[Marie-Bamberger syndrome].
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Diagnosis, Differential↗
Biomedical subjects
S Kitamura
Publications and source records attributed to S Kitamura.
Psychological maladjustment and academic achievement: a cross-cultural study of Japanese, Chinese, and American high school students.
Psychological maladjustment and its relation to academic achievement, parental expectations, and parental satisfaction were studied in a cross-national sample of 1,386 American, 1,633 Chinese, and 1,247 Japanese eleventh-grade students. 5 indices of maladjustment included measures of stress, depressed mood, academic anxiety, aggression, and somatic complaints. Asian students reported higher levels of parental expectation and lower levels of parental satisfaction concerning academic achievement than their American peers. Nevertheless, Japanese students reported less stress, depressed mood, aggression, academic anxiety, and fewer somatic complaints than did American students. Chinese students reported less stress, academic anxiety, and aggressive feelings than their American counterparts, but did report higher frequencies of depressed mood and somatic complaints. High academic achievement as assessed by a test of mathematics was generally not associated with psychological maladjustment. The only exception was in the United States, where high achievers indicated more frequent feelings of stress than did low achievers.
Achievement↗
[Measurement of T cell subsets in bronchoalveolar lavage fluid for diagnosis of pulmonary sarcoidosis].
Pulmonary sarcoidosis is characterized by the accumulation in the lower respiratory tract of large numbers of activated CD4 T cells and elevated ratio of CD4/CD8 in bronchoalveolar lavage fluid (BALF). To study the value of CD4/CD8 ratio in BALF in the diagnosis of pulmonary sarcoidosis, we measured T cell subsets in BALF of patients with pulmonary sarcoidosis. The CD4/CD8 ratio in the patients (7.5 +/- 4.3) was significantly higher than that of the controls (2.1 +/- 0.7). The sensitivity and specificity of CD4/CD8 ratio in BALF for the diagnosis of sarcoidosis were 86% and 100%, respectively. We found that the CD4/CD8 ratio in BALF plays an important role in the diagnosis of pulmonary sarcoidosis. The analysis of CD4 in BALF may be useful in assessing the activity of sarcoidosis. The measurement of the CD4/CD8 ratio may be used to determine prognosis of pulmonary sarcoidosis.
Adult↗
[Measurement of total glutathione concentration in bronchoalveolar lavage recovered from the patients with diffuse interstitial lung disease].
In order to investigate the change of glutathione concentration in BAL from the patients with diffuse interstitial lung disease. We measured the levels of glutathione in BAL from the patients with interstitial lung disease, including idiopathic interstitial pneumonitis (IIP), hypersensitivity pneumonitis (HP), collagen disease with pneumonitis, and sarcoidosis. The result showed that the glutathione concentration in BAL of the patients with IIP, HP, collage disease with pneumonitis, were significantly lower than that of the control group, but compared with the control group, the glutathione concentration of the patients with sarcoidosis did not show significant difference. The results may provide further insight into the pathogenesis of oxidant-induced interstitial lung disease and its therapy.
Adult↗
[Efficacy of GRF (gelatin-resorcin-formalin) glue on surgery for type A aortic dissection].
The tissue biological adhesive GRF glue has been used in our department to have dissected aortic layers adhered and to reinforce the dissected aortic stumps during surgery for aortic dissection. From May 1992 to August 1993, 12 patients were operated for type A aortic dissection; 4 patients with acute dissection and 8 patients with chronic dissection. There were 5 men and 7 women whose ages ranged from 51 to 69 years with an average of 60.6 years. Replacement of the ascending aorta alone was performed for 6 patients. Replacement of both the ascending aorta and transverse arch was carried out for 4 patients, and replacement of the ascending aorta, transverse arch and the descending aorta was accomplished in 1 patient. Primary repair was performed for 1 patient with intraoperative acute dissection that occurred during surgery for mitral valve. There were no operative or hospital deaths. Preoperative aortic regurgitation was present in 5 patients. Following gluing the aortic root dissection, aortic regurgitation disappeared in all patients confirmed by postoperative aortograms. The use of GRF glue significantly reduced the average amount of intraoperative bleeding from 2893 ml to 1169 ml and also significantly reduced the use of Teflon felt strips for the proximal anastomosis. We believe that use of GRF glue can improve the surgical outcome for acute and chronic aortic dissection.
Aged↗
[Myocardial protection during multiple coronary artery bypass grafting--a comparison of antegrade and combined antegrade-retrograde cardioplegia].
We compared the effectiveness of antegrade cardioplegia (A group, 100 cases) and combined antegrade-retrograde cardioplegia (A + R group, 66 cases) on myocardial protection in patients undergoing coronary artery bypass grafting for more than 3 vessels. The two groups were similar in patients' age, the extent of coronary artery diseases and preoperative risk factors, cardiac output and ejection fractions. The mean number of grafts was 3.3 in A group and 3.6 in A + R group (p < 0.05). The mean number of ITA grafts used was 1.2 in A group and 1.4 in A + R group (p < 0.05). Aortic cross-clamp time was 114 minutes in A group and 138 minutes in A + group (p < 0.01). The serum CK-MB concentration on postoperative day 1 was 38 IU/L in A group and 25 IU/L in A + R group (p < 0.05). The left ventricular stroke work index 3 hours after reperfusion was 33 gm min/m2 in A group and 43 gm min/m2 in A + R group (p < 0.05). The maximum dose of catecholamine required was similar in two groups. Intra-aortic balloon pump was used in 11 patients (11%) in A group and in 2 patients (3.6%) in A + R group (p < 0.05). We conclude that the combined method of intermittent antegrade and continuous retrograde perfusion of cardioplegic solution provides better myocardial protection than intermittent antegrade cardioplegia alone for multivessel coronary artery bypass surgery.
Aged↗
[A case of sarcoidosis with elevated SCC antigen in the serum and broncho-alveolar lavage fluid which was difficult to distinguish from lung cancer].
A case of sarcoidosis with a high level of SCC antigen in the serum and broncho-alveolar lavage fluid (BALF) which was difficult to distinguish from lung cancer is reported. A 66-year-old female was admitted with a fever, sputum and coughing. Chest X-ray on admission showed bilateral hilar swelling and infiltrative shadows in the left lower lung. Chest CT showed bilateral lymph node enlargement and a localized nodular mass. The level of SCC antigen in the serum and BALF was high. Initially she was suspected of having lung cancer, but she was subsequently diagnosed as having sarcoidosis from a bronchial biopsy specimen, BALF and gallium scintigraphy. It was difficult to distinguish this case showing lymph node enlargement and mass shadow from lung cancer. Although this is a rarely reported case of sarcoidosis with a high level of SCC antigen in the serum and BALF, it is possible that SCC antigen may be elevated in patients with benign inflammatory lung disease due to various interactions of cytokines.
Aged↗
Long-term outcome of myocardial revascularization in patients with Kawasaki coronary artery disease. A multicenter cooperative study.
The long-term outcome of myocardial revascularization by coronary artery bypass grafting in patients with severe coronary obstruction caused by Kawasaki disease is largely unknown. A multicenter follow-up study was performed in 1991. A total of 168 patients with Kawasaki disease (127 male [75.6%] and 41 female patients [24.4%]) who had undergone coronary bypass grafting were enrolled. Obstructive coronary artery disease affected the left main trunk in 11.8%, the right coronary artery in 77.6%, the left anterior descending in 87.6%, and the left circumflex in 25.9%. Old myocardial infarction was noted in 46.0% of the patients. Fifty-four patients (32%, 12.4 +/- 9.8 years) underwent bypass grafting with saphenous vein grafts alone. The remaining 114 patients (68%, 9.8 +/- 7.1 years) received at least one internal thoracic artery graft to the left anterior descending coronary artery. Gastroepiploic artery grafts were used in 12 patients. There were no significant differences between the saphenous vein and internal thoracic artery groups in the mean age at operation (12.4 versus 9.8 years), female ratio (22% versus 25%), the number of patients over 20 years of age (9.3% versus 9.6%), previous history of infarction (51.9% versus 41.2%), impaired left ventricular function (ejection fraction < 0.5) (13.0 versus 11.4%), left main trunk disease (11.1% versus 10.5%), the number of vessels involved (2.2 +/- 0.8 versus 2.0 +/- 0.6 per patient), or the mean number of grafts used (1.7 +/- 0.7 versus 1.7 +/- 0.7 per patient). The operative death rate was also the same in the two groups (1.9% versus 0%), but the late cardiac death rate was significantly higher in the saphenous vein graft group (13.0%) than in the internal thoracic artery group (0.9%) (p < 0.003). Actuarial analysis showed a significantly higher survival in the internal thoracic artery group (98.7% +/- 1.2% versus 81.6% +/- 7.0%, p < 0.05) at 90 months after the operation. Late death was strongly related to the absence of an internal thoracic artery graft (p < 0.003) and to the age at the time of operation (p < 0.05). The actuarial patency rate was significantly higher for arterial grafts (77.1% +/- 1.1%, n = 151) than for vein grafts (46.2% +/- 6.3%, n = 126) 85 months after the operation (p < 0.003). Arterial grafts were used for the non-left anterior descending coronary arteries in only 41 of 155 grafts (26.5%); in contrast, vein grafts were used in 85 of 133 grafts (63.9%) (p < 0.005 to 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)
Actuarial Analysis↗
[Two cases of IIP which developed acute exacerbation after bronchoalveolar lavage].
We reported two cases of idiopathic interstitial pneumonia (IIP) who developed acute exacerbation after bronchoalveolar lavage (BAL). One case was a 67-year-old male who presented with dry cough and exertional dyspnea. He was diagnosed as IIP and transbronchial lung biopsy revealed alveolitis. BAL was performed after administration of prednisolone. He complained of severe dyspnea after BAL and was diagnosed as having an acute exacerbation of IIP. In spite of extensive treatment including pulse therapy with methylprednisolone, he died. The other case was a 57-year-old male noted to have a chest X-ray abnormality who presented with dry cough and dyspnea on exertion. He was diagnosed as having IIP and primary lung cancer. BAL was performed to evaluate the activity of IIP, and respiratory distress subsequently became severe. After BAL, he developed an acute exacerbation of IIP and died in spite of treatment. In both cases, peripheral white blood cell counts were increased just before BAL. It was suggested that this condition might participate in acute exacerbation of IIP. It should be kept in mind that some patients with IIP may develop acute exacerbation after BAL.
Aged↗
Effects of a platelet-activating factor antagonist at different doses given simultaneously with double-filtration plasmapheresis on cardiac xenograft survival.
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Animals↗
[The relationship between postoperative changes of exercise capacity and pulmonary blood flow in the residual lung after lobectomy of the lung].
The purpose of this study is to investigate a relationship between the postoperative change of exercise capacity judged by the change of peal oxygen consumption and the pulmonary blood flow of the residual lung after lobectomy. Twenty eight patients undergoing lobectomy for lung cancer received an exercise tolerance test and 99mTc-MAA perfusion lung scans before and after lobectomy. The change rate in the peak level of oxygen consumption (peak VO2) did not differ depending on the number of resected sub-segments. A good correlation was found between the reduction of perfusion ratio of the lung of the operated side (delta Q) and that of the peak level of oxygen consumption (delta peak VO2) (r = 0.74, p < 0.01). A reduction in delta Q and delta peak VO2 was remarkable in patients with postoperative respiratory complications such as atelectasis and pulmonary air leakage. These results indicate that the perfusion lung scans at rest before and after surgery would be able to predict the change of exercise capacity after lobectomy.
Adult↗
[Early phase II clinical study of KW-2307 in patients with lung cancer. Lung Cancer Section in KW-2307 Study Group].
A multicenter early Phase II clinical study of KW-2307, a new vinca alkaloid derivative, in patients (pts) with lung cancer was conducted in 15 hospitals. Ninety-seven pts were enrolled, among whom 95 were eligible. Seventy of the eligible pts had non-small cell cancer (NSCLC) and 25 had small cell cancer (SCLC). PR was obtained in 13 (18.6%) of NSCLC pts and 3 (12%) of SCLC pts. Only those who had no previous chemotherapy showed PR in NSCLC pts, and the response rate in these pts was 29.5% (13/44). As to the correlation between dosage and tumor effect, a better effect was exhibited at higher doses, with response rates of 21.7% (5/23) and 38.1% (8/21) at 20 mg/m2 and 25 mg/m2, respectively. The major adverse effect of this drug was leukopenia (neutropenia), which was Grade 3 or 4 in many cases. Recovery from this complication, however, was rapid. Other adverse effects included mild hepatic dysfunction, anorexia, nausea/vomiting, fever, general fatigue, phlebitis and constipation. The incidence of peripheral nervous disorder such as the paresthesia commonly observed with vinca alkaloids, was as low as 10%, and the symptoms, if any, were mild.
Adult↗
[A case of lung cancer with cryptococcal infection in resected lymph nodes].
A 68-year-old female was admitted because of an abnormal shadow on chest X-ray film. Chest CT showed a nodular shadow in right S3a. Right upper lobectomy with mediastinal lymph node resection was performed under a diagnosis of lung cancer made by TBLB. Pathological examination of the resected lung revealed well differentiated adenocarcinoma. In addition, examination of the resected lymph nodes showed granulomas, some of which contained numerous cryptococci and showed central caseous necrosis, and others showed non-caseating epithelioid cell granulomas suggesting sarcoid reaction. No cryptococcal infection was found in the resected lung. Mediastinal lymph node involvement of cryptococcus in this case was considered to be the lymph node component of the primary pulmonary complex of cryptococcosis. Such a primary complex was demonstrated in 1% of the cases of cryptococcosis in previous reports.
Adenocarcinoma↗
[Renal actinomycosis: a case report].
A 56-year-old male presented with a history of dull pain in the abdomen, accompanied by anorexia and weight loss. On examination, he had a moderate tenderness in the right kidney region. Radiological investigation could not deny renal tumor, and the right kidney was removed. Microscopically, characteristic colonies of actinomyces were seen. Preoperatively it is difficult to differentiate renal actinomycosis and renal tumor. Removal of the involved kidney followed by appropriate antibiotic therapy may be promptly curative.
Actinomycosis↗
[Percutaneous transluminal angioplasty for stenosis of coronary artery bypass grafts: a comparison of arterial grafts versus vein grafts with regard to restenosis and re-do CABG].
Stenoses of ten arterial grafts and thirty-four venous grafts from previous coronary artery bypass grafting (CABG) were treated with percutaneous transluminal angioplasty. In all ten arterial grafts, stenosis occurred at the distal coronary anastomotic site (A-d). In vein grafts, stenosis occurred at the proximal aortic anastomotic site (V-p) in 10, at the graft body (V-b) in 9 and the distal coronary anastomotic site (V-d) in 10 vessels. The initial success rates of angioplasty were 89% (A-d), 100% (V-p), 89% (V-b) and 100% (V-d). The time period between CABG and angioplasty was significantly shorter for A-d (4 +/- 3.8 months) and V-d (8.1 +/- 9.9 months) groups than for V-p (56.9 +/- 35.7 months) or V-b (45.9 +/- 48.6 months) groups. The restenosis rates following angioplasty were 0% (A-d), 50% (V-p), 50% (V-b) and 0% (V-d). Repeat CABG surgery was required for restenosis in 2 patients of group V-p and V-b. Our experience suggests that angioplasty can be performed with a high success rate for stenosis at the distal anastomosis of either arterial or vein grafts after CABG.
Anastomosis, Surgical↗
Hemodynamic assessment during exercise after left ventricular aneurysmectomy.
The exercise hemodynamics of eight patients who underwent cardiac catheterization were assessed at rest and during exercise, before and after left ventricular aneurysmectomy by the classical technique. Left ventricular end-diastolic volume increased before operation and then significantly decreased after the operation (p < 0.05). The ejection fraction increased from 0.27 before the operation to 0.46 after the operation (p < 0.01). The cardiac index, which was low before operation, increased within the normal range after operation. Mean systolic circumferential tension also decreased significantly (p < 0.01) after the operation. Thus, the indexes at rest showed improvement. Left ventricular end-diastolic pressure showed a decreasing tendency after the operation both at rest and during exercise in comparison with that before the operation. However, the difference was not significant. The stroke work index increased significantly during exercise after the operation (p < 0.05). Before the operation, the stroke work index did not increase despite the elevation of left ventricular end-diastolic pressure; however, after the operation, the stroke work index increased during exercise without much increase of left ventricular end-diastolic pressure. This indicated improvement in the Frank-Starling curve and recovery of preload reserve by the resection of the left ventricular aneurysm. Thus, an important factor for demonstrating improvement in postoperative cardiac function was clarified through its relation to exercise load.
Cardiac Output↗