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Biomedical subjects

S Kawachi

Publications and source records attributed to S Kawachi.

At least 55 records · Page 3Linked to original sources
PubMed1997

Spontaneous healing of pancreatic abscess after fistulization to the duodenal bulb.

A 70-year-old man was admitted to the hospital because of sudden, upper abdominal and back pain. Laboratory and image data indicated acute pancreatitis. Shortly after the admission, pancreatic and liver abscess with bacteremia developed. Antibiotic therapy seemed effective. A month later, spontaneous fistulization of the pancreatic abscess to the duodenal bulb was found by gastroduodenal fiberscopy. Injection of contrast medium into the duodenal orifice showed that the fistula was draining the abscess and that no other fistula formed from the abscess. Endoscopic retrograde cholangiopancreatogram indicated no fistula formation to the pancreatic duct. The pancreatic abscess became smaller and was not visible using computerized tomography and ultrasonography 3 months later and thereafter. Closure of the duodenal orifice was ascertained by the endoscopy. It is suggested that retrograde infection from the fistula was prevented by the single fistulization to the acidic duodenal bulb, which is not supposed to allow most bacterial growth. Pancreatic abscess usually necessitates operative treatment, even with fistulization to the alimentary tract. It seems likely that the single, small fistulization to the bulb, in addition to the lack of underlying disease and medical and nutritional support, facilitated the spontaneous healing process.

Abscess↗
PubMed1997

[Clinicopathological findings in 5 patients with acute eosinophilic pneumonia].

We studied 5 patients with acute eosinophilic pneumonia. Radiologic findings were Kerley's lines and pleural effusion on chest X-ray films, and interlobular septa on chest CT scans. Examination of transbronchial lung biopsy specimens revealed infiltration of eosinophils and lymphocytes into alveolar walls and edema of alveolar walls, interlobular septa, and perivascular connective tissue. The findings of interstitial edema were consistent with the radiological findings. Epithelial damage and bud-type intraluminal fibrosis were also seen, but residual alveolar structure was maintained. Bronchoalveolar lavage fluid contained abnormally high percentages of eosinophils and lympocytes. It also contained basophils and mast cells, which were not seen in fluid from normal subjects. Fluid from patients with chronic eosinophilic pneumonia had significantly fewer basophils than did fluid from those with acute eosinophilic pneumonia (p < 0.01). These findings suggest that release of chemical mediators from basophils plays a key role in interstitial edema in acute eosinophilic pneumonia.

Acute Disease↗
PubMed1996

Changes in the cerebral arteriovenous oxygen content difference by surgical incision are similar during sevoflurane and isoflurane anaesthesia.

PURPOSE: To investigate changes of cerebral arteriovenous oxygen content difference (AVDO2) induced by surgical incision and to determine carbon dioxide (CO2) reactivity of the cerebral circulation during sevoflurane and isoflurane anaesthesia. METHODS: Twenty-one ASA 1-2 patients undergoing elective surgery for supratentorial tumours were randomly allocated to receive either 1.3 MAC sevoflurane/N2O anaesthesia (n = 10) or equi-MAC isoflurane/N2O anaesthesia (n = 11). Before and after incision, haemodynamic measurements and AVDO2 determinations were performed. After opening the dura, AVDO2 was determined before and after the respiration rate was increased by 50%. RESULTS: Incision produced an increase in mean arterial pressure from 69 +/- 11 to 97 +/- 22 mmHg (mean +/- SD) (P < 0.0005) and from 71 +/- 6 to 89 +/- 12 mmHg (P < 0.0001) in the sevoflurane and isoflurane groups, respectively, whereas the heart rate increased from 60 +/- 9 to 72 +/- 8 bpm (P < 0.001) and from 65 +/- 6 to 70 +/- 7 bpm (P < 0.001), respectively. Arterial carbon dioxide tension (PaCO2) was increased from 33.6 +/- 2.3 to 34.6 +/- 1.8 mmHg (P < 0.05) with incision in the sevoflurane group. The AVDO2 was decreased from 6.5 +/- 1.6 to 5.3 +/- 1.6 vol% (P < 0.0005) in the sevoflurane group and from 6.7 +/- 1.1 to 6.0 +/- 1.1 vol% (P < 0.01) in the isoflurane group. The % change of AVDO2 was larger in the sevoflurane group than in the isoflurane group (-18.3 +/- 8.4% vs -9.1 +/- 9.0%; P < 0.05) but no difference remained after the post-incisional AVDO2 value of the sevoflurane group was corrected for pre-incisional PaCO2. Carbon dioxide reactivity, calculated as the percent change in AVDO2 per mmHg change in PaCO2, was 6.1 +/- 3.0%.mmHg-1 in the sevoflurane group and 5.9 +/- 2.4%.mmHg-1 in the isoflurane group (P = NS). CONCLUSIONS: Sevoflurane and isoflurane are associated with similar impairment of cerebral flow-metabolism coupling at incision, while CO2 reactivity is maintained during both anaesthetics.

Adult↗
PubMed1996

Changes in tracheal tube position during laparoscopic cholecystectomy.

The distance from the carina to the tip of the tracheal tube was measured with a fibreoptic bronchoscope in 21 consecutive patients undergoing elective laparoscopic cholecystectomy. After placement of an Eschmann tracheal tube with a printed intubation guide mark at the vocal cords, the distance was 28 (15) [5-54] mm (mean (SD) [range]). The tube was then repositioned so that the distance was 34 (3) [30-40] mm from tip of the tube to the carina. After creation of pneumoperitoneum, the distance was significantly decreased to 26 (5) [17-35] mm (p < 0.005), which was not significantly altered by subsequent moving of the patient to the reverse Trendelenburg and left lateral tilt position. The maximum distance of tube migration was 8 (4) [0-15] mm. Four out of 21 patients would have been at risk of bronchial intubation after pneumoperitoneum if the tube had not been repositioned. Placement of the tube according to the guide mark is not recommended for laparoscopic cholecystectomy.

Adult↗
PubMed1995

Tracheal tube cuff pressure during cardiac surgery using cardiopulmonary bypass.

To determine the effects of cardiopulmonary bypass (CPB) on tracheal cuff pressure, we have measured intracuff pressure (ICP) in 29 consecutive patients undergoing cardiac surgery with CPB. Premedication comprised hyoscine and, after induction of anaesthesia with diazepam and fentanyl, followed by vecuronium, the trachea was intubated using a Portex Profile tracheal tube. Anaesthesia was maintained with high-dose fentanyl and 100% oxygen. ICP was measured with a transducer and the ICP was adjusted to 20 mm Hg. CPB was used with mild to deep hypothermia and blood-gas tensions were regulated according to alpha-stat (temperature uncorrected) pH management. Before CPB, ICP was significantly reduced from the mean baseline value of 20 (SEM 0.2) to 16.7 (0.6) mm Hg (P < 0.01). ICP changed significantly during CPB, decreasing to 8.0 (1.0) mm Hg before rewarming (P < 0.01 vs immediately before CPB) and increasing to 17.0 (0.6) mm Hg after the start of rewarming (P < 0.01 vs before rewarming). After CPB, ICP did not differ significantly from that immediately before CPB. We conclude that the decrease in ICP during the hypothermic phase of CPB may protect the tracheal mucosa against hypotensive ischaemic injury.

Adult↗
PubMed1995

Expression of alpha subunit of guanine nucleotide-binding protein Go in Merkel cell carcinoma.

The alpha subunit of guanine nucleotide-binding protein Go (Go alpha), which was initially isolated from bovine brain, interacts with muscarinic cholinergic receptors and regulates neuronal calcium channels. Go alpha is known to be localized in neural tissues, some endocrine cells, and neuroendocrine tumors. We have immunohistochemically investigated the expression of Go alpha in 4 cases of Merkel cell carcinoma using the method of microwave treatment. In all cases of Merkel cell carcinoma, Go alpha was consistently detected on the plasma membrane and cytoplasm of the tumor cells. Nerve fibers in the skin were also positive for Go alpha, but other epidermal or dermal components such as keratinocytes, melanocytes, fibroblasts, or lymphoid cells were negative. Tumor cells of squamous cell carcinoma, cutaneous lymphoma, sweat gland carcinoma, and malignant melanoma were negative for Go alpha. The present study indicates that Go alpha may be a useful immunohistochemical marker of Merkel cell carcinoma.

Aged↗
PubMed1993

Detection of early lesions of "ungual" malignant melanoma.

BACKGROUND: The nail area is commonly affected by malignant melanoma. The prognosis of malignant melanoma of the nail is poor, because at the time of diagnosis most lesions are in the advanced stage. Correct diagnosis of early lesions could improve the prognosis. METHODS: For 3 years, all patients with nail pigmentation at the dermatology clinic were screened for five specific criteria for the diagnosis of early lesions of malignant melanoma. Histologic examination was performed on 10 of 29 lesions. RESULTS: Five of the 29 lesions were advanced malignant melanoma, easily diagnosed clinically. Two of the remaining 24 lesions fulfilled most of our clinical criteria of early malignant melanoma of the nail apparatus; that is, they appeared as melanonychia striata during adulthood, were wide in breadth measuring 9 and 11 mm, and showed variegated shades of brown. Periungual pigmented macule (Hutchinson's sign) was observed in one of the two cases. Total resection of the lesions was performed, followed by skin grafting. CONCLUSIONS: Histologically, an increased number of atypical melanocytes, mainly arranged as solitary units, were observed only in the epithelia of the nail matrix and of the nail-bed, confirming that these lesions were "ungual" malignant melanoma in situ. Such an early lesion of malignant melanoma of the nail apparatus can be completely cured with conservative excision, and the phalanx of the affected digit can be preserved.

Adolescent↗
PubMed1993

[Effect of THP-CVP regimen for elderly patients with malignant lymphoma].

Between April 1990 and June 1992, a multicenter clinical trial of chemotherapy regimens was performed with patients, aged 65 years or more, suffering from malignant lymphoma. The total number of patients was 38 included 30 initial cases (median age: 72) and 8 relapsed cases (79). The chemotherapy regimen, administered every 3 weeks, included pirarubicin (30 mg/m2; day 1), cyclophosphamide (500 mg/m2; day 1), vindesine (1.5 mg/m2; day 1), and prednisolone (40 mg/m2; days 1-5) for the initial cases, and etoposide (100 mg/m2; days 1-5) in addition for relapse cases. The complete response and partial response rates were 50.0% and 40.0% in initial cases, respectively, and 50.0% and 0% in relapsed cases, respectively. The 50% survival period was 25.9 months in initial cases and 18.0 months in relapse cases. There were no serious side effects related to the regimens. Performance status deteriorated in only one case after chemotherapy. We concluded that the chemotherapy regimens were useful and safe for elderly patients with malignant lymphoma.

Aged↗
PubMed1992

Analysis of the expression of Hanganutziu-Deicher (HD) antigen in human malignant melanoma.

Hanganutziu-Deicher (HD) antigen is classified as a heterophile antigen and chemically defined as a ganglioside and/or glycoprotein containing N-glycolylneuraminic acid (NeuGc). HD antigen is absent from normal tissues in humans and chickens but can be expressed in human malignant neoplasms including melanoma. We analysed HD antigen expression in ganglioside and glycoprotein fractions of human melanoma tissues by means of TLC enzyme-immunostaining and Western blotting with biotinylated affinity-purified chicken anti-NeuGc-lactosylceramide (anti-HD3) antibody. No HD-antigenic gangliosides were detected in 11 specimens of human melanoma. In the glycoprotein fractions, however, a strong HD-positive band of 58 kD was detected in 3 of 10 specimens and several minor bands (37 kD, 13.5 kD, etc.) were also found in 5 specimens. The positive bands completely disappeared after treatment with neuraminidase. These results suggest that HD antigen is expressed on the carbohydrate chains of glycoproteins but not on those of gangliosides in human melanoma.

Antigens, Heterophile↗
PubMed1992

[Effects of prostaglandin E1 and dibutyryl cyclic AMP on hemodynamics after cardiopulmonary bypass in valve replacement surgery].

In view of vasodilating action of prostaglandin E1 (PGE1) and dibutyryl cyclic AMP (DBcAMP) we investigated the effect of each agent on hemodynamics after weaning from cardiopulmonary bypass (CPB) comparing with the effect in control group. PGE1 and DBcAMP were administered to patients who underwent valve replacement surgery with continuous low dose infusion at an average rate of 0.026 micrograms.kg-1.min-1 and 7.25 micrograms.kg-1.min-1 respectively. Following result was obtained. In PGE1 administered group, a significant reduction in pulmonary vascular resistance (PVR) and a significant decrease in mean arterial pressure (MAP) were observed during CBP, while there were no significant differences in other parameters, such as platelet counts, differences between core and peripheral temperature (delta T), urine output, systemic vascular resistance (SVR), cardiac index (CI), right-to-left shunt (Qs/Qt), oxygen delivery (DO2) and oxygen consumption (VO2). However, CI and platelet counts tended to increase but delta T and SVR tended to decrease. In DBcAMP administered group, there were no significant differences in all parameters compared with those of control group, showing a tendency of less improvement in hemodynamics than in PGE1 group. We have shown that the use of PGE1 rather than DBcAMP as vasodilator agent seems advantageous during open-heart surgery in patients especially with severe pulmonary hypertension, but it tends to cause severe hypotension during CPB.

Aged↗
PubMed1991

[Anesthetic management of caesarean section for the delivery of quadruplets].

Multiple gestation pregnancies are accompanied with risks for both mother and fetuses. Morbidity and mortality of both of them are increased compared with singleton pregnancies. We have presented a case of a 30-year-old parturient with quadruplets. The pregnancy had been complicated by premature labour, anemia, toxemia, coagulopathy, pulmonary congestion and malpresentation. On the 29th week of pregnancy, an elective Caesarean section was scheduled. There is no ideal anesthetic technique for quadruplets. In this case general anesthesia was chosen, because she had coagulopathy. The anesthesia and postoperative course were uneventful. The patient and the four babies had no complication nor sequela on their discharge. The anesthetic considerations for multiple gestation pregnancies were also discussed.

Adult↗
PubMed1990

Immunohistochemical detection of heterophile Hanganutziu-Deicher antigen in human malignant melanoma.

The Hanganutziu-Deicher (HD) antigen is a heterophile antigen whose immunodominant molecule is N-glycolylneuraminic acid, a sialic acid that cannot be found in normal tissues of either humans or chickens. Using biotinylated chicken anti-HD antibody purified with affinity chromatography, expression of HD antigen was immunohistochemically investigated in formalin-fixed tissues of human malignant melanoma. HD antigen-positive melanoma cells were clearly demonstrated in 7 of 11 lesions of malignant melanoma. No HD antigen-positive cells were found in 8 lesions of melanocytic nevus, and no components of normal human skin including epidermal melanocytes were stained with the antibody. This study is the first that immunohistochemically demonstrates HD antigen in tissue sections of human malignant melanoma. The expression of the HD antigen in transformed human melanocytes may have great immunological significance because the antigen is absent from normal human tissues and is immunogenic in humans.

Antigens, Heterophile↗
PubMed1990

Antimetastatic effect of defibrinogenation with batroxobin depends on the natural killer activity of host in mice.

Using batroxobin, a thrombin-like enzyme found in snake venom, the effects of defibrinogenation on artificial lung metastasis in mice were studied. The role of natural killer (NK) cells in the inhibitory effects of defibrinogenation on metastasis was also investigated. Artificial lung metastasis experiments were performed by inoculating either B16-F10 cells or B16-BL/6 cells, highly metastatic strains of B16 melanoma cells, into C57BL/6 mice via the tail vein. The administration of batroxobin significantly inhibited lung metastasis, as did NK activity augmented by poly (I).poly (C) were administered, lung metastasis was more markedly inhibited. When NK activity was suppressed by administration of anti-(asialo GM1) antibody, lung metastasis was markedly increased. When batroxobin was administered with anti-(asialo GM1) antibody, no inhibitory effects on lung metastasis, such as those seen with batroxobin alone, were observed. The administration of batroxobin had no effect at all on spleen lymphocyte NK activity. These results indicated that defibrinogenation due to batroxobin inhibits lung metastasis, and these effects depend on NK activity of the host.

Animals↗
PubMed1990

[Early phase II study of the combined use of AO-90 methionine-free amino acid solution and anticancer agents (5-FU and MMC) in patients with advanced and recurrent gastrointestinal cancer. AO-90 Study group].

Early phase II study in patients with advanced and recurrent gastrointestinal cancer was conducted from August 1986 through December 1987 to evaluate synergic effect of the combined use of AO-90 amino acid solution (free from Methionine) and anticancer agents (5-FU and MMC). Thirty five patients were subjected to the clinical evaluation according to the two criteria, i.e., the solid cancer chemotherapy direct efficacy criteria and the criteria of improvement of gastrointestinal passage disorder. Among 21 patients appropriately eligible for the direct efficacy criteria, the rate of more than partial response was 23.8% (5/21), while the rate of 27.8% (5/18) was observed in the patients who completely met the evaluation requirements. Among 14 patients with gastrointestinal passage disorder due to cancer, 57.1% (8/14) of the patients effectively responded to the therapy.

Adult↗
PubMed1989

[Anesthetic management in surgery of thoracic aortic aneurysms--a report of eleven cases].

Anesthetic management of patients with thoracic aneurysm is discussed. During a period of two years, 11 cases were observed; 7 cases of dissecting aneurysm and 4 cases of true aneurysm. Dissecting aneurysms were of DeBakey's type 1 in 5 cases and of DeBakey's type 2 in 2 cases. Four cases had hypertension. As many of these patients often have hypertension, it is important not to change the circulatory dynamics during induction of anesthesia. We employed high dose fentanyl in 9 cases and used nitroglycerin or nitroprusside to control systolic blood pressure at about 100-120 mmHg. Massive bleeding can occur during intraoperative period and it is important to secure a sufficient number of intravenous routes to protect the central nervous system during cardio-pulmonary bypass.

Aged↗
PubMed1989

[Cardiocirculatory disturbances after surgery of carcinoma of the thoracic esophagus].

From 1976 to 1985, 277 cases of carcinoma of the esophagus were resected in the Second Department of Surgery, Tohoku University School of Medicine. Postoperative cardiocirculatory disturbances occurred in 114 cases (41.2%), arrhythmia being the disturbance most frequently observed (86.8%). Low cardiac output syndrome occurred in 8 cases and myocardial infarction occurred in 3 cases. The majority of the cases were treated successfully, but 5 patients died within one month after operation. Causes of death were as follows: myocardial infarction, constrictive pericarditis, cardiac tamponade, non-occlusive mesenteric ischemia and acute cardiac failure. Postoperative arrhythmia occurred mainly up to the third postoperative day. Low cardiac output syndrome occurred just after operation or on the first postoperative day. All cases of myocardial infarction occurred on the first postoperative day. The rate of occurrence of cardiocirculatory disturbances in aged patients (greater than or equal to 70) was significantly higher than other group (less than or equal to 69), (56.7%:38.1%, p less than 0.05). The rate of occurrence of cardiocirculatory disturbances in patients who had a history of hypertension or in patients with abnormal preoperative electrocardiographic findings were relatively higher than those in patients who had no history of hypertension or in patients with no abnormal preoperative electrocardiographic findings. The rate of occurrence of cardiocirculatory disturbances in patients who had undergone total resection of the thoracic esophagus was significantly higher than that in patients who had undergone partial resection of the thoracic esophagus (42.8%:23.8%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Heterophile Hanganutziu-Deicher antigen in ganglioside fractions of human melanoma tissues.

Gangliosides were purified from melanoma tissue extracts obtained from 5 patients. GM3 and GD3 were identified as the major components in ganglioside fractions of the melanoma tissues. Following thin-layer chromatography, enzyme immunostaining with Hanganutziu-Deicher (H-D) antigen-specific chicken antisera demonstrated the presence of NeuGc-neolactotetraosylceramide (H-D5) and NeuGc-lacto-N-norhexa-osylceramide (H-D7) in all 5 melanoma extracts.

Antibodies, Heterophile↗