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Biomedical subjects

S Inoue

Publications and source records attributed to S Inoue.

At least 595 records · Page 33Linked to original sources
PubMed1997

[Premixing lidocaine reduces the incidence and severity of pain on injection of propofol].

The purpose of this study was to confirm the effect of premixed lidocaine for the reduction of pain during injection of propofol in adult patients. We conducted a prospective, randomized, double-blind trial on 106 patients. In the study group (n = 54), lidocaine 40 mg (2 ml of lidocaine 2%) was added to 180 mg of propofol (18 ml). In the control group (n = 52), 2 ml of normal saline was added to 180 mg of propofol. The pain on injection was rated as none, mild, moderate, or severe. Eleven patients (20.4%) in the study group experienced pain compared with 25 (48.1%) in the control group. Thirteen in the control group complained moderate or severe pain compared with only one in the study group. In conclusion, lidocaine 40 mg premixed with 180 mg propofol significantly reduces the incidence and severity of pain associated with propofol injection.

Adult↗
PubMed1997

[Two cases of tracheal injuries secondary to blunt trauma].

We present two cases of injury to the cervical trachea and the tracheal bifurcation due to blunt trauma. A 20-year-old man sustained complete disruption of the cervical trachea during a traffic accident. He underwent end-to-end anastomosis of the disrupted trachea. Nevertheless, 3 weeks after the initial surgery, tracheostomy was required because of suture failure. Two months after the second procedure, he underwent closure of the tracheostoma. Granulation developed temporarily, but diminished thereafter. The second case was a 14-year-old boy. He sustained a longitudinal laceration about 3 cm from the tracheal over the membranous portion during a traffic accident. The laceration was successfully repaired by interrupted sutures with absorbable materials. Our experiences emphasize the importance of debridement of the injured cartilageous portion during treatment of tracheal injury due to blunt trauma and the difficulty in managing complete disruption of the cervical trachea with bilateral paralysis of the recurrent nerve.

Accidents, Traffic↗
PubMed1997

[Emergency surgery making use of video-assisted thoracoscopy--2 case reports].

We recently experienced two emergency operating cases using video-assisted thoracoscopy. First case was a 17-year-old male with foreign body and pneumothorax in the right thorax. He was emergencilly treated by means of video-assisted thoracoscopic surgery. The operation was carried out using double-lumen endotracheal anesthesia. Short trocars were inserted through the right intercostal spaces to introduce a flexible video thoracoscope and surgical instruments. Foreign body was looked for easily and removed out. Second case was a 22-year-old male with hemo-pneumothorax at the right side. He was treated using video-assisted thoracoscopy emergencilly. Bleeding point was searched and hemostasis was done by the electrical mess and the clip. Bulla was removed out with surgical instruments. These were good adaptation of emergency operation using video-assisted thoracoscope. The advantages of this thoracoscopic surgery are: less operative invasion and postoperative pain, early recovery and short hospital stay, and cosmetic preservation.

Adolescent↗
PubMed1997

Clinical application of a new monoclonal antibody (19B7) against PIVKA-II in the diagnosis of hepatocellular carcinoma and pancreatobiliary malignancies.

OBJECTIVES: A new monoclonal antibody (19B7) against prothrombin induced by vitamin K absence or antagonist-II (PIVKA-II) was clinically applied in patients diagnosed with hepatocellular carcinoma and pancreatobiliary malignancies, and the results were compared with those obtained using the conventional monoclonal antibody (MU-3) against PIVKA-II. METHODS: The assays were the standard E-1023 using MU-3, a high sensitivity kit using MU-3 and a highly sensitive avidin-biotin complex method, and a new monoclonal antibody (19B7) kit. RESULTS: The rate of PIVKA-II positivity in patients with hepatocellular carcinoma (n = 182) was 44% with E-1023, 55.5% with the high sensitivity kit, and 58.2% with the new monoclonal antibody kit. Small liver cancers <2 cm in diameter (n = 45) had a positivity rate of 15.6% with E-1023, 26.7% with the high sensitivity kit, and 31.1% with the new monoclonal antibody kit. The incidence of PIVKA-II positivity in patients with pancreatobiliary carcinoma (n = 91) was 29.7% with the high sensitivity kit and 52.7% with the new monoclonal antibody kit. The PIVKA-II ratio (plasma concentration with the high sensitivity kit/plasma concentration with the new monoclonal antibody kit) was calculated as > 1.0 in 89 of the 113 (78.8%) patients with hepatocellular carcinoma with the new monoclonal antibody kit assay level above 0.002 arbitrary units/ml, compared with <1.0 in almost all patients with pancreatobiliary malignancies. CONCLUSIONS: MU-3 has much greater affinity for PIVKA-II in hepatocellular carcinoma than does 19B7, whereas 19B7 has much greater affinity for PIVKA-II in pancreatobiliary malignancies than does MU-3. The new monoclonal antibody, 19B7, is useful for diagnosing hepatocellular carcinoma and can also distinguish patients with hepatocellular carcinoma from those with other pancreatobiliary malignancies when combined with a PIVKA-II assay using the conventional monoclonal antibody, MU-3.

Adult↗
PubMed1997

[Two-peak monoclonal protein (IgA kappa and IgG kappa) in non-Hodgkin lymphoma].

A 72-year-old man was admitted because of general weakness. On physical examination, marked splenomegaly was found. Blood tests revealed anemia, thrombocytopenia and two-peak hypergammaglobulinemia composed of kappa type IgG and IgA monoclonal proteins. Peripheral blood and bone marrow (BM) contained abnormal lymphocytes including plasmacytoid lymphocytes and/or plasma cells. Pathological examination of the biopsied BM showed non-Hodgkin lymphoma consistent with the lymphoplasmacytoid type. Immunohistochemical staining revealed two different populations of cells, one with IgG and the other with IgA; no cell stained both and no solitary cluster of either IgG or IgA positive cell was seen. The surface phenotype of the lymphoma cells was CD19+, CD20+, HLADR+. Double immunofluorescence staining of the BM smear showed IgG or IgA positive plasma cells, whereas small lymphocytes were negative for IgG and IgA. Analysis of immunoglobulin genes in the BM cells showed 2 rearranged bands in each of heavy chain genes and kappa light chain genes. The patient was treated with modified MVCP therapy and the two monoclonal proteins decreased in parallel with the improvement of splenomegaly. These findings strongly suggest that the two-peak monoclonal protein was produced by monoclonal lymphoma cells. The patients has been disease-free without any therapy since August, 1995.

Aged↗
PubMed1997

[Cyclin and cell cycle].

Cell cycle progresses through the formation of cyclin produced and degraded in its specific phase and cyclin dependent kinase (Cdk) existing in all phases of the cell cycle and consequential phosphorylation of Cdk. The Cdk is activated by Cdk-activating kinase as well as cyclin, and its function is suppressed by its inhibitory subunits (CKIs). The cell cycle induced by extracellular stimuli in normal cells progresses toward cell differentiation and apoptosis or cell proliferation according to a certain law. The failure to complete cell-cycle progression can be detected and repaired at many checkpoints. Cancer cells have abnormal cell-cycle relating constituents, such as overexpression of cyclin, mutation or deletion of CKI and failures in feedback controls at checkpoints. These abnormal constituents may contribute to the evaluation of patients' prognosis and cellular sensitivity for chemotherapy and ionizing irradiation and may lead to a development of new promising anti tumor agents.

Apoptosis↗
PubMed1997

[A case of malignant lymphoma after renal transplantation].

A case of a primary brain malignant lymphoma after renal transplantation and immunosuppressive therapy is reported. A 41-year-old male patient had been treated with 125 mg/day of azathioprine and 10 mg/day of prednisolone after renal transplantation. He had also been suffering from various infectious diseases. Multiple brain tumors were found and diagnosed as having B-cell, diffuse large cell type malignant lymphoma. In spite of moderate response to irradiation, he died of pneumonia. The anti-Epstein Barr virus antibodies changed from a negative to a positive level after renal transplantation and they increased markedly after brain malignant lymphoma had been found. The number of T- and B-lymphocytes also decreased markedly at that time. So the Epstein-Barr virus was suspected to be the cause of the malignant lymphoma.

Adult↗
PubMed1997

[Massive bleeding from the ruptured liver and the inferior vena cava controlled with autotransfusion and cerebral ischemia treated with mild hypothermia].

A patient suffered massive bleeding from the ruptured liver and laceration of the inferior vena cava due to traffic accident, and developed hypotension and decreased level of consciousness. The patient was transferred to our hospital for an emergency operation against intra-abdominal massive bleeding. This massive bleeding was controlled with autotransfusion using washing salvaging autotransfusion device (Cell Savor). Suspected brain ischemia was treated with intended mild hypothermia. When blood pressure decreased to 30 mmHg of systolic pressure over 7 minutes during the operation, suggesting the possible brain ischemia, mild hypothermia was maintained at 33.8 degrees C. Total bleeding volume was 16,700 ml, and total transfused volume was 10,700 ml. Of total transfused volume, 4,500 ml was washed salvaged blood using the intraoperative autotransfusion device. No neurological deficit was found during the postoperative course. The patient was discharged uneventfully on the 20th postoperative day. In conclusion, intraoperative autotransfusion with washed salvaged blood is a useful method for treatment of massive bleeding, and mild hypothermia is efficacious for protecting the brain from ischemia resulting from accidental hypotension.

Accidents, Traffic↗
PubMed1997

[Intraoperative re-rupture of gastric varix immediately after the start of an operation in a patient with liver cirrhosis].

Gastroesophageal variceal hemorrhage is a rare complication during an operation. We present a case of gastric variceal re-rupture during an emergent operation for devascularization of the gastric veins. The patient was a 72-year old man with liver cirrhosis, who developed gastric variceal hemorrhage on the day of surgery. Sclerotherapy with an endoscope was performed, and the hemorrhage was controlled four hours before entering the operating theater. The induction of anesthesia and tracheal intubation were done with rapid sequence because the patient was regarded as full stomach. Induction was completed successfully. However, gastric varix ruptured immediately after the beginning of the surgery. The hemorrhage into the stomach amounted to 2,165 ml. The patient developed hypotension of 40 mmHg of systolic pressure for 15 minutes. With fluid resuscitation, continuous infusion of dopamine and ligation of varix, the patient recovered from this hypotensive event. No neurological deficit developed postoperatively. Portal hypertension results from increased resistance to portal venous blood flow or increased portal venous blood flow. Therefore, increased intravascular volume may play a significant role in precipitating variceal hemorrhage. In this case, abrupt circulatory change due to inadequate depth of anesthesia may partly cause massive hemorrhage. In conclusion, since potential adverse effects of increased blood volume and hepatic resistance on variceal hemorrhage must be considered during anesthesia, patients with episode of variceal hemorrhage should be treated as full stomach although endoscopic findings before the surgery indicate controlled hemorrhage from varix.

Aged↗
PubMed1997

[A case of twice catastrophic pulmonary vasoconstriction-type shock induced with protamine sulfate].

A 71-year-old female was scheduled for the re-replacement of a mechanical mitral valve. After the cardiopulmonary bypass (CPB) she was administered protamine sulfate. Subsequently mean systemic blood pressure went down below 20 mmHg and central venous pressure and mean pulmonary blood pressure were above 50 mmHg, and immediately CPB was restarted as an assist device for circulation. After the second CPB, she was administered protamine sulfate again, and the same shock occurred. At last the third CPB was restarted and the third protamine administration was not undertaken after the third CPB. Although her postoperative drainage may have been relatively much more compared with cases of neutralization of heparin, postoperative course was uneventful in this patient. Administered protamine to neutralize the anticoagulat effects of heparin may often cause temporary treatable hypotension. Although protamine may rarely cause severe pulmonary vasocontriction and anaphylactoid reactions, clinical pictures become critical once these reactions occur. It is important in these cases to identify protamine as the cause of shock and avoid repeating the shocks.

Aged↗
PubMed1997

[A case of intradural xanthogranuloma in the upper cervical spine].

An 18-year-old female patient suffered from posterior neck pain and gait disturbance. The neurological examination revealed left hemiparesis, general hyperreflexia and hypoalgesia on the right neck and upper limb, and left trunk and lower limb. MRI showed a large mass lesion in the right side of the spinal canal at the level of the C1 cervical spine, which was obviously compressing the spinal cord. An operation was performed through a right suboccipital craniectomy and right hemilaminectomy of the first vertebra. Though the mass lesion in the subarachnoid space compressed the spinal cord, it adhered neither to the spinal cord nor to the nerve roots. However, as it clearly adhered to the dura mater, the attachment site was also completely removed. In the pathological examination, lymphocyte, foamed macrophage and the giant cell of Touton type were shown. The immunohistochemical study with CD68 (Kp1) was positive, but it was negative for the lysozyme, neuron specific enolase and S-100 protein. The diagnosis was xanthogranuloma. The patient recovered completely after the operation. This is a rare case of juvenile type xanthogranuloma. This lesion in the spinal canal has usually its onset in the adult age.

Adolescent↗
PubMed1997

[Salivary gland masses: dynamic MR imaging and pathologic correlation].

PURPOSE: To evaluate the efficiency of dynamic contrast-enhanced magnetic resonance imaging (MRI) for the diagnosis of salivary gland masses. MATERIALS AND METHODS: We retrospectively examined 19 salivary gland masses that were pathologically diagnosed by surgical operation or biopsy. We obtained T1- and T2-weighted images on MRI, performed dynamic studies on each mass and examined the correlation between enhancement patterns and pathological findings. RESULTS: Four enhancement patterns were recognized on contrast-enhanced MRI: type 1 showed marked, homogeneous enhancement; type 2 slight, homogeneous enhancement; type 3 marginal enhancement; and type 4 poor enhancement of the mass. Most pleomorphic adenomas had a type 1 enhancement pattern, but two had a type 2 pattern. Pathologically, each mass enhancement pattern had different tumor cell and matrix components. Warthin's tumor generally showed the type 4 pattern. Primary malignant tumors of the salivary gland all showed the type 3 pattern, and pathological specimens showed many tumor cells along the marginal portion of the tumor. One inflammatory cyst and one Warthin's tumor also showed the type 3 pattern. Except for metastatic renal cell carcinoma, the enhancement patterns of late phase images and dynamic study images were the same. CONCLUSIONS: Dynamic MRI added little diagnostic information about salivary gland masses, but the contrast-enhanced MR features correlated well with the pathological findings.

Adenolymphoma↗
PubMed1997

[A case report of anomalous systemic arterial supply to the left basal lung].

A 38-year-old woman with a history of hemosputum once in a several years was admitted to our hospital because of a mass shadow in the left lower lung field on chest X-ray film. Physical examination revealed neither cardiac murmur nor any sign of heart failure. Chest X-ray film showed a tumorous shadow in the left posterior basal segment. Chest CT scan showed that this shadow was consisted of enhanced, dilated and torutuous vessel and was connected to the descending thoracic aorta. Angiographic examinations showed that there was no normal left basal trunk of the pulmonary artery, and revealed an anomalous arterial supply to the basal segments from the descending thoracic aorta, with an expanded left inferior pulmonary vein. Broncho-fiberscopy showed no abnormal findings in the bronchial tree except for mild stenosis of the left basal bronchus. This case was diagnosed as an anomalous systemic arterial supply to the left basal lung (Pryce type I). The left lower lobe without pulmonary sequestration and the anomalous systemic artery were resected. Microscopically, the anomalous artery showed an elastic type, and the peripheral lung areas showed congestion. The postoperative course was uneventful. We collected reports of 26 cases of the same anomalies in Japan and discussed the difference of this anomaly from pulmonary sequestration.

Adult↗
PubMed1997

Functions of the DNA dependent protein kinase.

The DNA dependent protein kinase (DNA-PK) is a trimeric nuclear complex consisting of a large protein kinase and the Ku heterodimer that regulates kinase activity by its association with DNA. Recent findings have shown structural similarities between DNA-PK and a family of lipid and putative protein kinases (PIK family). DNA-PK is one of the PIK members known to be a protein kinase with clearly identified effector subunits. A broad range of observations link DNA-PK to dual roles in double strand DNA break (DSB) repair and transcription. Unlike its most closely related PIKs, DNA-PK is not required for activating cell cycle regulated DNA damage signalling mechanisms. Instead, the phenotypes and biochemical properties of DNA-PK are most consistent with functions in DSB repair and joining steps in recombination mechanisms. DNA-PK is associated with RNA polymerase II and RNA polymerase I transcription complexes, where it most frequently has a negative regulatory role.

Animals↗
PubMed1997

Quantitative evaluation of human placental aromatase in abnormal pregnancy--anencephalus and hydatidiform mole.

To determine why estriol (E3) levels in the urine and serum are extremely low in pregnancies with anencephalus or hydatidiform mole, both the aromatase activity and the tissue P450arom concentration in solubilized fractions of placental or mole microsomes was measured. The aromatase activity was measured by tritiated water assay and the tissue P450arom concentration was determined by sandwich enzyme-linked immunosorbent assay (ELISA). Consequently, any tissue P450arom concentration was at a lower level than the regression line for that in normal placenta. The aromatase activity also showed a tendency to be lower than that in normal placenta. These results therefore suggest that a decrease of E3 in these abnormal pregnancies would result mainly in a lower level of tissue P450arom concentration.

Anencephaly↗