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Biomedical subjects

S Goto

Publications and source records attributed to S Goto.

At least 577 records · Page 32Linked to original sources
PubMed1993

Possible action of human placental aminopeptidase N in feto-placental unit.

Aminopeptidase N purified from human placenta actively hydrolyzed various immunomodulating peptides from their N-terminus such as splenopentin, thymopentin, thymic humoral factor gamma 2, tuftsin and rigin in vitro. Aminopeptidase N also actively hydrolyzed neuropeptide hormones (met-enkephalin, somatostatin and neurokinin A) and vasoactive peptides (lysyl-bradykinin and angiotensin III) from their N-terminus. In addition, angiotensin II, secretin, thymopoietin II peptide fragment, motilin, endothelin-I and insulin were tested for hydrolysis by aminopeptidase N. Km and Vmax values for the N-terminal amino acid, Thr, a liberation from tuftsin were 267 microM and 8.33 mumol/min/mg protein, respectively. L-Leucyl-p-nitroanilidase activity in the human placental membrane fraction was almost completely neutralized by anti-aminopeptidase N antibody. Our present study suggests that possible roles for surface enzyme aminopeptidase N in the human placenta would be to down-regulate the action of immunomodulating peptides as well as vasoactive and neuropeptide hormones, and to control both immunology and endocrinology of pregnancy.

Amino Acid Sequence↗
PubMed1993

[Serial changes in hemostatic and fibrinolytic states induced by coronary thrombolytic therapy].

The effects of coronary thrombolytic therapy with urokinase on the intrinsic hemostatic and fibrinolytic states were investigated by determining several markers for hemostatic and fibrinolytic activities in 6 patients with acute myocardial infarction who underwent coronary thrombolysis with urokinase. The markers for hemostasis and fibrinolysis were: markers for plasmin generation [alpha 2-plasmin inhibitor (alpha 2-PI), plasminogen, plasmin alpha 2-PI complex (PIC)]; markers for fibrinolysis [fibrin/fibrinogen degradation products-E fragment (FDP-E), FDP D-D dimer (D dimer), fibrinogen]; markers for hemostatic activity (prothrombin time (PT), antithrombin III (AT-III), protein C); markers for thrombin generation [thrombin antithrombin III complex (TAT)]; markers for intrinsic fibrinolytic activity [tissue plasminogen activator plasminogen activator inhibitor complex (TPA PAI complex)]. These markers were measured before, at 1 to 2 hours intervals during first 6 hours, daily during the next 3 days, and subsequently on the 7th and the 14th day after urokinase therapy. Fibrinolysis (determined by increased D dimer) occurred only when alpha 2-PI became unmeasurable with 96 x 10(4) or more units of urokinase administration, then persisted for more than 2 hours. TAT increased from 13.1 +/- 15.4 to 70.8 +/- 65.8 ng/ml soon after fibrinolysis occurred, indicating that thrombin generation occurred at the same time as fibrinolysis. The TPA PAI complex level before urokinase administration (26.4 +/- 6.4 ng/ml) was greater than the normal upper limit, indicating increased intrinsic fibrinolytic activity, then decreased after urokinase administration. These findings suggested that urokinase administration might affect the intrinsic fibrinolytic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Pregnancy after chemotherapy for trophoblastic diseases and psychosomatic development in the progeny.

We treated 542 patients with trophoblastic diseases from 1965 through 1988, and succeeded in preserving fertility in 269 of them (240 cases of invasive mole and 29 cases of choriocarcinoma). Of the 269 patients, 198 (79.5%) conceived after completing treatment. A total of 396 pregnancies in these women resulted in 295 term live births (74.5%), 51 spontaneous abortions (12.9%), and 4 recurrences of moles (1.0%). Four cases (1.32%) of malformations were discovered. The growth conditions of 101 children born in 1976 or later were followed up until the age of 18 months. Their heights or weights did not differ significantly from those of children measured in national infantile-growth surveys. The psychoneurological development of 54 children up to the age of 7 years who were studied by using infantile mental-development questionnaires showed no marked mental retardation. Our results provide strong evidence of the safety of chemotherapy for the treatment of trophoblastic diseases.

Adult↗
PubMed1993

[Post operative embolism and left atrial enlargement in the old-aged ASD (atrial septal defect) patients].

As the operation risk of ASD is little today, the unexpected postoperative complication such as embolism is a miserable concern. We experienced two cases of embolism, which were cerebral infarction, in old-aged patients after ASD correction. It has been reported that low cardiac function, atrial fibrillation and foreign body in the left atrium should be risk factors of the embolism after ASD correction. However, blood stasis in the left atrium due to its enlargement may be an essential risk factor of the embolism. Accordingly we evaluated the left atrial volume in 87 ASD patients without complicated cardiac disorder. There was a significant correlation between the age (X) and left atrial volume index (Y). (Y = 16.5 + 1.1X, r = 0.668, p < 0.001). Left atrial volume index in our two cases of cerebral infarction indicated 171.7, 190.8 ml/m2 respectively. The former case had sinus rhythm and its defect was directly closed, and the latter had atrial fibrillation and its defect was closed with teflon patch. In addition pulmonary artery pressure and cardiothoracic ratio correlated with left atrial volume index significantly. Although some investigators reported that pulmonary hypertension and cardiomegaly were the risk factors of embolism, the left atrial enlargement by aging was thought to be the main risk factor. Thus, we concluded that anticoagulant therapy was necessary for the ASD patients with marked left atrial enlargement.

Aged↗
PubMed1993

[Sinus thrombosis during CDDP and VP-16 (PE) therapy for suprasellar germ-cell tumor: case report].

A case of sinus thrombosis occurring during combination chemotherapy with CDDP and VP-16 (PE) for a suprasellar germ-cell tumor is presented. A 5-year-old girl developed polyuria, polydipsia and headache in April, 1991 and became unconscious on May 10, 1991, when MRI and CT demonstrated a suprasellar tumor and marked hydrocephalus. After a ventriculo-peritoneal shunt operation, radiotherapy and two courses of PE therapy were carried out. During the second course of PE therapy, diabetes insipidus became quite difficult to control and severe hypovolemic hypernatremia developed. While it was being treated, the patient developed a clonic convulsion of her left extremities and visual disturbance. CT scan demonstrated a right parietal hemorrhagic infarction and IV-DSA suggested thrombosis of the superior sagittal sinus. Laboratory data disclosed DIC. The main cause of sinus thrombosis in this patient was considered severe dehydration. It is also possible that cisplatin and steroid played a role. In addition to these, dysfunction of hypothalamus, which is one of the regulatory centers of the plasma concentration of factor VIII, may have contributed to the acceleration of blood coagulation. This case re-emphasized the importance of preventing dehydration and monitoring the blood coagulation fibrinolytic system during PE therapy in patients with a suprasellar germ-cell tumor accompanied with diabetes insipidus.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Intraocular lens implantation in severely mentally and physically handicapped patients].

We implanted a posterior chamber intraocular lens (PC-IOL) in 30 eyes of 17 severely mentally and physically handicapped patients, i.e., 14 eyes of 9 severely mentally retarded patients, 14 eyes of 7 patients with Down's syndrome, and 2 eyes of a mitochondrial encephalomyopathy patient. All surgery was performed under general anesthesia and 3 to 10 post-operative days of hospital care were needed in an ophthalmic ward. A post-operative intensive care unit was not necessary. Severe post-operative complications occurred in 2 eyes of 2 cases. One case was complicated by an iris prolapse, and in another case traumatic wound rupture caused a prolapse of the IOL, vitreous, and retina. However, in both cases, the other eye, which also had a PC-IOL implantation, showed an uneventful post-operative course. Vision and quality of life in all patients seem to have improved. The present observations indicate that cataract surgery with PC-IOL for these patients should be positively considered in spite of difficulties in pre- and post-operative management, and when done, calibration of IOL power immediately before surgery under general anesthesia and small incision techniques are essential.

Adult↗
PubMed1993

An anomalous lumbrical muscle with an independent muscle belly associated with carpal tunnel syndrome.

A rare case of carpal tunnel syndrome caused by an anomalous lumbrical muscle of the left hand in a 61-year-old female is reported. The anomalous lumbrical muscle, by which the median nerve of the patient was compressed, originated from the forearm and inserted to the region of the index finger. However, there was also a normal lumbrical muscle originating from the flexor digitorum profundus.

Carpal Tunnel Syndrome↗
PubMed1993

Identification of the pregnancy responsible for gestational trophoblastic disease by DNA analysis.

In three cases of choriocarcinoma, genetic loci including a variable number of tandem repeat regions were amplified by the polymerase chain reaction method on DNA from three established cell lines and from lymphocytes of patients and their husbands to identify the responsible pregnancy. Case 1, from whom NaUCC-3 was derived, had only one full-term fetal death. Case 2, from whom NaUCC-4 was derived, had one normal delivery followed by one complete molar delivery and one normal delivery. Case 3, from whom NaUCC-2 was derived, had one normal delivery followed by one complete molar delivery. In case 1, NaUCC-3 was found to be of parental origin and derived from the pregnancy with full-term fetal death. In cases 2 and 3, NaUCC-4 and NaUCC-2 were of probable androgenetic origin and were derived from the pregnancy with complete hydatidiform mole. We also conducted the restriction fragment length polymorphism method using case 1 samples, and it confirmed the results based on the polymerase chain reaction method product patterns. All nine cases of hydatidiform mole and three cases of invasive mole were of androgenetic origin. The polymerase chain reaction method thus makes it possible to identify easily the pregnancy responsible for choriocarcinoma using only a few specimens without isotopes.

Adult↗
PubMed1993

[Caesarean section in a patient with past history of fulminant malignant hyperthermia].

Caesarean section in a 26 year old patient (50 kg, normal weight 36 kg) with past history of fulminant malignant hyperthermia (f-MH) is reported. Hyperthermia over 42 degrees C and subsequent cardiac arrest occurred during general anesthesia with nitrous oxide-oxygen-halothane and succinylcholine when she had been planned to perform hip joint arthroplasty at the age of 7. Prophylactic oral dantrolene administration started 4 days before the operation and the dose went up to 75 mg. Further 25 mg was given as premedication on the day of the operation. Intravenous dantrolene was administered 1.2 mg.kg-1 during the operation and 0.6 mg.kg-1 on the day after surgery. The Caesarean section was performed under spinal anesthesia with hyperbaric tetracaine 20 mg. No clinical symptoms of MH occurred during perioperative period. The delivered baby was a healthy female and no side effects of dantrolene were observed.

Adult↗
PubMed1993

[A depression of respiratory function following the cardiopulmonary bypass in infants and children].

Fourty-one patients (2-44 month old) underwent the closure of ventricular septal defect using moderate-hypothermic cardiopulmonary bypass (CPB). The respiratory index (RI) were monitored after CPB, as functional parameters of oxygenation capacity. At 15 min after CPB, there was the increased level in RI (2.22 +/- 0.45; normal value: 0.1-0.37). Thereafter, RI gradually decreased by 90 min after CPB (1.22 +/- 0.19), and again increased reaching peak levels by 12 hrs after ICU-entry (2.56 +/- 0.64). The patients who exceed 1.00 at 15 min after CPB (RI-15) remained higher levels in RI compared to less than 1.00 and had the prolonged controlled ventilation. The RI-15 correlated with pulmonary-systemic flow ratio (Qp/Qs) and pulmonary-left ventricular pressure ratio (PA/LV). There was no significant correlation between RI-15 and CPB factors including CPB time, dilution rate, rectal temperature, flow and perfusion pressure. These results suggest that pulmonary dysfunction following the CPB may not be simply occurred by CPB but also involved by preoperative conditions. An increased pulmonary blood flow might be one of important and predictive factor for the depression of oxygenation following the cardiac surgery in infants and children.

Cardiopulmonary Bypass↗
PubMed1993

Long-term follow-up study of anterior surgery for cervical spondylotic myelopathy with special reference to the magnetic resonance imaging findings in 52 cases.

A series of 151 patients with cervical spondylotic myelopathy (CSM) were surgically treated through an anterior approach in the period from 1960 to 1987. Particular attention was given to the results of the 52 patients who were operated on more than 12 years ago. Satisfactory short-term results were obtained in all but the few who had incomplete decompression. In these patients, function deteriorated within five years. A disturbing incidence of progression of myelopathy was noted ten years after surgery. Magnetic resonance imaging identified many of the causes (e.g., newly developed intervertebral disk herniation and progression of spondylosis associated with spinal malalignment in both cephalad and caudal directions). Other adverse changes were hypertrophy of the yellow ligament and ossification of the posterior longitudinal ligament. The new and improved techniques consist of decompression to a width of 16 mm or more with intraoperative ultrasonography in addition to extirpation of the posterior longitudinal ligament. This new measure may reduce the incidence of late neurologic deterioration.

Adult↗