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Biomedical subjects

M Uematsu

Publications and source records attributed to M Uematsu.

At least 163 records · Page 9Linked to original sources
PubMed1986

A proposal for treatment of invasive thymoma.

Eleven patients with invasive thymoma were treated with radiotherapy. All patients had gross anterior mediastinal tumors that invaded the adjacent structures, four of whom showed intrathoracic dissemination. Before radiotherapy, only one had macroscopic complete resection of the tumor, and another had partial resection; the other nine patients underwent biopsy only. All 11 patients achieved complete remission after radiotherapy, eight of whom have been free from relapse for 31 to 202 months. Three patients experienced recurrence within the thorax but outside the radiation fields. Even after whole mediastinal irradiation, recurrence could occur in the pleural cavity. Therefore, extended radiation fields including the entire hemithorax is recommended. Intensive combination chemotherapy was administered for two patients with recurrence and they achieved complete remission. A possible role of intensive chemotherapy in induction phase for invasive thymomas is discussed.

Adult↗
PubMed1986

Noninvasive evaluation of aortic regurgitation by continuous-wave Doppler echocardiography.

Continuous-wave Doppler echocardiography was used to examine the aortic regurgitant flow velocity pattern in 32 patients with aortic regurgitation (AR) and 10 patients without AR. The aortic regurgitant flow velocity patterns, characterized by a rapid rise in flow velocity immediately after closure of the aortic valve, high peak flow velocity, and a gradual deceleration until the next aortic valve opening, were successfully obtained in 30 of the 32 patients with AR (sensitivity 94%, specificity 100%). The velocity decline was greater in patients with severe AR; thus, the slope of the velocity decline (deceleration) and the time to decline to half the peak velocity (half-time index) were measured from the flow velocity pattern. The deceleration became greater and the half-time index shortened in accordance with angiographic grading of AR (p less than .01). The deceleration and the half-time index also correlated well with the aortic regurgitant fraction (r = .79, p less than .01; r = -.89, p less than .01). Because the half-time index could be measured easily and independently of Doppler incident angle, it seemed a simple and accurate index of assessing the severity of AR. Thus continuous-wave Doppler echocardiography permitted the noninvasive evaluation of AR.

Adult↗
PubMed1986

Beneficial effects of atrioventricular sequential pacing on cardiac output and left ventricular filling assessed with pulsed Doppler echocardiography.

There has been increased interest in the beneficial effects of atrio-ventricular (AV) pacing over ventricular (V) pacing. This study attempted to evaluate the changes in cardiac output and left ventricular filling dynamics when the pacing mode was switched from V pacing to AV pacing. Study population consisted of 26 patients with multiprogrammable AV pacemakers. Cardiac output was determined as a product of echocardiographically determined cross sectional area of the aortic annulus and Doppler-determined velocity integral of left ventricular outflow over systole. Left ventricular peak rapid filling rate (PFR) and peak atrial filling velocity to peak rapid filling velocity ratio (A/R) were determined from measurements at the mitral annulus. Cardiac output showed a significant improvement when the pacing mode was switched from V to AV pacing, and the percent change ranged from 3 to 73% (average 26%). The improvement in cardiac output brought about by AV synchrony was greater in patients with smaller PFR (r = -0.71, p less than 0.01) and larger A/R ratio (r = 0.77, p less than 0.01). On the other hand, PFR was greater with V pacing than with AV pacing. Greater increment of the PFR was produced by the loss of atrial contraction in patients with smaller PFR (r = -0.82, p less than 0.01) and larger A/R ratio (r = 0.76, p less than 0.01). Thus, AV pacing provides a great improvement in left ventricular filling, i.e., cardiac output, which cannot be obtained with V pacing even with the compensatory enhancement of left ventricular rapid filling. These beneficial effects of AV pacing seemed to be greater in patients with impaired left ventricular rapid filling.

Adolescent↗
PubMed1986

[Coronary thrombolytic therapy in acute myocardial infarction: time dependence of beneficial effects assessed by two-dimensional echocardiography].

To elucidate the effects of coronary thrombolytic therapy in acute myocardial infarction, we observed serially the degree of left ventricular (LV) wall motion immediately after on day 1, and on days 7, 14, 21 and 28 after thrombolytic therapy, in 22 patients with acute anteroseptal myocardial infarction. Base-line coronary arteriography revealed significant lesions in the proximal portions of the left anterior descending artery of all the patients. The patients were categorized according to results of thrombolytic therapy as Group I-a: seven patients with spontaneous or successful recanalization within three hours of onset of chest pain; Group I-b: nine patients with successful recanalization between three and seven hours, with a mean of 4.8 hours from onset; and Group II: six patients in whom thrombolytic therapy was unsuccessful and infarct-related vessels remained totally occluded. The LV wall motion index (WMI) was defined as the sum of point scores for the degrees of regional wall motion at nine segments on serial two-dimensional echocardiograms, and used for quantitative assessments of LV function. Results were as follows: On day 1, immediately after thrombolytic therapy, the WMI of Group I-a was smaller than that of Group II. However, there was no significant difference between Groups I-a and I-b and between Groups I-b and II. These findings suggest that LV function cannot be recovered immediately after recanalization of occluded arteries unless recanalization occurs exceptionally early. Percent improvement of the WMI from days 1 to 28 in Group I-a, 65 +/- 14%, was significantly greater than that in Group I-b, 31 +/- 18%. However, Group II did not show significant improvement in the WMI. The WMI in Group I-a decreased significantly from days 1 to 7 (9.0 +/- 1.6 vs 7.1 +/- 1.8, p less than 0.05); whereas, the WMI in Group I-b showed no significant decrease until day 21. On day 1, the regional wall motion of the antero-apical wall was akinetic or dyskinetic in all patients studied. On day 28, it improved in six of seven patients in Group I-a, while it remained akinetic or dyskinetic in all patients in Groups I-b and II.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

[Pulmonary arterial end-diastolic pressure noninvasively estimated by continuous wave Doppler echocardiography].

To estimate pulmonary arterial end-diastolic pressures noninvasively, we measured the pulmonary regurgitant flow velocity by continuous wave Doppler echocardiography in 17 patients with pulmonary hypertension (pulmonary arterial end diastolic pressure greater than or equal to 18 mmHg) and in 23 patients without pulmonary hypertension. Pulmonary regurgitation was successfully detected by continuous wave Doppler echocardiography in 14 of the 17 patients with pulmonary hypertension and in 14 of the 23 patients without pulmonary hypertension. The end-diastolic pulmonary artery-to-right ventricular pressure gradient was estimated from the Doppler-determined pulmonary regurgitant flow velocity by means of a simplified Bernoulli equation. The Doppler-determined end-diastolic pulmonary artery-to-right ventricular pressure gradient correlated well with the catheter measurement (r = 0.94). It also correlated well with the pulmonary arterial end-diastolic pressure (r = 0.92). Thus, continuous wave Doppler echocardiography was useful in estimating noninvasively pulmonary arterial end-diastolic pressures.

Adolescent↗
PubMed1985

Selective expression of adult beta-globin but not embryonic y-globin genes in hybrids of mouse yolk-sac and erythroleukemia cells.

Hybrid cells from mouse erythroleukemia and yolk-sac cells from 12-day-old mouse embryos were formed, and the expression of adult beta-globin and embryonic y-globin genes was examined. In these hybrid cells, hemoglobin synthesis could be induced by the addition of dimethylsulfoxide. The adult beta-globin genes from both parental chromosomes were expressed, but embryonic y-globin genes were not. These results suggest that the expression of adult genes dominates that of embryonic genes.

Animals↗
PubMed1985

[Continuous wave Doppler echocardiography as a noninvasive evaluation of aortic regurgitation].

Continuous wave Doppler echocardiography permits measurement of high blood flow velocity, which is not obtained by conventional pulsed Doppler echocardiography. In this study, continuous wave Doppler echocardiography was used to measure aortic regurgitant flow velocity, and the utility of this method in evaluating aortic regurgitation (AR) was examined. Continuous wave Doppler recordings of the left ventricular outflow were obtained with the guidance of the long-axis two-dimensional echocardiogram from the apex in 20 patients with AR and 10 without AR. In 18 of the 20 patients with AR, Doppler signals of regurgitant flow were successfully detected. The recorded regurgitant flow velocity pattern had characteristic contours: the regurgitant flow was greater than 1.8 m/sec in velocity immediately after aortic valve closure, and gradually decelerated until the next ventricular systole. The Doppler half time index, which was the time profile to decline to 0.5 of the peak velocity, was significantly shortened in accordance with the degree of AR (p less than 0.01). Thus, continuous wave Doppler echocardiography is a simple, useful method for the noninvasive evaluation of AR.

Adult↗
PubMed1985

[A comparative double blind study of lenampicillin and talampicillin in the treatment of oral infections].

A comparative double blind study of lenampicillin (LAPC, KBT-1585) and talampicillin (TAPC) was carried out in order to objectively evaluate efficacy, safety and utility of LAPC in treatment of 238 patients with oral infections. Cases accepted by the Central Committee for evaluation of efficacy and utility were 218, consisting of 101 of the LAPC group and 117 of the TAPC group; safety were 234, consisting of 110 of LAPC and 124 of TAPC. Clinical effectiveness as rated by attending doctor was 84.2% for the LAPC group and 82.9% for the TAPC group. The clinical utility rating was 82.2% in the LAPC group and 82.1% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were found in 6 cases (5.5%) in the LAPC group and 5 cases (4.0%) in the TAPC group, showing no significant difference between the 2 drugs. Cases accepted by the controllers for evaluation of efficacy and utility were 236, consisting of 111 cases of LAPC and 125 cases of TAPC. Those for safety were 236, consisting of 111 cases of LAPC and 125 of TAPC. The clinical effectiveness rating was 77.5% in the LAPC group and 79.2% in the TAPC group. Clinical utility rating was 75.7% in the LAPC group and 78.4% in the TAPC group. Rate of adverse reactions was 5.4% in the LAPC group and 4.0% in the TAPC group, showing no significant difference between the 2 drugs. Cases evaluated for efficacy according to numerical rating on the 3rd day were 200 cases, consisting of 93 of LAPC and 107 of TAPC. The effectiveness rate was 83.9% in the LAPC group and 95.3 in the TAPC group, showing a significant difference between the 2 drugs. On the other hand, taking into consideration evaluation scores of the 5th day, the effectiveness rate was 88.7% in the LAPC group and 96.1% in the TAPC group, showing no significant difference between the 2 drugs. The effectiveness rate in cases of isolated organisms was 84.9% in the LAPC group and 79.7% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were mostly of gastrointestinal origin. Symptoms were not serious and disappeared soon after administration was discontinued or immediately after administration was completed.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

[Reconstruction of oral defects using free revascularized jejunum transfer].

Reconstruction of the oral cavity after extended surgery poses many difficult problems. The vital functions of the oral cavity, especially swallowing, mastication and breathing, are seriously impaired by resection of the tongue, floor of the mouth, gingiva or jaw bone. We have used the free revascularized jejunal transfer for reconstruction of the oral cavity in 10 patients and have had good functional and cosmetic results. The advantages of this method are as follows: 1) it is a one-stage operation; 2) the flexibility of the graft preserves maximal tongue function; 3) the graft can be applied to difficult anatomic sites, and 4) the mucosal defect is covered with jejunal mucosa and induration is minimum. Our success rate with this procedure has been 90%. In our experience, this transfer is useful for reconstruction of a massive defect in the oral cavity.

Aged↗
PubMed1984

Patterns of relapse of squamous cell carcinoma of the maxillary sinus.

Ninety-five M0 patients with squamous cell carcinoma of the maxillary sinus were treated mainly with combined surgery, radiation and chemotherapy. They were staged surgically according to the American Joint Committee TNM classification: 3 were T2N0, 55 T3N0, 27 T4N0 and 10 T3-4N1-3 patients. Relapse developed in 66 patients (69%): one (33%), 35 (64%), 22 (81%) and 8 (80%), respectively. All patients experienced relapse within 2 years after diagnosis. Local recurrence developed during the course of disease in 52 (79%) of the 66 patients who relapsed. Three patients with cervical relapse and one with local recurrence were successfully salvaged with rescue surgery. Local control achieved in 39 (41%) of the 95 patients: 2 (67%), 28 (51%), 7 (26%) and 3 (30%) in T2N0, T3N0, T4N0 and T3-4N1-3 patients, respectively. Autopsy findings of 17 patients are presented. An impact of computed tomography on staging of maxillary sinus tumors is discussed.

Adult↗
PubMed1984

[Fundamental and clinical studies of cefaclor in oral surgery].

Fundamental and clinical studies on cefaclor (CCL) have been performed and the following results were obtained. CCL was orally administered to NZW rabbits at the dose of 20 mg/kg, and its concentrations in blood and various tissues of oral organs were determined. Pattern of change in its blood concentration after the administration was similar to that of change in its concentration in the tissues of oral organs. Its concentration in blood was the highest followed by gingiva, parotid gland, submandibular gland, cervical lymph node and tongue in descending order. Comparative studies of CCL against cephalexin (CEX) were conducted in 5 healthy volunteers with cross over method. The 5 volunteers were orally given 500 mg of CCL or CEX at 1 dose after meal. Peak blood levels of CCL and CEX were 14.8 micrograms/ml at 2 hours and 11.5 micrograms/ml at 3 hours, respectively. The dose of 750 or 1,500 mg/day of CCL in 3 divided doses was orally administered to 71 patients with acute purulent infections in oral tissues for 3 to 13 days. Evaluation of effect was determined by the criteria for evaluation of antimicrobial agents in oral surgery. Out of the 70 patients, excellent clinical response was observed in 18 patients, good in 40, and poor in 12. Effective rate was 83%. In vitro antibacterial activities (MIC) of CCL and CEX were studied in 74 out of 81 strains (41 from aerobes and 40 from anaerobes) isolated from 47 patients. CCL showed stronger antibacterial activities than CEX. MICs of CCL against 30 strains of Gram-positive anaerobes were distributed from 0.10 to 3.13 micrograms/ml with a peak of 0.78 micrograms/ml. As adverse reaction due to CCL, eruption was observed in only 1 patient. Laboratory tests in 61 patients who received CCL showed elevation of GOT in 1 patient and elevation of GOT and GPT in 1 patient. From the above fundamental and clinical results, CCL was considered to be a useful antibiotic for the treatment of acute purulent infections caused by aerobes and anaerobes in oral surgery field.

Adolescent↗
PubMed1983

Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique.

We used a pulsed Doppler technique to examine the flow velocity pattern in the right ventricular outflow tract in 33 adults. In the patients with normal pulmonary artery pressure (mean pressure less than 20 mm Hg, 16 patients), ejection flow reached a peak level at midsystole (137 +/- 24 msec, mean +/- SD), producing a domelike contour of the flow velocity pattern during systole. In contrast, the flow velocity pattern in patients with pulmonary hypertension (mean pressure greater than or equal to 20 mm Hg, 17 patients) was demonstrated to accelerate rapidly and to reach a peak level sooner (97 +/- 20 msec, p less than .01); in 10 of the pulmonary hypertensive patients a secondary slower rise in flow velocity was observed during a deceleration, resulting in the midsystolic notching. The time to peak flow (acceleration time, AcT) and right ventricular ejection time (RVET) were measured from the flow velocity pattern. Either AcT or AcT/RVET decreased with increase in mean pulmonary artery pressure, and a very high correlation (r = -.90) was found between AcT/RVET and log10 (mean pulmonary artery pressure). The use of this technique permitted the noninvasive estimation of the pulmonary artery pressure.

Adolescent↗
PubMed1983

[Clinical studies of long acting amoxicillin in oral surgery].

Clinical studies with long acting amoxicillin (L-AMPC) have been carried out and the following results were obtained. 1. Forty-two patients with acute bacterial infections in the oral region were administrated orally L-AMPC at a daily dose of 1 gram. The clinical results obtained were classified as excellent in 3 cases, good in 28 cases, and the overall efficacy was 75.6%. 2. The antibacterial activity of AMPC was determined for 66 strains isolated from patients with oral infections. Of the strains tested, Gram positive cocci showed high sensitivity with MIC's less than 1.56 mcg/ml, while the sensitivity of PC resistance strains of S. aureus, K. pneumoniae and P. vulgaris was lower. 3. There was 1 case of transaminase elevation in the laboratory finding. 4. Five patients reported the following side effects, eruption 3, diarrhea 2, nausea 1, anorexia 1 and malaise 1. From the results of the present study, it is considered that L-AMPC is a useful antibiotic in the treatment of acute bacterial infections in oral region.

Adolescent↗