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Biomedical subjects

R Murakami

Publications and source records attributed to R Murakami.

At least 109 records · Page 6Linked to original sources
PubMed1995

Phasic right coronary blood flow in a patient with right ventricular hypertension using transesophageal Doppler echocardiography.

Although phasic right coronary artery blood flow in right ventricular hypertension has been studied in animals, reports on human subjects are not available. We observed right coronary artery blood flow before and after operation in a patient with right ventricular hypertension secondary to atrial septal defect using transesophageal Doppler echocardiography. Prior to surgery, blood flow was predominantly diastolic in both right and left coronary arteries. Reversal of right ventricular hypertension after surgery resulted in a change in the pattern of right coronary flow, with doubling of flow during systole.

Coronary Circulation↗
PubMed1995

Leukomyelopathy in ataxic calves.

Seventy-three fattening calves ranging from 6 to 15 months old on a farm were affected by ataxia over a period of four months. About 10 ataxic animals recovered after the administration of various kinds of vitamins and needle puncture therapy. The principal lesions in 14 ataxic animals examined were characterized by bilateral vacuolation with axonal degeneration confined to the spinal white matter. Ultrastructurally, the vacuoles were present in the periaxonal areas and bounded by dissociated myelin lamellae. No pathogen was isolated from the visceral organs of the animals. The serum copper remained within the normal range. Possible etiological factors remain unknown in the ataxic disease.

Animals↗
PubMed1995

Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation.

OBJECTIVE: Percutaneous microwave coagulation therapy (PMCT) is a new therapeutic technique for the treatment of solid neoplasms that uses an energy source different from those of other interstitial therapies. We report our initial experience using PMCT to treat hepatocellular carcinomas. MATERIALS AND METHODS: NIne hepatocellular carcinomas exceeding 3 cm in diameter in nine patients were treated with PMCT. Within 2 weeks before PMCT, all patients had been treated with transcatheter arterial embolization therapy, which had failed to produce complete necrosis of the tumors. PMCT was done under local anesthesia. A 14-gauge guiding needle was inserted percutaneously toward the lesion under sonographic guidance, and a needle electrode was positioned precisely within the lesion. Microwaves of 2450 MHz in frequency were produced for 60 sec with a 60-W emission. Three to 12 microwave emissions were administered in each case. RESULTS: Dynamic CT showed that unenhanced areas indicative of coagulation necrosis developed in all lesions. All lesions appeared smaller without enhancement: on CT, the tumor diameters (mean +/- SD) were 48 +/- 13 mm before treatment and 41 +/- 13 mm 1 month after treatment. Follow-up studies showed that five lesions were controlled without any signs of recurrence. All patients tolerated the treatments well, and no serious complications occurred. CONCLUSION: Our preliminary experience suggests that PMCT may be a useful alternative to other forms of interstitial therapy for the treatment of hepatocellular carcinomas.

Aged↗
PubMed1995

Superselective intraarterial infusion of cisplatin for squamous cell carcinoma of the mouth: preliminary clinical experience.

OBJECTIVE: The purpose of this study was to assess the initial clinical response to superselective intraarterial infusion of cisplatin for treating stage III and stage IV squamous cell carcinoma of the mouth. SUBJECTS AND METHODS: Thirteen patients received intraarterial cisplatin therapy. The tumors were located in the tongue (n = 7), gingiva (n = 3), buccal mucosa (n = 1), hard palate (n = 1), and floor of the mouth (n = 1). A coaxial technique was used to place microcatheters in the lingual, facial, inferior alveolar, buccinator, and distal internal maxillary arteries, depending on tumor location. The feeding vessels were identified by staining the tumor with infusion of indigocarmine dye in the selected vessel. Relatively low-dose cisplatin (30-40 mg/m2) was injected at the rate of 50 mg/hr. Two or three injections were performed, with a 1-week interval between injections. After chemotherapy, eight patients underwent surgery, four had radiation therapy, and one had both. RESULTS: Thirty-four intraarterial infusions were done successfully without any complications. Arterial infusion of indigocarmine dye was useful for exact identification of feeding vessels, especially when the tumor was extensive, at the margin of the arterial supply, or near the midline. The overall response rate was 92% (complete response [tumor completely resolved], 38%; partial response [tumor reduction > or = 50%], 54%). Ten of 13 patients had no recurrence from 4 to 19 months (mean, 10 months) after treatment. Two patients died of metastatic diseases 6 months after surgery or radiation therapy. One patient had local recurrence 8 months after surgery and postoperative irradiation. No systemic toxicity such as renal failure, liver dysfunction, or bone marrow suppression was observed. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. Trigeminal neuralgialike symptoms and reduced mouth opening occurred in two cases and one case, respectively, probably due to direct toxicity to the peripheral trigeminal nerve and masticatory muscles, respectively. CONCLUSION: Superselective intraarterial infusion of low-dose cisplatin is feasible and safe and may have important applications in treating advanced carcinoma of the mouth.

Aged↗
PubMed1995

[Superselective local infusion therapy with tissue-plasminogen activator for acute massive pulmonary thromboembolism: preliminary clinical experience].

Three cases of acute massive pulmonary thromboembolism were treated with the superselective infusion of tissue-plasminogen activator. Superselective pulmonary angiography immediately after administration of tissue-plasminogen activator demonstrated angiographic improvement in all patients. No complications were encountered during or after the procedure. It is considered that superselective infusion of tissue-plasminogen activator can be an effective therapy for massive pulmonary thromboembolism.

Acute Disease↗
PubMed1995

A case of gas-containing liver abscess associated with emphysematous change in the gallbladder.

We describe a 77-year-old man with diabetes mellitus who developed a large gas-containing pyogenic liver abscess after admission. Mild elevation of serum biliary enzyme levels suggested probable biliary trouble on admission. Ultrasonography and computed tomography showed a large abscess of the liver with gas formation and the presence of gas within the lumina of the gallbladder and biliary tract when the patient had fever, leukocytosis and evidence of hepato-renal dysfunction. These findings suggest that the large liver abscess may have developed as a result of emphysematous cholecystitis.

Aged↗
PubMed1995

[Complications of percutaneous transluminal angioplasty].

Four hundred twenty-three percutaneous transluminal angioplasties with 383 percutaneous arterial punctures in 346 patients were reviewed to determine the frequency, distribution and causes of complications. Complications were seen at the angioplasty site and puncture site along with miscellaneous complications, the incidence rates being 9.5% (40 of 423 PTAs), 11.7% (45 of 383 punctures), and 2.0% (7 of 346 patients), respectively. Major complications occurred in 20 cases, and surgical procedures were required in six cases. Mortality as a complication of PTA was not seen. Angioplasty site complications included 13 spasms, eight dissections, five thromboses, 13 distal embolizations and one perforation. Most puncture site complications were benign hematomas, but there were other types such as a pseudoaneurysm requiring bypass grafting, a thrombosis requiring thrombolysis and a large quantity of bleeding requiring transfusion. The incidence of angioplasty site complications was significantly higher (p < 0.01) in the procedure for complete occlusion than that for stenosis. The puncture site and miscellaneous complications were also more frequent in complete occlusions. The incidence of complications increased with age, although this tendency did not reach statistical significance.

Adolescent↗
PubMed1995

[Surgical treatment of aortic rupture by blunt chest trauma].

During a ten-year period, seven patients with traumatic rupture of the thoracic aorta were operated upon. Four patients of them were operated within one week. Chest X-rays and chest computed tomography could not always reveal the exact diagnosis of aortic rupture. Intravenous digital subtraction angiography was useful to confirm the diagnosis. The repair of the rupture was accomplished with the adjunct of left heart bypass using Bio-pump, which was useful to reduce the bloodloss with a limited systemic heparinization. Another three patients were diagnosed to have chronic post-traumatic aneurysm of the thoracic aorta and underwent aortic replacement with prosthetic graft. One of seven patients died at seventh postoperative day because of cerebral contusion, the associated lesion of an automobile accident. It is stated that the aortic rupture is immediately fatal in approximately 80% of individuals, and most of remaining 20% die within 2 weeks unless the lesion is repaired. Therefore immediate operative intervention is recommended when the aortic rupture is strongly suspected. Chronic post-traumatic aneurysms should be resected because it has become apparent that the majority of patients with this lesion will develop complication, such as sudden rupture.

Adolescent↗
PubMed1995

Skull metastasis from hepatocellular carcinoma. CT, MR and angiographic findings.

CT, MR and angiographic findings of 6 patients with 9 skull metastases from hepatocellular carcinoma (HCC) were reviewed. In 3 of 6 patients, local pain or neurologic deficit was the initial main manifestation of the disease, although all had been treated for chronic liver disease. In the remaining 3 patients, skull metastases were detected following treatment of HCC. The metastatic lesions appeared as expansile osteolytic masses on CT and as hypervascular masses on angiography. All lesions were demonstrated on MR imaging. Compared with the brain parenchyma, the lesions were iso- or hypointense on T1-weighted and T2-weighted MR images. The lesions were moderately to markedly enhanced by Gd-DTPA. Flow voids were shown in the tumors in 5 lesions. HCC should be included in the differential diagnosis of an osteolytic hypervascular lesion of the skull, especially in Oriental patients. The relatively hypointense tumor on T2-weighted MR images associated with flow void, different from primary skull tumors or directly invasive tumors, may support the diagnosis of HCC metastasis.

Aged↗
PubMed1995

Androgen-dependent and independent process of bone formation in the distal segment of Os penis in the rat.

The distal segment of the os penis of the rat develops as a fibrocartilage which is replaced with non-lamellar bone by endochondral ossification after puberty. Development of the fibrocartilage and its calcification have been shown to be induced by androgens, but androgen-dependency of the endochondral ossification has not been studied in detail. In the present study, immature male rats of various ages were castrated and the ossification of the fibrocartilage of os penis was examined. In rats castrated at 6 weeks, when the fibrocartilage was scarcely calcified, ossification did not occur even at 24 weeks. When the castrated rats were treated with testosterone, ossification started before 12 weeks of age. In rats castrated at 8 weeks, when the fibrocartilage was heavily calcified, endochondral ossification was observed in some of the animals (5/7) at 24 weeks of age. The results of this study indicate that once the fibrocartilage is calcified, the endochondral ossification can take place without androgen, although the androgen can promote the process of ossification.

Animals↗
PubMed1994

[Stent placement without thrombolysis in chronic iliac arterial occlusion: preliminary clinical evaluation].

Intra-arterial stent placement without thrombolytic therapy was performed in four patients with chronic iliac arterial occlusion. The length of angiographically observed occluded lesions ranged from 2.0 cm to 14.0 cm (mean: 5.1 cm). The implanted stents included four Wall stents, two Strecker stents and one Palmaz stent. The mean ankle-arm index before and after stenting improved from 0.48 to 0.77, while the mean pressure gradient improved from 82.5 mmHg to 3.0 mmHg. Symptoms were eliminated in all patients after the procedure. No major complications were encountered during the procedure. Primary stent implantation in chronic iliac occlusions is useful to avoid bypass surgery.

Aged↗
PubMed1994

[Changes in renal function immediately after the angiography].

The effect of radiographic contrast media upon renal function was investigated in 30 patients with normal renal function using Ioxaglate 320 mgI/ml (0.58 Osm/KgH2O), Iohexol 350 mgI/ml (0.88 Osm/kgH2O) and Iomeprol 400 mgI/ml (0.75 Osm/kgH2O). Before and immediately after conventional abdominal angiography, serum and urinary BUN, creatinine, sodium, osmolality and urinary volume were examined. Urinary minute volume increased remarkably immediately after angiography in all the contrast media groups. In Iohexol 350 and Iomeprol 400, creatinine clearance (Ccr) increased immediately after angiography, while no Ccr increase was observed in Ioxaglate 320. FENa increased immediately after angiography in all the contrast media groups. There were no statistical differences in the changes of FENa among Ioxaglate 320, Iohexol 350 and Iomeprol 400. There was no significant change in CH2O. It becomes evident that the osmotic diuresis and its effect on the proximal tubular function are induced by administrated low osmolar contrast media and that these changes are reversible.

Adult↗
PubMed1994

[Three interesting pediatric cases with penicillin-resistant Streptococcus pneumoniae infection].

Since penicillin-resistant Streptococcus pneumoniae first recognized in 1967, the rate of penicillin-resistant strains has been increasing worldwide. There have been up to 50% from pediatric specimens in Japan. We reported three pediatric cases with penicillin G resistant Streptococcus pneumoniae infection to show some important clue from these cases for clinical practice against resistant pneumococcal infection. The first case was a typical acute mastoiditis, although we have experienced only masked mastoiditis recently. The second case was meningitis with septicemia, which did not show any abnormality in the first obtained cerebrospinal fluid. The third case was recurrent bronchitis in a child with cerebral palsy. The minimum inhibition concentrations of these isolated strains were 0.25 microgram/ml in the second case an 2.0 microgram/ml in the first and third cases.

Adolescent↗
PubMed1994

Structure-activity relationships of diamines, dicarboxamides, and disulfonamides on vinblastine accumulation in P388/ADR cells.

Diamines, dicarboxamides, and disulfonamides that have terminal benzene, methyl- or chloro-substituted benzene rings were synthesized and evaluated for the activity of [3H]vinblastine accumulation in multidrug-resistant P388/ADR cells. The efficacy of these compounds was generally in the order of dicarboxamides < diamines < disulfonamides. N-Methylated diamine and disulfonamide compounds having terminal methyl- or chloro-substituted benzene rings in their structure also showed rather potent efficacy. From these findings, we synthesized a novel disulfonamide compound, 1,2,3,4,5,6-hexahydro-2,5-bis(p-toluenesulfonyl)benzo[2,5]diazocine++ + (22). Compound 22 suppressed the efflux of vinblastine from P388/ADR cells and increased its intracellular accumulation, while it barely increased the vinblastine accumulation in sensitive cells (P388/S). Compound 22 significantly potentiated the growth-inhibitory effects of vinblastine, vincristine, colchicine and Adriamycin against P388/ADR cells in vitro.

Amides↗
PubMed1994

Recurrent trismus: twenty-year follow-up result.

The authors encountered an unusual case of recurrent trismus in a patient who had oral synechia, cleft lip and palate, digital anomalies, and external genital anomaly. Mandibular movement was severely restricted by congenital soft-tissue adhesion in the retromolar region. Despite aggressive surgical efforts and postoperative manipulations, limitation of mouth opening recurred soon after each operation. Furthermore, congenital and postoperative soft-tissue adhesion resulted in severe subsequent jaw deformities, which needed combined maxillary and mandibular advancement.

Abnormalities, Multiple↗
PubMed1994

Phasic venous return abnormality in chronic pulmonary diseases: pulsed Doppler echocardiography study.

Features of venous return in chronic pulmonary diseases and factors determining such features were studied by analysis of respiration-related variation in the superior vena cava flow on pulsed Doppler echocardiography. Subjects of this study were 85 patients with chronic pulmonary diseases; 54 healthy subjects served as normal controls. In the healthy subjects, the velocity of the S and D waves increased during inspiration (type I pattern), and the velocity of the A wave increased during expiration. In the patients with pulmonary diseases, the pattern of the superior vena cava flow was either type I or type II (disappearance of the D wave or disappearance of both the D and S waves). The incidence of the type II pattern was significantly higher in the patients showing a reduction of both FEV1.0% and % VC. The respiration-related variation in the superior vena cava flow pattern was found to be determined by the pressure fall between right atrium and subclavian vein. A type II pattern was attributed to the elevation of right atrial pressure caused by positive pleural pressure. The velocity of the A wave increased during expiration, showing a good correlation with pulmonary vascular resistance. Venous return in the presence of chronic pulmonary disease was found to be affected by the type of ventilatory disturbance and intensity of pulmonary vascular resistance.

Adult↗
PubMed1994

Radiation therapy of adult T-cell leukemia.

Between January, 1983 and December, 1991, 30 adult patients with T-cell leukemia (ATL) and lymph node or skin lesions resistant to chemotherapy were treated by irradiation. Thirty Gy of high energy x-rays, 60Co gamma rays or electrons was delivered to 22 lymph node lesions in 17 patients, for focal cutaneous lesions in 6 patients, and as total skin irradiation in 7 patients. Irradiation therapy was effective in all patients with skin lesions and in 12 of 17 patients with lymph node lesions. Symptoms such as pain or itching diminished in all cases and no severe side effects were observed. Radiation therapy thus achieved good control of ATL associated focal lesions resistant to chemotherapy. Even if the prognosis of ATL is poor, radiation therapy should be considered as a palliative therapy.

Adult↗