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Biomedical subjects

S Kaku

Publications and source records attributed to S Kaku.

At least 73 records · Page 4Linked to original sources

Sigma receptor modulation of the muscle relaxant action of eperisone.

We examined the mechanism of the muscle relaxant action of eperisone, using Straub tail and binding studies. In vivo, eperisone (50 and 100 mg/kg i.p.) produced a dose-dependent inhibition of the Straub tail in mice and this inhibitory effect was significantly reversed by haloperidol (0.5 mg/kg i.p.). This drug in itself had no effect on the Straub tail. Sulpiride (50 mg/kg i.p.) failed to reverse the inhibitory effect of eperisone. In vitro, (+)-3-(3-[3H]hydroxyphenyl)-N-(1-propylpiperidine) ((+)-[3H]3-PPP) specific binding, in rat brain membrane, was prevented by eperisone and the IC50 value was 0.43 nM. The muscle relaxant action of eperisone may be modulated by sigma receptors.

Animals↗

[Left cor triatriatum. Clinical and echocardiographic polymorphism].

Four cases of cor triatriatum in children aged from 4 days to 12 months are described. In one case isolated classical form of the disease occurred, and in the other it was associated respectively to ventricular septal defect, anomalous pulmonary venous connexion and persistence of left superior venae cava. One child had successful surgical correction, two died before surgery could be attempted and one waits operation. Relevant clinical and investigational data are described and the role of echocardiography as an excellent diagnostic tool is stressed. We conclude that isolated form of cor triatriatum can simulate primary lung disease and when associated to other cardiac anomalies it has an earlier diagnosis due to early referral. Surgical results and prognosis depend not only on associated anomalies but also on early diagnosis.

Abnormalities, Multiple↗

[Percutaneous transluminal pulmonary valvuloplasty in children --5 years' experience].

OBJECTIVE: Assessment of the results of percutaneous transluminal balloon pulmonary valvuloplasty (BPV) in children. DESIGN OF THE STUDY: Retrospective analysis of the methodology and results between October 1985 and October 1990. SITE OF THE STUDY: Pediatric Cardiology Service, Santa Marta Hospital, Lisbon. PATIENTS: 43 consecutive children with pulmonary valve stenosis. 4 children with Noonan's Syndrome were excluded from the study and the results of 45 valvuloplasties in 39 patients are analysed. METHODS: Full diagnostic catheterization and right ventricular cineangiography were performed. One or two balloon dilatation catheters were inserted percutaneously in one or both femoral veins and positioned across the pulmonary valve under fluoroscopic control. The balloons were then inflated to their maximum pressure with diluted contrast medium. In 18 children follow up cardiac catheterization was performed 3 to 12 months after valvuloplasty (mean 6.7 /+- 2.7). RESULTS: A satisfactory dilatation was achieved in 35 patients (89%) with a substantial decrease in right ventricular systolic pressure (RVP) and in transvalvar peak systolic gradient (GR) (p less than 0.0001). A further significant spontaneous reduction in RVP and GR was recorded on follow up catheterization (p less than 0.01). A repeat BVP was performed in 6 children and was successful in 5. In cases a satisfactory relief of the stenosis was not achieved and 3 of them were submitted to surgery. There were no deaths. One child had cardiac arrest leading to successful surgical valvotomy and with no sequelae. Another child had cerebral embolism with hemiparesis. Ligation of a femoral vein was required in one case for haemorrhage. Mild pulmonary insufficiency resulted in 15 children. CONCLUSIONS: Our experience confirms that BPV is the method of choice for the treatment of children with pulmonary valve stenosis either isolated or associated to small ventricular septal defect. It proved to be a safe and effective technique for reduction of GR. Mortality, morbidity, costs of the treatment and hospitalisation time are lower for BPV than for surgery with comparable short term results.

Adolescent↗

Effects of carvedilol on common carotid arterial flow, peripheral hemodynamics, and hemorheologic variables in hypertension.

The effects of a beta-blocker, carvedilol, on peripheral hemodynamics and hemorheologic parameters were evaluated in 11 geriatric patients with essential hypertension [3 men and 8 women aged 62-79 years (mean, 68.6 years)]. Carvedilol was given orally after breakfast at a dose of 10 or 20 mg daily for 8 weeks. Peripheral hemodynamics, the common carotid arterial flow, and hemorheologic parameters were determined twice prior to administration and after 4 and 8 weeks of carvedilol treatment. The common carotid arterial flow was determined using the pulsed Doppler method. Peripheral hemodynamics were assessed by venous occlusion plethysmography. The hemorheologic parameters assessed include erythrocyte aggregation, erythrocyte deformability, plasma viscosity, whole-blood hematocrit, and platelet function tests. Erythrocyte aggregation was measured using an Erythrocyte Aggregometer MA-1 (Myrenne, USA), taking a high shear rate of 600 s-1 and a low shear rate of 3 s-1 as the indices. Statistical comparisons of values before and after carvedilol administration were made using the paired Student's t-test. Systolic and diastolic blood pressure were decreased by carvedilol. The common carotid arterial flow was increased, and peripheral hemodynamics were improved by carvedilol. Erythrocyte aggregation (measured at both a high and a low shear rate) and plasma viscosity were decreased, erythrocyte deformability was increased, and levels of circulating platelet aggregates were also improved by carvedilol. This improvement of hemorheologic variables may contribute to prevention of the initiation and progression of thrombosis and atherosclerosis in geriatric patients with essential hypertension.

Adrenergic beta-Antagonists↗

Effect of nicergoline on platelet aggregation, plasma viscosity and erythrocyte deformability in geriatric patients with cerebral infarction. Preliminary report.

The effects of nicergoline (Sermion) on platelet aggregation, plasma viscosity and erythrocyte deformability were evaluated in 11 geriatric patients with cerebral infarction, 2 men and 9 women (ages 61-78, mean age 71.6). Nicergoline was given orally at a dose of 5 mg 3 times daily after meals for 8 weeks. Hematological variables were determined twice prior to the administration and at 4 and 8 weeks after the administration. The platelet aggregation in vitro was determined by the turbidimetric method and the level of circulating platelet aggregates was determined according to the method of Wu-Hoak. Erythrocyte deformability was determined according to the method based on the examination of passing erythrocytes through a filter containing pores smaller than the undeformed cells. Collagen-, arachidonic acid- and PAF-induced platelet aggregation was decreased after nicergoline administration. Erythrocyte deformability was increased and plasma viscosity was also decreased after the administration. Thus the improvement of platelet aggregation, plasma viscosity and erythrocyte deformability in cerebral infarction may prevent disturbing blood flow and may contribute to prevention of formation and progression of thrombosis and atherosclerosis in geriatric patients with cerebral infarction.

Aged↗

Clinical study of primary carcinoma of the fallopian tube: experience with 15 cases.

Between 1950 and 1986, fifteen cases of primary carcinoma of the fallopian tube were diagnosed and treated at the Cancer Institute Hospital, Tokyo. These cases constituted 0.14% of the total number of gynecologic malignancies at the hospital during that period. The average age of the 15 patients was 55.7 years. The most frequent symptom was atypical genital bleeding, seen in 12 cases (80%). Massive watery discharge was seen in 4 cases (27%). In preoperative cytologic examination, 6 cases (40%) were positive for cancer. All cases underwent operation as therapy. Postoperative irradiation, adjuvant chemotherapy, and/or second- or third-look operations were also performed. Histopathologically, all materials were found to be adenocarcinoma. Four cases were well differentiated, eight were moderately differentiated, and three were poorly differentiated. As for the prognosis, 7 patients were followed more than 5 years postoperatively. The 5-year survival rate was 57% (4/7). In stage I cancers, the 5-year survival rate was 80% (4/5). The prognosis of stage I cancer patients was estimated to be rather good.

Adenocarcinoma↗

Use of angio computed tomography to evaluate extent of endometrial carcinoma.

Patients with endometrial carcinoma underwent angio computed tomography (CT) prior to surgery to evaluate the extent of the carcinoma. The subjects of the study were 87 patients operated on at the Cancer Institute Hospital during the period 1983 to 1986. After preoperative bilateral internal iliac angiography, angio CT was performed using the already inserted catheters. Although the intact uterine wall was enhanced by the angio CT, the cancerous lesion was not, which permitted easy recognition of the cancerous lesion as a low-density area. To evaluate the degree of myometrial invasion, the minimal thickness of intact uterine wall was measured in the CT image, and was compared later with findings from the operative materials. The comparison showed that for all the patients, the minimal thickness of the intact uterine wall as shown in the CT image was comparable to the actual minimal thickness of the operative materials. Because depth of myometrial invasion is known as an important prognostic factor, measurement of the minimal thickness of the intact uterine wall as shown in the CT image is useful as an objective prognostic factor. Angio CT facilitates recognition of myometrial invasion preoperatively.

Contrast Media↗

[Porencephaly. Case report].

A case of porencephaly in a 33-year-old male is presented. The patient exhibited right hemiparesis and generalized seizures. Computed tomography and, subsequently, craniotomy revealed a cerebral defect in the left parietal lobe, which communicated with the lateral ventricle. On angiography and at surgery, the cortical branches of the middle cerebral artery were found to be stretched over the surface of the cyst. Histopathological examination showed the outer membrane of the cyst to consist of arachnoid, subarachnoid space, vessels, pia mater, and a layer of degenerative brain tissue on histology. The diagnosis of porencephaly and its differentiation from arachnoid cyst are discussed.

Adult↗

Effect of flunarizine on volume flow of the common carotid artery, peripheral hemodynamics, erythrocyte deformability and platelet function.

The Ca2+ antagonist flunarizine (Flunarl) was administered to 14 patients (4 men and 10 women, 70.9 +/- 2.5 years old, mean +/- S.E.), suffering from cerebral atherosclerosis. The dose was 10 mg/day given for 8 weeks and the following results were obtained. The volume flow of the common carotid artery was increased in the 4th week after the administration, and this increase was maintained until the 8th week. Flunarizine caused improvement of peripheral hemodynamics, induced inhibition of platelet aggregation and improvement erythrocyte deformability. These results indicate that the Ca2+ entry blocker flunarizine improves cerebral and peripheral hemodynamics including microcirculation by inhibiting platelet aggregation and erythrocyte deformability.

Aged↗

[Clinicopathological study on clear cell carcinoma of the ovary].

The clinical and pathological findings in 23 cases of clear cell carcinoma of the ovary treated at Cancer Institute Hospital from January 1951 to September 1987 are discussed. Clear cell carcinoma accounted for 7.1% of all malignant tumors of the ovary. In the last 21 months of the study, the incidence of clear cell carcinoma increased to 23.7 at the institute. This tumor was frequently associated with endometriosis, and the ratio of nulliparous women was as high as 47.8%. Operative findings revealed adhesion of the tumor to surrounding tissues in more than half of the cases. Moreover, rupture of the tumor capsule during operation occurred in 42.1% of the cases. Incidences of clear cell carcinoma by clinical stage were 82.6% for stage I, 8.7% for stage II, 8.7% for stage III, and 0% for stage IV. The incidences of serous carcinoma were 20.8%, 24.2%, 45.8%, and 9.2%, respectively. Histologically, clear cell carcinoma could be divided into solid and tubular types, with the solid type being slightly more frequent. The three-year survival rate for stage I cases was 95.2% for serous carcinoma and 54.5% for clear cell carcinoma, showing a poor prognosis for clear cell carcinoma. When classified by the histologic type of clear cell carcinoma, the three-year survival rate was 50.0% for solid type and 60.0% for tubular type, with no significant difference. For clear cell carcinoma, the prognosis was poor despite even though most cases were stage I.

Adenocarcinoma↗

[Cytological study on uterine sarcoma].

Between 1958 and 1985 (28 years), 53 cases of uterine sarcoma were seen at the Cancer Institute Hospital. Their cytological examination produced the following findings: 1) The positive rate in preoperative cytologic diagnostic tests was a low 21.7 percent for pure sarcoma and 70.0 percent for mixed mesodermal tumor. 2) The preoperative cytologic diagnosis and the final histologic diagnosis agreed in only 13.0 percent of pure sarcoma and 16.7 percent of mixed mesodermal tumor cases. 3) About one-half of the cases of mixed mesodermal tumor were diagnosed preoperatively as adenocarcinoma. 4) The positive rate in the cytologic diagnosis and the clinical stage were not correlated. 5) The positive rate in the cytologic diagnosis was high in cases of intracavity growth type sarcoma, but all cases of intramuscular localized type sarcoma were negative.

Adenocarcinoma↗

[Clinical application of MRI for urological malignancy. 2: Usefulness of various imaging modalities for local staging of bladder cancer; a comparison between MRI, CT and transurethral ultrasonography].

MRI of bladder cancer was accomplished in 28 patients. All of the 28 patients were simultaneously studied by CT, and 22 were also studied by transurethral US before operation. MRI is not as useful as US for local staging of bladder cancer. However, MRI is more useful for diagnosing extravesical extension and covers the deficit of the overdiagnosing tendency of US.

Adult↗

[Four cases of upper urinary tract transitional cell carcinoma after radical cystectomy in bladder cancer].

One hundred and eighty-six patients with primary transitional cell carcinoma underwent radical cystectomy between 1965 to December, 1986. Four of them (2.2%) had developed upper urinary tract transitional cell carcinoma. Three of the 4 patients had received various transurethral treatments for the primary bladder lesions before radical cystectomy, but one patient had undergone total cystectomy and ileal conduit as primary treatment. All of the upper urinary tract tumors were invasive. Three patients died and one is alive. We consider the following to be high risk patients for the development of upper tract recurrence. 1) patients with carcinoma-in-situ and multicentric tumors in the bladder, 2) patients with recurrent bladder cancer treated with bladder preserving treatment for a long periods, 3) patients with vesicoureteral reflux, and 4) occupational bladder cancer patients.

Aged↗

[Relationship between peritoneal cytology and prognosis in endometrial carcinomas].

From 1971 to 1985, peritoneal cytologic examination was performed at the time of operation in 235 previously untreated patients with endometrial carcinoma. The relationship between the cytologic findings and prognoses by stage was investigated. The results were as follows: 1. In the peritoneal cytologic examination, 44 (18.7%) out of 235 cases were positive for cancer cells in all stages, 25 (14.5%) out of 173 cases in stage I, 7 (21.2%) out of 33 cases in stage II, and 8 (32.0%) out of 25 cases in stage III. 2. Among the 20 cases of stage I endometrial carcinoma that had no macroscopic metastasis and had positive peritoneal cytologic findings for cancer cells, 5- and 10-year cumulative survival rates were 94.7 and 94.7%, against 92.7% and 90.9% in cases with negative peritoneal cytology respectively. The recurrence rate in the same stage was 12.0% for positive cases, against 9.5% for negative cases. No significant differences between positive and negative cases were found. 3. In stages II and III, the difference between the survival rates for 9 cases which have positive peritoneal cytology without macroscopic peritoneal metastasis and 47 cases with negative peritoneal cytology were not statistically significant. 4. In endometrial carcinoma without macroscopic peritoneal metastasis, the appearance of cancer cells in peritoneal cytologic examination is not correlated with the prognosis.

Ascitic Fluid↗

[Detection of perinatal Chlamydia trachomatis infection by an enzyme immunoassay method].

During the one year period from February 1986 to January 1987, 839 pregnant women were screened for Chlamydia trachomatis infection of the uterine cervical canal by the enzyme immunoassay (EIA, Chlamydiazyme) method. Out of 768 normal pregnant women positive results were obtained in 21 women for a positive rate of 2.7%. In none of 64 women with spontaneous abortion or 7 women with stillbirth were positive results obtained. In 20 of EIA positive women labor was controlled. Extraordinary maternal abnormalities were not seen through labor and puerperium. Out of 21 babies born to these 20 pregnant women, chlamydial pneumonitis developed in 2 babies (10%) and chlamydial conjunctivitis in 1 baby (5%) and these babies were treated. Urethral samples were taken from 16 husbands of EIA positive women, and they were all EIA negative. As to the correlation between EIA and the culture method using HeLa 229 cells, the consistency rate was 78% (n = 18) for positive results and 100% (n = 66) for negative results. Chlamydial IgG antibodies were assayed in 19 out of 21 cases, and all of them yielded positive results. From these results, the importance of screening for Chlamydia trachomatis infection in our country was affirmed.

Adult↗

[Significance of preoperative diagnosis of endometrial carcinoma by angio-CT].

Angio computed tomography (CT) was performed in 87 previously untreated patients with endometrial carcinoma to study its clinical usefulness. All the patients subsequently underwent surgery and the angio CT findings were correlated with the surgical and pathologic findings. The results were as follows: 1. The tumor appeared as areas of low density in comparison with the surrounding myometrium after intraarterial infusion of contrast medium. 2. Angio CT proved to be useful in determining the depth of myometrial invasion. The myometrial invasion measured from the serosal surface in millimeters was assessed on angio CT. The CT findings were correlated well with pathologic findings. 3. Patients with intact myometrium greater than 10mm from the serosal surface assessed by angio CT had no nodal metastases. Angio CT provides a better display of cross-sectional uterine pathology than CT after intravenous infusion of contrast medium. The depth of myometrial invasion measured from the serosa on angio CT seems to be a useful prognostic factor in patients with endometrial carcinoma.

Female↗