern beginning Day 1. However, complete resynchronization was not apparent until Day 4 after the return.

Adaptation, Physiological↗

PubMed1991

[A case of localized pleural mesothelioma].

A case of localized pleural mesothelioma is reported. A 49-year-old man was operated for coin lesion detected on routine chest X-ray. A tumor arose from the visceral pleura of right lower lobe and was pedunculated. Size of the tumor was 4 x 3 x 3 cm. Cut surface of the tumor was solid and yellowish white. Pathological diagnosis was fibrous type of the pleural mesothelioma. The patient is well and has no sign of recurrence for three years. There are 123 cases of localized pleural mesothelioma including our case in Japan. Five in 78 cases which was diagnosed to be benign histologically at operation, had recurrence later. It is important to follow up strictly for long term.

Humans↗

PubMed1990

[Non-Hodgkin's lymphoma of the Waldeyer's ring: the treatment results of the past 22 years and the significance of CHOP].

From 1966 through 1988, 124 patients with non-Hodgkin's lymphoma of the Waldeyer's ring were treated. Seventy patients were male, and 54 were female. Age ranged from 5 to 81 years with a median value of 53 years. Pathological slides were reviewed and reclassified according to the Working Formulation. Diffuse large cell type was most common (53%). Since 1981, CHOP has been incorporated into the treatment including stage I and II patients. During these 22 years, new imaging modalities have developed, and an upstage rate by using those modalities has increased from 5% to 9%. In order to make the comparison meaningful, we used clinical stage determined at the day of the first visit. Fifty-one patients were clinical stage I, 64 were stage II, seven were stage III, and two were stage IV. B symptom was seen in 8 patients. Relapse developed in 45 patients (41%) out of 111 who achieved complete remission, and distant relapse was most frequent (89%). Salvage therapy was successful in only three patients of the 45 relapsed patients. Overall 5-year freedom from relapse (FFR) were 38% for the patients treated until 1980, and 69% for the patients treated thereafter (p less than 0.01). Addition of CHOP to radiotherapy has increased 5-year FFR of the stage II patients from 31% to 81% (p less than 0.01). In stage I, 5-year FFR was 71% in the patients treated with CHOP and radiotherapy, and it was 27% treated without CHOP. But the difference has no statistical significance, and we can not rule out the presence of selection bias.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

Doppler echocardiographic quantitation of cross-sectional area under various hemodynamic conditions: an experimental validation in a canine model of supravalvular aortic stenosis.

The hemodynamic effects on cross-sectional area calculated with the continuity equation were assessed in canine experiments. In 13 open chest dogs, 46 supravalvular aortic stenoses were created by aortic root banding. The cross-sectional area of the stenosis was calculated by Doppler echocardiography with application of the continuity equation before and after the following hemodynamic interventions: protocol 1, atrial pacing at 90, 120, 150 and 180 beats/min after sinus node crush; protocol 2, preload reduction by mild and severe clamping of the inferior vena cava; and protocol 3, afterload augmentation by mild and severe clamping of the descending aorta. In each observation, a dimension of the stenosis was directly measured by two-dimensional echocardiography, and the cross-sectional area was determined as a reference standard. As a result of the hemodynamic interventions, significant changes were observed in stroke volume and pressure gradient (protocol 1), in cardiac output, stroke volume and pressure gradient (protocol 2) and in heart rate, cardiac output and pressure gradient (protocol 3). Despite these changes in hemodynamic variables, the Doppler-derived cross-sectional area showed no significant change for a given stenosis. In addition, areas calculated with the continuity equation (x) agreed well with those determined by two-dimensional echocardiography (y) (r = 0.96, p less than 0.001, y = 0.97x + 0.02, SEE = +/- 0.06 cm2). Thus, it is concluded that Doppler echocardiography with application of the continuity equation accurately predicts the stenotic cross-sectional area over a wide range of hemodynamic conditions in supravalvular aortic stenosis.

Animals↗

PubMed1990

Transient global amnesia and Raynaud's phenomenon in scleroderma.

Transient global amnesia (TGA) is a well-recognized clinical entity, but its pathophysiology and prognosis have remained arguable. We reported that a 63-year-old woman with scleroderma developed two TGA episodes. The patient sometimes suffered from headaches when Raynaud's phenomenon appeared in her fingers, but she did not experience further cerebrovascular events. This case suggests that the unique clinical presentation of this syndrome may result from an ischemic event, possibly triggered by a vasospastic mechanism like Raynaud's phenomenon.

Amnesia↗

PubMed1990

Coping styles to basic disorders among schizophrenics.

Coping efforts to subjectively experienced basic disorders were investigated by self-report in 60 chronic schizophrenics in Japan, and the relationships to clinical and demographic variables, intelligence, personality, and attitude toward their illness were analyzed. Self-reports on coping efforts were obtained for more than half of all subjectively experienced basic disorders, and the predominant technique was reported to be the approach oriented towards problem-solving. Within each coping style, the behavioral change, divertive problem-solving approach correlated negatively with hospitalization and symptoms, and the struggle, problem-solving efforts without any effective results correlated positively with symptoms. Suggestions regarding integration of these self-efforts into psychosocial treatment of schizophrenia are discussed.

Adaptation, Psychological↗

PubMed1990

Quantitative color flow imaging to measure the two-dimensional distribution of blood flow velocity and the flow rate.

A quantitative Doppler color flow imaging was employed to measure the two-dimensional distribution of blood flow velocity and flow rate in a large vessel. Regional blood flow velocity was determined by converting the color intensity at the respective pixel into corresponding flow velocity and correcting the flow velocity for spatial ultrasound beam incident angle. Instantaneous flow rate was determined precisely from the image of velocity distribution on the cross-section of the flow tract in a steady flow model circuit. In clinical application, the differences in phasic changes in two-dimensional velocity distribution in the ascending aorta, between normal subjects and the patient with aortic regurgitation, were clearly depicted. The quantitative color flow imaging may have great potential to determine noninvasively and real-timely the two-dimensional distribution of flow velocity as well as flow rate in a large vessel.

Aortic Valve Insufficiency↗

PubMed1990

[Intrapleural administration of CDDP against malignant pleural effusions in breast cancer].

Malignant pleural effusion in the patients with breast cancer commonly occurs, and is a life-threatening factor. The present paper shows the usefulness of intrapleural administration of CDDP in six cases. A decrease of pleural effusions was observed in all cases. Treatment was effective in two cases of CR and four cases of PR. A median survival from initiation of intrapleural therapy is 17 months (range 2-47 months). This procedure produced distinctly fewer side effects than intravenous administration. The results of this trials suggest that CDDP should be considered as an active agent in the treatment of malignant pleural effusion in the patients with breast cancer.

Aged↗

PubMed1989

[Results of the treatment of Hodgkin's disease: the importance of establishing and executing a protocol].

A retrospective analysis was performed on 32 patients seen at Keio University Hospital and its affiliated hospitals from 1976 to 1987. Twenty-two patients were treated with our protocol, and the other 10 were not for several reasons. In this study, we compared the results of the treatment of these two groups. There were 20 males and 12 females. Age ranged from 13 to 72 years with a median value of 36 years. Histologically, six had lymphocytic predominance, 12 nodular sclerosis, 14 mixed cellularity. In the protocol group, seven were clinical stage I, 12 were CS II, two were CS III, and one was CS IV. Nine patients in the protocol group underwent staging laparotomy, and four CS II patients were upstaged to PS III. In the non-protocol group, five were CS I, four were CS II, one was CS III. According to the protocol, staging laparotomy was done excepting CS III.IV patients and some of CS I patients. In case of CS I without laparotomy, pathological stage(PS) I.II, or PS III1 with minimal splenic involvement, they were treated with radiation only. The rest of the patients were treated with chemotherapy and booster irradiation. Ten-year survival and 10-year relapse-free survival were 100%, 75%, respectively in the protocol group. In the non-protocol group, they were 31% and 32%, respectively. When picking up 17 patients treated by the authors through the whole process, 10-year survival and 10-year relapse-free survival were 100%, 92%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1989

Elevated plasma prostaglandin E2 levels in schizophrenia.

Plasma levels of prostaglandin E2 (PGE2) were determined with radioimmunoassay in 40 DSM-III schizophrenics, 15 patients with other mental disorders, and 23 normal controls. The mean value of plasma immunoreactivity of PGE2 was significantly higher in the schizophrenic patients than in the normal controls. Schizophrenic patients with high plasma PGE2 levels had more guilt feelings and hallucinatory behavior on BPRS, relatively successful heterosexual relations, and a higher incidence of birth complications.

Adolescent↗

PubMed1989

Limited atrial compensation to reduced early diastolic filling in hypertensive patients with advanced left ventricular hypertrophy: a Doppler echocardiographic study.

To assess atrial contribution to left ventricular (LV) filling in hypertension, we studied, using pulsed Doppler echocardiography, 22 hypertensive patients without apparent LV hypertrophy (LVH), 12 hypertensive patients with LVH, and 24 age-matched normal subjects. From mitral flow velocity waveform, we determined peak velocity of early diastolic filling flow (peak E), peak velocity of late diastolic filling flow (peak A), and the peak A/peak E ratio (peak A/peak E). Peak E decreased in hypertensives without apparent LVH and showed a further decrease in hypertensives with LVH compared with normal subjects (57 +/- 8 [mean +/- SD]; P less than 0.001, 46 +/- 7; P less than 0.0001, vs 65 +/- 10 cm/s). On the other hand, peak A/peak E increased in hypertensives without apparent LVH, and greatly increased in hypertensives with LVH (1.06 +/- 0.14; P less than 0.001, 1.40 +/- 0.29; P less than 0.0001, vs 0.79 +/- 0.21). However, increased peak A was not significantly different between the hypertensive groups (60 +/- 8 vs 64 +/- 8; NS, both; P less than 0.001 vs 50 +/- 10 cm/s for normal subjects). In hypertensives, we found no significant correlation between peak A and the wall thickness index (WTI, determined as mean LV wall thickness normalized by LV diastolic dimension), whereas peak E was significantly correlated with WTI (r = -0.65; P less than 0.001). Our findings indicate that atrial contraction can not fully compensate the decrease in early diastolic filling caused by advanced LVH. We conclude that atrial compensation for reduced early diastolic filling is limited in hypertensive patients with advanced left ventricular hypertrophy.

Adult↗

PubMed1989

Semiquantitative evaluation of aortic regurgitation by Doppler echocardiography: effects of associated mitral stenosis.

The accuracy of pulsed and continuous wave (CW) Doppler methods for evaluating aortic regurgitation (AR) was compared in patients with and without mitral stenosis (MS), with aortic root angiography as a gold standard. AR was diagnosed with pulsed Doppler echocardiography, by the detection of broad frequency spectral patterns in the isovolumic relaxation time. If these indications were present, AR was graded by examining the extent of diastolic turbulence in the left ventricular cavity (flow mapping method). With CW Doppler echocardiography, AR was diagnosed by the detection of a peak velocity of greater than 2 m/s; if this velocity was attained, AR was graded by measuring the time from the peak velocity to half the peak velocity (half-time method). The angiographic grade corresponded to that determined by the pulsed and CW Doppler methods in 37 and 37 of 46 patients without MS, respectively. Angiographic grade corresponded to the grade determined by the pulsed and CW Doppler methods in 13 and 17 of the 23 patients with MS, respectively. Eight of 10 discrepancies between pulsed Doppler and angiographic grades were due to overestimation of AR by the flow mapping method, apparently because the transmitral jet produces diastolic turbulence in the left ventricular cavity independent of AR. On the other hand, three of six discrepancies between CW Doppler and angiographic grades were due to the incapability of detecting signals of AR by CW Doppler echocardiography. Thus both the pulsed and the CW Doppler methods are useful to evaluate AR in patients without MS. In patients with MS, however, AR is most accurately diagnosed by the detection of AR signals in the isovolumic relaxation time by pulsed Doppler echocardiography, and the degree of AR is more accurately assessed by the CW Doppler half-time method.

Adult↗