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Biomedical subjects

S Fukuda

Publications and source records attributed to S Fukuda.

At least 631 records · Page 35Linked to original sources

[Detection and significance of calcified coronary arteries by computed tomography].

To investigate whether coronary artery disease is detected noninvasively, we correlated calcification on computed tomography (CT) with coronary angiographic (CAG) findings in 90 consecutive patients including 48 with angina pectoris or myocardial infarction. The mean age was 52.2 years and 83% were men. CT scans without contrast enhancement (3 sec scan time) were obtained at 1 cm thickness from the ascending aorta to cardiac apex to identify calcification in coronary arteries. Results; CAG revealed of 50 patients, and stenosis was present more often at calcified vessels on CT. (table; see text) Calcification occurred more often in 2 or 3 vessel disease. However, stenotic segments were not always calcified. We conclude that CT is sensitive for the detection of calcification and an important method for the diagnosis of coronary artery disease.

Calcinosis↗

Hypoxia in brain slices.

The effects of hypoxia on hippocampal CA1 neurones in tissue slices of the rat brain were studied in vitro by intracellular recording. In response to superfusion of a hypoxic medium equilibrated with 95%N2-5% CO2, a majority of the neurones showed a transient depolarization followed by a hyperpolarization of 5-15 mV in amplitude and 4-12 min in duration. The hyperpolarization was, in turn, followed by a slow depolarization which within 20 min of hypoxic exposure reached a plateau level of about 25 mV above the prehypoxic resting potential. Both the initial hyperpolarization and subsequent depolarization were associated with a reduction in membrane resistance. The hyperpolarization reversed in polarity at a membrane potential of -83 mV. There was an almost linear relationship between amplitude of the hyperpolarization and membrane potential. The hyperpolarization was markedly enhanced in potassium-free media and was depressed in high-potassium solution. Superfusion of ouabain (5-7 microM)-containing medium in normoxic conditions produced hyperpolarizing and depolarizing responses similar to those elicited by hypoxic exposure. The slow depolarization was also mimicked by elevation of the extracellular potassium concentration to 10-20 mM. Evoked i.p.s.p.s were abolished within 4 min of hypoxic exposure while evoked e.p.s. p.s were maintained for about 20 min of hypoxic superfusion. Soma spikes of the neurones elicited by a depolarizing pulse were also well preserved. Their threshold was, however, raised, concomitant with a decrease in the peak amplitude. In a minority of the neurones the slow depolarization was suddenly followed by a rapid depolarization, after which the neurones showed no functional recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Simplified technique for closure of median sternotomy incision: the use of bone stapler].

A new technique with the bone stapler (Staplizer) was applied in 11 patients undergoing open-heart surgery for closure of a median sternotomy incision. The staplers were used for fixation of the sternum following partial trans-sternal fixation with two wires. The method was quick and easy to perform, and effective in establishing firm and permanent approximation of the sternum. There were no instances of dehiscence among all the patients with stapler closure. We therefore recommend this technique in median sternotomy closure except for patients with the osteoporotic or elastic sternum.

Adolescent↗

[Total repair of complete atrioventricular canal: relationship between age at operation and late results].

Twenty five consecutive patients with complete atrioventricular canal (CAVC) underwent one-stage operation from April 1981 to Aug. 1987. Average ages at operation was 18 months (2 to 72) and average weight was 7.0 kg (2.8 to 13.8). Fifteen patients were infants and fifteen had Down syndrome. Conventional cardiopulmonary bypass with pulsatile bypass pump (PBP) and moderate hypothermia at 28 degrees C was utilized in all patients. Single patch technique (SPT) was adopted for initial five patients and two patch technique for the latter twenties. Two patients died perioperatively (operative mortality 8.0%), one of whom from mitral stenosis after SPT and the other from misdiagnosis of large subpulmonary VSD. There was no hospital death. Mean pulmonary artery pressure (mPA), pulmonary systolic pressure to systemic systolic pressure ratio (Pp/Ps) and pulmonary vascular resistance index (PVRI) were decreased remarkably from preoperative values of 56 +/- 14 mmHg, 0.92 +/- 0.13 and 6.2 +/- 4.9 WU.m2 to postoperative of 31 +/- 16 mmHg (p less than 0.001), 0.54 +/- 0.20 (p less than 0.001) and 4.6 +/- 4.0 WU.m2 (NS), respectively. Six patients had residual pulmonary hypertension in which mPA was more than 40 mmHg. One patient who was complicated with severe mitral regurgitation due to dehiscence of suture line and torn chordae had mitral valve replacement. Mean follow-up period was 26 months (5 to 63). The mean weights of 67%N at operation catched up with 87%N 3 years after operation. There were two late deaths, 4 and 20 months after operation between age at operation, both of whom had residual pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

[Angiographic findings in a patient with spontaneous hemopneumothorax].

We experienced one patient with spontaneous hemopneumothorax in whom angiography was performed preoperatively. The patient was a 23-year-old female and her plain chest X-ray revealed an index-finger-tip-sized bulla at the left apex and a narrow restiform shadow connecting the pleural cupola with the bulla. Left subclavian arteriography revealed preoperatively that the restiform shadow consisted of aberrant vessels branched from the left costocervical trunk and distributed in and around the bulla at the apex. In the present study very rare angiographic findings and excised specimens obtained from the patient are shown, with reference to surgical indication of spontaneous pneumothorax.

Adult↗

[Chondrosarcoma of the ribs: report of two cases].

Chondrosarcoma of rib origin is relatively rare in Japan. Two patients with chondrosarcoma of rib origin were treated surgically. Case 1: A 79-year-old male, 4 years ago, he noticed a tumor in the left anteroinferior part of the chest. The histological examination of the specimen obtained by incisional biopsy showed osteochondroma in another hospital and he had been under observation. Since the tumor has recently increased in size, he was referred to our department. Radical resection of the chest wall was performed. As expected, the tumor was found to be a secondary chondrosarcoma by postoperative histological examination. Case 2: A 49-year-old female. In the follow up studies after radical nephrectomy, Tc-MDP scintigram revealed an accumulation in the left second rib. Under the diagnosis of rib metastasis, radical resection was performed. The histological examination showed chondrosarcoma of rib origin postoperatively. This lesion was a primary central type, and is considered to have been resected in the earliest stage of all cases we have found in the Japanese literature.

Aged↗

Arterial switch operation for transposition of the great arteries, with special reference to left ventricular function.

Between June 1984 and September 1987, 48 patients underwent Lecompte's modification of the arterial switch operation for transposition of the great arteries, including transposition with intact ventricular septum with preparatory pulmonary artery banding (n = 18), with patent ductus arteriosus (n = 11), with dynamic left ventricular outflow tract obstruction (n = 4), and transposition with ventricular septal defect (n = 15). Ages ranged from 12 days to 36 months (mean 8 months) and weights ranged from 2.7 to 12.8 kg (mean 5.7 kg). Two deaths occurred, yielding an operative mortality rate of 4.2%. Preparatory pulmonary artery banding resulted in an increase to 65 +/- 5 mm Hg in the left ventricular afterload. Linear regression of the optimum circumference of the band (Y, millimeters) against left ventricular end-diastolic volume (X, milliliters) yielded the following formula: Y = 0.23X + 19.7 (r = 0.885, p less than 0.001). Influence of left ventricular mass on cardiac function after anatomic correction was evaluated. The total amount of dopamine used after repair in patients in whom the left ventricular mass was less than 60% of normal was significantly larger than that in patients with a left ventricular mass greater than or equal to 60% of normal (p less than 0.002). The left ventricular end-diastolic volume in patients with a left ventricular mass less than 60% of normal increased significantly 2 months after operation (p less than 0.05), whereas it decreased in patients with a left ventricular mass greater than 60% of normal (p less than 0.01). We believe it is safe to perform this procedure in patients in whom the left ventricular mass is larger than 60% of normal. Most newborn infants with simple transposition can undergo correction between 10 and 20 days of life if the ductus arteriosus is kept patent with prostaglandin E1 and the left ventricle is thereby loaded. Preparatory pulmonary artery banding, when necessary, will be satisfactory if the left ventricular pressure is greater than 65 mm Hg and/or the left ventricular/right ventricular pressure ratio is greater than 0.8.

Aorta↗

[Non-granulomatous anterior uveitis and HLA-B27 antigen].

In Caucasians, there is close correlation between acute anterior uveitis and histocompatibility antigen HLA-B27. But in Japanese, this is not clear. Therefore, we examined 58 patients with non-granulomatous anterior uveitis (NGAU) about HLA typing in our uveitis clinic at Tokyo Women's Medical College Hospital. HLA-B27 was identified in 20 out of 58 patients (34.5%) with NGAU and it was statistically significant. We also studied the clinical features of patients with HLA-B27 positive NGAU. We found that in HLA-B27-positive NGAU, the visual acuity was more strongly affected during the attack and the duration of inflammation was longer than HLA-B27 negative NGAU patients. The duration of the first attack was longer than re-attack, and the duration of the first attack was longer than HLA-B27 negative NGAU patients. It was less commonly associated with systemic disorders in Japanese HLA-B27 positive anterior uveitis than in Caucasian. However, in Japanese NGAU patients without systemic disorders, there was the same tendency concerning the HLA-B27 positive rate as in Caucasians.

Asian People↗

[Chemotherapy of chronic myelogenous leukemia--VP(M) regimen initiated during its chronic phase, and evaluation of MCNU in the phase of blastic crisis].

Seventy-four patients in the chronic phase of Ph1-positive chronic myelogenous leukemia (CML) have been treated with busulfan or other alkylating agents in a conventional way. During its chronic phase, 24 of these 74 cases had received additional intermittent therapy every 4 to 6 months, consisting of vincristine 2 mg or vindesine 3 mg per week, prednisolone 20-30 mg per day and partly 6 mercaptopurine 50 to 100 mg, combined with allopurinol 200 to 300 mg per day for 2 to 3 weeks. The 50% survival of these patients using the Kaplan-Meier's method was 73.7 months and 5-year survival was 69.6%, against 40.5 months and 14.4%, respectively, in the remaining patients. Nine patients in the blastic or accelerated phase of Ph1-positive CML have been treated with new regimens including MCNU. All cases had been refractory for usual types of induction chemotherapy. The new regimen consisted of MCNU 50-100 mg, combined with vindesine or 6-MP plus allopurinol or prednisolone. Five out of 9 cases attained complete remission and 1 partial remission. The major adverse effect of this regimen was slight liver damage. MCNU could be regarded as an useful agent in the blastic phase as well as in the chronic phase of CML.

Adolescent↗

[Multiple cerebral infarction following coronary artery bypass grafting for the patient with calcified aorta--a case report].

The cardiac surgeon occasionally may encounter a diseased or rigidly calcified aorta in the patient requiring myocardial revascularization. In this paper, a 72-year-old woman who suffered from neurological injury following coronary artery bypass grafting due to embolization of atheromatous debris from the calcified ascending aorta was described. A review of the literature was also performed to emphasize the importance of the recognition, and management of the calcified and diseased ascending aorta.

Aged↗

Cornelia de Lange syndrome associated with Wilms' tumour and infantile haemangioendothelioma of the liver: report of two autopsy cases.

Two cases of Cornelia de Lange syndrome associated with infantile haemangioendothelioma of the liver and Wilms' tumour are reported. The patients showed the characteristic facies of the Cornelia de Lange syndrome, with synophrys, long curly eyelashes and small upturned nose, and physical features, including generalized hirsutism, monodactyly, syndactyly and clinodactyly. Post-mortem examination revealed annular pancreas, patency of the foramen ovale, duodenal atresia and evidence of cytomegalic infection. The cases are reported to document a possible association between malformations and neoplasms in this syndrome.

De Lange Syndrome↗

Experimental mumps labyrinthitis in monkeys (Macaca irus)--immunohistochemical and ultrastructural studies.

Three monkeys (Macaca irus) were inoculated with mumps virus into unilateral cochleas and their inner ear were examined by immunofluorescent microscopy and transmission electronmicroscopy. The temporal bones were removed after survival period of 14 days when serological tests disclosed elevation of anti-mumps antibody titers. Immunofluorescent microscopy revealed that the viral antigen was positive in the stria vascularis. The ultrastructural study revealed that the pathologic changes in the cochleas were marked in the organ of Corti and stria vascularis. The outer hair cells were more susceptible to the infection than the inner hair cells. In the stria vascularis, both marginal and intermediate cells were affected. It was possible to find some of marginal cells in the basal turn shedding a large number of mature virions into the endolymph. These pathologic changes observed in the cochleas of the monkeys were similar to those previously revealed in the guinea pig cochleas and thus were considered as the specific features of acute mumps labyrinthitis.

Animals↗

Follicular thyroid carcinoma with clear cell change showing unusual ultrastructural features.

We report a case of follicular thyroid carcinoma with clear cell change displaying unusual ultrastructural features. Light microscopy revealed a metastatic neoplasm in the 12th thoracic vertebra that was composed of nests consisting mainly of clear cells. The tumor was interpreted as a metastasis of a clear cell type of thyroid carcinoma, based on positive immunohistochemical staining for thyroglobulin. However, unlike the metastatic bone lesions, the primary tumor in the thyroid consisted mainly of neoplastic follicular cells with lightly eosinophilic cytoplasm. A distinct follicular formation was noted throughout the tumor. In a portion of the tumor, a solid or stratified disposition of the cells was also observed. The primary tumor contained only a few clear cells similar to those seen in the metastatic bone lesions. In addition, we noted a transition between the follicular cells and the clear cells. Thus, this neoplasm was diagnosed as a follicular thyroid carcinoma with clear cell change, but not a specific type of thyroid neoplasm. Electron-microscopic examination revealed that the cells corresponding to clear cells under light microscopy had abundant cytoplasm characterized by varying degrees of dilation of rough endoplasmic reticulum (RER), which might reflect increased synthesis, storage of secretory products, or both.

Adenocarcinoma↗

Hypermineralocorticism without elevation of plasma aldosterone: deoxycorticosterone-producing adrenal adenoma and hyperplasia.

Two female patients were admitted for evaluation of hypertension and hypokalaemia. Plasma renin activity was suppressed and plasma aldosterone levels were within the normal value in a 52-year-old woman and below the normal value in the other patient, a 62-year-old woman. Plasma 11-deoxycorticosterone (DOC) levels were as high as 1.13 and 1.47 nmol/l, respectively. Adrenal scintigram and abdominal CT scan clearly showed a right adrenal tumour in the 52-year-old woman. After adrenalectomy plasma DOC level decreased to the normal level of 0.12 nmol/l, and her blood pressure and serum potassium became normal. Abdominal CT scan revealed no finding of adrenal tumour in the older woman. These results indicate that these two patients had hypermineralocorticism with elevation of plasma DOC. One patient had a DOC-producing adrenal adenoma, and the other probably had bilateral adrenal hyperplasia.

Adenoma↗