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Biomedical subjects

N Usui

Publications and source records attributed to N Usui.

At least 127 records · Page 7Linked to original sources

Clinical courses and treatment of splenic artery aneurysms--report of 3 cases and review of literatures in Japan.

We have treated three cases of splenic artery aneurysms recently, so we reported them with a review of 181 cases in Japan. All three cases are women and have characteristic clinical courses and pathogenesis in each to which we performed a reasonable operation so that they could be saved. First one is a ruptured case. So we performed ligation of the splenic artery from inside the aneurysm under 9 min.'s clamp of the aorta. Second one was pointed out the splenic artery aneurysm during admission for cholecystectomy, so we performed splenectomy and aneurysmectomy, and after that we reconstructed the splenic artery with end-to-end anastomosis. Third one suffered from splenomegaly and portal hypertension. We performed splenectomy with the aneurysm. From the clinical and pathological findings, we concluded that an aneurysm in our first case was associated with arterial dysplasia, second with hemodynamic changes in parous women, and third with portal hypertension. Aneurysms of the splenic artery have been rarely reported until recently, when developments in diagnostic procedures made their discovery easier. We have diagnosed splenic artery aneurysm in three patients preoperatively. The clinical symptoms and operative procedure was different in each case, and are reported here. We demonstrated the summary of our three cases of that at Table 1.

Aneurysm↗

[The possible association of Epstein-Barr virus and uveitis].

The possible association of Epstein-Barr Virus (EBV) with uveitis was investigated in 28 subjects with various types of uveitis. Serum or aqueous humor (AH) EB viral antibodies were measured in 28 uveitis patients and in 28 cataract patients as controls. Significant rises in EBV antibody levels were seen in 3 cases from the uveitis group. There was an 8-fold increase of the serum antibody titer in an infant subject, a 16-fold increase in the AH EB viral antibody titer in an adult subject, and a higher antibody quotient (10.2) compared with the serum and AH antibody titers in another adult case. No antibodies to EBV were detected in the AH in the control group. It appeared that EBV might have been involved in the pathogenesis of these 3 cases of uveitis. The clinical features of these cases were as follows. (1) A common cold-like prodrome was noted. (2) Severe acute anterior uveitis with fibrinous exudate was present at the onset. (3) A transition to chronic granulomatous anterior uveitis was seen in the 2 adult cases. (4) Little vitreous inflammation was present. (5) Marked hyperemia and swelling of the optic discs was noted. (6) At the onset there were no abnormal chorioretinal findings, except slight retinal vasculitis in the infant case. (7) Sunset-glow fundus appeared earlier in comparison with Harada disease in the adults and a retinal pigment epithelium disorder developed in the infant. (8) Bilateral involvement was seen in adults. (9) Good final visual acuity was recognized. (10) No systemic changes occurred in the course of the uveitis. This constellation of clinical features appears to comprise a new entity, i.e., EBV-associated uveitis.

Adolescent↗

[Comparison by 31P magnetic resonance spectroscopy of effect of simple immersion and continuous perfusion methods on organ viability of preserved rat hearts].

31P magnetic resonance spectroscopy was used to measure high energy phosphates of the heart continuously as an index of the viability of the preserved organ together with the cardiac function after preservation. Results with the simple immersion (SI) and the continuous perfusion (CP) methods were compared. With SI, ATP decreased to 14.8 +/- 4.1% of the base line after 12 hr of preservation, and phosphocreatine decreased to 27.8 +/- 6.2% after 3 hr, remaining at about 30% of the base line thereafter. With CP, ATP and phosphocreatine were unchanged even after 24 hr of preservation; they were 99.1 +/- 2.6% and 119.6 +/- 6.7%, respectively. The ATP/Pi ratio was 5.4 +/- 0.7% after 12 hr with SI and 62.2 +/- 5.8% after 24 hr with CP. LV dP/dt was 96.6 +/- 11.5% after 3 hr of SI (3-SI), which was not significantly different from the control. After 6 hr of SI (6-SI), the value was 122.7 +/- 0.2%, significantly higher (p less than 0.01) than the control. After 9 hr of SI (9-SI) or after 24 hr of CP (24-CP), it was 80.8 +/- 4.6% and 67.8 +/- 8.2%, respectively, both were significantly lower (p less than 0.01) than the control. The rate-pressure product returned to the control level after 3-SI and 6-SI, but after 9-SI or 24-CP, it was 74.2 +/- 3.7% and 53.0 +/- 11.0%, and they were significantly (p less than 0.01) lower than the control.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

[Effect of adenosine on recovery of lowered viability of preserved rat hearts measured by 31P magnetic resonance spectroscopy].

The restoration of the viability of rat hearts preserved for 5 hr by 50 microM adenosine (ADN) was evaluated in terms of the cardiac function after preservation and the recovery of myocardial high energy phosphates measured by 31P magnetic resonance spectroscopy. The hearts were perfused with modified Krebs-Ringer's solution (mKRS) with ADN (ADN group) or without AND (non-ADN group) for 1 hour after 5 hr of preservation by the simple immersion method. Control hearts were perfused but not preserved. ATP and phosphocreatine had decreased to 47.2 +/- 6.6% and 28.0 +/- 8.6% of the base line by 5 hr of preservation, but the levels returned to 147.2 +/- 2.3% and 127.4 +/- 5.6% after 1 hr of perfusion with ADN; at the same time, in the non-ADN group, they were 103.8 +/- 2.3% and 115.8 +/- 8.3% respectively. The same hearts were next perfused for 3 hr with standard Krebs-Ringer's solution so as to beat after the perfusion with mKRS. After 3 hr of beating, LV dP/dt was 3330 +/- 116 mmHg/s in the ADN group, which was not significantly different from the control (3034 +/- 60 mmHg/s). However, in the non-ADN group, the value was 2516 +/- 201 mmHg/s and significantly lower (p less than 0.05) than the control. The rate-pressure product was 19350 +/- 1154 in the ADN group, not significantly different from the control (20899 +/- 709), but it was 14559 +/- 1339 in the non-ADN group, which was significantly lower (p less than 0.01) than the control.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

[Histologic characteristics of the pathologic processes in thromboangiitis obliterans (Buerger's disease)].

In order to elucidate histologic characteristics of the pathologic processes in thromboangiitis obliterans (Buerger's disease) a histopathologic study of amputated legs of 9 patients diagnosed as this disease was carried out. The ages of the patients ranged from 27 to 47 years, all male, and the duration of symptoms prior to amputation was between 3 and 11 years. All of the patients had no history of hypertension. The initial stage of the pathologic processes was characterized by contraction of small arteries of legs followed by intimal thickening with laminar elastosis, the subsequent stage by occlusion of arterial lumens by both thrombosis and following organization and recanalization which occurred in the small arteries, and the later stage by lymphocytic infiltration of the arterial walls, suggesting some immunological mechanisms involved in the pathogenesis. Accompanying venules demonstrated similar processes to those of small arteries, which enhanced the local circulatory disturbances.

Adult↗

[Cumulative survival rate of chemotherapy with CDDP for malignant ovarian tumors].

The current study covered 159 patients with primary malignant ovarian carcinoma who underwent various kinds of chemotherapy between 1977 and 1987. The cases in each stage were first divided into two groups. Group A (CDDP Group) and Group B (non-CDDP Group), for comparative analysis. The stage I Group was further divided into Subgroup A (CAP Group) and Subgroup B (FAM Group). Similarly, the Stage III Group was subdivided into Subgroup A (three or more courses of ip administration of CDDP). Subgroup B (three or more courses of iv administration of CDDP centering on CAP), Subgroup C (FAM Group), and Subgroup D (non-CDDP Group). In Stage I, the five-year survival rate in Group A was 94% and the comparable figure in Group B was 59%. In Stage III, the two-year and five-year survival rates were 31% and 11% for Group A as opposed to 24% and 18% for Group B. In Stage Ia, the five-year survival rate for Subgroup A was 90% as compared to 75% for Subgroup B. In Stage III, the two-year survival rate for Subgroup A was 67% as compared to 28% for Subgroup B and 30% for Subgroup C. This indicated a very good prognosis in Subgroup A as compared with the other two subgroups.

Adolescent↗

Synergistic antitumor activity of etoposide and human interleukin-1 alpha against human melanoma cells.

To investigate the possibility of increased activity of cytotoxic anticancer drugs combined with cytokines, we treated human melanoma cells with combinations of etoposide (VP-16) and human recombinant interleukin-1 alpha (rIL-1 alpha). We evaluated the combined cytotoxic effects of VP-16 and rIL-1 alpha using A375-C6 cells, which are sensitive to rIL-1 alpha, and A375-C5 cells, a clonal variant line resistant to rIL-1 alpha. We used the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium-bromid e) assay and the inhibition of [3H]thymidine incorporation into DNA. We analyzed data using the median effects principle of Chou and Talalay (Chou's analysis). The calculated combination index values, at a dose ratio of VP-16 to rIL-1 alpha of 12:1 in simultaneous exposure, indicated synergistic cytotoxicity toward both A375-C6 cells and A375-C5 cells. We observed more pronounced synergism with VP-16 and rIL-1 alpha toward the A375-C5 IL-1 alpha-resistant melanoma cells. These results suggest that rIL-1 alpha combined with cytotoxic antitumor drugs may provide increased benefit in the treatment of malignant melanoma.

Antineoplastic Combined Chemotherapy Protocols↗

[Two-chambered right ventricle in an elderly patient with anoxic spells].

A 53-year-old woman with two-chambered right ventricle and ventricular septal defect (VSD) was treated by VSD closure and resection of the abnormal muscle bundle within the right ventricle. The patient remained asymptomatic only with a heart murmur until the age of 40. Then she became to get tired more easily and presented dyspnea on minimal exercise. And recently, she suffered from cyanosis with anoxic spells, which finally led her to our clinic. Cardiac catheterization showed a high pressure chamber of 110 mmHg and a low pressure chamber of 27 mmHg in the right ventricle; a pressure gradient being 83 mmHg in the right ventricle with bidirectional interventricular shunt. This disorder is rarely found in elderly patients and the natural history for patients who remain asymptomatic are still unknown. To the best of our knowledge, this is the first elderly patient to develop anoxic spells like tetralogy of Fallot and treated surgically. The case is presented here, together with a review of the literature.

Female↗

Cases of infective endocarditis caused by Campylobacter fetus.

An 18-year-old man with infective endocarditis caused by Campylobacter fetus is reported. This bacterial species has long been of interest in veterinary medicine, and recently it has been reported to be one cause of infantile diarrhea. Infective endocarditis arising from campylobacter fetus is rare. This is the fourth case reported in Japan. The organism was resistant to several antibiotics, and large vegetations were found to involve the aortic valve. Emergency excision of the infected aortic valve and replacement with a valve prosthesis were successful. Current clinical treatment of infective endocarditis is discussed, and the literature briefly reviewed.

Adolescent↗

Ventricular septal perforation following acute myocardial infarction in a patient with hypothyroidism--a case report.

A 61-year-old woman with profound hypothyroidism underwent surgery for a ventricular septal perforation 15 days following an acute myocardial infarction, with no preoperative thyroid replacement. Her immediate postoperative course was complicated by a low cardiac output, respiratory suppression and high output renal failure, requiring prolonged hemodynamic and respiratory support. Thyroid replacement (50 micrograms of thyronine and 100 micrograms of thyroxine daily) was given in two installments on the 2nd day after the operation. The effect of the inotropic agents increased gradually and the patient was weaned off intra-aortic balloon pumping. A large quantity of diuretics, hydration and hyperalimentation also successfully reduced her elevated BUN and serum creatinine. After full thyroid replacement, she was discharged in good health on the 40th postoperative day.

Female↗

[Clinical study on the effect of natural alpha-interferon (HLBI) in the treatment of adult T-cell leukemia].

The phase II trial of natural interferon-alpha (HLBI) in treatment of adult T-cell leukemia was carried out as a cooperative study. Of the 24 cases which could be evaluated, 3 cases in crisis type and 5 cases in chronic type with lymphadenopathy and/or skin infiltration achieved PR, giving a response rate of 33.3%. The anti-tumor effect of HLBI for skin lesion could be assessed in 16 cases with skin infiltration, giving a response rate of 50.0% (5 CR and 3 PR) and demonstrating a high efficacy. Of the 31 eligible patients, side effects were recognised in 27 (87.1%). Major subjective and objective symptoms were fever (38.7%), fatigue (25.8%), anorexia (12.9%) and nausea (12.9%), and leukopenia (22.6%), granulocytopenia (38.7%), thrombocytopenia (38.7), elevation of GPT (12.9%) and GOT (12.9%) were observed.

Adult↗