Biomedical subjects

S Kubo

Publications and source records attributed to S Kubo.

At least 307 records · Page 17Linked to original sources

PubMed1992

[Preoperative percutaneous transhepatic portal vein embolization to extend the indications for hepatectomy and to increase the safety of extended hepatectomy for hepatocellular carcinoma].

The usefulness of preoperative percutaneous transhepatic portal vein embolization (PTPE) in extending the indications for hepatectomy and increasing the safety of extended hepatectomy for hepatocellular carcinoma was studied in 21 patients who underwent right hepatic lobectomy with PTPE of the right first portal branch (group E), in 15 such patients but without PTPE (group N), and in seven such patients who underwent PTPE at this location but could not undergo surgery (group U). The mean volume of the left lobe increased but the results of a 15-minute indocyanine green retention test were worsened 2 weeks after PTPE and again 4 weeks after hepatectomy, but these changes after hepatectomy were almost the same in groups E and N. The worsening of liver function and coagulation test results was less in group E than in group N. The mean prognosis score was better in group E two weeks after PTPE than before, but not in group U. The four patients in group E with high portal vein pressure (> or = 30 cmH2O) or a high prognosis score (> or = 50 points) after PTPE developed hepatic failure after surgery. Preoperative PTPE was useful in extending the indications for hepatectomy and increasing the safety of extended hepatectomy. Evaluation of the clinical course after PTPE was also useful when decisions about the operative method to be used were being made.

Aged↗

PubMed1992

[Aging processes in the brain].

In 1991 the brains of 15 persons with an age of at least 60 years and without neurologic or psychiatric disorders were investigated prospectively. Different brain-areas (topographically exactly defined) were investigated for so-called brain-aging. Only the frequency of corpora amylacea and primitive senile plaques showed a tendency to increase in the elderly. A defined correlation to the calendaric age could not be stated.

Aged↗

PubMed1992

[The pitfalls in the clinical diagnosis of dissecting aortic aneurysm].

It is sometimes very difficult to diagnose dissecting aortic aneurysms (DAA), particularly in its early stage, due to manifold signs and symptoms. The purpose of this study is to clarify the reasons for such erroneous diagnoses. A total of 41 patients with DAA were referred to our hospitals for further examination and/or surgery from April 1986 to August 1989. In 18 of these patients, the diagnostic possibility of an underlying DAA was overlooked by the referring physicians. Among these 18 patients, 2 were mistakenly diagnosed as uncomplicated myocardial infarction (MI), one as pneumonia, 2 as cerebral infarction, 6 as acute abdominal disease, one as cholelithiasis, 5 as thrombosis of the lower extremities, and one as malignant metastasis to the pericardium. The following is the detail: In 2 cases thought to be uncomplicated MI, an expanding dissecting ascending aorta had crushed the lumen of the left coronary artery, causing MI, in turn, wasting clinical treatment and consuming precious time. In one case, enlargement of the descending aorta on the chest radiography was overlooked and the patient's symptoms were mistakenly attributed to pneumonia. In 2 cases in which symptoms of cerebral ischemia were thought to be attributed to cerebral thrombosis, the real cause turned out to be occlusion of the brachiocephalic artery following aortic dissection. Among 6 cases which were initially considered to have only acute abdominal disease, 3 presented with symptoms and signs of ileus, and their exploratory laparotomies yielded no positive findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1992

[Angioscopic findings of the peripheral pulmonary arteries in patients with chronic pulmonary diseases].

Angioscopic observation of the peripheral pulmonary arteries was performed in 14 patients with chronic lung diseases (male 9/female 5, age 70.8 +/- 8.3 years, pulmonary tuberculosis sequelae 6, chronic bronchitis 4, chronic pulmonary emphysema 3, pneumoconiosis 1). The blood flow was stopped by the inflated balloon of a 7F guiding catheter, and then the peripheral pulmonary arteries (inner diameter 1.0-4.5 mm) were observed with a fiberoptic catheter (outer diameter 0.7 mm). In 10 out of 14 patients abnormal findings were obtained, which included redness, erosion, ulceration of the vascular wall, thrombus, fibrous tissue, and occlusion of the lumen. The incidence of abnormal findings tended to be higher in chronic bronchitis and pulmonary tuberculosis sequelae than in chronic pulmonary emphysema. These results suggest that 1) various changes including "vasculitis" and thrombus exist in the peripheral pulmonary arteries of chronic lung diseases, and 2) that angioscopy may provide the detailed information about both the vascular wall and the lumen which cannot be obtained by pulmonary angiography.

Aged↗

PubMed1992

[The effect of epidural analgesia on respiratory muscles].

The effect of epidural analgesia on respiratory functions and muscular power was studied in patients. The subjects had no abnormality of cardiopulmonary system, and were classified into two groups; the adult group whose ages were 21 to 59, and the aged group, 60 to 72. Either 1% or 2% mepivacaine for epidural anesthesia was used to obtain the analgesic level up to Th4 and Th7 in adult group, and Th4 in aged group. The analgesic level was assessed by the pin-prick method. Vital capacity, forced vital capacity, forced expiratory volume 1 second, peak expiratory flow rate, maximal mid-expiratory flow rato, maximal inspiratory pressure and maximal expiratory pressure decreased significantly after epidural anesthesia in all patients whose analgesic levels were up to Th4. In all patients, the change of maximal expiratory pressure was larger than that of maximal inspiratory pressure after epidural analgesia. The patients whose analgesic levels were up to Th7 by 1% mepivacaine in adult group, showed a significant increase of maximal inspiratory pressure. It is concluded that epidural anesthesia diminishes respiratory functions and respiratory muscular power associated with a higher level of analgesia.

Adult↗

PubMed1992

[Extravascular thermal volume in pulmonary emphysema].

The extravascular thermal volume of the lung (ETVL) was measured by the heat-sodium double indicator dilution technique in 10 patients with chronic pulmonary emphysema. ETVL was 4.99 +/- 1.23 ml/kg, and correlated significantly with TLC(r = 0.747), %VC(r = 0.664), PaO2(r = 0.779), AaDO2(r = -0.796), shunt ratio(r = -0.7), and total pulmonary vascular resistance(r = 0.698). ETVL tended to decrease with the progression of the severity of emphysema as assessed by computed tomography. These results suggest that 1) the extravascular thermal volume decreases in chronic pulmonary emphysema parallel with an increase in the severity of the complaint, and that 2) the decrease of extravascular thermal volume may reflect a decrease in the size of the pulmonary capillary bed. It is concluded that the measurement of extravascular thermal volume may be useful for the evaluation of the severity of pulmonary emphysema.

Aged↗

PubMed1992

[A case of recurrent malignant glioma treated by superselective intraarterial chemotherapy with a combination of etoposide and cisplatin].

Superselective intraarterial infusion of etoposide and cisplatin was performed in a patient with recurrent malignant glioma located in the left midbrain extending to thalamus which had progressed after two courses of radiotherapy and chemotherapy with various anticancer agents. Infusion of etoposide (80 mg/m2) and cisplatin (80 mg/m2) at the basilar top did not result in any neurological deficits when infused for 60 minutes with intermittent infusion of papaverine and nicardipine. CT scan carried out 6 days after chemotherapy demonstrated disappearance of the tumor.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1992

[Study of meningeal carcinomatosis: diagnosis and treatment].

Thirty-four patients with meningeal carcinomatosis were treated at The Center for Adult Diseases, Osaka, from 1984 through 1990. The major origin of meningeal carcinomatosis was carcinoma of the lung (14 cases) and breast (8 cases). The most frequent histological type of carcinoma was adenocarcinoma (23 cases). Twenty cases still had active lesions and/or primary lesions in the lung, liver or bone at the time of diagnosis of the meningeal carcinomatosis. The primary lesions were treated surgically in 22 cases, with chemotherapy in 4 cases and with radiotherapy in 2 cases. Metastatic brain tumors were treated by surgical removal followed by chemo-radiotherapy in 12 cases, and with radiotherapy alone in 2 cases. The interval from the time of diagnosis of the primary lesion to the time of diagnosis of the meningeal carcinomatosis varied from one month to eight years, and the interval between surgical removal of metastatic brain tumors and the diagnosis of meningeal carcinomatosis ranged from 0 to 3 years. With regard to the diagnosis of meningeal carcinomatosis, positive cytology was seen in initial standard lumbar puncture in 32 of the 34 patients. CT scan showed abnormal findings in 28 of the 34 patients, including ventricular dilatation only (12 cases), and small enhancing lesions along the CSF space (12 cases). The EEG showed abnormal patterns in 14 of 15 cases. Intrathecal chemotherapy with methotrexate alone or combined methotrexate with cytosine arabinoside via the Ommaya reservoir or standard lumbar puncture alternately with or without radiation therapy was successful as treatment, and 22 of 29 treated patients showed symptomatic improvement of the meningeal irritation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1991

Echocardiographic assessment of left ventricular function and wall motion at high altitude in normal subjects.

To understand the effects of high-altitude hypoxia on cardiac function and the change in cardiac function during high-altitude acclimatization, precise studies were first performed at greater than 5,000 m of altitude in Himalaya by 2-dimensional echocardiography. In addition to examining well-known indexes of cardiac function, the centerline method was used to assess regional wall motion, which has not been examined under conditions of high-altitude hypoxia. The subjects were 11 climbing members (aged 21 to 43 years) of the Kyoto University Medical Research Expedition of Xixabangma (8,027 m) in 1990. Examinations were performed at sea level, at the base camp (5,020 m), and twice at the advanced base camp (5,650 m). Heart rate, left ventricular (LV) end-diastolic volume, cardiac output, mean rate of circumferential fiber shortening, ejection fraction, % fractional shortening, and regional LV wall motion were measured. At high altitude, heart rate increased to 136% of the sea level value, but gradually decreased in the degree of increment at the early and late advanced base camp measurements. LV end-diastolic volume decreased significantly by 70%. At base camp there were significant increases in ejection fraction, mean rate of circumferential fiber shortening, and % fractional shortening, which showed little change during the long-term stay at high altitude. Regional wall motion at high altitude (measured by the center-line method) decreased at the septal wall and increased at the posterolateral wall. These results demonstrate that: (1) LV cardiac performance at high altitude is enhanced significantly in spite of reduced preload. After good acclimatization, cardiac performance remains augmented, but there is a tendency to decrease the degree of augmentation. (2) In regional LV wall motion, septal wall motion is impaired, but LV posterolateral wall motion shows a compensatory increase.

Acclimatization↗

PubMed1991

Establishment of a human leukemia subline resistant to the growth-inhibitory effect of 12-O-tetradecanoylphorbol 13-acetate (TPA) and showing non-P-glycoprotein-mediated multi-drug resistance.

We have previously reported that K562/ADM, a typical P-glycoprotein-mediated multi-drug-resistant cell line, is cross-resistant to the growth-inhibitory effect of 12-O-tetradecanoylphorbol 13-acetate (TPA) and non-TPA type tumor promoters. To elucidate the mechanism of cross-resistance to tumor promoters in K562/ADM, we have established a K562 subline resistant to TPA-induced growth inhibition by exposing K562 cells to N-methyl-N'-nitro-N-nitrosoguanidine for 24 hr followed by continuous exposure to TPA. A K562 subline resistant to the TPA-induced growth inhibition, termed K562/TPA, was selected by a limiting dilution technique. K562/TPA was more than 500-fold resistant to TPA compared with parental K562 cells. K562/TPA showed cross-resistance to etoposide, teniposide, adriamycin (ADM), vincristine, vindesine and 3-[(4-amino-2-methyl-5-pyrimidinyl)] methyl-1-(2-chloroethyl)-1-nitrosourea, but showed collateral sensitivity to cisplatin. Although K562/ADM was not cross-resistant to 3'-deamino-3'-morpholino-13-deoxo-10-hydroxycarminomycin (MX2), an anthracycline derivative, K562/TPA was cross-resistant to MX2. By Northern blot analysis, K562/TPA did not express MDR-1. Accumulation of ADM by K562/TPA was no lower than that of K562 although that of K562/ADM was 5-fold lower than K562. We examined the subcellular distribution of ADM by fluorescence microscopy. The fluorescence of ADM was located in the nucleus of K562 and mainly in the cytoplasm of K562/TPA and K562/ADM. The distribution of ADM in K562/TPA, however, was different from that in K562/ADM. These results suggested that K562/TPA had a non-P-glycoprotein-mediated multi-drug-resistance phenotype and that the mechanism of drug-resistance in this cell line might be explained by an alteration in the intracellular drug distribution.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1991

Recurrent hepatocellular carcinoma: usefulness of ultrasonography compared with computed tomography and AFP assay.

Follow-up studies using monitoring with alpha1-feto protein (AFP), ultrasonography (US), and computed tomography (CT) were carried out in 75 patients who had prior partial hepatectomy for hepatocellular carcinoma (HCC). Recurrence in the remaining liver was confirmed in 31 patients (41.3%) during the 4 month to 3 years 7 month period. Ultrasonography detected recurrence in 29 cases (sensitivity: 93.5%), CT in 26 (83.9%), and AFP assay in 12 (38.7%). In 4 patients, ultrasonography detected four recurrent nodules that CT missed. In 1 patient, two subphrenic nodules were detected with CT but not with ultrasonography. The specificity of US, CT, and AFP assay was 90.9%, 95.5%, and 93.2% respectively. Frequent follow-up study with ultrasonography in combination with CT and AFP assay should be recommended for the early detection of recurrent HCC. Ultrasonography is mandatory for the follow-up of patients with a prior hepatectomy for HCC.

Adult↗

PubMed1991

Murine acute leukemia cell line with megakaryocytic differentiation (MK-8057) induced by whole-body irradiation in C3H/He mice: cytological properties and kinetics of its leukemic stem cells.

Five cases of murine leukemia with megakaryocytic differentiation were observed among the 417 cases of radiation-induced leukemias which developed in 30% of C3H/HeMs mice exposed at 8 to 10 weeks to 0.5 to 5 gy total body irradiation. Cells from individual leukemic colonies in the spleen of the irradiated mice, and cells from colonies in methylcellulose (MC) culture in vitro, derived from one of these leukemias, MK-8057, were injected into mice; both types of cells caused the deaths of the recipient mice by inducing the same type of leukemia. MK-8057 can be maintained in Dexter-type liquid culture with a feeder layer of irradiated bone marrow cells. There was a linear reciprocal relationship between the increasing number of MK-8057 cells injected versus the survival of the recipient mice. A reciprocal relationship also was seen between an increasing number of leukemic stem cells, corresponding to the number of MK-8057 cells, and the survival of mice injected with MK-8057. Giant nuclear megakaryocytes developed during the course of colony growth in the spleen as they did in the MC culture. Such megakaryocytes were acetylcholinesterase positive, whereas leukemic cells in the peripheral blood showed no sign of platelet production nor of a positive reaction to acetylcholinesterase. Cells maintained in culture were entirely positive in platelet glycoprotein IIb/IIIa when anti-human antibody was used. The larger cells in a splenic cell suspension derived from a moribund mouse were separated and enriched by velocity sedimentation using centrifugal elutriation (CE), and then subjected to flow cytometry using propidium iodide staining. Cells with up to 32N-DNA content were detected. After separating MK-8057 by counter-flow CE, the larger cell fraction (mode at 540 microns3) produced more leukemic colonies when injected into irradiated mice than did the small cell fraction (mode at 240 microns3). A higher percent of the larger cell fraction (61.9%) was killed by the addition of tritiated thymidine cytocide than in the smaller cell fraction (14.9%). Thus, the smaller cell fraction is considered to have more leukemic spleen colony-forming units (L-CFU-s) in the resting state.

Animals↗

PubMed1991

Can high-dose immunoglobulin therapy be indicated in neonatal rhesus haemolysis? A successful case of haemolytic disease due to rhesus (c + E) incompatibility.

A male neonate with hyperbilirubinaemia and progressing anaemia due to rhesus (c + E) incompatibility received high dose intravenous gammaglobulin (ivIgG) therapy at 13 days of age. Clinical response to therapy was confirmed by a rapid decrease in serum bilirubin level, and with the prevention of a further decline of the haemoglobin level. No side-effects were noted. High dose ivIgG therapy could be an alternative to (exchange) blood transfusion in case of some haemolytic diseases of newborn.

Humans↗

PubMed1991

Assessment of pancreatic blood flow with positron emission tomography and oxygen-15 water.

Dynamic positron emission tomography (PET) was performed following an intravenous bolus injection of 15O-water for the assessment of regional pancreatic blood flow in 4 normal volunteers and 11 patients with pancreatic cancer. The regional pancreatic blood flow index (PFI) was calculated by the autoradiographic method assuming the time-activity curves of the aorta as an input function. The mean PFI value was 0.514 +/- 0.098 in the normal pancreas but it was decreased in pancreatic cancer (0.249 +/- 0.076) (p less than 0.01), with a concomitant decrease in the pancreatic region distal to the tumor. On the other hand, in cases with body or tail cancer, the part proximal to the tumor (nontumorous head region) had a similar PFI value (0.554 +/- 0.211) to that of normal cases. Thus, a PET study with 15O-water permits quantitative assessment of pancreatic blood flow which decreased in both pancreatic cancer and concomitant obstructive pancreatitis distal to the tumor.

Adult↗

PubMed1991

Abdominal cyst formation following ventriculoperitoneal shunt in a case of hydrocephalus due to cryptococcal meningitis. Case report: completely cured by surgical removal of the cyst and treatment with a newly developed anti-fungal drug (Difulcan).

A 54-year-old woman was admitted to the hospital for evaluation of meningitis. Tuberculous meningitis was suspected initially because of general findings and a high adenosine deaminase activity (ADA) value in the cerebrospinal fluid. Administration of antituberculous drugs was not effective. Computed tomography scanning revealed progression of ventricular enlargement. A ventriculo-peritoneal shunt was placed upon diagnosis of hydrocephalus due to meningitis. The presence of a large abdominal cyst formation was demonstrated. Cryptococcus was detected in the cyst fluid, leading to a diagnosis of cryptococcal meningitis. Intravenous administration of fluconazole (400 mg/day) was begun. Excision of the cyst was performed when Cryptococcus was no longer detected in the cyst fluid. The patient recovered uneventfully.

Cerebrospinal Fluid Shunts↗

PubMed1991

Blood alcohol concentrations of sudden unexpected deaths and non natural deaths.

This study reports on the relationships between the blood alcohol concentration (BAC) and the cause of death - which is of course common knowledge for forensic scientists! Our special aim was to gain unselected data for generalizing conclusions. The blood of 2465 consecutive cases (86% of all 2852 sudden unexpected and unnatural fatalities investigated at the Institute for Legal Medicine in Hamburg during the year 1989) was analysed. The BAC was evaluated according to sex, age, cause of death and place of death. In natural causes of death there were 80% cases under 0.05% BAC. Endocrine and digestive system diseases in particular were associated with positive BAC values. In unnatural death cases the BAC under 0.05% was found in 64% of the suicides, 62% of the accidents, 54% of the homicides and 51% of the drug intoxications. The drowning cases showed higher BAC's than traffic accidents. In suicides middle aged males had high BAC's.

Accidents↗

PubMed1991

Molecular cloning and nucleotide sequencing of the Arthrobacter dextranase gene and its expression in Escherichia coli and Streptococcus sanguis.

A bacterial strain, which assimilated dextran and water-insoluble glucan produced by Streptococcus mutans, was isolated from soil. The bacterium produced and secreted potent dextranase activity, which was identified as Arthrobacter sp. and named CB-8. The dextranase was purified and some enzymatic properties were characterized. The enzyme efficiently decomposed the water-insoluble glucan as well as dextran. A gene library from the bacteria was constructed with Escherichia coli, using plasmid pUC19, and clones producing dextranase activity were selected. Based on the result of nucleotide sequencing analysis, it was deduced that the dextranase was synthesized in CB-8 cells as a polypeptide precursor consisting of 640 amino acid residues, including 49 N-terminal amino acid residues which could be regarded as a signal peptide. In the E. coli transformant, the dextranase activity was detected mostly in the periplasmic space. The gene for the dextranase was introduced into Streptococcus sanguis, using an E. coli-S. sanguis shuttle vector that contained the promoter sequence of a gene for glucosyltransferase derived from a strain of S. mutans. The active dextranase was also expressed and accumulated in S. sanguis cells.

Amino Acid Sequence↗

PubMed1991

[Clinical experience of extracorporeal shock wave lithotripsy for cystine calculi].

Thirty patients (16 men and 14 women) with cystine urinary stones were treated by extracorporeal shock wave lithotripsy (Dormer HM-3) from December 1984 through October 1989. The average patient age was 35.2 years with a range of 14 to 59 years. Seventy per cent of these subjects had had previous open surgical operations for stones. The cases consisted of 7 ureteral stones and 37 renal stones, including 15 staghorn calculi. An average of 1.3 session of ESWL was carried out to treat ureteral stones. Thirty-seven renal units with renal stone required 96 sessions of lithotripsy (average 2.6 sessions per unit). Seven patients with ureteral stones required auxiliary procedures, i.e., one transurethral lithotripsy (TUL), two percutaneous nephrostomies (PNS) and one open surgery. Thirty-seven renal stones, including staghorn calculi was treated by ESWL and auxiliary treatment of 21 TUL procedures, one PNS, 16 PNL procedures and one chemical chemolysis. Successful fragmentation (residual debris less than or equal to 4 mm) was achieved in 85.7% of ureteral stones, 90.9% of renal stones and 73.3% of staghorn calculi. The stone free rates of patients with ureteral stones, renal stones and staghorn calculi were 71.4%, 50.0% and 53.5%, respectively, at 3 months after ESWL. No serious complications were seen in this series. Fever above 38.5 degrees C was the most common complications (13.5%). Ureteral perforation was encountered once in TUL procedures. Transfusion and selective arterial embolization were needed for one case treated by PNL procedures. Although cystine stone is harder to be fragmented by ESWL than other stone composition, ESWL and endourology may be effective and safe procedures for cystine stone patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗