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Biomedical subjects

M Yamaguchi

Publications and source records attributed to M Yamaguchi.

At least 1,387 records · Page 77Linked to original sources
PubMed1989

Malignant mediastinal germ-cell tumors in childhood: a report of two cases achieving long-term disease-free survival.

Two cases of malignant mediastinal germ-cell tumor are reported. Case 1 is a 20-month-old girl with endodermal sinus tumor (EST) and is, to our best knowledge, the third female pediatric case of mediastinal EST in the literature. Case 2 is a 15-year-old boy with malignant teratoma (mature teratoma with poorly differentiated squamous cell carcinoma). Both cases were treated by primary combination chemotherapy of vincristine, actinomycin D, and cyclophosphamide or vinblastine, cisplatin, and bleomycin, secondary operation (complete resection), radiation to the tumor bed, and some courses of consolidation chemotherapy. Malignant mediastinal germ-cell tumors have been considered to have a poor prognosis, being different from gonadal tumors; however, long-term survivals with no evidence of recurrence were achieved both in case 1 (for 55 months) and in case 2 (for 56 months).

Adolescent↗
PubMed1989

[Surgical treatment of interrupted aortic arch in infants under three months of age].

From March, 1982, through March, 1988, 8 infants less than 3 months of age underwent surgical treatment of interrupted aortic arch. Five patients had IAA type A and 3 patients had type B. Seven patients with associated VSD underwent staged operations and 1 infant with aortopulmonary window underwent primary repair off cardiopulmonary bypass. Aortic arch reconstruction was by subclavian aortic anastomosis (6) or large tube graft (8 mm) interposition (2) combined with pulmonary artery banding (5). All seven patients with associated VSD survived the first-stage operation. One patient subsequently underwent pulmonary artery banding, two underwent patch aortoplasty and four patients underwent intracardiac repair and removal of a pulmonary artery band, with six survivors (86%). The operative death occurred in an infant in whom modified Damus-Kaye-Stansel operation was carried out for severe subaortic stenosis, which rerouting all left ventricular blood through VSD and the main pulmonary artery into the ascending aorta and reconstructing right ventricular-distal pulmonary artery connection by a valved external conduit. All six surviving patients are doing well at present (mean follow up of 3 years) without any significant pressure gradient between the ascending and thoracic aorta. Based on these data we conclude: (1) Aortic arch reconstruction and pulmonary artery banding can be reliably performed even in critically ill infants with IAA and isolated VSD. (2) The primary repair will provide better chance of survival in infants with IAA associated with significant LVOTO, truncus arteriosus or aortopulmonary window that do not readily lend themselves to pulmonary artery banding.

Anastomosis, Surgical↗
PubMed1989

[A case report of multiple intracranial tuberculoma associated with miliary tuberculosis and review of the literature].

We reported a case of multiple intracranial tuberculoma associated with miliary tuberculosis and reviewed the cases reported as intracranial tuberculoma in the past 11 years. A 41-year-old diabetic man was admitted to our hospital for the treatment of miliary tuberculosis and respiratory insufficiency. On admissIon, he had no neurological deficits except mild consciousness disturbance due to respiratory failure. He developed headache and mental confusion three weeks after the beginning of antituberculous therapy with isoniazid, streptomycin, rifampicin, and ethambutol. Neurological examination revealed that he had progressive right hemiparesis and was in a confusional state. Enhanced CT showed multiple intracranial nodular lesions. During 6 weeks, he had progressive neurological manifestations in spite of his initial antituberculous treatment. He responded well, however, to the chemotherapy with combination of isoniazid, kanamycin, pyrazinamide and ethionamide that were sensitive to tuberculous bacilli separated from his sputum. He became minimally right-hemiparetic by 6 weeks after the change of antituberculous medication. Serial enhanced CT scan proved to be of great value in the diagnosis and follow-up study of intracranial tuberculoma. From 1978 to 1988, there were 72 reported cases of intracranial tuberculoma in Japan; 37 were male, 32 were female and 3 were uncertain because of no detailed document. The age of onset was distributed from 6 month to 81 years in age and 2 peaks were seen in the second decade and fifth to seventh decade. Thirty-three (48%) out of 69 cases had multiple intracranial lesions. A few reports commented that neurological complications tended to appear even if they were under antituberculous therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Effect of beraprost sodium (TRK-100) on acetic acid-induced skin ulcer.

Effect of beraprost sodium (TRK-100), a stable PGI2 analog, on experimentally induced skin ulcer was studied in rats. An experimental skin ulcer was developed by intradermal injection of acetic acid. Injection of glacial acetic acid to the skin in the left hind leg instep of rats resulted in the necrosis of the skin, and a skin ulcer developed in 3 days. The ulcer area reached its peak on the 5th day, and recovered to its control level within 4 weeks. The effects of TRK-100 and indomethacin on the ulcer were tested. TRK-100 showed suppressive effects on the development of the ulcer. A dose of 30 micrograms/kg (p.o.) accelerated healing of the ulcer when scored macroscopically on the 9th or 15th day. At a dose of 100 micrograms/kg (p.o.), it reduced the development of the ulcer and accelerated healing with statistical significance from the 5th day and thereafter. Indomethacin also reduced the development of the ulcer and accelerated healing with statistical significance from the 7th day and thereafter. These results suggest TRK-100 may be effective on the inhibition of the development and accelerated the healing of the skin ulcer formed in various pathological states.

Acetates↗
PubMed1989

[Thoracoabdominal ectopia cordis with single ventricle and pulmonary stenosis. A case report of successful surgical repair].

A case of thoracoabdominal ectopia cordis with single ventricle and pulmonary stenosis is reported. A cyanotic boy with omphalocele was brought to our hospital soon after his birth and was diagnosed as thoracoabdominal ectopia cordis with single ventricle and pulmonary stenosis. A conservative treatment of omphalocele was performed successfully and a plastic chest shield had been made for him which protected the anterior surface of his chest. He continued to develop in a fairly satisfactory condition and operation was delayed until he was 8 years old when he had severe cyanosis and frequent episodes of headache. The operative procedures were; 1) ascending aorta to main pulmonary artery shunt with EPTFE tube; 2) to bring the heart into the thoracic and abdominal cavity by developing widely the pericardial and diaphragmatic defect behind the heart's preoperative position; 3) to reconstruct the new pericardial sac lying from thoracic to abdominal cavity by covering the heart using EPTFE sheet. This trial of making a new pericardial sac for thoracoabdominal ectopia cordis is not reported so far in the literature. It is expected that the heart has being raised to the thoracic cavity with patient's physical growth after this operation.

Child↗
PubMed1989

[Respiratory muscle fatigue].

To estimate the effect of the increase in ventilation induced by exercise on the dynamics of respiratory muscle in normal subjects and cases of respiratory diseases, we measured the changes of transdiaphragmatic pressure (Pdi), gastric pressure (Pga), tension time index of the diaphragm (TTdi) and tension time index of the abdomen (TTab). To confirm the effect of oxygen on exercise endurance, we investigated changes of parameters measured during exercise under air breathing and oxygen inhalation. In normal subjects, we found the increase in diaphragmatic activity as a gradual increase of exercise level, but TTdi always stayed in the non-fatigue zone. On the contrary, patients with COPD showed that TTdi was near fatigue threshold during quiet breathing and crossed easily into fatigue zone during exercise. There was an increase in endurance time with oxygen for COPD patients. Breathing with oxygen was associated with a smooth increase in Pdi during the inspiratory phase which indicates efficient contraction of the diaphragm. During the expiratory phase, the degree of increase in Pga was markedly reduced by oxygen inhalation.

Diaphragm↗
PubMed1989

[Successful simultaneous repair of tetralogy of Fallot and congenital tracheal stenosis in a 5-year old child].

Congenital cardiac anomaly combined with severe obstructive lesion of airway remains a surgical challenge. A case of 5-year old child with tetralogy of Fallot associated with congenital tracheal stenosis (cartilagenous ring) was reported. The patient had history of cyanosis and stridor since age 3 months and had been hospitalized repeatedly for recurrent respiratory distress. The diagnosis was first established and emergent Blalock-Taussig shunt was carried out during first admission at age 1 year and 7 months. On the fourth admission at age 5 year, a definitive surgical intervention was decided following re-evaluation of the patient by cardiac catheterization, bronchoscopy and bronchography. Trachea and heart were exposed through cervical collar and presternal skin incision and median sternotomy. Tracheal resection and end-to-end anastomosis combined with total correction of tetralogy of Fallot was carried out under cardiopulmonary bypass. Utmost care was paid to avoid contamination during the operation. He was extubated at 9th postoperative day and has been free from symptom 9 months after the operation.

Cardiopulmonary Bypass↗
PubMed1989

Hypothyroidism enhances carbachol-induced hypothermia in the rat.

We studied cholinergic regulation of body temperature in hypothyroid rats. Thyroidectomy caused a progressive decrease in core temperature. Intraventricular injection of carbachol in a dose of 10 nmol did not change core temperature of the normal rat, whereas the same dose of carbachol significantly decreased the temperature of thyroidectomized rats. One hundred nmol carbachol decreased to a greater extent core temperature of the thyroidectomized rats than that of normal rats. Intraventricular injection of atropine significantly increased core temperature of thyroidectomized rats. The present data indicate that brain cholinergic mechanisms participate in controlling temperature in the hypothyroid status and thyroid hormones play a significant role in the brain cholinergic regulation of body temperature.

Animals↗
PubMed1989

[Urinary cytodiagnostic abnormality in a patient with malignant lymphoma].

A 69-year-old man was admitted due to chronic subdural hematoma. He had lymphadenopathies in the neck. The diagnosis of non-Hodgkin lymphoma (diffuse, large, B cell type) was made by a cervical lymph node biopsy. The renal failure by obstruction of the urinary tract developed gradually, and the tumor cells were found by urinary cytodiagnosis. He was treated immediately with chemotherapy. After the treatment, the urine volume increased and the general conditions improved. It was indicated from this case that the urinary cytodiagnosis is useful for the detection of urinary tract infiltration by lymphoma cell. The urinary cytodiagnostic abnormalities in patients with non-Hodgkin lymphomas were discussed from the literature, including this case.

Aged↗
PubMed1989

[Allogeneic bone marrow transplantation as primary treatment in acute myelofibrosis].

A 20-year-old man with acute myelofibrosis received ablative chemotherapy consisting of busulfan, Ara-C and cyclophosphamide followed by bone marrow transplantation from his histocompatible sister. There was a prompt engraftment with a rising WBC and platelet count and with donor karyotype in specimen of marrow. A bone marrow examination on day 29 showed a prominent decrease in marrow fibrosis. However, fibrosis was again exacerbated with leukemic relapse as overt acute megakaryoblastic leukemia on day 110, The patient died on day 126. Marrow fibrosis was found to be reversible by ablation of malignant cells and repopulation of normal hemopoietic cells after bone marrow transplantation.

Acute Disease↗
PubMed1989

[Median sternotomy for lung and tracheal surgery].

Median sternotomy was used in 30 cases of lung surgery; (1) lung cancer with impaired pulmonary function or local invasion to the mediastinum-12 cases. An average FEV1.0, 960ml, 38% FVC was only reduced to 890ml one month after lobectomy. (2) concomitant heart disease-2 cases. A 5 year old boy, with tracheal stricture and tetralogy of Fallot, was successfully treated by one stage operation. Stenotic cartilage trachea, 2mm in diameter, was resected 15mm in length and anastomosed end to end under total extracorporeal circulation after cardiac operation. A left upper lobectomy for lung cancer was performed under partial extracorporeal circulation after mitral valve replacement and valvoplasty of tricuspid valve on a 62 year old man. Both patients are well two years after operation. (3) bilateral pulmonary lesions--11 cases. (4) others--5 cases. Median sternotomy provides less operative loss of lung function, and excellent exposure for selected cases. But these advantages may be lost in some cases in No. (3) when fragile metastatic nodules must be gently manipulated and when an autosuture must be used in different direction for bullae. Whether or not the median sternotomy or posterolateral skin incision is favorable, may be decided by CT findings preoperatively.

Adult↗
PubMed1989

[Case-control study of moyamoya disease].

The cause of Moyamoya disease is still unknown. We made a research about the factors closely related to Moyamoya disease through a case-control study. The number of cases studied was 66. Controls were selected from among patients' friends, matched as to sex, age and residential area. Questionnaires were sent to the cases and the respective controls by mail. The questions were about past history, developmental history, school records, habitual factors, dietary habits and pets. The first symptoms and age at onset were also surveyed in the cases. The response rate was 84.8% (56 cases) of the cases and 76.5% (101 cases) out of the 132 controls. There was no significant difference in the prevalence of tonsillitis, conjunctivitis, otitis media, and bronchitis. Odds ratio of fever of unknown origin is 2.793 and X2 is 7.213. Diseases whose odds ratio was over 1 were herpes, appendicitis, bronchitis, asthma, anemia, dental caries, head injury and drug allergy. But all of them were not significantly prevalent. Odds ratios of school records were 4-9 and X2 were 4-17 from elementary to junior high school. Odds ratio of western dishes was 2.709 and X2 was 5.189. There was no significant difference as to pets kept. We could not find overt relationships between Moyamoya disease and diseases of head and neck like tonsillitis.

Adolescent↗
PubMed1989

[Early and late results of surgical treatment of coarctation of the aorta in infants less than six months of life--including the propriety of pulmonary artery banding].

During an 8-year period, 53 infants less than six months of life underwent repair of coarctation of the aorta (CoA). Preoperatively 58 percent of patients received intensive circulatory and/or respiratory care. The diagnosis was established by echocardiography and counter current aortography via a radial artery in the majority of recent cases and the surgical relief of CoA was effected within 24 hours of the diagnosis. The last 51 patients were managed under the policy of simple repair of the CoA in patients with significant VSD (Group II), with the addition of pulmonary artery banding for patients with complex cardiac lesions with VSD (Group III) or for patients with incremental risk factors in Group II such as prematurity of body weight of less than 1500 gm, other organ anomalies requiring major operation in neonate, pulmonary complications or severe malnutrition. There was no intraoperative death, one (2%) postoperative and five (10%) late deaths among the lost 51 patients. Only one (2%) showed sign of recurrence among 46 patients followed for 16-112 (mean 47) months.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Coarctation↗
PubMed1989

[False aneurysm of the right pulmonary artery--a rare complication of aorto-pulmonary shunt in a patient with tricuspid atresia].

A 12-year-old girl with tricuspid atresia who underwent a side-to-end anastomosis between the ascending aorta and the right pulmonary artery at the age of two months, developed a false aneurysm of the right interlobar trunk artery. The diagnosis was established by angiography, computed tomography and bronchoscopy. Emergency surgical intervention was required because of impending aneurysmal rupture into the right interlobar bronchus. Creation of a left Blalock-Taussig shunt to tide over the anticipated postoperative hypoxemia and right middle and lower lobectomy were carried out successfully. The false aneurysm in this case occurred following an episode of a streptococcal infection and was probably mycotic in origin. But it is possible that the presence of aorto-pulmonary shunt itself might have affected as a predisposing factor for aneurysm formation in this case.

Aneurysm, Infected↗
PubMed1989

[Operative technique of systemic to pulmonary artery shunt and aortoplasty utilizing in aberrant subclavian artery].

This paper presents a review of our experience of 3 cases of systemic to pulmonary artery shunt operation and 2 cases of subclavian flap aortoplasty using aberrant subclavian artery. The aberrant subclavian arteries were divided to release the vascular rings and were used as shunt grafts or reversed subclavian flaps. In case of shunt operation, this graft would be superior to the EPTFE graft of modified Blalock-Taussig shunt, from the point of view of the grafts' growth ability. In case of aortoplasty, if arch hypoplasia exists, this flap can repair it beyond the coarctation segment. When the aberrant subclavian artery is dissected, it should be avoided to use the contralateral subclavian artery, as it may cause cerebral damage because of the impairment of bilateral vertebral arterial circulation.

Aorta↗
PubMed1989

A new technique for use of an anomalous subclavian artery for a systemic-pulmonary arterial shunt.

Anomalous subclavian arteries were used as interposition grafts for systemic-pulmonary arterial shunts in three infants and children with good early and long-term results. This is the first report of the use of an anomalous subclavian artery as an interposition graft for a systemic-pulmonary arterial shunt. The advantages and effectiveness of the technique are discussed.

Anastomosis, Surgical↗
PubMed1988

Amino acid sequence of the signal peptide of mitochondrial nicotinamide nucleotide transhydrogenase as determined from the sequence of its messenger RNA.

The amino acid sequence of the bovine mitochondrial nicotinamide nucleotide transhydrogenase was recently deduced from isolated cDNAs and reported [Yamaguchi, M., Hatefi, Y., Trach, K., and Hoch, J.A. (1988) J. Biol. Chem. 263, 2761-2767]. The cDNAs lacked the N-terminal coding region, however, and the 8 N-terminal residues were determined by protein sequencing. In the present study, the nucleotide sequence of the 5' upstream region was determined by dideoxynucleotide sequencing of the transhydrogenase messenger RNA, and amino acid sequences of the N-terminal region and the signal peptide of the enzyme were deduced from the nucleotide sequence. The N-terminal sequence of the enzyme as deduced from the mRNA sequence is the same as that determined by protein sequencing, with one difference. Protein sequencing showed Ser as the N-terminal residue. The mRNA sequence indicated that Ser is the second N-terminal residue, and the first is Cys. That preparations of the enzyme are mixtures of two polypeptides, one polypeptide being one residue shorter at the N terminus than the other, has been pointed out in the above reference. The signal peptide consists of 43 residues, is rich in basic (4 Lys, 2 Arg) and hydroxylated (4 Thr, 3 Ser) amino acids, and lacks acidic residues.

Amino Acid Sequence↗